For a few rare hours, COP30 wasn’t just about parts-per-million or political posturing. It was about bodies, systems, and communities under strain, and what the world intends to do about it. That shift in tone was unmistakable, and long overdue, as Health Day finally put people — not just policies — at the centre of the climate story.

Climate-Sensitive Diseases on the Rise

Climate change is intensifying the spread and severity of infectious diseases that thrive in warmer, wetter environments. Delegates at COP30 highlighted how shifting rainfall patterns and rising temperatures are expanding the range of vector-borne diseases, such as malaria and dengue fever. “Rainfall patterns are less regular, facilitating the spread of mosquito-borne diseases such as malaria and dengue,” reports Doctors Without Borders (MSF), which notes these illnesses can become deadlier when combined with malnutrition.

In 2024, the Americas experienced their largest dengue outbreak in history – a sign of how a warming climate is amplifying epidemics. Meanwhile, extreme heat is emerging as a major killer: heat-related deaths have surged 23% since the 1990s, now exceeding half a million per year. Health officials warn that without more decisive climate action, diseases like cholera, Zika, and yellow fever could similarly gain ground, placing millions more at risk in the coming decades.

Photo Credit: Médecins Sans Frontières

A mother tends to her child suffering from malnutrition and malaria at an MSF clinic in Madagascar. Climate change exacerbates nutrition and disease crises – droughts, crop failures, and flooding drive malnutrition, which in turn makes infections like malaria or dengue more deadly.

Beyond tropical diseases, extreme weather events linked to climate change are causing direct injury and indirect health crises. For example, successive floods and landslides in Brazil’s Rio Grande do Sul state in 2023–2024 killed thousands and displaced hundreds of thousands. MSF teams on the ground provided mobile clinics and mental health support, treating injuries and waterborne disease outbreaks in overwhelmed communities. Each disaster weakens local health systems and increases vulnerability to the next. “We are not talking anymore about distant or possible threats,” noted Dr Jarbas Barbosa, Director of the Pan American Health Organization (PAHO). He pointed out that the Americas just experienced its hottest year on record, with cascading health impacts: in 2024 alone, 154,000 people in the region died from exposure to wildfire smoke. Such statistics underscore that climate-sensitive health risks are no longer hypothetical – they are happening here and now, and they disproportionately strike vulnerable populations with the least resources to cope.

Air Pollution: A Dual Climate and Health Crisis

Air pollution emerged as a prominent concern at COP30, given its tight links to both climate change and public health. The burning of fossil fuels – the chief driver of global warming – also poisons the air, causing an estimated 7–8 million premature deaths each year from respiratory and cardiovascular diseases. This makes air pollution “the climate crisis already inside our lungs,” as advocates framed it. Cleaner air is a clear example of the co-benefits of climate and health. Every measure to reduce greenhouse gas emissions (such as phasing out coal and oil) also reduces particulate pollution, yielding immediate health benefits. “Cleaner air, safer water, sustainable food systems, and resilient infrastructure mean healthier communities and better lives – a triple win for human health, the economy, and the climate,” noted UN Climate Chief Simon Stiell. Policymakers at COP30 stressed that decarbonising energy and transport systems could prevent millions of deaths from air pollution while also slowing climate change.

Despite this, there was debate about how explicitly the COP30 process should link the phase-out of fossil fuels with health outcomes. A major climate-health plan launched in Belém notably omitted any reference to fossil fuels, reportedly at the host country’s instruction. Health experts warned that ignoring the root cause of both global warming and toxic air would be a mistake: “8 million people are dying annually from air pollution, yet the plan didn’t mention phasing out fossil fuels,” one observer noted. The omission comes as the International Energy Agency warns that oil and gas demand could continue rising for decades unless stronger policies are implemented.

Many countries still heavily subsidise fossil fuels – in fact, 15 nations spent more on net fossil subsidies than on their entire health budgets last year. In side events, organisations like the Global Climate and Health Alliance urged governments to commit to a just transition away from fossil fuels, framing it as a public health imperative. They emphasised that bold mitigation action – shifting to clean energy and transport – is needed not only to meet climate goals but to reduce the enormous health burden of air pollution.

Mental Health: The Invisible Toll of Climate Change

COP30 brought unprecedented attention to the mental health impacts of climate change. As climate-related disasters multiply, communities face not just physical harm but profound psychological stress. “Repeated and overlapping extreme events…erode psychological and emotional resilience, causing complex trauma,” MSF observed in a statement. In flood-ravaged areas of Brazil, for instance, families suffered the trauma of displacement, loss of loved ones, and the anxiety of rebuilding in an uncertain future.

MSF responded by training local professionals in psychological first aid and providing mental health support in emergency shelters. Such stories highlight what experts call “climate distress” – the depression, anxiety, and hopelessness that can follow climate disasters or even the anticipation of climate change. Youth delegates at COP30 spoke out about climate anxiety, noting that the fear of an unstable future is affecting the mental well-being of young people worldwide.

For the first time in COP history, mental health featured centrally in an official climate-health framework. The newly launched Belém Health Action Plan includes a comprehensive section on integrating mental health into climate adaptation. It urges concrete steps, such as embedding mental health and psychosocial support (MHPSS) in national climate-health plans, strengthening mental health services to withstand disasters, and providing community trauma support after extreme events. “Resilient communities are also mentally healthy communities,” advocates stressed, calling mental health an essential component of climate resilience. Negotiators in Belém acknowledged that addressing psychological recovery and well-being is critical to a comprehensive climate adaptation.

There were calls to track mental health outcomes under the Global Goal on Adaptation, using new indicators (such as the proportion of communities with MHPSS programs for climate emergencies) to ensure countries report progress. This represents a significant shift – from historically sidelining mental health in climate talks to recognising it as a pillar of the response. As one Brazilian official put it, “If our efforts overlook local and Indigenous knowledge, we risk ignoring real needs and deepening existing inequalities”, – and mental health needs are part of those fundamental needs. By the close of COP30’s Health Day, countries were encouraged not only to cut emissions but also to invest in healing the invisible scars that climate change leaves on minds and communities.

Nutrition and Food Systems Under Strain

Climate change is undermining food security and nutrition, a point that has been repeatedly underscored at COP30. Droughts, floods, and shifting weather patterns are disrupting agriculture and worsening hunger in many regions. As crops fail or yields decline, communities face higher rates of malnutrition, which in turn exacerbates health vulnerabilities.

“In Zimbabwe, drought resulted in crop failures,” MSF reported, “which drove farmers to informal mining…then access to safe water became a major issue” requiring emergency intervention. In the Sahel and Horn of Africa, prolonged droughts have pushed millions into a food crisis, illustrating how climate change can trigger a vicious cycle of famine and disease. Malnutrition weakens immune systems and makes infections more deadly; MSF noted that diseases like malaria became more lethal amid malnutrition spikes in Nigeria. Conversely, climate-fueled disease outbreaks (such as diarrheal illnesses or cholera after floods) can worsen malnutrition by causing nutrient loss.

At COP30, experts highlighted the resilience of food systems as a priority for both mitigation and adaptation. Sustainable, climate-smart agriculture was promoted to both reduce emissions and ensure reliable food supplies. Representatives from vulnerable countries emphasised that erratic seasons and extreme weather are already crippling farmers and driving up food prices, with the poorest communities being hit the hardest.

The World Health Organization has warned that climate change is a “risk multiplier,” exacerbating food insecurity, which in turn leads to undernutrition and stunted growth. Indeed, the COP30 special health report found that 3.3 to 3.6 billion people already live in areas highly vulnerable to climate impacts – many of these are subsistence farming communities facing heightened risks of hunger. In policy discussions, there has been a push to incorporate nutrition into climate adaptation plans, for example, by developing early warning systems for crop failures and integrating nutrition programs into disaster response efforts.

Delegates noted that every climate adaptation measure – from drought-resistant crops to flood-proof infrastructure – ultimately has a human face: “These are not statistics – they are families, communities, and futures already paying the price of global heating,” said Simon Stiell, emphasising that food security and health security go hand in hand. By the end of the summit, calls for “sustainable food systems” were woven into the broader narrative that climate action must protect the foundations of health, including the availability of nutritious food and clean water.

Building Climate-Resilient Health Systems

A clear theme at COP30 was that health systems themselves must be fortified against climate change. Hospitals and clinics on the front lines are increasingly overwhelmed by climate shocks – from cyclone damage to heatwaves flooding emergency rooms – and many lack the capacity to respond effectively. The WHO warned in a new report that “over 540,000 people [are] dying from extreme heat each year and 1 in 12 hospitals worldwide [is] at risk of climate-related shutdowns” as of 2025. By mid-century, the number of health facilities at risk could double unless we bolster infrastructure to withstand floods, storms, and heat. Already, hospitals face a 41% higher risk of damage from extreme weather compared to 1990. These stark figures underscore the urgency of investing in climate-resilient health systems, enabling clinics to withstand disasters and continue providing care when it’s most needed.

Photo Credit: Médecins Sans Frontières

MSF teams navigate a landslide in Mexico to reach remote communities after intense rains. Climate-related disasters are striking vulnerable areas with increasing frequency, underscoring the need for resilient infrastructure and rapid health responses.

At the COP30 Health Day, Brazil, as the host nation, unveiled the Belém Health Action Plan, a comprehensive framework to strengthen global health sector adaptation. “For decades, WHO has been calling for action to adapt health systems… The Belém Health Action Plan is how we can do that,” said Dr Tedros Adhanom Ghebreyesus, WHO’s Director-General. The plan lays out over 60 recommended actions across three pillars: (1) climate-informed surveillance and early warning, to predict outbreaks and extreme events; (2) evidence-based policies and capacity-building, to protect communities through measures like heat-health alert systems, clean energy in hospitals, and mental health support; and (3) innovation and green technologies, from telemedicine to climate-resilient medical supply chains.

These strategies align with the plan’s cross-cutting focus on health equity and climate justice – recognising that poor and marginalised groups are most at risk. “The climate crisis is one of the most significant health challenges of our time,” the plan declares, warning that rising temperatures and collapsing health systems will claim ever more lives without urgent intervention.

Real-world examples illustrate the scope of climate-resilient health measures. PAHO expanded its “Smart Hospitals” initiative, which has retrofitted over 70 Caribbean hospitals with disaster-proofing and solar power. Those upgrades paid off when Hurricane Melissa struck recently – the smart hospitals in Jamaica stayed operational and saved lives, even as other infrastructure failed. Similarly, early warning systems are scaling up: between 2015 and 2023, the number of countries with Multi-Hazard Early Warning Systems doubled to 101, covering approximately two-thirds of the global population.

However, many low-income nations still lack these capabilities (only ~46% of Least Developed Countries have an effective warning system). Critical gaps remain: fewer than half of national health adaptation plans assess climate risks to health facilities, and fewer than 30% consider the impacts on vulnerable groups, such as people with low incomes or women. Health workforce training is another gap – most countries need more climate-trained health personnel and emergency planners.

“Many health systems are fragile – lacking climate-trained personnel, resilient infrastructure, and adequate surveillance,” noted Stiell. To address this, delegates emphasised the need to integrate climate considerations into health sector planning at all levels, from hospital design standards to medical education curricula. The mantra of the day became “climate-proof every clinic” and ensure “no healthy people on a sick planet” – meaning a healthy future is impossible unless our health systems adapt to and mitigate climate change.

Policy Initiatives and Funding Commitments at COP30

Policymakers and organisations used COP30 to drive home the message that protecting health must be a core part of climate action – and they backed it with new initiatives (if not enough funding). Over 60 countries and numerous institutions endorsed the Belém Health Action Plan as a voluntary commitment to accelerate health adaptation. Initial supporters spanned Europe (e.g., France, Spain), small island states like Tuvalu, African nations from the Congo to Zambia, and others, including Canada, Japan, the UK, and Malaysia. Endorsing countries agreed to report on their progress by the Global Stocktake in 2028, using the WHO’s climate-health tracking framework (the ATACH initiative).

“There’s a very strong commitment from our government and ministers of health in this plan,” affirmed Brazil’s Health Minister Dr Alexandre Padilha. By COP30’s close, Brazil will have announced that over 80 nations and organisations had signalled support, describing the plan as a “blueprint… Now we have no alternative but to adapt and face climate change. If we don’t adapt, we will increase inequality…we will kill people”. Even the UNFCCC leadership embraced it:

“The Belém Health Action Plan gives us the blueprint. What we need now is sustained, coordinated, and well-financed action to turn its promises into protection for all,” said UN Climate Executive Secretary Simon Stiell. Importantly, health is becoming mainstream in climate policy: over 90% of national climate plans now include health considerations, and every National Adaptation Plan since 2024 addresses health risks, ranging from heat to infectious diseases – a remarkable shift toward health-centric climate planning.

However, financing emerged as the Achilles’ heel of these lofty commitments. The Belém plan was launched without any new funding pledges from governments attached. The only notable funding announcement was from a coalition of philanthropies (Wellcome Trust, Gates Foundation, Rockefeller Foundation, etc.), which committed $US 300 million toward climate and health initiatives. That one-time grant, while welcome, is a drop in the bucket. The UN Environment Programme estimates that low- and middle-income countries require at least $ US$11 billion annually for basic health adaptation, covering measures such as malaria and dengue control, climate-driven diarrhoea prevention, heatwave response, and surveillance upgrades. Even that $US 11B figure omits many costs included

in the Belém plan, such as addressing respiratory illnesses, malnutrition, mental health services, protecting healthcare workers, and decarbonising hospital systems. By 2050, the UNFCCC projects that global adaptation needs for health could reach US$277–29 billion per year. In stark contrast, current health-specific climate finance is estimated at only $US 500–700 million annually, roughly 0.5% of total climate finance.

“Health systems, already stretched and underfunded, are struggling to cope with these growing pressures… Existing finance falls short by billions. Without urgent investment, we will not be able to protect populations from escalating climate impacts,” warned Dr Marina Romanello of the Lancet Countdown on Health and Climate Change. Carlos Lopes, African Union envoy, lamented the “colossal deficit” in health adaptation funding. Indeed, many developing countries spend more on debt servicing than on healthcare, underscoring the need for grants and debt relief to fund climate-health needs.

To bridge this gap, COP30 negotiators and health leaders pressed for the integration of health into all climate funding mechanisms. They urged that a larger share of the promised US$100 billion or more in climate finance be earmarked for health adaptation (currently, only ~2% of adaptation funding goes to health). “The evidence is clear: protecting health systems is one of the smartest investments any country can make,” said Professor Nick Watts, chair of the COP30 health report advisory group. He noted that allocating just 7% of adaptation finance to health (up from ~2% now) could safeguard billions of people by keeping essential services running during climate shocks.

In line with this, the COP30 Special Report on Health and Climate Change calls on governments to integrate health into their climate plans (NDCs and NAPs), invest in resilient infrastructure (especially hospitals), and leverage the cost savings from low-carbon policies to reinvest in health capacity. It also highlights the need to empower communities and incorporate Indigenous knowledge in designing health responses, ensuring solutions fit local realities.

By framing climate change as “fundamentally, a health crisis”, COP30 succeeded in elevating health to the top tier of climate negotiations. Countries left Belém with a more explicit mandate: protect people’s health as a priority outcome of climate action. Achieving this will require following through on plans, such as the Belém Health Action Plan, with real resources. As Dr Tedros summed up, “This special report provides evidence of the impact of climate change on individuals and health systems, and real-world examples of what countries can do – and are doing – to protect health…

Now it’s time to turn commitments into action”. The challenge ahead is to turn the promises and piloted projects into scaled-up, well-funded programs that save lives. The hope emerging from COP30 is that health can become a unifying priority – a human-centric lens that drives faster climate ambition. In the words of one negotiator, “Humanity can only win this global climate fight if we connect stronger climate actions to people’s top priorities in their daily lives… and there are few higher priorities than our health”.

MSF teams navigate a landslide in Mexico to reach remote communities after intense rains. Climate-related disasters are striking vulnerable areas with increasing frequency, underscoring the need for resilient infrastructure and rapid health responses.

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The reality is more complicated. Brazil has staked its climate prestige on keeping COP30 in the Amazon. The UN’s official notice still lists the venue as Belém’s City Park and Hangar Convention Centre, 10–21 November. And the summit’s incoming president, veteran diplomat André Corrêa do Lago, has told critics there is “no plan B.” But here’s the catch: there may not be enough beds, and the beds that exist are often priced like Davos, not the delta.

This is not a hypothetical headache. After an emergency discussion at the UN climate bureau, Brazil faced pressure to shift at least part of the gathering — perhaps the leaders’ segment — out of Belém. Organisers demurred. Meanwhile, a government-backed booking platform showed rooms at $360 to $4,400 a night, and Brazil’s offer to reserve a handful of subsidised rooms for the poorest countries still overshot the UN per diem, a measure of daily allowance. The labels tell one story; the prices tell another.

Belém is racing to make it work. Brasília says roughly 4.7 billion reais (public and development-bank money) is flowing into airport upgrades, venues and transit fixes. The city boasts a 50% jump in scheduled flights for the COP window compared with last November. And organisers have added those cruise ships, docked at Outeiro, to ease the crunch. On paper, it sounds like progress. It isn’t — unless the pieces land on time and the access is fair.

Air travel is the hinge. The Val-de-Cans airport concession was amended to accelerate apron and terminal works to August — mere weeks before delegates land — though local reporting has flagged heat and construction delays that could complicate operations. You can feel the knife-edge timing in every press release and drone shot.

Why insist on Belém? Because the Amazon is the story. Brazil has engineered a conspicuous shift from oil-rich hosts in recent years to the world’s foremost carbon sink, and the Lula government wants negotiators to look deforestation drivers in the eye. To be fair, enforcement has helped Amazon forest loss fall to a nine-year low; at the same time, drought-fueled fires surged across vast areas last year. Both things can be true. Both matter for climate credibility.

And yet the city’s basic services and urban form were never designed for a 50,000-person, two-week jamboree. Belém routinely appears near the bottom of Brazil’s sanitation rankings; one widely cited analysis found only about 17% of residents connected to a sewage network. That’s not a moral failing — it’s a legacy of uneven investment, a reminder that climate summitry lands in real neighbourhoods with real pipes.

Then there’s the symbolism problem. In March, images of a new four-lane “Avenida da Liberdade” slicing through a protected green area ignited international outrage even as state officials argued the road was long planned and not a federal COP project. The paradox was brutal: clearing urban forest to ease access to a climate summit meant to protect forests. Belém’s defenders note wildlife crossings and solar lighting in the design; critics warn of the “fishbone” pattern of illegal expansion that often follows new roads. The Amazon rarely gives you a clean moral line.

Is there a fallback? Not officially. But something interesting is happening on Brazil’s southeast coast. Days before the COP opens, a COP30 Local Leaders Forum — mayors, governors, the people who move bins and buses — will convene in Rio de Janeiro, the city that hosted the 1992 Earth Summit that birthed the UN climate convention. It’s not the COP itself. It is, however, a tacit admission that a multi-city approach might be the most pragmatic way to include thousands who can’t afford Belém’s bottlenecks.

Meanwhile, business is hedging. Some companies and financiers are reportedly scaling back Belém plans, shifting events to São Paulo or Rio, where hotels, airports and meeting spaces are abundant. The risk is obvious: a hollowed-out core summit in the Amazon with a well-heeled, parallel circuit elsewhere. Climate diplomacy is bifurcated by bandwidth and room rates.

So should COP30 stay in Belém? Yes — with conditions. Because moving it would evacuate the point. The Amazon is where climate, food and health are braided so tightly you can’t tug one thread without the others tightening. Beef and soy supply chains that begin as pasture and clearings upstream ripple into supermarket meat cases and alternative-protein pitch decks far away. Fires and heatwaves feed respiratory illness and strained hospitals. Water security, flooding and sewage are not side stories; they are the texture of climate risk and resilience. Hosting the world here forces the agenda to stop floating above the canopy and come down to the ground.

But here’s what must happen, fast.

First, accessibility. Price gouging needs to be checked by moral suasion and market solutions. Brazil and the UNFCCC should expand the pool of capped-rate rooms, extend the cruise-ship model if needed, and underwrite shuttle networks from satellite lodging hubs so that least-developed countries and frontline communities aren’t priced out of the very talks that shape their futures.

Second, transparency. Publish a live, multilingual dashboard — rooms, prices, transit times, venue queues — so delegations can plan without panic. Fold in the Leaders’ Summit logistics as soon as they’re nailed down; people can’t book what they can’t see.

Third, split smart — formally. Take advantage of the Rio forum to design a sanctioned, high-bandwidth “twin” programme for side events and city-focused sessions, with guaranteed virtual bridges into negotiation rooms in Belém. Don’t let a thousand uncoordinated fringe conferences do this by accident. Organise it by design.

Fourth, leave a legacy that’s more than tarmac. If a highway is being built, hard-wire protection against the land-grabbing and settlement creep that so often follow new access roads. Pair every piece of concrete with measurable gains in sanitation, flood management and green jobs that outlast the motorcades. Otherwise, the summit’s footprint becomes the story, not its outcomes.

Fifth, connect the dots publicly. Use Belém to make explicit the chain from enforcement against illegal clearing (which Brazil has recently strengthened) to healthier forests, cooler cities, steadier rainfall, safer crops and fewer hospitalisations. If climate is a health crisis — as the WHO keeps saying — then COP30’s deliverables should read like a public-health plan as much as an energy one. People understand clinics and clean water. They vote with their bodies as well as their wallets.

Will this be enough? It has to be. Because relocating the COP to Rio or São Paulo might spare the delegates a humid queue and a pricey bed, but it would also spare the rest of us the jolt of seeing the climate’s front line up close. The labels tell one story; the science tells another. If we cannot convene in the Amazon without razing what makes it special — or pricing out the very countries that most need a voice — what does that say about the transition we’re building?

For now, at least, the plan is set: Belém or bust. Amazon will host the world. Whether the world shows up in a way that’s fair, focused, and honest is still up to us.

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Conflicts compound these inequities. Fragile and conflict-afflicted countries account for just a quarter of the world’s infants, yet they harbour half of all zero-dose children, whose numbers have increased from 3.6 million in 2019 to 5.4 million in 2024. In Sudan, vaccination coverage collapsed — from 85% pre-war to as low as 8% in conflict zones — while Yemen’s zero-dose figures climbed significantly, driven by instability, health service disruptions, and misinformation.

Conversely, Gavi-supported, low-income countries saw marked improvements, reducing un- and under-vaccinated cohorts by around 650,000 in 2024. Yet even high- and upper-middle-income economies are experiencing slippage, with measles coverage hovering at 84% (first dose) and 76% (second), below the 95% threshold needed for herd immunity. Consequently, measles outbreaks surged, with 60 countries reporting significant incidents in 2024, doubling since 2022.

Country case snapshots powerfully illustrate these trends. In Bosnia and Herzegovina, measles vaccination rates are at just 55%, compared to Croatia’s 90%, contributing to over 7,000 cases and two adolescent deaths, prompting WHO and UNICEF to urge intensified immunisation campaigns. In Pakistan, polio resurgence has occurred amid militant threats and disrupted campaigns, with over one million children missing doses in 2024. The government’s response includes large-scale vaccination drives and policy enforcement, such as arrest warrants, signalling both the challenge and political recognition of routine immunisation’s fragility. Meanwhile, Bangladesh has steadily expanded its vaccine schedule — adding Hib, rubella, PCV, IPV and MR2 — achieving DTP3 coverage around 93% and fully vaccinated rates near 84% by 2019.

These illustrations reveal both progress and vulnerability. Countries with strong political will, robust systems, and community trust — like Bangladesh — are managing gains. Others, like Pakistan and Bosnia, highlight how instability, mistrust, and misinformation can swiftly unravel public health gains.

The 2024 immunisation data reiterates an urgent message. Global coverage has stabilised and broadened, but millions of children remain vulnerable in conflict zones and complacent high-income settings. Measles outbreaks, polio flare-ups, diphtheria spikes, and new threats like RSV underscore that the progress we’ve made is neither permanent nor evenly shared. Unless we decisively fill funding gaps, fortify health delivery in emergencies, ensure vaccine equity, and strengthen trust, these vulnerabilities will deepen — and outbreaks will follow.

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Conflicts compound these inequities. Fragile and conflict-afflicted countries account for just a quarter of the world’s infants, yet they harbour half of all zero-dose children, whose numbers have increased from 3.6 million in 2019 to 5.4 million in 2024. In Sudan, vaccination coverage collapsed — from 85% pre-war to as low as 8% in conflict zones — while Yemen’s zero-dose figures climbed significantly, driven by instability, health service disruptions, and misinformation.

Conversely, Gavi-supported, low-income countries saw marked improvements, reducing un- and under-vaccinated cohorts by around 650,000 in 2024. Yet even high- and upper-middle-income economies are experiencing slippage, with measles coverage hovering at 84% (first dose) and 76% (second), below the 95% threshold needed for herd immunity. Consequently, measles outbreaks surged, with 60 countries reporting significant incidents in 2024, doubling since 2022.

Country case snapshots powerfully illustrate these trends. In Bosnia and Herzegovina, measles vaccination rates are at just 55%, compared to Croatia’s 90%, contributing to over 7,000 cases and two adolescent deaths, prompting WHO and UNICEF to urge intensified immunisation campaigns. In Pakistan, polio resurgence has occurred amid militant threats and disrupted campaigns, with over one million children missing doses in 2024. The government’s response includes large-scale vaccination drives and policy enforcement, such as arrest warrants, signalling both the challenge and political recognition of routine immunisation’s fragility. Meanwhile, Bangladesh has steadily expanded its vaccine schedule — adding Hib, rubella, PCV, IPV and MR2 — achieving DTP3 coverage around 93% and fully vaccinated rates near 84% by 2019.

These illustrations reveal both progress and vulnerability. Countries with strong political will, robust systems, and community trust — like Bangladesh — are managing gains. Others, like Pakistan and Bosnia, highlight how instability, mistrust, and misinformation can swiftly unravel public health gains.

The 2024 immunisation data reiterates an urgent message. Global coverage has stabilised and broadened, but millions of children remain vulnerable in conflict zones and complacent high-income settings. Measles outbreaks, polio flare-ups, diphtheria spikes, and new threats like RSV underscore that the progress we’ve made is neither permanent nor evenly shared. Unless we decisively fill funding gaps, fortify health delivery in emergencies, ensure vaccine equity, and strengthen trust, these vulnerabilities will deepen — and outbreaks will follow.

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Artificial Intelligence (AI) is rapidly reshaping public health — from enhancing disease surveillance and diagnostics to easing workforce burdens — but it also raises complex risks and ethical questions. In Europe and globally, public health leaders are grappling with how best to harness AI’s revolutionary potential while managing its pitfalls. After decades of experience, many recognise that AI is not a magic fix for health challenges; its value depends on thoughtful integration into health systems. This article provides an in-depth review of the current relationship between AI and public health. It examines the opportunities it offers, real-world innovations already underway, practical implementation challenges, and the risks and governance frameworks that must guide responsible use. All discussions equally consider European contexts (including emerging EU regulations) and broader global health perspectives.

TL;DR Summary

• AI’s growing role in health: Artificial intelligence is increasingly used to augment public health efforts — from automating administrative tasks to advanced disease surveillance and diagnostics — offering new ways to improve efficiency and reach.
• Tangible benefits observed: Early deployments show promising results. AI tools have reduced clinicians’ paperwork burden, flagged outbreaks days before traditional systems, and enhanced diagnosis in low-resource settings (e.g. catching 15% more TB cases via X-ray analysis).
• Innovations across sectors: NGOs, governments, and companies are all investing in AI for health. For example, PATH and others use AI in field programmes, the NHS has dozens of AI pilots improving care delivery, and pharma companies leverage AI to speed up drug and vaccine development.
• Practical hurdles remain: Successful implementation requires robust data infrastructure, interoperability, and high-quality data. Many health systems must modernise IT systems and address data silos and quality issues before AI can perform optimally.
• Human factors are critical: Integrating AI into workflows and gaining staff acceptance are significant challenges. Training health workers, providing explainable outputs, and maintaining human oversight are essential to building trust in AI-assisted care.
• Key risks to manage: AI in public health brings serious risks — privacy breaches, algorithmic bias harming disadvantaged groups, opaque “black box” decisions undermining trust, and AI-generated misinformation spreading false health advice. Over-reliance on AI without safeguards can also be dangerous.
• Ethics and governance frameworks: Clear principles and regulations are emerging to guide responsible AI use. WHO’s six ethical principles (e.g. transparency, equity, accountability) set value-based guardrails, while the EU’s AI Act will enforce strict requirements on high-risk health AI (mandating transparency, risk management, and human oversight).
• Collaboration and capacity-building: Effectively advancing AI in public health will require interdisciplinary collaboration (health experts with technologists), investment in workforce AI literacy, and inclusive approaches that involve LMICs and marginalised groups so benefits are shared widely.
• Continuous evaluation and adaptation: To ensure AI delivers on its promise, public health authorities must continually monitor outcomes, audit algorithms for bias or errors, and be ready to adjust or suspend systems if problems arise. Adaptive governance and ongoing community feedback are vital for safe, effective AI integration.
• Seizing the opportunity responsibly: When guided by ethical principles and strong oversight, AI can greatly strengthen public health, easing workforce burdens, expanding outreach, and providing data-driven insights. The next few years are crucial for implementing the policies, education, and trust-building measures that will allow AI to be a force for health equity and innovation rather than a source of new disparities or dangers.

Opportunities: Transforming Public Health with AI

AI is being deployed to alleviate several longstanding public health challenges. One significant opportunity is reducing clinician burnout and workforce shortages by automating routine tasks. For example, a 2024 survey found that 57% of physicians believe automating administrative burdens is the top opportunity for AI to ease workloads amid staff shortages. Machine learning systems can transcribe medical notes, pull up patient records, and handle scheduling or prescription refills — freeing clinicians to spend more time on patient care. Many doctors see such automation as a key to improving work efficiency and reducing stress, suggesting AI could help mitigate the healthcare burnout epidemic.

AI also offers powerful tools for disease surveillance and epidemic intelligence. Algorithms can continuously scan vast data sources — news reports, social media, travel data — to spot early signs of outbreaks far faster than traditional methods. Notably, the HealthMap and BlueDot platforms (which use natural language processing and machine learning) flagged the COVID-19 outbreak days before official alerts. By sifting through informal signals and anomalies, AI-driven systems can provide precious early warnings of emerging health threats. BlueDot’s AI surveillance tools have dramatically sped up outbreak detection, reducing manual scanning time by nearly 90% in some cases. Such early alerts enable public health agencies to mobilise quicker responses and potentially contain outbreaks before they spread.

Another area of opportunity is improving diagnostics and clinical decision support, especially in resource-constrained settings. AI image recognition has shown great promise in interpreting medical images like X-rays and retinal scans. For example, AI-based chest X-ray tools for tuberculosis (TB) are being used to help screen patients in low-resource areas that lack radiologists. A recent programme in India led by PATH found that an AI tool (qXR) boosted TB case detection by ~15.8% — identifying cases that human readers missed. Many countries are now utilising AI-assisted chest X-ray screening for TB, which can lead to earlier diagnosis and treatment in underserved communities. Beyond imaging, AI-powered diagnostic apps and chatbots can guide patients through symptom checks or flag high-risk cases for follow-up, expanding access to essential healthcare advice where clinicians are scarce.

Crucially, AI is also being enlisted to address climate-related health threats and environmental impacts on health. Public health researchers increasingly pair AI with climate data to predict disease patterns under changing environmental conditions. For instance, machine learning models can correlate weather patterns (temperature, rainfall) and even animal health data with disease outbreaks to anticipate risks in specific locations. By analysing such data, AI-driven predictive analytics can serve as early warning systems — forecasting surges in vector-borne diseases like malaria following heavy rains or heat-related illness during extreme heatwaves. This capability is ever more critical as climate change intensifies health hazards. AI can help public health officials prepare for climate-sensitive disease outbreaks, allocate resources proactively, and develop adaptation strategies to protect vulnerable populations.

Real-world Applications and Innovations

AI in public health is not just theoretical — numerous real-world initiatives by NGOs, governments, and private companies have already demonstrated its potential. Global health nonprofits and international agencies have been early adopters of AI to support their missions. For example, the Bill & Melinda Gates Foundation has invested heavily in AI-driven global health projects. In 2023, it awarded grants to nearly 50 pilot projects exploring AI solutions for health and development challenges — these range from AI-augmented diagnostic tools to data systems for disease surveillance in low-income settings.

One Gates-backed innovation is AI-assisted ultrasound: in 2020, a $44 million grant was given to develop an AI-guided portable ultrasound to improve lung disease diagnosis in low-resource countries (e.g. detecting pneumonia). Likewise, PATH and other NGOs are integrating AI into field programmes — as seen in the TB screening project, where an AI tool significantly increased case finding while illuminating practical deployment hurdles. These efforts by NGOs underscore AI’s promise to close gaps in healthcare access and quality for underserved populations.

Governments and public health agencies are also launching AI initiatives. In Europe, national health systems pilot AI to improve services and efficiency. For instance, the UK’s National Health Service (NHS) created an NHS AI Lab to fund and evaluate AI innovations in care delivery. By 2025, the NHS had over 80 AI projects live, targeting everything from optimising nurse rostering and predicting hospital bed occupancy to speeding up radiology workflows.

One NHS program provided £100+ million in awards to develop AI for earlier cancer detection, resource management, and patient safety improvements. The NHS AI Lab’s “Skunkworks” team has run short-term projects that yielded practical tools — e.g. an algorithm to streamline the placement of nurses across wards and a natural language processing engine to search health records more efficiently. Meanwhile, European public health agencies are leveraging AI for epidemiology; the European Centre for Disease Prevention and Control (ECDC) has incorporated systems like BlueDot’s AI to enhance epidemic intelligence, including monitoring outbreaks during events such as the 2020 Olympics. These government-led efforts illustrate growing public sector commitment to deploying AI for health system strengthening and emergency preparedness.

The private sector, particularly in healthcare and pharmaceuticals, is likewise driving innovation at the intersection of AI and public health. Pharmaceutical companies now routinely use AI in drug discovery and development. For example, Novartis recently struck a wide-ranging partnership (worth up to $1 billion) to use a generative AI platform for designing new protein-based therapies — aiming to accelerate the search for novel disease treatments. GSK has also embraced AI to speed up R&D: its CEO noted that AI modelling helped cut two years off an RSV vaccine trial by predicting where outbreaks would occur and optimising trial site selection. This led to the faster development of the world’s first RSV vaccine, an essential public health breakthrough.

Beyond pharma, medical technology firms are integrating AI into devices, from smart wearables that flag irregular heart rhythms to imaging systems where AI assists in analysing scans for early signs of cancer. Startups and tech companies are introducing AI-driven health apps and chatbots (such as symptom checkers and mental health conversational agents), which some health services in Europe are trialling for patient triage and support. These real-world examples underscore that AI is already deeply enmeshed in the health ecosystem — from global disease surveillance networks to hospital wards and R&D labs — delivering innovations that could improve population health outcomes.

Practicalities and Implementation Challenges

While the potential is immense, implementing AI in public health is a pragmatic challenge. Infrastructure and data interoperability are foundational hurdles. Effective AI requires robust digital infrastructure — high-quality data streams, electronic health records, and cloud computing capacity — which many health systems lack, especially in low-resource settings. Data needed for public health AI often reside in silos or incompatible formats across hospitals, labs, and agencies. Poor interoperability means AI tools struggle to aggregate and interpret information from disparate sources. Bridging these gaps will require significant investment in health information systems, common data standards, and connectivity. Encouragingly, current AI technology can assist in standardising and mapping messy health datasets to make them more usable. Nonetheless, without reliable infrastructure and data-sharing frameworks, even the best AI algorithms cannot deliver consistent results across a public health network.

A related challenge is data quality and representativeness. AI models are only as good as the data they learn from, and health data can be incomplete, biased, or unrepresentative of specific populations. Studies highlight issues like variability in how data are recorded, large amounts of unstructured text, missing information, and coverage bias (e.g. most training data coming from high-income populations).

These factors can undermine an AI system’s accuracy and value to end users. Developing good AI for health requires carefully cleaning and curating data to reflect clinical reality. For instance, algorithms trained only on European hospital data may perform poorly in rural African communities. Implementers must thus invest effort in data preparation and continuously monitor model outputs for anomalies. Establishing metadata standards, common terminologies, and data quality metrics can facilitate better AI development. Additionally, clarity on data ownership and governance is needed: questions about who “owns” health data (patients, providers, governments?) affect how data can be integrated for AI. Resolving these issues through policies and trust frameworks is key to unlocking data for public health AI while respecting privacy and rights.

Another practical consideration is integrating AI tools into healthcare workflows and gaining workforce acceptance. Introducing AI decision-support systems or automation in clinics requires adapting processes and training staff. Health workers may be understandably cautious — some lack familiarity with AI, worry about accuracy, or fear being displaced. Clear protocols are needed if an AI system’s recommendation conflicts with clinical judgment. Early experience shows that human-AI collaboration works best when AI is framed as an assistive tool rather than a professional replacement. Building trust among the workforce involves providing explainable outputs and demonstrating reliability in pilot phases. It also means training clinicians in basic AI concepts and ensuring they feel confident interpreting AI outputs.

Successful deployments (like the PATH TB screening program) emphasise that significant workflow integration and training efforts are required. In that program, implementers had to solve issues of installing the software in clinics, securing internet connectivity for the AI, and ensuring staff could effectively use the AI results within their screening workflow. Without such groundwork, even a high-performing algorithm might sit on the shelf unused. Thus, the human element is crucial: public health organisations must engage and educate their workforce, adjusting roles and processes so that AI enhances rather than disrupts care delivery. Over time, as clinicians see AI reducing drudgery (e.g. auto-filling forms) and improving outcomes, their acceptance tends to grow. Indeed, physician enthusiasm for health AI has been rising year-on-year. Patience and iterative refinement are needed to blend AI smoothly into the complex fabric of health systems.

Risks and Concerns of AI in Public Health

Despite the optimism, it is vital to acknowledge the risks and potential harms associated with AI in public health. Data privacy and security tops the list of concerns. AI systems often require large datasets of patient information, raising the stakes for protecting sensitive personal health data. Any breach or misuse of such data can erode public trust and violate individuals’ rights. There is also the risk of “function creep”, where data collected for health purposes might be used in other ways (for example, a COVID-19 contact tracing app’s data later being used for law enforcement — a scenario that drew criticism in some countries). Moreover, complex AI models could inadvertently leak private details — for instance, a model might be reverse-engineered to reveal records it was trained on. Ensuring robust cybersecurity and strict data governance is therefore paramount. Many call for comprehensive privacy safeguards and compliance with regulations like Europe’s GDPR whenever AI handles health data. Techniques such as anonymisation or synthetic data can help, but they are not foolproof (even de-identified data can sometimes be unidentified).

The bottom line: without public confidence that AI will maintain confidentiality and data security, its benefits will be lost. Public health agencies must be transparent about what data are used and how to obtain informed consent where appropriate and implement state-of-the-art security measures to prevent breaches. Privacy isn’t just a legal box to tick — it’s fundamental to preserving the trust on which public health interventions depend.

Another significant risk is algorithmic bias and the exacerbation of health inequalities. AI systems can unintentionally perpetuate or even worsen disparities if their design is not carefully managed. This was starkly illustrated by a widely used healthcare risk algorithm in the United States that was found to be racially biased. The algorithm helped determine access to extra care programs and used healthcare cost as a proxy for need. This choice systematically underestimated the needs of Black patients (who often had lower healthcare expenditures due to access barriers). As a result, many high-risk Black patients were less likely to be flagged for additional care, denying them the resources they needed. This example shows how bias in data or design can translate into inequitable outcomes: the AI effectively discriminates against a vulnerable group. Similar issues could arise in public health if an AI model is trained on predominantly male patients under-detect conditions in women or if disease surveillance AI better covers wealthier communities with more data. AI could widen gaps if not addressed, with marginalised populations benefiting the least or even being harmed.

Equity must be a central design principle to counter this: datasets should be diverse and inclusive, algorithms should be tested for bias, and bias mitigation strategies (like reweighing data or algorithmic fairness adjustments) should be applied. The WHO explicitly highlights inclusiveness and equity as core ethical principles for AI, ensuring that AI tools work for all segments of society regardless of race, gender, income, or other characteristics. Ultimately, careful governance and auditing of AI systems are needed to avoid encoding systemic biases into digital form and instead use AI to reduce health inequities (for example, by targeting interventions to underserved areas).

A further concern is the lack of transparency (“black box” issue) and its impact on trust and safety. Many AI models, especially deep learning networks, operate as complex black boxes — they do not explain their reasoning in human-understandable terms. In healthcare, this opacity is problematic. Clinicians and public health decision-makers are wary of acting based on a recommendation they don’t understand, particularly if an AI’s advice contradicts intuition or standard practice. Unexplainable AI can also undermine accountability: if an AI makes a harmful mistake, it may be unclear why it happened or who is responsible. This lack of transparency feeds directly into trust issues among professionals and the public. If people perceive AI as a mysterious, untrustworthy “magic wand” imposed on health decisions, they may reject its use. There have been cautionary tales: an AI system deployed in hospitals to predict which COVID-19 patients would need ICU care was later found to underperform because it hadn’t been adequately validated. Clinicians grew sceptical of its risk scores.

To prevent such scenarios, experts call for explainable and interpretable AI in health — algorithms that can provide reasons for their predictions or use transparent, logical rules where possible. At a minimum, users should have access to information about how an AI was developed and its known limitations. Regulatory frameworks like the EU AI Act are likely to mandate a degree of transparency for high-risk AI (including many medical applications) precisely to bolster trust and enable oversight. Building more explainability into AI models remains a technical challenge, but one that is essential for aligning with the principles of transparency and accountability in healthcare.

In the age of ChatGPT and generative AI, misinformation and “AI hallucinations” have emerged as new public health risks. Advanced chatbots can produce remarkably human-like answers to questions — but they do not guarantee factual accuracy. They can hallucinate false information, confidently output incorrect medical advice, nonexistent statistics, or even fake health news. The potential for harm is considerable if the public uses such tools for health information. There is concern that AI chatbots could magnify the health misinformation problem exponentially — for instance, by generating convincing anti-vaccine narratives or spurious cures, which then spread on social media.

In recent years, public health agencies have struggled to combat misinformation (for example, false claims about vaccines or COVID-19 treatments that undermine uptake). The rise of AI-driven content generators and deepfakes only fuels this fire. Misinformation undermines public trust and can lead people to reject proven interventions in favour of dangerous alternatives. Tackling this will require new strategies — such as watermarking AI-generated content, strengthening content moderation, and improving digital health literacy so the public can better discern credible information. On the flip side, public health communicators might also leverage AI to fight misinformation (for example, using AI to detect false rumours early or personalise accurate health messages). Regardless, the advent of easy, AI-generated disinformation is a serious risk factor that the global health community cannot ignore.

Finally, there is the risk of over-reliance and systemic dependency on AI. If health systems come to depend on AI for critical functions without adequate safeguards, any failures in the technology could have severe consequences. For example, an AI model might perform well in normal conditions but fail to generalise during an unexpected scenario. If everyone has come to rely on its output, they may miss the warning signs until too late. Moreover, heavy reliance on automation might erode human skills over time (a phenomenon observed in other industries). In healthcare, this raises concerns about “deskilling” — clinicians might lose practice in specific tasks (like reading x-rays or making complex diagnoses) if those are always handled by AI, leaving them less prepared to step in when needed.

Over-reliance can also dull vigilance: users might stop double-checking results if an algorithm usually works well so that an undetected error could propagate. The key is to maintain a human-in-the-loop approach: AI should support, not replace, human expertise. Mechanisms for human review of AI outputs and fallback plans in case of system outages are essential.

Additionally, performing regular audits and updates of AI models can prevent performance from degrading unnoticed. In summary, while AI can increase efficiency, public health systems must guard against blindly relying on algorithms. A balanced approach that values human judgment and institutional memory, alongside AI’s computational power, will be safest in the long run.

Ethical and Regulatory Frameworks

Addressing the above risks requires robust ethical guidelines and regulatory oversight for AI in health. Globally, there is growing consensus on core ethical principles that should govern AI development and use in public health. The World Health Organization’s landmark 2021 report laid out six guiding principles for ethical AI in health: (1) Protect human autonomy — humans should remain in control of health decisions, with informed consent and respect for privacy; (2) Promote human well-being and safety — AI must be safe, effective, and designed to improve health outcomes; (3) Ensure transparency, explainability and intelligibility — stakeholders should have sufficient information about how AI systems work and decisions should be traceable; (4) Foster responsibility and accountability — developers and users are accountable for AI behaviour, and mechanisms for redress must exist; (5) Ensure inclusiveness and equity — AI should benefit all groups, enhancing fairness and not amplifying disparities; and (6) Promote AI that is responsive and sustainable — meaning AI should be adaptable, monitored, and designed for long-term societal benefit.

These principles, while high-level, provide a value framework to guide everything from design choices (e.g. using diverse training data to ensure equity) to deployment (e.g. always keeping a human in the loop to protect autonomy). Public health organisations are increasingly adopting such ethical frameworks. For instance, the WHO urges that AI deployments be accompanied by community engagement, training for health workers, and continuous evaluation to ensure technologies remain aligned with the public interest. The ethos is straightforward: AI must be people-centred and uphold human rights. Ethics committees or advisory boards can help oversee AI projects, reviewing them for compliance with these principles before they scale up.

On the regulatory front, governments are now moving to establish formal rules for AI in healthcare. The European Union’s AI Act is a pioneering example of comprehensive regulation. Passed in 2024, the EU AI Act takes a risk-based approach, classifying AI systems by risk level and imposing requirements accordingly. Health-related AI is generally deemed “high-risk” under this law, given its potential impact on people’s lives and rights. High-risk AI systems (including most AI used for medical diagnostics, decision support, or resource allocation in health) will face strict obligations. These include rigorous standards for transparency, risk management, and human oversight. For instance, developers of a clinical AI tool must implement a quality management system, ensure their model is trained on appropriate data, and provide documentation detailing the AI’s function and limitations. They must also conduct risk assessments and put in place human oversight measures to prevent automation bias. Notably, the EU AI Act doesn’t just apply to creators of AI — it also holds deployers (such as hospitals or public health agencies) accountable for the safe use of AI.

Health providers must monitor AI system performance, keep logs, and retain ultimate responsibility for decisions (clinicians must have the authority to override AI recommendations if needed). These provisions aim to ensure that human accountability and patient safety remain paramount even as AI becomes embedded in care delivery. Additionally, the Act has a broad reach: any AI system impacting people in Europe must comply, even if developed elsewhere. This could set an effective global benchmark as companies worldwide adjust their practices to meet the EU’s requirements.

Other jurisdictions are also crafting guidelines. The United States, through the FDA, has been evolving its regulatory approach for AI/ML-based medical devices, focusing on premarket evaluation and the idea of “continuously learning” algorithms needing ongoing monitoring. International bodies like the WHO have issued guidance and urged governance innovation, suggesting that governments update regulations to cover AI, establish certification processes, and possibly create registries of approved AI health products. We also see emerging governance models such as algorithmic impact assessments (to evaluate a health AI system’s potential societal impact before deployment) and independent reviewers’ bias audits. In some health systems, procurement of AI now requires meeting ethical checklists or obtaining approval from institutional review boards, similar to new medical interventions.

These steps are part of building a “responsible innovation” culture around AI, encouraging experimentation and advancement, but within guardrails that protect individuals and communities. Multi-stakeholder collaboration is key here — regulators, technologists, health professionals, and patient representatives need to work together to define safe and effective AI in practice and update those definitions as the technology evolves. As one example, the NHS AI Lab in the UK partnered with regulators to create a sandbox for AI developers, guiding them on navigating regulatory pathways and using synthetic data for testing. Such efforts show that with thoughtful governance, innovation and safety can advance hand in hand.

Future Directions and Recommendations

To fully realise AI’s promise in public health while minimising its downsides, several changes and strategic efforts are needed going forward:

• Investing in data and digital infrastructure: Health systems, especially in low- and middle-income countries, need support to build the data foundations for AI. This means digitising health records, improving data quality, and ensuring platform interoperability. Governments and global donors should prioritise funding for health information systems and broadband connectivity as part of public health capacity building. Better data infrastructure not only enables AI — it strengthens health systems overall. Innovative approaches like federated learning (where AI models train on distributed data without moving it) could be scaled to allow resource-constrained regions to benefit from AI insights without breaching privacy. The goal is to create a world where data flows securely and efficiently to wherever it can improve health outcomes.
• Strengthening workforce capacity and AI literacy: As AI becomes a standard tool, public health and healthcare workers must be equipped to use and oversee it. Training programmes are needed to raise AI literacy among the health workforce, including understanding AI’s capabilities and limitations. This may involve updating medical and public health curricula to cover data science basics. Additionally, new specialist roles (such as clinical AI safety officers or epidemiologists with AI expertise) could be developed to bridge the gap between tech and health domains. Frontline staff should be engaged in co-designing AI solutions so that tools are user-friendly and address actual pain points. When health workers understand and trust AI, they can become champions for its adoption and serve as critical watchdogs who notice when something isn’t right. Fostering a culture of continuous human oversight and feedback will ensure that AI remains a servant to health professionals, not a black box dictator.
• Ensuring inclusivity and equity in AI advancement: The global health community must actively work to prevent a digital divide in AI. Much cutting-edge AI development is concentrated in wealthier countries and tech companies. Deliberate efforts are needed to include researchers and perspectives from low- and middle-income countries in AI design so that solutions address diverse needs. This could consist of research funding earmarked for LMIC-led AI projects, technology transfer programs, and south-south collaboration on AI for health. Moreover, data from underrepresented populations should be collected (with consent and protection) to improve algorithms’ relevance in those settings. By democratising AI knowledge and resources, we can avoid a scenario where only certain countries or communities benefit from AI while others are left behind or subject to unchecked harm. Equity considerations should also extend to gender, age, and other demographics — for instance, ensuring women and minority groups are included in AI development teams and that tools serve users of different languages and literacy levels. An inclusive approach will make AI tools fairer and enlarge the talent pool working on creative AI solutions for entrenched public health challenges.
• Fostering collaboration between public health and technology sectors: Effective AI in public health sits at the intersection of epidemiology, medicine, data science, and engineering. No single sector can do it alone. We need stronger partnerships: governments linking with academia and tech firms, NGOs working with startups, and international agencies convening multi-sector consortia for global health AI initiatives. Such collaboration can accelerate innovation and ensure that public health priorities guide technological development (and vice versa, that technologists are aware of on-the-ground needs). For example, a partnership between a national health ministry and AI researchers might focus on building an early warning system for malaria outbreaks, combining epidemiological expertise with cutting-edge modelling. A pharmaceutical company could also collaborate with global health organisations to use AI in vaccine R&D for diseases of poverty. These cross-sector collaborations should be underpinned by fair agreements (e.g. around data sharing or intellectual property) so that all parties benefit and trust is maintained. The complexity of health + AI demands breaking down silos. International forums and networks can play a role here, enabling countries to share best practices and lessons learned (e.g. how one country successfully regulated an AI symptom-checker or how another trained health workers on AI). Since pathogens do not respect borders, a collaborative global approach to AI-enhanced public health security is in everyone’s interest.
• Adaptive governance and continuous evaluation: As AI tools roll out, it is critical to monitor their real-world impact and be ready to adjust course. Public health authorities should implement mechanisms to continuously evaluate AI interventions — collecting data on their accuracy, outcomes, and any unintended effects. Are the predictions helping improve disease control? Is a triage algorithm safely directing patients to the right level of care? This requires establishing key performance indicators and perhaps creating independent evaluation units. When problems are identified (such as an AI starting to drift in accuracy due to changes in data), there should be processes to update or pull back the tool until fixes are in place. Regulation must also remain adaptive; rigid rules could stifle innovation or become outdated as technology advances. One idea is regulatory sandboxes where new AI solutions can be tested under supervision, allowing regulators to learn and guidelines to evolve. Governance models should be proactive yet flexible, emphasising learning and iteration. Importantly, communities and civil society should have a voice in evaluating AI in public health — their feedback on whether these tools are culturally acceptable, understandable, and improving services is invaluable. Responsible AI is not a one-time certification but an ongoing commitment to quality and ethics throughout the technology’s lifecycle.

Looking ahead, it is clear that AI will play an expanding role in public health — whether in combating the next pandemic, extending healthcare to remote villages via smart apps, or analysing big data to pinpoint disease drivers. The revolution is already underway, but its trajectory depends on our current choices. With enlightened leadership, adequate safeguards, and inclusive collaboration, AI could usher in significant public health gains — from more efficient health systems to healthier communities worldwide. However, if we ignore the risks — allowing unchecked use, widening inequities, or losing the human touch in care — the potential benefits could unravel, and public trust could be irrevocably lost. The coming years are thus pivotal. Armed with decades of hard-won experience, public health professionals have a key role in steering this journey. By insisting on evidence, equity, transparency, and community engagement, they can ensure that the AI revolution in health truly becomes a boon and not a threat. The opportunity is immense, but so is the responsibility to guide AI’s integration into public health thoughtfully and ethically.

The post AI in Public Health: Revolution, Risk and Opportunity appeared first on Medika Life.

The Return of Most Favoured Nation Pricing

The new order is now essentially a return of “Most Favored Nation” (MFN) pricing, which Trump previously and unsuccessfully implemented in his first term. The structure, conceptually, is straightforward: cap U.S. drug prices at the lowest price of any other peer country. International reference pricing is not new, Trump attempted a similar program in 2020 but was stopped through litigation. In that effort, he focused on the most expensive drugs in Medicare and estimated U.S. taxpayer savings of $85 billion over seven years while providing access to lower-cost drugs. It never got off the ground. However, the concept lived on. However, with Trump back in the Oval Office and empowered by an “America First” mandate, MFN pricing is back in style as official policy. The executive order instructs U.S. health agencies to peg what the country pays for drugs to what prices are in other high-income countries — a major deviation from the status quo, more so because U.S. prices are sometimes three times higher than those in other developed countries.

What is, I think, particularly edgy about this resurgence is Trump’s open admission the rest of the world may have to adjust. “They are going to go up all over the World to equal and bring FAIRNESS TO AMERICA!”, he said of drug prices abroad. This means that if America is paying less, drug companies will be able to raise prices elsewhere as an offset. It will certainly receive lots of scrutiny when it is all done, however, there should be no ambiguity about the priority for the Administration: lower bills at U.S. pharmacies, no matter what the downstream consequences may be. The process will likely target Medicare — lobbyists believe the order will apply to more medicines than were included last year in the Inflation Reduction Act for price negotiation for Medicare. However, we just don’t know. Trump made sweeping promises without detailing any process. The hard work — and legal small print — will be left to health officials who have to figure out how to advance “fair” prices without collapsing the system. It is one thing to proclaim that we won’t pay more for insulin than France or Australia, it is another to turn that into actual practice.

Industry vs. Payers: Who Toasts, Who Dreads?

All of this is not without its dissenters. The drug industry fought back strongly, reliving its now familiar tale that any form of government price interference would be harmful to both innovation and patients. “Government price setting in any form is bad for American patients,” Alex Schriver, spokesman for PhRMA — the powerful lobby for drug makers. One executive said that Trump’s pricing proposal is “the largest, multifaceted existential threat to the industry and U.S. biosciences innovation.” In other words, for Big Pharma, this is not just an adjustment but a threat to their business model of high U.S. margins funding drug research. Wall Street took note. As more of Trump’s plan became clearer, shares of pharma began to tumble globally, with the U.S. pharma heavyweights Pfizer and Merck down approximately 2–4% and European drug makers with shares down over 3% apiece. In Japan, pharmaceutical shares were knocked down over 6%. The market is treating this as a real risk to future profits and potentially the large R&D budgets that depend on those profits.

On the other side of the ledger, payers and insurers are quietly smiling. For them, Trump’s order is essentially a gilt-edged cost cut. If both Medicare and private plans can pay European-level prices for cutting-edge therapies, the savings would be enormous, if the multiple middlemen allow it. Keep in mind that the U.S. spends over $400 billion a year on drugs, it is a tiny proportion of health spending, but still 30% off is a lot of spending power freed up.) For government health programmes, such as Medicare, the potential upside is almost experimental; as earlier mentioned, the MFN demo would have nearly cut Medicare pharmaceutical spending in half! It is hardly surprising that public support for reducing drug prices is a strong position that crosses party lines. Payers see an opportunity to potentially save some money, and patient advocates hope this may yield lower premiums or out-of-pocket costs — the question is, will it? That is less than clear. In theory, insurers could work to give that money back to their customers by also having lower premiums or by expanding coverage. But in practice, the real question is: what percentage of that windfall will be rebated to consumers after claim settlements at the pharmacy counter? The U.S. healthcare system is not exactly known for its rapid generosity. Any premium reductions will likely come slowly and through competitive pressure or regulation. Nevertheless, there is cautious optimism. At a minimum, it is believed that Medicare beneficiaries will see at least some reduction in their Part D premiums or out-of-pocket cost sharing if the government’s costs from expensive drugs come crashing downward.

Global Impact: Who Else Pays?

While President Trump’s executive order may proclaim “America First,” the shocks to the rubble of the global drug market are now outlined. Drug manufacturers do not simply sit tightly with lower revenues — they attempt to “equalise” lower prices by seeking additional money. So what happens if the U.S. says it will only pay what we pay for cancer drugs in the UK or Poland? For the manufacturer, what’s the easiest solution? Raise prices in the UK? Not likely; this would need a further Health Technology Assessment (HTA), which significantly influences drug prices, primarily through the National Institute for Health and Care Excellence (NICE) in England and the Scottish Medicines Consortium (SMC) in Scotland.

In particular, global health advocates are uneasy. Do we create upward price pressure in Europe or other high-income markets as companies seek to recover their U.S. losses? The early signs are indeed for upward price pressure. “This announcement is likely to have an impact on EU–US tariff negotiations… Is the U.S. president about to impose price caps on pharmaceutical imports rather than tariffs?” “If yes, this may have significant implications” for pharma companies and profits in Europe and perhaps elsewhere,” said one market analyst, pointing to possible trade friction if Europe is unwilling to change as well. In reality, European governments might very well push back against major price increases — they will not simply throw open the purse if U.S. policy changes. But pharma negotiators will “definitely” try to squeeze higher reimbursements from any country that has benefitted from significant discounting so far. The power dynamic in price negotiations could change: companies may tell EU health ministries, implicitly, “Pay up, or the consequences of America’s low price deal means we will no longer sell to you at a discount again.” Some even predict drug makers will delay the launches of new medicines, specifically in lower-price countries, to ensure that there is no “cheap” reference pricing that undermines their U.S. price.

This is not unprecedented. In Europe, international reference pricing has already been shown to influence delays in European access to new drugs in lower-income EU members. One study noted that international reference pricing caused about half of all delays in new drug launches in lower-income European countries (about one-year delays on average). In practice, a company might delay the launch of a breakthrough therapy in, say, Poland or Greece, until a higher price has been negotiated in Germany and France so these lower-price markets don’t pull down the global average. Trump’s global price peg could exaggerate these dynamics. If a U.S. reimbursement can be larger by any country offering a lower price, pharma companies will be even more resistant to lower prices. Low-income countries or lower-margin markets could be the hardest hit. They might have inflated prices, or they might simply be deprioritised — fewer affordable options, longer waits for new drugs, or products leaving those markets altogether. As one analysis suggested, manufacturers would be motivated to “reduce or even terminate the discounts they offer other countries”, putting pressure on those countries to pay significantly higher prices. Indeed, Trump’s own policy team has, essentially, recognised this trade-off: their expectation is other countries will, in our case, contribute more, i.e. pay closer to what Americans are paying. Great for the U.S. health dollar; not so great if you are a patient or an insurer in a country that, until now, benefitted from lower costs negotiated on a good-faith basis.

And what of patients in poorer countries? While Trump’s MFN model will likely primarily focus on high-income counterparts (no one would expect the U.S. drug price to be pegged to the lowest price for its product in sub-Saharan Africa, for example), there could still be spillover effects that might affect middle-income countries. Global health organisations fear if pharmaceutical companies cannot segment the market (i.e. more for rich countries and less for poor ones), they will stop doing business entirely in lower-profit markets. The unintended result of a goodwill reform of U.S. costs could be reduced access to innovative medicines in places that could least afford that reduction. As experts have cautioned, linking U.S. prices to other countries can result in “unintended complications, such as delaying drug entry in other countries and raising prices abroad.” Put bluntly, Americans may pay less, but some of that cost may just be shifted onto sick people elsewhere.

Where next on the outlook?

Will this policy be delivered to U.S. citizens? It is certainly possible, especially in the short run. If implemented quickly and thoroughly, Americans might see significant drops in many brand-name drugs — particularly, high-cost treatments for things like cancer, rheumatoid arthritis, and multiple other conditions where U.S. prices are considerably higher than in much of the world. But there is no free lunch. Someone pays the costs for drug research and manufacturing, and Trump is betting the rest of the wealthy world will pick up more of the costs so that Americans will have to pay less. Drug companies, not too surprisingly, will be all-out protecting their R&D budgets and profits — whether they do that by litigating (as they did the last time), negotiating harder against the health systems in Europe and Asia, or cutting costs somewhere else in their operations (like R&D, when their revenue estimates go south). The push-pull between the pharmaceutical industry and government will be furious.

For payers (like insurers and government programmes), this is clearly a nice win for them — it could potentially reduce the amount of money they spend. But whether or not American patients are able to see that in their pockets will depend on the details of implementation and ongoing enforcement at all levels. Reduced drug prices may translate into reduced insurance premiums and reduced taxpayer funding (in theory), provided the healthcare system appropriately passes along those savings. There is every chance that the opposite will occur. After all, the U.S. supply chain for drugs is complicated, with all of the middlemen, pharmacy benefit managers, and insurance entities taking their cuts. There would need to be heavy observation to ensure that price reductions at the highest level do not become additional profits for the next tier of entities in the long supply chain.

We will be watching carefully

Trump’s pharmaceutical international pricing order is a high-stakes experiment to reform drug pricing and challenge the pharmaceutical sector’s price-setting practices. It is also a step toward reclaiming some balance back to U.S. payers. It is also possible that, if implemented appropriately, it could mean that American patients have greater access to cutting-edge medicines at affordable prices if it can bring down what Americans pay for the same pills cheaper abroad. That is a relief many have been waiting for. It also exports the issue.

The neutral, critical reality is this: Someone pays for innovation. As is always the case with Trump, he talks a big game, but the end result remains to be seen. For now, Americans have been promised lower drug bills. The world will be waiting for the bill.

FINN Partners will be watching this develop and continue to analyse the situation.

The post Trump’s Drug Price Gambit: Cheaper for America, But Who Pays the Price? appeared first on Medika Life.

Security, Migration, and Budget Pressures

A confluence of political and fiscal forces is accelerating this shift. Europe’s strategic priorities have evolved, driven by concerns ranging from war and migration to domestic economic strains. Many governments feel pressure to divert funds toward defence and security amid Russia’s war in Ukraine and other threats. In Britain, for example, leaders explicitly tied an aid rollback to military needs: Prime Minister Keir Starmer vowed to boost defence spending to 2.5% of GDP and fund it by cutting the aid budget from 0.5% to 0.3% of national income. “National security must always come first,” Starmer said, framing the cut as a painful necessity in a “dangerous new era”.

Curbing immigration is another powerful motivator. Italy’s Prime Minister Giorgia Meloni, elected on a hard-right platform, has bluntly rejected the notion of altruistic aid in favour of deals that keep migrants from leaving Africa. “What needs to be done in Africa is not charity,” she declares. “What needs to be done in Africa is to build cooperation and serious strategic relationships as equals, not predators”. For Rome, that means investing in African infrastructure and economies (dubbed the “Mattei Plan”) to create jobs in migrants’ home countries — and securing Italian energy and business interests — rather than simply writing checks. Other governments in Europe’s north echo this tougher line: the Netherlands’ new ruling coalition plans to trim aid by 2029 while “prioritising the interests of the Netherlands,” shifting funds toward domestic migration control and trade promotion.

At the same time, budget constraints and surging nationalist politics have made foreign aid a prime target for cuts. The populist refrain of “charity begins at home” has grown louder amid economic uncertainty, pandemic debts, and inflation. Even in France — historically a champion of development aid — the government quietly backtracked on a legally enshrined promise to reach the U.N.’s 0.7% aid spending target by 2025. Facing pressure to reduce deficits, President Emmanuel Macron’s administration postponed the 0.7% goal to 2030 and slashed next year’s aid budget by over one-third. A €742 million reduction in 2024 was followed by plans for a further 37% cut (more than €2 billion) in 2025. Such steep cuts, unprecedented in modern French policy, were justified as tough choices in a tight fiscal environment — though critics called it a betrayal of France’s global commitments. Likewise, aid has been swept up in a broader fiscal odyssey in Germany. After a constitutional court ruling forced Berlin to reallocate spending, the development ministry’s 2024 budget was pared down by about 8% (roughly €940 million) compared to the previous year. Germany’s humanitarian relief budget also dropped about 10%. These reductions make it unlikely Germany will maintain its recent 0.7% GNI aid level.

European Aid Budgets in Retreat

The result of these pressures is a marked pullback in many European aid budgets — a trend that spans both EU member states and neighbours like the UK and Switzerland. Recent moves include:

• United Kingdom — Once a leader in aid, the UK has reversed course. It first lowered its long-held 0.7% of GNI aid commitment to 0.5% in 2021 and now plans to sink to just 0.3% by 2027 to free up billions for defence. Aid groups warn this will drag UK assistance to its lowest share of national income in generations, a “short-sighted and appalling move” that will “undoubtedly risk lives,” according to UNICEF.
• France — After years of incremental increases, France is making an abrupt U-turn. The 2025 budget envisions a 35% cut in official development assistance, delaying ambitions to scale up programmes. Lawmakers in Paris concede domestic needs and security priorities are eclipsing foreign aid — a stark change for the world’s fourth-largest donor, which in 2023 still spent €13.9 billion (0.48% of GNI) on development.
• Germany — The eurozone’s largest economy is trimming aid amid belt-tightening. Germany’s 2024 federal budget reduced core development spending to €11.2 billion, about 7–8% lower than in 2023. Humanitarian and crisis aid saw even sharper declines. Further cuts are on the table for 2025 as Berlin prioritises energy price relief and defence.
• Belgium — A new coalition government in Brussels has agreed to cut development cooperation funding by 25% over five years. Belgium’s aid agency has sounded the alarm, with Enabel CEO Jean Van Wetter warning that “disinvestment in international cooperation is a poor decision in our interconnected world” and will undermine Belgium’s global influence.
• Switzerland — Historically, Switzerland has been a steady donor, but the Swiss government is also scaling back. It approved a CHF 110 million reduction in its aid budget and plans to shut down or hand off development programmes in at least three countries (Albania, Bangladesh, and Zambia) by 2028. Swiss officials argue that resources must be focused on fewer priorities as part of a wider cost-cutting drive.
• Italy — Italy’s aid budget has not seen dramatic cuts, but its focus has pivoted under Meloni’s leadership. Rome is redirecting funds toward projects that dovetail with Italy’s geopolitical agenda — chiefly stemming migration. Italian ministers talk of “investment, not charity” and have struck deals, for instance, to finance development projects in Tunisia in exchange for cooperation on keeping migrants from crossing the Mediterranean.

Notably, this contraction is Europe-wide. A recent review tallied seven European donor governments announcing major aid reductions or reallocations in the past year. The collective EU aid effort is sliding: EU institutions and member states gave 0.51% of GNI as aid in 2023, down from 0.56% the year before. In a mid-2024 budget review, the EU reallocated €2 billion of its external aid fund into migration and refugee support — effectively a 7.5% pro-rata cut to other development programmes. As one analyst bluntly summed up, “The door is just closing on aid everywhere we look.”

From Grants to “Blended” Finance

Beyond budget cuts, Europe is fundamentally changing how it delivers whatever aid remains. Rather than simply funding government budgets or health clinics in poor countries, European donors are channelling money into financial instruments — loans, equity stakes, guarantees — that attract co-investors and, ideally, pay for themselves. The buzzword is “blended finance,” which means using a small amount of public or aid money to unlock a larger pool of private capital for development projects. In theory, everyone wins: poor countries get more investment than aid alone could provide, while investors (including European development banks) get risk cushioned by public funds.

All across Europe, aid agencies have been refashioned as mini-development banks. The UK’s famous aid department has been folded into the Foreign Office, and its once grant-focused bilateral programmes are diminished. Instead, Britain is leaning on British International Investment — a government-owned DFI (development finance institution) — to finance projects from renewable energy in India to tech start-ups in Africa, expecting modest returns. France’s Agence Française de Développement (AFD) has likewise expanded its lending, often via its private-sector arm Proparco, under what President Macron calls a “policy of results” approach. “The ambition of this strategic plan is [for AFD] to become a platform for development policy,” Rémy Rioux has said, describing AFD’s evolution beyond traditional aid. AFD now provides billions in low-interest loans for infrastructure and climate programmes, blending French funds with multilateral and private money.

Germany’s KfW Development Bank and its investment subsidiary DEG follow a similar model, financing everything from solar parks to microfinance institutions in developing markets. Even smaller donors have set up investment vehicles — Switzerland’s SIFEM fund, for instance, takes equity stakes in emerging market SMEs. Increasingly, European aid is less about writing checks than structuring deals. As Rioux explains, “Development financing is undergoing a major transformation… Investment has another advantage: it’s built for the long term. It creates lasting partnerships, allows us to track tangible impacts, and demonstrates returns… far more effective and convincing than traditional public aid”. In his view, and that of many peers, mobilising “sustainable resources” through investment is the only way to meet 21st-century challenges as government grants stagnate.

Critically, Europe’s new approach isn’t just about altruism — it’s about mutual gain. Donor governments are so unabashed that they expect strategic payoffs. “International cooperation is not just an act of global solidarity,” says Enabel chief Jean Van Wetter, whose Belgian agency increasingly ties aid to domestic interests. “It is a strategic investment that will bring numerous benefits to Belgium, its businesses and its citizens… By encouraging stability, growth and sustainability in partner countries, Belgium strengthens its own security, economy and international reputation”. This “good for them, good for us” philosophy now permeates European development strategy. Nowhere is it clearer than the European Union’s flagship Global Gateway initiative — a €300 billion plan unveiled in 2021 to fund infrastructure in Africa, Asia, and Latin America. Billed as Europe’s answer to China’s Belt and Road, Global Gateway explicitly seeks “mutually beneficial partnerships” that serve development needs and boost the EU’s strategic autonomy. Projects range from African internet connectivity (benefiting EU telecom firms) to renewable energy grids that could one day supply Europe. “We are moving away from traditional development to mutually beneficial partnerships,” the EU’s development commissioner’s office said, underscoring that the old donor-recipient dynamic is being replaced with joint ventures.

Ripple Effects on Poor Countries

Europe’s pivot has profound implications for countries on the receiving end. In the short term, budget cuts are already being felt in vulnerable communities. Programmes that tackle poverty and disease — but yield no financial return — face an uncertain future. Global health initiatives, in particular, are reeling. Several of Europe’s biggest aid donors have been mainstays of funding for vaccines, HIV treatment, and health systems in Africa. Now, those budgets are shrinking just as need remains high. “Some of Europe’s biggest global health funders are slashing their aid budgets, which health groups fear could spell catastrophe for countries reliant on foreign cash to combat malaria, HIV, tuberculosis,” reports Euronews. Because Europeans are turning inward, health programmes that saved millions of lives may lose support. In 2023, about 10% of European ODA went to global health. Still, going forward, that share must compete with climate projects and private-sector loans for a “shrinking pot of money”. “Many lives are at stake,” warns Dr Michael Charles, head of a major anti-malaria partnership, describing the situation as “quite dire” in countries where donor-backed health services are now at risk.

Lower-income countries could also struggle to attract the kind of private investment Europe is now favouring. The pivot to loans and equity tends to favour middle-income states or commercially viable ventures — where investors see a reasonable chance of returns. Poorer nations, or social sectors like basic education, may be left behind because they offer little profit. Aid advocates note that European funds are flowing increasingly to regions of strategic interest (for example, North Africa for migration control or Ukraine, which alone absorbed nearly €19 billion of EU institutions’ aid in 2023 (Donor Profile: EUI)). Meanwhile, the share going to the least-developed countries has been “trending downward since 2017”. If this continues, the world’s poorest countries may face a double blow: less grant money and limited access to investment capital. Those who do take on more loans could risk new debt burdens down the line. “We have to ensure no one is left behind as we shift to finance and investment,” cautions one development official, noting that purely market-driven aid could bypass fragile states that need help most.

On the other hand, some developing nation leaders welcome the rhetoric of partnership over patronage. African governments have long bristled at the demeaning connotations of “aid” and have called for “trade, not aid” for decades. They see opportunity in Europe’s investment pivot — if it delivers real infrastructure and business growth. In their view, being treated as an investment destination, not a charity case, is a step toward equality. However, they also emphasise that partnerships must be genuine. At a recent EU-Africa forum, several African presidents pointedly rejected mere “EU charity”, saying Europe should address structural imbalances in trade and invest in African value chains rather than offer handouts as a way to buy political favours. In practice, the jury is still out on whether Europe’s new model will benefit developing nations or mainly serve Europe’s interests.

A New Hybrid Model — End of Aid as We Know It?

Is this the end of traditional aid? In many respects, yes. Europe’s development assistance is becoming inseparable from its economic and geopolitical strategy. Whereas 20th-century aid often aimed to foster development for its own sake — rooted in post-colonial moral duty or Cold War diplomacy — 21st-century aid from Europe is increasingly transactional. Grants with no strings attached give way to loans, equity investments, and deals tied to policy conditions (migration management, economic reforms, climate goals). The old model of wealthy nations simply donating money is fading. “The old model of public development aid is disappearing and must be replaced by sustainable and inclusive investment,” says AFD’s Rémy Rioux, who argues that virtually all stakeholders now “agree that we need to rethink the model”. European officials often bristle at the word “aid” altogether. They prefer terms like “cooperation,” “partnership,” and “investment.”

Yet this is not so much an end as an evolution into a hybrid model. Europe isn’t abandoning poorer countries; it is just engaging on different terms. In place of one-way charity, it envisions joint ventures — what one Belgian policy paper calls “reciprocity-based development”. Even as budgets tighten, Europe is leveraging other tools to stay involved abroad: development banks, venture funds, risk guarantees, and diplomatic agreements linking aid to trade. In effect, official development assistance is blended with foreign and commercial policies. It’s no coincidence that the UK merged its aid agency into its diplomatic service or that the EU’s development projects now fall under a strategy explicitly tied to European industrial and security interests. As the European Council concluded its next budget, the goal is to “ensure the [aid] budget advances the EU’s strategic priorities, which are increasingly shaped by domestic interests such as competitiveness, access to raw materials, migration, and security.” This signals a permanent change in mindset.

Whether this new approach can deliver positive results for developing nations remains an open question. Optimists argue that by making development cooperation more about business and mutual gain, Europe will sustain political support and unlock larger pools of money than stagnant aid budgets could. They point to initiatives like Global Gateway and say that if Europe invests smartly in emerging economies, it can help build sustainable industries (from African solar farms to Southeast Asian supply chains) that benefit everyone. Sceptics, however, worry that something fundamental is lost when self-interest justifies aid. There are fears that vital but unprofitable work — fighting extreme poverty, tackling malnutrition, bolstering primary healthcare — will fall by the wayside. They note that global pandemics or climate change require outright grants and global solidarity, not investments that expect a financial return.

European officials insist they are not retreating from global development, just modernising their approach. “France is not stepping back from its international role,” Rioux insists, citing Europe’s $150 billion collective development contribution — roughly three times the U.S. level. But he and others acknowledge the need to “build a more resilient and efficient model” that can withstand domestic political winds. That model increasingly blurs the line between aid and business. It treats poorer countries less as beneficiaries and more as partners — or, in some cases, markets. The Wall Street Journal once dubbed this trend “aid as investment”, and today it’s an apt description of Europe’s new paradigm. Traditional aid may not be entirely dead, but it has undeniably been subsumed into a broader strategy of strategic partnerships.

As Europe resets its development playbook, the world is watching to see if this grand experiment produces genuine development — or if “mutual benefit” mostly benefits the donor. For millions in Africa, Asia, and beyond who have depended on European aid, the hope is that this new era will bring a different rhetoric and tangible progress. If Europe’s investments can drive growth and stability in poorer nations while satisfying European taxpayers, it could herald a new global development model for the 21st century. If not, retreating from traditional aid could leave a void that other powers — or crises — will fill. The only certainty is that Europe’s role in international development is changing profoundly, in real-time, trading in the old charity mindset for something more hard-nosed and, it believes, sustainable for the long haul.

The post Europe Reimagines Foreign Aid as Investment appeared first on Medika Life.

GLP-1 agonists have also shown promise in reducing the risk of major adverse cardiovascular events, such as stroke and heart attack. This adds to their potential benefits in managing obesity and its related health complications.

Clinical Trial of Semaglutide and Bimagrumab

One promising avenue of research involves combining existing GLP-1 receptor agonists with experimental drugs designed to preserve muscle mass. A clinical trial, known as the BELIEVE Phase 2b study, is currently underway to test the combination of semaglutide and bimagrumab. Bimagrumab is a first-in-class, fully humanized monoclonal antibody developed by Versanis Bio, a clinical-stage biopharmaceutical company recently acquired by Eli Lilly. It targets activin type II receptors, which play a role in regulating muscle growth and fat storage. This trial aims to assess the efficacy and safety of bimagrumab in preserving or increasing muscle mass while promoting weight loss with semaglutide in non-diabetic patients with overweight or obesity.

To be eligible for the BELIEVE study, participants must have a body mass index (BMI) greater than or equal to 30, or greater than or equal to 27 with one or more obesity-related comorbidities. Key exclusion criteria include a history of hypersensitivity to monoclonal antibody drugs, treatment with any medication for obesity within 30 days before screening, and a diagnosis of diabetes requiring current use of any antidiabetic drug.

Pre-clinical studies have shown that blocking activin type II receptors with bimagrumab leads to increased lean mass and decreased fat mass in mice. In a Phase 2 study, bimagrumab produced a 22% reduction in fat mass and a 4.5% increase in lean mass in patients with type 2 diabetes and obesity. Notably, no weight regain was observed after stopping bimagrumab treatment, unlike the rebound effect often seen with GLP-1 therapies. This suggests that bimagrumab may offer long-term benefits in maintaining weight loss even after treatment cessation.

The ongoing clinical trial will provide valuable insights into the potential of combining semaglutide and bimagrumab to achieve superior fat loss while preserving muscle mass. This combination therapy could offer a more comprehensive weight management approach, addressing fat loss and muscle preservation.

Semaglutide and Bimagrumab: Mechanisms of Action

Semaglutide and bimagrumab work through distinct mechanisms to achieve their therapeutic effects. Semaglutide, a GLP-1 receptor agonist, mimics the action of GLP-1, a natural gut hormone crucial in regulating blood sugar and appetite. GLP-1 agonists work by

• Triggering insulin release from the pancreas
• Blocking glucagon secretion
• Slowing stomach emptying
• Increasing feelings of fullness

Semaglutide helps lower blood sugar levels, reduce appetite, and promote weight loss by mimicking these effects.

Bimagrumab, on the other hand, is a human monoclonal antibody directed against type II activin receptors (ActRII). Upon administration, bimagrumab binds to ActRII, which prevents binding the natural ligands, myostatin and activin, to activin receptors and blocks ActRII-mediated signalling. This increases protein synthesis, decreases protein degradation, stimulates skeletal muscle cell growth, and increases muscle function and strength10. Overstimulation of the ActRII-mediated signalling pathway is associated with muscle loss and weakness.

Other Anti-Obesity Drugs in Development

The success of semaglutide and tirzepatide has fueled a surge in the development of new anti-obesity drugs. These drugs target various biological pathways and aim to improve upon the limitations of existing therapies. Targeting multiple pathways simultaneously could allow for lower doses that achieve the same weight loss with fewer side effects. Some of the key areas of development include:

GLP-1 and GIP Receptor Agonists

Tirzepatide is a dual GLP-1 and GIP receptor agonist that has shown superior weight loss results compared to semaglutide in a large head-to-head trial by Eli Lilly. Participants who took tirzepatide lost an average of 20% of their body weight, outpacing the 14% reduction achieved with semaglutide. Tirzepatide is already available under the brand names Mounjaro and Zepbound.

There are two main strategies for modulating GIP activity: activation and blocking. While both approaches can lead to weight loss, they have different potential benefits and drawbacks. As seen with tirzepatide, GIP activation can further enhance energy metabolism and promote weight loss. However, some concerns blocking GIP signalling could adversely affect bone health, as GIP also plays a role in bone metabolism.

Amylin Analogues

Amylin is a hormone co-secreted with insulin that regulates blood sugar and appetite. CagriSema, a combination therapy developed by Novo Nordisk that pairs a long-acting analogue of amylin (cagrilintide) with semaglutide, has shown promising results in clinical trials. Participants in a 68-week, phase 3 trial lost an average of nearly 23% of their body weight.

Glucagon and GLP-1 Receptor Co-agonists

Glucagon is a hormone that raises blood sugar levels, while GLP-1 lowers them. Combining these two hormones in a single drug could offer a balanced approach to weight loss by increasing energy expenditure while maintaining blood sugar control. Survodutide, a glucagon and GLP-1 receptor co-agonist developed by Boehringer Ingelheim, is currently in clinical trials.

Triple-Hormone Receptor Agonists

Retatrutide, a triple-hormone receptor agonist developed by Eli Lilly that targets GLP-1, GIP, and glucagon receptors, has shown impressive weight loss results in Phase 2 trials. This drug, dubbed “triple G,” delivered an average weight reduction of 24% after 48 weeks, setting a new benchmark for obesity treatments.

Alternative Delivery Methods for Anti-Obesity Drugs

Companies are also exploring alternative delivery methods to once-weekly injections, which can be challenging to incorporate into people’s routines and come with manufacturing challenges. Once-monthly injectables are in the works, but oral formulations of GLP-1 receptor agonists, such as orforglipron produced by Eli Lilly, could arrive first.

Another potential alternative is oral semaglutide. In a phase 3 study called OASIS 1, people taking oral semaglutide 50 mg once daily lost up to 15% of their initial body weight after about 15 months (68 weeks) of use. This is comparable to the weight loss benefits of Wegovy, the injectable version of semaglutide.

Potential Side Effects of Anti-Obesity Drugs

While anti-obesity drugs offer a promising approach to weight management, they can also cause side effects. Some of the common side effects of GLP-1 receptor agonists include nausea, vomiting, diarrhoea, and constipation. More serious side effects, such as pancreatitis and gallbladder problems, are rare but can occur.

Specific side effects associated with semaglutide include nausea, vomiting, diarrhoea, abdominal pain, constipation, heartburn, and burping. In rare cases, semaglutide can cause more serious side effects such as pancreatitis, kidney problems, and changes in vision.

Tirzepatide can cause similar side effects, including nausea, diarrhoea, decreased appetite, vomiting, constipation, and stomach pain. Serious side effects, such as pancreatitis, gallbladder problems, and low blood sugar, can also occur.

Another concern with GLP-1 and GIP drugs is the potential risk of pulmonary aspiration during anaesthesia. These drugs can cause delayed gastric emptying, which may increase the risk of residual gastric contents despite preoperative fasting. This can lead to aspiration, where food or liquid gets into the lungs during surgery.

The increased demand for GLP-1 receptor agonists and dual GIP/GLP-1 receptor agonists has led to temporary product shortages. This has resulted in the emergence of compounded formulations of these drugs, which produce entities that bypass regulatory measures. The American Diabetes Association recommends against using non-FDA-approved compounded GLP-1 and dual GIP/GLP-1 receptor agonist products due to concerns regarding their safety, quality, and effectiveness. The FDA has also issued an alert on dosing errors associated with compounded semaglutide injectable products, which have led to adverse events and hospitalisations in some cases.

It is important to note that the potential side effects of anti-obesity drugs vary depending on the specific medication and individual factors. Patients should discuss these medications’ possible risks and benefits with their healthcare provider to determine the most appropriate treatment option.

Alternative Treatments for Obesity: Bariatric Surgery

For some individuals, bariatric surgery may be an alternative treatment option for obesity. Bariatric surgery involves making changes to your digestive system to help you lose weight. It is typically considered for people with a BMI of 40 or higher or those with a BMI of 35 or higher who have obesity-related health problems.

There are several types of bariatric surgery, including

• Roux-en-Y gastric bypass: This procedure involves creating a small pouch at the top of the stomach and connecting it directly to the small intestine, bypassing most of the stomach and the first section of the small intestine
• Sleeve gastrectomy: This procedure involves removing about 80% of the stomach, leaving a long, tube-like pouch
• Biliopancreatic diversion with duodenal switch (BPD/DS): This is a two-part surgery that involves performing a sleeve gastrectomy and then connecting the end of the small intestine to the duodenum, bypassing most of the small intestine

Bariatric surgery can be very effective for long-term weight loss and can also improve or reverse obesity-related conditions such as diabetes, high cholesterol, and sleep apnoea. However, it is a major surgical procedure with potential risks and complications, such as bleeding, infection, and leaks in the gastrointestinal system. Patients should carefully consider the risks and benefits of bariatric surgery with their healthcare provider.

Emerging Applications of GLP-1 and GIP Drugs

While GLP-1 and GIP drugs are primarily known for their role in treating obesity and type 2 diabetes, research is exploring their potential applications in other disease areas. These include:

• Neurodegenerative diseases: Conditions such as Parkinson’s and Alzheimer’s disease involve protein misfolding and chronic inflammation. Studies have found that GLP-1 mimetics can cross the blood-brain barrier and have neuroprotective effects, including reducing oxidative stress and chronic inflammatory responses in the brain.
• Liver disease: GLP-1 and GIP receptor agonists have shown potential in improving liver health, particularly in individuals with nonalcoholic fatty liver disease (NAFLD).

These emerging applications highlight the versatility of GLP-1 and GIP drugs and their potential to address a wide range of health challenges beyond obesity and diabetes.

Conclusion

The field of anti-obesity drug development is rapidly evolving, with new therapies emerging that offer the potential for more effective and personalised weight management. While GLP-1 receptor agonists like semaglutide and tirzepatide have revolutionised the field, ongoing research is exploring new targets and combination therapies to address the limitations of existing medications. These advancements, such as the combination of semaglutide and bimagrumab, the development of triple-hormone receptor agonists like retratrutide, and the exploration of alternative delivery methods, hold promise for improving the lives of millions of people struggling with obesity and its related health complications.

However, it is crucial to acknowledge the potential side effects of these therapies, including gastrointestinal issues, pancreatitis, and the risk of pulmonary aspiration during anaesthesia. Patients should carefully consider the risks and benefits of these medications with their healthcare provider to determine the most appropriate treatment option.

Developing new anti-obesity drugs has significant implications for public health and the future of obesity management. These advancements offer hope for a more comprehensive and personalised approach to weight loss, potentially reducing the burden of obesity and its associated health problems.

The post The Evolving Landscape of Anti-Obesity Drugs appeared first on Medika Life.

In anticipation of the first time tourism has been included on the COP agenda, a panel attempted to answer the question. The panel, led by Debbie Flynn, Managing Partner and Global Travel Lead at FINN Partners, explored how grassroots efforts, industry commitments, and generational collaboration might fuel the next wave of transformative environmental action.

The discussion began by reflecting on the original plastic straw movement, sparked in 2011 by a nine-year-old boy highlighting the shocking number of straws used daily in the US. Amplified by the viral image of a turtle with a plastic straw lodged in its nostril, the movement led to bans and significant shifts in consumer behaviour. Debbie set the tone by asking whether we had done enough and what bold steps could drive future change.

Collaboration, Speed, and Scale

Inge Huijbrechts, Chief Sustainability and Security Officer for Radisson Hotel Group emphasised collaboration’s importance in achieving bold environmental action. “We need speed and scale,” she asserted, highlighting her company’s journey towards net zero by 2050. While acknowledging the challenges ahead, Inge championed incremental actions like Radisson’s 100% climate-compensated meetings and programmes and Radisson’s adherence to the WTTC HSB program. “We’re not there yet,” she admitted, “but we’ve reduced our carbon emissions by 35% since 2019.”

Glenn Mandziuk, CEO of the World Sustainable Hospitality Alliance, echoed this call for collaboration and noted that while many in the hospitality industry are pioneering change, others lag behind. He spoke about the need for transparency, shared data, and collective metrics to measure energy, water, waste, and carbon footprints. “We have to simplify and digitise tools to bring everyone on this journey,” he said, underscoring storytelling’s critical role in inspiring action.

The Role of Finance and Bold Leadership

Amber Nuttal, Sustainability Director at Extreme Hangout, urged industries to align their financial priorities with sustainability goals. “We need people to invest in all of our futures, not just theirs,” she said. Amber highlighted the travel industry’s unique ability to connect people with the planet’s beauty while stressing the need for responsible tourism practices.

It’s not just about suncream-wearing lounge lizards; people want meaningful and authentic experiences.

Amber’s frustration with wasteful hospitality norms resonated with the audience. Recalling her time as a chef, she critiqued the overuse of non-seasonal produce: “Who wants strawberries in December? It’s time we, as experts, championed seasonal and local food choices.”

Intergenerational Collaboration and Community-Led Solutions

Jervon Sands, a Rhodes Scholar and Bahamas Climate Youth Ambassador highlighted the urgency of addressing climate justice, particularly for vulnerable communities like his own. Recalling the devastation of Hurricane Dorian in 2019, he stressed the importance of public pressure and community-driven action.

The power of people starts with one person recognising an injustice,

He said, citing examples of young activists making significant impacts.

Jervon also called for intergenerational dialogue, advocating for solutions involving young people and established leaders. “We need to move away from generational divides and work together as human beings. Time is running out, especially for island nations.”

Bridging the Intention-Action Gap

One recurring theme was the “intention-action gap” — the disparity between consumers’ desire to act sustainably and their actual behaviours. Inge noted that many people want to travel responsibly but find it challenging to identify trustworthy options. Radisson’s Hotel Sustainability Basics programme addresses this by providing a globally recognised standard for responsible tourism, starting with 12 essential actions. “We shouldn’t leave anyone behind,” she stressed.

Amber advocated for making sustainable choices accessible and affordable. “The greener choice shouldn’t always be the most expensive,” she said. She urged companies to reward responsible behaviour rather than price it out of reach.

The Next Big Movement

As the panel drew to a close, the question of what might spark the next significant environmental movement remained open-ended. Glenn suggested that human rights issues, such as modern slavery in the hospitality sector, could galvanise public opinion. He said:

Ten per cent of modern slaves work in our industry. Addressing this could profoundly impact brand reputation and social equity.

Others pointed to the growing backlash against overtourism and the strain it places on popular destinations. “Tourism needs to be reframed as a force for good,” Glenn argued, advocating for regenerative practices that benefit communities and visitors.

Jervon, however, cautioned against relying on a single spark. “When we put all our eggs in one basket, we risk focusing on one issue while others collapse,” he said. Instead, he called for incremental, community-led steps that collectively address the broader climate crisis. “Everyone has a role to play, and no one should be excluded from contributing to solutions.”

A Call to Action

The panel’s message was clear: the next “plastic straw movement” may not come from one dramatic event but from the collective actions of individuals, industries, and communities. Whether through transparent metrics, intergenerational collaboration, or reimagining the hospitality industry as a leader in sustainability, the path forward requires courage, creativity, and commitment.

As the audience left the Extreme Hangout Pavilion, one thing was sure: the movement was already underway and started with each of us. As Inge reminded everyone:

“We are all activists with our wallets. Let’s use them wisely.”

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COP29 President Mukhtar Babayev’s Bold Opening Remarks

Setting the tone, COP29 President Mukhtar Babayev launched the ceremony with a sobering message. “Colleagues, we are on a road to ruin,” he stated bluntly, calling attention to the harsh reality of the climate crisis. “But these are not future problems. Climate change is already here. Whether you see them or not, people are suffering in the shadows. They are dying in the dark, and they need more than compassion, more than prayers and paperwork. They are crying out for leadership and action.”

Babayev’s words underscored the profound human impact of climate change that often goes unseen. In his view, COP29 represents an “unmissable moment” to carve a meaningful path forward that transcends political pledges and delivers concrete action for vulnerable communities worldwide. His rallying call emphasised the urgency for nations to honour the Paris Agreement and support its objectives to limit global temperature rise to 1.5 degrees Celsius.

A Moment of Truth for Global Cooperation

President Babayev urged delegates to view COP29 as a pivotal test of the global commitment to the Paris Agreement. His words were stark: “We need much more from all of you. COP29 is a moment of truth for the Paris Agreement. It will test our commitment to the multilateral climate system. We must now demonstrate that we are prepared to meet the goals we have set ourselves.”

As nations prepare to navigate difficult negotiations over climate finance and emission targets, Babayev’s challenge places the burden of action on the world’s most powerful economies and governments, pressing them to put politics aside and prioritise climate over profit.

Outgoing COP28 President Sultan Al Jaber’s Closing Advice

Following Babayev’s remarks, Sultan Al Jaber, outgoing president of COP28, encouraged attendees to take a hopeful, action-driven negotiation approach. “I urge you all to prove once again that we can unite, act, and deliver,” Al Jaber said, stressing the importance of collective action in a world where political will often falters. He reminded leaders that results must “outlast the rhetoric,” urging them to channel positivity as they seek pragmatic solutions.

In a memorable line, he declared, “We are what we do, not what we say,” an appeal for delegates to let their actions speak louder than words. For Al Jaber, the focus should remain on tangible results that benefit all nations, especially those already bearing the brunt of climate impacts.

UNFCCC Climate Chief Simon Stiell on Finance and Resilience

A central issue at COP29 is the need for increased climate finance to support developing countries in mitigating and adapting to climate impacts. UNFCCC Climate Chief Simon Stiell took the stage with a frank reminder that climate finance is not an act of charity but a matter of global self-interest. “Here in Baku, we must agree on a new global climate finance goal. If at least two-thirds of the world’s nations cannot afford to cut emissions quickly, then every nation pays a brutal price.”

Stiell highlighted the potential consequences if nations fail to act, warning that the fragility of global supply chains and economic systems could spell disaster if they are not built to withstand climate shocks. “If nations can’t build resilience into supply chains, the entire global economy will be brought to its knees. No country is immune,” he cautioned.

Calling for ambitious targets, Stiell noted that finance reform is essential to give countries the necessary fiscal space. “We must work harder to reform the global financial system,” he said, insisting that fiscal reforms are key to equipping vulnerable nations with the resources to invest in climate resilience. He ended his address with a strong message: “We cannot leave Baku without a substantial outcome.”

The Path Forward: New Goals, Financial Commitments, and Accountability

COP29’s opening ceremony made it clear that this summit will be judged on its ability to secure solid financial commitments and actionable climate goals. Substantial financial support is critical for developing nations to implement emissions reductions and adapt to climate impacts. Babayev’s call for “leadership and action,” Al Jaber’s emphasis on “actions over words,” and Stiell’s insistence on a reformed financial framework all point towards the weighty expectations facing this year’s summit.

Leaders are expected to negotiate a new climate finance target, building on the $100 billion annual commitment made in 2009 that developed nations have yet to realise fully. Additionally, discussions will address the structural reform of financial institutions to support climate action in the most vulnerable regions. These issues will likely spark contentious debates, but the consensus is that failure is not an option.

A Defining Moment for Climate Diplomacy

As COP29 unfolds, the challenge for leaders will be to bridge the gap between ambition and action, especially given the year’s climate-fuelled disasters. The calls for reform, responsibility, and results at the opening ceremony reflect a shift in tone, with leaders of developing nations no longer content to wait for incremental progress.

COP29’s start signals a new phase in climate diplomacy that demands accountability from the global community. As Babayev noted, “COP29 is a moment of truth.” The question is whether leaders will heed this call and deliver tangible outcomes that protect our shared future. COP29 can potentially be a historic turning point — provided nations commit to real change.

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