This paper examined changes in the portrayal of health system strengthening (HSS) in Zimbabwe from the mid-2000s to the period post-2020 using a framing analysis methodology. Four main frames were identified, namely HSS as an external funder imperative, a pathway to resolve crisis, a strategy for achieving long-term stability and a foundational investment for a resilient health system. HSS as a remedy for a crisis frame has been the most influential, but the greater involvement of external funders and reductions in their funding has shifted towards more governmental responsibility, resulting in health system shocks in critical areas such as personnel. The vulnerability and emotional frames that attracted external funding during peak crisis are found to have lost potency over time, and the shifts require policy response, to avoid missed opportunities for improvement and a loss of public trust in government effectiveness and responsiveness. Nascent, overly futuristic framings such as resilience are noted to be interpreted with caution, as they may cloud the reality that HSS is simply sufficient investment in basic functions. The authors argue that HSS needs to be reframed as a routine, country-owned strategy aimed at improving health system performance rather than a crisis response shaped by external funder interventions.
Values, Policies and Rights
The WHO Pandemic Agreement, adopted 20 May 2025 as WHO's second legally binding health treaty, mandates a One Health approach for preventing zoonotic spillovers (75% of emerging infectious diseases) and establishes a Pathogen Access and Benefit-Sharing system requiring manufacturers to provide WHO with 20% of pandemic product production in exchange for pathogen genetic sequence data access. Learning from COVID-19's inequitable distribution (low-income countries: <33% vaccination coverage vs. high-income: ~80%) and the 2022 TRIPS patent waiver's failure due to lack of technology transfer, Article 11 shifts focus from patents to building tangible manufacturing capabilities through WHO-led technology transfer hubs. Critical implementation challenges include procedural dependency on a May 2026 annex negotiation that must occur before the Agreement can be signed (Article 31) and ratified by 60 parties (Article 33), plus geopolitical fractures from US nonparticipation and abstentions by 11 countries including Italy, Israel, and Russia, which fragment global pharmaceutical supply chains and undermine the benefit-sharing system. The Agreement's success in reshaping pandemic response depends on successfully negotiating operational modalities and bridging the gap between equity goals and fragmented geopolitical realities involving major pharmaceutical manufacturing nations.
Together with the communities of Kiteezi, in Wakiso District, CEHURD filed a landmark case in the Civil Division of the High Court of Uganda against the Kampala Capital City Authority (KCCA) and the National Environment Management Authority (NEMA) challenging the rights violations that followed the August 2024 catastrophic collapse of the Kiteezi landfill. This tragedy resulted in fatalities, displacement, and extensive environmental contamination. The legal intervention seeks to compel KCCA and NEMA to decommission the landfill, comprehensively restore the surrounding environment, and adopt sustainable waste management systems for the betterment of the communities in Kiteezi. Through this action, CEHURD further aims to address the failure of KCCA and NEMA to fulfil their constitutional and statutory mandates to safeguard the right to a clean, safe, and healthy environment, an omission that escalated risks, including hazardous waste leakage and water source contamination to the communities. CEHURD aims to set a precedent for environmental accountability and the protection of health-related human rights.
This paper explored the social norms shaping perceptions, attitudes, and decision-making around family planning among men in three provinces of Kasai Central, Lualaba, and Sankuruthe of the Democratic Republic of the Congo through semi-structured interviews and focus group discussions. The authors found that while social norms oppose the use of modern contraceptive methods and advocate for larger family size, there is notable social support for birth spacing. Some men reported they would support their wives in learning about contraceptive methods if they were able to make the final decision. However, other men felt that allowing their wives to seek a method would undermine their authority, or their virility. To increase modern contraceptive uptake, the authors recommend that interventions address the underlying issues that contribute to non-adherence, addressing the three categories and their associated norms individually and engaging reference groups important to each, including healthcare providers, religious leaders, and male peer groups, in family planning programming.
This paper analysed the two prominent regulatory approaches to Artificial Intelligence (AI) in Europe that have adopted risk-based and principles-based approaches. It investigates whether these approaches are suitable for regulating AI in Uganda’s healthcare and in achieving Universal Health Coverage (UHC). The strengths and weaknesses of each approach are examined. The paper advocates for considering a human rights-based approach that can be integrated with the principles-based approach. Regulation is argued to have a potential to emancipate ordinary people’s lives so Uganda should leverage the positive aspects of both principles-based and human rights-based approaches to regulation to ensure that AI’s potential to achieve UHC is effective. The hybrid approach to AI regulation is best suited to serve Uganda’s healthcare needs. However, such a hybrid approach while contributing will not be a silver bullet and the author recommends that Uganda supplement efforts to achieve UHC with other non-regulatory strategies.
This Third World Network (TWN) statement on the adoption of the Pandemic Agreement at the 78th World Health Assembly states that "The adoption of the Pandemic Accord marks the beginning, not the end, of the equity debate." The organization views the agreement as a milestone following three years of intense negotiations, deep divides, and difficult compromises, representing an initial multilateral effort to address global inequities and promote international cooperation for pandemic prevention, preparedness and response in a world marked by growing health inequities and geopolitical fragmentation. However, TWN stresses that the real test lies ahead, particularly in the next phases of negotiations beginning with the Pathogen Access and Benefit-Sharing System (PABS). The upcoming PABS discussions offer WHO Members a rare opportunity to build a transparent and accountable system, anchored in legally binding rules for sharing biological materials and sequence data of pathogens with pandemic potential, coupled with enforceable benefit-sharing obligations. The statement warns that if these next steps fail, the world may once again face a pandemic armed only with empty promises, risking a repeat of the devastating failures seen during COVID-19, emphasizing that the agreement's success will be measured by whether it becomes a meaningful tool for equity or remains merely symbolic in ensuring developing countries can access affordable vaccines, treatments, and diagnostics swiftly and fairly during health emergencies.
The UN’s principal judicial body, the International Court of Justice, ruled that States have an obligation to protect the environment from greenhouse gas (GHG) emissions and act with due diligence and cooperation to fulfil this obligation. This includes the obligation under the Paris Agreement on climate change to limit global warming to 1.5°C above pre-industrial levels. The Court further ruled that if States breach these obligations, they incur legal responsibility and may be required to cease the wrongful conduct, offer guarantees of non-repetition and make full reparation depending on the circumstances. The Court used Member States’ commitments to both environmental and human rights treaties to justify this decision. Firstly, Member States are parties to a variety of environmental treaties, including ozone layer treaties, the Biodiversity Convention, the Kyoto Protocol, the Paris Agreement and many more, which oblige them to protect the environment for people worldwide and in future generations. But, also because “a clean, healthy and sustainable environment is a precondition for the enjoyment of many human rights,” since Member States are parties to numerous human rights treaties, including the Universal Declaration of Human Rights, they are required to guarantee the enjoyment of such rights by addressing climate change.
This article highlights the devastating impact of sexual violence on women and girls in Sudan's ongoing conflict, focusing on the humanitarian crisis that has displaced over 11 million people. The author, drawing from a personal visit to a refugee camp in Renk, South Sudan, shares the harrowing story of Afrah, a 15-year-old who was raped by soldiers while protecting her younger siblings, exemplifying the widespread weaponization of sexual violence in the conflict. The narrative underscores the urgent need for African leaders to take concrete action, emphasizing that the systematic rape of women and girls has become a common war tactic with virtually no accountability. By centering the experiences of survivors like Afrah, the article calls for immediate international intervention, humanitarian access, and comprehensive support for victims, arguing that addressing the plight of women and girls is crucial to Sudan's potential path to healing and peace.
This paper explored stakeholders’ perspectives on the challenges of implementing Namibia's National School Health Policy (NSHP) in schools using a specifically designed interview guide. A total of 20 stakeholders participated, including educators, nurses, principals, and health program administrators from three regions in Namibia. The study identified significant barriers to effectively implementing the school health policy, including staffing shortages, inadequate resources, limited learner awareness of health rights, and insufficient teacher well-being. Additional challenges involve resource constraints, a lack of monitoring and evaluation, and limited coordination between the education and health sectors. The analysis emphasizes the need for increased resource allocation, comprehensive training, collaborative policy development, and initiatives to improve teacher well-being, and highlights the importance of strong leadership, stakeholder involvement, and adequate funding to support the policy goals.
Solidarity is one of the emerging values in global health ethics, with some bioethics papers linking it to decoloniality. However, conceptions of solidarity in global health ethics are influenced primarily by Western perspectives, suggesting any inclusion of decolonial ideas need to include non-Western perspectives. This article explores a decolonial interpretation of solidarity. It employs a palaver approach, typical of African (Yorùbá) relational culture, developing a conception of solidarity grounded in a beehive metaphor. Through this approach, the authors posit that a beehive metaphor allegorically symbolises solidarity, embedding it in relational virtues and duties that foster harmony, particularly for people with whom one shares similar circumstances for harmonious well-being through concerted efforts. The authors address five potential objections to this account of solidarity in global health ethics and explores what an African account of solidarity means for global health research funding, including for expanding conceptual perspectives on solidarity in global health ethics.