Do you remember how COVID19 literally brought humanity to its knees? Antimicrobial Resistance (AMR) could do worse!
It is making infections harder to treat, increasing the spread, severity and fatality of diseases as a silent pandemic, and reversing decades of gains in improvement in human and animal health. Without a robust response, AMR could reduce global average life expectancy by 1.8 years within a decade, and cause up to 39 million deaths by 2050. Globally, annual treatment costs and productivity losses combined are projected to reach US$855 billion by 2035. Those are huge figures. But within them most of the risks and burdens are borne by low-income countries, especially in Sub Saharan Africa. AMR is increasing in our region at a time when limited and inequitable access to diagnostics, medicines, including antibiotics are currently causing more deaths than AMR, according to the Africa CDC. In Africa, 24-27 deaths in every 100 000 people are directly attributable or associated with AMR. This is about 5 times the rate in North America. Africa bears the highest AMR burden globally, and deaths from AMR surpass deaths from HIV/AIDS, malaria and tuberculosis combined. The AU and partners estimate that without action AMR will affect 4.1 million Africans annually by 2050.
AMR is a consequence of socioeconomic drivers, and engaging communities is essential. Where people are born, live and work affect health equity, and those in poorer conditions have higher health risks and poorer access to health services. Many in informal communities self-medicate with antibiotics when they cannot access quality services or sick leave when they are ill. With the increase in work pressures, people are pushed to settle for quick fixes such as over-the-counter antibiotics, worsening AMR. WHO/UNICEF data indicates that poor access to safe water increases disease risk and complicates prevention, while industries, large scale farms and hospitals pollute waterways with chemicals or a spill of antibiotics.
Climate Change has intensified such direct and indirect drivers of AMR, creating hot, water scarce or flooded environments that allow pathogens and resistance to thrive, increasing exposure to disease and death, while also destroying or disrupting livelihoods, biodiversity infrastructures, food and water systems, and other essential services and resources, further burdening already vulnerable communities and countries.
From 2015, when World Health Organisation (WHO) first produced a Global Action Plan on AMR (GAP AMR), the agenda was driven by concerns of those in the health sector about the growing threat of drug resistance, and the lack of data to understand the full extent of the problem or to effectively monitor its spread. Adopted by the World Health Assembly and supported by a Political Declaration on AMR at the 71st UN General Assembly (resolution A/RES/71/3), GAP set out five strategic objectives to fight AMR that were integrated into National Action Plans. However, these made little reference to gender, climate or other health equity related sources of vulnerability, or how to address them.
While by the end of 2023 over 170 countries had developed National Action Plans (NAP) based on GAP, they generally reflected limited focus on inequities affecting AMR and only 10% of the countries provided specific finances for their implementation. A 2025 WHO AFRO progress report showed that all 47 Member States had drafted NAPs using the One Health Approach, only 40% had established focal points for implementation and 38% were conducting national awareness campaigns. More positively, 85% had laws or regulations on the prescribing and sale of human antimicrobials. At the same time, concern has been growing about an inadequate response to the socioeconomic and commercial determinants of AMR, weakening AMR interventions. The distribution and use of substandard and counterfeit drugs, the unregulated sale of antibiotics without prescriptions, the misuse of antibiotics/antimicrobials in commercial farming to promote animal growth and profits and the release of untreated industrial and pharmaceutical waste into the environment exemplify commercial activities contributing to AMR in the region. This has ignited multistakeholder processes to address this equity gap and its drivers, facilitated by WHO and with participation of diverse countries and communities. Debates and evidence have linked AMR to social justice, to health as a right and to socioeconomic and other inequalities, together with the changes needed to address these issues and the range of disparities that make communities and countries more at risk of AMR.
Reflecting this, the quadripartite GAP on AMR 2026-2036 adopted at 2026 World Health Assembly gives greater focus on multisectoral governance, sustainable financing, and equitable access to conditions, antibiotics/antimicrobial medicines, environmental surveillance and services to address persistent implementation gaps, with specific impact focused targets by 2030. GAP 2026 shows many shifts from its 2015 predecessor. It emphasises strong robust surveillance systems and ‘prevention first’, and promotes community engagement beyond basic awareness. GAP 2026 embraces One Health and greatly emphasizes the environmental dimensions of AMR, such as the presence of antimicrobial residues and resistant microbes in the ecosystem.
This has formally established the role of UNEP in AMR, together with other UN agencies. GAP 2026 has been intentional in focusing on equity, with a monitoring and evaluation framework and quantitative targets. It goes beyond bacterial resistance to include fungal, parasitic, and viral resistance, and wastewater/environmental surveillance/residues in its actions and targets. GAP 2026 has recognised the financial barriers to implementation of plans and included specific guidance on investment and financing mechanisms, governance through multisectoral structures, and on prioritizing investment in diagnostics and vaccines over new era antibiotics.
It would appear that there is increasing recognition that AMR policies and interventions must advance equity. This is reflected in more attention being given to multisectoral governance, financing and accountability, to local manufacturing of and access to diagnostics and vaccines and to ensuring sustained access to quality antibiotics/antimicrobials. Equity is also reflected in greater attention on prevention, with improved surveillance and health impact assessment to bring data on the lived experiences of those unable to access/reach health facilities and strategies to address the structural, socioeconomic and commercial drivers of AMR. It includes understanding of the need for local research and effective, tested interventions to produce tangible results for low-income communities. Associated with this is recognition of the need to give more attention to people-centred approaches that amplify, strengthen and resource local voices and indigenous knowledge, and of the importance of low-income country voice in diplomacy on AMR. At all levels within countries, and in relation to the inequities that exist globally across countries, an equity and solidarity lens in AMR related agreements and strategies is essential for an effective response, understanding that AMR is everyone’s concern, crisis and responsibility, and that as we learned during COVID-19, we are all only as safe as the weakest amongst us.
We welcome your feedback or queries on the issues raised in this oped – please send them to the EQUINET secretariat. You can read more on AMR in the May version of the WHO global action plan on AMR 2026–2036 at https://apps.who.int/gb/ebwha/pdf_files/WHA79/A79_5Add2-en.pdf
Current Issue
EQUINET NEWSLETTER 245 : 01 October 2026
CONTENTS: 1. Editorial, 2. Latest Equinet Updates, 3. Equity in Health, 4. Values, Policies and Rights, 5. Health equity in economic and trade policies, 6. Poverty and health, 7. Equitable health services, 8. Human Resources, 9. Public-Private Mix, 10. Resource allocation and health financing, 11. Equity and HIV/AIDS, 12. Governance and participation in health, 13. Monitoring equity and research policy, 14. Useful Resources, 15. Jobs and Announcements
1. Editorial
Antimicrobial resistance - The not so silent pandemic generating inequity
Connie Walyaro, Talk AB[M]R, Kenya
2. Latest Equinet Updates
Beyond the Headlines: Reclaiming health equity and sovereignty from the America First Health Deals
SEATINI; EQUINET; AHAKI: June, 2026
Between September 2025 and April 2026, the United States Government State Department rolled out the America First Global Health Strategy (AFGHS) which is a coordinated programme of five-year bilateral Memoranda of Understanding (MoUs) that reshaped US health cooperation in African. At least 19 African countries are reported to have signed these MoUs by May 2026. This Working paper and information resource (Version June 24, 2026) is a live document that will be regularly updated. Feedback on the document is welcomed, and the document will integrate feedback received, and new evidence, analysis and experience as it emerges. While noting the specific resources covered in the MoUs, the brief reports six interlinking public health problems for East and Southern Africa, relating to domestic jurisdiction; fragmentation of continental policy positions; asymmetric data and pathogen extraction; erosion of data sovereignty; conditioning health on mineral access and trade; and forfeited benefit sharing. These problems are argued to call for regional engagement, legal and policy analysis, public information and diplomacy to protect health equity and sovereignty and African benefit from domestic health, genetic, and data resources.
Brief on climate, health equity and antimicrobial resistance in East and Southern Africa
EQUINET; TalkAB[M]R; TARSC: June 2026
EQUINET is sharing knowledge, experiences and learning on health equity impacts of climate in webinars on various areas of health equity. The webinars include voices and expertise at community, local, national and regional levels within East and Southern Africa (ESA). This brief from the ninth webinar in June 2026 focuses on the interplay between antimicrobial resistance, heath equity and climate. Antimicrobial/antibiotic resistance (AMR/ABR) has reached significant levels in all regions, including Africa, is a significant threat to public health, and has interacted with climate change to intensify significant health burdens and inequalities. The brief summarises key issues related to: (i) the interconnectedness and impact of climate change and AMR from a health equity lens (ii) actions proposed to address these issues at local, national, regional and in global level processes; and (iii) issues for further research and discussion.
Challenging the Social License of the Fossil Fuel Industry: A Strategy for Public Health and Systemic Change
GCHA, EQUINET, Groundwork South Africa: World Congress on Public Health, September 2026
The 18th World Congress on Public Health took place in Cape Town, South Africa, from 6–9 September 2026. Held under the theme “Health Without Borders: Equity, Inclusion and Sustainability,” the Congress brought together public health leaders, practitioners, researchers and advocates to address some of the world’s most pressing health challenges. The Global Climate and Health Alliance, in partnership with groundWork South Africa, EQUINET and the Training and Research Support Centre, participated in the Congress and hosted several conversations exploring the connections between climate change, health and fossil fuels. This session examined how the fossil fuel industry maintains its social license through disinformation, sponsorship and narratives that normalise its role in society. It explored how public health can challenge this influence by reframing fossil fuels as a health-harming product, advancing accountability, and centering health equity and justice. The discussion also highlighted practical strategies for communications, litigation, conflict-of-interest safeguards and cross-sector coalition-building to support a just transition.
Report of the WCPH session on Measures to amplify the implementation of health impact assessment in East and Southern Africa
Loewenson R, Modisenyane M, Mlangeni N: World Congress on Public Health, September 2026
A neoliberal globalisation has amplified transnational commercial activity in East and Southern Africa (ESA) and weakened market regulation, such as in mining, infrastructures, energy, and manufacturing. While these activities potentially bring health benefit, they also bring significant population health harms that need to be controlled. Health impact assessment (HIA) provides an internationally recognised method to assess and manage health risks in commercial activities. Inequitably, it is scarcely applied in ESA, despite greater need. This workshop organised within the World Congress on Public Health, September 6-9 2026, in Cape Town international Convention Centre, South Africa presented evidence from convenor experience, desk review and government, professional and civil society structured dialogue during regional HIA training, to stimulate group discussion in the session on the barriers, enablers to, and measures to scale-up HIA in the region. The report summarises the information presented and discussed in the session.
Video podcast: Our comprehensive primary health care systems are vital to respond to climate impacts
EQUINET; TARSC; CITE; Reach Trust, June 2026
EQUINET is producing a series of short video podcasts on the different areas of intersect between climate justice and health equity in east and southern Africa. We follow some characters that we have met in previous podcasts in this video podcast. Health services in East and Southern Africa have faced increased demand from climate-related impacts, but also experience damage to service infrastructures, transport and communication networks that makes people less likely to access services, or to find the medicines they need when they reach them. The podcast includes voices on how States must take action to ensure health care rights, and to protect against the violations caused by climate impacts, especially by investing in comprehensive primary health care and public health approaches. They say that our health sector response to climate change is not just about building health services that can withstand climate emergencies. It’s about building health systems that involve people and are a force for equity and action.
Webinar video: Health equity, climate and antimicrobial resistance
EQUINET, TalkABMR, TARSC: June 2026
This webinar involved presentations from three presenters providing local, national and international level lenses on the issues and actions to be taken on the intersect between health equity, climate and antimicrobial resistance (AMR). Panellists and participants shared experiences and noted areas for action to address the challenges raised, including the drivers of the intersect between climate, inequalities in heath and a silent pandemic of AMR in east and southern Africa.
3. Equity in Health
Access to healthcare amongst adolescent girls and young women in Ugandan artisanal and small-scale mining communities
Chidwick H C; Balaban S; Kwagala B; et al: International Journal for Equity in Health, 1-31, doi: https://doi.org/10.1186/s12939-025-02717-7, 2026
The authors assessed access to health amongst adolescent girls and young girls and young women in artisanal and small scale mining communities in Busia, Mubende, and Namayingo communities, from three mining regions in Uganda. Data were analyzed deductively based on the Tanahashi Model on access to care. Overall, AGYW working in artisanal small scale-mining (ASM) communities expressed interest in using the health care facilities to treat their illnesses and for family planning services. However, with the exception of a few, they reported various challenges they face in accessing healthcare. All participants discussed challenges such as lack of personnel at facilities, lack of youth friendly health services, limited resources, distance to facilities, cost of care, and negative provider attitudes especially towards sexual and reproductive health care for unmarried AGYW. The authors observe that the gaps identified highlight a need to strengthen health systems and especially sexual and reproductive health care in ASM communities in Uganda for Universal Health Coverage and health equity. Mitigating the inequities in these communities is argued to call for formalization, advocacy and rights-based accountability, and leveraging existing initiatives in national Ugandan health policies.
The burden and risk factors of NCDs in Zimbabwe: evidence from the Zimbabwe population based HIV impact assessment 2020 survey
Mapingure M P; Dzinamarira T; Chingombe I; et al: BMC Public Health, 1-24, doi: https://doi.org/10.1186/s12889-026-28362-5, 2026
The authors leveraged data from the Zimbabwe Population-Based HIV Impact Assessment 2020 survey to provide further insights and understanding of the prevalence and risk factors from 19,535 participants associated with non-communicable diseases (NCDs) in the country. Findings revealed that approximately 14% of the population reported being diagnosed with at least one NCD, with hypertension and diabetes presenting prevalences of 11% and 2%, respectively. Age was a significant predictor of NCD burden, and there were disparities, particularly among women and individuals in higher wealth quintiles. Approximately one in seven Zimbabwean adults had been diagnosed with at least one NCD before 2020, with hypertension and diabetes the most common conditions. Older age increases NCD risk, and women and people in higher wealth quintiles were found to carry a higher burden. These patterns suggest the need to keep prioritizing NCD prevention, screening, and management.
Trends and socioeconomic inequalities in contraceptive use, skilled birth attendance, and fertility in Malawi (2015–2024)
Ngoma C: BMC Public Health, 1-24, doi: https://doi.org/10.1186/s12889-026-28516-5, 2026
The author examined changes in modern contraceptive use, skilled birth attendance, and fertility between 2015 and 2024, with a focus on socioeconomic inequalities and underlying mechanisms, using the Malawi Demographic and Health Surveys for those years. Between 2015/16 and 2024 modern contraceptive use increased from 45% to 53%; skilled birth attendance from 91% to 96%; and fertility declined. In the same periods there was an increase in modern contraceptive use and skilled birth attendance. There were, however, persistent socioeconomic gradients in skilled birth attendance, particularly by education and wealth, indicating that gains have not been evenly distributed.
4. Values, Policies and Rights
Contradictions in value systems, social norms, and the disconnect between expectations and reality of sexuality and contraceptive use among youth in Karamoja, Uganda
Ojanduru L; Siu G; Tumwesigye N M; et al: BMC Public Health, 1-42, doi: https://doi.org/10.1186/s12889-026-28455-1, 2026
The authors explored how social norms affect young people’s attitudes, perceptions, and behaviour regarding sexuality and contraceptive use in the Karamoja region, Uganda, through 12 focus group discussions, eight in-depth interviews, and 8 key informant interviews. Contradictory and shifting social norms shaped youth sexuality and contraceptive use. Premarital sex was discouraged and sanctioned, yet engagement sex is legitimized as a pathway to marriage. Gendered expectations restricted girls more severely, linking their value to virginity and bride price, while early and forced marriages were common, driven by paternal authority and cattle wealth. Norms varied by context: rural and less‑educated youth faced tighter regulation, while urban, educated peers reported greater freedom and covert contraceptive use. Fertility was celebrated as a measure of women’s respect and marital value, tied to bride price, with strong pressure to bear children immediately after marriage. Contraceptive use was stigmatized as addictive and incompatible with marital expectations as a girl who starts using contraceptives would continue with that habit even when married. Contradictory and gendered social norms, combined with misconceptions about modern contraceptives, constrain youth agency and reinforce gendered control over reproduction.
Developing a contextualized mHealth integrated system for tracking and reporting obstetric violence incidences in Tanzania
Masoi T J; Kibusi S M; Mselle L T; et al: BMC Digital Health 4:31, 1-11, doi: https://doi.org/10.1186/s44247-026-00266-9, 2026
This paper presents the development of a contextualized mobile health system, designed to monitor and report incidences of obstetric violence in the Central Zone of Tanzania. A qualitative study of context-specific components of obstetric violence among postnatal mothers, healthcare providers, and key community informants was used to develop the contextualized mHealth system. During the pilot, 25 pregnant women at between 34 and 36 weeks of their pregnancy and seven health care providers were randomly selected and followed for four weeks in one of the health care facility in Dodoma city. The system successfully captured 17 incidents of obstetric violence during pilot and sent 128 messages within a four-week period. It reported lack of supportive care and treatment, verbal violence, lack of autonomy, stigma and discrimination, psychological and emotional violence, Sexual violence and lack of privacy. It also captured five self-reflection messages from the healthcare providers on system functionalities and improvements were made. The m-Health system was reported to have the potential to empower women and healthcare providers, offering an easily accessible reporting system towards reducing obstetric violence.
From Rights on Paper to Rights in Practice: Legal Literacy, Access and the Limits of Formal Equality
Kassis-Mohamed S: Pambazuka News, 17 September 2026
The author argues that formal legal equality is not the same thing as lived protection. South Africa has one of the continent's strongest constitutional and statutory frameworks for gender equality and protection from domestic violence, guaranteeing equal protection and benefit of the law and prohibiting unfair discrimination on the grounds of gender. The Domestic Violence Act provides protection orders and related remedies intended to protect people from abuse within domestic relationships. Yet the distance between a right on paper and a right in use is produced by more than one problem. A woman may not know the right exists; she may know it exists but not know the procedure; she may understand the procedure but face cost, distance, language, fear of retaliation or economic dependency; or the institution meant to enforce the right may lack capacity. Legal literacy is therefore argued to be a necessary link in a longer chain of access and implementation, not a substitute for either. The author notes that passing a law is a visible event. Making that law legible across languages, literacy levels, economic constraints and competing authority structures is slower and less visible. That work deserves attention precisely because it is easy to celebrate legislative victories while overlooking whether the people they were written for can use them.
Your Iris Is Not for Sale: Africa’s Fight to Keep Biometric Data a Right, Not a Resource
Kipng'eno R: Pambazuka news, 17 September, 2026
Biometric data is a new gold which various countries and corporate entities are seeking to extract profit from and exert control over populations across the world. The High Court of Kenya resisted this new extractivism and ordered the deletion of biometric data of several thousands of Kenyans whose economic difficulties had been exploited to obtain records of their iris. The court found that a company (Tools for Humanity – an operator of the Worldcoin cryptocurrency project) had never registered as a data controller, never conducted the legally required impact assessment, and had obtained “consent” from people whose economic circumstances made refusal almost unthinkable. The author argues that the case is a preview of a much larger and quieter contest now unfolding across the continent, over what biometric data actually is, and whose rules should govern it when foreign firms, financiers, and technology increasingly sit at the centre of Africa’s digital infrastructure. The author argues that the The AfCFTA Digital Trade Protocol should formalise Standard Contractual Clauses that African states could require of any partner before biometric data crosses a border.
5. Health equity in economic and trade policies
Household soybean processing, protein content, and caregiver acceptability of complementary porridges in rural Malawi
Chilanga E: BMC Public Health, 1-27, doi: https://doi.org/10.1186/s12889-026-28098-2, 2026
In assessing the nutritional and practical effectiveness of soybean-based complementary foods the authors noted that this depends on household-level processing methods and caregiver acceptability. A community-based experimental study was conducted in Dowa District, Central Malawi, in July 2025. Four locally cultivated soybean varieties were subjected to five household-level processing methods: untreated, soaked, roasted, dehulled, and dehulled-and-roasted. Measured protein content differed significantly across soybean processing methods, and integrated assessment demonstrated that dehulled and dehulled-and-roasted soybean processing methods produced the most favorable combined nutritional and caregiver acceptability outcomes. The authors found that dehulling with or without roasting, represents a locally feasible household processing strategy with potential to strengthen soybean-based complementary feeding using existing agricultural resources. They note that nutritional quality be integrated with caregiver acceptability for sustainable community-based child nutrition interventions in low-resource settings.
WHO PABS: Developing Countries Rally Behind Equal Footing, Contracts and Federated Model
Third World Network: TWN Info Service on Health Issues, September 2026
The 8th session of the Intergovernmental Working Group (IGWG) negotiating the Pathogen Access and Benefit-Sharing (PABS) Annex to the World Health Organization (WHO)’s Pandemic Agreement heard a consistent message from developing countries in their opening statements: Article 12 has already been negotiated and agreed, the task before the IGWG is to operationalize it, not reopen or rebalance it. According to the Africa Group, this requires six elements already established by the Agreement: rapid and timely access, monetary and non-monetary benefit-sharing on an equal footing, recognition of States’ sovereign rights over their biological resources, legal certainty for providers, researchers and manufacturers, traceability to ensure accountability and transparency, and simultaneity, so that all elements of the PABS System come into operation together rather than one preceding the others. The Group also stressed that the system must be consistent with the objectives of the CBD and its Nagoya Protocol, while its governance should remain transparent, inclusive and balanced, with fundamental decisions under the authority of the Parties. It is against this legal and operational framework, Algeria explained, that the Africa Group has proposed the federated model as the architecture for the PABS System as a whole: “sovereign national nodes, common rules for all, a shared index, access on agreed terms, and obligations that travel with the material and the information.
6. Poverty and health
Satellite-derived longitudinal evidence of flood effects on community water and sanitation resilience in coastal Kenya
Oluoch F; Ondiek R I; Gudda F; et al: BMC Global and Public Health (2026) 4:63, 1-16, doi: https://doi.org/10.1186/s44263-026-00291-w, 2026
The authors analyzed repeated Community Health Units (CHUs) data from ten CHUs in Kilifi County, Kenya, across eleven rounds from 2017 to 2024. For each round, the authors calculated the percentage of households with safe drinking water and with access to a functional latrine, and linked these outcomes to corresponding flood exposure derived from Sentinel-1 radar imagery. The flood-by-outcome interaction was negative and statistically significant: an increase in flood frequency was associated with a decline in functional latrine coverage, more than in safe water coverage. Rural CHUs had substantially lower safe water coverage than peri-urban CHUs, but the difference in latrine coverage was much smaller. Repeated flooding was associated with greater disruption of functional latrine access than safe water access, and rural disadvantage was concentrated mainly in safe water coverage. The authors suggest that this kind of data guide targeted investments in protected water systems and flood-resistant sanitation in coastal Kenya.
7. Equitable health services
Assessing the preparedness of hospitals for road traffic accident in Central Africa: a hospital-based cross-sectional study in Cameroon and the South Kivu province in the Democratic Republic of Congo
Bashombwa A M; Tchio-Nighie K H; Guenou E; et al: BMC Health Services Research, 1-40, doi: https://doi.org/10.1186/s12913-026-14743-4, 2026
This paper reports on the preparedness of health facilities to provide adequate care to patients suffering from road traffic injuries, from a study of 53 hospitals located along the road axes most involved in road traffic accidents (RTAs) in South Kivu province in Democratic Republic of Congo (DRC). Regarding facility capacity, only 24 of the 53 hospitals in DRC met the minimum service requirements for managing RTAs cases. Services were disproportionately concentrated in higher-level facilities, and only seven hospitals met the minimum personnel requirements necessary for appropriate RTA care, mainly in high level facilities. The authors note that hospitals are inadequately prepared to respond to road traffic accidents due to deficiencies in response planning and the insufficient availability of both material and human resources required for effective accident management.
Effectiveness of mobile phone text messages sent as reminders for self-monitoring of blood pressures and blood glucose at home among low income patients in Kenya: an open label randomized controlled trial
Asiki G; Otieno P; Wilunda C; et al: BMC Digital Health 4: 43, 1-10, doi: https://doi.org/10.1186/s44247-026-00276-7, 2026
This paper assessed the effectiveness of mobile phone text message (SMS) reminders for self-measurements on blood pressures (BP), and blood glucose (BG control in low-income patients from healthcare facilities in three Kenyan counties. To be eligible, patients had to be an adult with a diagnosis of hypertension or type 2 diabetes, own a mobile phone, and accept self-measurements at home. Between January and December 2020, 252/282 patients with hypertension completed the study. The frequency of self-measurements increased among patients with hypertension who received weekly SMS and this was independently associated with BP control. Daily SMS was not associated with BP control. For diabetes, 104/128 completed the study and there was no significant effect of weekly SMS on BG control. Weekly SMS reminders among patients on BP self-monitoring substantially improved BP control. SMS reminders are thus recommended as an adjunct intervention to improve adherence to self-measurements of BP at home.
Health system stakeholders’ perceptions of religious and socio-cultural influences on measles vaccine hesitancy in Madagascar: a qualitative study
Alain F; Raharinivo M; Razafimahatratra M J J; et al: BMC Public Health, 1-19, doi: https://doi.org/10.1186/s12889-026-28130-5, 2026
The authors explored the religious and socio-cultural beliefs and perceptions that act as barriers to the acceptance of the measles vaccine in Madagascar through semi-structured, in-depth interviews with key health system stakeholders, including regional health officials, community leaders, and managers of basic health centres in 2024. The results indicated that from the perspective of health system stakeholders, opposition to measles vaccination is perceived as being primarily driven by deep-seated religious and socio-cultural convictions and by limited health literacy. Caregivers lacked vaccine knowledge. and a 'healing theology' viewed vaccines as an interference with divine sovereignty. This was accompanied by a misconception of vaccines as curative treatments for the sick rather than preventive tools for the healthy, and ancestral skepticism regarding modern medicine’s impact on longevity. Institutional mistrust, and fear of adverse side effects were found to significantly contribute to resistance. Specific ethnic groups, such as the Antemoro and Antandroy, manifest localised social prohibitions against injections. Resistance to measles vaccination in Madagascar was thus found to be multifaceted, rooted in fatalism, institutional mistrust, and functional misunderstandings of immunisation. Engaging local and religious leaders as trusted messengers was suggested to be essential for building community trust and developing culturally sensitive communication strategies that integrate local realities into future vaccination campaigns.
8. Human Resources
Healthcare providers’ knowledge, attitudes, and practices in nutrition management for patients with type 2 diabetes mellitus in Kinshasa: a cross-sectional study in Democratic Republic of the Congo
Botomba S; Horwood C; Muyer M C; BMC Health Services Research, 1-47, doi: https://doi.org/10.1186/s12913-026-14799-2, 2026
Between November and December 2024, the authors evaluated healthcare providers’ knowledge, attitudes, and practices related to nutrition management for patients with type 2 diabetes in Kinshasa and the links between knowledge, attitudes, and practice. The study was implemented across all 35 health zones, and 877 healthcare providers were interviewed. The median age was 39 years, and a minority had received diabetes-related training within the past 12 months. Mean scores for knowledge were 11.9/19, for attitude 11.9/14, and for practice 10.0/17. While most healthcare providers agreed that nutrition is fundamental for diabetes care, many viewed this to be the nutritionist’s responsibility and did not use any record form for nutritional assessment or for recording nutrition-related issues or diagnoses. The study revealed major gaps in healthcare providers’ knowledge and practices on nutrition management in Kinshasa, shaped by both knowledge and attitudes. Differences by profession and sex highlighted training inequities. The study highlighted the need for targeted, context-specific interventions to strengthen frontline healthcare providers’ skills and attitudes on nutrition support.
Interventions involving community health workers and their effect on cervical cancer screening uptake in sub-Saharan Africa: a systematic review
Makajio S H L; Murtas M; Kenfack B; et al: BMC Public Health, 1-34, doi: https://doi.org/10.1186/s12889-026-28109-2, 2026
A systematic search of study databases in 2023 and 2025 explored community health worker roles in cervical cancer screening (CCS) in sub-Saharan Africa. Despite methodological limitations, all studies involved CHWs in health education and counseling. CHWs conducted home visits to recruit participants for CCS, rescheduled follow-up appointments, facilitated access to care, and provided childcare during screening attendance. Interventions involving CHWs significantly increased CCS uptake in three of the five studies assessing it as the primary outcome and improved follow-up attendance in the single study examining this indicator. The authors argue that while the effectiveness of CHW-based interventions varies by type and context, CHWs show potential to enhance CCS uptake in SSA.
9. Public-Private Mix
Commercial interests in health policy dialogues: a qualitative content analysis of NEDLAC’s engagement with South Africa’s Health Promotion Levy
Naidoo D, Nzimande N, Goldstein S. et al.: Global Health 22, 67 https://doi.org/10.1186/s12992-026-01234-8, 2026
Non-communicable diseases (NCDs) are rising rapidly in South Africa, prompting the introduction of the Health Promotion Levy (HPL) in 2018 to reduce the consumption of sugar-sweetened beverages. This study examined the mandate and role in the HPL process of the National Economic Development and Labour Council (NEDLAC), a statutory body designed to promote dialogue between government, business, labour, and community constituencies, with particular attention to the inclusivity and transparency of its deliberations. The findings indicated that NEDLAC’s handling of the HPL illustrated how participatory governance structures may, in practice, enable industry influence and weaken public health objectives. To enhance the integrity and effectiveness of policy dialogue on health-related fiscal measures, the authors recommend that NEDLAC adopt clearer procedural guidelines to ensure inclusive representation, strengthen transparency through public access to documentation, and institutionalise the role of civil society in its processes, including to safeguard them from corporate capture.
10. Resource allocation and health financing
Climate change, financial development, and health outcomes in sub Saharan Africa
Amoah L; Ofori-Sasu D; Amoah J; et al: International Journal for Equity in Health, 1-47, doi: https://doi.org/10.1186/s12939-026-02894-z, 2026
This study examines the relationship between climate change and health outcomes in Africa and the role of financial development in moderating the relationship between climate change and health outcomes. the authors analysed a panel dataset of 43 African countries in 2000–2023. Higher carbon dioxide emissions were found to significantly reduce life expectancy and increase mortality rates, whereas financial development had a positive effect on life expectancy but negatively affected mortality rates. The authors suggest that financial development plays a role in the nexus between climate change and health outcomes. They suggest that while governments are encouraged to increase investments in climate-resilient healthcare infrastructure, clean water systems, sustainable energy, and disease monitoring, financial sector players could prioritize innovative financial tools related to climate and health, such as climate risk insurance, weather-indexed insurance, and health insurance.
Ways to address health financing pressures and donor transition, Kenya
Wesongaa CSA, Kulohoma BW: Bulletin of the World Health Organisation, doi: 10.2471/BLT.26.297090, 2026
The authors argue from the experience of Kenya that the simultaneous dwindling of international funding requires strategic alignment. To safeguard public health gains and ensure uninterrupted service delivery, they suggest that policy-makers and health authorities should prioritize four actions. First, institutionalize domestic
financing transition strategies by establishing multiyear treasury allocations
to absorb the recurrent costs for health workers and commodities currently dependent on external grants. Second, protect primary health-care services and those receiving them by safeguarding targeted prevention programmes for high-risk and key populations, ensuring that fiscal contractions do not disproportionately affect marginalized groups. Third, strengthen supply chain resilience by accelerating domestic procurement mechanisms and regional manufacturing partnerships to prevent commodity stock-outs during international procurement transitions. Fourth, strengthen data systems and surveillance by restoring and maintaining robust monitoring and evaluation infrastructure to accurately measure
health outcomes and track service retention in real time. Without adequate
financing of the health system when international funding declines, decades of
hard-won public health gains risk being reversed, leaving populations vulnerable
to preventable disease and placing an increasing economic burden on health
systems.
11. Equity and HIV/AIDS
It’s not easy, but we need to support them so they don’t get tired on the way: provider perspectives on delivering HIV services for people returning to HIV care in Cape Town, South Africa
Phillips T K; Wolpe H; Gwiji N; et al: BMC Health Services Research, 1-31, doi: https://doi.org/10.1186/s12913-026-14898-0, 2026
The authors characterized the implementation context for re-engaging in HIV care in Cape Town, South Africa, with a view to inform the design of future interventions in this setting, through semi-structured in-depth interviews with nurses, counsellors and administrative clerks at two public-sector health facilities. Limited staffing and fragmented clinic organization contributed to delays and frustration for both clients of HIV services and providers, reinforcing negative client-provider interactions. Despite valuing person-centred care, providers struggled to uphold these principles amid high workloads and systemic pressures relating to physical, information system, and infrastructure limitations. There was also a challenge of inter-facility transfers, driven by geographic mobility and stigmatizing clinic interactions, and difficulties in linking client information across clinics affecting supportive care for people returning to HIV services. The authors assert that addressing these challenges requires interventions that accommodate the changing life circumstances of people living with HIV and facility- and system-level changes to support the providers and their working environments, as both are needed for strong reciprocal client-provider relationships.
12. Governance and participation in health
Leadership practices and maternal and child health outcomes in Sub-Saharan Africa: a systematic review
Mayeden S Y; Hoffmann I; Chit M; et al: BMC Health Services Research 26:878, 1-14, doi: https://doi.org/10.1186/s12913-026-14953-w, 2026
This paper examined how leadership and management practices influence Maternal, newborn, and child health (MNCH) outcomes in Sub-Saharan Africa (SSA). Thirteen studies from seven countries and one multi-country analysis were included. Leadership approaches clustered around three domains, ie: leadership capacity building and supportive supervision, participatory and accountable governance, and community engagement mechanisms; were consistently associated with measurable improvements in antenatal care utilization, skilled birth attendance, and immunization completion rate. Management practices including mentorship, routine monitoring, and data-driven decision-making strengthened provider performance, coordination, and service delivery efficiency. The authors argue that strengthening leadership and management capacity within primary health care systems represents a high-impact strategy for improving service delivery and accelerating progress toward MNCH targets in SSA.
Opportunities and barriers to implementing artificial intelligence for public health in the Democratic Republic of Congo: a case study of the Ibanda health zone and lessons from African pilot programs
Karemere H; Baderha C B; Kani A K; et al: BMC Health Services Research 1-14, doi: https://doi.org/10.1186/s12913-026-15492-0, 2026
The authors used semi-structured interviews with 11 purposively selected health professionals in the Ibanda Health Zone, DRC and findings of a critical narrative review of 56 scientific and grey-literature documents from the DRC, Rwanda, Kenya, and South Africa to examine artificial intelligence (AI) -related practices and implementation readiness in an urban health zone in the Democratic Republic of Congo (DRC) and to provide African experience to contextualize the findings. No institutionally implemented clinical AI system was identified in Ibanda. Some professionals reported informal use of consumer generative AI, and Google Search and DHIS2. Participants perceived potential benefits for diagnosis, laboratory turnaround, and data management, but reported major barriers related to training, connectivity, paper records, regulation, and governance. The combined evidence suggested that any future deployment should be gradual, locally validated, and preceded by investment in data systems, infrastructure, workforce capacity, and accountable governance.
They could distance themselves from me claiming I still had Ebola: experiences of Ebola virus disease survivors in Central Uganda
Nabawanuka B; Epuitai J; Muhoozi M; et al: BMC Public Health, 1-32, doi: https://doi.org/10.1186/s12889-026-29195-y, 2026
The authors explored experiences of 14 Ebola survivors during and after the recovery period through a descriptive qualitative study in central Uganda in 2024. Participants were initially hesitant to seek care, but they eventually agreed with their Ebola diagnosis and complied with medical treatment. Ebola survivors had conspiracy theories regarding Ebola which persisted even after survival. Ebola was attributed to witchcraft, while others thought it was introduced to reduce their population size and as a vehicle for organ donation. Survival was attributed to trade-offs with government and pretence of being sick. Ebola patients and survivors had formal and informal support from government and non-governmental organization which helped meet their social, physical and emotional needs during and after admission. Ebola patients and survivors had emotional, social, and physical challenges during admission and after discharge. They experienced enormous emotional trauma related to worries of survival. Emotional and physical challenges persisted after discharge due to stigma, discrimination, financial constraints, marital problems and persisting physical ailments. EVD survivors experience significant health concerns and poor coping mechanisms, and the authors note that this calls for community-based mental health and psychosocial interventions integrated within a broader package of care for them.
13. Monitoring equity and research policy
Motherhood in crisis: lived experiences of mothers with babies admitted to a neonatal intensive care unit in Northern Uganda
Namukwana B; Abeja C J; Ekung E; et al: BMC Pregnancy and Childbirth, 1-27, doi: https://doi.org/10.1186/s12884-026-09620-1, 2026
The authors explored the lived experiences of mothers with babies admitted to the neonatal intensive care units of Lira Regional Referral Hospital in Northern Uganda, through a descriptive phenomenological study with in depth interviews with ten mothers whose babies had been admitted to the neonatal intensive care units for at least three days. Mothers described intense emotional distress characterized by fear, uncertainty, hopelessness, and disruption of maternal expectations. Financial hardship, prolonged hospitalization, and separation from family further intensified their experiences. Despite these challenges, many mothers expressed appreciation for the compassionate care provided by healthcare workers and relied on spirituality and hope as coping mechanisms. Mothers’ experiences were shaped by communication from health workers, the baby’s clinical condition, hospital requirements, and the availability of interpersonal support. Improving communication, ensuring availability of essential supplies, and strengthening interpersonal support are argued to potentially improve mothers’ experiences during neonatal intensive care units admission.
14. Useful Resources
Cradle to Grave: The health toll of fossil fuels
Global Climate and Health Alliance: 2025
Most discussions about fossil fuels stop at the moment of combustion. Cradle to Grave takes a ground-breaking approach – mapping the entire fossil fuel lifecycle and exposing the health harms at every stage, from extraction to abandoned sites. This flagship report takes a novel approach: it maps the entire fossil fuel lifecycle, examines effects across every stage of human life and every system of the body, and pairs global scientific evidence with case studies and personal testimonies to show how fossil fuels deepen inequity. Peer-reviewed by 15 experts across medicine, public health, toxicology, law, and climate policy, it provides the clearest picture yet of why fossil fuels are not just an environmental threat, but a public health emergency. The site provides various resources for public health personnel to use in advancing work on ending fossil fuel public health impacts.
SADC Charts a Bold New Course for Food and Nutrition Security in Southern Africa
Southern African Development Community: Johannesburg, September 2026
The Southern African Development Community (SADC) convened the SADC Food and Nutrition Security Technical Steering Committee Meeting in Johannesburg, Republic of South Africa, from 14–18 September 2026, bringing together Member States, regional experts and development partners to review implementation of the 2015–2025 SADC Food and Nutrition Security Strategy and refine the draft SADC Food and Nutrition Security Strategy 2026–2036. The meeting formed part of SADC’s efforts to shape a new 10-year agenda for food and nutrition security, with a stronger focus on resilient food systems, addressing the triple burden of malnutrition, preparedness, accountability and evidence-based action. Member States emphasised the importance of ensuring that the new Strategy responds to national realities while remaining aligned with regional, continental and global development frameworks. Member States called for stronger action to address all forms of malnutrition, including the growing triple burden of malnutrition, through coordinated interventions across food, health, WASH, education and social protection. Stronger dietary guidelines, consumer awareness, safeguards around the marketing of food to children and behaviour-change interventions were among the areas highlighted. The draft Strategy places greater emphasis on effective implementation, stronger coordination, sustainable resource mobilisation and clear accountability.
The African Critical Minerals Atlas (ACMA)
Southern Africa Resource Watch (SARW): Online, 2026
The Southern Africa Resource Watch (SARW) launched the African Critical Minerals Atlas (ACMA) on 9 February 2026, on the sidelines of the Investing in African Mining Indaba. ACMA is designed to spotlight Africa's most important mining sites and bring more voices into the continent's critical minerals conversation — particularly as Africa's role in global energy transition, electronics, defence, and AI infrastructure supply chains becomes increasingly pivotal. ACMA currently features six flagship mining sites across the continent in Gabon, DRC, Zambia, Mozambique, Zimbabwe and South Africa. Each site offers a visual deep dive into geology, ownership, industrial and trade infrastructure, ESG standards, human settlements, and the natural environment. The broader goal is to support policymakers, researchers, investors, students, and the public in understanding Africa's strategic role in global value chains — and to accelerate the answering of the big questions shaping the continent's resource futures.
15. Jobs and Announcements
5th International Conference on Public Health in Africa
Addis Ababa, Ethiopia, 23-27 November 2026
The International Conference on Public Health in Africa (CPHIA) is noted to be transformative platform for Africa’s health. CPHIA, a flagship conference of the Africa Centres for Disease Control and prevention (Africa CDC) and African Union Member States is a unique annual event that connects political leaders, policy makers, private sector and community actors with scientists and programme implementers. This platform provides an opportunity for Africans to have open dialogue on critical issues impacting its health and to share new scientific breakthroughs and innovations with potential to catalyse positive change. CPHIA 2026 is under the theme Africa's Health Security and Sovereignty.
Addressing Environmental Drivers of Health to Advance Health Equity: an Intergenerational Dialogue
GCHA, Youth Climate and Health Network (YCHN), the WHO Youth Council – Planetary Health Working Group, Amplify Health and Development in Africa (AHDA), and Save the Children: 11th October 2026, Berlin
Climate change and other environmental drivers are shaping health outcomes across generations, and children and young people are among those most affected. This roundtable brings together a wide range of stakeholders to share lived experiences and to highlight youth- and community-led solutions, policy examples, and cross-sector collaborations. Designed as a participatory dialogue, participants will shape recommendations on priority areas for intergenerational cooperation to advance health equity.
Human Health and Climate Change
UN CC: e learn, Online courses, 2026/7
The UN offers an online short course that explores challenges and opportunities on climate change and health, combining theory with practical examples to give participants the tools to advocate for climate and health policies that protect people, strengthen resilience, and promote a healthier, more sustainable future. Over 34,000 learners worldwide who have already taken this engaging course on human health and climate change. The course explores how climate change impacts health through heatwaves, air pollution, and shifting disease patterns. Learn how stronger health systems and climate-smart policies can protect communities, while actions to cut greenhouse gas emissions also bring major health benefits. Through interactive exercises, real-world case studies, and a wealth of resources, this course makes complex issues easy to understand and act on.
The Africa Health Agenda International Conference (AHAIC) 2027
AMREF Afrcia, Government of Rwanda, Kigali Convention Centre, 28 Feb - 3 Mar 2027
Global health is changing, with a shrinking aid landscape and shifting geopolitics. Climate threats are intensifying. Pandemics, infectious diseases, and the growing burden of non-communicable diseases continue to test health systems across the continent. Meanwhile, inequities persist, leaving millions without access to the care they need and deserve. AHAIC 2027 brings together governments, communities, youth leaders, researchers, investors, frontline health workers, innovators, private sector leaders, and development partners to shape what a new world health order should look like, one grounded in equity, resilience, sovereignty, and African leadership.
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