Presented by Eleanor Crook Foundation
Polio eradication efforts will be leaner in 2026.
The Global Polio Eradication Initiative — a partnership of some of the biggest names in global health — plans to shrink its budget by 30% next year. The move comes as several traditional donors, including the United Kingdom and Germany, are expected to scale back support.
In simple terms, that means some key interventions will have to take a back seat.
GPEI’s 2026 work plan states it may not be able to respond at scale to all polio outbreaks, and there will be a sharp reduction in its surveillance activities, raising concerns about the risk of missed transmission, especially in countries that will no longer receive ad hoc field support. Funding for its work in Afghanistan and Pakistan — where GPEI hopes to end wild poliovirus transmission by June 2026 — will also drop by about 18%.
Officials say funding will continue for crucial work, such as laboratory processing, shipping of samples, and case investigation. But the cuts come at a tough moment — with escalating geopolitical tensions, regional instability, and economic constraints, which the initiative recognizes pose “significant financial and operational risks for the polio eradication effort.”
In Afghanistan, a Taliban ban on house-to-house campaigns remains in effect, and humanitarian crises in places such as Sudan, Gaza, the Lake Chad basin, Somalia, northern Nigeria, and northern Yemen are leaving large numbers of children unvaccinated and vulnerable to the virus.
Read: Global polio coalition braces for 30% budget cut
ICYMI: Against the odds — Madagascar’s fragile polio victory
Not so fast
United Nations Secretary-General António Guterres’ plan to wind down UNAIDS by 2026 is causing quite a stir — not just among HIV and AIDS advocates, but also some government officials who say it’s too soon and could derail the HIV response.
It has also created confusion, as the proposal does not align with decisions already made by the UNAIDS board.
So our resident U.N. expert, Colum Lynch, put together an explainer to detail what the secretary-general can and cannot do. The bottom line? The secretary-general “wields limited bureaucratic power,” and agencies don’t have to abide by his proposals.
“Guterres can impose a hiring freeze, fire employees, eliminate overtime for interpreters, and turn down the air conditioning at U.N. headquarters to save money. Want to eliminate a program that has outlived its usefulness, shutter a department that no longer makes sense, or whack off a few posts? You’ll need to get the U.N.’s 193 member states to sign off on that,” Colum writes.
The UNAIDS board has since reaffirmed its plan for a gradual transition, and I heard U.N. Deputy Secretary-General Amina J. Mohammed told NGOs this week that Guterres’ recommendations were just that — recommendations.
Still, nerves remain frayed. As one official puts it, when a message comes from the top, even a suggestion can sound like an order, even if that’s not the intention.
Explainer: How much power does the UN secretary-general have to reform the body?
ICYMI: UNAIDS faces uncertain future amid UN reform push
Truth be told
“Let me also shock you: We don't need more than 40% of [the] money we were receiving before.”
— Dr. Jean Kaseya, director-general, Africa Centres for Disease Control and PreventionThe Trump administration has slashed billions in foreign aid, dismissing it as “wasteful spending.” Turns out, some African officials don’t entirely disagree.
Kaseya said the region doesn’t actually need a lot of aid — arguing that about 60% of past aid was wasted anyway.
“If we have an integrated plan, if we have strong governance and if partners … come to be aligned to the national plan, we don’t need more than 40%,” he said during a Devex Impact House event on the sidelines of the World Bank and International Monetary Fund annual meetings.
Former Ethiopian Minister of Health Dr. Lia Tadesse Gebremedhin agreed, pointing to years of aid fragmentation, inefficiencies, and programs that didn’t match government priorities.
But it seems the stars are starting to align. Kaseya said the “America First” global health strategy aligns with African governments’ call for more ownership, although there’s still room for improvement.
Read: Africa CDC chief — 60% of foreign health aid was effectively wasted
Background reading: Trump administration releases long-awaited global health strategy
Multiple options
Cases of dengue, cholera, and leptospirosis are rising in parts of the world, and that’s worrying, because we still don’t have enough tools to diagnose, treat, or prevent them.
Take dengue, for example. Two vaccines are approved for use, but they’re not easily accessible — and there’s still no specific treatment, just supportive care.
Leptospirosis is in even worse shape. The disease affects about 1 million people globally and can be fatal if left untreated. But there’s no widely available vaccine, and no promising treatments in the final stages of development.
A new landscape study suggests that smarter financing tools — such as advance market commitments, pooled procurement, blended finance, and product development partnerships — could help turn things around. These mechanisms can make it more attractive for drugmakers to invest in research and development for diseases that have long been neglected.
+ Are you unfamiliar with these financing tools? Here’s our free essential glossary of global development financing.
Read: Can innovative models close financing gaps for neglected disease R&D? (Pro)
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The ‘after’ in aftercare
October is Breast Cancer Awareness Month — which means it’s time for those mammograms!
But beyond early detection and treatment, there’s another part of the conversation that deserves attention: breast reconstruction surgery. It’s a crucial part of posttreatment care, helping restore a woman’s identity, confidence, and overall well-being — and it shouldn’t be treated as an “optional afterthought,” write a group of surgeons and health experts in an opinion piece for Devex.
In the U.S., that’s already recognized under the Women’s Health and Cancer Rights Act, which requires insurance providers to cover breast reconstruction for anyone who’s had a mastectomy.
Elsewhere, access isn’t as straightforward, due to a shortage of reconstructive surgeons and necessary equipment. But, as the authors note, progress is possible — they’ve seen it firsthand in Ethiopia and Vietnam.
Opinion: Breast reconstruction is a matter of equity in cancer care
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Speed vs. trust
The COVID-19 pandemic was a dark period in contemporary world history. Unfortunately, in the world of global health, the aftershocks are still being felt.
COVID-19 showcased what’s scientifically possible, with vaccines becoming available in the same year the virus was identified. But that very speed also fueled doubts about safety and effectiveness, and misinformation ended up spreading faster than the vaccines themselves, Devex contributor Paul Adepoju writes.
While the world is no longer in emergency mode, that lingering distrust continues to haunt routine childhood immunization programs. And for regulators, it’s been a tough lesson on the importance of public trust.
“That period showed us what was possible, but it also showed how fragile trust can be when people don’t understand what’s going on behind the scenes,” Mojisola Adeyeye, director general of Nigeria’s National Agency for Food and Drug Administration and Control, tells Paul.
Read: Can Africa’s drug regulators be both fast and trusted?
What we’re reading
Fiji has eliminated trachoma as a public health problem, making it the first neglected tropical disease to be eliminated in the country. [The Fiji Times]
WHO chief warns that the combination of famine and mental health problems in Gaza is creating a crisis that will last for generations. [BBC]
The last Ebola patient has been discharged from a treatment center in the Democratic Republic of Congo. If no new cases are detected over the next 42 days, officials are expected to declare the outbreak over. [Al Jazeera]
About the author
Jenny Lei Ravelo@JennyLeiRavelo
Jenny Lei Ravelo is a Devex Senior Reporter based in Manila. She covers global health, with a particular focus on the World Health Organization, and other development and humanitarian aid trends in Asia Pacific. Prior to Devex, she wrote for ABS-CBN, one of the largest broadcasting networks in the Philippines, and was a copy editor for various international scientific journals. She received her journalism degree from the University of Santo Tomas.
