It may seem like most of the people you know are on vacation this week, but ideas and opinions never take a break here at CheckUp. Particularly at this moment, with future funding for global health in doubt, even as the challenges continue to multiply. There is a growing sense of concern among experts that some of those problems are at risk of falling off the radar — and with devastating consequences.
• Take cholera, for instance. In the first of three crucial opinion pieces we’re highlighting this week, Nicolas Villeminot of Action Against Hunger USA writes that a disease that “should be relegated to history books” is actually “surging to levels not seen in over a decade.”
An ongoing cholera epidemic had resulted in at least 355,800 cases and 4,000 deaths by July 2025. I write “at least” because cholera tracking remains difficult and current reporting levels are insufficient.
As Villeminot highlights, this is all easily preventable: Stopping transmission requires clean water, sanitation, and hygiene, or WASH. And with appropriate and strategically targeted investments, these can be achieved. For example, smart spending in Somalia reduced cholera case fatality rates in some districts to zero.
But more money is needed to scale up the WASH infrastructure in places where it is lacking, alongside the distribution of a cholera vaccine.
Opinion: Cholera is surging, yet we know how to stop it. So what’s missing?
• Experts have been warning for years about the threat of antimicrobial resistance, or AMR. Chinwe Catherine Eze, a public health microbiologist, writes that in Africa, it has become “a present danger that climate change is exacerbating.”
The heart of the problem remains the prescription of antibiotics without laboratory confirmation of the disease. This is not negligence; it’s simply that many clinicians lack the necessary diagnostic tools.
That problem is compounded by climate change, Ewe writes. Amid emergencies such as droughts and floods, rapid diagnosis becomes even more essential to halt outbreaks and stem the spread of AMR.
This challenge has prompted some promising interventions, she writes, including rapid diagnostic tests and broader surveillance networks to more quickly identify and appropriately address possible outbreaks. But the question of who is going to pay to develop these interventions is still unclear.
Opinion: A diagnostic gap is fueling Africa’s antimicrobial resistance
• Amid this funding crisis and the challenges it has created in tackling cholera, AMR, and a host of other problems, Ambassador Amma A. Twum-Amoah of the African Union sees opportunity for African countries to break free from the aid dependency model that has dominated the global health sector.
It’s not just domestic resource mobilization that she’s looking for, though that is important. She highlights efforts emerging from the Africa Leadership Meeting – Investing in Health 2019 declaration that work to align the efforts of development partners behind national health priorities.
At the same time, she emphasizes the ongoing importance of global solidarity, warning that the impact of global health crises, whether it’s the outbreak of cholera or the rise of AMR, will eventually be felt by everyone.
Opinion: Recent global funding cuts must be a catalyst for Africa’s prosperity
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Contraception can be key to protecting the future of adolescent girls and young women. Yet, even as the use of contraceptive services has grown in eastern and southern Africa, critical gaps remain.
One expert with the U.N. Population Fund tells Devex contributing reporter David Njagi that adolescent pregnancy rates in the region are twice the global average.
If a young girl becomes pregnant, she might then be forced into an early marriage, robbing her of the opportunity to finish school and establish a career. In some cases, girls pursue unsafe abortions that put them at risk of severe consequences, including death.
Places like Mozambique had been making some gains in ensuring access to family planning services for young women, including implants and IUDs. But those services are beginning to disappear in the wake of U.S. President Donald Trump’s cuts to global programs for sexual and reproductive health and rights.
Read: How aid cuts are unraveling family planning progress in Mozambique
Looking for some good news on the global health front? Cash transfers might be as effective at reducing infant and under-five mortality as vaccines and antimalarial drugs. This is according to a new study from the University of California, Berkeley and Oxford University.
Between 2014 and 2017, GiveDirectly sent one-time cash transfers of $1,000 to 10,500 households in rural Kenya. Infant mortality was reduced by 48% and under-five mortality fell by 45%.
As Dr. Miriam Laker-Oketta of Give Directly explains in an opinion piece for Devex, if they were timed correctly, the funds seemed to offer vital help in a number of ways: Mothers were able to take time off work and to go to a hospital or health center to deliver, and children were less likely to go to bed hungry.
The cash is not enough on its own. As Laker-Oketta explains: “The takeaway isn’t that cash replaces health care. It’s that cash makes health care reachable.”
Opinion: Cutting aid could kill children. Giving cash could save them
Background reading: Is unconditional cash the missing link in maternal and child survival?
An mpox outbreak in Africa remains a public health emergency of international concern, or PHEIC, more than a year after the declaration by the World Health Organization. Twenty-four countries are still contending with outbreaks of the disease, according to the Africa Centres for Disease Control and Prevention, with cases climbing higher than 97,000 and deaths reaching nearly 600 since the start of the year.
Since WHO declared the PHEIC, the highest level of emergency, there have been some advances. WHO prequalified a vaccine shortly after the declaration. Supplies have fallen short, though, amid ongoing efforts to vaccinate the people who would benefit most and to create a stockpile that would ease distribution.
Laboratories and health workers across Africa are also better equipped to deal with the disease than they were a year ago.
With new cases now on the decline, there are indications the PHEIC could soon be declared over. Yet, experts warn that it has taken far too long to get the outbreak under control. They worry that if a PHEIC can’t motivate a more robust effort, then nothing will.
Background reading: The majority of mpox cases can’t be tracked
As a result of overcrowding and poor sanitation, tuberculosis is spreading in immigration detention centers across the United States. [The American Prospect]
A scheme by the Indian government to help subsidize secondary and tertiary care for the country’s poorest citizens has been plagued by delayed reimbursements and fraud allegations. [Health Policy Watch]
Nepal introduced rubella vaccines through a 2012 immunization program. Thirteen years later, the country has officially been declared free of the highly contagious viral infection. [UN News]