Central to this emerging crisis is a series of pivotal U.S. actions undermining international efforts to combat infectious diseases. Withdrawal from the World Health Organization (WHO) marks a significant retreat from global health leadership, stymying multilateral coordination crucial for pandemic response. Moreover, drastic reductions in funding allocated to fight pervasive diseases such as HIV/AIDS, malaria, and tuberculosis in impoverished nations have hampered progress in controlling these chronic epidemics. Concomitantly, alterations to the U.S. childhood vaccination schedule threaten to lower immunization coverage domestically, which in an interconnected world, reverberates globally by increasing vulnerability to vaccine-preventable diseases. Further exacerbating the issue, diminished commitment to pandemic preparedness impairs the readiness to identify and contain emerging infectious threats at an early stage.

The framework defining a Public Health Emergency of International Concern (PHEIC), as outlined in International Health Regulations (IHRs), stipulates that such a designation arises from an extraordinary event that poses a public health risk to other countries through international disease spread. Historically, no PHEIC has ever been declared solely based on the political missteps of a single nation. Yet, Herder and colleagues argue that the amplified risk engendered by the current U.S. policies satisfies these criteria. More than a theoretical construct, a PHEIC declaration functions as a critical lever to mobilize international funding and invoke legal mechanisms such as compulsory licensing of essential medicines, which can mitigate the global health damage caused by policy failures.

Critics caution that invoking a PHEIC in this context might provoke retaliatory measures from the United States, potentially further complicating global cooperation. Nonetheless, the authors emphasize that the tangible human toll already observed—hundreds of thousands of deaths attributable to policy-driven disruptions since President Trump assumed office in early 2025—renders inaction untenable. The specter of escalating health catastrophes underscores the imperative for the global community, spearheaded by the WHO, to unify its response, transcending political frictions to safeguard global public health.

A pivotal feature of the crisis lies in the shifts to U.S. foreign aid regulations, which have erected what has been termed a “deadly triple tripwire” for recipient organizations. These new rules expand existing abortion-related funding restrictions and introduce prohibitions against financing programs focused on gender and diversity. The ramifications for health service providers operating under these constraints are dire: facility closures, staff departures, and curtailment of essential services. Sara Casey, an associate professor at Columbia University’s Mailman School of Public Health, highlights the likely reverberations, including rises in maternal mortality rates and unsafe abortions, reflecting the cruel human cost of these policy changes.

At the nexus of political ideology and public health outcomes, this evolving situation illustrates how national policy decisions extend far beyond borders. Infectious diseases do not respect geopolitical boundaries, and the erosion of critical health partnerships and funding cascades globally. The disruption of vaccination programs risks the resurgence of diseases once brought under control, such as measles and polio, posing renewed threats to vulnerable populations worldwide. Moreover, weakened surveillance and preparedness capabilities jeopardize the global ability to detect and contain emergent pathogens swiftly, elevating the chances of worldwide transmission with devastating consequences.

The invocation of International Health Regulations as a tool to address these risks brings to light the complex interplay between politics, law, and health. Under the IHRs, a PHEIC declaration triggers international mobilization and grants the WHO enhanced authority to coordinate responses, ramp up resources, and issue binding recommendations. Such mechanisms are designed to prevent localized health crises from escalating into global pandemics. Applying this framework in response to state policies rather than disease outbreaks is an unprecedented but arguably necessary step to arrest the growing public health fallout from the U.S. policy shifts.

Compulsory licensing of essential medicines is another critical mechanism linked to PHEIC declarations. This legal instrument allows governments to override patent protections to ensure the widespread availability of life-saving medications during public health emergencies. Should a PHEIC be declared in relation to the U.S. policy actions, it could facilitate broader access to treatments for infectious diseases disproportionately affected by funding cuts and stalled programmatic support. Such a move could counterbalance some of the negative impacts while amplifying pressure on policy-makers to reconsider their stance on global health commitments.

Despite potential geopolitical backlash, the global community’s ethical obligation to protect population health transcends diplomatic concerns. The unprecedented scale of avoidable mortality linked to these policies mandates a robust international response. Collective action is vital to re-establish funding flows, restore essential health service delivery, and prioritize pandemic preparedness. Without coordinated efforts, the international health architecture risks fragmentation, with lasting consequences that extend well beyond the immediate crises at hand.

The situation also underscores the importance of sustained investment in health systems strengthening. Many low and middle-income countries rely heavily on external aid to maintain critical disease control programs and maternal health services. Disruptions caused by funding shortages jeopardize these fragile gains and threaten to reverse decades of progress. In particular, reductions in sexual and reproductive health programs amplify vulnerabilities, leading to increased unsafe abortions and maternal deaths. This multidimensional threat profile reveals the interconnectivity of health determinants and the consequences of policy decisions made in distant capitals.

In examining the broader context, it becomes evident that the current U.S. policy trajectory conflicts profoundly with principles of global solidarity that have underpinned successful international health initiatives. This divergence challenges existing frameworks designed to foster equitable access to health resources and collective pandemic defenses. Without re-engagement and recommitment by influential stakeholders, there is a risk of precipitating a protracted era marked by fragmented responses, escalating infectious disease burdens, and widening health disparities.

As the world grapples with these unprecedented challenges, the call from experts like Matthew Herder serves as a clarion reminder. Whether or not the WHO formally designates the situation as a PHEIC, it is imperative to recognize the scale of the crisis triggered by these policy choices. The characterization of the U.S. administration’s approach as “the worst public health emergency in the world” underscores the urgency and magnitude of the threat. In response, the global health community must marshal political will, scientific expertise, and legal tools to counteract these adverse trends and protect vulnerable populations.

Ultimately, the unfolding crisis epitomizes how intertwined public health is with political decision-making on the world stage. It highlights the critical need for robust governance structures and accountability mechanisms within international health policy. The moment demands unprecedented solidarity, innovative strategies, and unwavering commitment to universal health principles to mitigate threats that no single country can tackle alone. The health security of all nations depends on such collective resolve.

Subject of Research: Public health implications of U.S. foreign policy decisions and their global impact.

Article Title: The United States is driving a public health emergency of international concern

News Publication Date: 25-Mar-2026

Web References: http://dx.doi.org/10.1136/bmj-2026-089474

Keywords: Public health emergency, infectious disease outbreaks, World Health Organization, International Health Regulations, PHEIC, global health policy, U.S. foreign aid, vaccination schedules, pandemic preparedness, maternal mortality, sexual and reproductive health

The systematic review provides a thorough examination of existing CPD programs tailored for midwifery educators across various LMICs. It delves into the effectiveness and challenges associated with implementing these programs, underscoring the need for sustained educational frameworks that can adapt to the evolving landscape of healthcare. As healthcare systems worldwide continue to face challenges in providing quality services, the findings from this review become increasingly pertinent.

One of the pivotal points raised by the authors is the multifaceted approach required to design successful CPD programs. They emphasize that these programs must not only impart knowledge but also foster critical thinking and practical skills among midwifery educators. The review highlights a range of methodologies that have shown promise, including workshops, mentorship, and online learning platforms. This diverse set of strategies allows educators to experience different forms of learning, which can significantly enhance their teaching effectiveness and, consequently, the learning experience of their students.

Moreover, the authors shed light on the existing gaps in CPD for midwifery educators, particularly in LMICs where resources are limited. A startling number of healthcare workers in these regions lack access to quality educational resources and training opportunities. This deficiency can lead to disparities in care, with vulnerable populations—particularly women and infants—bearing the brunt of inadequate education among healthcare providers. By identifying these shortcomings, the review paves the way for targeted interventions that can bridge the gap between available resources and the educational needs of midwifery educators.

The review also reflects on the barriers that often impede the effective implementation of CPD programs. Socio-economic factors, logistical challenges, and a lack of institutional support are among the prominent hurdles identified. In many cases, educators are required to juggle their teaching responsibilities with the demands of ongoing professional development. The need for institutional buy-in and the creation of supportive environments is therefore critical. Policymakers and health education authorities must prioritize CPD to ensure that midwifery educators are not merely recipients of knowledge but are also empowered to apply this knowledge effectively in their teaching.

One of the noteworthy contributions of this review is its call for a collaborative approach to CPD. The authors advocate for partnerships between governments, educational institutions, and international organizations to pool resources and expertise. Such collaborations can lead to the development of comprehensive CPD programs that are more effective in addressing the specific needs of midwifery educators in various cultural contexts. By working together, stakeholders can ensure that educators receive meaningful ongoing training that enhances their competencies and ultimately leads to improved health outcomes for mothers and infants.

In terms of measurable outcomes, the review observes that countries that have invested in robust CPD for midwifery educators exhibit marked improvements in key health indicators. For instance, reductions in maternal and neonatal mortality rates correspond with enhanced training opportunities for those responsible for delivering care. The findings provide a compelling argument for investing in CPD programs as a means to uplift entire communities through improved healthcare education.

The authors also present a model for evaluating the effectiveness of CPD programs. They propose a framework that includes qualitative and quantitative assessments, with indicators reflecting both the educators’ improved performance and the impact on student learning outcomes. This structured approach not only helps in measuring the success of CPD initiatives but also informs future iterations, driving continuous quality improvement within educational programs.

A deeper understanding of the interconnections between education, practice, and patient outcomes emerges as a key theme throughout the review. It reinforces the idea that investing in the education of midwifery educators is tantamount to investing in the health of communities. Furthermore, the review advocates for integrating CPD into national healthcare policies, encouraging a holistic view that places education at the forefront of health system strengthening initiatives.

As the landscape of healthcare continues to evolve, the importance of CPD cannot be overstated. The review calls on educators, policymakers, and healthcare institutions to recognize the vital role of midwifery educators in shaping the future of maternal and child health. By fostering environments where continuous learning is encouraged and supported, we can create a sustainable framework for health education that transcends borders.

The implications of this review reach beyond the immediate context of midwifery education. It serves as a clarion call for all healthcare educators to seek opportunities for growth and development. In an ever-changing field, the ability to adapt and learn is essential. As midwifery educators enhance their skills through CPD, they not only benefit themselves but also contribute to the larger goal of universal health coverage.

In conclusion, the systematic review by Shikuku, Bar-Zeev, and Ameh underscores the urgent need for robust national continuous professional development programs for midwifery educators in low-and-middle-income countries. As healthcare continues to evolve, so too must the educational frameworks that support it. Investing in CPD is not just an opportunity; it is a necessity for ensuring that midwifery educators are equipped to provide the highest quality of care. The authors’ insights offer a roadmap for future endeavors that ultimately seek to improve health outcomes for some of the most vulnerable populations globally.

With ongoing commitment from governments, educators, and healthcare organizations, it is possible to create a future where midwifery educators are empowered, informed, and instrumental in delivering high-quality care. By prioritizing and supporting continuous professional development, we can ensure that every mother and infant receives the care they deserve.

Subject of Research: Continuous Professional Development Programs for Midwifery Educators in LMICs

Article Title: National continuous professional development programmes for midwifery educators and their effectiveness in low-and-middle-income-countries: a systematic review.

Article References:

Shikuku, D.N., Bar-Zeev, S. & Ameh, C. National continuous professional development programmes for midwifery educators and their effectiveness in low-and-middle-income-countries: a systematic review.
BMC Med Educ 25, 1264 (2025). https://doi.org/10.1186/s12909-025-07877-2

Image Credits: AI Generated

DOI: 10.1186/s12909-025-07877-2

Keywords: Continuous Professional Development, Midwifery Education, Low-and-Middle-Income Countries, Healthcare Quality, Maternal Health

With approximately 400 million individuals in need of medical oxygen each year, the data highlights a staggering reality: over five billion people, equivalent to 60% of the world’s population, remain without reliable access to safe and affordable medical oxygen services. This inequity poses a significant challenge for healthcare systems, especially in low- and middle-income countries (LMICs), where the need is most acute and options are severely limited. Without appropriate measures, countless lives are at risk, reinforcing the call for immediate and strategic action to fill this gap.

Dr. Hamish Graham, a co-author of the report from the Murdoch Children’s Research Institute, emphasizes the role of oxygen at all levels of healthcare for individuals suffering from both chronic and acute conditions. His commentary reveals that previous efforts, particularly during the pandemic era, focused primarily on augmenting the supply side by producing more oxygen-generating equipment. However, this approach failed to address the underlying challenges related to distribution, maintenance, and safe administration, which are equally crucial for effective oxygen delivery.

In addressing the medical oxygen crisis, Dr. Graham advocates for strategic investments in national oxygen plans that would not only enhance the healthcare infrastructure but also promote the routine use of pulse oximeters. These small devices measure blood oxygen levels and are therefore essential for determining the need for oxygen therapy in patients. As it stands, these devices are found in just over half of general hospitals in LMICs, and their availability often suffers from regular shortages and malfunctioning equipment. The inequitable access further complicates healthcare delivery, with pulse oximetry rarely being performed on patients in primary care settings, particularly in remote and rural areas.

The report reveals that a significant portion of the population affected by respiratory ailments resides in Sub-Saharan Africa, where healthcare facilities frequently lack the necessary resources to provide adequate oxygen care. This alarming scenario calls for urgent action to ensure that affordable and high-quality pulse oximeters are broadly accessible to healthcare providers throughout these underserved regions. According to Dr. Graham, the pivotal point falls on both national governments and health organizations to innovate and devise suitable mechanisms that facilitate the integration of medical oxygen into standard treatment protocols across all healthcare settings.

Recognizing the importance of incorporating medical oxygen into national health strategies, the Commission stresses the need for cross-sector collaboration. Governments are urged to engage with public and private sector stakeholders, including representatives from health, education, industry, energy, and transportation, to devise a coherent governance structure that supports the Global Oxygen Alliance (GO₂AL) framework. Such collaboration would enable enhanced resource mobilization and better alignment of oxygen services, ultimately benefiting communities in need.

The report articulates key findings that illustrate the magnitude of the medical oxygen need globally. Annually, approximately 374 million people require oxygen, comprising a vast array of patients afflicted with acute and chronic health conditions. Additionally, amid pandemic-related investments, stark gaps in oxygen access persist, with less than 33% of the affected population in LMICs receiving the oxygen they need for acute health situations. This disparity further necessitates targeted investments, which the report estimates to involve six point eight billion US dollars per year to effectively address the access gap.

Furthermore, it points out that less than thirty countries have so far established National Medical Oxygen Plans. The recommendation is clear: governments should aim for the development of such plans by 2030. These plans are essential for facilitating investment and ensuring effective coordination in the delivery of medical oxygen services.

The report also tackles the significant operational aspect of oxygen systems, stating that their designs must be contextualized to meet local healthcare demands while maintaining affordability for all patients involved. There is no universally applicable model for medical oxygen systems—adaptations are necessary to suit local conditions and prioritize tailored solutions. Emphasizing pulse oximetry, the document advocates for its integration into clinical guidelines and education at all healthcare levels, reinforcing the idea that pulse oximeters are the gateway to ensuring safe and effective oxygen therapy delivery.

The Commission highlights the pressing need for revitalized engagements between the medical oxygen industry, national governments, and global health agencies. It calls for corporate partners to establish specific targets for increased oxygen access and to track their progress transparently, similar to mechanisms in place for the pharmaceutical industry where accountability metrics are regularly evaluated.

To enable informed decision-making, the availability of accurate and timely data regarding oxygen systems is essential. The report introduces innovative tools, like the Oxygen Coverage Indicators and the Access to Medical Oxygen Scorecard (ATMO₂S), both of which would empower governments to plan their national oxygen strategies effectively, while concurrently tracking progress in alignment with the World Health Organization’s Oxygen Resolution.

The global medical oxygen crisis poses a considerable threat to health outcomes, particularly in an era marked by increased vulnerability to respiratory diseases and rising health inequities. This recently published report acts as a clarion call for action, signaling that the time to address these gaps has never been more urgent. As the world continues to grapple with the long-term impacts of both the COVID-19 pandemic and existing healthcare disparities, the insights from the Lancet Global Health Commission report will prove invaluable in guiding future investments and interventions aimed at securing medical oxygen access for all.

By strategically investing in infrastructure, advocating for collaborative partnerships across multiple sectors, and fostering innovations in data collection and analysis, stakeholders can work together to reshape the landscape of medical oxygen access, ultimately contributing to the saving of millions of lives annually while advancing global health equity.

Subject of Research: Medical Oxygen Access and Inequities
Article Title: Reducing Global Inequities in Medical Oxygen Access: The Lancet Global Health Commission on Medical Oxygen Security
News Publication Date: February 17, 2025
Web References: Lancet Global Health Commission on Medical Oxygen Security
References: Hamish R Graham et al., Reducing global inequities in medical oxygen access
Image Credits: Murdoch Children’s Research Institute

Keywords: Medical Oxygen, Global Health, Health Equity, Pandemic Preparedness, Pulse Oximeters, Low and Middle-Income Countries