France

Trump’s willingness to sell out allies should cause a rethink in Taipei.

A war of choice has turned into a strategic disaster for Washington.

Development aid remains the best way to reduce drug production.

ENTRETIEN - L’eurodéputé, vice-président des Républicains, presse l’exécutif français de s’emparer du règlement retour, voté définitivement mercredi, pour créer des centres de rétention pour migrants hors d’Europe en coopération avec des pays tiers.

Alors que le président américain Donald Trump a annoncé dimanche soir la conclusion d'un accord avec l'Iran, le président de la commission des Affaires étrangères de l'Assemblée nationale, Bruno Fuchs, estime que "la situation sera plus défavorable au monde qu'elle ne l'était". Concernant la situation au Liban, le député Les Démocrates privilégie "une vision politique et non pas militaire, qui est une impasse à long terme".

The Iran war is only the latest in a string of U.S. failures.

DÉCRYPTAGE - La proposition de loi du député Renaissance Charles Rodwell a été largement votée à l’Assemblée nationale ce mardi après-midi.

Emmanuel Macron a convié Donald Trump mercredi à un dîner au château de Versailles "pour célébrer les 250 ans de l'indépendance américaine". C'est la quatrième fois que le président français reçoit un chef d'État étranger au palais de Louis XIV. Retour en images sur les réceptions précédentes.

Foreign intervention is a policy with a long history of disaster.

Shein n’aura bientôt plus sa place au BHV Marais. La Société des grands magasins (SGM) de Frédéric Merlin, qui exploitait le bâtiment parisien depuis 2023 a annoncé mardi céder le fonds de commerce du grand magasin. Le partenariat avec la marque d'ultra fast-fashion Shein, présenté comme une "erreur stratégique", va lui s'arrêter.

A group of children sit near a garden in Tamasgo Primary, in Burkina Faso, which is one of the most climate-vulnerable countries in the world. Credit: UNICEF Office in Burkina Faso

By Oritro Karim
UNITED NATIONS, Jun 16 2026 (IPS)

A new report from the United Nations Children’s Fund (UNICEF) highlights the vast, overlapping climate threats affecting children worldwide, which is leaving them increasingly vulnerable to escalating risks across health, security, and education.

The report, Children’s Climate Risk Report, emphasizes that while these risks are most pronounced in heavily vulnerable regions in the Global South—such as South Asia and sub-Saharan Africa—nearly half of the world’s children are exposed to at least three climate hazards, with some exposed to as many as six at once.

“Across the globe, millions of children are now facing multiple climate threats without the necessary services to cope,” said UNICEF Executive Director Catherine Russell. “They are experiencing extreme heat that causes heatstroke and dehydration. Their homes and schools are being destroyed by storms and floods. Devastating droughts are limiting their access to food and water. And in many cases, the intensity of these hazards is increasing with each passing year.”

“We must invest more in adapting essential services to the impact of climate change,” Russell added. “Through political will, partnerships, and collaboration with young people, the case studies in this report prove that progress is possible. But the scale and ambition of action must be rapidly accelerated to ensure that every child is protected from climate impacts.”

According to UNICEF’s findings, nearly every child globally is now affected by air pollution. Additionally, over 296 million children live in areas that are exposed to a dangerous combination of prolonged drought, extreme heat, and heatwaves, while another 115 million simultaneously face droughts, extreme heat, and tropical storms.

The agency stresses that these risks often overlap across multiple regions, noting that riverine and coastal floods, fires, and sand and dust storms have caused widespread displacement, disruptions to livelihoods and schooling, the spread of infectious diseases, or various forms of health and food insecurity.

Nowhere are the consequences of these overlapping threats more evident than in sub-Saharan Africa and South Asia, which have been described by climate experts as the two most climate-vulnerable regions in the world. These regions are at a heightened risk primarily due to high environmental exposure and a limited capacity to respond. The resulting shocks overwhelm local health systems, cripple fragile infrastructure, and leave entire communities deprived of basic, lifesaving services.

The report notes that over 4 million children in the Sahel region are exposed to heatwaves, extreme heat, and sand and dust storms. Meanwhile, South Asian countries like Bangladesh, Myanmar and Pakistan, face more hazards at once and at higher intensities than anywhere else in the world.

“While some countries may face a single devastating event, such as a tropical storm that can wipe out an entire island, many countries in Asia are dealing with a combination of threats, from floods and storms to extreme heat,” Rohini Sampoornam Swaminathan, UNICEF Statistics and Monitoring Manager, tells Inter Press Service. “Children may cope with one or two shocks, but after three, four or five, families’ ability to respond becomes severely strained. Moreover, risk is not only about exposure to hazards, but it is also about the availability and accessibility of essential services. For children without reliable access to health care, nutrition, or water and sanitation, even a moderate flood or heatwave can become life‑threatening.”

On 20 January 2026, an aerial view of the flooded Xai Xai village after extreme rainfall in Gaza Province, Mozambique. Credit: UNICEF/Guy Taylor

According to the report, in 2024, approximately 634 million children lacked access to safe drinking water, over 1 billion lacked access to sanitation services, and 489 million lacked access to basic hygiene services. Currently, nearly 160 million children live in areas where water systems are severely strained, and droughts are extremely pronounced, while another 270 million children live in flood-prone zones where less than half of the population has access to adequate sanitation.

As a result, the World Health Organization (WHO) projects that there could be over 250,000 additional yearly deaths by the 2030s from malaria, diarrhoea, heat stress, and undernutrition. These consequences are dire for children, particularly those living in fragile contexts where health systems and local infrastructures are strained.

In Pakistan, children face extreme vulnerability due to glacial melt and erratic rainfall patterns, which frequently trigger large-scale flooding. The historic 2022 floods affected over 33 million people—roughly half of whom were children—and stripped more than 5.4 million people of access to clean water, leaving them at a heightened risk of contracting infectious diseases and waterborne illnesses. This has been compounded by frequent heatwaves and prolonged droughts, with temperatures routinely exceeding 48 degrees Celsius, or 118.4 degrees Fahrenheit, which have caused high rates of severe dehydration and acute malnutrition, as a result of decimated crop yields.

Without urgent intervention, UNICEF projects that an additional 28 million children globally could experience acute malnutrition and stunted growth by 2050. In sub-Saharan Africa alone, approximately 10 million more children are expected to suffer from stunted growth by 2050. Over the last few years, increasingly frequent and destructive climate shocks have devastated food systems around the world, leaving roughly 66 percent of children under five—approximately 440 million—to live in severe food poverty.

Additionally, climate shocks are increasingly stripping children of their education, with UNICEF recording nearly 242 million students across 85 countries and territories who have their education disrupted by climate-induced hazards in 2024 alone. The agency has also recorded rising rates of school closures, absenteeism, and worsened school performance. Swaminathan noted that when classrooms become too hot, children struggle to concentrate, learn and stay engaged.

“Heat increases dehydration, fatigue and absenteeism, especially in schools without cooling, shade or reliable water,” she added. “As temperatures rise, schools are also closing more often. While closures protect children’s health, they expose how unprepared many education systems are for a hotter world. When children lose learning, societies lose potential. Repeated disruptions affect education outcomes, future earnings and economic growth, while deepening inequalities.”

It is estimated that disrupted education across low- and middle-income countries could yield future economic losses of up to USD 11 trillion in lifetime earnings. The report further notes that establishing climate-resilient education systems is crucial in preventing these losses and protecting children from facing adverse mental health impacts and deepened social and economic inequalities.

Furthermore, volatile climate shocks around the world continue to displace entire communities and push millions of children into insecurity. Between 2016 and 2023, UNICEF recorded over 62 million internal displacements of children as a result of climate-induced hazards—or roughly 21,000 child displacements per day.

“When families are forced to move because of climate shocks, children face heightened risks of violence, exploitation and family separation, both during the journey and in temporary settlements. These risks increase when displacement is sudden, support networks collapse, and protection systems are overwhelmed,” said Swaminathan. “Climate-related displacement acts as a threat multiplier. It weakens livelihoods, strains fragile services and deepens existing tensions.”

Child protection services around the world have been pushed to the brink of collapse as a result of the vast scale of needs triggered by climate-induced displacement. This strain has been linked to a significant rise in violence, exploitation, abuse, and childhood trauma, with many families resorting to negative coping mechanisms such as child labour and child marriage.

According to UNICEF estimates, rates of child labour have surged in recent years, particularly in areas with agriculture-dependent economies, where roughly 70 percent of this exploitation can be found. Additionally, communities frequently turn to child marriage to secure short-term financial stability following severe climate shocks. The consequences are particularly dire for girls who are married before the age of 18, who face a significantly higher risk of domestic violence, alongside severely compromised health and economic outcomes compared to those who marry later in life.

To accelerate climate action and protect millions of children from these escalating risks, UNICEF is urging global leaders and the private sector to prioritize investments in renewable energy, underscoring that this is a critical first step in reducing the intensity of climate shocks. Additionally, the agency stresses the importance of integrating climate-resilient schools, water systems, and healthcare facilities into national emergency plans and expanding climate education to ensure that the next generation has a voice in decisions that affect their lives.

“UNICEF’s message is clear: invest in children’s resilience, especially the most vulnerable. Invest in the communities they live in and the social services they depend on, and ensure these services continue to function during and after climate shocks,” said Swaminathan. “The climate crisis is a child rights crisis. We know where children are at risk and what they face. Now we must act.”

IPS UN Bureau Report

 

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Months of fighting revealed that multiple countries can impose costs, but none can impose order.

Israel is resisting Donald Trump’s demands that it fall in line with his Middle East policy.

The Russian state has, through legislation and stigmatising rhetoric, systematically worked to isolate the LGBTQ+ community. Graphic: IPS

By Ed Holt
BRATISLAVA, Jun 16 2026 (IPS)

LGBTQ+ people in Russia are being forced to increasingly use self-censoring strategies in their daily lives as they struggle with systemic vulnerability, one of the largest surveys of the LGBTQ+ community in the country has shown.

The latest annual survey of more than 6,000 people across Russia by the Coming Out and Sphere Foundation organisations showed that, in 2025, the situation for the community had neither improved nor significantly worsened.

But it showed a reinforcement of existing adaptive strategies among LGBTQ+ people, including selective approaches to coming out and avoidance of situations in which their gender identity or sexual orientation could be revealed.

There was also an increase in some forms of abuse, particularly in online spaces, and threats of violence, extortion, denunciation, and pressure from close circles continued to contribute significantly to the everyday vulnerability of LGBTQ+ people.

The groups say the findings reinforce the perception that LGBTQ+ people in Russia – where a series of repressive laws demonising and persecuting the community – are likely to face persistently high levels of vulnerability and threats to their safety, health, and quality of life for some time to come as they come under attack simply for being who they are.

“Our data shows that repression of LGBTQ+ people has moved from persecution for specific actions to persecution for their identity, for who a person is, not what they do. There are more and more legal cases against people who are living their lives, not doing anything against the government or trying to promote human rights,” Denis Oleinik, Executive Director at Coming Out, told IPS.

“What we have seen in 2025 is a “normalisation” or “routinisation” of catastrophe. LGBTQ+ people now just live with [the situation], with these things happening. It’s as if this has become normal life. It’s absolutely horrible,” he added.

Russia’s LGBTQ+ community has faced increasing discrimination and marginalisation for more than a decade.

While there has historically been a degree of anti-LGBTQ+ sentiment in Russian society, this has deepened significantly with the introduction of a series of laws and increasingly hostile government policies against the community.

In 2013, not long after Vladimir Putin had returned to power as president, a law was implemented banning “the propaganda of non-traditional sexual relations” to anyone under the age of 18.

The start of what critics say has been a decade-long campaign by the Kremlin to marginalise and vilify the LGBTQ+ community in the country, the law was extended in 2022 to cover all public information or activities supporting LGBTQ+ rights or displaying non-heterosexual orientation, regardless of age.

A ban on same-sex marriage was also written into the constitution, and in 2023, legislation was passed banning transgender people from officially or medically changing their gender.

The same year also saw a ruling by the Supreme Court, which outlawed the non-existent ‘international LGBT movement’, declaring it ‘extremist’ – allowing people to be fined or prosecuted for anything that could be construed as promoting “non-traditional sexual relations”.

At the same time, homophobic political discourse has become increasingly normalised, as the Kremlin has looked to promote ‘traditional family values’ in society and cast LGBTQ+ activism as a product of a degenerate West and a threat to Russia.

This has fuelled a growingly virulent and often violent rejection of LGBTQ+ people in large parts of society and has left many in the community fearing for their physical and mental health.

Grigory*, an LGBTQ+ student from a major city in Russia, said they were selective in revealing their sexuality and gender identity and that while they do not live in permanent fear of physical attacks, they have adjusted their behaviour to avoid certain locations.

“Sometimes in the evenings I avoid certain places because I could be considered stereotypically gay, perhaps because of my voice or the way I walk. I don’t hide my sexuality in public, but I don’t manifest it either,” they said, adding that this was easier for them than for some other members of the LGBTQ+ community.

“Transgender people suffer the worst problems. It must be very hard for someone to be transgender in Russia. They are so brave and strong. I’m astonished they can keep going,” they said.

The Coming Out and Sphere Foundation showed the situation for transgender people in the vast majority of indicators for quality of life, including specific measures of discrimination and well-being, was worse than for other members of the LGBTQ+ community. Notably, they were significantly more likely to face physical threats and experience actual physical violence, including sexual and domestic violence, more frequently than other LGBTQ+ people.

“A lot of trans people right now live their whole lives at home without even going outside to the shops if they have access to courier services or some relatives or friends who can help them buy what they need. We’re seeing this more and more,” said Oleinik.

Grigory said they felt, along with many others in the community, if not fear of physical attacks, a specific sense of aggression towards them.

“I feel it indirectly. It comes through government narratives in the media and in the public sphere, or in something an acquaintance might say. Queerphobia in Russia is mainly government-induced. Of course it existed before all these awful laws, but it wasn’t that strong. The laws have made it much worse,” they said.

LGBTQ+ rights campaigners say the patterns of behaviour among the community in Russia described in the report are unsurprising given the years of growing repression against them.

“When marginalisation and criminalisation on any grounds are a long-term feature of daily life, people develop ways of managing their daily exposure to harm,” Anastasia Smirnova, Deputy Director and Director of Programmes at rights group ILGA-Europe, told IPS.

She added, though, that LGBTQ+ people in Russia were facing a very specific challenge, as the Russian state has, through increasingly harsh legislation and stigmatising rhetoric, systematically worked to isolate LGBTQ+ human rights defenders and then LGBTQ+ people from each other and from everyone around them as part of a broader dismantling of the conditions for free association and dissent.

“This is what makes it different from social prejudice: it is not a reflection of society, it is a project of the state, and its target is civic life. For many people living through this, the daily acts of self-censorship described in the report are the lived reality of that project,” Smirnova said.

The potential harms of such actions on individuals and the wider community are severe, with impacts on both mental and physical health as individuals are left isolated and in some cases afraid to access healthcare.

“The impact on children is particularly severe. State propaganda targeting schools, the absence of age-appropriate relationship and sex education, and the climate of fear surrounding LGBTI topics leave young people exposed to extreme harm and isolation, especially children who are themselves LGBTI or have LGBTI family members, but also any child who might be perceived as LGBTI,” said Smirnova.

While the report did not show a significant deterioration in a number of indicators compared to previous years – in fact there was a slight improvement in some areas – its authors warn this could be misleading, highlighting that the report relied on the willingness of respondents to “share sensitive information in an increasingly oppressive environment” and that real levels of discrimination and violence could be higher.

Whatever the true levels of discrimination against the community are in Russia, many people are suffering gravely in the current environment.

Grigory said they are currently in therapy, partly to help them deal with the challenges of being LGBTQ+ in Russia.

They said that among the community, “thoughts of killing oneself and suicide attempts are pretty common.”

LGBTQ+ people and activists in touch or working directly with members of the community who spoke to IPS said substance abuse, or self-medication through unsupervised use of anti-depressants, was not uncommon either.

Trying to get help for such problems is difficult though amid mistrust of state health institutions because of widespread homo- and transphobia and concerns over staff potentially breaching patient confidentiality about sexuality.

As the pressure on LGBTQ+ people continues, many feel they have had no choice but to leave the country.

The annual report included responses from hundreds of people who had emigrated, both in 2025 and in the last few years before that.

Severe anxiety and psychological discomfort were the most commonly cited reasons for emigration (66%), while other major reasons included intensified censorship (59%), personal safety risk (57%), and increased homophobia and transphobia in Russian society (57%).

Tellingly, the majority of participants who had emigrated (63%) did not consider returning to Russia an option – a rise of 8 percentage points on the previous year.

This is perhaps unsurprising, given that many in the community see little or no prospect of the situation in Russia improving for many years.

“Many things have changed in the last few years, not just in Russia but all around the world – the far right is winning everywhere, and LGBTQ rights are under attack all over the world. I’m not expecting anything good to happen inside Russia in the next five to ten years,” said Oleinik.

But others say that despite, or perhaps because of, the report’s findings, there is an even greater need now for LGBTQ+ people in Russia and groups both inside and outside the country to do whatever they can to resist the state’s ongoing repression of the community.

“There is an important distinction to draw between acknowledging that a democratic reversal in Russia is not on the near horizon and concluding that nothing can or should be done in the meantime. The power of the Russian state, backed by resource wealth and a willingness to use every available instrument of repression, is real and cannot be minimised. And yet what we see from our position, working in support of human rights organisations, defenders, organisers, and activists, is not resignation, but realism paired with determination,” said Smirnova.

“People are continuing to organise, even though the time horizons are long and murky and the measures of ‘value’ of the organising are different from what they might be somewhere else. But keeping the lights on for the possible forms of civic engagement, critical thought, and solidarity is a form of resistance that does have long-term value,” she added.

Oleinik vowed his organisation would not be giving up on LGBTQ+ people in Russia.

“We need to continue our work, our support, because we know that LGBTQ+ people in Russia need us. Right now it might look like there is little hope of positive change, but that does not mean we should stop what we are doing,” he said.

*Name changed for security reasons

IPS UN Bureau Report

 

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An illustration by Serhiy Ofitserov, a Ukrainian civilian currently held in Russian captivity. Serhiy began drawing while in prison; here is a view of his prison cell. Courtesy: Hennadiy Ofitserov

By Mykhailo Savva and Oleh Martynenko
KYIV, Jun 16 2026 (IPS)

People often discuss Russia’s aggressive war against Ukraine in terms of drones, missiles, shifting front lines, and territorial borders. But this war has another dimension — the human one.

More than 90,000 Ukrainians are considered missing under special circumstances. These are official data. Some of them are currently held captive by Russia — both prisoners of war and civilians. The latter ended up behind bars when Russian forces occupied the territories where they lived.

In March 2026, in an interview with Axios, Ukrainian President Volodymyr Zelenskyy said that the administration of U.S. President Donald Trump sees no other way to end the war except by handing over the entire Donbas to Russia. But it is important to understand this – it is not just about land but also about the people who live there. And occupation is not peace.

Mykhailo Savva is a Doctor of Political Sciences and an expert at the Center for Civil Liberties.

 

Oleh Martynenko is a Doctor of Law, a Professor, a criminologist, a veteran of Russia’s war against Ukraine, and also an expert at the Center for Civil Liberties.

‘The Chain of Persecution’

The terrorisation of the civilian population is one of the tactics that Russia is using in its war against Ukraine. Imprisonment has become a punishment for failing to comply with the rules established by the occupying authorities.

At the heart of this system lies what might be called “the chain of persecution.” This pattern is repeated in all occupied regions.

Stage 1: Identification. Local officials, teachers, journalists, volunteers, and ordinary residents who express even the simplest pro-Ukrainian views come under the scrutiny of the occupying authorities. Sometimes, an overheard conversation or a social media post is enough.

Russia has been using this method since 2014: it tested it in occupied Crimea and later expanded it to all occupied territories. For example, in March 2026,  a resident of Alupka was arrested in  Crimea after Russian security forces accused him of “justifying terrorism” based on posts in a messaging app.

The words on this drawing are “Hold on. I’m holding on.” This phrase reflects the emotional state of both those held in captivity and those waiting for their loved ones to return from imprisonment. The illustrator, Serhiy Ofitserov, has been in detention since August 2022. In January 2026, he was sentenced to 17 years on fabricated charges; he turned 50 in May. Courtesy: Hennadiy Ofitserov

Stage 2. Enforced disappearance. Detainees are not officially registered. Their whereabouts are concealed or denied. Relatives are left in the dark. This is done deliberately so that everything that happens next remains beyond their control.

Stage 3. Cruel treatment. Torture is not an exception but a systematic practice. Survivors describe beatings, electric shocks, mock executions, and prolonged deprivation of food and water. Sexual violence is used against both men and women.

“They’d take a person out into the hallway, where there were no cameras, where everyone was, let’s say, on their side. No one would object. And there, they’d simply beat the person as much as they saw fit. They used stun guns. And this was with about 10 to 12 people there. If not more. They said, “You’ve had your little taste of life – well, that’s enough – you’ve already experienced what it’s like. You won’t have any more of that,’” recalls Viktoria Andrusha, a teacher whom the occupiers took from her parents’ home on September 25, 2022.

During the search, they found messages on her phone from chatbots about the movement of Russian military equipment. Viktoria was accused of “spying” and taken away: first, she was held in a makeshift detention centre in the boiler room of the neighbouring village of Novy Bykiv, and later in a pre-trial detention centre in the Kursk region of Russia. She was released in October 2023.

Stage 4: The Sham Trial. Detainees are often transported over long distances. Such transfers sever ties with their communities, complicate search efforts, and further deprive people of legal protection.

Next comes the “trial”, which merely mimics legality. Civilians are prosecuted on trumped-up charges — extremism, terrorism, or espionage.

For example, Yana Suvorova, the administrator of the Telegram channel “Melitopol Is Ukraine”, was sentenced to 14 years in a general-regime penal colony after nearly two years of unlawful detention. The verdict was handed down by the Southern District Military Court of Rostov-on-Don on October 23, 2025.

Southern District Military Court of Rostov-on-Don, October 23, 2025.

Stage 5: Imprisonment. People are placed in a network of detention facilities where supervision is minimal or nonexistent. Conditions are often inhumane. Contact with families is restricted or completely prohibited. For many, this stage becomes indefinite.

What the world will face if this is not stopped

Each of these stages violates human rights and international norms. But together, they form something more—a system in which crimes against humanity occur sequentially and reinforce one another.

Persecution, unlawful detention, deportation, enforced disappearances, torture, sexual violence, and imprisonment are not isolated incidents. They are parts of a single, integrated, and deliberate structure.

The goal of this system is to consolidate control over the occupied territories, create an atmosphere of fear, and force people to submit to imposed rules—legal, administrative, and educational. The message is clear: people are expected to be submissive. In effect, the occupation is turning into a form of criminal governance.

This poses a question to the international community: if such systems are allowed to operate without consequences, what precedent will this set for future conflicts?

Normalising the “chain of persecution” risks cementing these practices as tools of modern warfare. And then this model of control will extend far beyond Ukraine’s borders. Therefore, the issue of accountability concerns more than just Ukraine. The task is complex—but the law is clear.

All that remains is the will to act. If that will is lacking, this practice will become the norm rather than the exception. And the price for this will be paid not only by those currently behind bars, but also by the very integrity of international law.

IPS UN Bureau Report

 

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À la veille de l'ouverture du salon VivaTech, dédié aux nouvelles technologies, à Paris, le Premier ministre a annoncé mardi un investissement supplémentaire de 655 millions d'euros dans l’intelligence artificielle. Ces fonds doivent notamment renforcer les infrastructures, la recherche, les entreprises et les filières industrielles". L'objectif affiché est de soutenir la souveraineté technologique française et moderniser les services publics, afin "que cette révolution profite aux Français".

Dr Elizabeth Igaga in one of the operating rooms at Smile Train partner, CORSU hospital, Uganda during a partner visit. Credit: Smile Train

By Elizabeth Igaga
KAMPALA Uganda, Jun 16 2026 (IPS)

Global health has a habit of mobilizing around the visible and the dramatic. Ebola, malaria, and Mpox have all dominated headlines related to Africa in recent years, and understandably so. But nobody is talking about one of the most consequential regional health crises waiting to happen.

When a child needs surgery, the first challenge is not the procedure itself. It is getting them safely to sleep. For decades, hospitals across sub-Saharan Africa have relied on a drug called halothane to do that. It has a faintly sweet smell, which means children breathe it in calmly, without distress or resistance. It’s affordable, stable in warm climates, and it works. Although there are anesthetics with fewer side effects that have been used for decades in higher-income countries, in low-resource settings with limited options, it has been indispensable.

Dr. Elizabeth Igaga, Senior Director of Program Safety, Smile Train

In 2023, the sole global manufacturer of halothane abruptly and permanently shut down production. There was very little warning time, no wind-down period, and no coordinated plan for the countries most dependent on the drug. What remains is the stock that was already distributed across global markets. That stock will not last much longer. Based on what we know about consumption patterns, it is very likely that by the end of 2026 or in early 2027, the last bottle of halothane in Africa will be gone.

I am an anesthesiologist and perioperative patient safety specialist based in Uganda. I work with hospitals across low and middle-income countries to ensure that children who need surgical care receive it safely. Safe anesthesia is not a luxury. It is a foundation of surgical care. What I see on the ground makes the halothane shortage one of the most pressing and underacknowledged patient safety problems in global health today.

The obvious alternative is a drug called sevoflurane. As a more modern anesthetic, it’s safer and more effective than halothane. But in Uganda, sevoflurane costs approximately ten times more than halothane. In settings where health budgets are already stretched, this is not a simple swap.

This matters on an enormous scale. Research published in The Lancet shows that outcomes for children undergoing surgery in Africa are already significantly worse than those in high-income countries, including African mortality rates that are approximately 11 times higher. Remove access to the one anesthetic drug that most African pediatric facilities currently rely on, and those numbers will get worse.

The demographic stakes make this more urgent still. Africa is projected to be home to roughly 40 percent of the world’s children by 2050. The continent already carries an enormous burden of conditions that can only be treated with surgery, much of it in pediatric populations, not to mention a child hit by a car, diagnosed with cancer, or rushed to the hospital with a ruptured appendix. All of these children face the same anesthesia infrastructure as everyone else, and when that infrastructure fails, what would have been a survivable crisis becomes something far worse.

What is often misunderstood about the transition away from halothane is that it is not simply a matter of substituting one drug for another. It is a systems problem with at least four distinct components that all need to move at the same time.

The first is government procurement. Halothane is currently embedded in national drug budgets across the continent at a price point that sevoflurane cannot match. Ministers of health and national procurement authorities must make an active decision to fund the difference and begin revising their drug budgets now, before shortages force their hand under emergency conditions. Market dynamics mean dwindling supplies will make halothane increasingly expensive, another component that could put essential surgeries out of reach.

The second is equipment. Many anesthesia machines currently in use across African hospitals are not compatible with sevoflurane without modification or outright replacement. That requires hospital-by-hospital assessment to understand what is needed before a single bottle of the new drug is ordered. Committing to a new anesthetic without first confirming that the infrastructure can deliver it safely is not a transition plan; it is a different kind of crisis.

The third is the supply chain. Sevoflurane needs to be formally incorporated into national essential medicines lists and procurement frameworks so that it reaches facilities reliably and at negotiated prices, rather than arriving sporadically through fragmented channels.

The fourth is workforce training. The majority of anesthesia care in Africa is delivered by non-physician anesthesia providers rather than doctors. Administering anesthesia to a child is one of the most technically demanding and emotionally weighty responsibilities in medicine, requiring precise judgment in real time when the margin for error is razor-thin. Nobody should be put in the position of performing that task for the first time on an unfamiliar drug in the middle of an emergency. These providers need structured, supervised training on sevoflurane before the transition happens, not after. National anesthesia societies have a direct role to play here, both in alerting their members to what is coming and in developing and delivering the training programs they will need.

The World Federation of Societies of Anaesthesiologists has already called on national and regional health authorities to rapidly budget for and implement a safe transition to sevoflurane. That call deserves a far more urgent response than it has received so far. Countries that stockpiled halothane may have a few additional months of runway. Countries that did not are already running low.

The Philippines and Indonesia have already navigated this shift successfully, and they offer a promising roadmap, including training for local biomedical engineers and anesthesia providers to ensure the transition is safe, practical, and sustainable. The lesson from those experiences is not that transition is easy, but that it is entirely achievable when governments, health systems, and the medical community move together with a shared plan.

The difference between those countries and much of sub-Saharan Africa right now is time and attention. Unlike other urgent global health situations, halothane depletion will not arrive with an outbreak curve or a dramatic headline. It will arrive quietly, one empty bottle at a time, in a hospital where a child needs surgery and the only drug the staff knows how to use is no longer on the shelf. By the time that moment becomes a crisis visible enough to mobilize a response, it will already be too late.

We know this is coming and what the solution requires. The only thing that remains uncertain is whether we will treat it with the urgency it deserves.

Elizabeth Igaga is Senior Director of Program Safety, Smile Train

IPS UN Bureau

 

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