WHO charts health gains in the Eastern Mediterranean amid conflict and budget strain
Countries across the Eastern Mediterranean still managed measurable progress in vaccination, disease elimination, health system capacity, and emergency response during a year dominated by war, outbreaks, natural disasters, and shrinking budgets. The annual report presented in Cairo described a region under sustained pressure, yet still producing advances that would have been difficult even in calmer circumstances.
The tension at the center of the report is stark. The Eastern Mediterranean holds only 9% of the world’s population, but it accounts for nearly half of all people requiring humanitarian assistance globally. As of June 2026, WHO was responding to 14 graded emergencies, eight of them at the highest level, Grade 3. During the 12-month period from July 2025 to June 2026, WHO verified 632 attacks on health care across the region, with more than 1,530 people killed.
Funding followed the same downward slope. The regional base programme budget for 2026–2027 was cut by 14%, and the regional health emergency response remained more than 40% underfunded at the end of June 2026. In 2025, budget reductions affected nearly 2,000 health facilities and close to 26 million people across seven countries. Dr Adham Ismail put the pressure plainly: “There comes a point when doing more with less means doing less for people who need more.”
Elimination targets held even as service delivery came under strain
The clearest signal of resilience came from communicable disease control. Egypt, Libya, and Tunisia eliminated trachoma as a public health problem. Morocco achieved hepatitis B control. Kuwait and Qatar were verified as having eliminated measles and rubella for the first time. Oman sustained elimination of mother-to-child transmission of HIV and syphilis. Those outcomes matter because elimination is not a single campaign victory; it reflects years of immunization coverage, surveillance quality, laboratory confirmation, and primary care access that can withstand political and operational disruption.
These are not abstract public health achievements. Trachoma elimination depends on sanitation, access to antibiotics, and repeated surveillance in communities where infection can recur silently. Measles and rubella elimination requires consistently high vaccine uptake and rapid outbreak detection, because both viruses exploit even brief immunity gaps. Sustained elimination of vertical transmission of HIV and syphilis points to a functioning antenatal system, early testing, and reliable treatment pathways for pregnant women and newborns.
The Regional Healthy Cities Network also expanded to 186 cities, with activity noted in Bahrain, Saudi Arabia, and the United Arab Emirates. Urban health platforms rarely draw the same attention as outbreak response, yet they shape the daily conditions that determine whether prevention sticks: safer environments, stronger local health promotion, and better integration of services across rapidly growing populations.
Vaccination campaigns reached millions despite disrupted access
Immunization delivery remained one of the report’s most consequential themes. In Sudan, coverage with the third dose of pentavalent vaccine rose from 38% to 71% in one year. That jump matters because pentavalent coverage is a basic marker of whether routine childhood immunization can function under stress. In Pakistan, the first national HPV vaccination campaign protected more than 9.6 million girls. Iraq carried out its first seasonal influenza vaccination campaign, reaching about 800,000 people. Yemen trained and equipped 6,000 health workers to reinforce routine immunization.
The public health logic here is direct. Vaccines only avert disease when delivery systems survive conflict, displacement, cold chain interruptions, and workforce shortages. A campaign that reaches millions in a single year can prevent future cervical cancer burden, reduce influenza complications in high-risk groups, and create a wider protective buffer against outbreaks that usually flourish when routine services collapse.
One country’s numbers often conceal the operational work behind them, but the report makes the point through scale alone. These gains were achieved while access constraints, insecurity, and supply disruption continued to reshape the region’s health map.
Emergency response remained central to survival in several countries
WHO’s emergency footprint stayed extensive. During the regional escalation in 2026, more than 14 countries were affected. WHO delivered emergency medical supplies to the Islamic Republic of Iran, supported mass-casualty management in Lebanon, and evacuated critically ill patients from the Gaza Strip. In the Syrian Arab Republic, more than 7 million people received essential medicines and supplies. Emergency preparedness expertise was also deployed across the Gulf, while alternative supply routes kept commodities moving after disruption to WHO’s logistics hub in Dubai.
Sudan, Somalia, and Yemen illustrate the operational cost of prolonged instability. Somalia reduced cholera deaths by 93% in 12 months, a result that points to better case management, faster response, or both. Cholera mortality falls only when dehydration is recognized early and treatment is available quickly, which means the real intervention is not a slogan but a functioning referral and supply system. In settings where water and sanitation remain fragile, that capacity can mean the difference between localized transmission and repeated fatal outbreaks.
Health system capacity expanded, but fragility remains visible
Several countries strengthened the back-end systems that keep care available. Saudi Arabia’s medicines regulator, now at maturity level 4, is moving toward becoming the region’s first WHO Listed Authority. Jordan expanded pharmaceutical warehousing capacity by about 50% and reduced medicine stockouts by 30%. Workforce planning advanced through labor market analyses in eight countries, while 14 countries scaled up community-based mental health services.
Those system changes matter because emergency response cannot substitute for routine infrastructure. Warehousing capacity influences whether insulin, antibiotics, and chronic disease medications reach clinics before supply gaps appear. A stronger regulator improves confidence in product quality and oversight. Mental health expansion is especially important in a region where displacement, injury, grief, and trauma have become part of ordinary clinical practice.
Polio surveillance and digital systems kept advancing in parallel
Polio eradication efforts continued to narrow transmission in Afghanistan and Pakistan, the last two countries where wild poliovirus remains endemic. No circulating vaccine-derived poliovirus has been detected in the Gaza Strip since March 2025 or in Djibouti since May 2025. More than 400 environmental surveillance sites across 18 countries and territories are now helping detect the virus earlier.
Digital health also moved forward. All 22 countries and territories assessed their health information systems, 16 updated national health information or digital health strategies, and 12 adopted DHIS2 to integrate surveillance and service data. Better data systems matter because outbreaks are rarely defeated by clinical care alone; they are controlled when laboratory results, case reporting, and service delivery are linked quickly enough to trigger action.
WHO also strengthened its own operating base. During the reporting period, the Regional Office mobilized US$ 690 million in voluntary contributions from 33 new contributors, and more than 70% of regional base programme resources were allocated to country offices.
The report closes with a warning as direct as the numbers themselves: progress made under pressure can be lost under pressure. Predictable financing, stronger health systems, better financial protection, and accelerated elimination efforts will determine whether these gains survive the next cycle of conflict, outbreak, and budget reduction.