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East Darfur, Sudan — Hawa Adam did not expect a childhood illness to kill her son. Ali was two years old when he fell sick on February 25 in Labado, in Sudan’s East Darfur state. He died two days later.“I thought it was one of the ordinary childhood diseases,” the 37-year-old told Al Jazeera. “I never imagined I would lose my child to this epidemic.”Hawa attributes his death to the absence of basic medical care – no vaccination, no qualified doctors. “Most doctors”, she says, “left the area after the war broke out, forcing those with means to seek treatment abroad, in South Sudan or Uganda.”The Collapse of Routine Immunization in East DarfurA measles outbreak has struck several Labado districts since March, killing approximately 70 people and infecting about 1,000 others across 12 residential neighbourhoods, in a population of roughly 12,000, which includes displaced people who arrived during the war, according to Mohamed Abdel Aziz, 32, coordinator of the Labado crisis unit.Those numbers were disputed by East Darfur’s health director, Dr Jabir al-Nadeef, who confirmed to Al Jazeera that measles has struck four districts of the state, but only reported 300 cases and 26 deaths, figures that diverge substantially from those documented by the Labado emergency room.“Vaccines only arrived on April 11 from Chad via UNICEF [United Nations Children’s Fund ], after a prolonged period with no supply, and a vaccination campaign is scheduled to run from April 18 to 24 across the state,” he said.Measles is one of the world’s most contagious diseases, spread by contact with infected nasal or throat secretions or breathing in air that was breathed out by someone with measles, according to the World Health Organization (WHO). Outbreaks can result in severe complications and deaths, especially among young, malnourished children.Transmission: Contact with infected secretions or airborne particles.Current Coverage: Measles vaccination has fallen to 46 percent.Routine Immunization: First dose of diphtheria, tetanus, and pertussis dropped to 48 percent in 2024.Quantifying the Human Cost: Disputed Death Toll and Economic BarriersThe first measles cases in Darfur in the current outbreak were recorded in January, according to UNICEF. It is unfolding against the backdrop of a near-total collapse of public health infrastructure across Darfur, where war has gutted facilities, halted routine vaccination and driven out medical personnel.“We discovered the outbreak by accident,” Abdel Aziz, the coordinator, told Al Jazeera. The teams had been conducting home visits for a fire-prevention workshop when they saw the scale of the outbreak, with almost half of the homes visited having measles cases.In the al-Nil neighbourhood, Ismail Issa, 38, lost his two-year-old daughter Makarem on March 11. His brother Ahmed lost an 18-month-old son, Issa, on March 25. Then Hasan, the three-year-old son of Ismail’s sister Medeeha, died on March 23. All three families live in adjoining homes, and the infection passed between them.Abdel Aziz traced much of the death toll directly to a supply failure. Medicines ran out at the government health centre on February 23. Drugs remain available at private pharmacies, but most residents cannot afford them.Intravenous fluids: 8,000 Sudanese pounds ($20.50).Antibiotics: 10,000 to 15,000 pounds ($25.60 to 38.40).A Public Health Catastrophe UnfoldingAsmaa Jalaluddin, 28, lives in the Dar al-Naim West neighbourhood of Labado with her three children. Her three-year-old daughter, Mashaer Rajab al-Sheikh, fell ill on April 5 with fever, diarrhoea and persistent vomiting. She stopped eating and kept her eyes shut for four days.On April 8, Asmaa took her to the Labado health centre, where she was told her daughter had measles. With no medicines available, she was directed to travel to Shuairiya, 40 kilometres north. There, on April 10, Mashaer received fever reducers and vitamins and slowly began to open her eyes again. She was discharged two days later.Local doctors are now calling for intervention from international health organisations, noting that diseases that had been eliminated are returning.UNICEF spokesperson for Sudan, Eva Hinds, told Al Jazeera that “measles cases continue to be reported across Darfur, with insecurity, displacement, damaged health facilities, and prolonged disruption to routine immunisation all constraining the response.”UNICEF says that a measles-rubella vaccine catch-up campaign has been completed across all localities in Central Darfur and West Darfur, as well as parts of North and South Darfur, reaching approximately 2.1 million children aged nine to 14. Vaccination in remaining areas, including East Darfur, is scheduled for mid to end of April, aiming to reach close to 750,000 children across all nine of the state’s localities.The Long Road to RecoveryFor the families of Labado, the calendar offers little comfort. In the al-Nil neighbourhood, three siblings buried their children within days of one another over the Eid holiday. In Dar al-Naim West, a mother counts the days until her daughter’s 14-day isolation ends. In the Safaa neighbourhood, Hawa Adam has already buried hers.“They could have still been alive,” Hawa Adam said. “Those without money die in Darfur.”

Tehran, Iran – Amid a tentative cease‑fire with the United States and ongoing war‑related disruptions, Iran’s government has shifted its economic policy to prioritize the import of essential goods at a subsidised exchange rate. Reinstating a Preferential Exchange Rate for Essential Imports The cabinet added a clause to the annual budget allowing a 285,000 rials per US dollar rate for wheat, medicines, medical equipment and baby formula—far below the open‑market rate of 1.55 million rials and the budget rate of 1.23 million rials. This policy reversal follows protests against the previous plan to eliminate the cheap rate. Financial Scale of Subsidies and Sovereign Fund Withdrawals Up to $3.5 bn from oil and gas proceeds will be funneled to a network of trustees for essential imports. An additional $1 bn is slated to be drawn from the National Development Fund to purchase sugar, rice, barley, corn, soy‑bean meal, red meat and chicken. Current monthly cash assistance to citizens is less than $10 per person. Implications for Iranian Food Security and Inflation Officials say the cheap rate is intended to “guarantee food security” across 11 categories that have seen sharp price hikes, though exact inflation figures were not disclosed. The government is also considering larger handouts and electronic coupons to offset what is described as one of the world’s highest food‑inflation rates. Outlook for Iran’s Economy Amid Ongoing Conflict Analysts warn that while the exchange‑rate subsidy may provide short‑term relief, the broader economy remains vulnerable to sanctions, port blockades and the continued internet shutdown that has crippled jobs and commerce. The expanded powers granted to border governors to streamline imports could mitigate shortages, but persistent smuggling concerns and rising consumer anxiety suggest that price stability will be hard to achieve without a durable cease‑fire.

MPs Challenge New Ministerial Power Over NHS Drug PricingThirty‑one MPs from Labour, the Greens, the Liberal Democrats, the SNP, Plaid Cymru and independents have signed a House of Commons motion opposing a statutory instrument that gives Wes Streeting the authority to tell the National Institute for Health and Care Excellence (NICE) which cost‑effectiveness threshold to apply when appraising new medicines.The opposition frames the change as a “power grab” that could erode the agency’s role as an international benchmark for value‑for‑money drug decisions.Numbers Behind the Opposition31 MPs have signed the motion.The statutory instrument was issued in 2026 as part of a broader UK‑US drug‑pricing deal.Health experts warn the deal could add billions of pounds to the NHS drug bill.Potential Consequences for NHS Funding and Drug RegulationCritics, including former health secretary Andrew Lansley, argue the new power may conflict with the Health and Social Care Act 2012, which protects NICE’s independence. If the threshold is lowered, pharmaceutical companies could secure higher prices, forcing the NHS to divert funds from other services such as surgeries or nursing staff.Think‑tanks like the Health Foundation warn that a larger drug spend will trigger “difficult cuts” to preventative and primary‑care programmes.What the Next Parliamentary Battles May HoldWith the motion tabled as a “prayer”—a formal way for MPs to register dissent on secondary legislation—the opposition could pressure the government to amend or repeal the instrument. John McDonnell and other senior Labour figures have signalled readiness to push for a full debate in the Commons, while the House of Lords may see a “motion of regret” from Lord Lansley.If the government persists, legal challenges could arise over the compatibility of the statutory instrument with existing health law, potentially leading to judicial review.

The Petrochemical Achilles Heel of Modern MedicineThe escalating conflict in Iran has triggered a critical vulnerability within the NHS, revealing that modern healthcare is inextricably linked to the volatile petrochemical industry. As the war disrupts shipping lanes and energy infrastructure, the health service is bracing for a potential 'huge shock' of price increases and supply shortages that could impact everything from basic surgical gloves to complex cancer treatments.The Strategic Bottleneck at the Strait of HormuzThe core of this crisis lies in the dependency on naphtha, a byproduct of crude oil used to manufacture the raw materials for millions of medical products. Approximately 60% of naphtha used in Asia is sourced from or routed through the Middle East, making the Strait of Hormuz a choke point for global healthcare logistics. This disruption is not merely theoretical; it is already causing shutdowns at Asian chemical makers and forcing suppliers to declare force majeure.Quantifying the Cost of DisruptionNHS Spending Scale: The NHS is one of the world's largest bulk buyers, spending £21.6bn on medicines and £8bn on equipment and consumables annually.Petrochemical Price Surge: Naphtha prices in north-west Europe have soared from $560 to over $900 per tonne since February.Medical Equipment Inflation: The average price of a box of 1,000 synthetic rubber gloves has jumped 40% to $29.Material Cost Increases: Polyester fibre, used for surgical masks and gowns, has surged by 28% in recent months.The Fragility of NHS Supply ChainsExperts warn that the supply chains for essential treatments are 'absolutely Byzantine' and often rely on just a single supplier. Richard Sullivan, a professor at King's College London, highlights that while the NHS has built buffers to mitigate immediate risks, the thinness of these chains means that prolonged disruption could lead to severe stockouts. Furthermore, the disruption of airspace hubs like Dubai and Doha is complicating the air freight of medicines from India, the world's pharmacy.Navigating the Post-Conflict Healthcare LandscapeThe immediate future for the NHS will likely involve a shift toward more prudent resource management. With suppliers like Polyco Healthline and Karex signaling further price hikes of up to 50%, the health service may be forced to enforce stricter waste reduction protocols. Jim Mackey has already warned that the NHS will require extra government funding to absorb these cost shocks, suggesting that the war in Iran could fundamentally alter the financial structure of the UK's healthcare system for years to come.

The Global Medicine Crisis UnfoldsThe United States and Israel's war on Iran has pushed up the price of nearly everything, with recent days seeing pharmacists note a spike in the price of medicines and contraceptives. In the United Kingdom, pharmacies are charging 20 to 30 percent more for over-the-counter medicines, while the common painkiller paracetamol has more than quadrupled in price. In India, chemists are reporting price rises of common painkillers of as much as 96 percent.Supply Chain Disruption Behind Medicine Price HikeSince the early days of the war, Iran has blocked the Strait of Hormuz, through which 20 percent of the world's oil and liquefied natural gas (LNG) supplies are shipped in peacetime. This has disrupted pharmaceutical supply chains, which are reliant on oil supplies. Pharmaceuticals are tied to petrochemical feedstocks, with many logistics routes between East Asia and Europe having important sea and air transhipment stops in the Gulf, particularly in Dubai.Furthermore, 35 percent of pharmaceuticals move by air, and about 90 percent of critical or life-saving pharmaceuticals and vaccines do so too. With the US-Israel war on Iran causing severe disruption for airlines, featuring widespread cancellations, airspace closures and a looming jet fuel crisis, approximately 22 percent of global air cargo flows are exposed to Middle East disruptions.Soaring Prices for Essential MedicationsPharmacies in the UK and India have noted significant increases in the price of paracetamol, a drug commonly used to treat headaches and the flu. In India, a former board member of the Visakha Chemists Association reported that paracetamol is rising by approximately 96 percent, with potential further increases of 30 to 40 percent due to spikes in raw material costs.In the UK, the price of paracetamol has also increased substantially. Olivier Picard, chair of the National Pharmacy Association, noted that the price he pays wholesalers for a pack of 100 500mg paracetamol tablets had jumped 41 pence to 1.99 pounds by the end of March, though it has since eased back to 1.09 pounds.Unequal Impact Across NationsThe impact of this pharmaceutical crisis varies significantly across different countries. The United States has domestic hydrocarbon and petrochemical supply, while China can source most of its demand from elsewhere. India, however, is a major producer of pharmaceuticals and depends on supplies from the Gulf, making it particularly vulnerable.The European Union has a 'solidarity mechanism' with stockpiling strategies including pharmaceuticals, with country-specific stockpiling requirements of two-10 months' worth of medicines. However, the problem is more acute for Global South countries, especially in sub-Saharan Africa, that have fewer or no stockpiles and limited financial resources to afford the price increases.Future Outlook for Global Medicine SupplyWhile the situation remains challenging, there are signs that some pharmaceutical supply chains may be stabilizing. The countries most likely to continue suffering are those directly touched by the conflict and regional disruption, including Lebanon, Palestine, and Iran. Fragile, aid-dependent countries that were already under severe pressure before this war also face significant risks.Import-dependent Gulf markets represent another conditional risk group, particularly for cold-chain and cancer medicines. However, in the Middle East region (excluding conflict zones), the situation remains more manageable than feared, with risks and delays rather than a generalized collapse. Pharmaceutical shipments continue to receive priority in air cargo due to their critical nature.

The Geopolitical Ripple Effect on UK MedicineThe ongoing conflict in Iran is creating a significant ripple effect across the UK healthcare sector, driving up the cost of essential over-the-counter medications and threatening supply chains. Community chemists are reporting that the war has pushed up the price of widely used medicines, including painkillers and hay fever medication, leading to a crisis for both patients and pharmacists.The Surge in Over-the-Counter Medication CostsCommunity chemists are charging customers 20-30% more for paracetamol than they did in February, according to the National Pharmacy Association (NPA). Over-the-counter prices for cetirizine tablets, a common hay fever medication, have also risen by the same margin. Furthermore, many pharmacies have run out of certain strengths of aspirin and co-codamol, with some temporarily halting sales of aspirin altogether due to supply constraints.The Supply Chain Shock: Fuel and FreightThe jump in petrol and diesel prices since the war began nearly eight weeks ago has increased manufacturing and transport costs for medicine suppliers by 40-50%. The conflict has also doubled air freight costs, as one in five NHS medicines comes in by air. Additionally, supplies of petroleum derivatives from the Gulf, essential for making common medications like paracetamol and aspirin, have been strangled.Paracetamol Price Spike: Purchase price for a pack of 100 500mg tablets jumped from 41p to £1.99 before easing back to £1.09.Reimbursement Gap: The government reimburses only 49p for a prescribed 32-pack of paracetamol, often forcing pharmacies to sell at a loss.Pharmacy Closures: Over 1,400 community pharmacies have closed since 2020, with one or two closing per week.The Crisis for Community Pharmacies and the NHSManufacturers of generic off-patent drugs operating on low margins have started to increase their prices, driving up the NHS medicines bill. While suppliers have long-term agreements with NHS hospitals, they have more leeway over drugs provided to pharmacies. This has led to a record 230 items on the price concessions list in March, compared to 90 in the same month last year. However, popular items like paracetamol and cetirizine remain excluded, meaning pharmacies are absorbing the cost.Looming Shortages and Future Price HikesAs manufacturers move to replenish stocks, transportation costs have risen by 700%, and some chemicals are in very short supply. Mark Samuels, chief executive of Medicines UK, warned that if the conflict continues, rising prices or shortages of essential medicines could occur as soon as the next few weeks. Patients are also warned that allergy sufferers could face more price increases by May or June, the peak of the hay fever season.

The Fallout of Theramex's Regulatory CollapseOne of the UK's largest producers of hormone replacement therapy (HRT) has been publicly reprimanded by the Prescription Medicines Code of Practice Authority (PMCPA) for "systemic failures" that directly jeopardized patient safety. The case against Theramex, the maker of popular drugs Evorel and Intrarosa, highlights a critical breakdown in compliance standards that regulators say has eroded trust in the pharmaceutical industry.Systemic Failures in HRT Safety ProtocolsThe PMCPA found that Theramex breached the Association of the British Pharmaceutical Industry (ABPI) code of practice 21 times. These failures were not isolated incidents but a pattern of negligence that included:Failing to update crucial prescribing information for years, including for Evorel patches.Not clearly warning that certain drugs, such as Yselty (linzagolix), must not be used during pregnancy.Ignoring internal whistleblower concerns regarding incomplete side-effect data.The Scale of Prescribed RiskThe impact of these failures is magnified by the sheer volume of prescriptions. Evorel patches, which contain estradiol, are among the most prescribed forms of transdermal HRT, with 250,000+ items issued in the last financial year. Overall, nearly 10 million items of estradiol were prescribed in the 2024/25 financial year, meaning thousands of patients may have been exposed to incomplete or outdated safety data.The Erosion of Self-RegulationThe decision by Theramex to leave the PMCPA's jurisdiction in January 2026 has sparked a debate on the efficacy of self-regulation. The PMCPA condemned the move, stating it inevitably delayed oversight. However, the Medicines and Healthcare products Regulatory Agency (MHRA) has stepped in, asserting that leaving the self-regulatory framework does not grant immunity. Dr Amit Aggarwal noted that Theramex has "brought discredit upon" the industry, signaling a potential shift toward stricter, government-led enforcement.Future Scrutiny and Industry ReformLooking ahead, the Theramex case is likely to trigger a comprehensive review of compliance frameworks across the pharmaceutical industry. With the MHRA retaining full legal powers to investigate and prosecute criminal offences, companies can no longer rely on voluntary self-regulation to shield them from liability. The industry faces a critical juncture where patient safety must take precedence over administrative efficiency.

President Donald Trump signed an executive order on Saturday in the Oval Office, joined by podcaster Joe Rogan, to fast‑track the federal review of psychedelic drugs such as ibogaine, aiming to broaden treatment options for serious mental illness.The ceremony highlighted Rogan’s long‑standing advocacy for ibogaine, a plant‑derived compound used by some veteran groups to address post‑traumatic stress. Rogan recounted texting Trump about the drug, to which the president replied, “Sounds great. Do you want FDA approval? Let’s do it.”Trump framed the order as a lifeline for patients: “Today’s order will ensure that people suffering from debilitating symptoms might finally have a chance to reclaim their lives and lead a happier life.” He added that successful outcomes could have “a tremendous impact.”In a brief moment of levity, Trump joked, “Can I have some, please? I’ll take some.” He quickly refocused, noting he has no time for depression and stays busy instead.The move enjoys rare bipartisan backing, despite ibogaine and other psychedelics remaining classified under the federal government’s most restrictive drug schedule.Health Secretary Robert F. Kennedy Jr. had previously pledged to ease medical access to psychedelics, a stance echoed in the new order, which directs the Department of Health and Human Services to allocate at least $50 million to states developing programs for serious mental‑health conditions.Simultaneously, the FDA is set to issue “national priority” vouchers for three psychedelic candidates. Commissioner Marty Makary said the vouchers will enable rapid approval “if they align with our national priorities.”The agency also plans the first human trials of ibogaine in the United States, overcoming earlier concerns about potential fatal heart effects.Ibogaine’s origins trace back to the Bwiti religious ceremonies in West‑Central Africa, where the plant has been used for centuries in spiritual contexts.Former Navy SEAL Marcus Luttrell, also present at the event, praised ibogaine, stating, “It absolutely changed my life for the better.”Rogan’s endorsement and the executive order have added a new dimension to Trump’s 2024 campaign narrative, even as he has publicly questioned the administration’s stance on the war with Iran.

The ongoing conflict between Israel and Iran has led to a substantial increase in global fuel prices, affecting Americans and forcing them to make difficult trade-offs. Many are struggling to access essential items, including medication and groceries, while others are facing financial insecurity and even homelessness.The impact of rising gas prices is being felt across various aspects of life, from accessing essential medicines to facing the brink of homelessness amid an already rising cost of living. For Mandy, a 42-year-old mother in central Utah, higher gas prices have made it harder to visit one of her children, who has disabilities and lives hours away.“Before [Donald] Trump and [Israeli prime minister Benjamin] Netanyahu started their war, gas in my town was $2.70 a gallon. Now it’s $4.19 and I’m terrified it’s going to go closer to $5 before all is said and done. One of our children is disabled and lives in a group home two and a half hours away,” she said.Rising gas prices are also affecting people’s ability to access necessary medication. Lisa, a 56-year-old living with disabilities on a tribal reservation in Oregon, said rising gas prices had disrupted her ability to access necessary medication.“My caregiver and I have had to cut back our trips to pick up my prescriptions, even though they are necessary. Because I live in rural Oregon, the basic necessities are 40 minutes away, so if a doctor calls in an additional prescription after I’ve already been in town for the week, that prescription has to wait for the following week for me to pick it up,” she said.The strain is also being felt by food banks and pantries. Melissa Meyer, chief executive of IPM Food Pantry in Cincinnati, Ohio, said rising gas prices had driven more people to rely on food pantries – even as those same costs strain the operations of local food banks and their volunteers.“Increased gas prices put additional costs on our operations as we must increase gas costs for picking up and delivering food across five counties of south-west Ohio … We are not cutting back our services in any way, yet,” she said.The rising cost of fuel is also having indirect effects, such as impacting small businesses and artists. Cathi Newlin, a 63-year-old ceramic artist in Sacramento, California, who also cares for her husband with Parkinson’s disease, said her income had been hit as consumers pull back.“A substantial portion of our household income is generated from the sale of my art and the classes I teach. These are surely luxury items in any economy but when people have to spend more on basics like gasoline, they don’t have as much money or desire to spend on art. The rise in oil prices very much affects my income and the price of my materials,” Newlin said.