The Health Thread

The risk of getting TB disease is among the highest in unhoused and other marginalised persons but the likelihood of them seeking public TB services is low – and finishing lifesaving TB therapy is even lower. The delay is long – very long – for them to get right diagnosis (if at all) – and so are the catastrophic costs which they may incur until getting correctly diagnosed. Not being able to finish lifesaving TB treatment is not helping either- the person suffers and so does the TB response – because we collectively fail to disrupt TB transmission. 

At the world’s largest conference on TB and lung diseases, a couple of scientific presentations provide a strong beam of light to address TB with success (and in a person-centred manner) among those who are at one of the highest risks (of getting the disease – as well as of being left behind).

 Jahangeer Alam, a TB survivor and champion himself, made two important scientific presentations at World Conference on Lung Health in Copenhagen, Denmark. He works with Humana People to People India (HPPI).

Journeying from shadow to light

It is humbling to listen to real experiences of unhoused persons of their journeys from dark shadows in the lung towards treatment and care, and from services that were inaccessible earlier towards receiving person-centred care and getting cured of TB – thanks to HPPI and support and partnership of Indian government’s National TB Elimination Programme (NTEP) and its partners on the ground.

 Jahangeer shared with the delegates of the world conference some of the key learnings from HPPI’s experiences of working with unhoused persons in India since 2017.

Timeless wisdom of Margaret Mead’s words come to life when we hear Jahangeer speak: “Never doubt that a small group of thoughtful committed individuals can change the world. In fact, it’s the only thing that ever has.”

HPPI implemented 7 initiatives during 2017-2025 to find more TB among the unhoused persons in Delhi, India and link them to public services. HPPI developed a person-centred, rights-based, and gender transformative model to do so. There were estimates that the number of unhoused persons in Delhi could be around 300,000.

During 2017-2025, frontline healthcare workers of HPPI reached out to 225,022 unhoused persons who were highly vulnerable to TB and hard to reach. Out of those screened for TB, 10,976 people were found with presumptive TB and offered a (free) confirmatory TB test in government facility. 2283 unhoused persons were found to have active TB disease and 53 of them had a very serious form of TB, referred to as drug-resistant TB (where TB bacteria become resistant to some of the most powerful anti-TB medicines).

Overall, for every 99 unhoused persons screened for TB, 1 was found with active TB disease between 2017-2025 by HPPI. However, in some areas or projects, this rate was alarmingly high: 1 in every 44 screened for TB had the disease.

 Making a difference

 When HPPI began working with unhoused persons in 2017, a lot of them dropped out of care. 15% was the loss to follow up rate. And dropping out of lifesaving TB treatment meant that the person continues to suffer, has higher risk of TB death, and the disease keeps spreading to others (if the person had lung TB). Death rate among the unhoused peoples in 2017 who were on TB treatment was 8.8%.

 HPPI model demonstrated that it is possible to reduce human suffering and save lives: loss to follow up rate dropped to 1.7% by 2024 (from 15% in 2017), and TB death rate dropped to 2.5% by 2024 (from 8.8% in 2017).

 Jahangeer explained that there were 3 groups of unhoused persons HPPI was working with: those living on the roadside, shelters and temporary slums (referred to as ‘jhuggi’).

 “Unhoused persons had higher TB vulnerability because of several reasons: higher substance use (such as alcohol, tobacco or drugs), living in unhygienic conditions, low TB awareness and health literacy, and a range of access barriers to reach public health services. Lack of government identity documents, gender identities, fear of discrimination or losing daily wage were other barriers we found that blocked access to existing services,” said Jahangeer.

 In-person follow up and support to unhoused persons based on HPPI model was a gamechanger

 Jahangeer Alam shared that trained frontline healthcare workers to implement the HPPI model were critical to follow up and support unhoused persons. Those with TB disease and receiving treatment could finish the therapy successfully, thanks to the workers on the ground.

 HPPI had established a flexible partnership with local private X-Ray laboratories so that unhoused persons could be brought by their workers to get X-Ray screening at a community-convenient time (for example, early morning or late evening if convenient to the person being screened). “Typical 9am to 5pm would not work for most of them. Community-convenient and friendly timing must be adopted,” said Jahangeer.

 HPPI workers helped collect and take quality sputum samples of unhoused persons to government laboratories for confirmatory testing. For those with active TB disease, workers accompanied them for initiation of treatment from the nearest government centre.

 Daily follow up during the first 2 weeks after initiation of TB treatment, and then at least once weekly follow up till the person got cured, proved very helpful to ensure the unhoused person could adhere to TB therapy. Counselling, facilitating medical consultations in government centres as needed for side effect management or other healthcare needs, facilitating access of unhoused persons to social welfare schemes such as nutrition, financial support directly transferred by the government of India to their bank account during TB treatment every month, and other such benefits could also happen because of the assistance provided by HPPI workers on the frontline.

 Linkage to local community people also proved important because location of unhoused persons kept changing on an ongoing basis. HPPI workers identified such local allies and fostered these relationships. These allies included unhoused persons who were cured of TB (TB survivors who became TB champions), local vendors, caretakers of night shelter homes, among others. These allies were very helpful for HPPI workers to follow up with unhoused persons on an ongoing basis.

 “Intensified treatment adherence support is lifeline. We need to make this available to every unhoused person if we want them to adhere to the treatment and finish it. Field officer is needed on the ground if we want favourable TB programme outcomes from high-risk TB populations,” stressed Jahangeer.

 HPPI screened unhoused persons for TB using a range of approaches: verbal screening, X-Ray screening and AI-based cough screening (cough screening is being tested currently, showing promising initial results, but is not yet a part of government programme).

 Those who were found presumptive for TB were offered a confirmatory TB test at the nearest government-run facility (thanks to NTEP).

 But even sputum collection could become a challenge. Multiple efforts were needed in some instances and support of local communities remained vital, said Jahangeer – reemphasising the need of trained frontline workers to support unhoused persons regularly.

 Reducing diagnostic delays is key

 Leveraging, Engaging and Advocating to Disrupt TB transmission (LEAD) is another flagship initiative of HPPI that has demonstrated robust impact in reaching to unhoused and other marginalised persons in urban areas of India. “According to several studies in India, delay in TB diagnosis contributes to increased TB transmission, morbidity and higher mortality especially among marginalised populations, such as those living on the roadside, under flyovers, or in very temporary structures,” said Jahangeer Alam at the World Conference on Lung Health 2025. “Reducing diagnostic delays also reduces out of pocket expenses.” Delay in diagnosis also fails us in breaking the chain on infection transmission. We cannot end TB unless we disrupt TB transmission and take care of everyone with the TB bacteria in a science-based and person-centred manner.

 There is also a deadly synergy between diagnostic delays and catastrophic costs – both need to be eliminated if we are to ensure all those in need can access public services in a person-centred manner.

 “In 2024-2025, the turnaround time from identifying a person with presumptive TB to correct diagnosis for 75% of people was less than 5 days, and for 92% of them it was less than 10 days,” said Jahangeer. “Remaining 8% people took longer time as they needed further medical tests.”

 Three-fold increase in molecular testing

 During May 2023 and April 2024, LEAD-1 was first implemented during which 30% of those with presumptive TB were offered WHO-recommended upfront molecular testing in nearest government-run health facility (thanks to NTEP). Rest of them were offered microscopy (or were bacteriologically not confirmed and put on treatment upon expert medical advice).

 But in LEAD-2 (October 2024-January 2025, which was disrupted due to funding cuts and reinitiated recently), upfront molecular testing increased by almost 3 times to around 90%.

 This is a major science- and evidence-based difference HPPI could demonstrate with support from NTEP. Sputum microscopy underperforms in diagnosing TB (misses 50-60% of TB cases). That is why WHO called upon countries in 2018 to completely replace microscopy by 2027 with upfront molecular testing (that finds almost all TB and also tests if TB bacteria is resistant or sensitive to rifampicin – one of the most powerful anti-TB drugs). Political Declaration adopted at 2023 United Nations General Assembly High Level Meeting on TB re-echoes this promise to offer upfront molecular testing to 100% of those with presumptive TB. We cannot miss TB if we are to end TB. Right and timely diagnosis is entry gate to right treatment, care and support.

 Jahangeer underlines HPPI’s approach of encouraging unhoused persons to seek healthcare, be aware of their rights, and seek public services including social welfare support. Street plays to engaging people especially cured ones in public awareness rallies and other such initiatives have proven helpful.

 If we are to end TB and deliver on SDG-3 goal of ensuring all are healthy where no one is left behind, we need to scale up proven initiatives like that of HPPI and serve those who are most underserved.

Shobha Shukla, Bobby Ramakant – CNS

(Shobha Shukla is the founding Managing Editor of CNS (Citizen News Service) and Bobby Ramakant works as CNS Health Editor. Both are on the boards of Global Antimicrobial Resistance Media Alliance (GAMA) and Asia Pacific Media Alliance for Health, Gender and Development Justice (APCAT Media). Follow them on Twitter/X: @Shobha1Shukla, @BobbyRamakant, @CNS_Health

According to the latest WHO Global TB Report 2025 released a week ago, tobacco smoking is among the top-5 risk factors for the deadliest of all infectious diseases worldwide – tuberculosis (TB). In countries with alarmingly high tobacco use, like Indonesia, tobacco use is the biggest risk factor for TB. Tobacco is also among the major common risk factors for a range of other non-infectious (or non-communicable) diseases, such as heart diseases and stroke, cancers, diabetes, chronic respiratory diseases, among others.

 If we are to protect people from TB or other deadly diseases and avert untimely deaths, the writing on the wall is clear: end all forms of tobacco and nicotine use. If we can protect human beings and our planet from tobacco and nicotine, we will majorly help governments implement lifesaving health policies and address infectious and non-communicable diseases effectively. Holding tobacco and nicotine industry liable for the deadly harm they are causing to human life and our planet remains critical too.

 No one should suffer or die of tobacco or nicotine use

 “Tobacco use is the single largest preventable cause of death globally. Over 8 million people die of tobacco use every year in the world. We can entirely prevent this manmade (or tobacco industry propelled) epidemic,” said Dr Tara Singh Bam, a noted global health leader and tobacco control advocate. Dr Bam serves as Asia Pacific Director (Tobacco Control) of Vital Strategies and Board Director of Asia Pacific Cities Alliance for Health and Development (APCAT), and till recently led International Union Against Tuberculosis and Lung Disease (The Union) in the Asia Pacific region. 

Dr Bam is right: Good news is that all 3: TB, nicotine and tobacco are preventable. We need to support all tobacco and nicotine users and help them quit, become tobacco-free and nicotine-free – and protect others from such deadly products. Also, we have to ensure that we are protecting everyone from TB and ensuring that right and timely diagnosis, correct treatment, care and support is accessible to everyone with TB disease in a person-centred manner, said Dr Bam.

TNT is explosive: Tobacco, Nicotine and TB

Tobacco smoking increases the risk of developing TB and makes TB treatment less effective – and – heightens risk of many other deadly diseases too.

Extensive scientific research underlines tobacco smoking’s substantial role in TB, amplifying the risk of infection, death, treatment relapse, heightened clinical severity, and delays in both: diagnosis and treatment, said Dr Bam. He was chairing an important hybrid session at the world’s largest lung health conference, formally known as Union World Conference on Lung Health in Copenhagen, Denmark.

Delayed diagnosis and treatment also means that the person with TB suffers more, has a higher risk of TB death, while the infection spreads to potentially more people – all of this is so avoidable.

 Tobacco use worsens TB outcomes, said Dr Bam while calling upon integrating smoke free policies and tobacco and nicotine cessation efforts into TB programmes.

 Agrees Dr Rakesh Gupta, Chairperson of Tobacco Control section of The Union: There is enough robust scientific evidence to effectively integrate tobacco cessation in TB programmes because it will yield very favourable public health outcomes, economic outcomes and social welfare outcomes. Evidence is there. Time is to really transform the science and evidence into policy, and policy into practice.

 Nicotine has been proven to be as addictive as cocaine and heroin and could even be more addictive. There is no doubt that if we are to live our lives healthy, we need to stay tobacco-free and nicotine-free.

 Dr Rakesh Gupta recommended evidence-based strategy that on every visit, a patient should be asked about tobacco use history along with brief advice on quitting and cessation support as needed. He also recommended that we should record this data (of tobacco use history) in TB treatment cards and registers.

We can prevent 15% TB cases if we help people quit tobacco use

“We can prevent 15% of the new TB cases if we stop tobacco smoking,” said Dr Akihiro Ohkado, Head of the Department of Epidemiology and Clinical Research, Research Institute of TB, Japan Anti-TB Association, Japan. He reemphasised that tobacco smoking significantly contributes to TB diagnostic delays, decreases TB treatment success rates, and also increases the risk of TB release.

Tobacco use steals away the gains made in TB control. Likewise, tobacco and nicotine use are also threatening the gains made in addressing major killers like heart diseases and stroke, cancers, diabetes, chronic respiratory diseases, among others.

Passive tobacco smoking is dangerous too

1 in 10 of tobacco-related deaths are due to passing tobacco smoking every year. Breathing must be smoke-free as a matter of human right.

Dr Tara Singh Bam also reminded the delegates of world conference that despite tobacco being a major risk factor for several lung diseases (like TB, asthma, COPD, among others), it is not a major focus area of world conference on lung health in Copenhagen.

Since TB patients are closely monitored by national TB programmes for the duration of the treatment – 6 months or more – it is an important opportunity to ensure they remain free of tobacco or nicotine use, alcohol use, and do active health promotion.

 We cannot dislocate #endTB goal from SDGs

There are a lot of doable science and evidence-based actions that must get implemented locally. Some of these are – raising awareness about “saying no to all forms of tobacco and nicotine use”, screening people for both (tobacco use and TB), early and accurate TB detection and linkage to care, linking those with tobacco use to cessation services, treatment adherence support, ending all forms of TB related stigma, engaging TB survivors meaningfully to make a difference, implementing the full package of evidence-based tobacco control interventions recommended by the WHO (including raising taxes and smoke-free policies), ensuring that effective tobacco cessation services are functional across the healthcare facilities, and, most importantly, protecting public health from tobacco industry interference.

Tobacco industry interference in public health policy is the biggest obstacle in implementing tobacco control policies. That is why the legally binding global tobacco treaty, formally called the WHO Framework Convention on Tobacco Control, has an important Article 5.3 that was adopted by governments in 2008. Preamble of WHO FCTC Article 5.3 clearly states to protect public health policy from tobacco industry interference because there is a direct and irreconcilable conflict of interest between the two. WHO FCTC Article 19 calls to hold tobacco industries liable for the harm they cause.

 “Break the chain of TB transmission and protect all people from tobacco use,” emphasises Dr Bam.

 Science has proven that it is critically important to screen everyone in high TB burden settings (not just those with symptoms) for TB with WHO recommended tools and offer them upfront molecular testing and linkage to treatment, care and support. Not doing so is among the factors responsible for decades of failure in TB response.

Same goes for tobacco control. No one needs to suffer from diseases caused by tobacco use or die of them. Not implementing tobacco control policies effectively and protecting everyone from tobacco use worldwide is another major failure.

Shobha Shukla – CNS

(Shobha Shukla is a feminist, health and development justice advocate, and an award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service). She was also the Lead Discussant for SDG-3 at United Nations inter-governmental High Level Political Forum (HLPF 2025). She is a former senior Physics faculty of prestigious Loreto Convent College; current President of Asia Pacific Regional Media Alliance for Health, Gender and Development Justice (APCAT Media); Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024); and Host of SHE & Rights (Sexual Health with Equity & Rights). Follow her on Twitter/X @shobha1shukla or read her writings here www.bit.ly/ShobhaShukla)

@Shobha1Shukla, @CNS_Health

Right to health is a fundamental human right. There is no doubt that everyone – without any exception or exclusion – should be able to live healthily in a rights-based manner – everywhere. Along with ensuring high to health is a reality for all, it is also important to recognise health financing as a smart investment.

 One important example is how one of the top threats to global health and food safety and security have been addressed in the past few years. We are referring to antimicrobial resistance (AMR) or drug resistance, which is fuelled by misuse and overuse of medicines. Because of AMR, disease-causing bacteria, virus, fungi and/or parasite become resistant to the medicine (due to inappropriate use of medicine) – and therefore, these medicines become ineffective.

 Misuse and overuse of antimicrobial medicines is rampant in human health, animal health and livestock, food and agriculture – and also polluting our environment.

 So, to address AMR, we need a multi-sectoral response that prevents it in all the sectors where inappropriate use of medicines is happening.

 That is why, global agencies on these sectors, the World Health Organization (WHO), Food and Agriculture Organization of the United Nations (FAO), United Nations Environment Programme (UNEP) and World Organisation for Animal Health (WOAH) joined hands – now known as Quadripartite Joint Secretariat on AMR.

 “Addressing AMR requires urgent, coordinated action and sustained commitment from governments and diverse sectors across the One Health spectrum,” said Dr Jean-Pierre Nyemazi, Director of the Quadripartite Joint Secretariat on AMR.

 9 in 10 countries with national AMR action plans have NO financing to implement them

 Over 90% of the countries came up with their national AMR action plans globally. But only 1 in 10 countries are fully implementing these plans with monitoring and financing in place. For 9 in 10 countries with national AMR action plans, financial crunch has paralysed them from addressing one of the top global health threats using One Health approach.

World leaders at the 2024 UN General Assembly High Level Meeting on AMR had adopted a Political Declaration – one of the promises of which is to ensure that at least 60% of the countries must have fully funded national AMR action plans and implementing them by 2030.” Currently, only 11% of the countries have national AMR action plans with financing in place.

But, where domestic health financing is not adequate, who will fund a multi-sectoral and inter-ministerial national AMR action plan?

 AMR Multi-Partner Trust Fund came to life in 2019

 One option that came to life since 2019 to help low- and middle-income countries to seek financing to implement their national AMR action plans, based on One Health approach, was AMR Multi-Partner Trust Fund of the UN. It was established with an initial US$ 5 million funding from the Netherlands in 2019 so that governments could implement their national AMR action plans where needed in low- and middle-income countries.

 Dr Nyemazi who leads the Quadripartite AMR agencies said in the 5th Annual Global Media Forum on Antimicrobial Resistance: “For us to reach that goal (at least 60% of countries to have fully funded national AMR action plans and implementing them by 2030), governments also committed to mobilise at least US$ 100 million by 2030, including through AMR Multi-Partner Trust Fund (AMR MPTF) and other mechanisms. This is a powerful signal that the world understands the urgency and shared responsibility. However, technical solutions alone won’t win this fight. We need a shared responsibility.”

 AMR MPTF is the world’s principal pooled-financing mechanism specifically to support low- and middle-income countries implement and strengthen multisectoral AMR National Action Plans.

 World AMR Awareness Week (WAAW 2025) observed globally every year during 18-24 November is another reminder for richer governments to fully replenish the fund for global health security.

 We cannot afford to lose the gains made in addressing compelling health challenges

 “The gains made in AMR policy development, risk stalling without the means to act,” said Dr Emmanuel Kabali, AMR Project Coordinator, Food and Agriculture Organization of the UN (FAO).

 The AMR MPTF uniquely harnesses the expertise of the AMR Quadripartite agencies to advance country-led actions across human, animal, plant, and environmental sectors. It is breaking silos because it blends high-level global governance, surveillance, and policy with collaborative local action by leveraging knowledge and coordinating efforts of resource partners, governments, community-based organisations, and other sectors. AMR MPTF is bridging and filling gaps.

 AMR MPTF saving lives and reducing economic loss in Zimbabwe

 Thanks to AMR MPTF, Zimbabwe revived domestic production of the BOLVAC vaccine to combat tick-borne disease (in cattle etc), reducing antibiotic misuse and linking the AMR response to high-priority livestock sector issues, ensuring sustainability, shared Dr Tapfumanei Mashe, AMR Project Coordinator, WHO Zimbabwe. “Zimbabwe is an agricultural economy. So, with initiatives like BOLVAC vaccine we are not merely addressing antimicrobial resistance but also addressing the economic loss it was causing.”

 “There are a lot of scientific studies to show impact of expanded vaccination programmes and improved water, sanitation and hygiene in addressing AMR effectively – we can avert 750,000 deaths occurring due to AMR every year in low- and middle-income countries (LMICs) with such proven approaches,” said Dr Mashe.

 “In 2019, Zimbabwe also introduced typhoid conjugate vaccine (TCV) to prevent typhoid fever caused by bacteria Salmonella typhi. Typhoid fever was also a cause of increasing AMR. Using AMR MPTF resources we are tracking impact of introducing TCV. We saw a reduction in incidence of typhoid fever from 1373 per 100,000 before introduction of TCV vaccine to 341 per 100,000 after the introduction of TCV vaccine. This has also resulted in reduction of AMR,” said Dr Mashe.

 “By introducing typhoid conjugate vaccine, we are not merely addressing AMR but also addressing healthcare of the people and reducing costs which the government was incurring for those with typhoid. In 2018, the first-line medicine for typhoid (ciprofloxacin) was not working because of drug resistance, so we had to treat with azithromycin which was more expensive. So, typhoid conjugate vaccine has not only reduced AMR but also reduced the expenditure for government as well as mortality and morbidity for the people,” said Dr Mashe.

 “As a result of multi-sectoral team working together, we have strengthened surveillance, where we are tracking antimicrobial resistance in different sectors, including human health, animal health, environment and food and agriculture. Quality of medicine is another important area to focus on for us in Zimbabwe. Thanks to AMR MPTF, Zimbabwe is also tracking phosphide resistance by setting up a surveillance system where we can check the prevalence of fortified medicines circulating in the country,” added Dr Mashe.

 Cambodia had ambition but no means: MPTF enabled it to go the One Health way

 In 2019, Cambodia had a multi-sectoral national AMR action plan but hardly any finances to implement it. AMR MPTF funding not only enabled it to implement the plan but also transition from AMR inter-ministerial committee towards a broader One Health governance framework.

 “Without enough financial resources, before MPTF funding, Cambodia’s efforts to implement AMR National Action Plan were very fragmented. When MPTF funding came to Cambodia, we were able to significantly step up the implementation of Cambodia’s National Action Plan on AMR. Resourced by MPTF, we established Cambodia’s national multi-sectoral coordination body based on the One Health approach. It brought together different agencies in sectors like human health, animal health and livestock, food and agriculture, and environment,” said Dr Makara Hak, Adviser on Animal Health, FAO (Food and Agriculture Organization of the United Nations), Cambodia. “Thanks to MPTF support, different committee meetings were convened regularly to review policy regulations to guide implementation of Cambodia’s AMR National Action Plan – something which could never happen in the past.”

 “Cambodia could also accelerate its capacity building efforts at national as well as sub-national levels to address AMR. Over 200 provincial and district veterinarians and over 1000 village animal health workers in the private sector have been trained as per the AMR treatment guidelines. All this could happen due to the support of MPTF,” confirmed Dr Mak.

 “Thanks to MPTF, Cambodia could invest in strengthening animal health laboratories which is very important for addressing AMR as well as for AMR surveillance systems. Cambodia introduced Laboratory Information Management System to ensure that data meets international standards. We also invested in building the capacity of the academia and laboratories (including fishery laboratories) as part of Animal Health Laboratory Network,” said Dr Mak.

 “This progress in Cambodia has unlocked new opportunities to further strengthen AMR response. We received US$ 1 million from AMR MPTF to strengthen Cambodia’s capacity which enabled us to secure another US$ 34 million for AMR and One Health in Cambodia through German Development Bank (KfW). Now, we can not only sustain these efforts but also further build upon them,” he said.

 Cambodia recently endorsed the 2nd phase of AMR multi-sectoral action plan 2025-2030. We are going to develop additional legally binding policy document to strengthen and reinforce antimicrobial use in animal health sector,” added Dr Mak.

 MPTF protecting livelihoods and safeguarding medicines we depend upon

 “Through the AMR multi-partner trust fund, low- and middle-income countries are building surveillance systems, strengthening laboratory capacity, improving infection prevention and control, and promoting responsible use of antimicrobials in human, animal and plant health. These initiatives are not abstract. They save lives. They protect livelihoods and they safeguard medicines we depend upon,” said Professor Ernst Kuipers, Global Leaders Group on AMR (GLG) member, and Former Minister of Health, Welfare and Sport, Netherlands.

 “If we act decisively now, we can preserve the effectiveness of lifesaving medicines for generations to come. If we however delay, we risk losing the very tools that make modern healthcare possible,” concluded Prof Kuipers.

 Investing in AMR MPTF is smart

 “The European Commission supports and invests in the AMR MPTF because it ensures donor coordination. It avoids duplication and fragmentation, and it gives the beneficiary countries the flexibility to focus on their priorities and their needs. And it also strengthens the One Health response by aligning all the relevant sectors,” said Dr Gunilla Eklund, the European Commission’s Directorate-General for Health & Food Safety (DG SANTE), European Commission.

 “MPTF is more than just a fund – it is a platform for partnership. And as such, we believe it is a smarter model for aid. It allows collective action to deliver more than what isolated projects would have done by themselves. And in these times, I think we cannot emphasize enough the importance of pooling resources in the current climate of tight budgets. The MPTF is a tried and a trusted mechanism that is efficient and effective. It ensures that the investments align, with the country needs and the country’s own priorities,” added Dr Eklund.

Shobha Shukla, Bobby Ramakant – CNS

(Shobha Shukla is the founding Managing Editor of CNS (Citizen News Service) and Bobby Ramakant works as CNS Health Editor. Both are on the boards of Global Antimicrobial Resistance Media Alliance (GAMA) and Asia Pacific Media Alliance for Health, Gender and Development Justice (APCAT Media). Follow them on Twitter/X: @Shobha1Shukla, @BobbyRamakant, @CNS_Health

A robust sense of humor isn’t merely a pleasant diversion during challenging times; it’s a valuable asset in our pursuit of overall well-being. When we find ourselves amused by a friend’s witty remark or a comedian’s act, the positive impacts of humor resonate through our bodies, minds, and social connections. It’s more than just entertainment; it contributes to enhancing our physical, mental, and emotional health.

According to Dattilo, an instructor of psychology at Harvard Medical School, humor’s psychological benefits are immediate, lifting mood and reducing stress and anxiety, while also affecting us physically by reducing cortisol levels and increasing dopamine and serotonin neurotransmitters (Harvard Gazette, 2023).

Research has shown that laughter’s health benefits are extensive, including pain relief, increased happiness, and enhanced immunity. Positive psychology recognizes laughter and a sense of humor as one of the 24 main signature strengths (Verywell Mind).

The physical benefits of laughter are diverse:

• Laughter boosts heart and respiratory rates and oxygen consumption temporarily, leading to subsequent relaxation. While it’s not equivalent to aerobic exercise, it still offers physical benefits. Laughing for 10-15 minutes daily can burn an additional 10-40 calories.
• It positively impacts heart function by increasing stroke volume, cardiac output, and dilating blood vessels.
• Intense laughter enhances muscle tone.
• Watching funny videos stimulates the sympathetic nervous system (SNS) without raising blood pressure.
• Laughter reduces cortisol levels, the stress hormone.
• It activates the brain’s mesolimbic dopaminergic reward system.
• Laughing boosts levels of serum immunoglobulins A and E and tends to increase natural killer cell activity.
• It raises levels of beta-endorphins, the body’s feel-good chemicals, and increases human growth hormone (U.S. Department of Veterans Affairs).

Relationship between Laughter and Mental Health

The relationship between laughter and mental health is profound. It interrupts distressing emotions, promoting relaxation, stress reduction, increased energy, focus, and productivity. Additionally, laughter fosters a more positive perspective on situations, creating psychological distance and diffusing conflict. It also strengthens social bonds, which can profoundly impact mental and emotional well-being (HelpGuide).

In conclusion, laughter emerges as a potent medicine for holistic health, offering a multitude of benefits across physical, psychological, and social dimensions