"Catholic theology does not have preclusions, on a religious or ritual basis, in using any animal as a source of organs, tissues or cells for transplantation to human beings," the document noted.

However, the Vatican set out conditions that treatments should follow best medical practice, animals should not be subjected to cruelty, and research should be carried out in a way it described as “purposeful, proportionate and sustainable.”

The guidelines also urge doctors to be explicit with patients about the risks of xenotransplantation, including possible rejection by the immune system and the chance of infections linked to microorganisms.

Animal-to-human transplants remain uncommon, but rapid advances, including experimental procedures involving genetically modified pigs,  have pushed the issue higher on medical and ethical agendas, prompting the Vatican to update and expand earlier guidance first issued in 2001 .

The response was uniform: "No vacant bed available". By 12:50 am GMT, Charles Amissah was dead —not for lack of medical expertise or a responding ambulance, but for lack of a piece of furniture.

His tragic death has reignited fury over Ghana’s "no bed syndrome," a systemic failure where emergency care is routinely denied based on physical space. 

However, a look into healthcare systems across sub-Saharan Africa reveals that Amissah’s death is not an isolated incident; it is a symptom of a continental crisis where hospital beds have become a tool of lethal exclusion.

The Ghana context

In Ghana, the "no bed syndrome" is a chronic ailment. In 2024, the Korle Bu Teaching Hospital (KBTH), the nation’s largest medical facility, had to suspend referrals to its Surgical Medical Emergency unit because it was housing 60 patients in a 36-bed unit. Photos on social media captured the dehumanising reality: patients receiving treatment in plastic chairs, wheelchairs, and on the bare floor.

The Ministry of Health, on February 18, announced that it had constituted a three-member committee to probe Amissah’s death , examining decision-making processes and contributing factors. Yet, local experts argue the problem is structural. Beyond the physical shortage, the system suffers from abandoned facilities, a lack of medicines, and a severe brain drain as medical professionals flee for better opportunities abroad. 

Despite a national health insurance scheme, the cost of emergency care remains prohibitively high for many, and the referral chain is often broken by a lack of coordinated communication between ambulances and receiving wards.

The Nigerian mirror

Nigeria faces a nearly identical "no bed" crisis, often overshadowed by the "Japa syndrome"—the mass exodus of healthcare workers. The story of Ifelola Abiona last year, a 42-year-old mother of two, mirrors that of Charles Amissah. 

Despite doctors being physically present and ready to operate at the Lagos State University Teaching Hospital (LASUTH), she was left to "languish" and eventually die because no bed could be found. Her husband recounted a harrowing ordeal of being referred between facilities, paying nearly a million naira (about $745) for redundant tests, only to be told again: "No bed".

The Nigerian Medical Association (NMA) blamed this on a dysfunctional referral system and a weak primary healthcare foundation.

Chairman of the NMA in Lagos, Dr Saheed Babajide, revealed that in Lagos, only 57 out of 300 primary health centres are comprehensive enough to have doctors, forcing patients to swarm tertiary hospitals for minor ailments. This over-subscription, according to reports, means that many hospitals consistently operate at over 90% occupancy.

Furthermore, the lack of space extends to the families. Informal caregivers—relatives who perform the roles of nurses due to staffing shortages—are forced to sleep on staircases , wooden benches, or bare concrete. They report being bitten by mosquitoes, shivering in the rain, and eventually falling ill themselves, creating a secondary public health risk.

The ICU crisis in South Africa

In South Africa, the crisis shifts from general ward beds to the even more critical shortage of Intensive Care Unit (ICU) beds. Reports reveal that South Africa has a mere five ICU beds per 100,000 people . In some provinces, the ratio drops to one bed per 100,000.

The consequences are visceral. In Gauteng, South Africa's economically dominant province, which houses its financial capital, Johannesburg, a 29-year-old man died after a one-hour wait for medical attention; his family attributed the delay to "corruption led by the political elite" and a lack of available ICU space. Another patient waited six weeks for an ICU bed for a bypass surgery; during that time, gangrene spread, resulting in a double amputation.

The shortage is not just about infrastructure but specialised human capital. Only 25% of ICU nurses in the country are actually trained in critical care. This deficit, combined with crumbling utilities and water/power shortages, means that even when a physical bed is available, there may be no one qualified to man it. 

There have also been reports of financial mismanagement where security budgets outweigh clinical budgets, leaving hospitals under-equipped while funds are siphoned away.

Liberia and Kenya: Crumbling walls and digital deadlocks

In Liberia, the "no bed" crisis is exacerbated by the scars of civil war and the 2014 Ebola epidemic. At Phebe Hospital, the second-largest in the country, reports from 2024 indicated that a lone surgeon had been forced to carry out operations by the light of storm lanterns because of frequent electricity cuts. 

The hospital, burdened by $300,000 in debt to vendors, often lacks basic drugs, forcing doctors to watch patients die while relatives run to local pharmacies to buy supplies. At the James Jenkins Dossen (JJ Dossen) Hospital in Harper, the coastal capital of Maryland County in southeastern Liberia, the influx of patients was so high that pregnant women and their newborn babies were forced to sleep on the floor.

Kenya offers a more modern, albeit equally frustrating, version of the crisis. Recent transitions to the Social Health Authority (SHA) portal resulted in chaotic situations where hospitals with physical beds were shown as having "zero occupancy" in the digital system. Hospital owners reported being forced to turn away women in need of maternity services because the digital dashboard "locked," preventing admissions and reimbursements. 

Officials claim this was a deliberate downgrade to protect patient safety in facilities lacking essential equipment, but providers allege it is a cost-containment strategy by a state grappling with billions in unpaid claims.

A continental death trap

The collective data across these nations paints a grim picture:

Why the bed is just the symptom

The "no bed syndrome" is rarely just about furniture. It is the end result of the "Three Delays" model, according to researchers :

Many governments in Africa still view Emergency Medical Services (EMS) as a luxury rather than an essential component of Universal Health Coverage (UHC). 

In Nigeria, for instance, only 9% of the population is covered by a formal EMS system. Governments struggle to maintain ambulance fleets, and most response is left to expensive, private hospital-owned vehicles that can cost more than a month’s wages to hire.

The path forward: Essential, not optional

The African Critical Illness Outcomes Study , which investigated about 20,000 patients from 180 hospitals in 22 countries across the continent, suggests that thousands of lives could be saved through simple, low-cost interventions that can be provided in general wards, such as ensuring oxygen availability and training staff in basic life support.

Case studies in Sierra Leone and Malawi show promise. Sierra Leone utilised ambulances from its Ebola response to create a national EMS system that now achieves national coverage with 80 ambulances and over 400 paramedics. Malawi is piloting a coordinated "118" emergency number and trauma registry along its deadliest road corridor.

Under the proposal , consultation fees for patients will rise modestly, including a new inflation-related surcharge. Basic hospitalization fees will also increase, alongside higher out-of-pocket costs for hospital meals and utilities for long-term patients. 

The changes will be introduced in stages beginning this year.

One major goal of the fee increase is to help medical institutions cope with inflation. Rising energy, food and equipment costs have squeezed hospital finances, particularly smaller facilities in rural areas.

Another priority is boosting wages for healthcare workers, as existing surcharges that allow hospitals to collect additional fees if they raise nurses’ pay will be expanded, and institutions that increase salaries for younger doctors will also become eligible. 

The overall revision will increase medical service fees by an average of 3.09% over two years, while official drug prices will be cut by 0.87%. 

By adjusting service and pharmaceutical costs separately, the government aims to balance financial sustainability with patient access.

Old population

The reform also reflects structural pressures from Japan’s demographics. With one of the world ’s oldest populations, demand for chronic care, long-term hospitalization and complex treatments continues to grow. Policymakers are using fee incentives to guide the system’s direction without sharply increasing total spending.

To improve quality and efficiency, the review promotes telemedicine and digital tools, including support for artificial intelligence , voice recognition and online consultations. Hospitals performing advanced procedures such as robot-assisted surgeries will also see fee adjustments.

At the same time, authorities are tightening rules around certain practices. Facilities that fail to reduce the use of physical restraints may face lower payments, while new fees will encourage hospitals to accept emergency patients from depopulated regions.

What is Nipah virus?

Nipah virus (NiV) is a zoonotic pathogen carried by fruit bats. It can jump to humans via infected animals or contaminated food (notably raw date palm sap), and it can spread between people through close contact. The World Health Organization lists it as a high-priority pathogen because of its severity and outbreak potential.

Symptoms to watch for

Infection ranges from mild or asymptomatic to severe:

How does it spread?

Nipah reaches humans in three main ways:

No cure, no vaccine

Where has it appeared before?

Malawi, in turn, has committed to increasing its own health spending by $143.8 million over the same period. US officials say this shared financing model is designed to reduce long-term dependence on foreign aid and ensure that gains made during the agreement can be sustained after it ends.

A key focus of the deal is Malawi’s progress against HIV. The country is close to achieving the global 95-95-95 targets, which aim for 95% of people living with HIV to know their status, 95% of those diagnosed to receive treatment, and 95% of those on treatment to achieve viral suppression.

The agreement is meant to help Malawi maintain these gains through integrated health services that the government will eventually manage and fund itself.

The strategy rests on three pillars: “making America safer, stronger, and more prosperous by prioritising U.S. interests; protecting Americans by preventing global outbreaks from reaching U.S. shores; saving lives abroad while helping partner countries build 'resilient and durable' health systems.”

According to the fact sheet from the Department of State, only 40% of foreign health aid currently reaches frontline workers and supplies. Roughly 25% funds commodities such as diagnostics and drugs, 15% supports 270,000 health workers, while 60% goes to overhead and technical assistance.

“We will keep America safe by monitoring and helping quickly contain infectious disease outbreaks before they reach U.S. shores,” the document states, adding that the U.S. will continue supporting a global surveillance system and be prepared to “surge resources” when outbreaks emerge abroad.

How is Africa affected?

Africa has benefited for decades from U.S.-backed health programs targeting HIV/AIDS, malaria, tuberculosis, and emerging diseases.

The strategy suggests that while Africa will remain “a focus,” U.S. health investments may increasingly shift toward the Western Hemisphere, raising doubts about whether African countries with the greatest need will continue receiving robust support.

“Africa is going to continue to be a focus, but we’re going to invest more in the Western Hemisphere,” a senior official told Semafor.

Officials say the new model will channel more resources into direct, results-driven bilateral agreements and cut waste.

The warehouse was rented by Lim Zhi Wei, who told police in 2022 that electronics had been stolen. Investigators later uncovered that the unit had been storing large quantities of vapes imported from Malaysia. Lim admitted to packing, delivering, and selling the products locally and was eventually fined $8,500. 

The probe into the burglary led to Chua’s name surfacing. Authorities allege he directed others to rent storage units, coordinated shipments across the border, and oversaw distribution in Singapore.

Chua was arrested during an islandwide operation on October 10, 2024, carried out jointly by the Singapore Police Force and the Health Sciences Authority (HSA). He has since been held in remand for nearly a year while facing a series of charges, including cheating and attempting to obstruct the course of justice .

The police and HSA issued a joint statement describing him as a “key syndicate figure” in the illegal trade .

An inter-agency discussion will be held to finalise the implementation plan, which will then be submitted to the Cabinet for approval.

“The outcome of these deliberations and the proposed implementation plan will be presented to the Cabinet for policy approval, which will form the basis for the full ban on vapes in Malaysia,” Dzulkefly said.

Currently, Malaysia only prohibits the online sale of vapes. But users easily bypass the restriction by searching for specific brand names rather than generic terms such as “vape” on e-commerce platforms and search engines.

The announcement comes less than a year after Malaysia introduced Act 852 — the Control of Smoking Products for Public Health Act 2024 — which banned the sale of tobacco and vape products to minors and regulated advertising, packaging, labelling, point-of-sale displays and online sales.

However, the act also formally recognised the vape industry, which Dzulkefly said complicates the legal path to an outright ban.

“This has created a ‘legitimate expectation’ under the law , meaning that if we now impose a sudden ban after establishing Act 852, we must be ready to face possible legal challenges,” he said. 

Some Malaysian states have already acted independently. Perlis, Terengganu, Kedah and Pahang have moved to ban vape sales, while Johor and Kelantan have enforced similar bans since 2016 and 2015, respectively.

Another complication of a sweeping ban would be its economic impact on the burgeoning vape sales industry. In 2023, the market value of this industry reached RM3.48 billion (S$1.05 billion) in 2023 from RM2.27 billion in 2019, according to the Malaysia Vape Chamber of Commerce.

A 2023 Global Adult Tobacco Survey estimated that 1.4 million Malaysian adults — out of a population of 34.2 million — use vapes.

If implemented, the ban would place Malaysia alongside regional neighbours such as Brunei, Thailand and Singapore, which already prohibit vaping — in Singapore’s case under some of the strictest enforcement measures in the region.

“We still have diseases that we can treat with little means. It is  infectious diseases  that kill the most. It's the haemorrhages affecting mothers giving birth. We can treat it with a compress. Its diseases are caused by the lack of vaccines. So these are diseases that we can treat with little means,” he said in an interview at the Crans Montana Forum in Casablanca. 

Kamba estimates that for as little as $13 per person or around $2 billion a year, he could solve 60% of his people’s health problems. That still represents a considerable chunk of the country’s $15 billion budget but Kamba believes it is achievable because of the potential to draw tax revenue from the vast swathes of the informal economy.

Kamba points to initiatives like free medical care during childbirth, an achievement of which the former pediatric doctor is clearly proud as it addresses the top cause of premature mortality in the country and an expanded vaccination programme. His goal is to increase life expectancy by two years annually, moving the DRC quickly clear of the top 20 worst-performing countries in the  world .

Big Pharma look elsewhere

He stresses that he wants Congo to pay its own way, but at the same time is critical of a lack of engagement from big pharmaceutical companies which he says are missing the opportunity to find a place in a huge potential market.

“Big Pharma is very interested in new formulas, in new products that are still expensive. And that Africans in general and the Congo in particular can't buy yet. And so they don't make much effort on the older formulae, on the older medicines that are still effective in our country. Because in our countries, with infectious diseases, with the problems of women and newborns, we still need old medicines that still are very good for us. And Big Pharma is not very involved in this,” he told Global South World.

A bigger immediate challenge for Kinshasa’s health officials is the conflict in North and South Kivu which has displaced around 7 million people. As well as putting those individuals in peril through malnutrition and lack of sanitation, the destruction of health centres and attacks on medical staff pose an array of problems. Of particular concern from an  international  perspective is the inability of the authorities to monitor cases of mpox, as patients flee the fighting and take their illnesses into vulnerable communities.

Despite the  war , Kemba genuinely seems to feel that his country has turned a corner in taking control of its destiny and putting its people first. He laments how, as a doctor for three decades he didn’t see a single public hospital built in his country. And had he worked twice as long, back to the first days of independence he still would not have.

That drought has been ended by President Félix Tshisekedi who has also backed Kamba in bringing in measures such as centralised purchases of medicines. But the health system remains fragile, especially following the withdrawal of US funding, and will depend on far-reaching economic reform to deliver the resources it needs to fulfil Kamba’s hopes.

Here's some of what they said.

You can share your opinions on our Facebook , Instagram , TikTok , or X posts.

Bangkok, Thailand

Ayush: “No, I love smoking weed. Never ban smoking. Cigarettes? If that's your thing... I don't like how they smell, but don't ban smoking.”

Ethan: "No."

Grace: "Everyone has their own outlet. We all have our vices and our virtues. It's a personal thing. I don't think it should be banned, but I think those who indulge in it should know their limits."

Mahmoud: "Yes. It's incredibly unhealthy. It's bad for the environment. It should be banned anywhere and everywhere."

Aiden: "Like any vice, I'm not sure I would completely advocate a ban. An immediate ban would put it underground. I think it would cause a lot more harm. Perhaps there need to be more measures in place to ensure that we discourage people from becoming more addicted to it."

Azman: "Targeting smoking solely will not solve the problem. To eradicate it, you would have to eradicate any other alternative."

Aiya: "It should be more controlled. There should be some designated smoking areas and not people just smoking on the street. But you shouldn't ban smoking."

Yuta: "No. I'm supportive of smoking. Smoking should be allowed everywhere, except for where there are younger kids or older people."

Fam: "Moderation is everything. I mean, I smoke, so… [laughs]."

Kim: "Hell no. But it shouldn’t be allowed everywhere."

Larry: "No."

Accra, Ghana

Nancy: "Smoking should be banned. It's destroying our lungs and causing so much harm."

Shadrach: "No, people smoke for reasons. I think it should be regulated rather than banned."

Joyceline: "Smoking should be banned because it affects our health and the environment in general."

Ernest: "Of course, it should be banned. It has to be banned in Ghana because people act really weird when they smoke. It affects the economy, too, so it should be banned."

Felix: "Absolutely, it should be banned. It causes so many dangers to human life."

Ansah: "Smoking should be banned right now."

Evans: "Obviously, yes. It also contributes to climate change. It has its own side effects on society, especially when it comes to lung cancer, environmental pollution, and other issues."

Godwin: "It should be banned for people under certain conditions. It should be banned for some people, and for others, it should be used."

Ruth: "It should be left to the individual, but you shouldn't do it in public. You don’t know the health state of the person you're standing by."

Samuel: "Outright. I support that smoking should be banned. I don't see why people smoke, honestly. Especially in this weather. Why would one smoke? Companies producing these cigarettes should be penalized. Put heavy taxes on them and collapse them."

Ebenezer: "Smoking is bad. It has a long-term effect on our bodies. I think banning smoking is just one step in regulating it. More education needs to be done to help us understand why people even smoke in the first place."

John: "Of course, it must be banned."

Rio de Janeiro, Brazil

Erleyvaldo: "Probably not. People are free to choose what they want."

Eduardo: "It should. I’m a smoker, but it should. Unfortunately, quitting smoking is difficult. It's not easy at all."

Tarcio: "No, I think so many things should be banned and are not. Smoking is a personal choice. Everyone knows the harm they’re willing to accept."

Victoria: "No, but I don’t think it should be encouraged."

Filipe: "Smoking should be banned for people who smoke in public, surrounded by children... But I don’t have anything against people who smoke. If you want to smoke, smoke at home."

Maria Clara: "No. I think that people can have the freedom to choose. They know the risks, they can choose what they want."

Silvia: "The important thing is to make it clear what benefits and harms something can bring. Then, everyone is free to make their own choice."

Artur: "Everyone has to be responsible for their own well-being and health. If someone wants to smoke, they smoke, but they’ll have to take responsibility for the consequences and effects."

Mayara: "In public, yes."

Anderson: "It should. All drugs should be banned. Smoking, drinking, alcohol… everything."

Maria: "It should be. It’s already prohibited in some places, but it should be prohibited everywhere."

Tokyo, Japan

Interviewee 1: "If we think about the climate, yes, but if people want to smoke, I think it's OK."

Interviewee 2: "Generally, yes."

Interviewee 3: "Well, it depends. I'm not going to elaborate."

Interviewee 4: "We need to look at solutions that involve cutting off smoking for certain age groups, trying to avoid getting future generations addicted. When you're dealing with people who are currently addicted to nicotine, it gets a bit more complicated."

Interviewee 5: “I certainly would say that if smoking should be banned, then so should drinking. Drinking probably has larger negative impacts on society as a whole, not necessarily on individual health, but on society. But in the same way, I also think that people probably should be allowed to decide if they're going to give themselves lung cancer or not."

Interviewee 6: "People have the right to choose what they put in their bodies. Educate the masses as much as possible on the dangers of it, but at the same time, taking it away completely shouldn't be allowed."

Interviewee 7: "Smoking is obviously a very big health risk, but I don't know about a ban. I think it's probably good to be highly regulated though."

Interviewee 8: "Yes."

Interviewee 9: "No."

Interviewee 10: "Realistically, probably, but like… Nah."

A Global South World video series

This video is part of a Global South World’s series exploring global opinions on pressing issues.

You can share your thoughts on our Facebook , Instagram , TikTok , or X posts.

In previous videos, we asked:

Is the US a friendly power?

Are you scared of AI?

Is capitalism working?

Stay tuned for more perspectives.