Health

Tedros Adhanom Ghebreyesus says children, the elderly at particular risk after damage to Iranian petroleum facilities.

The head of the World Health Organization has warned that recent Israeli attacks on oil facilities in Iran could have negative effects on public health, with Iranian children and the elderly among the most vulnerable.

Tedros Adhanom Ghebreyesus said in a statement on Monday that damage to Iranian petroleum facilities “risks contaminating food, water and air”.

Those hazards “can have severe health impacts especially on children, older people, and people with pre existing medical conditions”, Tedros warned in a post on X. “Rain laden with oil has been reported falling in parts of the country.”

The Iranian authorities said oil facilities in the capital, Tehran, and the nearby province of Alborz were targeted on Saturday in the United States-Israeli war against the country, the Fars news agency reported.

Israel said it struck “a number of fuel storage facilities in Tehran” that were used “to operate military infrastructure”.

The strikes sent massive flames and clouds of thick, black smoke into the sky above Tehran, with Al Jazeera’s Tohid Asadi reporting that black raindrops fell early on Sunday morning.

The attacks on Iran’s energy infrastructure came as the US and Israeli governments had vowed to continue to bombard the country despite mounting international concern over the widening conflict.

Iran has retaliated to the US-Israeli strikes by launching missiles and drones at targets across the Middle East, including energy infrastructure in nearby Arab Gulf states.

Human rights groups have condemned both Iran and the US and Israel for targeting civilian infrastructure.

Agnes Callamard, the head of Amnesty International, said on Monday that “Israel should have taken all feasible precautions to avoid or minimize the risks to civilians when targeting oil refineries” in Iran.

“The incidental harm to civilians, including the release of toxic substance, appears to indicate that too little precautions were taken and that the incidental harm to civilians is disproportionate,” she wrote on X.

“The scenes of catastrophe described by Iranians after Tehran’s oil depots were bombed are yet another demonstration that ultimately, whatever they may say, the US and Israel’s attacks on Iran are harming first and foremost civilians, including children.”

Israeli strikes on fuel depots and petroleum logistic sites in Tehran on Sunday saw apocalyptic images coming out of the Iranian capital, as the spilled oil ignited a river of fire, and thick black smoke blanketed the city of 10 million, leaving streets and vehicles covered with soot.

Israel and the United States claimed they were targeting Iranian military and government sites, but government officials and people say civilian structures such as schools, hospitals and major landmarks are increasingly coming under attack. At least 1,255 people have been killed in the strikes since February 28.

What Israeli and US military planners frame as a calculated degradation of state infrastructure is being described by local officials and environmental experts as an act of total warfare, and collective punishment.

Shina Ansari, head of Iran’s Department of Environment, described the systematic destruction of the oil depots as a blatant act of ecocide.

The attacks systematically targeted four major storage facilities and a distribution centre, including the Tehran refinery in the south and depots in Aghdasieh, Shahran, and Karaj. In the Shahran district, witnesses reported unrefined oil leaking directly into the streets as temperatures hovered around 13C (55F).

Ansari from Iran’s Department of Environment stated that the environment remains the silent victim of the war, noting that the incineration of vast fuel reserves has trapped the capital under a suffocating shroud of pollutants.

The medical and environmental fallout is immediate and severe. The Iranian Red Crescent Society warned that the smoke contains high concentrations of toxic hydrocarbons, sulphur, and nitrogen oxides. The organisation noted that any rainfall passing through these plumes becomes highly acidic, posing risks of skin burns and severe lung damage upon contact or inhalation.

Ali Jafarian, Iran’s deputy health minister, told Al Jazeera that this acid rain is already contaminating the soil and water supply. Jafarian added that the toxic air poses a life-threatening risk to the elderly, children, and those with pre-existing respiratory conditions, prompting authorities to advise residents to remain indoors.

The destruction has also forced the Iranian Ministry of Petroleum to slash daily fuel rations for civilians from 30 litres [8 gallons] to 20 litres [5 gallons]. At least four employees, including two tanker drivers, were killed in the depot strikes.

The strategic bombing myth

Major General Mamoun Abu Nowar, a retired Jordanian military analyst, told Al Jazeera that the primary objective of the strikes is to break the resilience of the Iranian people and paralyse the country’s logistics and economy.

“They are preparing the Iranian environment for an uprising against the regime,” Abu Nowar said, adding that the broader goal is to halt state operations and curb Tehran’s regional influence.

However, Abu Nowar raised urgent concerns about the specific munitions deployed, urging Iranian authorities to investigate the bomb fragments given the unusual density of the smoke and the resulting acid rain.

Some military strategists argue that striking an adversary’s vital infrastructure can paralyse the state from the inside out, bypassing the need to fight its military forces directly.

Modern warfare has increasingly relied on this strategic bombing via precision drones and missiles to destroy morale and incapacitate an adversary’s ability to wage war. For Israel, which is engaged in a genocidal war in Gaza and wider regional conflicts, targeting oil depots is viewed as a way to send a coercive message while avoiding a ground war.

However, Adel Shadid, a researcher in Israeli affairs, told Al Jazeera Arabic that the strategy is designed to make life hell for ordinary Iranians in hopes of sparking an uprising. Shadid noted a glaring contradiction in the rhetoric of Israeli Prime Minister Benjamin Netanyahu, who claims to support the Iranian people while overseeing the destruction of their basic means of survival.

Raphael S Cohen, director of the Strategy and Doctrine Program at the RAND Corporation, notes that such bombing campaigns consistently fail to achieve their primary goal of breaking a population’s will. Instead, Cohen argues, strategic bombing typically produces a rally-around-the-flag effect, unifying societies against a common foe rather than causing them to capitulate.

Historical echoes and retaliation

The reality of targeting oil infrastructure rarely aligns with sterile military theory, as history shows that such tactics reliably produce devastating, long-term environmental consequences.

During the 1991 Gulf War, the torching of Kuwaiti oil wells created a regional environmental catastrophe. Similarly, during the battle against ISIL (ISIS) in Iraq, the burning of the Qayyarah oil fields created a “Daesh Winter” that blocked out the sun for months.

The fires released vast quantities of toxic residues, including sulphur dioxide and polycyclic aromatic hydrocarbons, causing severe respiratory illnesses, soil acidification, and long-term carcinogenic risks for the local population.

Meanwhile, Mokhtar Haddad, director of the Al-Wefaq newspaper, told Al Jazeera Arabic that the targeting of energy hubs could trigger a global energy war.

According to Al Jazeera’s Sohaib al-Assa, reporting from Tehran, the Islamic Revolutionary Guard Corps (IRGC) has already retaliated by striking the Haifa oil refinery and targeting a US base in Kuwait, signalling that the conflict is no longer confined to military targets.

On Monday, Bahrain’s state-run oil company Bapco declared force majeure after waves of Iranian strikes targeted its energy installations. Iran has also been accused of also targeting energy facilities in other Gulf Cooperation Council (GCC) countries.

SACRAMENTO — California Gov. Gavin Newsom has positioned himself as a national public health leader by staking out science-backed policies in contrast with the Trump administration.

After Health and Human Services Secretary Robert F. Kennedy Jr. fired Centers for Disease Control and Prevention Director Susan Monarez for refusing what her lawyers called “the dangerous politicization of science,” Newsom hired her to help modernize California’s public health system. He also gave a job to Debra Houry, the agency’s former chief science and medical officer, who had resigned in protest hours after Monarez’s firing.

Newsom also teamed up with fellow Democratic governors Tina Kotek of Oregon, Bob Ferguson of Washington and Josh Green of Hawaii to form the West Coast Health Alliance, a regional public health agency, whose guidance the governors said would “uphold scientific integrity in public health as Trump destroys” the CDC’s credibility. Newsom argued establishing the independent alliance was vital as Kennedy leads the Trump administration’s rollback of national vaccine recommendations.

More recently, California became the first state to join a global outbreak response network coordinated by the World Health Organization, followed by Illinois and New York. Colorado and Wisconsin signaled they plan to join. They did so after President Trump officially withdrew the United States from the agency on the grounds that it had “strayed from its core mission and has acted contrary to the U.S. interests in protecting the U.S. public on multiple occasions.” Newsom said joining the WHO-led consortium would enable California to respond faster to communicable disease outbreaks and other public health threats.

Although other Democratic governors and public health leaders have openly criticized the federal government, few have been as outspoken as Newsom, who is considering a run for president in 2028 and is in his second and final term as governor. Members of the scientific community have praised his effort to build a public health bulwark against the Trump administration’s slashing of funding and scaling back of vaccine recommendations.

What Newsom is doing “is a great idea,” said Paul Offit, an outspoken critic of Kennedy and a vaccine expert who formerly served on the Food and Drug Administration’s vaccine advisory committee but was removed under Trump in 2025.

“Public health has been turned on its head,” Offit said. “We have an anti-vaccine activist and science denialist as the head of U.S. Health and Human Services. It’s dangerous.”

The White House did not respond to questions about Newsom’s stance and Health and Human Services declined requests to interview Kennedy. Instead, federal health officials criticized Democrats broadly, arguing that blue states are participating in fraud and mismanagement of federal funds in public health programs.

Health and Human Services spokesperson Emily Hilliard said the administration is going after “Democrat-run states that pushed unscientific lockdowns, toddler mask mandates, and draconian vaccine passports during the COVID era.” She said those moves have “completely eroded the American people’s trust in public health agencies.”

Public health guided by science

Since Trump returned to office, Newsom has criticized the president and his administration for engineering policies that he sees as an affront to public health and safety, labeling federal leaders as “extremists” trying to “weaponize the CDC and spread misinformation.” He has excoriated federal officials for erroneously linking vaccines to autism, warning that the administration is endangering the lives of infants and young children in scaling back childhood vaccine recommendations. And he argued that the White House is unleashing “chaos” on America’s public health system in backing out of the WHO.

The governor declined an interview request, but Newsom spokesperson Marissa Saldivar said it’s a priority of the governor “to protect public health and provide communities with guidance rooted in science and evidence, not politics and conspiracies.”

The Trump administration’s moves have triggered financial uncertainty that local officials said has reduced morale within public health departments and left states unprepared for disease outbreaks and prevention efforts. The White House last year proposed cutting Health and Human Services spending by $33 billion, including $3.6 billion from the CDC. Congress largely rejected those cuts last month, although funding for programs focusing on social drivers of health, such as access to food, housing and education, were axed.

The Trump administration announced that it would claw back more than $600 million in public health funds from California, Colorado, Illinois and Minnesota, arguing that the Democratic-led states were funding “woke” initiatives that didn’t reflect White House priorities. Within days, the states sued and a judge temporarily blocked the cut.

“They keep suddenly canceling grants and then it gets overturned in court,” said Kat DeBurgh, executive director of the Health Officers Assn. of California. “A lot of the damage is already done because counties already stopped doing the work.”

Federal funding has accounted for more than half of state and local health department budgets nationwide, with money going toward fighting HIV and other sexually transmitted infections, preventing chronic diseases, and boosting public health preparedness and communicable disease response, according to a 2025 analysis by KFF, a health information nonprofit that includes KFF Health News.

Federal funds account for $2.4 billion of California’s $5.3-billion public health budget, making it difficult for Newsom and state lawmakers to backfill potential cuts. That money helps fund state operations and is vital for local health departments.

Funding cuts hurt all

Los Angeles County public health director Barbara Ferrer said if the federal government is allowed to cut that $600 million, the county of nearly 10 million residents would lose an estimated $84 million over the next two years, in addition to other grants for prevention of HIV and other sexually transmitted infections. Ferrer said the county depends on nearly $1 billion in federal funding annually to track and prevent communicable diseases and combat chronic health conditions, including diabetes and high blood pressure. Already, the county has announced the closure of seven public health clinics that provided vaccinations and disease testing, largely because of funding losses tied to federal grant cuts.

“It’s an ill-informed strategy,” Ferrer said. “Public health doesn’t care whether your political affiliation is Republican or Democrat. It doesn’t care about your immigration status or sexual orientation. Public health has to be available for everyone.”

A single case of measles requires public health workers to track down 200 potential contacts, Ferrer said.

The U.S. eliminated measles in 2000 but is close to losing that status as a result of vaccine skepticism and misinformation spread by vaccine critics. The U.S. had 2,281 confirmed cases last year, the most since 1991, with 93% in people who were unvaccinated or whose vaccination status was unknown. This year, the highly contagious disease has been reported at schools, airports and Disneyland.

Public health officials hope the West Coast Health Alliance can help counteract Trump by building trust through evidence-based public health guidance.

“What we’re seeing from the federal government is partisan politics at its worst and retaliation for policy differences, and it puts at extraordinary risk the health and well-being of the American people,” said Georges Benjamin, executive director of the American Public Health Assn., a coalition of public health professionals.

Robust vaccine schedule

Erica Pan, California’s top public health officer and director of the state Department of Public Health, said the West Coast Health Alliance is defending science by recommending a more robust vaccine schedule than the federal government. California is part of a coalition suing the Trump administration over its decision to rescind recommendations for seven childhood vaccines, including for hepatitis A, hepatitis B, influenza and COVID-19.

Pan expressed deep concern about the state of public health, particularly the uptick in measles. “We’re sliding backwards,” Pan said of immunizations.

Sarah Kemble, Hawaii’s state epidemiologist, said Hawaii joined the alliance after hearing from pro-vaccine residents who wanted assurance that they would have access to vaccines.

“We were getting a lot of questions and anxiety from people who did understand science-based recommendations but were wondering, ‘Am I still going to be able to go get my shot?’” Kemble said.

Other states led mostly by Democrats have also formed alliances, with Pennsylvania, New York, New Jersey, Massachusetts and several other East Coast states banding together to create the Northeast Public Health Collaborative.

Hilliard, of Health and Human Services, said that even as Democratic governors establish vaccine advisory coalitions, the federal Advisory Committee on Immunization Practices “remains the scientific body guiding immunization recommendations in this country, and HHS will ensure policy is based on rigorous evidence and gold standard science, not the failed politics of the pandemic.”

Influencing red states

Newsom, for his part, has approved a recurring annual infusion of nearly $300 million to support the state Department of Public Health, as well as the 61 local public health agencies across California, and last year signed a bill authorizing the state to issue its own immunization guidance. It requires health insurers in California to provide patient coverage for vaccinations the state recommends even if the federal government doesn’t.

Jeffrey Singer, a doctor and senior fellow at the libertarian Cato Institute, said decentralization can be beneficial. That’s because local media campaigns that reflect different political ideologies and community priorities may have a better chance of influencing the public.

A KFF analysis found some red states are joining blue states in decoupling their vaccine recommendations from the federal government’s. Singer said some doctors in his home state of Arizona are looking to more liberal California for vaccine recommendations.

“Science is never settled, and there are a lot of areas of this country where there are differences of opinion,” Singer said. “This can help us challenge our assumptions and learn.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling and journalism.