Poverty and Development

Banana Islands, Sierra Leone – As the sun dips below the horizon, Emmanuel Pratt tugs a worn cord and the outboard engine sputters to life. His wooden canoe, painted in white and faded blue, cuts through the darkening waters. Fruit bats screech overhead.

Pratt, 35, is a seasoned sea cucumber diver from the Banana Islands – an archipelago home to about 500 people in Sierra Leone. For 15 years, he has made a living scouring the ocean floor for these creatures that resemble warty, oversized sea slugs. They hide in the silt by day and emerge at night to inch across the ocean floor, gobbling up decomposing matter.

Also on the canoe, 25-year-old Omolade Jones – sweating in a half-zipped-up wetsuit – perches on the edge of the boat and gazes out at the dark water.

After 10 minutes, the younger diver gestures at Pratt to cut the engine and readies himself to dive. Jones blows on his mask, grabs an underwater torch and wraps a breathing hose around his waist.

The seabed surrounding the small, jungle-coated archipelago used to teem with sea cucumbers. Nowadays, they are scarce and scattered.  Freediving is no longer an option. Pratt and Jones have to dive deeper, for longer, to find their catch.

They have turned to “hookah diving” – a makeshift system where air is pumped from a diesel-powered generator on the boat down through a plastic hose. It is a risky and fragile lifeline. The engines are often old and the air is easily contaminated by diesel fumes. And experts say it is much more dangerous than scuba or free diving.

As the diesel engine that powers his air supply rattles in the boat, Jones quietly slips over the edge into the black water. The yellow hose trails behind him as he swims away from the canoe. Minutes later, his torch lights up a column of water above the seabed.

Pratt sits in the canoe, a cigarette dangling from his lips, his eyes fixed on the spot where Jones’s light is. “The cucumbers are running out,” he says glumly.

While they used to haul in dozens of buckets of sea cucumbers a night, now they struggle to find a handful. Pratt says the divers rarely make more than $40 on a dive – barely enough to cover the costs of fuel or to hire some of the diving equipment.

Not long after Jones exits the boat, he flashes his torch to signal that he is ready to swim back in. When he reaches the canoe, he hoists himself up on the side with his forearms. In one hand, he holds the torch, in the other, a small, brown sea cucumber.

Pratt takes his turn and disappears into the dark water. He surfaces a while later with a sea cucumber. But the divers are unimpressed. After a couple of hours at sea, they head back to the mooring with a meagre catch of just three specimens.

Overhead, the almost-full moon casts a white sheen over the water and dimly illuminates the way home.

Israeli forces killed at least 115 Palestinians across Gaza on Sunday, most as they waited for desperately needed food aid in one of the deadliest single incidents involving aid seekers since May.

Dozens more Palestinians have been wounded, according to health officials.

In northern Gaza, at least 67 people were killed near the Zikim crossing when an Israeli strike hit crowds gathering for aid. Another six people were killed near a separate distribution site in the south. The day before, 36 Palestinians were killed in similar circumstances.

The death toll brings the total number of people killed while trying to access food relief to more than 900 since May.

Ahmed Hassouna, who attempted to collect food from an aid site of the United States-backed Gaza Humanitarian Foundation (GHF), described the moment Israeli forces opened fire.

“There was a young man with me, and they started firing gas at us. They killed us with the gas. We barely made it out to catch a breath,” he told Al Jazeera.

Another man, Rizeq Betaar, carried a wounded elderly man away from the gunfire.

“We were the ones who carried him on the bicycle… There are no ambulances, no food, no life, no way to live any more. We’re barely hanging on. May God relieve us,” he said.

The United Nations World Food Programme (WFP) said a convoy of 25 trucks carrying aid came under gunfire shortly after entering Gaza.

“WFP reiterates that any violence involving civilians seeking humanitarian aid is completely unacceptable,” the agency said in a statement.

Israel’s military said its forces fired “warning shots” at what it called “an immediate threat”, but denied deliberately targeting aid convoys.

The UN Office for the Coordination of Humanitarian Affairs (OCHA) warned on Sunday the situation in Gaza has reached “catastrophic” levels, with children “wasting away” and some dying before aid reaches them.

“People are risking their lives just to find food,” OCHA said, calling the conditions “unconscionable”.

The US-based Council on American-Islamic Relations (CAIR) also denounced Israel’s continuous attacks on aid seekers.

“The escalating massacres of starving Palestinian women, children and men murdered with US-supplied weapons and with the complicity of our government as they desperately search for food to feed their families is not only a human tragedy, it is also an indictment of a Western political order that has enabled this genocide through inaction and indifference,” said Nihad Awad, CAIR’s national executive director, in a statement.

“Western governments cannot claim ignorance. They are watching in real time as innocent civilians are intentionally starved, forcibly displaced, and slaughtered – and are choosing to do nothing. History will long remember the Western world’s indifference to the forced starvation, ethnic cleansing and genocide in Gaza.”

Man-made starvation

Philippe Lazzarini, the head of the UN agency for Palestinian refugees, UNRWA, said staff in Gaza are sending desperate messages about the lack of food.

“All man-made, in total impunity. Food is available only a few kilometres away,” he wrote on X, adding that UNRWA has enough supplies at the border to feed Gaza for three months. But Israel has been blocking aid since March 2.

Dr Mohammed Abu Afash, the director of the Palestinian Medical Relief Society in Gaza, told Al Jazeera women and children are collapsing from hunger.

“We are heading into the unknown. Malnutrition among children has reached its highest levels,” he said, warning of a looming disaster if aid is not allowed in immediately.

Gaza’s Ministry of Health echoed that warning, saying hundreds of Palestinians suffering from malnutrition and dehydration could soon die.

“We warn that hundreds of people whose bodies have wasted away are at risk of imminent death due to hunger,” a spokesperson said.

Palestinian families say basic staples such as flour are impossible to find. The ministry said at least 71 children have died of malnutrition since the war began in 2023, while 60,000 others show signs of severe undernourishment.

On Sunday alone, it reported 18 deaths linked to hunger.

Food prices have soared beyond the reach of most people in Gaza, where 2.3 million are struggling to survive under siege conditions implemented by Israel.

Al Jazeera’s Hind Khoudary, reporting from central Gaza, said a 35-day-old baby in Gaza City and a four-month-old child in Deir el-Balah had died of malnutrition at Al-Aqsa Martyrs Hospital.

“The mother was touching her body, saying, ‘I am sorry I could not feed you,’” Khoudary said.

“Parents go to the GHF distribution sites to risk getting killed or leave their children starving. We met a mother who is giving her children water just to fill their stomachs. She can’t afford flour – and when she could, she couldn’t find it.”

More forced evacuations

Meanwhile, more Palestinians are being forced to flee. After Israel dropped leaflets containing evacuation threats over neighbourhoods in Deir el-Balah, residents reported air attacks on three homes in the area, prompting families to leave with what little they could carry.

Israel’s military said it had not yet entered those districts but promised to continue targeting what it called “terrorist infrastructure”.

Reporting from Deir el-Balah, Al Jazeera’s Hani Mahmoud said: “We are face to face with another misleading evacuation order. People are told to move to al-Mawasi, a so-called safe zone, but since day one, Palestinians have been killed there.

“This is not a safe zone. There is no safe zone in a war zone. Palestinians know that walking into al-Mawasi is like walking into a death trap – they’ll be killed in days, hours, or even minutes.”

Labour Minister Marta Elena Feito Cabrera’s comments dismissing poverty in the Caribbean island nation trigger angry backlash.

Cuban Labour and Social Security Minister Marta Elena Feito Cabrera has resigned after saying there are no beggars in Cuba, only people pretending to be.

Cuba’s presidency said in a post on social media on Wednesday that Feito had “acknowledged her errors and submitted her resignation” over her “lack of objectivity and sensitivity” in addressing issues that are “at the centre of political and governmental management”.

The news came a day after Feito made the comments about poverty in the island nation to deputies in a National Assembly committee.

“We have seen people, apparently beggars, [but] when you look at their hands, look at the clothes these people are wearing, they are disguised as beggars. They are not beggars,” Feito said.

“In Cuba, there are no beggars,” she said.

The minister added that people cleaning car windscreens live “easy” lives and they use the money they make to “drink alcohol”.

Feito also lashed out against those who search through rubbish dumps, saying they are recovering materials “to resell and not pay tax”.

The remarks quickly went viral, prompting calls for Feito’s impeachment and a wave of criticism in a country experiencing a tough economic situation in recent years.

Even Cuban President Miguel Diaz-Canel was critical.

Without mentioning her by name but referring to the meeting at the National Assembly committee in which Feito participated, Diaz-Canel said on his X account: “The lack of sensitivity in addressing vulnerability is highly questionable. The revolution cannot leave anyone behind; that is our motto, our militant responsibility.”

Cuba blames its economic woes on a Cold War-era United States trade embargo, which complicates financial transactions and the acquisition of essentials, such as fuel and spare parts. The US imposed the embargo in 1960 after the Cuban Revolution, led by Fidel Castro.

The embargo is widely criticised with 185 of 193 countries at the United Nations voting to condemn it.

US President Donald Trump recently tightened sanctions on the island’s Communist Party-run government, pledging to restore a “tough” policy towards the Caribbean country.

Former US President Barack Obama took considerable steps to ease tensions with Cuba during his time in office, including restoring US-Cuba relations and making the first visit by a US president to the country in 90 years. Cuba has also faced an energy crisis and blackouts in recent months as supplies of subsidised Venezuelan oil have become increasingly precarious as Venezuela grapples with its own economic woes.

Last week, the US Department of State imposed sanctions against Diaz-Canel as well as the luxury high-rise Hotel Torre K in central Havana.

Travel and tourism are important to Cuba’s struggling economy with millions of tourists visiting the island nation each year.

According to the UN Conference on Trade and Development, Cuba had a gross domestic product of $9,296 per person in 2019, making it an upper middle income country.

“A budget is a moral document,” as numerous human rights activists have said over the decades. If that is true, then the so‑called “One Big, Beautiful Bill” represents a grotesque example of the immorality of US leadership in 2025.

It is a budget that slashes Medicare and Medicaid by $930bn over the next decade and could leave as many as 17 million without healthcare insurance. The cuts to the Supplemental Nutrition Assistance Program (SNAP) – a food aid scheme for Americans living in deep poverty – will render about 1 million vulnerable people ineligible for the basic human right of not starving. The US social welfare system – one that President Franklin D Roosevelt and Congress introduced with the Social Security Act of 1935 and President Lyndon B Johnson extended with Medicare and Medicaid in 1965 – is on its way to an emergency room.

This is one of the steepest rollbacks of social welfare programmes in the US since their inception in 1935. Many will attribute it to Project 2025. But the disdain for social welfare in the US has always been present – because the US cannot be the US without millions of Americans who must work on the cheap, so that a select few can hoard wealth and power, and mega-corporations can hoard resources.

That the US has had a mediocre and begrudging social welfare system for the past 90 years is nothing short of a miracle. While much of the Western world and other major empires either established or modernised their social welfare systems in the 19th and early 20th centuries, the US persisted with limited government intervention for citizens. Only radicals within the US labour movement typically advocated a national social welfare policy. Until the Great Depression of the 1930s, only individual states – not the federal government – provided limited economic relief to unemployed people or their families.

US Secretary of Labor Frances Perkins played a critical role in persuading Roosevelt to pursue what would become the Social Security Act of 1935. Once enacted, this provided the elderly, the unemployed, disabled workers, and single mothers with federal assistance for the first time. But both of the bill’s champions were aware that there would be opposition to the federal government assuming responsibility for providing benefits to Americans, even with unemployment at 25 percent.

Leading business tycoons such as Ford Motor Company founder Henry Ford expressed their disdain for federal social welfare. “No government can guarantee security. It can only tax production, distribution, and service and gradually crush the poor to pay taxes,” Ford said. Alf Landon, a millionaire oilman who served as Republican governor of Kansas and ran against Roosevelt in 1936, also opposed the Social Security Act, on the grounds that the tax burden would further impoverish workers. “I am not exaggerating the folly of this legislation. The saving it forces on our workers is a cruel hoax,” Landon stated in a 1936 speech, also fearing that the federal government would eventually dip into Social Security funds to pay for other projects.

Even when Congress enacted the Social Security Act in August 1935, the compromises made served to racialise, feminise, and further limit social welfare provision. The bill excluded agricultural workers like sharecroppers (two‑thirds white and one‑third African American, who were overrepresented in this work), domestic workers (in which Black women were overrepresented), nonprofit and government workers, and some waiters and waitresses from welfare benefits. It took amendments in the 1950s to rectify some of the racial, gender, and class discrimination embedded in the original legislation.

Johnson’s War on Poverty in 1964-65 prompted resistance and helped catalyse a new conservative movement. Johnson sought to add Medicare and Medicaid to the Social Security regime, provide food assistance via programmes such as Women, Infants, and Children (WIC) and SNAP (originally Food Stamps), and expand Aid to Families with Dependent Children (AFDC). Republican and future US President George HW Bush ran unsuccessfully for Senate in Texas in 1964 against a pro‑Medicare Democrat, calling Johnson’s plan “socialised medicine” – a Cold War‑era slur equating it with communism. Racial segregationist Strom Thurmond remarked of social welfare programmes, in general – and Johnson’s Medicare and Medicaid plans, specifically – “You had [the poor] back in the days of Jesus Christ, you have got some now, and you will have some in the future,” a pitiful excuse for refusing to reduce poverty or extend federal assistance.

The entire conservative pushback against what Republicans termed “entitlements” grew from the expansion of the welfare state under Johnson. So much so that when Ronald Reagan became president in 1981, “his administration slashed Medicaid expenditures by more than 18 percent and cut the overall Department of Health and Human Services budget by 25 percent”. Those and other austerity measures in the 1980s resulted in one million fewer children eligible for free or reduced‑price school lunches, 600,000 fewer people on Medicaid, and one million fewer accessing SNAP – according to one study.

I can speak to the effect of such cuts directly. As a teenage recipient of AFDC and SNAP during the Reagan years – the second eldest of six children (four under the age of five in 1984) in the New York City area – I can say that the $16,000 in annual state and federal assistance between 1983 and 1987 felt like a cruel joke. It barely covered housing, offered minimal healthcare via underfunded public clinics, and still left us without food for a week every month. If this is what they call “entitlements”, then I was clearly entitled to almost nothing.

In the past 30 years, leaders who opposed the federal social welfare apparatus have celebrated their victories with disturbing heartlessness. Senate Majority Leader Bob Dole declared gleefully in 1995 that he “was there, fighting the fight, voting against Medicare… because we knew it wouldn’t work in 1965”. During his 2008 presidential campaign, the late Republican senator John McCain proposed $1.3 trillion in cuts to Medicare and Medicaid, along with a huge “overhaul” of Social Security to balance the federal budget. Fiscal conservative Grover Norquist infamously said he wanted to “get it [social‑welfare programmes] down to the size where we can drown it in the bathtub”. US Speaker Mike Johnson claimed last week that Trump’s budget would usher in “a new golden age”. Budget priorities that ultimately harm those in poverty, restrict access to healthcare, and force people to work for food aid or medical care are nothing short of monstrous.

Ninety years – and 44 years of tax breaks later – the greed and callousness of conservatives and the far right have precipitated yet another round of tax cuts favouring the uber wealthy and mega-corporations. It is only a matter of time before those whose grandparents once benefitted from Social Security and New Deal‑era welfare will seek to gut what remains of America’s Swiss‑cheese safety net.

The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera’s editorial stance.

On July 3, the United States House of Representatives passed President Donald Trump’s signature tax cut and spending package, which he has called the “One Big Beautiful Bill“.

The bill combines tax reductions, spending hikes on defence and border security, and cuts to social safety nets.

Democratic Minority Leader Hakeem Jeffries warned that the bill “hurts everyday Americans and rewards billionaires with massive tax breaks”.

Trump’s erstwhile ally, billionaire Elon Musk, publicly opposed the bill, arguing it would bloat expenditure and the country’s already unmatched debt.

Trump is expected to sign the bill into law on Friday, July 4 – the US’s independence day – at 4pm ET.

Here’s what’s next – and whom the bill will affect:

How have taxes been lowered?

The main goal of the bill was to extend Trump’s first-term tax cuts.

In 2017, Trump signed the Tax Cuts and Jobs Act, which lowered taxes and increased the standard deduction for all taxpayers, primarily benefitting higher-income earners.

More than a third of the total cuts went to households with an income of $460,000 or more.

The top 1 percent (roughly 2.4 million people) received average tax cuts of about $61,090 by 2025 – higher than any other income group. By contrast, the middle 60 percent of earners (78 million people) saw cuts in the range of $380 to $1,800.

Those tax breaks were set to expire this year, but the new bill has made them permanent. It also adds some more cuts Trump promised during his latest campaign.

For instance, there is a change to the US tax code called the State and Local Taxes deduction.

This will let taxpayers deduct certain local taxes (like property taxes) from their federal tax return.

Currently, people can only deduct up to $10,000 of these taxes. The new bill would raise that cap from $10,000 to $40,000 for five years.

Taxpayers will also be allowed to deduct income earned from tips and overtime, until 2028, as well as interest paid on loans for buying cars made in the US from this year until 2028.

Elsewhere, the estate tax exemption will rise to $15m for individuals and $30m for married couples.

In all, the legislation contains about $4.5 trillion in tax cuts.

How big are social welfare cuts?

To help offset the cost of the tax cuts, Republicans plan to scale back Medicaid and food assistance programmes for low-income families.

Their stated goal was to focus these programmes on certain groups – primarily pregnant women, people with disabilities and children – while also reducing what they deem to be waste, including by limiting access to immigrants.

Currently, more than 71 million people depend on Medicaid, the government health insurance program.

According to the Congressional Budget Office (CBO), the bill would leave an additional 17 million Americans without health cover in the next decade.

While Medicaid helps Americans suffering from poor health, the Supplemental Nutrition Assistance Program (SNAP) helps poor people afford groceries.

About 40 million Americans currently receive benefits through SNAP, also known as food stamps.

The CBO calculates that 4.7 million SNAP participants will lose out over the 2025-2034 period, due to program reductions.

Changes to Medicaid and SNAP could become permanent provisions, with no sunset clauses attached to them.

A recent White House memo pointed to more than $1 trillion in welfare cuts from the new bill – the largest spending reductions to the US safety net in modern history.

Will there be new money for national security?

The bill sets aside about $350bn, to be spread out over several years, for Trump’s border and national security plans. This includes:

• $46bn for the US-Mexico border wall
• $45bn to fund 100,000 beds in migrant detention centres
• Billions more to hire an extra 10,000 Immigration and Customs Enforcement (ICE) agents by 2029, as part of Trump’s plan to carry out the largest mass deportation effort in US history.

Will clean energy be affected?

Republicans have rolled back tax incentives that support clean energy projects powered by renewables like solar and wind, instead giving tax breaks to coal and oil companies.

These “green” tax breaks were a part of former President Joe Biden’s landmark Inflation Reduction Act, which aimed to tackle climate change and reduce healthcare costs.

A tax break for people who buy new or used electric vehicles will expire on September 30 this year, instead of at the end of 2032 under current law.

How will the bill affect the US debt profile?

The legislation would raise the debt ceiling by $5 trillion, from $36.2 trillion currently (which amounts to 122 percent of gross domestic product or GDP), going beyond the $4 trillion outlined in the version passed by the House in May.

Washington cannot borrow more than its stated debt ceiling. But since 1960, Congress has raised, suspended or changed the terms of the debt ceiling 78 times, facilitating more leverage and undermining the US’s long-term fiscal stability.

In his first term, Trump oversaw a roughly $8 trillion increase in the federal debt, which surged due to 2017 tax cuts and emergency spending, approved by Congress, during the COVID-19 pandemic.

Debt as a share of GDP was already higher last year than it was anytime outside of World War II, the aftermath of the 2008 financial crisis or the COVID-19 pandemic. Deficit concerns contributed to Moody’s downgrading of the US credit score in May.

For its part, the White House claims the new tax bill will reduce projected deficits by more than $1.4 trillion over the next decade, in part by spurring additional growth. But economists on both sides of the aisle have strongly disputed that.

Indeed, according to the non-partisan Committee for a Responsible Federal Budget, interest payments on national debt will rise to $2 trillion per year by 2034 owing to the legislation, crowding out spending on other goods and services.

How did the House of Representatives vote on the bill?

The lower house of the US Congress voted by a margin of 218 to 214 in favour of the bill on Thursday.

All 212 Democratic members of the House opposed the bill. They were joined by Representatives Thomas Massie of Kentucky and Brian Fitzpatrick of Pennsylvania, who broke from the Republican majority.

On July 1, the Senate narrowly passed the bill by a 51–50 vote, with the deciding vote cast by Vice President JD Vance.

Who will benefit the most?

According to Yale University’s Budget Lab, wealthier taxpayers are likely to gain more from this bill than lower-income Americans.

They estimate that people in the lowest income bracket will see their incomes drop by 2.5 percent, mainly because of cuts to SNAP and Medicaid, while the highest earners will see their incomes rise by 2.2 percent.

Joypurhat/Dhaka, Bangladesh, and New Delhi/Kolkata, India – Under the mild afternoon sun, 45-year-old Safiruddin sits outside his incomplete brick-walled house in Baiguni village of Kalai Upazila in Bangladesh, nursing a dull ache in his side.

In the summer of 2024, he sold his kidney in India for 3.5 lakh taka ($2,900), hoping to lift his family out of poverty and build a house for his three children – two daughters, aged five and seven, and an older 10-year-old son. That money is long gone, the house remains unfinished, and the pain in his body is a constant reminder of the price he paid.

He now toils as a daily labourer in a cold storage facility, as his health deteriorates – the constant pain and fatigue make it hard for him to carry out even routine tasks.

“I gave my kidney so my family could have a better life. I did everything for my wife and children,” he said.

At the time, it didn’t seem like a dangerous choice. The brokers who approached him made it sound simple – an opportunity rather than a risk. He was sceptical initially, but desperation eventually won over his doubts.

The brokers took him to India on a medical visa, with all arrangements – flights, documents, and hospital formalities – handled entirely by them. Once in India, although he travelled on his original Bangladeshi passport, other documents, such as certificates falsely showing a familial relationship with the intended recipient of his kidney, were forged.

His identity was altered, and his kidney was transplanted into an unknown recipient whom he had never met. “I don’t know who got my kidney. They [the brokers] didn’t tell me anything,” Safiruddin said.

By law, organ donations in India are only permitted between close relatives or with special government approval, but traffickers manipulate everything – family trees, hospital records, even DNA tests – to bypass regulations.

“Typically, the seller’s name is changed, and a notary certificate – stamped by a lawyer – is produced to falsely establish a familial relationship with the recipient. Forged national IDs support the claim, making it appear as though the donor is a relative, such as a sister, daughter, or another family member, donating an organ out of compassion,” said Monir Moniruzzaman, a Michigan State University professor and a member of the World Health Organization’s Task Force on Organ Transplantation, who is researching organ trafficking in South Asia.

Safiruddin’s story isn’t unique. Kidney donations are so common in his village of Baiguni, that locals know the community of less than 6,000 people as the “village of one kidney”. The Kalai Upazila region that Baiguni belongs to is the hotspot for the kidney trade industry: A 2023 study published in the British Medical Journal Global Health publication estimated one in 35 adults in the region has sold a kidney.

Kalai Upazila is one of Bangladesh’s poorest regions. Most donors are men in their early 30s lured by the promise of quick money. According to the study, 83 percent of those surveyed cited poverty as the main reason for selling a kidney, while others pointed to loan repayments, drug addiction or gambling.

Safiruddin said that the brokers – who had taken his passport – never returned it. He didn’t even get the medicines he had been prescribed after the surgery. “They [the brokers] took everything.”

Brokers often confiscate passports and medical prescriptions after the surgery, erasing any trail of the transplant and leaving donors without proof of the procedure or access to follow-up care.

The kidneys are sold to wealthy recipients in Bangladesh or India, many of whom seek to bypass long wait times and the strict regulations of legal transplants. In India, for example, only about 13,600 kidney transplants were performed in 2023 – compared with an estimated 200,000 patients who develop end-stage kidney disease annually.

Al Jazeera spoke with more than a dozen kidney donors in Bangladesh, all of whom shared similar stories of being driven to sell their kidneys due to financial hardship. The trade is driven by a simple yet brutal equation: Poverty creates the supply, while long wait times, a massive shortage of legal donors, the willingness of wealthy patients to pay for quick transplants and a weak enforcement system ensure that the demand never ceases.

The cost of desperation

Josna Begum, 45, a widow from Binai village in Kalai Upazila, was struggling to raise her two daughters, 18 and 20 years old, after her husband died in 2012. She moved to Dhaka to work in a garment factory, where she met and married another man named Belal.

After their marriage, both Belal and Josna were lured by a broker into selling their kidneys in India in 2019.

“It was a mistake,” Josna said. She explained that the brokers first promised her five lakh taka (about $4,100), then raised the offer to seven lakh (around $5,700) to convince her. “But after the operation, all I got was three lakh [$2,500].”

Josna said she and Belal were taken to Rabindranath Tagore International Institute of Cardiac Sciences in Kolkata, the capital of India’s West Bengal state, where they underwent surgery. “We were taken by a bus through the Benapole border into India, where we were housed in a rented apartment near the hospital.”

To secure the transplant, the brokers fabricated documents claiming that she and the recipient were blood relatives. Like Safiruddin, she doesn’t know who received her kidney.

Despite repeated attempts, officials at Rabindranath Tagore International Institute of Cardiac Sciences have not responded to Al Jazeera’s request to comment on the case. Kolkata police have previously accused other brokers of facilitating illegal kidney transplants at the same hospital in 2017.

Josna said her passport and identification documents were handled entirely by the brokers. “I was OK with them taking away the prescriptions. But I asked for my passport. They never gave it back,” she said.

She stayed in India for nearly two months before returning to Bangladesh – escorted by the brokers who had her passport, and still held out the promise of paying her what they had committed to.

The brokers had also promised support for her family and even jobs for her children, but after the initial payment and a few token payments on Eid, they cut off contact.

Soon after he was paid – also three lakh taka ($2,500) – for his transplant, Belal abandoned Josna, later marrying another woman. “My life was ruined,” she said.

Josna now suffers from chronic pain and struggles to afford medicines. “I can’t do any heavy work,” she said. “I have to survive, but I need medicine all the time.”

‘In front of this gang’s gun’

In some cases, victims have become perpetrators of the kidney scam, too.

Mohammad Sajal (name changed), was once a businessman in Dhaka selling household items like pressure cookers, plastic containers and blenders through Evaly, a flashy e-commerce platform that promised big returns. But when Evaly collapsed following a 2021 scam, so did his savings – and his livelihood.

Drowning in debt and under immense pressure to repay what he owed, he sold his kidney in 2022 at Venkateshwar Hospital in Delhi. But the promised 10 lakh taka ($8,200) never materialised. He received only 3.5 lakh taka ($2,900).

“They [the brokers] cheated me,” Sajal said. Venkateshwar Hospital has not responded to repeated requests from Al Jazeera for comment on the case.

There was only one way he could earn what he had thought he would get for his kidney, Sajal concluded at the time: by joining the brokers to dupe others. For months, he worked as a broker, arranging kidney transplants for several Bangladeshi donors in Indian hospitals. But after a financial dispute with his handlers, he left the trade, fearing for his life.

“I am now in front of this gang’s gun,” he said. The network he left behind operates with impunity, he said, stretching from Bangladeshi hospitals to the Indian medical system. “Everyone from the doctors to recipients to the brokers on both sides of borders are involved,” he said.

Now, Sajal works as a ride-share driver in Dhaka, trying to escape the past. But the scars, both physical and emotional, remain. “No one willingly gives a kidney out of hobby or desire,” he said. “It is a simple calculation: desperation leads to this.”

Acknowledging the cross-border kidney trafficking trade, Bangladesh police say they are cracking down on those involved. Assistant Inspector General Enamul Haque Sagor of Bangladesh Police said that, in addition to uniformed officers, undercover investigators have been deployed to track organ trafficking networks and gather intelligence.

“This issue is under our watch, and we are taking action as required,” he said.

Sagor said that police have arrested multiple individuals linked to organ trafficking syndicates, including brokers. “Many people get drawn into kidney sales through these networks, and we are working to catch them,” he added.

Across the border, Indian law enforcement agencies, too, have cracked down on some medical professionals accused of involvement in kidney trafficking. In July 2024, the Delhi Police arrested Dr Vijaya Rajakumari, a 50-year-old kidney transplant surgeon associated with a Delhi hospital. Investigations revealed that between 2021 and 2023, Dr Rajakumari performed approximately 15 transplant surgeries on Bangladeshi patients at a private hospital, Indian officials said.

But experts say that these arrests are too sporadic to seriously dent the business model that underpins the kidney trade.

And experts say Indian authorities face competing pressures – upholding the law, but also promoting medical tourism, a sector that was worth $7.6bn in 2024. “Instead of enforcing ethical standards, the focus is on the economic advantages of the industry, allowing illegal transplants to continue,” said Moniruzzaman.

‘More transplants mean more revenue’

In India, the Transplantation of Human Organs Act (THOA) of 1994 regulates organ donations, permitting kidney transplants primarily between close relatives such as parents, siblings, children and spouses to prevent commercial exploitation. When the donor is not a near relative, the case must receive approval from a government-appointed body known as an authorisation committee to ensure the donation is altruistic and not financially motivated.

However, brokers involved in kidney trafficking circumvent these regulations by forging documents to establish fictitious familial relationships between donors and recipients. These fraudulent documents are then submitted to authorisation committees, which – far too often, say experts – approve the transplants.

Experts say the foundation of this illicit system lies in the ease with which brokers manipulate legal loopholes. “They fabricate national IDs and notary certificates to create fictitious family ties between donors and recipients. These papers can be made quickly and cheaply,” said Moniruzzaman.

With these falsified identities, transplants are performed under the pretence of legal donations between relatives.

In Dhaka, Shah Muhammad Tanvir Monsur, director general (consular) at Bangladesh’s Ministry of Foreign Affairs, said that the country’s government officials had no role in the document fraud, and that they “duly followed” all legal procedures. He also denied any exchange of information between India and Bangladesh on cracking down on cross-border kidney trafficking.

Over in India, Amit Goel, deputy commissioner of police in Delhi, who has investigated several cases of kidney trafficking in the city, including that of Rajakumari, the doctor, said that hospital authorities often struggle to detect forged documents, allowing illegal transplants to proceed.

“In the cases I investigated, I found that the authorisation board approved those cases because they couldn’t identify the fake documents,” he said.

But Moniruzzaman pointed out that Indian hospitals also have a financial incentive to overlook discrepancies in documents.

“Hospitals turn a blind eye because organ donation [in general] is legal,” Moniruzzaman said. “More transplants mean more revenue. Even when cases of fraud surface, hospitals deny responsibility, insisting that documentation appears legitimate. This pattern allows the trade to continue unchecked,” he added.

Mizanur Rahman, a broker who operates across multiple districts in Bangladesh, said that traffickers often target individual doctors or members of hospital review committees, offering bribes to facilitate these transplants.​ “Usually, brokers in Bangladesh are in touch with their counterparts in India who set up these doctors for them,” Rahman told Al Jazeera. “These doctors often take a major chunk of the money involved.”

Dr Anil Kumar, director of the National Organ and Tissue Transplant Organisation (NOTTO) – India’s central body overseeing organ donation and transplant coordination – declined to comment on allegations of systemic discrepancies that have enabled rising cases of organ trafficking.

However, a former top official from NOTTO pointed out that hospitals often are up against not just brokers and seemingly willing donors with what appear to be legitimate documents, but also wealthier recipients. “If the hospital board is not convinced, recipients often take the matter to higher authorities or challenge the decision in court. So they [hospitals] also want to avoid legal hassles and proceed with transplants,” this official said, speaking on condition of anonymity.

Meanwhile, organ trafficking networks continue to adapt their strategies. When police or official scrutiny increases in one location, the trade simply moves elsewhere. “There is no single fixed hospital; the locations keep changing,” Moniruzzaman said. “When police conduct a raid, the hospital stops performing transplants.

“Brokers and their network – Bangladeshi and Indian brokers working together – coordinate to select new hospitals at different times.”

Porous borders and the fallout

For brokers and hospitals that are involved, there is big money at stake. Recipients often pay between $22,000 and $26,000 for a kidney.

But donors get only a tiny fraction of this money. “The donors get three to five lakh taka [$2,500 to $4,000] usually,” said Mizanur Rahman, the broker. “The rest of the money is shared with brokers, officials who forge documents, and doctors if they are involved. Some money is also spent on donors while they live in India.”

In some cases, the deception runs even deeper: traffickers lure Bangladeshi nationals with promises of well-paying jobs in India, only to coerce them into kidney donations.

Victims, often desperate for work, are taken to hospitals under false pretences, where they undergo surgery without fully understanding the consequences. In September last year, for instance, a network of traffickers in India held many Bangladeshi job seekers captive, either forced or deceived them into organ transplants, and abandoned them with minimal compensation. Last year, police in Bangladesh arrested three traffickers in Dhaka who smuggled at least 10 people to New Delhi under the guise of employment, only to have them forced into kidney transplants.

“Some people knowingly sell their kidneys due to extreme poverty, but a significant number are deceived,” said Shariful Hasan, associate director of the Migration Programme at BRAC, formerly the Bangladesh Rural Advancement Committee, one of the world’s largest nongovernmental development organisations. “A rich patient in India needs a kidney, a middleman either finds a poor Bangladeshi donor or lures someone in the name of employment, and the cycle continues.”

Vasundhara Raghavan, CEO of the Kidney Warriors Foundation, a support group in India for patients with kidney diseases, said that a shortage of legal donors was a “major challenge” that drove the demand for trafficked organs.

“Desperate patients turn to illicit means, fuelling a system that preys on the poor.”

She acknowledged that India’s legal framework was aimed at preventing organ transplants from turning into an exploitative industry. But in reality, she said, the law had only pushed organ trade underground.

“If organ trade cannot be entirely eliminated, a more systematic and regulated approach should be considered. This could involve ensuring that donors undergo mandatory health screenings, receive postoperative medical support for a fixed period, and are provided with financial security for their future wellbeing,” Raghavan said.

Back in Kalai Upazila, Safiruddin nowadays spends most of his time at home, his movements slower, his strength visibly diminished. “I am not able to work properly,” he said.

He says there are nights when he lies awake, thinking of the promises the brokers made, and the dreams they shattered. He doesn’t know when, and if, he will be able to complete the construction of his house. He thought the surgery would bring his family a pot of cash to build a future. Instead, his children have been left with an ailing father – and he with a sense of betrayal that Safiruddin can’t shake off. “They took my kidney and vanished,” he said.

Reporting for this story was supported by a grant from Journalists for Transparency.

Dubbed the “One Big Beautiful Bill Act”, President Donald Trump’s signature policy bill would slash taxes, largely benefitting the wealthiest Americans.

To pay for it, federal spending would be reduced, including on Medicaid, food stamps and student loans. Supporters say the bill could jumpstart economic growth and create jobs.

Critics, including some Republicans, say millions of Americans would pay the price. And the non-partisan Congressional Budget Office estimates the bill would actually add an estimated $3.3 trillion to debt over a decade.

Why did Canada scrap its digital tax on US tech companies?

Plus, Nigeria’s tax reform.

The United States Senate is debating President Donald Trump’s “One Big Beautiful Bill“, which promises sweeping tax breaks, as Republicans hope to pass it before Friday’s Independence Day holiday.

On Saturday, the Senate voted 51-49 to open debate on the latest 940-page version of the bill,  despite two Republican senators joining the Democrats to oppose the motion. Trump’s Republicans hold 53 seats in the Senate, and Democrats hold 47.

What’s next if the Senate passes the bill?

On May 22, the Republican-controlled House of Representatives passed an earlier version of the bill in a 215-214 vote.

That bill has been revised by the Senate, and both chambers of Congress must pass the same legislation for it to become law. If the Senate passes its version, then members from both chambers would work to draft compromise legislation that the House and Senate would have to vote on again. Republicans hold 220 seats and Democrats hold 212 in the House.

If the compromise bill is passed, it would advance to Trump, who is expected to sign it into law.

So, who would be some of the winners and losers if the bill – opposed by Democrats and some conservatives – becomes law?

Who would benefit from the bill?

The groups who would benefit include:

High-income households

The bill would extend tax cuts that Trump introduced during his first term. While Trump has pitched this as a gain for the American people, some will benefit more than others.

More than a third of the total cuts would go to households with an annual income of $460,000 or more. About 57 percent of the tax cuts would go to households with a yearly income of $217,000 or more.

According to an analysis by the nonpartisan Tax Policy Center, the Senate bill would slash taxes on average by about $2,600 per household in 2026. “High-income households would receive much more generous tax benefits”, its analysis said.

Families with children

If the bill does not pass, the child tax credit, currently at $2,000 per child per year, would drop to $1,000 in 2026.

However, if the current version of the Senate bill passes, the child tax credit will permanently increase to $2,200. This is a smaller increase than the $2,500 in the version of the bill that the House approved.

Traditional car manufacturers

Makers of traditional petrol-driven cars could benefit from the bill because the Senate version seeks to end the tax credit for purchases of electric vehicles (EVs), worth up to $7,500, starting on September 30.

This could decrease consumer demand for EVs, levelling the playing field for cars that run on petrol or diesel.

Workers who receive tips

Tips will not be taxed if the bill passes.

Currently, workers – whether waiters or other service providers – are required to report all tips in excess of $20 a month to their employers, and those additional earnings are taxed.

This bill would end that.

Who would lose out because of the bill?

Some of the groups that would not benefit include:

Food stamp recipients

The Senate version of the bill proposes slashing the food stamps programme, called the Supplemental Nutrition Assistance Program (SNAP), by $68.6bn over a decade, according to an analysis by the nonpartisan Congressional Budget Office (CBO).

Food stamps help low-income families buy food. In the 2023 fiscal year, 42.1 million people per month benefited from the programme, according to the US Department of Agriculture.

Medicaid beneficiaries

The Senate version of the bill proposes federal funding cuts by $930bn to Medicaid, the largest US programme providing healthcare to low-income people. These are cuts to budget outlays by 2034.

The bill says that starting in 2026, able-bodied adults under the age of 65 will be required to work 80 hours a month to continue to receive Medicaid, with the exception of those who have dependent children.

More than 71 million low-income Americans were enrolled in Medicaid for health insurance as of March.

EV manufacturers

The EV tax credit would end on September 30 if the Senate version of the bill passes. The House version aims to phase out the tax credit by the end of 2025.

Billionaire Elon Musk, who owns the EV manufacturer Tesla, has voiced his opposition to the bill online. “I’m sorry, but I just can’t stand it anymore. This massive, outrageous, pork-filled Congressional spending bill is a disgusting abomination,” Musk wrote on X on June 3.

He doubled down on his criticism before the Senate deliberations on the bill on Saturday.

“The latest Senate draft bill will destroy millions of jobs in America and cause immense strategic harm to our country,” Musk wrote on X, a platform he owns.

The latest Senate draft bill will destroy millions of jobs in America and cause immense strategic harm to our country!

Utterly insane and destructive. It gives handouts to industries of the past while severely damaging industries of the future. https://t.co/TZ9w1g7zHF

— Elon Musk (@elonmusk) June 28, 2025

Fiscal conservatives

Some conservatives have criticised the bill, saying it would inflate the country’s enormous debt.

The CBO estimated that the Senate version would raise the national debt by $3.3 trillion from 2025 to 2034. Under the House version, the CBO estimated a $2.4 trillion increase in the debt over a decade.

The current US national debt stands above $36 trillion and represents 122 percent of the country’s gross domestic product (GDP).

The reversal has been stark. Last year alone, more than 302,200 people attempted to travel northwards from South America, according to the United Nations.

However, as President Donald Trump makes asylum all but impossible to obtain in the US, migration northwards has slowed to a trickle.

The Darien Gap — a sliver of untamed forest and steep terrain — used to be the main artery connecting South America to the north. Every year, hundreds of thousands of people would struggle to cross the land bridge on their way to the US.

But not any more. The United Nations notes that, between January and March of this year, only 2,831 people made the dangerous trek. That marks a 98-percent drop compared with the same period in 2024.

Yagua Parra made that journey himself, in his efforts to reach the US. The International Organization for Migration has called the path north to the US the world’s deadliest land route for migration.

“The road was tough. Many things happened — kidnappings, everything,” Yagua Parra said, tattoos freckling his young features. “People are hungry there. It’s hard. Ugly things happen.”

When he reached the southern US border, though, he found himself one of the thousands unable to cross.

Upon taking office for a second term in January, President Trump cancelled the CBP One app, the online portal used to schedule asylum appointments.

Anyone who crossed the border without documents was also barred from claiming asylum protections.

Meanwhile, the US increased the military presence on the border, further driving down crossings.

The Trump administration touted those measures as contributing to “historic lows” for border apprehensions. But the migrants unable to cross found themselves stuck in Mexico, stranded in a border region beset by trafficking and exploitation.

At least 50 world leaders gather in Seville to address global concerns, including hunger, climate change and healthcare.

The United Nations Conference on Financing Development has opened in the southern Spanish city of Seville, as member states are expected to discuss global inequality amid a significant financial loss following the United States Agency for International Development (USAID) funding cut.

The once-in-a-decade event will be held from Monday to Thursday, aiming to address pressing global concerns, including hunger, poverty, climate change, healthcare, and peace.

At least 50 world leaders gathered in Seville, including UN Secretary-General Antonio Guterres, European Commission President Ursula von der Leyen, French President Emmanuel Macron, and Kenyan President William Ruto.

More than 4,000 representatives from businesses, civil society and financial institutions are also participating in the fourth edition of the event.

But the group’s most significant player, the US, is snubbing the talks following President Donald Trump’s decision to slash funding shortly after taking office in January.

In March, US State Secretary Marco Rubio said the Trump administration had cancelled more than 80 percent of all the USAID programmes.

Moreover, Germany, the United Kingdom, and France are also making cuts to offset the increased spending on defence, being imposed by Trump on NATO members.

But the series of cuts to developmental aid is concerning, with global advocacy group Oxfam International saying the cuts to development aid were the largest since 1960.

The UN also puts the growing gap in annual development finance at $4 trillion.

‘Seville Commitment’

The conference organisers have said the key focus of the talks is restructuring finance for the 17 UN Sustainable Development Goals (SDGs) adopted at the last meeting in 2015 and expected to be met by 2030.

But with shrinking development aid, the goals of reaching the SDGs in five years, which include eliminating poverty and hunger, seem unlikely.

Earlier in June, talks in New York produced a common declaration, which will be signed in Seville, committing to the UN’s development goals of promoting gender equality and reforming international financial institutions.

Zambia’s permanent representative to the UN, Chola Milambo, said the document shows that the world can tackle the financial challenges in the way of achieving the development goals, “and that multilateralism can still work”.

However, Oxfam has condemned the document for lacking ambition and said “the interests of a very wealthy are put over those of everyone else”.

Israeli attacks across the Gaza Strip have killed dozens of Palestinians, including people seeking food at aid distribution hubs, as the already catastrophic humanitarian situation in the besieged enclave deteriorates by the day.

Medical sources told Al Jazeera on Sunday that at least 72 people were killed since dawn in Israeli strikes targeting multiple locations across Gaza, including at least 47 in Gaza City and the north of the territory.

Al Jazeera’s Moath al-Kahlout, reporting from Gaza City, described “catastrophic” scenes at the al-Ahli Hospital in the northern city as dozens of wounded civilians sought help following Israeli strikes on the Zeitoun and Sabra neighbourhoods, as well as al-Zawiya market.

“There are too many wounded civilians here, including children. Many are lying on the ground because there are not enough beds or medical supplies to treat them. This facility is struggling to cope due to severe shortages,” he said.

“The Israeli military has dropped leaflets in eastern Gaza City, ordering civilians to move south. These leaflets are often followed by intense and repeated attacks, resulting in the large number of casualties we are witnessing now.”

The victims on Sunday also included at least five Palestinian aid seekers killed near food distribution centres run by the controversial Gaza Humanitarian Foundation (GHF) north of Rafah, according to medics.

Since the United States- and Israel-backed GHF took over limited aid deliveries in Gaza in late May amid a punishing Israeli blockade, Israeli soldiers have regularly shot at Palestinians near distribution centres, killing more than 580 people, and wounding more than 4,000, according to the Gaza Government Media Office.

A recent report by Israel’s Haaretz newspaper quoted unnamed Israeli soldiers as saying they had received orders to fire at crowds of unarmed aid seekers to disperse them.

Geoffrey Nice, a human rights lawyer, told Al Jazeera that the killings going on around the GHF are “inexplicable”.

“What is absolutely astonishing to outsiders is that it is in the business of apparently providing aid where it is desperately needed, and those providing aid with you end up shooting dead hundreds of people,” said Nice, who also took part in the International Criminal Tribunal for the former Yugoslavia.

‘Most vulnerable are dying’

Meanwhile, the humanitarian crisis in the Strip is worsening, with babies and toddlers dying due to a lack of nutrients.

Christy Black, an Australian nurse volunteering in Gaza City, said the hospital she’s based in is short of medical supplies, including formula for pregnant women who require nasogastric feeding. That leaves many without the nutrients needed to lactate – as well as baby formula, she said.

“Our most vulnerable are dying,” Black told Al Jazeera. “We’ve seen a couple of babies die over the last couple of days in Gaza City. It’s really desperate here.”

Malnourishment also makes it difficult to heal from wounds, she said, adding that there is a significant uptick in respiratory illnesses due to the number of bombs being dropped on Gaza.

“We’re seeing children going through the rubbish trying to find something to eat … Children who might be nine or 10 years old that look like two-year-olds,” she added.

Ceasefire talks

With Israeli bombardment of the besieged enclave relentless, there are indications of a fresh impetus to end the war in the wake of the US and Israeli bombings of Iran’s nuclear facilities and the ensuing ceasefire between Israel and Iran.

On Sunday, US President Donald Trump seemed determined to seal a truce. “MAKE THE DEAL IN GAZA. GET THE HOSTAGES BACK!!” he said in a Social Truth post. His comments came after he said he believed a ceasefire could be reached within a week. “I think it’s close. I just spoke to some of the people involved,” Trump said on Saturday.

While Israeli Prime Minister Benjamin Netanyahu did not comment on the push for a truce, he said in the past week that behind-the-scenes talks have been taking place to try and secure a 60-day pause in fighting.

Negotiations revolve around a proposal put forward by the US back in March to extend phase one of a ceasefire that Israel violated by resuming its bombing of Gaza.

Al Jazeera’s Hamdah Salhut, reporting from Amman, Jordan, said, “Netanyahu is under a lot of pressure as Trump has been quite outspoken for some time that he wants to see a ceasefire in Gaza.”

“And prior to Israel’s attacks on Iran, just about two weeks ago, there was a lot of pressure from European allies because of the Israeli military’s conduct in the Gaza Strip,” she said.

In the meantime, the Jerusalem District Court cancelled this week’s hearings in Netanyahu’s long-running corruption trial, accepting a request that the Israeli leader made, citing classified diplomatic and security grounds.

It was unclear whether a social media post by Trump – one suggesting the trial could interfere with Netanyahu’s ability to join negotiations with Hamas and Iran – influenced the court’s decision.

The ruling, seen by Reuters, said that new reasons provided by Netanyahu, the head of Israel’s spy agency Mossad and the military intelligence chief justified cancelling the hearings.

Netanyahu was indicted in 2019 on charges of bribery, fraud and breach of trust – all of which he denies. He has cast the trial against him as an orchestrated left-wing witch-hunt meant to topple a democratically elected right-wing leader.

On Friday, the court rejected a request by Netanyahu to delay his testimony for the next two weeks because of diplomatic and security matters following the 12-day conflict between Israel and Iran, which ended last Tuesday.

He was due to take the stand on Monday for cross-examination.

“It is INSANITY doing what the out-of-control prosecutors are doing to Bibi Netanyahu,” Trump said in a Truth Social post. He said Washington, having given billions of dollars worth of aid to Israel, was not going to “stand for this”.

A spokesperson for the Israeli prosecution declined to comment on Trump’s post. Netanyahu reposted Trump’s comments on X and added: “Thank you again, @realDonaldTrump. Together, we will make the Middle East Great Again!”

Trump said Netanyahu was “right now” negotiating a deal with Hamas, though neither leader provided details, and though officials from both sides have voiced scepticism over prospects for a ceasefire soon.

‘Brutal funding cuts leave brutal choices,’ says aid chief, as humanitarian appeal slashes and priorities refocused.

The United Nations has announced sweeping cuts to its global humanitarian operations, blaming what it described as the “deepest funding cuts ever” for a drastic scaling back of its aid ambitions.

In a statement released on Monday, the UN Office for the Coordination of Humanitarian Affairs (OCHA) said it was now appealing for $29bn in aid – down sharply from the $44bn it had requested in December – and would refocus on the most critical emergencies under a “hyper-prioritised” plan.

The move follows a steep decline in funding from key donors, with the United States – historically the largest contributor – having slashed foreign aid under the administration of President Donald Trump.

Other donors have since followed suit, citing global economic uncertainty. So far this year, the UN has received only $5.6bn, a mere 13 percent of what it initially sought.

This comes as humanitarian needs soar in conflict zones, including Sudan, Gaza, the Democratic Republic of the Congo (DRC) and Myanmar.

“Brutal funding cuts leave us with brutal choices,” said undersecretary-general for humanitarian affairs and emergency relief coordinator, Tom Fletcher.

“All we ask is 1 percent of what you spent last year on war. But this isn’t just an appeal for money – it’s a call for global responsibility, for human solidarity, for a commitment to end the suffering,” he added.

OCHA said remaining aid efforts would be redirected towards the most urgent crises and aligned with planning already under way for 2025 to ensure maximum impact with limited funds.

“We have been forced into a triage of human survival,” Fletcher said. “The math is cruel, and the consequences are heartbreaking. Too many people will not get the support they need, but we will save as many lives as we can with the resources we are given.”

The World Bank has slashed its 2025 global growth forecast, citing trade tensions and policy uncertainty as the United States imposed wide-ranging tariffs that weigh on global economic forecasts.

On Tuesday, the bank lowered its projection for global gross domestic product (GDP) growth to 2.3 percent in its latest economic prospects report, down from the 2.7 percent that it expected in January. This is the most recent in a series of downgrades by international organisations.

In its twice-yearly Global Economic Prospects report, the bank lowered its forecasts for nearly 70 percent of all economies, including the US, China and Europe, as well as six emerging market regions, from the levels it projected just six months ago before US President Donald Trump took office.

“That’s the weakest performance in 17 years, outside of outright global recessions,” said World Bank Group chief economist Indermit Gill.

Global growth and inflation prospects for this year and next have worsened because of “high levels of policy uncertainty and this growing fragmentation of trade relations”, Gill added.

“Without a swift course correction, the harm to living standards could be deep,” he warned.

By 2027, the World Bank expects global GDP growth to average 2.5 percent in the 2020s, which would be the slowest rate in any decade since the 1960s.

The Trump effect 

The gloomier projections come as Trump imposed a 10 percent tariff on imports from almost all US trading partners in April as well as higher rates on imports of steel and aluminium. He had initially also announced radically higher rates on dozens of these economies, which he has since suspended until early July.

Trump’s on-again off-again tariff hikes have upended global trade, increased the effective US tariff rate from below 3 percent to the mid-teens, its highest level in almost a century, and triggered retaliation by China and other countries.

He also engaged in tit-for-tat escalation with China, although both countries have hit pause on their trade war and temporarily lowered these staggering duties as well. But a lasting truce remains uncertain.

While the World Bank’s growth downgrade was proportionately larger for advanced economies, the bank cautioned that less wealthy countries have tricky conditions to contend with.

Commodity prices are expected to remain suppressed in 2025 and 2026, Gill said.

This means that some 60 percent of emerging markets and developing economies – which are commodity exporters – have to deal with a “very nasty combination of lower commodity prices and more volatile commodity markets”.

GDP downturn 

By 2027, while the per capita GDP of high-income economies will be approximately where it was in pre-pandemic forecasts, corresponding levels for developing economies would be 6 percent lower.

“Except for China, it could take these economies about two decades to recoup the economic losses of the 2020s,” Gill cautioned.

Even as GDP growth expectations have been revised downwards, inflation rates have been revised up, he said, urging policymakers to contain inflation risks.

Despite trade policy challenges, however, Gill argued that “If the right policy actions are taken, this problem can be made to go away with limited long-term damage.”

He urged for the “differential in tariff and non-tariff measures with respect to the US” to be quickly reduced by other countries, starting with the Group of 20, which brings together the world’s biggest economies.

“Every country should extend the same treatment to other countries,” Gill stressed. “It’s not enough to just liberalise with respect to the US. It’s also important to liberalise with respect to the others.”

The World Bank said developing economies could lower tariffs on all trading partners and convert preferential trade deals into pacts spanning the “full range of cross-border regulatory policies” to boost GDP growth.

Generally, wealthier countries have lower tariffs than developing countries, which could be seeking to protect budding industries or have fewer sources of government revenue.

This month, the Paris-based Organisation for Economic Co-operation and Development also slashed its 2025 global growth forecast from 3.1 percent to 2.9 percent, warning that Trump’s tariffs would stifle the world economy.

This came after the International Monetary Fund in April too cut its world growth expectations for this year on the effects of Trump’s levies, from 3.3 percent to 2.8 percent.

Millions of people around the world are unable to have the number of children they desire, and financial constraints, lack of quality healthcare and gender inequality are some of the barriers to reproductive choices, according to a UN report.

The UN Population Fund (UNFPA) unveiled its State of the World Population report on Tuesday, warning that a rising number of people are being denied the freedom to start families due to elevated living costs, wars and lack of suitable partners and not because they reject parenthood.

Roughly 40 percent of respondents cited economic barriers – such as the costs of raising children, job insecurity and expensive housing – as the main reason for having fewer children than they would like, according to the report based on an online survey conducted by the UN agency and YouGov.

Fertility rates have fallen to below 2.1 births per woman – the threshold needed for population stability without immigration – in more than half of all countries that took part in the survey.

On the flip side, life expectancy continues to grow across almost all regions of the world, according to the survey conducted in 14 countries that are home to one-third of the world’s population.

Right-wing nationalist governments, including in the United States and Hungary, are increasingly blaming falling fertility rates on a rejection of parenthood.

But the 2025 State of the World Population report found most people did indeed want children. The survey findings indicated that the world is not facing a crisis of falling birth rates but a crisis of reproductive agency.

How was the study conducted?

UNFPA surveyed 14,000 people from four countries in Europe, four in Asia, three in Africa and three in the Americas.

The study examined a mix of low-, middle- and high-income countries and those with low and high fertility rates.

They were picked to try to represent “a wide variety of countries with different cultural contexts, fertility rates and policy approaches”, according to the report’s editor, Rebecca Zerzan.

South Korea, which is included in the study, has the lowest fertility rate in the world. The report also looked at Nigeria, which has one of the highest birth rates in the world.

The other countries included, in order of population size, are India, the US, Indonesia, Brazil, Mexico, Germany, Thailand, South Africa, Italy, Morocco, Sweden and Hungary.

The survey is a pilot for research in 50 countries later this year.

When it comes to age groups within countries, the sample sizes in the initial survey are too small to make conclusions.

But some findings are clear.

What were the key findings from the report?

According to UNFPA, 39 percent of people said financial limitations prevented them from having a child.

Job insecurity and fear of the future – from climate change to war – were cited by 21 percent and 19 percent of respondents, respectively, for reasons to avoid reproducing.

Elsewhere, 13 percent of women and 8 percent of men pointed to the unequal division of domestic labour as a factor in having fewer children than desired.

Only 12 percent of people cited infertility or difficulty conceiving for not having the number of children they wanted.

That figure was higher in countries like Thailand (19 percent), the US (16 percent) and South Africa (15 percent).

In many cases, there were significant differences in responses depending on which country people were reporting from.

But for Natalia Kanem, executive director at UNFPA, a universal finding from the report is that “fertility rates are falling in large part because many feel unable to create the families they want.”

In South Korea, three in five respondents reported financial limitations as an obstacle to having children.

It was just 19 percent in Sweden, where both men and women are entitled to 480 days of paid parental leave per child, which may also be transferred to grandparents.

Still, birth rates in Sweden are among the lowest in the world.

Zerzan pointed out that one factor alone does not account for falling fertility rates.

“I fully agree with that,” said Arkadiusz Wisniowski, professor of social statistics and demography at the University of Manchester.

“The decision to have a child is complex. Yes, it’s about money. But it’s also about time and access to the right kind of childcare,” he told Al Jazeera.

What role can immigration play?

When deaths outpace births, that is an indication that fertility rates are falling. “That’s not currently true at the global level,” Wisniowski said. “But it is true for numerous countries around the world, especially wealthier nations.”

“And some governments are having to navigate the reality of falling birth rates against the backlash against immigration. Clearly, immigrants can fill labour market gaps, and there is evidence they contribute to economic growth,” he said.

“But it’s no panacea.”

What can governments do about this?

“We can see both the problem and solution clearly,” the UNFPA report noted. “The answer lies in reproductive agency, a person’s ability to make free and informed choices about sex, contraception and starting a family – if, when and with whom they want.”

UNFPA warns against simplistic and coercive responses to falling birth rates, such as baby bonuses or fertility targets, which are often ineffective and risk violating human rights.

“We also see that when people feel their reproductive choices are being steered, when policies are even just perceived as being too coercive, people react and they are less likely to have children,” Kanem said.

Instead, the UN body urged governments to expand choices by removing barriers to parenthood identified by their populations.

Its recommended actions included making parenthood more affordable through investments in housing, decent work, paid parental leave and access to comprehensive reproductive health services.

“The recommendations [in the report] are all good,” Wisniowski said. “They would all empower people to try and achieve their family-linked aspirations. But these comprehensive policies will come with a cost.”

For years, labour economists have warned that falling fertility poses a threat to future prosperity because it increases fiscal pressures due to ageing populations – when the number of pensioners in relation to workers rises.

“Governments may need to tax working people more or take on more debt to address the reality of fewer young people,” Wisniowski noted. “But fertility isn’t something that you can easily tinker with. We are facing considerable uncertainty.”

At least 13 Palestinians have been killed and more than 150 injured after Israeli troops and American security contractors opened fire on crowds waiting for food near two aid distribution sites in Gaza, one east of Rafah and another near the Wadi Gaza Bridge.

Sunday’s killings are the latest in a series of attacks on civilians seeking food at aid centres operated by the controversial Gaza Humanitarian Foundation (GHF), a US-led initiative backed by Israel in Israeli-controlled zones.

More than 130 people have now been killed and more than 700 wounded by Israeli troops while desperately trying to access meagre food parcels for their hungry families from the aid sites since the GHF programme began on May 27.

At least nine people are still missing.

In a statement, Gaza’s Government Media Office condemned the distribution sites as “human slaughterhouses”, accusing Israeli forces of luring desperate civilians to their deaths.

“These are war crimes and crimes against humanity,” the statement said, urging an independent international probe and an immediate suspension of GHF’s delivery model.

The drive backed by Israel and the United States has faced growing criticism from human rights organisations and the United Nations for violating basic humanitarian standards and bypassing organisations that have decades of experience distributing aid to the entire population of the besieged enclave.

‘This is a trap for us, not aid’

The latest bloodshed reportedly began around 6am local time (03:00 GMT), as hundreds of Palestinians stalked by starvation gathered near the aid point in the al-Alam area of Rafah.

Witnesses said people had started forming queues as early as 4:30am, desperate to get food before the site became overwhelmed.

“After about an hour and a half, hundreds moved toward the site, and the army opened fire,” said witness Abdallah Nour al-Din.

The Israeli military later said its troops opened fire on individuals who “continued advancing in a way that endangered the soldiers”, and claimed the area had been designated an “active combat zone” at night. However, survivors insist the shooting took place after sunrise.

“This is a trap for us, not aid,” said Adham Dahman, speaking to the Associated Press from Nasser Hospital in southern Gaza with a bloodied bandage on his chin. He said a tank fired towards the crowd, and people were left scrambling for cover.

Doctors Without Borders (MSF) said that 13 wounded individuals and one person who was dead on arrival came to its clinic in the al-Mawasi area of southern Khan Younis today.

MSF said the injured and dead were “carried in donkey carts, on bicycles, or on foot”.

The wounded were all men between the ages of 17 and 30. The victims said they were shot in the Shakoush area while travelling to a food distribution site in Saudi village.

Footage from outside the hospital showed mourning families weeping over blood-soaked shrouds, as emergency workers rushed to treat the wounded.

UN Special Rapporteur on the Occupied Palestinian Territories Francesca Albanese called the GHF operation “humanitarian camouflage” and “an essential tactic of this genocide”.

In a post on social media, Albanese blamed “the moral and political corruption of the world” for enabling the destruction of Gaza.

Al Jazeera’s correspondent Hani Mahmoud, reporting from Gaza City, said the GHF’s delivery model has proven woefully inadequate. “Today’s deadly attacks in the south show that the GHF is insufficient in the way it’s running aid delivery,” he said.

“In the north, living conditions are becoming even more difficult. People are not just spending hours searching for water and food — they are spending the entire day. By the end of it, many are completely exhausted and dehydrated, simply because they could not find anything.”

An unnamed GHF official claimed there has been no violence in or around its aid distribution sites, all three of which delivered food on Sunday, according to The Associated Press.

Hospitals overwhelmed

The violence comes as Gaza’s Health Ministry reports that the total death toll from Israel’s ongoing war has reached 54,880, with more than 126,000 injured since October 7, 2023. Since Israel ended a ceasefire on March 18, 4,603 Palestinians have been killed and more than 14,000 injured.

In just the last 24 hours, Israeli strikes have killed at least 108 people and wounded nearly 400 more across the besieged enclave, the ministry said.

Hospitals are overwhelmed and on the brink of collapse, the ministry said.

Rafah’s Red Cross Field Hospital has declared 12 mass casualty emergencies in just two weeks, with more than 900 wounded arriving during that period — 41 of them already dead. Most of those treated had been trying to reach food distribution sites when they were shot or injured.

A spokesman at Al-Aqsa Martyrs Hospital in Deir el-Balah warned that fuel supplies for Gaza’s health facilities may run out within 48 hours, leaving patients without care. “The hospital’s artificial kidney department is out of service due to the occupation’s attacks,” he told Al Jazeera.

Meanwhile, the director of al-Shifa Hospital told Al Jazeera that the lives of 300 kidney failure patients hang in the balance. “We are facing a real disaster in the hospital if electricity is not provided,” he warned.

Southern Shan State, Myanmar – Tian Win Nang squats on the hard-packed earth, balancing a kilogramme (2.2 pounds) of chocolate-coloured raw opium in each hand like a human weighing scales.

“Each kilogramme is worth around $250,” said Tian Win Nang, wearing worn white flip-flops and a black T-shirt.

The son of poppy farmers, Tian Win Nang appears to be barely out of his teens.

“Chinese traders pay us in advance for the harvest,” he said, showing Al Jazeera three dinner-plate-sized mounds of opium.

“We don’t know what happens after,” he says of the journey that will see the opium go “north to the labs” where it will be processed into morphine and eventually refined into heroin.

“We do this to survive,” he adds.

The sun is high and the air is still in the poppy fields blanketing the hills in this part of southern Shan State in eastern Myanmar.

Men and women, young and old, their faces shielded with scarves and straw hats, move with quick, practised motions as hands use sharp tools to score green poppy pods before silently progressing on to another plant.

A milky fluid slowly oozes from the wound inflicted on the pod. When it has dried to the consistency of gum, the same hands will scrape off the sticky substance, gather it together and leave it to dry in the sun until it reaches the toffee-like consistency of raw opium.

This is a daily ritual for many farmers in this part of Shan State near where drug shipments have flowed along these mountain roads near the town of Pekon for decades. The routes wind towards the borders with neighbouring Thailand, Laos and China.

Armed conflict between Myanmar’s military and ethnic armed organisations in these regions has fuelled opium farming and drug production for generations, but the trade has surged in step with the country’s intensifying civil war.

Alliances have long existed, experts say, between high-ranking Myanmar military officers, ethnic armed groups, local criminal networks and transnational syndicates that handle the drug trade’s logistics, refining and distribution.

“Drug trafficking in Myanmar has been facilitated by the military since the 1990s,” said Mark Farmaner, director of the London-based Advance Myanmar charity and an expert on Southeast Asia. “Many officers profit personally, and the institution as a whole reaps political advantages,” he said.

One of the most powerful regional syndicates is Sam Gor, a sprawling network made up of an alliance of rival Chinese triad gangs that operates across China, Myanmar, Laos, Thailand, Cambodia and beyond.

Despite the 2021 arrest and extradition to Australia of Tse Chi Lop – a Canadian national of Chinese origin widely believed to be the leader of Sam Gor – the network remains largely intact.

The United Nations Office on Drugs and Crime (UNODC) estimates that the Sam Gor syndicate generated at least $8bn – and possibly as much as $17.7bn – in 2018 from controlling between 40 and 70 percent of the wholesale methamphetamine market in the Asia Pacific region.

Despite the high-profile arrest of Tse Chi Lop, the regional drug trade is flourishing with more than 1.1 billion methamphetamine pills seized across Southeast Asia in 2023 – a historic record, according to UNODC.

‘We oppose the production, trafficking and use of narcotics’

Most of the methamphetamine originates from laboratories hidden in the mountains of northern Shan State and other areas on Myanmar’s eastern borders, which have become the region’s epicentre of synthetic drug production and are part of the “Golden Triangle” – the lawless territory encompassing the shared borders of Myanmar, Thailand and Laos.

But before the explosion in methamphetamine production, the Golden Triangle was infamous for its opium crops and the heroin it produced while under the rule of the self-styled drug lord Khun Sa – the undisputed drug kingpin of the 1980s and 1990s regional drug trade.

Khun Sa is believed to have commanded a personal army of some 15,000 men and under his direction much of Shan State became the global centre of heroin production. He surrendered to the military government in Myanmar in 1996 and died in Yangon in 2007, under the protection of the same generals who had shielded him for years.

“In the early 1980s, the United States Drug Enforcement Administration estimated that 70 percent of the heroin consumed in the US came from his organization ,” Kelvin Rowley, a lecturer at Swinburne University of Technology in Australia, wrote after Khun Sa’s death.

“The US government placed a $2 million bounty on [Khun Sa’s] head – an amount reportedly less than what he earned in a single month,” Rowley said.

Opium has now made a comeback in the Golden Triangle.

After the Taliban banned poppy cultivation in Afghanistan in 2022, Myanmar returned to being the world’s top producer of opium.

In 2023, according to UNODC estimates, Myanmar’s poppy fields stretched over more than 47,000 hectares (more than 116,000 acres), and by 2024, some 995 tonnes of raw opium was produced – an increase of 135 percent since the military takeover in 2021. The gross value of the opium and heroin trade in Myanmar last year was estimated to be between $589m and $1.57bn, according to UNODC.

The scale of drug production, the UN reports, is also tied to the civil war in Myanmar, which is now in its fourth year.

Myanmar’s economy has collapsed since the military coup in 2021, and with options narrowing, people have traditionally turned to poppy cultivation as a means to survive.

The UN notes that opium poppy cultivation in Southeast Asia has long been linked to poverty, lack of government services, economic challenges and insecurity.

“Households and villages in Myanmar that engage in poppy cultivation and the broader opium economy do so to supplement income or because they lack other legitimate opportunities,” the UN said.

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But now parts of Pekon, long a military stronghold and a key drug trafficking corridor, are under the control of the Karenni Nationalities Defence Force (KNDF) and other Karenni armed groups fighting the ruling military.

They say they want to change things.

“We oppose the production, trafficking, and use of narcotics,” said Maui, a deputy commander of the KNDF.

“When we capture Burmese soldiers, they’re full of meth,” Maui said.

“We ask where it comes from and they tell us, without hesitation, it’s distributed by their superiors to push them to the front lines,” he said.

“Once the war is over, we’ll go after the opium too. We want it to be used only for medical purposes,” he added.

As part of those antidrug efforts, Karenni police forces stop and search motorcycles and vehicles on roads in the areas of Shan State they now control.

“We are stopping cars and motorbikes we don’t recognise to search for drugs,” said Karenni police commander Win Ning Thun, standing at a checkpoint just outside a village in Pekon district.

“We’re looking for yaba pills,” said Win Ning Thun, using the local name for methamphetamine pills.

“Until recently, this area was under military and pro-junta militia control,” Win Ning Thun said.

“Meth was moving freely under their supervision. They took a percentage of the profits from every shipment passing through,” he said.

‘I was supposed to make a lot of money’

Deep in the forests surrounding Pekon, a small prison holds rows of detainees arrested by Karenni police.

“Everyone here has been arrested for drug trafficking. Some were carrying yaba pills to the Thai border. Others were internal couriers,” a Karenni police official told Al Jazeera.

“These are the pills we confiscated just this past month,” he said, holding up a plastic bag stuffed with small red yaba pills that are easy to conceal, sold cheaply, but represent a trade that is worth millions of dollars.

Among the detainees in the prison was Anton Lee, who wore glasses and a calm, unassuming look.

“They stopped me at a checkpoint with 10,000 pills,” Lee said.

“I was taking them to the Thai border. I was supposed to make a lot of money,” he said, offering no further details, only to say that the profit he hoped to earn would have fed his family for a year.

Now, he faces a long time in prison.

Not too far from the prison, the civil war grinds on in Myanmar as the military regime buys more advanced weaponry, and the rebel forces try to hold out and extend their advances.

The military’s air raids, drone strikes and artillery fire hammer schools, hospitals, homes and religious sites, turning entire villages into targets.

Yet, even under fire, here in southern Shan State, some appear to be trying to staunch the flow of drugs.

With limited resources, they tell of doing what they can in another battle inside a much larger war.

Many of the world’s poorest countries are due to make record debt repayments to China in 2025 on loans extended a decade ago, at the peak of Beijing’s Belt and Road Initiative, a report by the Sydney-based Lowy Institute think tank has found.

Under the Belt and Road Initiative (BRI), a state-backed infrastructure investment programme launched in 2013, Beijing lent billions of dollars to build ports, highways and railroads to connect Asia, Africa and the Americas.

But new lending is drying up. In 2025, debt repayments owed to China by developing countries will amount to $35bn. Of that, $22bn is set to be paid by 75 of the world’s poorest countries, putting health and education spending at risk, Lowy concluded.

“For the rest of this decade, China will be more debt collector than banker to the developing world,” said Riley Duke, the report’s author.

“Developing countries are grappling with a tidal wave of debt repayments and interest costs to China,” Duke said.

What did the report say?

China’s BRI, the biggest multilateral development programme ever undertaken by a single country, is one of President Xi Jinping’s hallmark foreign policy initiatives.

It focuses primarily on developing country infrastructure projects like power plants, roads and ports, which struggle to receive financial backing from Western financial institutions.

The BRI has turned China into the largest global supplier of bilateral loans, peaking at about $50bn in 2016 – more than all Western creditors combined.

According to the Lowy report, however, paying off these debts is now jeopardising public spending.

“Pressure from Chinese state lending, along with surging repayments to a range of international private creditors, is putting enormous financial strain on developing economies.”

High debt servicing costs can suffocate spending on public services like education and healthcare, and limit their ability to respond to economic and climate shocks.

The 46 least developed countries (LDCs) spent a significant share – about 20 percent – of their tax revenues on external public debt in 2023. Lowy’s report implies this will increase even more this year.

For context, Germany used 8.4 percent of its budget to repay debt in 2023.

Lowy also raised questions about whether China will use these debts for “geopolitical leverage” in the Global South, especially with Washington slashing foreign aid under President Donald Trump.

“As Beijing shifts into the role of debt collector, Western governments remain internally focused, with aid declining and multilateral support waning,” the report said.

While Chinese lending is also beginning to slow down across the developing world, the report said there were two areas that seemed to be bucking the trend.

The first was in nations such as Honduras, Burkina Faso and Solomon Islands, which received massive new loans after switching diplomatic recognition from Taiwan to China.

The other was in countries such as Indonesia and Brazil, where China has signed new loan deals to secure critical minerals and metals for electric batteries.

How has China responded?

Beijing’s Ministry of Foreign Affairs said it was “not aware of the specifics” of the report but that “China’s investment and financing cooperation with developing countries abides by international conventions”.

Ministry spokesperson Mao Ning said “a small number of countries” sought to blame Beijing for miring developing nations in debt but that “falsehoods cannot cover up the truth”.

For years, the BRI has been criticised by Western commentators as a way for Beijing to entrap countries with unserviceable debt.

An often-cited example is the Hambantota port – located along vital east-west international shipping routes – in southern Sri Lanka.

Unable to repay a $1.4bn loan for the port’s construction, Colombo was forced to lease the facility to a Chinese firm for 99 years in 2017.

China’s government has denied accusations it deliberately creates debt traps, and recipient nations have also pushed back, saying China was often a more reliable partner than the West and offered crucial loans when others refused.

Still, China publishes little data on its BRI scheme, and the Lowy Institute said its estimates, based on World Bank data, may underestimate the full scale of China’s lending.

In 2021, AidData – a US-based international development research lab – estimated that China was owed a “hidden debt” of about $385bn.

Does the Lowy report lack ‘context’?

Challenging the “debt-trap” narrative, the Rhodium consulting group looked at 38 Chinese debt renegotiations with 24 developing countries in 2019 and concluded that Beijing’s leverage was limited, with many of the renegotiations resolved in favour of the borrower.

According to Rhodium, developing countries had restructured roughly $50bn of Chinese loans in the decade before its 2019 study was published, with loan extensions, cheaper financing and debt forgiveness the most frequent outcomes.

Elsewhere, a 2020 study by the China Africa Research Initiative at Johns Hopkins University found that, between 2000 and 2019, China cancelled $3.4bn of debt in Africa and a further $15bn was refinanced. No assets were seized.

Meanwhile, many developing countries remain in hock to Western institutions.

In 2022, the Debt Justice Group estimated that African governments owed three times more to private financial groups than to China, charging double the interest in the process.

“Developing country debt to China is less than what is owed to both private bondholders and multilateral development banks (MDBs),” says Kevin Gallagher, director of the Boston University Global Development Policy Center.

“So, Lowy’s focus on China lacks context. The truth is, even if you remove China from the creditor picture, lots of poor countries would still be in debt distress,” Gallagher told Al Jazeera.

Following the COVID-19 pandemic and Russia’s invasion of Ukraine, inflation prompted the United States Federal Reserve, as well as other leading central banks, to hike interest rates.

Attracted to higher yields in the US, investors withdrew their funds from developing country financial assets, raising yield costs and depreciating currencies. Debt repayment costs soared.

Global interest rates have since come down slightly. But according to the UN, developing country borrowing costs are, on average, two to four times higher than in the US and six to 12 times higher than in Germany.

“A crucial aspect about Chinese lending,” said Gallagher, “is that it tends to be long-term and growth enhancing. That’s precisely why a lot of it is focused on infrastructure investment. Western lenders tend to get in and out faster and charge higher rates.”

Amnesty International says torture, killings and enforced disappearances have taken place in areas under rebel control.

M23 rebels in the eastern Democratic Republic of the Congo (DRC) have committed serious abuses against civilians, “including torture, killings and enforced disappearances”, in areas under their control, according to Amnesty International.

“These acts violate international humanitarian law and may amount to war crimes,” Amnesty said in a statement on Tuesday.

The allegations come amid a renewed surge in violence that erupted in January, when the Rwandan-backed M23 group captured the strategic city of Goma in North Kivu province. The rebels went on to seize Bukavu in South Kivu in February, escalating a conflict that has displaced hundreds of thousands.

Between February and April, Amnesty researchers spoke to 18 people who had been detained by M23 in Goma and Bukavu. Many said they were held on accusations of supporting the Congolese army or government – claims for which no proof was presented. Several were not told why they were being held.

According to Amnesty, detainees were crammed into overcrowded, unhygienic cells, lacking adequate food, water, sanitation and medical care. Some of those interviewed said they saw fellow prisoners die due to these conditions or from acts of torture.

Witnesses described gruesome scenes, including two detainees being bludgeoned to death with hammers and another shot dead on the spot.

All of the former detainees said they were either tortured or saw others being tortured with wooden sticks, electric cables or engine belts, the rights group said.

Relatives searching for the missing were often turned away by M23 fighters, who denied the detainees were being held – actions Amnesty says amount to enforced disappearances.

Peace deal remains elusive

“M23’s public statements about bringing order to eastern DRC mask their horrific treatment of detainees. They brutally punish those who they believe oppose them and intimidate others, so no one dares to challenge them,” said Tigere Chagutah, Amnesty International’s regional director for East and Southern Africa.

“Regional and international actors must pressure Rwanda to cease its support for M23,” added Chagutah.

The United Nations and DRC’s government say Rwanda has supported M23 by providing arms and sending troops – an accusation Kigali denies.

The UN estimates that about 4,000 Rwandan soldiers support M23.

M23 is among roughly 100 armed groups fighting for control in eastern DRC, a region rich in minerals and bordering Rwanda. The ongoing conflict has driven more than seven million people from their homes, including 100,000 who fled this year alone.

Despite recent pledges by the Congolese army and the rebels to seek a truce, clashes have continued. M23 previously threatened to advance as far as the capital, Kinshasa, more than 1,600km (1,000 miles) away.

In April, Rwanda and DRC agreed to draft a peace deal by May 2, committing to respect each other’s sovereignty and refraining from providing military support to armed groups.

Public spending cuts across six African countries have resulted in the incomes of health and education workers falling by up to 50 percent in five years, leaving them struggling to make ends meet, according to international NGO ActionAid.

The Human Cost of Public Sector Cuts in Africa report published on Tuesday found that 97 percent of the healthcare workers it surveyed in Ethiopia, Ghana, Kenya, Liberia, Malawi and Nigeria could not cover their basic needs like food and rent with their wages.

The International Monetary Fund (IMF) is to blame for these countries’ failing public systems, the report said, as the agency advises governments to significantly cut public spending to pay back foreign debt. As the debt crisis rapidly worsens across the Global South, more than three-quarters of all low-income countries in the world are spending more on debt servicing than healthcare.

“The debt crisis and the IMF’s insistence on cuts to public services in favour of foreign debt repayments have severely hindered investments in healthcare and education across Africa. For example, in 2024, Nigeria allocated only 4% of its national revenue to health, while a staggering 20.1% went toward repaying foreign debt,” said ActionAid Nigeria’s Country Director Andrew Mamedu.

The report highlighted how insufficient budgets in the healthcare system had resulted in chronic shortages and a decline in the quality of service.

Women also appear to be disproportionally affected.

“In the past month, I have witnessed four women giving birth at home due to unaffordable hospital fees. The community is forced to seek vaccines and immunisation in private hospitals since they are not available in public hospitals. Our [local] health services are limited in terms of catering for pregnant and lactating women,” said a healthcare worker from Kenya, who  ActionAid identified only as Maria.

Medicines for malaria – which remains a leading cause of death across the African continent, especially in young children and pregnant women – are now 10 times more expensive at private facilities, the NGO said. Millions don’t have access to lifesaving healthcare due to long travel distances, rising fees and a medical workforce shortage.

“Malaria is an epidemic in our area [because medication is now beyond the reach of many]. Five years ago, we could buy [antimalarial medication] for 50 birrs ($0.4), but now it costs more than 500 birr ($4) in private health centres,” a community member from Muyakela Kebele in Ethiopia, identified only as Marym, told ActionAid.

‘Delivering quality education is nearly impossible’

The situation is equally dire in education, as budget cuts have led to failing public education systems crippled by rising costs, a shortage of learning materials and overcrowded classrooms.

Teachers report being overwhelmed by overcrowded classrooms, with some having to manage more than 200 students. In addition, about 87 percent of teachers said they lacked basic classroom materials, with 73 percent saying they paid for the materials themselves.

Meanwhile, teachers’ wages have been gradually falling, with 84 percent reporting a 10-15 percent drop in their income over the past five years.

“I often struggle to put enough food on the table,” said a teacher from Liberia, identified as Kasor.

Four of the six countries included in the report are spending less than the recommended one-fifth of their national budget on education, according to the UNESCO Institute for Statistics.

“I now believe teaching is the least valued profession. With over 200 students in my class and inadequate teaching and learning materials, delivering quality education is nearly impossible,” said a primary school teacher in Malawi’s Rumphi District, identified as Maluwa.

Action Aid said its report shows that the consequences of IMF-endorsed policies are far-reaching. Healthcare workers and educators are severely limited in the work they can do, which has direct consequences on the quality of services they can provide, it said.

“The debt crisis and drive for austerity is amplified for countries in the Global South and low-income countries, especially due to an unfair global economic system held in place by outdated institutions, such as the IMF,” said Roos Saalbrink, the global economic justice lead at ActionAid International. “This means the burden of debt falls on those most marginalised – once again. This must end.”