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The CAF Champions League Final between the two North African clubs, Al Ahly and Esperance Tunis, in May will be another occasion to celebrate African football. The winner of the competition will take home US$4 million in prize money, while the runner-up will receive US$2 million.

For the north African clubs, it is another occasion to showcase their dominance over the African football leagues.

Al Ahly, based in Cairo, and Esperance, in Tunis, are among the most successful clubs in the history of the main club cup competition in Africa, the CAF Champions League.

Al Ahly has reached the finals multiple times and boasts 11 titles, making it the most successful club in the competition’s history. Similarly, Esperance has secured the title multiple times.

These successes have not occurred by accident. The two clubs have financial muscle, effective management systems and large fan bases. These factors do not only boost their performances in competition but also influence their strategic decisions at the Confederation of African Football (CAF) level.

As a scholar of sports policy and management who has researched sports in north Africa and the Arab regions, I argue that the dominance of clubs like Al Ahly and Esperance is rooted in various factors. These include the history and culture of the clubs, their fan base, financial and political support and the strength of their domestic leagues. They have some of the best infrastructures in Africa, and their models of football development focus more on the local domestic leagues.

This approach contrasts with the dominant model of African clubs and academies, which depend on the export of players, which affects their performance in African football league tournaments. Nigeria, South Africa, Congo and Cameroon are exceptions.

Al Ahly

Al Ahly is based in Cairo, the capital of Egypt, and is often referred to as the “club of the people”. It was founded on 24 April 1907. The club has won the Egyptian Premier League 43 times and the Egypt Cup 39 times. On the continental level, it is the record winner of the CAF Champions League, having won it 11 times. The club’s success is supported by strong organisational backing, extensive training facilities, and a significant fan base.

Al Ahly’s budget is among the highest in Africa, reported to be about EGP 2.54 billion (around US$100 million). It’s able to invest in operations and facilities. The club’s home matches are played at the Cairo International Stadium, which has a capacity of 75,000, making it one of the largest and best equipped sporting venues in the region. It currently has 19 players active in their respective national teams, including players representing Egypt and other countries.

Esperance

Esperance Sportive de Tunis, commonly known as Esperance, was founded in 1919 in Tunis, capital of Tunisia. The club emerged during a period of national consciousness against the French protectorate, becoming a symbol of Tunisian identity and resistance. Esperance has won the Tunisian League title 30 times. The club’s colours, red and gold, are iconic in Tunisian sports. On the African stage, Esperance has won the CAF Champions League four times, affirming its status as a leading club in African football.

Unlike its opponents in the final, Esperance has a more modest budget, reflecting the current economic situation in Tunisia. Since the fall of the Ben Ali regime in 2011, which previously forced national companies to sponsor sports clubs, public and private corporations are now more reluctant to financially back football clubs.

Despite this, the club enjoys substantial investment in its facilities and operations to maintain competitive standards in both domestic and continental competitions. Esperance plays at the Stade Olympique de Radès, which provides considerable capacity and modern facilities conducive to high-level sports performance.

Teaching lessons

There is a lot that teams from the continent can learn from Al Ahly and Esperance. The success of these two clubs is the result of meticulous planning, investment in infrastructure, a strong domestic league and a dedicated fan base. Both Egypt and Tunisia, similar to Morocco and Algeria, are known for their strong domestic leagues with competitive clubs in both the first and lower divisions. Each club has a strong local identity, contributing to the rivalry between clubs in their respective countries.

Their football model focuses on producing local talent to strengthen their domestic leagues and national teams. Additionally, clubs in Egypt and Tunisia have been destinations for many top African players who see these leagues as a stepping stone towards more lucrative contracts in Europe or as providing better conditions for professional contracts than in their home countries. The growth of leagues in the Arabian Peninsula, particularly the Qatar Stars League and the Saudi League (RSL), which allows clubs to enlist up to eight foreign players, also attracts top African football talent.

This is a proven template that other teams can pick up and modify to suit their circumstances and build their own success. South African team Mamelodi Sundowns has achieved considerable recent success with a similar approach. Läs mer…

When the Shell petroleum company announced in 2021 that it wanted to explore for fossil fuels off South Africa’s pristine Wild Coast, Indigenous communities in the area immediately fought back through the country’s courts.

In two separate cases, the communities successfully challenged Shell. They won both cases, winning an interim interdict to put Shell’s exploration on hold and having the company’s exploration right set aside. Shell is appealing the second ruling on several, largely procedural, grounds; that process got underway in the Supreme Court of Appeal on 17 May this year.

If the Supreme Court of Appeal upholds the High Court’s judgment, this would affirm the Indigenous communities’ rights and interests. If, on the other hand, it overturns the judgment, the exploration right, which was granted 10 years ago, would continue to stand.

Whatever the outcome of this appeal, the two cases are unique. Litigants in other South African climate court cases have mainly relied on environmental arguments. But here, the litigants relied specifically on their Indigenous rights and knowledge to argue why Shell should not be allowed to carry out a seismic survey in their seas.

One of the applicants, Sinegugu Zukulu, is a resident of the Baleni village on the Wild Coast. He is a part of the Amadiba community, which has been living for several centuries in the area. Like other members of his community, Zukulu takes pride in the land on which he lives, partly because his ancestors fought to protect it. In his affidavit, Zukulu said that the land belonged to the community – but the community also belonged to the land:

The land sustains us and is central to our identity.

The courts engaged with the communities’ cultural beliefs and practices. They also recognised that Indigenous peoples have a wealth of knowledge related to sustainable living, and that their livelihoods, cultural practices and identities are all threatened by the proposed activities.

We are a team of lawyers who research the space where environmental law meets human rights and constitutional law. We also focus on the political and governance issues that arise within this space, as well as the role of law in mediating the relationship between humans and the environment.

In a recent academic paper we examined the two cases in question. We argue that, in future, Indigenous people’s concerns and considerations could provide a strong basis for climate litigation in South Africa. Using Indigenous knowledge in court to argue against exploration and mining by carbon majors (big oil, coal and gas producers) could potentially contribute to both efforts to protect Indigenous communities and to drive climate action.

The courts’ findings

In October 2021, Shell announced that it would undertake a 3D seismic survey along the country’s south-eastern coast in its search for oil and gas resources. Seismic surveys have the potential to harm diverse marine species and adversely affect humans. They can also contribute to catastrophic climate change. Faced by these threats, activists and affected Indigenous communities brought two applications to the court in 2021 (Shell 1) and 2022 (Shell 2).

In their founding affidavit, the applicants emphasised the importance of the land and sea to their identities, livelihoods and culture. They set out the threats posed by the proposed seismic surveys to their livelihoods and way of life.

They also highlighted that the seismic survey would disrupt their cultural and spiritual relationship with the sea. The applicants told the court that if the seismic survey went ahead, it would have a negative impact on their ancestors and their relationship with those ancestors.

The Indigenous communities argued that, like earlier colonial and apartheid powers, Shell had ignored their right to self-determination, something that is increasingly recognised in domestic and international law. The right to self-determination essentially refers to the right of people to govern themselves without interference from anyone; to determine their own political status; to be free from domination and to have the right to form their own independent state or place to live.

Finally, the applicants were concerned about the seismic survey going ahead without a climate change impact assessment being carried out first. They worried about what the climatic effects might be if the survey revealed hydrocarbon resources.

In the Shell 1 case, the Eastern Cape High Court found that the Indigenous community applicants had met the requirements for an interim interdict against Shell. Shell was temporarily prevented from carrying out the seismic survey. In the Shell 2 case, the applicants successfully established that the consultation process leading to the award of the exploration right was procedurally unfair. The exploration right was set aside.

These were fantastic outcomes for the communities and the environment that sustains them. The greatest significance, we argue, lies in the extent to which the courts engaged with the Indigenous community applicants’ cultural beliefs and practices and their knowledge about sustainability.

Constitutional duty

In the Shell 1 case, the court emphasised the importance of accepting the applicants’ customary practices and spiritual relationship with the sea. The court also emphasised that it had a constitutional duty to protect the holders of such practices and beliefs, and the environment, from the possible infringement of their rights.

The court accepted the applicants’ statements about sustainability and the need for and practice of Indigenous knowledge transfer. For example, it noted that the Amadiba traditional community “practise(s) the customary practices which they have been taught, namely when they fish, they think of tomorrow”. This knowledge about the environment, and ways of living in harmony with the environment, is transferred from one generation to the next.

In the Shell 2 case, the court made similar findings. It emphasised that cultural rights are protected by the constitution.

It accepted the applicants’ belief that

the ocean is the sacred site where their ancestors live and so (they) have a duty to ensure that their ancestors are not unnecessarily disturbed and that they are content.

The court also found that Shell’s proposed measures to limit the impacts of their environmentally harmful activities clearly failed to address potential harm to the communities’ practices and beliefs.

Significance

These cases represent the first time that Indigenous communities in South Africa specifically invoked their cultural rights in climate litigation. This decision adds to a growing body of indigenous-oriented climate litigation cases around the world, such as in Australia and the US.

The judgments are especially noteworthy as they indicate that South Africa’s courts are willing to engage with the cultural beliefs and practices of Indigenous communities, as well as their knowledge related to sustainability. Läs mer…

Graduations throughout the United States erupt with some familiar sounds every year: the passionate cheering of friends and families, the lofty grandeur of speeches and, of course, one very recognizable tune.

Most Americans – if they’re even aware of its name – know it simply as “Pomp and Circumstance.”

More specifically, it is the “trio” section of the most famous of Edward Elgar’s five Pomp and Circumstance marches, “March No. 1 in D Major.”

When Elgar composed the piece in 1901, he wasn’t thinking about graduation or scholarship. He wrote it as a patriotic military march.

The phrase “pomp and circumstance” originates in Shakespeare’s “Othello,” where Othello uses it as he speaks of the allure of the “spirit-stirring drum” of “glorious war.”

In Britain, the melody still evokes the confident grandeur of an empire at its peak – just years before World War I shattered that confidence. The tune soon acquired a different set of associations in America, where by the 1920s it had become a graduation staple.

The unbridled optimism of empire

For a British military march to be reinvented as a graduation tune – by a former Colonial subjects of the U.K., no less – shows how people can bestow entirely new meanings onto old songs.

Elgar had already achieved acclaim in the 1890s for works such as “The Black Knight” and “King Olaf.” By the time of Queen Victoria’s death in 1901, Elgar was, according to biographer Basil Maine, the greatest musician of the land.

The premiere of “March No. 1” elevated him into an even greater stratosphere of fame. Music critics and the public considered it one of Elgar’s best for its stately, soaring majesty.

The new king of Britain, Edward VII, was among those who lavished praise on the tune, and he persuaded Elgar to incorporate it into a significantly longer ode that Elgar composed for the king’s coronation.

A version of ‘March No. 1’ with lyrics was performed during the 1902 coronation of Edward VII.
Hulton Archive/Getty Images

Essayist and critic A.C. Benson wrote lyrics for the performance of Elgar’s melody at the coronation, resulting in the patriotic anthem “Land of Hope and Glory.”

British audiences are most familiar with this form of “March No. 1.” Along with “Jerusalem” and “I Vow to Thee, My Country,” “Land of Hope and Glory” is one of the most famous British patriotic songs outside of the national anthem. The Proms, a series of popular summer concerts in Britain that began in 1895, traditionally feature “Land of Hope and Glory” during the final concert of the year.

Perhaps no piece of music better fits the mood of Britain before World War I. As a scholar of this era, I cannot help but notice the unbridled boldness of the piece, the sonorous confidence that Britain is and always will be the most powerful, influential country in the world.

This stability, of course, would not last. The devastation of World War I shattered this fantasy and signaled the start of its declining importance in world affairs. Several decades later, World War II and its aftermath led to the rapid dissolution of the British Empire.

Now, in the 21st century, the tune evokes the nostalgia for a vanished, golden age. But the lyrics of “Land of Hope and Glory” have also generated controversy for their encouragement of imperialism and expansionism – “wider still and wider shall her bounds be set.”

Elgar conducts ‘March No.1’ at the opening of London’s Abbey Road Studios in 1931.

A send-off fit for a king

Unlike British audiences, Americans didn’t associate the song with an imperial past; for over a century, they’ve used it to celebrate the future.

The tune’s tie to graduation began in 1905, when Elgar received an honorary doctorate at Yale. At the end of the ceremony, the school orchestra played “March No. 1” in order to honor him.

This started a trend among prestigious universities. Princeton first played the song in 1907, followed by the University of Chicago in 1908 and Columbia in 1913.

The song spread organically, owing to the increasing interconnectedness of the nation. Because of railroads, telegraphs and advances in printing technology, news and people could travel quickly.

In less than 20 years, “March No. 1” went from an Ivy League novelty to a widely embraced musical standard for high school and college graduations.

Why did it catch on so quickly? I’d say its mix of optimism and grandeur – with a hint of wistfulness – resonated.

It’s an appropriate send-off for a student entering a new stage of life – one fit for a king. Läs mer…

A 13,000-word article in The New Yorker magazine about convicted murderer Lucy Letby is blocked to UK online readers.

Conservative MP David Davis claimed preventing members of the UK public reading the essay seemed “in defiance of open justice” in parliament, and asked justice secretary Alex Chalk to look into the matter. Is he right?

The principle of open justice means courts in England and Wales must administer justice in public. Members of the public can observe and cases can be reported by the media. The Letby case is no different. However, there are laws to protect the integrity of criminal trials heard by a jury.

The presumption of innocence is a fundamental right of the justice system. Anyone accused of committing a crime is innocent until proven guilty, with the onus on the prosecution to prove guilt beyond reasonable doubt.

Convicted criminals, including serial killers and rapists, charged with new offences have this right. This includes Letby, who faces a retrial next month on one count of attempted murder on which the original jury failed to reach a verdict.

The original trial took place at Manchester Crown Court in 2023. The neonatal nurse was sentenced to 14 whole-life orders for the murder of seven babies and the attempted murder of six others between June 2015 and June 2016.

Given the forthcoming retrial, anyone reporting or publishing must take care not to breach the Contempt of Court Act 1981. This law applies as soon as criminal proceedings are active in England and Wales – when someone is arrested, a warrant is issued, they are charged, an appeal is lodged, or they face a retrial.

Under this law, the media must not publish anything which creates a substantial risk of serious prejudice or impediment to the proceedings. The central idea is that potential jurors should not see anything in the media which might give them a negative impression of the defendant. Non-contentious information such as the defendant’s name, age and address can be reported, along with the charges, the plea, and the names of the judge, court and barristers. The date of the hearing and whether or not the defendant is in custody can also be reported.

Sometimes, information is published which could prejudice jurors, so there are steps taken in court to minimise this risk. In criminal trials, jurors take an oath or affirmation to try each case only on the evidence presented to them in court. They are given a leaflet warning them of the consequences of breaking this oath.

Jurors are not told of defendants’ previous convictions in case it prejudices their decision, and are warned by the judge they should not read about the case or research it online. This is a criminal offence punishable with an unlimited fine or up to two years in prison, and jurors have been jailed.

Global publicity and contempt of court

The Letby case attracted huge publicity, so jurors at her new trial will likely know who she is. With this in mind, the trial judge made a special reporting restriction under the Contempt of Court Act, known as a Section 4(2) order. This further restricts what can be reported by the media to avoid “substantial risk” of prejudice. It is a temporary ban on reporting, lifted at the court’s discretion, usually at the end of a trial or series of trials.

The New Yorker piece, although unavailable online, can currently be accessed in the print edition of the magazine in the UK and on its app, and those who know how can find it on archived sites online. This could break the UK law, but no legal action has been taken against the publication.

It’s possible the judge will ask potential jurors at the start of the retrial if they’ve read the article – and if they have, they may not be selected to serve on the jury.

Lucy Letby, drawn at her trial, faces retrial on one count of attempted murder.
Elizabeth Cook/Alamy

The law applies to all publishers, whether they’re trained journalists or members of the public, and generally works well in terms of protecting the integrity of jury trials. Professional journalists and news organisations with large followings know the rules.

However, we live in the age of the internet and social media, where everyone with a mobile phone is a publisher. This is problematic because many don’t know the law. Online links are easily shareable, so the reporting restriction may also be protecting members of the public from accidentally breaching contempt law.

Read more:
Sarah Everard: social media and the very real danger of contempt of court

Temporary reporting restrictions are used all the time – for example, in the case of prolific rapist Reynhard Sinaga in 2020, and in the Victoria Station murder trials in 2013.

This is why the New Yorker piece is currently unavailable online in the UK. The publisher, Condé Nast, appears to be complying with this court order, to reduce the small chance a UK juror sitting in the retrial reads the article. (US laws are much more relaxed about reporting criminal trials, as is evident in the ongoing trial of former president Donald Trump.)

The question is, how likely is it that they will read the piece? While not every juror is likely to read through a 13,000-word article behind an online paywall, there is a risk of prejudice. Whether it’s substantial or not is another matter.

This is not an assault on open justice; quite the opposite – the aim is to ensure Letby receives a fair trial, as is her right under the Human Rights Act. Then, once the trial ends and the restriction is lifted, the New Yorker article will be available to everyone. Läs mer…

The High Court in Belfast has ruled that key elements of the UK’s Illegal Migration Act are incompatible with the Windsor framework and should not be applied in Northern Ireland. Once again, Northern Ireland appears to be a block on the Brexit ambition to “take back control of our borders”.

This time, though, the implications go beyond the island of Ireland. The judgement reaches across the Irish Sea to the core of the UK’s post-Brexit immigration policy. The court found that parts of the act, which gave the government expansive powers to remove asylum seekers, violate the human rights of those seeking refuge in Northern Ireland.

Unsurprisingly, the government has vowed to appeal. But the ruling has already exposed something about the UK.

This matter is greater than debates around migration, Brexit or the integrity of the UK union. It centres on human rights: something the UK recognised after the second world war to be essential to human dignity, and acknowledged in 1998 to be essential to peace in Northern Ireland. In the wake of brutal conflict, the UK had agreed with its neighbours to apply better and universal standards to protect humanity.

Read more:
Asylum chaos triggers fresh tensions over how to manage Ireland’s post-Brexit border

Amid the tortuous Brexit negotiations, the need to uphold human rights was so obvious that it was the point the UK and EU agreed upon most readily. An article on protecting the “rights of individuals” in Northern Ireland was included in the first draft of the UK-EU withdrawal agreement in March 2018.

It remained unchanged through the various iterations of the Protocol on Ireland/Northern Ireland within that agreement that followed: Theresa May’s “backstop” in November 2018, Boris Johnson’s deal in October 2019 and Rishi Sunak’s Windsor framework in February 2023.

The purpose of the protocol (now “Windsor framework”) was not just to avoid a hard border on the island of Ireland but, as article 1 states, to “protect the 1998 [Good Friday/Belfast] Agreement in all its dimensions”.

The principal purpose of article 2 of the Windsor framework is to safeguard that peace agreement. It is striking that, even though this is a joint agreement between the UK and the EU, the article focuses on solely one protagonist. It says: “The United Kingdom shall ensure that no diminution of rights, safeguards or equality of opportunity, as set out in … the 1998 Agreement … results from its withdrawal from the [European] Union”.

As was clearly outlined to a Westminster committee recently, the constitutional incorporation of human rights in Northern Ireland is fundamental to its post-conflict governance. Crucially, the 1998 agreement, which brought 30 years of violence to an end, also established institutions to uphold these protections, including dedicated human rights and equality commissions.

The second part of article 2 of the Windsor framework commits the UK to continuing to facilitate the work of these bodies. It may be seen either as ironic or reassuring that those very same institutions are the ones who have taken the UK government to court for breaching that very same article.

Rolling back on human rights

The legal proceedings taken by the Northern Ireland Human Rights Commission centred on article 2. In essence, the ruling means that elements of UK law diminish rights that are fundamental to the 1998 agreement, including the European Convention on Human Rights. Notably, this is the second time this year the Belfast High Court has found this to be so.

The Illegal Migration Act is a key part of the UK government’s plans to send asylum seekers to Rwanda.
Sean Aidan Calderbank/Shutterstock

Critics have claimed the judgement will make Northern Ireland a “magnet” for asylum seekers hoping to avoid being sent to Rwanda. But they miss the bigger picture.

Northern Ireland does have a unique place in the UK but this is primarily as a conduit for applying international standards of human rights – even as the government is appearing to unravel them.

Indeed, Northern Ireland’s governance and constitution are uniquely and directly subject to international agreements. This is for good reason.

The protections they offer prevail over domestic law, giving reassurance after a shameful history of state discrimination and rights abuses. Were there to be a change in the constitutional status of Northern Ireland, international standards – and defence – of human rights will remain just as important.

For that, after all, is the point of universal human rights: we do not get to choose whether or not we might need to draw upon their protection. Läs mer…

The infected blood scandal has been hailed the worst treatment disaster in the history of the NHS. Over 3,000 people have died as a result of receiving contaminated blood products in the 1970s, 80s and 90s, and it is estimated that an infected person still dies every four days.

As the scandal unfolded, repeated calls for justice and recognition were ignored. An independent public inquiry was finally announced in 2017. The delay is itself a source of harm.

Too many have died without redress or adequate support. The infected blood inquiry, chaired by Sir Brian Langstaff, is the largest public inquiry ever carried out in the UK. The inquiry is due to issue its final report on May 20 2024.

Read more:
’They call us the fatherless ones’: the trauma of families devastated by the infected blood scandal will last for generations

Public inquiries are major investigations set up by government to respond to catastrophic events. The infected blood inquiry has investigated the causes and effects of the infected blood scandal to get to the truth of what happened.

The inquiry team has reviewed extensive evidence, including many thousands of pages of public records, and evidence from the government, the NHS, the national blood services and pharmaceutical companies.

Thousands of oral and written submissions from those infected and affected were considered.

In oral hearings across the UK, people gave powerful accounts of their experiences and heard, in turn, from people who had been involved in offering treatment, determining policy and responding to the emerging disaster.

Some 2,007 of the infected and affected were appointed as “core participants”, and they worked with the inquiry team to formulate questions put to ten expert groups.

Nowadays, the infections with which the inquiry has been particularly concerned – hepatitis B, hepatitis C and HIV – are better understood and effective treatments are available. However, although doctors were aware of the risks of hepatitis B in the 1970s, hepatitis C and HIV took much longer to identify and understand.

Unexplained hepatitis was discussed from 1969, and the infectious agent hepatitis C, which can lead to chronic infection, serious liver damage and death, was identified in 1989.

The first UK case of Aids was in 1981. HIV was identified as the cause in 1983, but there was no treatment for Aids and the stigma was considerable.

Of the thousands of men, women and children infected with hepatitis C or HIV, the route of infection was most commonly a direct result of a contaminated blood transfusion, or through the use of medical treatment derived from contaminated human blood products.

People were put at risk by blood transfusions required to save their lives or aid their recovery, and by treatments aimed at managing blood clotting conditions such as haemophilia.

In the 1960s, patients with haemophilia were generally treated with a frozen blood product called cryoprecipitate, or cryo for short. Cryo posed a relatively low risk of passing on infection because a single dose was derived from a single blood donation. But it was difficult to store and administer and made life difficult for patients.

In the early 1970s, a revolutionary new treatment, factor VIII, resolved many of these problems and was seen as a major advance. However, factor VIII was made by concentrating pooled plasma collected from tens of thousands of donors. This increased the risk of passing on blood-borne infections, as just one donor carrying a virus could contaminate an entire batch that would then be used to treat many patients.

As doctors switched to offering factor VIII, the NHS struggled to meet demand and began to import supplies from the US.

These products were especially hazardous because in the US, people with a high risk of infection, including prisoners, were paid to provide blood. This was in contrast to the UK blood donation system which has always relied on altruistic donation.

Against this backdrop, the inquiry considered whether patients were treated appropriately in terms of issues such as informed consent, information sharing around risk, openness and transparency, and involvement and subsequent infection in research.

Factor VIII was made from blood plasma.
dpa picture alliance / Alamy Stock Photo

Compensation

In 2022, an independent report, chaired by Sir Robert Francis, recommended compensation irrespective of any issue of legal liability or of the findings of the inquiry.

The UK government accepted the moral case for compensation and made initial payments of £100,000 to 4,000 of the infected and bereaved partners in 2022.

Though welcomed, this was far from the compensation package recommended by Francis. In an interim report, Langstaff concluded that “wrongs were done at an individual, collective and systemic level”.

He was also clear that there was a strong moral case for compensation for the wrongs and the harms people had suffered. He recommended that a full compensation scheme should not wait until the final report was published on May 20.

The government resisted, citing the need to base compensation considerations on the final report, and has set up a new expert group to advise. Läs mer…

On the day of her uncle’s funeral in 1995, Jane’s life changed forever.* That was when she found out her uncle Edward, a person with haemophilia, had been infected with human immunodeficiency virus (HIV) from the treatment he was taking for his condition.

Adding to the family’s pain, the stigma that surrounded HIV and the disease it causes, Aids – because of its association with homosexuality and drug addiction – meant they kept the cause of Edward’s death to themselves. At the same time, they knew that Jane’s father, Roy, also had haemophilia and had been receiving the same treatment as his brother.

A UK public information poster from the 1980s.
Retro AdArchives/Alamy Stock Photo

A rare genetic condition means that throughout their lives, people with haemophilia – of whom there are around 6,000 in the UK – must seek medical care when they bleed because one of their key blood clotting proteins, factor VIII or IX, is either partly or completely missing. In the 1970s and 80s, a new treatment to give people with haemophilia their missing protein using concentrated blood plasma was seen as potentially life-changing. In fact, it dealt many of them a death sentence.

Read more:
Infected blood scandal – what you need to know

The factor VIII concentrate was supplied by US pharmaceutical companies. Donors were paid for their blood, and much of it came from communities at higher risk of carrying infectious disease, including drug addicts and people in prison.

A bottle of factor VIII concentrate.
Factor 8 campaign, CC BY-NC-ND

Gradually, haemophilia communities on both sides of the Atlantic noticed some among them were getting sick from a mysterious new virus. The first death of a person with haemophilia from Aids occurred in the US state of Florida in January 1982. The following year, both the Lancet medical journal and the World Health Organization published recommendations that people with haemophilia should be warned of the new health risks they faced – which also included infection with hepatitis C, a potentially deadly virus that affects the liver. Yet no such warnings were given.

While Edward soon became ill with HIV, Jane’s father did not reveal his hepatitis C infection, even to his daughter, until she was 18. He later died from liver cancer. Jane recalls:

My dad died ten years ago now – it’s nearly his anniversary. When he died, I went back to the doctors and said: ‘Do you think the hepatitis has caused the issues with his liver?’ The room fell silent. I didn’t need an answer. Their body language, their silence, told me everything I needed to know.

Jane says her father’s mistrust of doctors and medical advice meant he avoided the factor VIII treatments unless he really needed them, and “in some respects that prolonged his life” by limiting the amount of infected concentrate he was subjected to. One of Jane’s earliest memories is of him refusing to go to hospital, despite intense pain from a bleed into his joint. But each of these bleeds caused new damage to Roy’s body, resulting in increasing pain and disability as his life went on.

This article is part of Conversation Insights
The Insights team generates long-form journalism derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.

The societal stigma surrounding Aids meant many people with haemophilia lived with their infections in silence – assuming, that is, they were aware of their diagnosis. Another shocking aspect of this global contaminated blood scandal is that often, the victims weren’t being told the truth themselves.

During a recent conversation with her mother, Jane discovered that, for a long time, her father and uncle had not been told of their infections by doctors who by then knew about the problem of contaminated blood, leaving her family at risk of catching hepatitis C and her uncle at risk of passing on HIV. In her father’s case, it was only when, in 2004, he was notified by the NHS that factor VIII concentrate carried a very small risk of Creutzfeldt-Jakob disease (CJD) – a rare and fatal brain disease better known in the UK as “mad cow disease” – that he was informed this was because of his hepatitis C infection. Jane recalls:

My dad was like: ‘Excuse me, what?’ It was the same for my uncle Edward. There was no formal notification [of his HIV diagnosis] – the doctors and nurses just suddenly started wearing a lot of blue gloves around him.

Jane’s own story encapsulates the multigenerational impact of the infected blood scandal, which I (Sally-Anne) have researched with colleagues at the University of Gloucestershire. Jane carries the haemophilia gene, which is passed from mother to son with a 50% chance, and one of her two sons has haemophilia. Jane recalls the moment she told her father Roy, who was already infected and unwell with hepatitis C, that she was having a son:

We bought a blue romper suit and I took it home and gave it to my dad. He opened the bag and just threw it back at me. He went: ‘No, I can’t deal with this.’ And that’s not okay – he should have been proud, excited.

When Jane’s son was born, it was difficult for the family to face up to the treatments for haemophilia that would be a regular part of his life. She recalls her father “holding our newborn child, begging me not to ever let him have these treatments”.

The Scottish government’s report into the contaminated blood scandal is burned by a campaigner on its publication in March 2015.
Andrew Milligan/PA Images/Alamy

‘A criminal cover-up on an industrial scale’

The infection of people with haemophilia is just one aspect of the global contaminated blood scandal – which in the UK is regarded as the “worst treatment disaster in the history of the NHS”. In total, around 30,000 NHS patients were infected with HIV and hepatitis C between 1970 and 1991, either through contaminated blood products such as factor VIII and IX or blood transfusions during surgery, treatment and childbirth.

Recently Sam Roddick, daughter of Body Shop founder Anita Roddick, wrote in the Sunday Times about a “chain of decisions that were morally unlawful” which led to her mother contracting hepatitis C from a blood transfusion after giving birth to Sam in 1971. The blood used for transfusions, which is donated for free in the UK, was not routinely screened for HIV until 1986 and hepatitis C only five years after that.

One person still dies every four days in the UK as a result of having received contaminated blood. An estimated 26,800 people became infected with hepatitis C and 1,243 with HIV. Of those infected with HIV, 380 were children – more than half of whom have died. Following earlier inquiries by Lord Archer and the Scottish government (which was branded a “whitewash” by some of those affected), the UK’s infected blood public inquiry was finally announced by the then-UK prime minister, Theresa May, in July 2017. She called the scandal an “appalling tragedy which should simply never have happened” – adding:

Today will begin a journey which will be dedicated to getting to the truth of what happened and in delivering justice to everyone involved.

A brief history of the UK infected blood inquiry.

A few months earlier, in his final speech as an MP in April 2017, Labour’s health secretary Andy Burnham had described the scandal as a “criminal cover-up on an industrial scale”, suggesting there might be a case for corporate manslaughter charges. Of people like Jane’s father and uncle with haemophilia, Burnham said:

The Department of Health, and the bodies for which it is responsible, have been grossly negligent of the safety of people in the haemophilia community over five decades.

Like so many family members, Jane’s life plans as a young woman were turned upside down by her father’s illnesses. One of hundreds of witnesses heard during the seven-year inquiry, Jane wants the long-awaited final report, which will be published on May 20, to recognise the suffering of all those affected by the scandal, explaining:

I don’t think there’s been any real recognition for the families and what they’ve been through. People and families in particular have been destroyed by this. I was at university trying to be a teacher but dropped out, much to my university’s dismay. I wanted to be at home to stay with dad. There’s a generation of us that have lost our families – they call us ‘the fatherless ones’.

Many of those affected by the scandal blame the UK government and NHS trusts who they claim knew but did not share information about a potential infection risk with those taking the new treatment.

Deaths, loss, and continued denial

In January 1982, one of the UK’s leading experts in haemophilia, Arthur Bloom, co-wrote an infamous letter to haemophilia centres throughout the country, telling them that it was very important to ascertain whether a new American blood product already being given to people with haemophilia in the UK showed reduced levels of hepatitis C. “As far as we know,” he wrote, “the products have been subjected to a heat treatment process”, adding:

Although initial production batches may have been tested for infectivity by injecting them into chimpanzees, it is unlikely that the manufacturers will be able to guarantee this form of quality control for all future batches.

‘Cheaper than chimps’: relatives of the deceased gather outside the infected blood inquiry in central London, July 2023.
Guy Corbishley/Alamy Stock Photo

This method of producing factor VIII protein involved taking large amounts of blood (up to 40,000 units) from many different people and reducing this to a concentrate that could be easily self-injected at home. Bloom suggested “the most clearcut way” of testing the infectivity of the new heat-treated product was on patients requiring treatment who had not been previously exposed to large-pool concentrates – including children.

One of the children treated by Bloom himself at the University Hospital of Wales was Colin Smith, who had haemophilia and weighed just 13 pounds when he died of Aids in 1990 at the age of seven. He was a year old when he was given the factor VIII treatment, and his HIV status was confirmed at two-and-a-half. The stigma of HIV meant the family were shunned by many in their community, including having the words “Aids dead” painted on the side of their house in six-foot high letters. As Colin’s mother, Janet Smith, recently told BBC Wales:

We were known as the Aids family … We’d have phone calls at 12, one o’clock in the morning, saying: ‘How can you let him sleep with his brothers? He should be locked up, he should be put on an island’… He was three.

An example of the abuse received by those infected with contaminated blood, January 1987.
Hartlepool Mail

The same BBC investigation found evidence that Bloom had ignored internal NHS guidelines, written by his own department, that discouraged the use of the imported factor VIII treatment on children because of the risk of infection. Bloom was clearly aware of the risks when he began treating Colin in the autumn of 1983. “This wasn’t an accident,” Colin’s father said. “It could have been avoided.”

None of the young patients, known as “previously untreated patients”, or their parents knew they were part of a nationwide experiment at the time. Documents subsequently released reveal that the UK government funded some of these studies – including one of pupils at Treloar’s College, a specialist school in Hampshire with an NHS Haemophilia unit on site. Of 122 pupils with Haemophilia attending the school between 1974 and 1987, to date 75 have are reported to have died as a result of HIV and hepatitis C infections.

By 1984 – just over two years after the first death from Aids in the UK – government experts were aware that people receiving American factor VIII blood concentrate were at risk of HIV infection. Yet despite the mounting evidence, denials and silence continued well into the 1990s.

A plaque in a Hampshire church honours the Treloar College students who died after receiving contaminated blood.
Gillian Pullinger/Alamy Stock Photo

Trevor Graham, one of the hundreds of contributors to the infected blood inquiry, spoke to us about his father, who had haemophilia and died in 1991 when Graham was only 13. “We had no idea at the time he had died of Aids,” Graham explains. “We thought he died of a brain haemorrhage, as that was what the doctors treating dad at the Manchester Royal infirmary told my mother.”

Yet for the four years before his death, Graham’s father had been unable to work and sought the support of the Macfarlane Trust, a discretionary grant-making trust that was set up and funded by the then-Department of Health to “alleviate the financial needs of those haemophiliacs infected with HIV through contaminated NHS blood products”, and also their families. Graham says:

It is heartbreaking to read the letters my dad wrote requesting assistance, one of which states that he was concerned about Christmas presents for myself and my sister. In that letter, he stated he was HIV positive and couldn’t work as a result of his infection.

Despite there being no reference to HIV on their father’s death certificate, Graham says rumours soon spread around their school and local community. Once again, the legacy of this infection continues to affect following generations:

My sister and I were bullied at school. People said that our dad was gay and that he died of Aids. Mum became agoraphobic when I was 13 and was advised to see a psychiatrist, but in her grief she refused. I was suffering from hidden anxiety as a young teenager and developed a stutter. The anxiety and bouts of depression have never left me since my dad passed away. Even 30 years later, I still struggle with my mental health.

A monster arrives

“The monster arrived as a wolf in sheep’s clothing,” writes Elaine DePrince in her moving memoir about the contaminated blood scandal in the US, Cry Bloody Murder. The monster was factor VIII concentrate created from blood infected with HIV and hepatitis C. Three of her sons had haemophilia; all three would die slow, painful deaths due to Aids, having been infected by the treatment that was meant to help them lead normal lives:

When Teddy died, he was the last of our three boys with hemophilia and Aids to leave us. He was the last of our three little boys, our three musketeers … He was 24 years old, and it seemed like he had lived forever with Aids.

Elaine DePrince’s moving account of losing her children to the blood scandal.
Random House

In the book, DePrince, whose family were living in a suburb of Philadelphia, describes an earlier conversation with her husband when a warning label finally appeared on vials of factor VIII concentrate. She pointed out there was no need to worry, as all three of their sons with haemophilia were already infected with HIV.

As their youngest son Cubby’s condition worsened, he wrote a list to ease his concerns about other children getting Aids, at a time when it was untreatable, entitled “64 reasons why you do not want to get AIDs”. These included:

If your liver gets too big, you have to sit half-lying down and half-sitting up. Then it’s hard to paint your model airplanes because the paint drips on your stomach.

The battle to gain justice took DePrince from writing letters to campaigning for a change in the law and writing a book to explain the reality of the contaminated blood scandal and her family’s suffering from it. She concludes:

I cannot repress my sorrow, my pain, and my rage … The FDA [US Food & Drug Administration] failed my children. The blood-banking industry failed them. Government agencies failed them. The law failed them.

Jonathan is a haematologist in the US who comes from a family of men with haemophilia. When he was around seven years old in 1989, both his uncles were infected with HIV. One died in 1992 and the other shortly afterwards. “Our family and the haemophilia community were ravaged – we lost an entire generation. I had to watch my uncles deteriorate over the years.”

Jonathan, who also has haemophilia, grew up in a rural suburb in Illinois. He reflects on how that made getting treatment all the harder for his uncles:

It turns out that not only was there the contaminated supply that ravaged an entire generation of people with haemophilia and other severe bleeding disorders, but there wasn’t even equal access to care in the US at that time. Growing up in the Midwest, we didn’t have the same HIV therapies available on the east and west coasts of the US, where HIV research was being done. Some of the medical innovations at that time really did not penetrate the heartland of the US like it did on the coasts. So, I just had to watch my uncles deteriorate.

Jonathan himself was “only” infected with hepatitis C from his treatment. He says “that actually made me feel guilty – why was I spared [from HIV and Aids]? You know, everyone else is dying. Why should I be alive?”

The experience drove him to become a doctor in haematology, in order to try to make the experience better for other families like his:

People have been left to suffer. I grew up not knowing if I was going to live. The sad thing now, being a physician, is that HIV is such a manageable disease now.

The fight for justice

Across the world, many people have devoted their lives to fighting for justice for all those affected by the contaminated blood scandal. In the UK, groups such as TaintedBlood, Birchgrove Group, Factor 8, BloodLoss Families, Contaminated Blood Campaign, Contaminated Whole Blood UK and many others have continued the brave battles of the early whistleblowers and campaigners.

Jason Evans’ father Jonathan, who had haemophilia, was infected with HIV and hepatitis C and died in 1993 aged 31, when Evans was four. He has been campaigning for justice for his father and others for more than a decade, using freedom of information acts to reveal documents relating to the scandal. In one shocking memo from 1985, a UK government official discussed the financial implications of the fact that many people with haemophilia who were infected with HIV would soon die:

Of course, the maintenance of the life of a haemophiliac is itself expensive, and I am very much afraid that those who are already doomed will generate savings which more than cover the cost of testing blood donations.

Interview with Factor 8 campaign founder Jason Evans on BBC News, July 2022.

Evans, the founder and director of the campaign group Factor 8, is leading a legal action against the UK government for more than 500 people. Their action resulted in permission to launch a High Court action to seek damages but is currently on hold pending the outcome of the current inquiry on May 20.

Evans has expressed concern that ministers are “seeking to water down” the inquiry’s strong recommendations from the interim reports. He recently told the Guardian:

What I want from the inquiry is it finally to be on the official record that what happened was entirely preventable and was motivated by unethical practices. For decades, the line from government was that this was an unavoidable accident that no one could have possibly have foreseen – that no one did anything wrong.

In November 2022, “interim” compensation payments of £100,000 each were made to around 4,000 infected people or their bereaved partners in the UK (on top of an “ex gratia payment” by the government in 1990 of £20,000 or £25,000, depending how badly a patient’s body had been damaged by their infection). But this has left many others affected by the scandal, including those who have lost their children or parents, without any compensation – along with those whose death left nobody behind to claim.

However, a recent amendment to the Victims and Prisoners Bill added a requirement for the UK government to set up a compensation scheme within three months of it passing on May 1. On May 5, The Times reported that ministers were preparing a compensation package of £10 billion minimum for contaminated blood victims; the details are to be announced after the public inquiry’s report is released.

Two court cases are in progress in the UK: the one led by Evans, and another against Treloar College by 36 former students, who claim the experiments on them breached its duty of care by giving the treatment without discussing the risks with the students or their parents. In 2023, in testimony to the inquiry, the college’s former headteacher, Alec Macpherson, admitted that doctors at the school were “experimenting with the use of factor VIII”.

Elsewhere, criminal proceedings were brought against government officials and executives in pharmaceutical companies as long ago as the 1990s, with French and Japanese officials being given prison sentences. In 1997, Bayer and the other three manufacturers of the factor VIII concentrate paid out a total of US$660 million (around £1 billion in today’s prices) to the estimated 6,000 people with haemophilia who were infected in the US.

There is also the potential for criminal charges or other consequences for those involved in the UK scandal. It is possible that those identified as responsible may be charged with gross negligence manslaughter, and, in the case of collective fault of an organisation, corporate manslaughter charges could be brought. Individuals who supplied the contaminated blood could be prosecuted for grievous bodily harm.

Campaigners often use the phrase “justice delayed is justice denied” – not least for the one person infected with contaminated blood who continues to die every three days in the UK. But the effects of this medical scandal will be felt for years and generations to come – and whatever the outcome of the inquiry, campaigners will continue to fight for justice. As Evans explained when he was nominated for an award in 2021:

I think something that fuelled our renewed campaign was a new energy, particularly from those whose parents had died. We were grown up now and we were angry. I think that energy spread to the older campaigners who had been let down by the government time and time again.

This complex, seven-year inquiry was forced to delay its final report for five months to allow the many people and organisations referenced sufficient time to respond. Some victims have found out things they did not know about their treatment. Others have called for national memorials for the victims in each UK countries – including one specifically for the children infected at Treloar College.

The inquiry has affected people in different ways. Some have felt compelled to attend every sitting. Harrowing testimony has been heard throughout – not least when Colin and Janet Smith spoke about their son Colin, the youngest person to have been infected in the UK. His father told the inquiry:

There’s no way a child should have to die the way Colin did. It wasn’t pleasant. It still affects us now. But it’s not just our son – there’s lots of children who have had to go through that … I would cope with death, but not with the death of my son. I still have trouble today; the fact that he’s in a grave on his own. The guilt will never go away.

*Some names in this article are pseudonyms, created to protect the identity of our interviewees.

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The opening of any new business can be a nerve-wracking affair. Will everything work? Will things go wrong? Will the whole enterprise fall flat on its face?

For the owners of a new concert venue in Manchester, things went very wrong. The £365 million Co-op Live arena was supposed to launch on April 23 with a performance by comedian Peter Kay. But after technical issues emerged, it had to be cancelled at the last minute.

Then the show was cancelled again. Kay, and thousands of ticket holders, were not amused. After that, appearances by The Black Keys, Take That, A Boogie wit da Hoodie and Keane were all either postponed or moved to another venue. Eventually, Co-op Live opened with a concert by local band Elbow on May 14.

The delays were both embarrassing and expensive. Costs from reputational damage and business interruption are likely to be significant. But how harmful will they be to the venue’s future prospects?

The answer probably lies in the basic economics of supply and demand. If, over the coming months and years, Co-op Live can supply enough acts that a large number of fans are happy to pay to watch, it will be sticking to a tried-and-tested business model.

And the arena will also benefit from the economies of scale. While increasing costs have led to an alarming number of independent venues closing, large venues can sell more tickets, rent their space out to high-profile events, and sell commercial and naming rights. Co-op Live reportedly has the largest maximum capacity (23,500) of any indoor arena in Europe.

It also has two wealthy and experienced owners – not to mention Harry Styles as an investor. One is Oak View Group, a venue development and management company, and the other is City Group, owners of Manchester City football club (and many others).

The arena project has also managed to secure a well-known brand: the Co-op. The sale of naming rights tends to bring in much-needed revenue to a project, particularly at the start – where it is useful for both sides.

The first naming rights partner to any project gets benefits as people get used to calling the venue by the brand name. Even if that brand pulls out of the arrangement at a later date, the benefits of name recognition remain. Other well-known brands associated with venues include Brighton & Hove Albion’s Amex Stadium and the O2 concert venue in London.

However, research shows that naming rights are only valuable if the sponsors get their timing right. Newcastle’s St James’ Park was not popularly referred to as the Sports Direct Arena when it was renamed for a short period.

Facing the music

Big building projects always come with risks, particularly in recent years in the UK.

The cost of living has increased – and with it, the price of goods, services and wages. This means many big projects, including the now (mostly) cancelled HS2 railway line, have suffered from soaring costs.

Music box.
Bardhok Ndoji/Shutterstock

But the investors behind Co-op Live also have reason to feel optimistic. One particular venue comes to mind which demonstrates how teething problems can soon be replaced with profit and popularity.

When the Millennium Dome opened in south-east London on December 31 1999, it had been plagued with controversy. Almost a quarter of a century later, after redevelopment and the sale of its naming rights to telecoms group O2 in 2005, the project is now synonymous with success, boasting record-breaking ticket sales and a number of industry awards.

Of course, the people running Co-op Live need to ensure there are no further blips in the immediate road ahead. Hosting successful events to large crowds will be essential to ensure that people focus on the positives of the venue, rather than the issues that plagued it at the start.

If this happens, everyone wins. People get to watch great live events, artists get to perform in a state-of-the-art venue, and investors can start to claw back some of their financial outlay. The owners will certainly hope their initial failures will swiftly be forgotten, and that the many shows planned for the future will go on and on. Läs mer…

Slovak society is in shock after a 71-year-old man fired five shots at the prime minister, Robert Fico, while he was greeting a small crowd after a meeting.

Some members of the coalition government immediately blamed the opposition and the media for encouraging anger towards Fico, who has been implementing reforms that threaten media and judicial freedom.

Fortunately, Fico has survived, but the fallout from the attack will nevertheless be severe. Many will be reminded that the repercussions of another murder, of reporter Ján Kuciak and his partner Martina Kušnírová in February 2018. It was this crime that set in course the chain of events that would make Fico the politician he is today.

Fico was prime minister at that time, too. But due to the fact that the murder investigation led dangerously close to his political circles, he was forced to resign.

In a wave of public indignation, lawyer Zuzana Čaputová, who wanted to fight against political corruption, decided to run for the office of president. In March 2019, to everyone’s surprise, she became the first female president in Slovak history. In the second round of these elections, she convincingly defeated the candidate of Fico’s centre-left Smer party.

Fico was humiliated by his forced departure and Čaputová’s victory, but he did not intend to give up and leave politics for good. He wasn’t even deterred when his own party split in two in 2020, with his former ally Peter Pellegrini leading the splinter party Hlas SD.

President Zuzana Čaputová appeals for calm after the prime minister was shot.
Alamy/AP

Fico is the most seasoned player in Slovak politics. He became prime minister for the first time in 2006 and the current administration is his fourth stint in the role. Until 2018, despite some reservations, he was not considered a politician tending to extremes. He was even prime minister when Slovakia joined the euro in 2009.

However, he began to radicalise more and more during his years in opposition. He increasingly criticised the investigation into Kuciak’s murder, the western orientation of his country and, above all, Čaputová as president.

It appears to have become clear to Fico that he would lose support from moderate Slovaks because of his extreme views, but he has been careful not to alienate either the far left or the far right. On one hand, he, personally, has roots in the communist party, and on the other, he has been cautious not to alienate the extreme right. Doing so would close the door to the possibility of future coalition cooperation.

By radically rejecting liberalism, Fico appeals to extremists from both the right and left. According to him, the real extremists are the people promoting membership of the European Union, Nato, and support for Ukraine.

Čaputová: an embattled president

In June of last year, Čaputová announced that due to the threats and abuse she and her family had endured, she no longer had the strength to continue in politics. She decided not run for a second term as president. But the timing of her announcement, a long time before the presidential contest and only a few months before parliamentary elections, appears to have been a strategic error.

Sensing an opportunity in the president’s weakness, Fico and Smer were able to win the parliamentary election, forming a new government coalition with Pellegrini’s Hlas SD and the extremely nationalist Slovak National Party.

Even now, as Fico lies in hospital, Čaputová remains in office. She is in the process of handing over to her successor – the very same Peter Pellegrini who was once part of Fico’s party. But he doesn’t begin in the role until June. Meanwhile, Čaputová must appeal for calm in Fico’s name.

Fico’s election victory on an illiberal platform and antagonism towards the president he was supposed to be working alongside at the time of the attack, combined with the centre-right’s failure to provide an alternative, has left Slovak society polarised to an unprecedented degree.

Paradoxically, it was Fico who predicted the consequences of all this most accurately. In a speech published on Facebook this April, he cast himself as victim and declared that he would not be surprised if the hatred towards him led to the murder of a government politician.

He has survived, but Fico has nevertheless become a martyr to “liberal tyranny” for his supporters – regardless of the fact that everyone, including all of Fico’s critics, have unequivocally condemned the attack.

The murders of Kuciak and Kušnírová remain unsolved. Solving the case of the failed assassination of the prime minister will apparently be much faster and easier, given that a man has already been charged.

However, it is more likely that efforts to point the finger across the political divide will dominate Slovakian discourse for the foreseeable future. And this will come at the expense of a full discussion about what factors led to this crisis in the first place, and how best to avoid them in the future. Läs mer…

Since April 2024, wide areas of south and south-east Asia, from Pakistan to the Philippines, have experienced prolonged extreme heat. Covering some of the most densely populated regions in the world, the series of heatwaves has affected everything from human health and wellbeing to the economy and education.

Many pupils in India, Bangladesh, and Philippines have been told to stay at home for days due to a severe health risk from extreme heat, while the heatwaves are becoming a major issue in India’s election. Bangladesh even closed all primary schools for weeks while the temperature reached 43.8°C on April 30.

Once the temperature goes above 38°C, it exceeds the core human body temperature (about 37°C) and the chance of heat exhaustion and even heatstroke increases dramatically. This is compounded by increasing humidity in the region which puts additional heat stress on the human body, as sweat is not able to evaporate as effectively (the primary mechanism for cooling the human body).

That is why extreme heat in a tropical country can be less pleasant and more dangerous than the same temperature in a desert.

Read more:
Why 40°C is bearable in a desert but lethal in the tropics

Tens of millions of people have been exposed to such health threatening conditions in south and south-east Asia in April and May so far, and this extreme heat has substantially affected labour productivity.

Unusually prolonged periods of extreme heat:

Parts of India, Burma, Thailand and Cambodia were extremely hot almost all April.
Neven Fuckar / Data: MSWX

Now shifting westwards:

The most consistent extreme heat is currently in western India and Pakistan.
Neven Fuckar / Data: MSWX

How it got so hot

Extreme heat is driven by several processes, operating from global down to local scales. At the local level, less vegetation and soil moisture tends to mean more heat, while cities of concrete and asphalt are hotter than the surrounding countryside thanks to the urban heat island effect. Other local and regional factors include the wind, and whether conditions are ripe for clouds to form.

Then there are the more global factors: El Niño, and of course global warming. El Niño refers to the warm phase of a natural fluctuation of temperatures in the tropical Pacific (its opposite side is La Niña).

The Pacific has been in an El Niño phase since May 2023, releasing additional heat and exacerbating global warming in many regions. In parts of Asia, this leads to periods of extreme heat happening more often, lasting longer and being even more extreme in addition to global warming contribution.

This is particularly dangerous for the many cities in south and south-east Asia being hit by the current series of heatwaves, which over the past 85 years have already experienced long-term increase in the number of days in April with such dangerously high temperatures.

Short term noise, long term trends:

Extreme heat in April since 1940 in three selected cities (labelled in the previous maps).
Neven Fuckar / Data: ERA5

Occurrences of extreme heat days over years typically looks rather noisy when plotted on a graph. Some years may have many days of extreme heat, others only few or none. But over a longer timescale of multiple decades, a clear trend emerges of more and more very hot days, driven by climate change.

Indeed, scientists from the World Weather Attribution team recently described the latest heatwaves as “impossible” without climate change.

Action needed

April and May are typically the hottest months in south and south-east Asia. As the climate keeps warming, is the region ready for extreme heat?

The projected increases in extreme hot temperatures demands rapid adaptation measures, along with the obvious global efforts to reduce greenhouse gas emissions. That means heat action plans that are tailored to address the specific climate, public health and socioeconomic conditions in a given region. What works in Singapore (urban, wealthy, incredibly humid) might not be appropriate in drier, poorer and more rural parts of India.

We have to combine estimates of environmental hazards with exposure and vulnerabilities information on population and assets to provide actionable risk assessment and formulate efficient temperature mitigation measures for different levels of extreme heat.

Some countries in south and south-east Asia are making progress with their heat action plans in response to extreme heat they have already experienced. However, there is room for further improvement and a more targeted approach at the district level. This is critical as we expect that disruptive extreme heat events in this part of the world will become more frequent, widespread, and intense. Läs mer…