Africa

By Oritro Karim
UNITED NATIONS, Oct 21 2026 (IPS)

In recent months, Afghanistan’s humanitarian crisis has severely deteriorated, with the UN reporting record-high levels of acute malnutrition and hunger. Compounded by rampant human rights violations, limited access to basic services, and persistent barriers to humanitarian aid, the UN warns that conditions could considerably worsen in the coming months.

The latest figures from the Integrated Food Security Phase Classification (IPC) show that approximately 15.9 million people—32 percent of the analyzed population—are currently facing Crisis-levels of hunger (IPC Phase 3) or worse. Of those, roughly 3.4 million face Emergency-levels of hunger (IPC Phase 4), just one step away from the highest level, which could entail the onset of famine.

IPC projects that food insecurity could surge from November to April during the winter lean season. As agricultural activity slows down, unemployment remains widespread, and harsh weather hinders aid delivery and basic services, IPC estimates that nearly 19.2 million people—including 10 million children—could face Crisis-levels of hunger or worse, with 5 million at risk of Emergency-levels of hunger.

The World Food Programme (WFP) and the Food and Agriculture Organization (FAO) warn that food assistance, agricultural support, and healthcare operations must be scaled up ahead of the winter season. WFP Country Director John Aylieff stressed that the “window to act” is rapidly closing if families are to survive the winter “with dignity.” Meanwhile, FAO Representative Richard Trenchard underscored that creating dependable income is essential in preparing communities to withstand future shocks.

Ashish Damle, Save the Children’s Country Director in Afghanistan, warned that the country is trapped in a “deadly” hunger crisis with “no end in sight,” as humanitarian needs rise while critical aid funding dries up. Young people are projected to bear the heaviest burdens, as roughly 4.04 million children under five will require treatment for acute malnutrition in 2027—a 9 percent increase from 2026. Severe acute malnutrition is forecast to surge by 16 percent in the coming year, rising from 942,000 in 2026 to 1.1 million in 2027.

With winter approaching, Damle stressed that harsh weather conditions will make survival even harder for children already facing acute malnutrition.“Our doctors and nurses witness the devastating consequences of the hunger crisis every day: malnourished children arriving at our clinics, mothers going hungry so their families have something to eat, and parents desperately seeking help as their children’s health deteriorates,” said Damle.

Despite recent rainfall improvements and promising harvests, widespread unemployment and weak purchasing power still keep adequate nutrition out of reach for most families, even when it is available. Conditions are compounded by the return of over 1.2 million Afghans from Iran and Pakistan in 2026, further stretching already limited resources.

“I saw firsthand that this crisis is not simply about whether food exists, but whether people can afford it, whether they can earn an income, access basic services, or whether they have anything left to fall back on when the next shock comes,” said Olga Cherevko, Spokesperson for the Office for the Coordination of Humanitarian Affairs (OCHA). She added that years of conflict, economic instability, and climate shocks have severely eroded community resilience, leaving families with little capacity to adapt to new shocks.

Cherevko highlighted the Taliban’s systematic exclusion of women and girls from education and public life as a primary driver of the crisis. Figures from the United Nations Children’s Fund (UNICEF) show that Afghanistan stands to lose up to 20,000 women teachers and 5,400 female health workers by the end of the decade. She emphasized that barring women and girls from society has alarming implications for access to healthcare, dietary diversity, education, and the ability to sustain livelihoods.

On October 15, the UN Assistance Mission in Afghanistan (UNAMA) issued a report detailing the persistence of human rights abuses between July and September. During this period, UNAMA documented over 50 cases of women arrested or detained relating to the hijab. Women continue to be barred from accessing health clinics and markets without a male guardian (mahram).

The mission also recorded around 443 cases of arbitrary detention and 97 instances of ill-treatment over minor infractions such as hijab violations, trimmed beards, skipped prayers, and listening to music. It further documented public corporal punishments of 28 individuals, including six women, and the detention of 14 former security force members, with at least four others killed.

Beyond individual rights, Afghanistan has also experienced a severe breakdown of civic space conditions over the past year, marked by the arbitrary suspension of multiple media outlets without clear reasons or opportunities for appeal. New legislation enacted in August bans all demonstrations and protests, effectively silencing civilian dissent across the country.

Cherevko emphasized the need for sustained, expanded humanitarian aid while calling for strategic investments in long-term resilience. She highlighted agriculture, rural livelihoods, local markets, employment, water systems, and health services as key areas for investment, stressing that expanding opportunities for women in the workforce is essential in building communities that are less dependent on emergency assistance.

“We cannot keep asking humanitarian aid to compensate indefinitely for the absence of economic opportunity and essential public services. We must act before winter, not after families have exhausted their options,” said Cherevko.

Ground operations remain significantly constrained due to persistent funding shortfalls. According to OCHA, as of mid-September, the agency had received just 31 percent of the funding needed to support Afghanistan’s 21.9 million vulnerable people. Earlier in August, WFP warned that these shortfalls had forced nutrition programs to scale back when they are needed the most, leaving more children at risk of being malnourished.

Despite these shortfalls, the UN and its partners continue to work on the ground to deliver emergency and essential services, reaching roughly 8.3 million people with at least one form of assistance between January and July.

IPS UN Bureau Report

 

 

 

 

The Gambia has confirmed receiving $2.5m from the sale of the house in Maryland.

Nino Niederreiter spielt bei Winnipeg schon wieder in einer anderen Linie, muss aber weiter auf seinen Punkte-Meilenstein warten. Siegenthaler und Hischier skoren beim Sieg von New Jersey gegen Colorado.

By James Alix Michel
VICTORIA, Seychelles, Oct 21 2026 (IPS)

When you grow up on a small island, the ocean is not scenery. It is your neighbour, your livelihood, and the measure of time itself. For decades, as I walked the beaches of Seychelles, I watched the subtle shifts that scientists were warning the world about. The tide crept a little higher up the sand each year. After a warm season, vibrant coral gardens turned ghost-white. Storms that once belonged to rare memory began arriving with unsettling regularity.

James Alix Michel

For a long time, when leaders from small island developing states spoke of these things in great conference halls, we were listened to with polite sympathy. Our plight was treated as tragic, yes, but distant—a problem for small dots on the map, far from the capitals of global power.

No one can afford that illusion anymore.

What began on our island shores has arrived at the heart of every continent. The floods that submerge towns, the relentless heatwaves across Asia and the Americas, the droughts parching African farmlands, and the wildfires darkening the skies of the northern hemisphere all tell the exact same story. Small islands were never a separate case; we were simply the planet’s early warning system. Today, the alarm bell is ringing in every home. No nation, however vast its territory or deep its treasury, can build a wall high enough to shut out a warming world.

Next month, from 9 to 20 November, world leaders and negotiators will gather on the Mediterranean coast in Antalya, Türkiye, for the 31st United Nations Climate Change Conference (COP31). The summit carries an unusual and promising diplomatic architecture: Türkiye will host the gathering and hold the Presidency, while Australia leads the negotiations, fresh from partnering with Fiji and Tuvalu to host the Pre-COP meetings in the Pacific. Having Pacific island voices help shape the road to Antalya is a welcome sign.

Yet as the countdown begins, the overarching question hanging over COP31 is not whether the world can draft another eloquent communiqué. It is a much simpler, sharper question: will we finally keep our promises?

Türkiye’s Presidency has rightly framed Antalya as an “Implementation COP”. That label must mean something in practice, because the global climate process is facing a profound test of trust. Across the Global South, and especially among small islands and least developed countries, there is a deep and justified fatigue. Summit after summit produces historic pledges—on cutting emissions, on adaptation funds, on compensating for loss and damage—only for those commitments to stall in a maze of bureaucracy and broken timelines.

Trust in international diplomacy is not built by the grandeur of a pledge made before television cameras. It is built when resources actually reach the fishing village rebuilding its sea wall, or the farmer adapting to shifting rains. If Antalya is to restore faith in multilateralism, three imperatives must guide the leaders gathering there on 11 and 12 November.

First, climate finance must move from paper to people. For too many vulnerable countries, accessing climate funds feels like running an obstacle course designed for them to fail. Initiatives like the new Climate Implementation Bridge—developed by the Presidency and the UN Development Programme to connect national climate plans with real financing—are a step in the right direction. But we need speed, simplicity, and scale. Adaptation and loss and damage funding are not acts of charity from the rich to the poor; they are investments in global stability.

Second, we cannot talk honestly about climate resilience without confronting the crushing burden of sovereign debt. It is a cruel paradox of our time that the nations which contributed least to global emissions are forced to borrow heavily just to rebuild after climate disasters they did not cause. How can a government invest in a green transition or coastal defences when its revenues are swallowed by debt servicing?

We already know that innovative solutions exist when there is political courage. In Seychelles, we pioneered the world’s first sovereign debt-for-nature swap designed for ocean conservation, alongside the world’s first sovereign Blue Bond. We showed that you can relieve fiscal pressure while legally protecting vast stretches of marine territory. What small islands proved on a modest scale must now become a standard tool of the international financial system.

Third, the ocean must move from the margins of climate negotiations to the very centre. For too long, the ocean was treated as a silent victim of climate change rather than our greatest ally in stopping it. The sea covers more than 70 percent of our planet, absorbs the vast majority of excess heat, and locks away immense quantities of carbon in its mangroves, seagrass meadows, and marine ecosystems.

COP31 has dedicated a thematic day on 18 November to oceans, coastal resilience, and the blue economy. That is encouraging, but the ocean cannot be confined to a single day on the calendar. Protecting marine biodiversity, unlocking blue carbon finance, and connecting the UNFCCC process with the new High Seas Treaty (BBNJ) are essential if we want to keep the 1.5-degree goal alive.

During my years in public life, and in the years since, I have learned that leadership is ultimately tested when the gap between words and reality grows too wide to ignore. We are at that moment now.

In Antalya, small island states will once again raise their voices with clarity and determination. We will speak of our reefs, our coastlines, and our children’s heritage. But make no mistake: we are not pleading only for ourselves. The ocean that washes the shores of islands is the same ocean that regulates the climate of London, Istanbul, Sydney, and New York.

The tide is rising for all of us. COP31 is our chance to show that humanity can rise to meet it—not with another round of promises, but with the courage to deliver.

James Alix Michel is a former President of Seychelles, a Blue Economy pioneer and a champion of ocean protection.

IPS UN Bureau

 

 

 

 

A female patient is in isolation and receiving medical care after being admitted to a hospital in Abuja.

Credit: UN Photo/Luke Powell

By FAO and WFP
KABUL, Afghanistan, Oct 20 2026 (IPS)

Nearly 40 percent of the population of Afghanistan is projected to face high levels of acute food insecurity this winter, and cases of acute malnutrition are expected to soar during 2027, the Food and Agriculture Organization of the United Nations (FAO) and the United Nations World Food Programme (WFP) warned.

This is according to the latest Integrated Food Security Phase Classification (IPC) analysis, which projects that approximately 19.2 million people (38% of the population) will face high levels of acute food insecurity during the November-April lean season, which lasts through the winter. This is an increase from 17.4 million projected for the same period a year earlier.

An estimated five million of those who are acutely food insecure will be facing emergency levels of hunger (IPC Phase 4) – double the number projected for April-September 2026 – meaning immediate food assistance and urgent emergency agriculture support are needed to prevent deaths and total livelihood collapse. The most severe classifications are projected in Badakhshan, Badghis, Daykundi, Ghor, Samangan, Sar-e-Pul and rural Ghazni.

Acute malnutrition is beginning to define the crisis in Afghanistan with mothers and children at the forefront. Malnutrition cases are expected to increase by nearly 10 percent compared to 2026 to four million. One-quarter of these are expected to be severe and life-threatening. Prevention and treatment services are lagging well behind despite cases increasing, leaving women and particularly children more exposed.

The crisis in Afghanistan is being driven by several shocks that are affecting Afghan families and the humanitarian response. More than 1.2 million Afghans have been forced to return home from Iran and Pakistan this year, adding pressure to already overstretched communities. Border closures and disruptions to shipping through the Strait of Hormuz and other critical trade routes are also driving up prices for basic goods. At the same time, dramatic funding shortfalls are limiting humanitarian assistance just as needs are growing. All these issues are converging to drive hunger and malnutrition higher, particularly as winter approaches.

Improved harvests have not restored families’ access to nutritious food

Favorable rainfall supported crop production and pasture recovery in 2026, benefiting many farming households. The anticipated El Niño season could also bring above-average rainfall, helping replenish water sources, restore pasture and support winter and spring crops. Timely agricultural support could help farmers turn favorable conditions into food and income, but rainfall alone will not secure the next harvest. High fertilizer and agricultural input costs and low crop prices may force poorer farmers to plant less or use fewer inputs. Wetter conditions also increase the risk of localized flooding, erosion, crop damage and plant and animal disease.

However, improved harvests and greater food availability are not necessarily translating into improved food security. Persistent unemployment means many families who do not grow their own food cannot afford a nutritious diet, even when food is available. Winter will bring fewer opportunities for agricultural work, further reducing incomes and increasing the need for humanitarian assistance.

Scale up support before needs deepen further

FAO and WFP are calling for urgent funding to scale up food assistance, emergency agricultural support, and malnutrition prevention and treatment. Support must reach families before winter restricts access to vulnerable communities and farmers miss critical planting windows. Afghanistan cannot afford another year of worsening hunger and malnutrition.

Richard Trenchard, FAO Representative in Afghanistan:

“This year’s strong harvest shows what Afghan farmers can achieve. But for a parent with no steady income, nutritious food in the market can still be out of reach for their family. The drumbeat of shock and crisis is relentless, but we know progress is possible. Past experience shows that timely, targeted food and emergency agricultural assistance can bring acute food insecurity down. Helping families grow or afford nutritious food for their children can also help prevent malnutrition long before children need treatment. We need to scale up these practical solutions now, act ahead of foreseeable shocks and invest in processing and local agribusinesses that connect farmers to markets and create jobs. Families need support to get through this winter and opportunities to earn a dependable living that helps them withstand the next shock.”

John Aylieff, WFP Country Director in Afghanistan

“Hunger and malnutrition are tightening their grip on Afghanistan’s families, pushing more people towards the brink just as resources to respond are running short. This crisis is increasingly being defined by the gap between growing needs and shrinking funding. We still have a window to act, but it is closing fast. With urgent support, families can get through the winter with dignity. Without it, many will face impossible choices no parent should have to make.”

IPS UN Bureau

 

 

 

 

Excerpt:

High food and transport costs, scarce work and declining humanitarian assistance are squeezing families’ access to food as winter approaches.

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Members of the Kabul Critical Thinking Movement conceal their identities to minimise the risk of being identified and facing reprisals from the Taliban. Credit: Learning Together.

By External Source
PARWAN, Afghanistan, Oct 20 2026 (IPS)

Afghan women have resorted to online protests as their only available recourse, even though the risks of being caught are high and carry enormous consequences.

Dawn has not yet fully broken over the quiet streets of Parwan. The morning air carries the stillness of the early hours, and the footsteps of a few passersby are the only sounds that break the silence.

In one of the town’s more modest homes lives 28-year-old Gulsuum (name changed), who is effectively living two lives.

To her neighbors, she is a quiet young woman who goes out to buy food, lives with her family, and tries to lead an ordinary life. Yet behind this facade is a person fighting, under a pseudonym, for the education, freedom, and human dignity of Afghan women.

"Sometimes I wonder if we will ever see the results of our efforts, if this path is worth all the fear and uncertainty. But whenever I think of the girls who have been denied the right to go to school, I know I must go on. If we stay silent today, the next generation might lose even the hope of protesting"

She uses the name Gulsuum to protect her identity. Her fears, hopes, and life story, however, are entirely real.

Gulsuum lives with her father, mother, aunt, and two brothers in a residential area of ​​Parwan province. Her unmarried aunt has long been an integral part of the family.

 

Only her aunt knows Gulsuum’s secret

Her aunt has not only kept Gulsuum’s secret but has also supported her during her most difficult moments. She lets Gulsuum use her mobile phone when needed, keeps an eye on the situation, and warns her immediately if she senses danger.

Gulsuum’s biggest worry is her older brother. The reason lies in his traditional views: he considers women’s protests dangerous. Gulsuum is certain that if her brother found out about her activities, he would take away her phone, restrict her movements, or send her to live with relatives in another province.

Before the Taliban returned to power, Gulsuum studied law and taught at a private school. Back then, her life revolved around books, pens, and the voices of her students.

“My entire life was bound up with books, writing, and the classroom. I believed that Afghanistan’s future would be built by girls who could transform society through knowledge and education, not weapons.”

After the Taliban returned to power, universities and girls’ schools across Afghanistan were shut down one by one. The private school where Gulsuum taught ceased operations, and her own studies came to an end as well.

Gulsuum’s gaze drifts to the corner of the room, where her university books still sit on the shelf.

“My books are still there, but there is no longer a classroom, no students, and no dream I can pursue the way I used to.”

Gulsuum says she remained silent during the first few months, fearing arrest and that her family would be put in danger.

“But whenever I heard about the arrests of female protesters or girls being denied an education, I asked myself: Is silence, too, a form of surrender?”

That question changed the course of her life.

“Two years ago, a university friend introduced me to the Kabul Critical Thinking Movement. At first, I only followed the movement’s statements and writings. Gradually, I began participating in its online meetings under a pseudonym, and later, I became one of its active members.”

Most of the movement’s activities take place on its official Facebook page, where statements, campaigns, and public messages are published.

 

Even a small mistake could endanger everything

To protect their identities, members never share material on their own social media accounts. Instead, they record images and videos independently and submit them for publication via the movement’s official page. Pseudonyms are used to protect the identities of those involved.

Many images and videos are recorded indoors or in locations with few or no other people present. Members wear face masks, sunglasses, and black chadari robes to minimize the risk of being identified.

Gulsuum explains that every action requires careful planning and an assessment of potential risks, as even a single protest could lead to consequences for both her and her family.

“Every decision I make, every phone call, and every message I send could have serious consequences. My phone is protected by multiple passwords. I carefully manage messages, photos, and anything else that could put me in danger. I never reveal the identities of other members or where we meet to anyone. Even a small mistake could endanger my life and the lives of my family members.”

Gulsuum says she sometimes wonders whether her brothers, who browse through her phone, have found out about her activities.

“A moment later, I realize nothing has happened. They were just scrolling through social media. But those few minutes feel like hours to me. Fear has become a part of my everyday life.”

Once, while walking through the city, she noticed a Taliban pickup truck a few blocks behind her. She told a passing woman she was thirsty and was invited into her home for tea. The vehicle was still nearby when she left, but she was relieved to learn that Taliban members had rented a house in the neighborhood a few days earlier. The truck had nothing to do with her.

“I could breathe again, and I realized that sometimes fear paralyzes us long before any danger is even in sight. Every unknown call, every suspicious glance, and every unexpected question brings a new wave of fear. But I don’t think fear should define the lives of Afghan women.”

Despite fear, activism continues

Despite her fears, Gulsuum has not given up her activism.

“Sometimes I wonder if we will ever see the results of our efforts, if this path is worth all the fear and uncertainty. But whenever I think of the girls who have been denied the right to go to school, I know I must go on. If we stay silent today, the next generation might lose even the hope of protesting.”

The chadari robe she wears at demonstrations is more than just a garment.

“Every evening, I tuck it away in the corner of my room. Whenever I hide it, it feels as though I am concealing a part of my identity, my dreams, and my true life from the eyes of others.”

Gulsuum’s voice is calm, devoid of hesitation.

“I believe that no voice raised for justice goes to waste. Change may not happen today. But if no one speaks, there is no hope for tomorrow.”

“What matters most to me is that the world knows Afghan women, even under the most intense pressure, continue to stand up for freedom, justice, and human dignity. Our voice may be quiet, but it will never be silenced.”

Gulsuum’s story is not that of just one woman. It reflects the lives of thousands of Afghan women and girls, caught between fear and hope, continue the fight for education, freedom of choice, and human dignity.

Beneath the black chadar worn for safety, her voice still rings out. It is quiet, yet unwavering. Despite everything, that voice has not been silenced.

Excerpt:

The author is an Afghanistan-based female journalist, trained with Finnish support before the Taliban take-over. Her identity is withheld for security reasons

Jährlich sterben in der Schweiz rund 2800 Menschen an einem Schlaganfall. Besonders Ältere sind betroffen, doch die Fälle bei Jüngeren nehmen zu. Nils Peters, Chefarzt Neurologie an der Hirslanden Klinik, erklärt Ursachen, Symptome und Prävention im Podcast «Durchblick»

Jahrzehntelang hat Europa lieber in seine Sozialsysteme als in seine Verteidigung und seine Energie-Unabhängigkeit investiert. Das rächt sich jetzt. Hoffnungsschimmer gibt es – aber auch ein potenziell tödliches Problem.

Decisions about ending one’s life are often complex, reflecting a combination of medical, psychological, social, and personal considerations. Credit: Shutterstock

By Joseph Chamie
PORTLAND, USA, Oct 20 2026 (IPS)

People who choose to end their lives through voluntary assisted dying typically face terminal, incurable, or debilitating conditions that cause severe physical or psychological suffering.

Research on requests for medical assistance in dying and euthanasia shows that most individuals seeking these options have advanced, irreversible illnesses or incurable, debilitating conditions that cause severe suffering or diminish their autonomy, dignity, or the ability to engage in meaningful activities.

Despite becoming legally permitted in an increasing number of countries, voluntary assisted dying remains controversial. The debate centers on a fundamental tension between respecting personal autonomy and relieving suffering, on the one hand, and protecting human life, on the other

Although physical pain is an important factor, psychological, existential, and quality-of-life concerns also play major roles in decisions to end life. These include losing independence and physical abilities, losing control over bodily functions, depending on others for basic care, and fearing future pain, suffering, and distress during the final stages of an illness.

Eligibility requirements for medical assistance in dying vary by jurisdiction. Where access is restricted to terminally ill patients, individuals generally must have a prognosis of six months or less to live.

Other jurisdictions permit access under different eligibility criteria. Applicants generally must demonstrate decision-making capacity and make a voluntary, informed request. Independent medical assessments are generally required, and many jurisdictions impose waiting periods or other safeguards.

Amyotrophic lateral sclerosis (ALS), cancer, and other serious illnesses are frequently associated with requests for voluntary assisted dying. Other requests involve advanced cardiovascular and lung diseases, as well as neurodegenerative conditions, including Alzheimer’s disease and other forms of dementia.

Cancer, particularly when advanced and no longer responsive to treatment, can also involve severe pain, weakness, loss of function, and other debilitating symptoms. Other requests for voluntary assisted dying include terminal illnesses such as advanced cardiovascular and lung diseases and neurodegenerative conditions, such as Alzheimer’s disease and other forms of dementia.

Severe physical pain or psychological distress that cannot be adequately relieved through standard medical or palliative care may lead some people to consider ending their lives. However, the reasons for requesting voluntary assisted dying generally extend beyond physical pain alone.

Loss of autonomy, including the inability to engage in meaningful activities, care for oneself, or maintain personal dignity, may strongly influence these decisions. Some individuals also fear increasing dependence on family members or caregivers, losing control over basic aspects of daily life, or experiencing further deterioration in their quality of life.

Decisions about ending one’s life are often complex, reflecting a combination of medical, psychological, social, and personal considerations. For some individuals, the prospect of prolonged deterioration or increasing dependence may be as important as the symptoms of the underlying illness.

Consequently, requests for voluntary assisted dying generally require careful assessment of an individual’s medical condition, decision-making capacity, wishes, and available alternatives, including palliative and hospice care.

When people actively choose the timing and manner of their death, their choices generally fall into three primary categories, each governed by different legal frameworks, medical protocols, and procedures.

These categories differ principally in who administers the life-ending medication, whether the person must take the medication themselves, and whether the choice involves voluntarily forgoing food and fluids rather than receiving life-ending medication (Table 1).

Source: Compassion & Choices.

The first category is medical aid in dying (MAID), also known as physician-assisted dying or, in some jurisdictions, death with dignity. MAID allows a mentally capable, terminally ill adult who meets specific legal requirements to request and self-administer prescribed medication intended to end their life. In many U.S. jurisdictions where MAID is legal, eligibility generally requires a terminal illness with a prognosis of six months or less, although specific requirements vary by jurisdiction.

The emphasis on self-administration is an important distinction between MAID and voluntary euthanasia. Under MAID, the individual—not a physician or other health professional—takes the medication, retaining control over the timing of the final act. Depending on the jurisdiction, safeguards may include repeated requests, confirmation of the diagnosis and prognosis, assessment of decision-making capacity, and other measures to ensure the decision is voluntary and informed.

MAID is generally intended for people who meet specific legal eligibility requirements. It is not a general option for anyone experiencing suffering or wishing to die. Each jurisdiction determines who qualifies, what medical assessments are required, how requests must be documented, and what waiting periods and other safeguards apply.

The second category is voluntary euthanasia. Unlike MAID, which involves self-administration, voluntary euthanasia occurs when a healthcare professional administers medication intended to end the patient’s life at the individual’s explicit and competent request, typically to relieve otherwise intolerable suffering. It is legally permitted in several countries and jurisdictions, although eligibility requirements, procedures, and safeguards vary considerably.

The third category is voluntarily stopping eating and drinking (VSED). For people who do not qualify for MAID or live where MAID or voluntary euthanasia is unavailable, VSED may be another end-of-life option. It involves a voluntary decision to stop consuming food and fluids, eventually resulting in death. Medical and palliative care may be provided to relieve discomfort during the process.

Voluntary assisted dying is legally permitted in a growing number of countries. In 2026, some form of the practice is legal in approximately 16 countries. Estimates indicate that more than 30,000 people die each year through voluntary assisted dying in jurisdictions where the practice is permitted.

Nearly 5% of the world’s population, or more than 400 million people, live in countries or areas where some form of voluntary assisted dying is legal. These jurisdictions include Australia, Austria, Belgium, Canada, Colombia, Ecuador, France, Germany, Luxembourg, the Netherlands, New Zealand, Portugal, Spain, Switzerland, and Uruguay.

In the United States, Illinois and New York recently joined 11 other states and the District of Columbia in permitting medical aid in dying (MAID) under specified conditions. Nearly one-third of the U.S. population lives in a state where the practice is permitted.

About 60% of U.S. adults consider MAID acceptable or do not view it as a moral issue. Opinions differ by political party, however. About 75% of Democrats compared with 50% of Republicans consider the practice morally acceptable.

Across many regions, including North America, Europe, and Australia, international opinion polls generally find majority support for voluntary assisted dying. A cross-sectional survey of physicians in 17 countries also found nuanced but generally supportive views of physician-assisted death when strict safeguards are in place.

Methods of administering medication also vary across jurisdictions. In Switzerland, individuals self-administer the medication, usually by swallowing a liquid. In Québec, Canada, physicians or nurse practitioners administer it, usually intravenously. In Australia, both self-administration and practitioner administration are permitted.

The laws governing voluntary assisted dying differ considerably across countries and jurisdictions. Nevertheless, the medical conditions and personal circumstances associated with requests for assisted dying tend to show similar patterns across regions and over time.

People with ALS, for example, have been found to have the highest rate of voluntary assisted dying, often several times those of cancer patients. Cancer patients, in turn, are more likely to access voluntary assisted dying than people with other illnesses, such as lung or heart disease. However, cancer remains the most common diagnosis among assisted dying cases, largely because it affects far more people than these other conditions.

Voluntary assisted dying accounts for a relatively small share of all deaths in countries where it is permitted, generally 1% or less in countries such as Germany, Spain, and Switzerland. In other countries, the proportions are considerably higher. Around 2023, assisted dying accounted for 5.4% of deaths in the Netherlands, 4.7% in Canada, and 3.6% in Belgium.

The number of voluntary assisted deaths has increased substantially in some countries. In the Netherlands, for example, the number has reportedly increased threefold since 2002. In Canada, the number initially increased rapidly before growth slowed; assisted dying now accounts for nearly 5% of all deaths.

Despite becoming legally permitted in an increasing number of countries, voluntary assisted dying remains controversial. The debate centers on a fundamental tension between respecting personal autonomy and relieving suffering, on the one hand, and protecting human life, on the other (Table 2).

Source: British Medical Association (BMA).

Arguments in favor of voluntary assisted dying emphasize patient autonomy, relief from suffering, dignity at the end of life, regulatory safeguards, and reduced burdens on families. Arguments against it stress the sanctity of life, risks to vulnerable people, the potential for a “slippery slope”, concerns about medical ethics, and the importance of palliative care.

In sum, voluntary assisted dying is legally permitted in a growing number of countries and jurisdictions, and its use has increased substantially in many of them. Nevertheless, voluntary assisted dying remains a sensitive, controversial, and deeply personal issue, even where it is legally permitted.

Joseph Chamie is a consulting demographer, a former director of the United Nations Population Division, and author of numerous publications on population issues.

Dan Mackenzie initially defended his father but now says he felt he had to report his own grandmother.

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More than 400 people, mostly children, become ill after drinking contaminated water, east of Pretoria.

Mass demonstrations and protests have taken place in countries across Europe in recent days, staged for the most part by young people. In many cases there have been outbreaks of violence and looting, with property being set on fire in France and Albania. Europe's media examines the causes.