Responding to the presentation of a report by the Commission on Human Rights in South Sudan (CHRSS) on Friday 27 February to the UN Human Rights Council that documents the deteriorating human rights situation in the country, Amnesty International’s Regional Director for East and Southern Africa Tigere Chagutah said;
“The report by the Commission on Human Rights in South Sudan, which paints a bleak picture of the human rights situation in the country, finds that the “scale and recurrence of violations are enabled by impunity, implicating all parties to the conflict.
“Speaking at the Human Rights Council on 27 February, Amnesty International called on the Council to extend the mandate of the Commission for at least two years. The critical conditions that led to the establishment of the CHRSS in 2016 remain unchanged. Now is not the time to end or relax scrutiny of the violations occurring in South Sudan.
Speaking at the Human Rights Council on 27 February, Amnesty International called on the Council to extend the mandate of the Commission for at least two years.
Tigere Chagutah, Amnesty International’s Regional Director for ESARO
“It is also critical that the Council passes a strong resolution that reflects the worsening situation in South Sudan, making clear that it stands ready to respond to any further deterioration of human rights in the country.”
It is also critical that the Council passes a strong resolution that reflects the worsening situation in South Sudan, making clear that it stands ready to respond to any further deterioration of human rights in the country.
Tigere Chagutah
Background
A new report presented by the CHRSS to the UN Human Rights Council on 27 February 2026, documents serious violations of international human rights law and international humanitarian law in various regions of South Sudan, including Upper Nile and Jonglei states, as well as Central and Western Equatoria states. The report implicates senior military and political officials in the violations, which include airstrikes on civilians and indiscriminate bombardments, and the forced recruitment of boys and young men by the South Sudan People’s Defence Forces (SSPDF).
The Human Rights Council established the CHRSS in March 2016 and mandated it to collect and preserve evidence of, and clarify responsibility for, alleged gross human rights violations and abuses and related crimes. South Sudan is one of the few states to cooperate with a mechanism set up to address its human rights situation.
The Algerian authorities must ensure the upcoming retrial of 94 people in connection with the August 2021 events in the Kabylie region, in northeastern Algeria, adheres strictly to international fair trial standards without recourse to the death penalty and excluding any torture-tainted statements, Amnesty International said today.
On 1 March 2026, 94 individuals will face trial again by the Algiers Court of Appeals after the Supreme Court overturned a previous appeal ruling related to the lynching of an activist, devastating wildfires and other violence in the Kabylie region in August 2021. On 24 November 2022, 56 people were convicted of involvement in acts including membership in an organisation committing acts of sabotage, premeditated murder, torture and arson. They were sentenced to death in proceedings marred by uninvestigated torture claims and politically motivated charges.
During the initial trial, at least five defendants said they were subjected to torture and other ill-treatment in detention, including the use of electric shocks, attempted waterboarding, and threats of rape, to extract statements under duress, which were used to convict them. Despite this, the court failed to investigate the claims, with judges instead telling defendants it was their own responsibility to file complaints.
“The flawed investigation and grossly unfair trial that led to these callous death sentences are a stain on Algeria’s justice system. The new trial represents an important opportunity for the Algerian authorities to end the travesty of justice, redress past violations and ensure accountability without recourse to the death penalty,” said Diana Eltahawy, Deputy Regional Director for the Middle East and North Africa at Amnesty International.
“Justice for the terrible violence of the events of August 2021 must mean a fair trial fully in line with international standards. All allegations of torture and other ill-treatment must be thoroughly, impartially, transparently and effectively investigated and forced ‘confessions’ extracted under torture or duress must be excluded from evidence. Individuals detained solely for the peaceful exercise of their human rights must be immediately released and charges against them dropped.”
The new trial represents an important opportunity for the Algerian authorities to end the travesty of justice, redress past violations and ensure accountability without recourse to the death penalty
Diana Eltahawy, MENA Deputy Regional Director
Amnesty International analysed the initial ruling and interviewed three lawyers and four family members who asked to remain anonymous. According to the information gathered, the prosecution of at least 10 defendants sentenced to death appears to solely be based on their political affiliations or alleged ties to the Movement for the Self-determination of Kabylie (MAK), a political opposition group labelled as “terrorist” by the Algerian authorities. No evidence has been presented by the prosecution indicating their presence at the scene of the crime and/or linking them to acts of violence. Four of the 10 defendants were outside of the country at the time of the events.
Furthermore, the court failed to allow defence lawyers to cross examine prosecution witnesses including police officers, relying instead on written testimonies. In August 2021, Algerian television channels aired videos of 12 of the defendants in which they appeared to ‘confess’ their involvement in the lynching or their ties with the MAK, violating their rights to presumption of innocence and against self- incrimination.
Amnesty International is calling on the Algerian authorities to ensure the right to a fair trial, including by the rights to a fair and public hearing, to adequate defence and to examine witnesses.
Background
Algeria has not carried out any executions since 1993. Amnesty International opposes the death penalty unconditionally, in all cases and under any circumstances. Under international law, the imposition of the death penalty following unfair proceedings renders the punishment arbitrary.
Since April 2021, the Algerian authorities have extensively used Article 87 bis of the Penal Code and overbroad terrorism accusations to prosecute activists, human rights defenders, and journalists. Many have been targeted for demanding political change or for their alleged ties to the MAK or Rachad, both opposition groups which were designated as “terrorists” in 2022 through a process that runs counter to international human rights standards.
The current case involves the August 2021 lynching of activist Djamel Ben Smail in Larbaa Nath Irathen and the fires that spread throughout the Kabylie region, resulting in at least 90 deaths. On 24 November 2022, as shared by the public prosecutor’s office at the Court of Algiers, a criminal court in Algiers sentenced 49 individuals to death after convicting them on charges including terrorism, murder and setting fires, in addition to seven people sentenced to death in their absence. The court issued sentences ranging from two to ten years in prison against 28 others. Seventeen people were acquitted. While the Algiers Court of Appeals maintained 38 death sentences in October 2023 and retained prison sentences for 30 others and acquitted 26 people, the Supreme Court overturned the appeal ruling in cassation on 28 November 2024 and ordered a retrial. Among the defendants, 52 are currently detained.
The Algerian authorities must ensure the upcoming retrial of 94 people in connection with the August 2021 events in the Kabylie region, in northeastern Algeria, adheres strictly to international fair trial standards without recourse to the death penalty and excluding any torture-tainted statements, Amnesty International said today.
On 1 March 2026, 94 individuals will face trial again by the Algiers Court of Appeals after the Supreme Court overturned a previous appeal ruling related to the lynching of an activist, devastating wildfires and other violence in the Kabylie region in August 2021. On 24 November 2022, 56 people were convicted of involvement in acts including membership in an organisation committing acts of sabotage, premeditated murder, torture, and arson. They were sentenced to death in proceedings marred by uninvestigated torture claims, and politically motivated charges.
During the initial trial, at least five defendants said they were subjected to torture and other ill-treatment in detention, including the use of electric shocks, attempted waterboarding, and threats of rape, to extract statements under duress, which were used to convict them. Despite this, the court failed to investigate the claims, with judges instead telling defendants it was their own responsibility to file complaints.
“The flawed investigation and grossly unfair trial that led to these callous death sentences are a stain on Algeria’s justice system. The new trial represents an important opportunity for the Algerian authorities to end the travesty of justice, redress past violations and ensure accountability without recourse to the death penalty,” said Diana Eltahawy, Deputy Regional Director for the Middle East and North Africa at Amnesty International.
“Justice for the terrible violence of the events of August 2021 must mean a fair trial fully in line with international standards. All allegations of torture and other ill-treatment must be thoroughly, impartially, transparently and effectively investigated and forced ‘confessions’ extracted under torture or duress must be excluded from evidence. Individuals detained solely for the peaceful exercise of their human rights must be immediately released and charges against them dropped.”
The new trial represents an important opportunity for the Algerian authorities to end the travesty of justice, redress past violations and ensure accountability without recourse to the death penalty
Diana Eltahawy, MENA Deputy Regional Director
Amnesty International analysed the initial ruling and interviewed three lawyers and four family members who asked to remain anonymous. According to the information gathered, the prosecution of at least 10 defendants sentenced to death appears to solely be based on their political affiliations or alleged ties to the Movement for the Self-determination of Kabylie (MAK), a political opposition group labelled as “terrorist” by the Algerian authorities. No evidence has been presented by the prosecution indicating their presence at the scene of the crime and/or linking them to acts of violence. Four of the 10 defendants were outside of the country at the time of the events, and six of them were sentenced in their absence.
Furthermore, the court failed to allow defence lawyers to cross examine prosecution witnesses including police officers, relying instead on written testimonies. In August 2021, Algerian television channels aired videos of 12 of the defendants in which they appeared to ‘confess’ their involvement in the lynching or their ties with the MAK, violating their rights to presumption of innocence and against self- incrimination.
Amnesty International is calling on the Algerian authorities to ensure the right to a fair trial, including by the rights to a fair and public hearing, to adequate defense and to examine witnesses.
Greenpeace Africa is in solidarity with Friends of Karura Forest following disturbing reports of tree felling and land disturbance inside Karura Forest without clear public communication or consultation.
According to information shared publicly by the Green Belt Movement after engaging the Kenya Forest Service (KFS), the development has been acknowledged by KFS leadership and described as “temporary structures” expected to remain in place until 2032. However, the scale of tree clearing, site preparation, and ground disturbance observed on site raises serious concerns about whether this undertaking is truly temporary, or something more permanent and expansive.
Karura Forest is protected public land governed under a participatory forest management framework. Public participation is not optional; it is a constitutional requirement and a legal obligation under the Forest Conservation and Management Act. Yet no public participation process preceded the commencement of these works. The legally recognised Community Forest Association – Friends of Karura Forest – was reportedly neither informed nor consulted before indigenous trees were felled.
Greenpeace Africa is deeply concerned by the pattern this represents. In recent years, Kenya’s forests have faced increasing pressure – from controversial logging decisions to infrastructure encroachments in protected areas. At the same time, the government has committed to expanding forest cover and planting 15 billion trees. These commitments ring hollow if protected indigenous forests can be cleared without transparency, environmental scrutiny, and public oversight.
Several urgent questions now demand answers:
Was an Environmental Impact Assessment conducted prior to the initiation of this project?
If so, where is the public disclosure, and was it subjected to public participation as required by law?
On what legal basis was tree clearance authorised inside a protected urban forest?
Why was the Community Forest Association not formally engaged before works commenced?
Why establish accommodation facilities and a two-million seedling nursery within an ecologically sensitive forest when alternative KFS headquarters land exists?
Karura Forest is not merely a site for operational convenience. It is a biodiversity sanctuary, a climate buffer for Nairobi, and a symbol of people-led environmental protection rooted in decades of citizen resistance and stewardship.
Greenpeace Africa calls upon the Kenya Forest Service to:
Immediately halt ongoing tree clearance and construction activities pending full public clarification;
Publicly disclose all approvals, environmental assessments, and planning documents related to this project;
Convene a transparent public participation process involving Friends of Karura Forest and the wider public;
Provide clear assurances that Karura’s protected status and participatory governance model will be upheld.
Forests in Kenya are held in public trust. They cannot be reconfigured through silence.
Kenyans deserve full transparency about what is happening inside Karura Forest.
The Israeli High Court has ruled in favour of an urgent request from 19 humanitarian organisations, including Oxfam, for an interim order which would prevent the cessation of all activities until a final ruling is reached.
In response, Oxfam’s Policy Lead, Bushra Khalidi, said:
“We are grateful that our request for an interim order has been agreed. Although this news is positive, the humanitarian situation in Gaza remains critical and we don’t yet know what effect this ruling will have.
“When the court issues its final decision on the petition submitted by Oxfam and others, we hope it recognizes the very real threat to civilian lives and upholds humanitarian principles and international law.”
Ends
For more information and interviews, please contact Lisa Rutherford, News Manager Oxfam International, on +44 (0) 7345 772278
As Trump tears down renewable energy, once again, Mozambique bears the brunt of climate harm caused by fossil fuel producers.
By Tigere Chagutah
In his address to the World Economic Forum (WEF) in Davos on 21 January, US President Donald Trumpargued against renewable energy solutions. In a wide-ranging speech, he described them as a “green new scam”, while calling world leaders, mainly from the Global North, to extract more fossil fuels to “avoid a catastrophic energy collapse”. The burning and production offossil fuels is the major driver of global warming, accounting for 89% of greenhouse gas emissions. In addition to global harm to the planet, fossil fuel productionharms nature and human rights.
As Trump made this speech, Mozambique was experiencing deadly floods caused by a tropical depression, an eventin part made more likely by human-induced climate change.
Mozambique is not helping itself
Daniel Chapo, Mozambique’s president,cancelled his participation at the 2026 WEF, ostensibly to monitor the impact of the floods and the delivery of assistance to victims. However, such actions are meaningless in the absence of an adequate, consistent and coherent implementation of Mozambique’s Climate Action Strategy.
As global calls for the world to equitably phase out fossil fuels and transition to renewable energy grow ever louder, Mozambique continues to invest heavily in fossil fuel production.
YASUYOSHI CHIBA/AFP/Getty Images
The country is home to the biggest fossil gas project in Africa, the Mozambique Liquefied Natural Gas project, in the poorest province of Cabo Delgado, owned by TotalEnergies, the French oil and gas giant. After its halt in 2021, due to a deadly attack by armed groups that have been fighting against the government since 2017, Chapo authorised the project to resume operation, despite strongallegations of human rights abuses and violations, and the improper displacement of communities to give way to the project.
Besides this project,there are three other major fossil fuel projects in the same province: Rovuma LNG, owned by Eni and ExxonMobil; Coral Sul FLNG, owned by Eni; and Coral North LNG, also owned by Eni. Combined, these facilities will produce9.9 gigatons of CO2 greenhouse emissions, which will significantly increase Mozambique’s total emissions.
In 2019, Cabo Delgado province was hit by Cyclone Kenneth, which flattened the villages of Quissanga, Macomia and Ibo, killing dozens and leaving thousands of people without shelter, food, crops and assets.
Deadly floods
Once again, Mozambique is experiencing deadly climate-related floods. Between 9 and 26 January, about 692,522 people (151,962 families) were affected across southern and central Mozambique, mainly in Gaza (75%), Maputo and Sofala provinces, where 12 people died, 45 were injured, and four remain unaccounted for. The floods destroyed or damaged more than 4,000 homes and flooded almost 155,000 others.
According to the Mozambique Disaster and Risk Management Institute, since the beginning of the rainy season in October, 137 people have died and 800,000 people have been affected. About 72,000 homes were destroyed, and essential infrastructure, including roads, bridges, health care facilities, agricultural land and schools, was damaged.
Pictures taken by activists in different communities in Sofala province, Mozambique in the weeks after the cyclone.
The country will need $644-million to rebuild its essential infrastructure washed away by the rains, which are expected to continue, with the situation likely to worsen.
Despite its insignificant greenhouse gas emissions (60.26 megatons of CO2, about 0.11% of the global total, in 2024), Mozambique is among the top 10 countries most severely affected by climate change and natural hazards. Climate projections indicate that Mozambique’s land surface temperaturesare likely to keep rising.
Unprecedented warming
As Trumpfiercely opposes renewable energy, the world is warming at an unprecedented rate. After record heat in2024, the first year to exceed 1.5°C above pre-industrial levels, the critical temperature threshold set in the Paris Agreement, 2026 is likely to be the fourth year in succession with high temperature levels (at least 1.44ºC, above the pre-industrial levels).
Besides Trump’s obstruction of climate action and the devastating effects of climate change, research has shown that fossil fuel companies were responsible for half of all greenhouse gas emissions globally.
According to a recent update to the Carbon Majors’ database, state-owned companies comprised 17 out of the top 20 emitters. All 17 companies are controlled by countries that refused the proposed phase-out plan at COP30, including Saudi Arabia, Russia, China, Iran, the United Arab Emirates and India.
If the world wants to address global warming, unlike the outcome of COP30, at which world leaders failed to commit to a phase-out roadmap, the transition to renewable energy produced in a manner consistent with human rights is paramount, and it must be just.
As reflected inAmnesty International’s COP30 outcome analysis, this must also be accompanied by, inter alia, the operationalisation of the Fund for Responding to Loss and Damage, to meet the needs of vulnerable nations such as Mozambique, which is among the most affected by climate change impacts and is currently experiencing the unjust impact of climate change.
Higher income historical emitters must:
Provide technical and grant-based or non-debt financial assistance to support Mozambique’s mitigation and adaptation efforts; and
Provide reparations for loss and damage due to irreversible climate harm, such as the recent floods.
On its side, Mozambique must:
Invest in more robust emergency disaster response systems and provide remedies to individuals or groups affected by the floods; and
Embark on an equitable transition away from fossil fuels and invest in adaptation. DM
Tigere Chagutah is the regional director for Amnesty International East and Southern Africa.
This opinion piece first ran in South Africa’s Daily Maverick.
Commenting on the Green Party winning the Gorton and Denton by-election, Greenpeace UK Head of Politics Ami McCarthy (they/them) said:
“The message from Gorton and Denton to Westminster is loud and clear: people are hungry for change. This is a victory for people power over billionaires and big polluters, for the politics of hope over the politics of hate, for decency over denial and division. More than twice as many votes went to parties determined to tackle the climate crisis than to Reform, showing the limited public appeal of Nigel Farage’s climate-denying, renewable-hating, Trump-loving platform. And there’s a clear lesson here for Labour too: if they want to regain ground from the Greens, they need to offer the bold solutions on cost of living, climate and nature that people are clearly looking for.”
ENDS
Contact: Greenpeace UK press team on 020 7865 8255
Responding to a landmark judgement by an Athens court which found four individuals linked to spyware maker Intellexa, guilty of unlawful access to private communication systems and data, and of violating privacy and data protection laws, Rebecca White, Amnesty International’s Security Lab Researcher said:
“Almost four years since the ‘Predatorgate’ scandal hit Greece, we are finally seeing consequences for those involved in the abuse of surveillance technology.
Amnesty International and other organizations have shown time and again that Intellexa’s products have been used to mount brazen attacks against journalists, activists, academics and politicians around the world.
“We hope this landmark ruling signals the end of the era of impunity for the surveillance industry.
“Questions remain about the role of the Greek government which has consistently denied purchasing or using Predator. Transparency is a crucial part of accountability – as is remedy for the many victims of the human rights violations brought about by the unlawful use of this technology.”
Background
The ‘Predatorgate’ scandal surfaced in March 2022 when journalist Thanasis Koukakis discovered that his phone had been infected with the highly invasive spyware, Predator and that he had been wiretapped by the Greek National Intelligence Service. Four months later, Nikos Androulakis, leader of the opposition party PASOK-KINAL, also discovered his phone had been targeted with Predator while serving as a Member of the European Parliament.
On 26 February 2026, the Athens court sentenced four individuals – Tal Dilian, a former Israeli intelligence officer and founder of Intellexa, Sara Hamou – Dilian’s business partner, Felix Bitzios – a former deputy administrator and shareholder of Intellexa and Yiannis Lavranos – owner of Kriel, the company through which Predator was allegedly procured, to 126 years and eight months in prison each, though the sentence has been suspended pending an appeal. A prosecutor has asked for their investigation along with eight others for espionage and any other people who maybe involved in the case citing the possibility of collaboration with foreign state forces.
To mark Poland’s official withdrawal from the Ottawa Convention or the Anti-Personnel Mine Ban Treaty, Julia Głębocka, Human rights researcher for Amnesty International Poland, reflects on what the return of these indiscriminate weapons means for human rights in Europe.
Not so long ago, in 2020, the European Union was funding mine relief efforts in Lebanon and hoping to see an anti-personnel mine-free world within five years. HALO Ukraine, an EU-supported organization, had already been making tangible change, removing explosives from Ukrainian soil since 2016. In Chad, the EU-funded project PRODECO, was reintegrating anti-personnel mine victims into society through long-term medical care and rehabilitation, as well as supporting demining efforts.
At the beginning of 2025, all 27 EU member states had been parties to the Ottawa Convention, which bans the use, production, stockpiling and transfer of anti-personnel mines, for over two decades.
But any hope for a more peaceful world was short lived.
While many of us dreamed that one day these indiscriminate weapons would be eradicated, these ghosts of twentieth century warfare are making a comeback.
In March 2025, the governments of Estonia, Latvia, Lithuania and Poland announced their intention to withdraw jointly from the Ottawa Convention. Finland followed suit with a similar announcement in April 2025. While the withdrawal has already come into effect for other countries, Poland’s exit entered into force on Friday. The move from multiple EU member states marks a disturbing shift in national security policies undermining the bloc’s credibility on its own adherence to international humanitarian law.
For decades, Brussels has been an avid supporter of the Ottawa Convention. EU strategies on conventional weapons explicitly condemn anti-personnel mines as indiscriminate tools that cause harm far beyond the battlefield. EU funds are routinely channeled into demining operations, victim assistance programmes and international advocacy against anti-personnel mines. And yet, when several of its own members openly abandon this consensus, the EU refused even to utter words of condemnation.
Meanwhile, in my home country, Poland, arms companies wasted no time in seizing on the opportunity that the Ottawa withdrawal presented.
Almost immediately after Poland announced its withdrawal, two major arms-industry companies signaled their readiness to restart anti-personnel mine production. State-owned Bydgoszcz Electromechanical Plant Belma and Niewiadów Polish Military Group JSC declared that they could produce enough mines to secure the entire 800-kilometre eastern border of Poland, with plans to sell any surplus to the Baltic states and Ukraine.
The Polish government justifies its decision in the language of military deterrence. But according to international monitoring organisations, roughly 80 to 85 percent of anti-personnel mine victims worldwide are civilians, many of them children. In Ukraine, where anti-personnel mines have been deployed on a massive scale, their effects extend far beyond military targets. It is worth mentioning that severe mine contamination affected local communities not only in terms of physical safety, but also economically. Ukrainian farmers had to take the initiative and start demining operations themselves and were then reimbursed by their government. Anti-personnel mines do not end wars. They survive them.
Absent, however, from public debate is how the use of these mines might put refugees and migrants at risk.
Julia Głębocka
In 2021-2022 Amnesty International documented Poland’s unlawful pushbacks and ill-treatment of refugees and migrants at its border with Belarus, the adoption of legislation limiting access to the border for humanitarian organizations, and the granting of powers to the Polish Border Guard to reject asylum applications without examination, in breach of international law standards.
On the other side of the border, Amnesty International revealed how Belarusian authorities ruthlessly forced people under duress across the border, in full knowledge of the violence they would face at the hands of Polish border guards on the other side. seeking protection in Europe.
Since then, restrictions to accessing the border were once again re-introduced through the creation of a “buffer/exclusion zone” in June 2024, the effects of which were repeatedly extended and remain active to date. Soon after, the law regulating the use of arms by the Border Guard was amended, limiting their accountability for excessive force.
In a flagrant violation of international law, in March 2025 (at the same time Poland announced its withdrawal from Ottawa) the right to seek asylum at the border was temporarily suspended. Humanitarian organizations warned at the outset that these measures were a slippery slope.
Amnesty International has serious concerns about how a possible re-introduction of anti-personnel mines compounds risks for refugees and migrants, creating a new horrifying and dangerous reality for people seeking protection in Europe.
These developments along Europe’s northeastern borders are retrograde moves that will only further weaken the global consensus aimed at minimizing civilian harm during armed conflict. Antipersonnel mines’ devasting impact on civilians, sometimes decades after they are deployed, and unexploded anti-personnel landmines can blight whole regions for generations.
The decision to leave the Convention must be reversed.
Europe once committed itself to leave anti-personnel mines in the past. Allowing them to return uncontested means accepting that some ghosts are welcome after all.
Source: International Atomic Energy Agency (IAEA) –
Cardiac imaging technologies, such as nuclear cardiology and computed tomography, are essential tools for diagnosing coronary artery disease. (Photo: AdobeStock)
Differences in the amount of radiation patients receive from diagnostic tests for coronary artery disease (CAD) have been revealed in a major international study coordinated by the International Atomic Energy Agency (IAEA) and Columbia University in the United States. The study underscores an urgent need for improved training, standardized protocols and updated equipment — particularly in low- and middle-income countries, where data suggests radiation doses could be lowered without compromising test results.
CAD occurs when the arteries that supply blood to the heart become narrowed or blocked, typically due to plaque buildup in the artery walls, a process known as atherosclerosis. When the heart does not receive enough blood, it can lead to chest pain, heart attacks, abnormal heart rhythms or heart failure.
CAD remains the leading cause of death worldwide, and the use of modern imaging tests to detect CAD has increased steadily in recent decades. The study, Worldwide Radiation Dose in Coronary Artery Disease Diagnostic Imaging, published yesterday in JAMA, the Journal of the American Medical Association,analyzed data from more than 19 000 patients at 742 centres in 101 countries, making it the largest and most comprehensive global assessment of radiation exposure from non-invasive cardiac imaging. Each centre collected and contributed data from one of nine defined weeks in the fourth quarter of 2023.
Researchers examined radiation doses from widely used imaging techniques, including nuclear cardiology tests and computed tomography (CT) scans of the heart. While many centres were able to keep radiation exposure within recommended limits, the study found marked variation between countries, regions and income levels, with some patients receiving higher doses of radiation than others for the same test.
“Radiation from medical imaging saves lives every day by enabling accurate diagnosis and treatment, but it must always be optimized,” said Professor Andrew J Einstein, the study’s principal investigator and corresponding author. Einstein is Director of Nuclear Cardiology, Cardiac CT and Cardiac MRI at the Seymour, Paul and Gloria Milstein Division of Cardiology at Columbia University’s Vagelos College of Physicians and Surgeons in New York City.
Key findings
The study found that median radiation doses varied widely by imaging modality, income levels and geography. Optimized protocols and use of newer technology, which often deliver clearer images, were consistently associated with lower patient exposure.
Patients in low- and middle-income countries often received significantly higher doses, particularly for coronary CT angiography, a test that is increasingly used because of CT’s availability and technological improvements.
“This study shows that where a patient lives, the resources available to a health system and how those resources are used can strongly influence how much radiation they receive — even when undergoing the same test,” Einstein said. “These differences are not inevitable. In many cases, the technology and knowledge to reduce dose already exist. The challenge is ensuring that they are applied consistently and equitably across the world.”
The authors emphasize that reducing radiation doses does not mean reducing diagnostic quality.
The IAEA’s role
For more than six decades, the IAEA has worked with countries to strengthen the safe and effective use of medical imaging, especially where access to advanced health care is limited. The findings of this study will help guide future efforts to improve radiation safety, while expanding access to life-saving diagnostic tools.
“This research provides critical evidence that can inform national policies and international action,” saidDiana Paez, Head of the Nuclear Medicine and Diagnostic Imaging Section at the IAEA. Paez was the senior investigator and co-lead of the study. “By identifying where radiation doses are highest and why, we can better target training, quality assurance programmes and technical support to help countries optimize cardiac imaging for their populations,” she added
The study also highlights the importance of investing in modern imaging equipment and ensuring that health professionals are trained to use dose-reduction techniques effectively.
“Access to diagnostic imaging is essential for tackling the growing global burden of heart disease,” said May Abdel-Wahab, Director of the IAEA Division of Human Health. “At the same time, patient safety must remain central. This study underscores the need for updated equipment, harmonized standards and improved training to expand access while reducing unnecessary radiation exposure. Building on these findings, the next step is to work with partners to provide relevant continuing medical education and long-term training.”
The study points to further opportunities for peer-to-peer knowledge sharing, development of regional and global dose reference levels, and closer collaboration between regulators, professional societies and industry.
“As the use of cardiac imaging continues to grow worldwide, ensuring that every patient benefits from the safest possible practices is both a medical and an ethical imperative,” Einstein said. “Patients deserve the highest standards of safety while undergoing testing that is critical to heart health.”
