Tuberculosis has plagued humans for thousands of years and continues to do so. In advance of this year’s World TB Day, March 24, the World Health Organization is issuing a call to action to eradicate the disease by 2030.  

As part of these efforts, the WHO is launching an oral drug regimen it says can more effectively treat people with multi-drug resistant tuberculosis.  

TB remains the world’s deadliest infectious disease, killing nearly 4,500 people a day and infecting 10 million people a year.

Despite the grim statistics, much progress has been made in the diagnosis, prevention and treatment of the disease.  The WHO says 54 million lives have been saved since 2000.  But the WHO also warns the gains risk being lost with the emergence of multidrug-resistant TB or MDR-TB.

The current treatment for MDR-TB involves a two-year treatment course of painful injections, which provoke many bad side effects.  

The WHO says it is hopeful the new oral treatment program it is launching will be more effective in controlling the spread of the particularly virulent form of tuberculosis.  

The director of the WHO’s Global TB Program, Tereza Kasaeva, told VOA the new oral drug treatment the WHO is recommending has far fewer adverse side effects.

“Of course, it will be definitely much, much easier and there will not be a need for regular frequent visits of the physicians or health workers for making these injections.  No doubt, as we see from the data, the effectiveness, the treatment success will be definitely much, much higher,” Kasaeva said.

The South African government has announced it plans to adopt the injection-free treatment.  Kasaeva said the cost of the oral treatment is around $2,000, which is largely unaffordable for low-income countries.   

She said South Africa is engaging in talks with pharmaceutical companies to drop the price to $400.

The WHO says South Africa is one of the 20 countries most affected by MDR-TB.  Others include Russia, China, India, Nigeria, Pakistan and Vietnam.

 
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NASA’s plan to scoop up dirt and gravel from an asteroid has hit a snag, but scientists say they can overcome it.

The asteroid Bennu was thought to have wide, open areas suitable for the task. But a recently arrived spacecraft revealed the asteroid is covered with boulders and there don’t seem to be any big, flat spots that could be used to grab samples. 

In a paper released Tuesday by the journal Nature, scientists say they plan to take a closer look at a few smaller areas that might work. They said sampling from those spots poses “a substantial challenge.”  

“But I am confident this team is up to that substantial challenge,” the project’s lead scientist, Dante Lauretta, told reporters at a news conference Tuesday.

The spacecraft, called Osiris-Rex, is scheduled to descend close to the surface in the summer of 2020. It will extend a robot arm to pick up the sample, which will be returned to Earth in 2023. The spacecraft began orbiting Bennu at the end of last year, after spending two years chasing down the space rock.

When the mission was planned, scientists were aiming to take dirt and gravel from an area measuring at least 55 yards (50 meters) in diameter that was free of boulders or steep slopes, which would pose a hazard.

“It is a more rugged surface than we predicted,” said Lauretta, of the University of Arizona in Tucson and one of the paper’s authors. But he said he believed a sample could still be collected.

NASA project manager Rich Burns said a spot will be chosen this summer and the setback won’t delay the sampling.

Patrick Taylor, who studies asteroids at the Lunar and Planetary Institute in Houston but didn’t participate in the spacecraft mission, noted in a telephone interview that the spacecraft was evidently maneuvering more accurately and precisely than had been expected. 

“That gives me confidence they will be able to attempt a sample acquisition,” he said.

Bennu is 70 million miles (110 million kilometers) from Earth. It’s estimated to be just over 1,600 feet (500 meters) across and is the smallest celestial body ever orbited by a spacecraft.

A Japanese spacecraft, Hayabusa2, touched down on another asteroid in February, also on a mission to collect material. Japan managed to return some tiny particles in 2010 from its first asteroid mission.
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It would be irresponsible for any scientist to conduct human gene-editing studies in people, and a central registry of research plans should be set up to ensure transparency, World Health Organization experts said Tuesday.

After its first two-day meeting in Geneva, the WHO panel of gene-editing experts — which was established in December after a Chinese scientist said he had edited the genes of twin babies — said it had agreed on a framework for setting future standards.

It said a central registry of all human genome-editing research was needed “in order to create an open and transparent database of ongoing work,” and asked the WHO to start setting up such a registry immediately.

“The committee will develop essential tools and guidance for all those working on this new technology to ensure maximum benefit and minimal risk to human health,” Soumya Swamanathan, the WHO’s chief scientist, said in a statement.

A Chinese scientist last year claimed to have edited the genes of twin baby girls.

News of the births prompted global condemnation, in part because it raised the ethical specter of so-called “designer babies” — in which embryos can be genetically modified to produce children with desirable traits.

Top scientists and ethicists from seven countries called last week for a global moratorium on gene editing of human eggs, sperm or embryos that would result in such genetically-altered babies — saying this “could have permanent and possibly harmful effects on the species.”

The WHO panel’s statement said any human gene-editing work should be done for research only, should not be done in human clinical trials, and should be conducted transparently.

“It is irresponsible at this time for anyone to proceed with clinical applications of human germline genome editing.”

The WHO’s director-general, Tedros Adhanom Ghebreyesus, welcomed the panel’s initial plans. “Gene editing holds incredible promise for health, but it also poses some risks, both ethically and medically,” he said in a statement.

The committee said it aims over the next two years to produce “a comprehensive governance framework” for national, local and international authorities to ensure human genome-editing science progresses within agreed ethical boundaries.
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A Chinese national has been sentenced to 18 months in a U.S. prison in connection with a scheme to sell mislabeled dietary supplements to U.S. companies.

Xu Jia Bao, an executive with Shanghai Waseta International Trade Co., was also sentenced to one year of probation for selling synthetic stimulant ingredients to a purported U.S. manufacturer of dietary supplements.  The U.S. company was, in fact, an undercover informant for the U.S. government.

The prosecutors said Xu admitted that he and other executives at Waseta knew major American retailers would not carry supplements known to contain certain stimulants, such as DMHA.  The stimulant, commonly known by its trade name octodrine, has been promoted for such uses as weight loss and enhanced athletic performance.  But researchers have warned about such possible side effects as high blood pressure, shortness of breath and heart attack. 

Xu also admitted that he and Waseta were responsible for a falsely labeled shipment of DMHA that was sent to Texas.

“Consumers are entitled to trust that dietary supplement products accurately identify their ingredients,” said Assistant Attorney General Jody Hunt for the Department of Justice’s Civil Division. “We will vigorously pursue and prosecute those who attempt to circumvent.”

Xu was arrested in September 2017 while attending a dietary supplement trade show in Las Vegas.
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The investigation into the final minutes of Ethiopian Airlines Flight 302 turned on Tuesday to the secrets in the cockpit voice recorder as Boeing and a shaken global aviation industry hung on the outcome.

The voices of Captain Yared Getachew and First Officer Ahmednur Mohammed could reveal what led to the March 10 crash of the Boeing 737 MAX that has worrying parallels with another disaster involving the same model off Indonesia in October.

The twin disasters killed 346 people.

Black box data was downloaded in France but only Ethiopian experts leading the probe have heard the dialogue between Getachew, 29, and Mohammed, 25. The data was back in Addis Ababa on Tuesday, sources familiar with the probe told Reuters.

Experts believe a new automated system in Boeing’s flagship MAX fleet — intended to stop stalling by dipping the nose — may have played a role in both crashes, with pilots unable to override it as their jets plunged downwards.

Both came down just minutes after take-off after erratic flight patterns and loss of control reported by the pilots.

However, every accident is a unique chain of human and technical factors, experts say.

The prestige of Ethiopian Airlines, one of Africa’s most successful companies, and Boeing, the world’s biggest planemaker and a massive U.S. exporter, is at stake.

Awkward questions for industry

Lawmakers and safety experts are questioning how thoroughly regulators vetted the MAX model and how well pilots were trained on new features. For now, regulators have grounded the existing fleet of more than 300 MAX aircraft and deliveries of nearly

5,000 more — worth well over $500 billion — are on hold.

Pressure on the Chicago-headquartered company has grown with news that federal prosecutors and the U.S. Department of Transportation are scrutinizing how carefully the MAX model was developed, two people briefed on the matter said.

The U.S. Justice Department was looking at the Federal Aviation Administration’s (FAA) oversight of Boeing, one of the people said. And a federal grand jury last week issued at least one subpoena to an entity involved in the plane’s development. The rest of the world is watching anxiously.

The European Union’s aviation agency EASA promised its own deep look at Boeing’s software updates and failure modes.

“We will not allow the aircraft to fly if we have not found acceptable answers to all our questions,” its executive director Patrick Ky told an EU parliament committee hearing.

“Whatever the FAA does. OK? This is a personal guarantee that I make in front of you.”

Canada said it would independently certify the MAX in future, rather than accepting FAA validation, and would also send a team to help U.S. authorities evaluate proposed design changes.

In the hope of getting its MAX line back into the air soon, Boeing said it will roll out a software update and revise pilot training. In the case of the Lion Air crash in Indonesia, it has raised questions about whether crew used the correct procedures.

The MAX, which offers cost savings of about 15 percent on fuel, was developed for service from 2017 after the successful launch by its main rival of the Airbus A320neo.

Argus Research cut Boeing stock to “hold” from “buy”, giving the planemaker at least its fourth downgrade since the crash, Refinitiv data showed. Its shares, however, were enjoying a rare respite on Tuesday, up 1.6 pct to $378 and cutting losses since the crash to under 11 pct.

Global ramifications

In the hot seat over its certification of the MAX without demanding additional training and its closeness to Boeing, the FAA has said it is “absolutely” confident in its vetting.

The crisis has put pressure on airline companies.

Norwegian Airlines has already said it will seek compensation after grounding its MAX aircraft.

Various firms are reconsidering Boeing orders, and some are revising financial forecasts given they now cannot count on maintenance and fuel savings factored in from the MAX.

Illustrating the hoops airlines were jumping through, Air Canada said it intends to keep its MAX aircraft grounded until at least July 1, would accelerate intake of recently acquired Airbus A321 planes, and had hired other carriers to provide extra capacity meantime.

Beyond the corporate ramifications, anguished relatives are still waiting to find out what happened.

Many have visited the crash site in a charred field to seek some closure, but there is anger at the slow pace of information and all they have been given for funerals is earth.

“I’m just so terribly sad. I had to leave here without the body of my dead brother,” said Abdulmajid Shariff, a Yemeni relative who headed home disappointed on Tuesday.
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Laura Levine says she never smoked a cigarette or touched a drink until age 35. Then the mother of five tried heroin, and she was hooked.

After some brushes with the law — petty larceny to support her habit — she was booked into Nassau County jail and withdrawal started kicking in. As the nausea, shaking and sweating grew worse, she began pleading with guards for help.

“They kind of laughed and said, ‘You’ll be fine. Nobody dies from heroin withdrawal,’” said Levine, who is in recovery and now works to help others struggling with opioids. “I would rather give birth to all five of my children again without medication than go through withdrawal again.”

More help for people like Levine could be on the way, as lawmakers in New York are considering a measure to make medication-assisted treatment such as methadone or suboxone available to all prison and jail inmates struggling with opioid addiction.

States across the country are considering similar approaches amid research that shows that the drugs along with behavior therapy can help addicts reduce the withdrawal symptoms and cravings that drive many addicts to relapse.

Federal statistics suggest more than half of all inmates in state prisons nationwide have a substance- abuse problem. New York officials say that percentage could be as high as 80 percent in state and local lockups, which at any given time have about 77,000 inmates.

Drug policy experts point to the success of a similar program in Rhode Island, which has seen a sharp drop in the number of former inmates who died of overdoses, from 26 in 2016 to nine last year.

Other successes have been reported in local jails in Louisville, Kentucky; Sacramento, California and in Massachusetts.

“It makes no sense that people who have a public health issue don’t have access to medicine,” said Jasmine Budnella, drug policy coordinator at VOCAL-NY, a group that advocates on behalf of low-income New Yorkers on such issues as criminal justice, drug policy and homelessness. “In the U.S., we talk about human rights but we are literally torturing these people.”

Two years ago, 24-year-old Matt Herring died of a drug overdose after years of struggling with addiction and bouncing in and out of correctional facilities. His mother, Patricia Herring, said Matt once tried to smuggle suboxone into jail in order to avoid the horrors of withdrawal. Guards found the medication and took it away.

Patricia Herring has now become a self-described “mom on a mission” to push for greater resources for addiction treatment in correctional facilities.

“If he had been given medication-assisted treatment when he entered, I don’t know, maybe things would have been different,” she said.

With no organized opposition, the debate over supporting medication-assisted treatment in correctional settings comes down to dollars and cents. Some counties have paid for programs in their jails; others have not. A total of six state and local lockups in the New York City area, for example, have limited drug-assistance programs for opioid addicts.

Albany County became the first county in the state outside of New York City to offer medication-assisted treatment. Sheriff Craig Apple said he’s become a believer.

“It took me a while to get on board with this, but we’re already seeing early success,” he said.

A state budget proposal from Democratic Gov. Andrew would spend $3.75 million to expand access in county jails, and use more than $1 million to expand its use in state prisons. Democratic leaders of the state Legislature have called for more, and advocates say they want to see at least $7 million in the annual budget.

A decision is expected before April 1, when the new budget is due.

“Addiction is a disease,” said New York Assemblywoman Linda Rosenthal, a Manhattan Democrat who is sponsoring the drug-treatment legislation. “We should treat it like a disease.”
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Hawaii would be the first state in the U.S. to ban most plastics used at restaurants under legislation that aims to cut down on waste that pollutes the ocean

Hawaii would be the first state in the U.S. to ban most plastics at restaurants under legislation that aims to cut down on waste that pollutes the ocean.

Dozens of cities across the country have banned plastic foam containers, but Hawaii’s measure would make it the first to do so statewide. The liberal state has a history of prioritizing the environment — it’s mandated renewable energy use and prohibited sunscreen ingredients that harm coral.

A second, more ambitious proposal would go even further and prohibit fast-food and full-service restaurants from distributing and using plastic drink bottles, utensils, stirring sticks, bags and straws.

The Hawaii efforts would be stricter than in California, which last year became the first state to ban full-service restaurants from automatically giving out plastic straws, and broader than in Seattle, San Francisco and other cities that have banned some single-use plastics.

Activists believe the foam container measure has a better chance of passing in Hawaii.

“We have this reputation of setting the example for the world to follow, and that’s what we’re trying to do here,” state Sen. Mike Gabbard, lead author of the more ambitious measure, said to the Senate. “Our state can once again take the lead in protecting our environment.”

Gabbard, father of Democratic presidential candidate and U.S. Rep. Tulsi Gabbard, said 95 percent of plastic packaging worldwide is thrown out after being used once. In the U.S., 500 million plastic straws are used and thrown out every day, he said.

Discarded, slow-to-degrade plastic is showing up at sea, as in a massive gyre northeast of the Hawaiian islands, and on beaches.

Plastics also contribute to climate change because oil is used to make them, said Stuart Coleman, Hawaii manager for the Surfrider Foundation.

Eric S.S. Wong, co-owner of two fast-food establishments on Oahu, said not being able to serve food in plastic foam containers would drive up his costs at a time when he faces rising health insurance charges for his employees and a possible minimum wage hike that lawmakers also are considering.

He said he’ll have to raise prices.

“Now all of the sudden, your family’s $30 dining experience became $37 or $38,” Wong said.

His Wiki Wiki Drive Inn takeout counter in Honolulu sells sandwiches, breakfast meals and Hawaii favorites like Loco Moco, which features white rice topped with a hamburger patty, fried egg and gravy.

A package of 200 foam boxes costs him $23, while the same number of biodegradable boxes would cost $57, he said.

Chris Yankowski of the Hawaii Restaurant Association, which represents 3,500 restaurants, said lawmakers are trying to do “too much too fast.”

Yankowski, who is also president of Triple F Distributors, argued that good alternatives to plastic products are not yet available. Hawaii’s cities and counties also don’t provide composting facilities, so there is no organized place to dispose of compostable containers that lawmakers say restaurants should use instead, he added.

 “It’s almost like we want to do great things for the environment, but we’re not ready to handle it when we change it over,” Yankowski said.

The Hawaii Food Industry Association, which counts the state’s biggest supermarkets and convenience stores as members, initially opposed the foam container ban but now supports it.

The group said in written testimony that it’s encountered difficulties coping with varied local regulations and it wants the state to create a consistent standard. Two main counties — Hawaii and Maui — have already adopted plastic foam bans. Maui’s took effect on Dec. 31, while Hawaii’s takes effect on July 1.

The association still opposes the broader measure, which also would ban plastic garbage bags.

The president of Island Plastic Bags, a Hawaii company that makes plastic bags, said the legislation would prohibit his company from selling trash bags to nursing homes and hospitals as well as restaurants and hotels.

Grocery stores wouldn’t be able to sell trash can liners, Adrian Hong said in written testimony. It would create a “public health crisis,” he said.

Gabbard said his proposal was in the early stages so lawmakers have time to address such concerns.

The state Senate has passed both bills. They still must get through several House committees and the full House before heading to the governor.

Cindy McMillan, a spokeswoman for Gov. David Ige, said he hasn’t stated a position on the measures yet.

Justin Macia, a pharmacist in Honolulu, said he would like people to use less plastic and stop using plastic foam entirely because of how long it takes to degrade. Cardboard containers would be a great alternative, he said.

“It’s definitely something that’s got to go,” he said, after eating a sandwich from a foam takeout box.
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Nineteen-year-old college student Margaret Pisacano can usually feel a panic attack coming on; her thoughts start to spiral, her breathing speeds up, and her heart races.

“It’s as if a tornado and a tsunami of emotions just like overcame your body and you couldn’t control anything,” Pisacano says. “It was like almost a total loss of control over any feeling or thinking in your body.”

The Arizona native, who attends college in Florida, was first diagnosed with general anxiety disorder in middle school. She is among millions of stressed-out members of Generation Z — the group of young people born roughly between 1995 and 2015, who are currently between 4 and 24 years old.

A report released Thursday by the American Psychological Association finds the rate of adolescents reporting symptoms of major depression increased 52 percent between 2005 and 2017 — from 8.7 percent to 13.2 percent — among youth from the ages of 12 and 17.

The increase was even higher — 63 percent from 2009 to 2017 — among young adults between the ages of 18 and 25.

The survey examined data from 611,880 adolescents and adults. The researchers did not find a similar increase in adults older than 26. 

Today, one in three teens between the ages of 13 and 18 has an anxiety disorder.

“The current rate of anxiety is 31 percent in adolescents,” says Dr. Elena Mikalsen, head of the Psychology Section at the Children’s Hospital of San Antonio in Texas. “It’s an epidemic. It’s a mental health emergency.”

Everyone gets anxious some of the time, but that anxiety is usually temporary. However, for a person with an anxiety disorder, the feeling doesn’t go away and can worsen over time to the point where it might trigger headaches, chronic pain, stomach issues, immune system suppression and disrupted sleep.

School and the pressure to get good grades appears to be the leading source of stress for many young people.

“We see all of our anxiety referrals very clearly as soon as the school year starts, almost like from the first week and until the school year ends and then we see none of them in the summer,” says Mikalsen. “The worst is the end of May when all of the teens get their grades…they’re just panicking terribly. We hospitalize kids for all kinds of medical issues because they get their grades and their immune system just collapses. The highest rate of suicide is in April and May when they’re having finals, when they’re having exams.”

The American Psychological Association found that almost one-third of teens say they feel sad or depressed and overwhelmed due to stress.

Claire Taylor, a 17-year-old high school junior in Massachusetts, was diagnosed with generalized anxiety a couple of years ago, but didn’t have her first panic attack until she started visiting colleges ahead of her scheduled high school graduation next year.

“For my whole life, college has kind of been my end goal…It kind of hit me that college is not the end, and that there’s more after that,” Taylor says. “I’m really not sure what I want to do when I go to college for and so just the whole prospect kind of freaked me out…I was shaking and crying and I couldn’t quite articulate why until after the fact.”

College-related anxiety is rising, according to a 2017 report from the Higher Education Research Institute at UCLA. The institute surveyed 8,264 incoming first-year students at 30 U.S. colleges and universities and found that 39 percent reported frequently feeling anxious, but fewer than half of those students say they sought personal counseling in college.

Tarek Saoud, 22, began suffering from panic attacks after he went to college and felt the mounting pressure to set a course for success in life.

“I tried switching my (college) majors a few times, but I really did not like anything,” he says. “Not being able to find something was a big issue for me…Where I grew up here in Northern Virginia, it’s very expected to be either a businessman, a lawyer, a doctor, a scientist, something like along those lines. Those are what is seen as successful.”

Getting an appointment at the on-campus mental health center proved almost impossible, according to Saoud, who recounts a near-suicide attempt that was interrupted by a concerned friend who came looking for him.

“I’d been thinking about suicide for months at that point…there’s this big ledge I was sitting on with this big fall under it. I was just kind of sitting there thinking about, ‘Could I do this right now? Like, do I have everything in order? Did I forget anything that would get anyone in trouble and what not?’ Not like sad about it, just getting my things in order,” he says.

“I kind of felt crazy in my own head,” Saoud says. “When I was getting anxiety, super-irrational thoughts were running through my head all the time. Things like, ‘You’re never going to be happy, things are never going to get better’…It’s really easy to mask whatever inner issues are going on by being a super social, outgoing person, drinking a lot.”

He left school in Ohio during his sophomore year in college, returning home to Northern Virginia where he was eventually diagnosed with anxiety and clinical depression.

There are two new stressors impacting young people are perhaps a sign of the times. Mikalsen says more of her patients are concerned about school shootings and the lockdown drills they practice at school.

“I’ve been a psychologist for about twenty years and this is the first year that I now have patients who have Post Traumatic Stress Disorder from school lockdowns,” she says. “Before, it was you hide and now the hiding is not working, so now it’s attack the shooter and everybody’s like, ‘I can’t attack anybody. I’m too scared.’ And they’re supposed to be climbing on desks and throwing things and they’re practicing that in the classroom.”

The way their parents use social media is also causing stress for some teens.

“There is a problem happening right now with parents wanting to videotape their children and take pictures of their children in vulnerable moments. Like when kids are really stressed out, like when they’re anxious, when they’re upset,” says Mikalsen. “There’s a general lack of boundaries now because we’re all on social media…and I think it’s become a really big problem for kids that their information is just shared out there everywhere with everybody, causing stress and anxiety.”

Saoud says learning to express his feelings has helped get his anxiety under control, but not all young people feel free to be candid about their mental health.

“I don’t think a lot of my friends know because I don’t talk about it that often,” says Pisacano, the 19-year-old Florida college student. “It feels like they don’t want to hear me talk about it almost. It’s almost like I want to shield them from discomfort. I’m not uncomfortable talking about my mental health issues, but I think my friends are uncomfortable that I’m mentally ill.”

Taylor, the 17-year-old Massachusetts high school student, feels that she has generally accepted her anxiety as a fact of life. But she does feel regret when her mental illness stops her from doing things she would otherwise enjoy, like an exchange trip to Spain that she passed on due to her fear of flying.

“Even though I had a lot of great friends on the trip, I was still too afraid,” she says, “so in that sense, like I wish that my anxiety either manifested itself differently, or that I didn’t have anxiety, because I think it would have been really fun to go on the trip and it would have been an experience that I would remember forever, but usually I just kind of accept it as part of who I am.”

Saoud is attending community college for now and intends to transfer to a four-year college soon. Still on medication and seeing a psychologist, he doesn’t say he’s ‘cured,’ but feels there’s been a huge improvement over when he hit bottom.

“Sometimes I get in my head about the future and I think, ‘Where’s the point?’…but those are the times that I really sit down with myself and think about what I have achieved, what I want to achieve, how much I have to be grateful for,” Saoud says. “I’d like to say I’m hopeful. I really do believe that I have a lot of potential for the future.”

 
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