Economy

China’s proposal to create a cyber ID system faces criticism

Taipei, Taiwan — Concern is rising among China’s more than 1 billion internet users over a government proposal portrayed as a step to protect their personal information and fight against fraud. Many fear the plan would do the opposite.

China’s Ministry of Public Security and the Cyberspace Administration issued the draft “Measures for the Administration of National Network Identity Authentication Public Services” on July 26.

According to the proposal, Chinese netizens would be able to apply for virtual IDs on a voluntary basis to “minimize the excessive collection and retention of citizens’ personal information by online platforms” and “protect personal information.”

While many netizens appear to agree in their posts that companies have too much access to their personal information, others fear the cyber ID proposal, if implemented, will simply allow the government to more easily track them and control what they can say online.

Beijing lawyer Wang Cailiang said on Weibo: “My opinion is short: I am not in favor of this. Please leave a little room for citizens’ privacy.”

Shortly after the proposal was published, Tsinghua University law professor Lao Dongyan posted on her Weibo account, “The cyber IDs are like installing monitors to watch everyone’s online behavior.”

Her post has since disappeared, along with many other negative comments that can only be found on foreign social media platforms like X and Free Weibo, an anonymous and unblocked search engine established in 2012 to capture and save posts censored by China’s Sina Weibo or deleted by users.

A Weibo user under the name “Liu Jiming” said, “The authorities solemnly announced [the proposal] and solicited public opinions while blocking people from expressing their opinions. This clumsy show of democracy is really shocking.”

Beijing employs a vast network of censors to block and remove politically sensitive content, known by critics as the Great Firewall.

Since 2017, China has required internet service and content providers to verify users’ real names through national IDs, allowing authorities to more easily trace and track online activities and posts to the source.

Chinese internet experts say netizens can make that harder by using others’ accounts, providers, IDs and names on various platforms. But critics fear a single cyber ID would close those gaps in the Great Firewall.

Zola, a network engineer and well-known citizen journalist originally from China’s Hunan province, who naturalized in Taiwan, told VOA “The control of the cyber IDs is a superpower because you don’t only know a netizen’s actual name, but also the connection between the netizen and the cybersecurity ID.”

Mr. Li, a Shanghai-based dissident who did not want to disclose his full name because of the issue’s sensitivity, told VOA that the level of surveillance by China’s internet police has long been beyond imagination. He said the new proposal is a way for authorities to tell netizens that the surveillance will be more overt “just to intimidate and warn you to behave.”

Some netizens fear China could soon change the cyber ID system from a voluntary program to a requirement for online access.

A Weibo user under the name “Fang Zhifu” warned that in the future, if “the cyber ID is revoked, it will be like being sentenced to death in the cyber world.”

Meanwhile, China’s Ministry of Public Security and Cyberspace Administration say they are soliciting public opinion on the cyber ID plan until August 25.

Marchand captures 4th Olympic swimming gold

NANTERRE, France — The party for Léon Marchand spread beyond the pool, quickly sweeping across Paris.

At Stade de France, hosting the first night of track and field, an enormous ovation broke out when Marchand won his fourth gold medal of the Olympics. The roar was so loud that the first heat of the 400-meter run in the decathlon was delayed.

At the French Olympic house, nearly 20,000 gathered outside to watch Marchand cap his dominating run at the pool, including 19-year-old Arthur Oursel.

“He’s a hero,” Oursel said. “He’s our hero.”

With French President Emmanuel Macron among the more than 15,000 fans cheering him on in a rugby stadium-turned-natatorium, Marchand soared to another runaway victory in the 200-meter individual medley Friday night.

“I don’t think anything went wrong this week,” Marchand said. “It was just perfect.”

The 22-year-old French phenomenon left no doubt he’ll be remembered as one of the biggest stars of the Summer Games in his home country. He finished in an Olympic record of 1 minute, 54.06 seconds, just missing Ryan Lochte’s 13-year-old world mark.

That was about the only thing he didn’t accomplish in six magical days at La Defense Arena, previously winning the 400 IM, 200 butterfly and 200 backstroke — the latter two about two hours apart in the same session.

Marchand became only the fourth swimmer in Olympic history to win four individual golds at a single Games.

The others? Michael Phelps, who did it in both 2004 and 2008; Mark Spitz in 1972; and East German Kristin Otto in 1988.

Heady company, indeed.

“That’s crazy. Those guys are legends,” Marchand said. “I don’t think I have realized it yet. Maybe I will in a few days.”

The silver went to Britain’s Duncan Scott, a body length behind at 1:55.31. China’s Wang Shun grabbed the bronze in 1:56.00, edging out American Carson Foster for a spot on the podium.

What a night for France

A packed house at La Defense Arena came to cheer on their favorite son one more time. They chanted, sang Sweet Caroline, waved the French tricolor flag and unveiled a huge tifo in the upper deck.

After Marchand touched the wall, he held up four fingers — one for every gold. He climbed from the pool, pumped his fists, then held out his arms as if to say, “What more could you want?”

Not a thing.

He had done it all, more than fulfilling the expectations of his nation and the comparisons to Phelps, who was here to cheer Marchand on. What might have been a burden to some athletes only seemed to push Marchand to even greater heights.

Macron shook Marchand’s hand during Friday’s celebration and sent his congratulations via social media.

“The impossible isn’t French!” Macron wrote in French. “Four home gold medals and a new Olympic record — it’s historic. It’s Leon Marchand.”

Marchand certainly enjoyed his moment, which his American coach Bob Bowman — Phelps’ coach, in an appropriate touch — had encouraged him to do.

He led the fans behind the podium in a cheer before climbing to the top step one more time. The crowd erupted in its most rousing rendition yet of La Marseillaise — though, of course, they’ve had plenty of chances to work on the French national anthem this week.

Chants of “Léon! Léon! Léon!” filled the arena as soon as the anthem was done. Someone held up a sign that simply said “Merci Léon.”

“I’m extremely proud,” Marchand said, “to be French.”

Australian gold for McEvoy, McKeown

Before Marchand’s triumph, Cameron McEvoy and Kaylee McKeown won more gold for Australia.

McEvoy touched first in the 50 freestyle, denying Caeleb Dressel a repeat in swimming’s most frantic event. McKeown followed with a victory in the 200 backstroke to become the first female swimmer to sweep the back at two straight Summer Games.

Asked if she could’ve envisioned such an accomplishment, McKeown said, “Not in a million years.”

McEvoy became the first Australian man to win gold at these games, and McKeown quickly boosted her country’s total to an Olympics-leading seven golds overall — three more than both the U.S. and Marchand, who is essentially a country unto himself.

McKeown noted what an amazing time this is for women’s sports, following in the footsteps of athletes such as Simone Biles and Caitlin Clark in raising the profile of female athletes.

“Not just the Aussie girls, but the whole world and female sports has been unreal this year,” McKeown said.

McEvoy made it from one end of the pool to the other in 21.25, edging Benjamin Proud of Britain by five-hundredths of a second. Florent Manaudou of France gave the home crowd another thrill by taking the bronze in 21.56.

Dressel, who won five gold medals at the Tokyo Olympics, finished sixth in 21.61.

McKeown rallied again, just as she did in the 100 backstroke, to chase down perennial American runner-up Regan Smith. The winning time was an Olympic record of 2:03.73, breaking the mark that Missy Franklin set at the 2012 London Games.

Another silver for Regan Smith

Smith touched in 2:04.26 for the fifth silver medal of her career, to go along with a single bronze. She has yet to win gold.

The bronze went to Canada’s Kylie Masse in 2:05.57.

Smith insisted that she was satisfied with the result, even though a gold medal remained just out of reach.

“That’s one of my fastest times ever. I think I really gave Kaylee a run for it and I made things really close and exciting. So I’m thrilled with it.”

Dressel comes up short

The American star qualified in two individual events, and he won’t be winning a medal in either of them.

Shortly after his sixth-place showing in the 50 freestyle, he returned to the pool for the semifinals of the 100 butterfly — another of the events he won in Tokyo.

Dressel couldn’t pull off the grueling double, managing only the 13th-fastest time to miss out on the final Saturday night.

He did anchor the U.S. to gold in the 4×100-meter freestyle relay for the eighth gold medal of his career.

It was a disappointing showing for one of the biggest stars of the Tokyo Games, but not all that unexpected given what he’s been through.

A year after the pandemic-delayed 2021 Olympics, Dressel walked away from swimming in the middle of the world championships.

He desperately needed a break to recapture his love of swimming, which is still a bit of a work in progress. Dressel seems much happier now, welcoming his first child about five months ago, but he couldn’t recapture that blazing speed from three years ago.

“Obviously not my best work,” Dressel said. “I’ve had a lot of fun, but this hasn’t been my best week. I don’t think I need to shy away from that.”

He has one more relay to go in Paris, giving him another shot at his ninth career gold.

Dressel would like to go out on a high note, because these Games have been “a little heartbreaking, a little heartbreaking for sure.”

After leaving the pool deck, he broke down in tears.

Turkey blocks access to Instagram, gives no reason

ANKARA, Turkey — Turkey’s communications authority blocked access to the social media platform Instagram on Friday, the latest instance of a clampdown on websites in the country.

The Information and Communication Technologies Authority, which regulates the internet, announced the block early Friday but did not provide a reason. Sabah newspaper, which is close to the government, said access was blocked in response to Instagram removing posts by Turkish users that expressed condolences over the killing of Hama political leader Ismail Haniyeh.

It came days after Fahrettin Altun, the presidential communications director and aide to President Recep Tayyip Erdogan, criticized the Meta-owned platform for preventing users in Turkey from posting messages of condolences for Haniyeh.

Unlike its Western allies, Turkey does not consider Hamas to be a terror organization. A strong critic of Israel’s military actions in Gaza, Erdogan has described the group as “liberation fighters.”

The country is observing a day of mourning for Haniyeh on Friday, during which flags will be flown at half-staff.

Turkey has a track record of censoring social media and websites. Hundreds of thousands of domains have been blocked since 2022, according to the Freedom of Expression Association, a nonprofit organization regrouping lawyers and human rights activists. The video-sharing platform YouTube was blocked from 2007 to 2010.

Young fencer shows NY grit on Paris 2024 stage

EAUBONNE, France — Growing up in cutthroat New York gave Lauren Scruggs the competitive mindset needed to claim an unexpected fencing silver medal on her Olympic debut in Paris.

The 21-year-old Queens native shared the podium with fellow American Lee Kiefer, who retained her Olympic title in the women’s individual foil event gold medal bout on Sunday.

“I’ve grown up in New York my whole life. It can be kind of rough sometimes,” Scruggs, the first Black American fencer to win an Olympic medal in a women’s individual event, told Reuters.

“You develop a hard shell, and in terms of how that translates to my fencing, I think it came out, that energy and that toughness.”

When Scruggs found herself neck-and-neck with then world No. 2 Arriana Errigo in the quarterfinals, she managed to score the last touch, knocking out the Italian 15-14.

“I think that was my toughest bout of the day in terms of energy, and going past my limits, and I have definitely New York to thank for that,” said Scruggs, one of the rare Black fencers at the highest level.

“Fencing is predominantly white, I think for a multitude of reasons, it’s just the history of the sport, and the lack of representation and encouragement,” she explained.

“To have this accomplishment is a big deal for me, because when I was younger I only had a few people to look up to in the sport, so to be someone that little kids now can look up to is very special to me.”

They can draw inspiration from her impressive grit, which coach Sean McClain described in the U.S. training venue in Eaubonne, in the outskirts of Paris, saying that since she was eight, Scruggs only cared about winning medals.

“And she’s maintained that distaste for losing her entire career,” he said. “I really think in an event like the Olympics, it’s more about how you compete.”

Expensive sport

Born in the U.S. to Jamaican immigrants, Scruggs grew up in Queens with her mother and grandmother.

“I was in a single-parent household early on, so my family had to basically cut some corners around here and there to support us,” said Scruggs, whose brother was the first to get into fencing and inspired her to take up the sport.

Now a college student at Harvard, where she trains every day, Scruggs had to fight to make it into a “pretty expensive” sport.

“It was not easy growing up, trying to fence while being from where I’m from, just income-wise,” she said.

“If you have the funds, it makes it a lot easier to pursue the sport and feel comfortable asking that from your family.

“But if you’re coming from a lower-income background, it might push you harder. And I think it’s what happened with me. I just wanted it more than my peers.”

On paper, Scruggs did not have a big medal chance, but she showed her mettle at the Grand Palais arena.

“Fencing skill wise, Lauren is on par with the better fencers in the world, but she’s not better than them. What made the difference was that competitiveness,” said McClain, who has also become Scruggs’ stepfather.

“That comes from my wife,” he added. “I knew it was possible, but I didn’t really think Lauren was going to win a medal in her first Olympics. But my wife did. She was like, she’d better win a medal. So that’s where it comes from — that’s the fiery spirit!”

With Kiefer and alongside teammates Jackie Dubrovich and Maia Weintraub, Scruggs will represent the U.S. against China on Thursday in the quarterfinals of the women’s foil team event.

Scruggs is aiming for gold this time and is dreaming already of qualifying for the next Games, which will take place in Los Angeles in four years’ time.

“I can’t imagine myself not fencing,” she said. “It’s not even love, it’s just a part of me. It’s connected to who I am,” she said. 

Online misinformation fuels tensions over deadly Southport stabbing attack

LONDON — Within hours of a stabbing attack in northwest England that killed three young girls and wounded several more children, a false name of a supposed suspect was circulating on social media. Hours after that, violent protesters were clashing with police outside a nearby mosque.

Police say the name was fake, as were rumors that the 17-year-old suspect was an asylum-seeker who had recently arrived in Britain. Detectives say the suspect charged Thursday with murder and attempted murder was born in the U.K., and British media including the BBC have reported that his parents are from Rwanda.

That information did little to slow the lightning spread of the false name or stop right-wing influencers pinning the blame on immigrants and Muslims.

“There’s a parallel universe where what was claimed by these rumors were the actual facts of the case,” said Sunder Katwala, director of British Future, a think tank that looks at issues including integration and national identity. “And that will be a difficult thing to manage.”

Local lawmaker Patrick Hurley said the result was “hundreds of people descending on the town, descending on Southport from outside of the area, intent on causing trouble — either because they believe what they’ve written, or because they are bad faith actors who wrote it in the first place, in the hope of causing community division.”

One of the first outlets to report the false name, Ali Al-Shakati, was Channel 3 Now, an account on the X social media platform that purports to be a news channel. A Facebook page of the same name says it is managed by people in Pakistan and the U.S. A related website on Wednesday showed a mix of possibly AI-generated news and entertainment stories, as well as an apology for “the misleading information” in its article on the Southport stabbings.

By the time the apology was posted, the incorrect identification had been repeated widely on social media.

“Some of the key actors are probably just generating traffic, possibly for monetization,” said Katwala. The misinformation was then spread further by “people committed to the U.K. domestic far right,” he said.

Governments around the world, including Britain’s, are struggling with how to curb toxic material online. U.K. Home Secretary Yvette Cooper said Tuesday that social media companies “need to take some responsibility” for the content on their sites.

Katwala said that social platforms such as Facebook and X worked to “de-amplify” false information in real time after mass shootings at two mosques in Christchurch, New Zealand, in 2019.

Since Elon Musk, a self-styled free-speech champion, bought X, it has gutted teams that once fought misinformation on the platform and restored the accounts of banned conspiracy theories and extremists.

Rumors have swirled in the relative silence of police over the attack. Merseyside Police issued a statement saying the reported name for the suspect was incorrect, but have provided little information about him other than his age and birthplace of Cardiff, Wales.

Under U.K. law, suspects are not publicly named until they have been charged and those under 18 are usually not named at all. That has been seized on by some activists to suggest the police are withholding information about the attacker.

Tommy Robinson, founder of the far-right English Defense League, accused police of “gaslighting” the public. Nigel Farage, a veteran anti-immigration politician who was elected to Parliament in this month’s general election, posted a video on X speculating “whether the truth is being withheld from us” about the attack.

Brendan Cox, whose lawmaker wife Jo Cox was murdered by a far-right attacker in 2016, said Farage’s comments showed he was “nothing better than a Tommy Robinson in a suit.”

“It is beyond the pale to use a moment like this to spread your narrative and to spread your hatred, and we saw the results on Southport’s streets last night,” Cox told the BBC.

Drag queen in Olympic opening ceremony has no regrets, calls it ‘a photograph of France in 2024’

Paris — As a gay youth growing up in central France, Hugo Bardin never felt he lived in a world that represented who he was — a world in which he had a place.

And that is why Bardin, who performs as the drag queen Paloma, felt it was meaningful and important to be part of a Paris Olympics opening ceremony that presented a multifaceted, multiethnic France with people of different ethnicities and orientations.

“It was a really important moment for the French people and the representation of France around the world,” says Paloma, who took part in a single scene that has drawn some furious criticism — including from presidential candidate Donald Trump in the United States, who called it “a disgrace.”

Although the ceremony’s artistic director, Thomas Jolly, and other participants have repeatedly said the scene wasn’t inspired by “The Last Supper,” critics interpreted that part of the show as a mockery of Leonardo Da Vinci’s painting showing Jesus Christ and his apostles. 

Paloma, best known for winning “Drag Race France,” appeared with other drag artists and dancers alongside Barbara Butch, a popular DJ who wore a silver headdress that looked like a halo. Butch has now filed a complaint alleging online abuse and harassment, and Paris police have launched an investigation.

Paloma is not, at this point, planning to take legal action over online harassment, and would prefer to focus on the many “loving messages” that have been pouring in. The performer been getting thousands of messages daily, she told The Associated Press, most of them positive but some that he described as “violent” and even “from the Middle Ages.”

Still, there are no misgivings, despite the backlash. Paloma said she was proud to have been part of a show that did not rely on a series of French cliches — for example, “the Parisian with a baguette under their arm.”

“It could have been a postcard from 1930,” she said of the ceremony. “But instead, it was a photograph of France in 2024.”

Many agreed, and praised the ceremony for its creativity, style and showmanship.

But French Catholic bishops and others were among those who said Christians had been offended, though Paris Olympics organizers have said there was “never an intention to show disrespect to any religious group” but rather to “celebrate community tolerance.”

Trump was asked on Fox News what he thought of the so-called “Last Supper” scene. “I’m very open-minded,” the former president and current Republican nominee told host Laura Ingraham, “but I thought what they did was a disgrace.”

Of Trump’s comments, Paloma said: “My first reaction is to say that if Donald Trump is not reacting, then we have not done our job.”

The criticism, she said, has been fueled by hate. “Where is the Catholicism, the Christianity in that? It is very hypocritical that their message is not about religion or kindness, it’s about hate towards Jews, fat people, queer people and trans people.”

“We have been accused of trying to impose our vision on the world,” Bardin said. “We are not. … We just want to let people know that we have a place in the world, and we are claiming that place.”

Paloma spoke to the AP in a phone interview and later at her Paris workshop, a studio devoted to her drag performance. Bardin debuted the drag queen persona some five years ago, the Spanish name inspired by the films of Pedro Almodóvar.

Asked if she had any regrets, Paloma replied: “My only regrets is people’s reactions. I’m sorry if people are offended but we did not try to parody, to mock ‘The Last Supper.’ It was not the point. So I can’t regret what I did. I’m sorry for people to only see things in a bad way.”

She added: “Maybe change the perspective. Change the point of view. Try to see the beauty in what we did. Because it was just beauty. It was just only about beauty and reunion, and reparation.” 

Rafah water facility demolition raises health risks in Gaza, UN says

GENEVA — U.N. agencies warn that the demolition of a critical water facility in Rafah in the southern Gaza Strip increases the risk of infectious diseases as people are forced to drink unsafe water while sanitary conditions continue to deteriorate.

“Until recently, that reservoir served thousands and thousands of internally displaced people who had sought refuge in Rafah in the area,” James Elder, UNICEF spokesperson, told journalists at a briefing in Geneva on Tuesday.

“Now without it, vulnerable children and families are likely to be forced again increasingly to resort to unsafe water, so putting them again at all those risks that we see time after time, day after day in Gaza — dehydration, malnutrition, diseases,” he said.

The Israeli daily Haaretz reported Monday that the troops blew up the central reservoir “on the orders of the brigade commanders” but without receiving permission from the senior level of the Southern Command. It added that the incident was being investigated by Israel’s Military Police as “a suspected violation of international law.”

 

Infections spreading

Elder said the destruction of the Canada Well reservoir “is yet another grim reminder of the assaults on families who already are in desperate need of water.”

“We have seen spikes in diarrhea, in skin infections — all due to a lack of access to hygiene and a lack of access to water,” he said, noting that people in emergencies require a minimum of 15 liters (almost 4 gallons) of water per person per day.

Now, the range of water availability in Gaza has been reduced to between 2 and 9 liters per person, per day, and some people are getting just a fraction of that, Elder said.

“Somehow, people are holding on, but of course, we are now in that deathly cycle whereby children are very malnourished. There is immense heat. There is [a] lack of water. There is a horrendous lack of sanitation, and that is the cycle,” he said.

The World Health Organization reports a surge in infectious diseases in the Gaza Strip. As of July 7, it has recorded nearly 1 million cases of acute respiratory infections, 577,000 cases of acute watery diarrhea, 107,000 of acute jaundice syndrome and 12,000 of bloody diarrhea. It also has recorded nearly 200,000 cases of scabies, lice, skin rashes, chicken pox and other illnesses.

Polio threat

The recent identification of circulating vaccine-derived poliovirus type 2 in Gaza’s sewage system is of particular concern. Under prevailing conditions in Gaza, there is a high risk of spread of this paralytic, deadly disease within the Palestinian enclave and across borders.

“Having a vaccine-derived polio virus in the sewage very likely means that it is out there somewhere in people,” WHO spokesperson Christian Lindmeier said. “It most likely is in the population, but that does not necessarily mean that we see an outbreak of cases.

“But of course, we need to be prepared. We need to be utterly prepared. And we need vaccinations, and we need vaccination campaigns,” he said.

WHO Director-General Tedros Adhanom Ghebteyesus has announced that the organization will be sending more than 1 million doses of polio vaccine to Gaza to avert the spread of the disease.

“While no cases of polio have been recorded yet, without immediate action, it is just a matter of time before it reaches the thousands of children who have been left unprotected,” he said, adding that infants under 2 are especially vulnerable “because many have not been vaccinated over the nine months of conflict.”

Before Israel began its military offensive in Gaza following a brutal attack on Israel by Hamas militants on October 7, nearly the whole population of Gaza had been immunized against polio.

However, due to the impact of the conflict, “coverage of polio now is around 89%, down from around 99% before the conflict,” UNICEF’s Elder said. “Hence, there is an increased risk for children. Now, if the child gets the full course of the vaccine, then the risk of the child getting paralyzed by polio is negligible.

“This is why it is so critical that all children are immunized. But the mass displacement, the decimation of the health infrastructure, the tremendously insecure operating environment — they all make it much more difficult, hence putting more children at risk,” he said.

Cases of polio have declined by 99% since WHO launched its global polio eradication campaign in 1988.

WHO reports polio now is endemic only in Pakistan and Afghanistan. However, more than 30 countries, including Egypt and Israel, are subject to outbreaks. The reemergence of polio tends to occur in areas of conflict or instability and within countries with poor health systems.

“We were very, very close to eradicating polio fully,” WHO spokesperson Lindmeier said. “As you know, wartime, unfortunately, creates the situation where it is very difficult to get that last mile. And it has been less than a mile that we needed to go.

“There are a few pockets around the world. Hopefully, Gaza will not become another one,” he said.

Urgent action needed to stop spread of drug-resistant malaria, scientists warn

Bangkok — Millions of lives could be put at risk unless urgent action is taken to curb the spread of drug-resistant malaria in Africa, according to a new paper published in the journal Science.

The paper says the parasite that causes malaria is showing signs of resistance to artemisinin, the main drug used to fight the disease, in several east African countries.

“Mutations indicating artemisinin-resistance have been found in more than 10% of malaria infected individuals in Ethiopia, Eritrea, Rwanda, Uganda, and Tanzania,” according to the report.

Artemisinin Combination Therapies, or ACTs, have been the cornerstone of malaria treatment in recent years — but there are worrying signs that they are becoming less effective, says report co-author Lorenz von Seidlein of the Mahidol Oxford Tropical Medicine Research Unit in Bangkok.

“We have increasing reports from eastern Africa saying that they have documented resistance against the first line treatments against malaria,” he says. “The first line treatments are artemisinin combination therapy – that has been used for the last 20 years and has worked excellently well. And it’s now not working quite as well as it used to do.”

It’s estimated that over one thousand children die every day from malaria in Africa. The World Health Organization estimates that the global death toll from malaria in 2022 — the most recent figures available — was 608,000.

Past lessons

Before artemisinin therapies were developed, chloroquine was the medicine most used to treat malaria. The report authors say that in the 1990s and early 2000s, signs that the malaria parasite was developing resistance to chloroquine were widely ignored.

“When chloroquine resistance slowly sneaked into Africa there was a whole wave of childhood mortality followed by it. So really, a large number of children — probably in the millions — died because chloroquine didn’t work as well as it used to do. And now we see these first signs that something similar is happening with the ACTs. And that is of course very worrying,” von Seidlein says.

Urgent action

The report authors urge policymakers and global funding bodies to act now to prevent artemisinin resistance taking hold.

Their recommendations include combining artemisinin drugs with other medicines.

“Combining an artemisinin derivative drug with two partner drugs in triple artemisinin combination therapies [TACTs] is the simplest, most affordable, readily implementable, and sustainable approach to counter artemisinin resistance,” the report says.

The authors also call for the rollout of new, more effective insecticides and mosquito nets; better training of community health workers; the rapid deployment of new malaria vaccines; and better monitoring of parasite mutations.

Southeast Asia

Many of these methods were used to halt the spread of artemisinin resistance in south-east Asia since 2014, notes von Seidlein.

“Ultimately, there was an understanding that this could be a major health emergency globally and so there were a lot of investments from funders for the from high-income countries towards these countries in the Greater Mekong sub-region to stop the spread of artemisinin resistant parasites,” he says.

The report says that sense of urgency must now be applied to tackling artemisinin resistance in Africa.

“We ask funders, specifically the Global Fund to Fight AIDS, Tuberculosis and Malaria [GFATM] and the U.S. Government’s President’s Malaria Initiative, to be visionary and to step up funding for malaria control and elimination programs to contain the spread of artemisinin resistance in Africa — as they have done effectively in Southeast Asia since 2014,” says report co-author Ntuli Kapologwe, the director of preventive services at Tanzania’s Ministry of Health.

Ancient secrets unearthed in vast Turkish cave city 

Midyat, Turkey — Through a basement door in southeastern Turkey lies a sprawling underground city — perhaps the country’s largest — which one historian believes dates back to the ninth century before Jesus Christ.

Archaeologists stumbled upon the city-under-a-city “almost by chance” after an excavation of house cellars in Midyat, near the Syrian border, led to the discovery of a vast labyrinth of caves in 2020.

Workers have already cleared more than 50 subterranean rooms, all connected by 120 meters of tunnel carved out of the rock.

But that is only a fraction of the site’s estimated 900,000-square-metre area, which would make it the largest underground city in Turkey’s southern Anatolia region.

“Maybe even in the world,” said Midyat conservation director Mervan Yavuz who oversaw the excavation.

“To protect themselves from the climate, enemies, predators and diseases, people took refuge in these caves which they turned into an actual city,” Yavuz added.

The art historian traces the city’s ancient beginnings to the reign of King Ashurnasirpal II, who ruled the Neo-Assyrian Empire from 883 to 859 BC.

At its height in the seventh century BC, the empire stretched from The Gulf in the east to Egypt in the west.

Referred to as Matiate in that period, the city’s original entrance required people to bend in half and squeeze themselves into a circular opening.

It was this entrance that first gave the Midyat municipality an inkling of its subterranean counterpart’s existence.

“We actually suspected that it existed,” Yavuz recounted as he walked through the cave’s gloom.

“In the 1970s, the ground collapsed and a construction machine fell down. But at the time we didn’t try to find out more, we just strengthened and closed up the hole.”

A hiding place underground

The region where the cave city is located was once known as Mesopotamia, recognized as the cradle of some of the earliest civilizations in the world.

Many major empires conquered or passed through these lands, which may have given those living around Matiate a reason to take refuge underground.

“Before the arrival of the Arabs, these lands were fiercely disputed by the Assyrians, the Persians, the Romans and then the Byzantines,” said Ekrem Akman, a historian at the nearby University of Mardin.

Yavuz noted that “Christians from the Hatay region, fleeing from the persecution of the Roman Empire… built monasteries in the mountains to avoid their attacks”.

He suspects that Jews and Christians may have used Matiate as a hiding place to practice their then-banned religions underground.

He pointed to the inscrutable stylized carvings — a horse, an eight-point star, a hand, trees — which adorn the walls, as well as a stone slab on the floor of one room that may have been used for celebrations or for sacrifices.

As a result of the city’s long continuous occupation, he said it was “difficult to pinpoint” exactly what at the site can be attributed to which period or group.

But “pagans, Jews, Christians, Muslims, all these believers contributed to the underground city of Matiate,” Yavuz said.

Centuries of invasions

Even after the threat of centuries of invasions had passed, the caves stayed in use, said curator Gani Tarkan.

He used to work as a director at the Mardin Museum, where household items, bronzes and potteries recovered from the caves are on display.

“People continued to use this place as a living space,” Tarkan said.

“Some rooms were used as catacombs, others as storage space,” he added.

Excavation leader Yavuz pointed to a series of round holes dug to hold wine-filled amphorae vessels in the gloomy cool, out of the glaring sunlight above.

To this day, the Mardin region’s Orthodox Christian community maintains that old tradition of wine production.

Turkey is also famous for its ancient cave villages in Cappadocia in the center of the country.

But while Cappadocia’s underground cities are built with rooms vertically stacked on top of each other, Matiate spreads out horizontally, Tarkan explained.

The municipality of Midyat, which funds the works, plans to continue the excavation until the site can be opened to the public.

It hopes the site will prove a popular tourist attraction and attract visitors to the city of 120,000.

Galapagos Islands, many unique creatures at risk from warming waters

GALAPAGOS ISLANDS, Ecuador — Warm morning light reflects from the remains of a natural rock arch near Darwin Island, one of the most remote islands in the Galapagos. In clear, deep blue water, thousands of creatures — fish, hammerhead sharks, marine iguanas — move in search of food.

The 2021 collapse of Darwin’s Arch, named for the famed British naturalist behind the theory of evolution, came from natural erosion. But its demise underscored the fragility of a far-flung archipelago that’s coming under increased pressure both from climate change and invasive species.

Warming oceans affect the food sources of many of the seagoing animals in the Galapagos. Marine iguanas — one of many species that are endemic, or unique, to the Galapagos — have a harder time finding the red and green algae they prefer. Sea turtles struggle to nest in warmer temperatures. Raising young gets harder as water warms and fewer nutrients are available.

While the Galapagos are known for a great multitude of species, their numbers aren’t unlimited.

“We have something of everything here – that’s why people say the Galapagos is so diverse – but we have a small number of each thing,” said Natasha Cabezas, a naturalist guide.

The Galapagos have always been sensitive to changes in ocean temperature. The archipelago itself is located where major ocean currents converge — cool from the south, warm from the north, and a cold upwelling current from the west. Then there’s El Nino, the periodic and natural Pacific Ocean warming that affects weather worldwide.

While temperatures vary depending on the season and other naturally-occurring climate events, ocean temperatures have been rising because of human-caused climate change as oceans absorb the vast majority of excess heat in the atmosphere. The ocean experienced its warmest decade since at least the 1800s in the last 10 years, and 2023 was the ocean’s warmest year on record.

Early June brings winter in the Southern Hemisphere, and the Cromwell current brings whale sharks, hammerheads, and massive sunfish to the surface. It also provides nutrients for penguins, marine iguanas and sea lions in search of food. As more of those animals make themselves known this season, scientists are tracking how they fared in the warming of the past year’s El Nino.

El Nino can bring food shortages for some species like marine iguanas and sea turtles, as the warmer ocean means dwindling food sources. Scientists observing the species have noted a significant decline in population numbers during El Nino events.

Marine iguanas swim like snakes through the water from rock to rock as waves crash against the shore of Fernandina Island. They latch themselves onto the undersea rocks to feed on algae growing there, while sea lions spin around them like puppies looking for someone to play with.

The iguanas were “one of the most affected species from El Niño last year and right now they are still recovering,” said Galapagos Conservancy Director Jorge Carrión.

As rising ocean temperatures threaten aquatic or seagoing life, on land there’s a different problem. Feral animals — cats, dogs, pigs, goats and cattle, none of them native — are threatening the unique species of the islands.

After the COVID-19 pandemic, many people are abandoning the dogs and cats they wanted to keep them company, Cabezas said.

“If you don’t take care of them they become a problem and now it’s a shame to see dogs everywhere. We have a big problem right now I don’t know what we’re going to do,” she said.

The non-native animals are a special threat to the giant tortoises closely associated with the Galapagos. The tortoises declined dramatically in the 19th century due to hunting and poaching, and authorities have worked to protect them from humans. It’s been illegal to kill a giant tortoise since 1933.

“In one night, a feral pig can destroy all nesting sites in an area,” Carrión said. Park rangers try to visit areas with nesting sites once a day, and kill pigs when they find them. But the pigs are elusive, Carrion said.

Feral cats feed on marine iguana hatchings, and both pigs and cats compete for food with the tortoises.

If invasive species and warming oceans weren’t enough, there’s the plastic that is a widespread problem in the world’s oceans. One recent study reported microplastics in the bellies of Galapagos penguins.

“There are no animals in the Galapagos that do not have microplastics in their food,” Carrión said.

Edna O’Brien, Irish literary giant who wrote ‘The Country Girls,’ dies at 93

NEW YORK — Edna O’Brien, Ireland’s literary pride and outlaw who scandalized her native land with her debut novel “The Country Girls” before gaining international acclaim as a storyteller and iconoclast that found her welcomed everywhere from Dublin to the White House, has died. She was 93.

O’Brien died Saturday after a long illness, according to a statement by her publisher Faber and the literary agency PFD.

“A defiant and courageous spirit, Edna constantly strove to break new artistic ground, to write truthfully, from a place of deep feeling,” Faber said in a statement. “The vitality of her prose was a mirror of her zest for life: she was the very best company, kind, generous, mischievous, brave.”

O’Brien published more than 20 books, most of them novels and story collections, and would know fully what she called the “extremities of joy and sorrow, love, crossed love and unrequited love, success and failure, fame and slaughter.” Few so concretely and poetically challenged Ireland’s taboos on religion, sex and gender. Few wrote so fiercely, so sensually about loneliness, rebellion, desire and persecution. A world traveler in mind and body, O’Brien was as likely to imagine the longings of an Irish nun as to take in a man’s “boyish smile” in the midst of a “ponderous London club.”

O’Brien was an unknown about to turn 30, living with her husband and two small children outside of London, when “The Country Girls” became one of Ireland’s most polarizing works of fiction in memory. Written in just three weeks and published in 1960, for an advance of roughly $75, “The Country Girls” follows the lives of two young women — Caithleen (Kate) Brady and Bridget (Baba) Brennan journey from a rural convent to the risks and adventures of Dublin. Admirers were as caught up in their defiance and awakening as would-be censors were enraged by such passages as “He opened his braces and let his trousers slip down around the ankles” and “He patted my knees with his other hand. I was excited and warm and violent.”

Fame, wanted or otherwise, was O’Brien’s ever after. Her novel was praised and purchased in London and New York while back in Ireland it was labeled “filth” by Minister of Justice Charles Haughey and burned publicly in O’Brien’s home town of Tuamgraney, County Clare. Detractors also included O’Brien’s parents and her husband, the author Ernest Gebler, from whom O’Brien was already becoming estranged.

O’Brien would be recognized well beyond the world of books. The 1980s British band Dexy’s Midnight Runners” named her alongside Eugene O’Neill, Samuel Beckett and Oscar Wilde among others in the literary tribute “Burn It Down.” She dined at the White House with then-first lady Hillary Rodham Clinton and Jack Nicholson and befriended Jacqueline Kennedy, whom she remembered as a “creature of paradoxes. While being private and immured she also had a hunger for intimacy — it was as if the barriers she had put up needed at times to be battered down.”

O’Brien’s other books included the novels “August Is a Wicked Month,” the story of a woman’s sexual liberation that was banned in parts of Ireland; “Down By The River,” based on a true story about a teenage Irish girl who becomes pregnant after being raped by her father, and autobiographical “The Light of Evening,” in which a famous author returns to Ireland to see her ailing mother. Her most recent work, “Girl,” a novel about victims of Boko Harem, came out in 2019.

Josephine Edna O’Brien was one of four children raised on a farm where “the relics of riches remained. It was a life full of contradictions. We had an avenue, but it was full of potholes; there was a gatehouse, but another couple lived there.” Her father was a violent alcoholic, her mother a talented letter writer who disapproved of her daughter’s profession, quite likely out of jealousy. Lena O’Brien’s hold on the author’s imagination, the force of her regrets made her a lifelong muse and a near stand-in Ireland itself, “the cupboard with all things in it, the tabernacle with God in it, the lake with the legends in it.”

By her early 20s, she was working in a pharmacy in Dublin and reading Tolstoy, Thackeray and O’Connor among others in her spare time. She had dreams of writing since sneaking out to the nearby fields as a child to work on stories, but doubted the relevance of her life until she read a biography of James Joyce and learned that “Portrait Of An Artist As a Young Man” was autobiographical. She began writing fiction that ran in the literary magazine The Bell and found work reviewing manuscripts for the publishing house Hutchinson, where editors were impressed enough by her summaries to commission what became “The Country Girls.”

“I cried a lot writing ‘The Country Girls,’ but scarcely noticed the tears. Anyhow, they were good tears. They touched on feelings that I did not know I had. Before my eyes, infinitely clear, came that former world in which I believed our fields and hollows had some old music slumbering in them, centuries old,” she wrote in her memoir.

“The words poured out of me, and the pen above the paper was not moving fast enough, so that I sometimes feared they would be lost forever.”

Manipulated video shared by Musk mimics Harris’ voice, raising concerns about AI in politics

New York — A manipulated video that mimics the voice of Vice President Kamala Harris saying things she did not say is raising concerns about the power of artificial intelligence to mislead with Election Day about three months away.

The video gained attention after tech billionaire Elon Musk shared it on his social media platform X on Friday evening without explicitly noting it was originally released as parody.

The video uses many of the same visuals as a real ad that Harris, the likely Democratic president nominee, released last week launching her campaign. But the video swaps out the voice-over audio with another voice that convincingly impersonates Harris.

“I, Kamala Harris, am your Democrat candidate for president because Joe Biden finally exposed his senility at the debate,” the voice says in the video. It claims Harris is a “diversity hire” because she is a woman and a person of color, and it says she doesn’t know “the first thing about running the country.” The video retains “Harris for President” branding. It also adds in some authentic past clips of Harris.

Mia Ehrenberg, a Harris campaign spokesperson, said in an email to The Associated Press: “We believe the American people want the real freedom, opportunity and security Vice President Harris is offering; not the fake, manipulated lies of Elon Musk and Donald Trump.”

The widely shared video is an example of how lifelike AI-generated images, videos or audio clips have been utilized both to poke fun and to mislead about politics as the United States draws closer to the presidential election. It exposes how, as high-quality AI tools have become far more accessible, there remains a lack of significant federal action so far to regulate their use, leaving rules guiding AI in politics largely to states and social media platforms.

The video also raises questions about how to best handle content that blurs the lines of what is considered an appropriate use of AI, particularly if it falls into the category of satire.

The original user who posted the video, a YouTuber known as Mr Reagan, has disclosed both on YouTube and on X that the manipulated video is a parody. But Musk’s post, which has been viewed more than 123 million times, according to the platform, only includes the caption “This is amazing” with a laughing emoji.

X users who are familiar with the platform may know to click through Musk’s post to the original user’s post, where the disclosure is visible. Musk’s caption does not direct them to do so.

While some participants in X’s “community note” feature to add context to posts have suggested labeling Musk’s post, no such label had been added to it as of Sunday afternoon. Some users online questioned whether his post might violate X’s policies, which say users “may not share synthetic, manipulated, or out-of-context media that may deceive or confuse people and lead to harm.”

The policy has an exception for memes and satire as long as they do not cause “significant confusion about the authenticity of the media.”

Musk endorsed former President Donald Trump, the Republican nominee, earlier this month. Neither Mr Reagan nor Musk immediately responded to emailed requests for comment Sunday.

Two experts who specialize in AI-generated media reviewed the fake ad’s audio and confirmed that much of it was generated using AI technology.

One of them, University of California, Berkeley, digital forensics expert Hany Farid, said the video shows the power of generative AI and deepfakes.

“The AI-generated voice is very good,” he said in an email. “Even though most people won’t believe it is VP Harris’ voice, the video is that much more powerful when the words are in her voice.”

He said generative AI companies that make voice-cloning tools and other AI tools available to the public should do better to ensure their services are not used in ways that could harm people or democracy.

Rob Weissman, co-president of the advocacy group Public Citizen, disagreed with Farid, saying he thought many people would be fooled by the video.

“I don’t think that’s obviously a joke,” Weissman said in an interview. “I’m certain that most people looking at it don’t assume it’s a joke. The quality isn’t great, but it’s good enough. And precisely because it feeds into preexisting themes that have circulated around her, most people will believe it to be real.”

Weissman, whose organization has advocated for Congress, federal agencies and states to regulate generative AI, said the video is “the kind of thing that we’ve been warning about.”

Other generative AI deepfakes in both the U.S. and elsewhere would have tried to influence voters with misinformation, humor or both.

In Slovakia in 2023, fake audio clips impersonated a candidate discussing plans to rig an election and raise the price of beer days before the vote. In Louisiana in 2022, a political action committee’s satirical ad superimposed a Louisiana mayoral candidate’s face onto an actor portraying him as an underachieving high school student.

Congress has yet to pass legislation on AI in politics, and federal agencies have only taken limited steps, leaving most existing U.S. regulation to the states. More than one-third of states have created their own laws regulating the use of AI in campaigns and elections, according to the National Conference of State Legislatures.

Beyond X, other social media companies also have created policies regarding synthetic and manipulated media shared on their platforms. Users on the video platform YouTube, for example, must reveal whether they have used generative artificial intelligence to create videos or face suspension.

Frank Stewart photos captured culture of jazz, church and Black life in US

CHADDS FORD, Pa. — At first glance, it looks like an aerial photo of a cemetery destroyed by war, with charred coffins ripped from broken concrete vaults and arched marble tombstones flattened by a bomb blast.

Then, the viewer begin to discern details: the coffins and vaults are actually parts of a keyboard. Instead of names and dates, the apparent tombstones are inscribed with words like “vibrato” and “third harmonic.”

“It looks like a graveyard,” photographer Frank Stewart said.

Stewart’s ghostly photograph of a New Orleans church organ ravaged by the floodwaters of Hurricane Katrina is part of a career retrospective of his decades documenting Black life in America and exploring African and Caribbean cultures.

“Frank Stewart’s Nexus: An American Photographer’s Journey, 1960s to the Present,” is on display at the Brandywine Museum of Art through Sept. 22. Brandywine is the fourth and final stop for the exhibition, which was organized by The Phillips Collection in Washington, D.C., and the Telfair Museums in Savannah, Georgia.

“I wanted to talk about the Black church and what influence they had on the culture,” Stewart said of his post-Katrina work in New Orleans. “This organ, the music and everything corresponds. It all comes together. I just wanted to show the devastation of churches and the music and the culture.”

Music is elemental to Stewart’s practice. He was the long-time photographer for the Savannah Music Festival, and for 30 years he was the senior staff photographer for Jazz at Lincoln Center Orchestra, which paired him with artistic director and Grammy-winning musician Wynton Marsalis.

“He’s like my brother,” said Stewart, whose exhibition includes “Stomping the Blues,” a 1997 photograph of Marsalis leading his orchestra off the stage during a world tour of his Pulitzer Prize-winning jazz oratorio “Blood on the Fields.”

Stewart, who was born in Nashville, Tennessee, and grew up in Memphis, Tennessee, and Chicago, has his own ties to jazz and blues. His stepfather, Phineas Newborn Jr., was a pianist who worked with the likes of musicians Lionel Hampton, Charles Mingus and B.B. King.

Describing himself as a child of the “apartheid South,” Stewart has drawn inspiration from photographers such as Ernest Cole and Roy DeCarava, who was among Stewart’s instructors at New York’s Cooper Union, where Stewart received a bachelor of fine arts degree. DeCarava’s photographs of 1950s Harlem led to a collaboration with Langston Hughes on the 1955 book, “The Sweet Flypaper of Life.”

Cole, a South African photographer, achieved acclaim in 1967 with “House of Bondage,” the first book to inspire Stewart. It chronicled apartheid using photographs he smuggled out of the country. Cole was never able to replicate his early success and fell on hard times before dying at age 49 in New York City. A documentary about him, “Ernest Cole: Lost and Found,” premiered at this year’s Cannes Film Festival.

“He came to New York and he was homeless in New York, so I would see him on the street and we would talk,” said Stewart, who is quick to draw a distinction between his work and Cole’s.

“I consider myself an artist more than a documentarian,” explained Stewart, who attended the School of the Art Institute of Chicago before enrolling at Cooper Union and was a longtime friend and collaborator of artist Romare Bearden.

That’s not to say Stewart doesn’t have journalistic instincts in his blood. He recounts a work history that includes the Chicago Defender, the largest Black-owned daily in the country at the time, and stringing for Ebony, Essence and Black Enterprise magazines. He looks back less fondly on a short stint of large-format work photographing fine art for brochures and catalogs, an undertaking he described as “tedious.”

Through it all though, Stewart has maintained an artistic approach to his work, looking to combine pattern, color, tone and space in a visually appealing manner while not leaving the viewer searching for the message.

“It has to still be ‘X marks the spot,'” he explained. “It still has to be photographic. It can’t be just abstract.”

Or maybe it can. How else to explain the color and texture seen in “Blue Car, Havana” from 2002?

“It’s all about abstract painting,” Stewart said in wall text accompanying the photo.

The retrospective shines a light on how Stewart’s work has evolved over time, from early black-and-white photographs to his more recent prints, which feature more color.

“It’s two different languages,” he said. “English would be the black and white. French would be the color.”

“I worked in color the whole time, I just didn’t have the money to print them,” he added.

While photography can inform people about the world around them, Stewart has noted there is a gulf between the real world and a photograph.

“Reality is a fact, and a photograph is another fact,” he explained. “The map is not the territory. It’s just a map of the territory.”

Princess Leia bikini costume from ‘Star Wars’ movie set sells for $175K

HOUSTON — The gold bikini-style costume that Carrie Fisher wore as Princess Leia while making “Return of the Jedi” in the “Star Wars” franchise has sold for $175,000, according to the auction house that handled the sale.

The costume was made famous when Fisher wore it at the start of the 1983 film when Leia was captured by Jabba the Hutt at his palace on Tatooine and forced to be a slave.

The costume, one of the most memorable in the ” Star Wars ” movies, was sold on Friday by Dallas-based Heritage Auctions.

Joe Maddalena, Heritage’s executive vice president, said the costume that was sold was one that was screen tested and worn by Fisher on the movie’s set but ultimately did not make it onto the final version of the film as it was switched out for one that was more comfortable.

The auction house said the costume sparked a bidding war among collectors.

Maddalena said he wasn’t surprised by the attention bidders gave to the costume as well as to a model of a Y-wing fighter that took on the Death Star in the original “Star Wars” film that sold for $1.55 million. He said “Star Wars” and “Star Trek” have very avid fan bases.

“The power of ‘Star Wars’ proves itself again. These movies are just so impactful,” Maddalena said.

In a November 2016 interview with NPR’s “Fresh Air,” Fisher said wearing the costume was not her choice.

“When (director George Lucas) showed me the outfit, I thought he was kidding and it made me very nervous. I had to sit very straight because I couldn’t have lines on my sides, like little creases. No creases were allowed, so I had to sit very, very rigid straight,” said Fisher, who died about a month after the interview.

Richard Miller, who created the costume, said in an interview that’s included in a “Star Wars” box set that he used soft material to build the costume so that Fisher could move around more freely.

“However, she still didn’t like it. I don’t blame her,” said Miller, who was the chief sculptor for Industrial Light & Magic, the visual effects company founded by “Star Wars” creator George Lucas. “I did put leather on the back of it to help it feel better.”

The costume had its share of critics, who thought it sexualized Fisher for the franchise’s male fan base.

In “Interview” magazine in 2015, Fisher told actor Daisy Ridley, who starred in “Star Wars: The Force Awakens,” “You’re going to have people have fantasies about you. That will make you uncomfortable, I’m guessing.” She pushed back against the idea of being a sex symbol and told Ridley to “fight for your outfit.”

Blood tests could help diagnose Alzheimer’s, study finds

Washington — New blood tests could help doctors diagnose Alzheimer’s disease faster and more accurately, researchers reported Sunday – but some appear to work far better than others.

It’s tricky to tell if memory problems are caused by Alzheimer’s. That requires confirming one of the disease’s hallmark signs — buildup of a sticky protein called beta-amyloid — with a hard-to-get brain scan or uncomfortable spinal tap. Many patients instead are diagnosed based on symptoms and cognitive exams.

Labs have begun offering a variety of tests that can detect certain signs of Alzheimer’s in blood. Scientists are excited by their potential, but the tests aren’t widely used yet because there’s little data to guide doctors about which kind to order and when. The U.S. Food and Drug Administration hasn’t formally approved any of them and there’s little insurance coverage.

“What tests can we trust?” asked Dr. Suzanne Schindler, a neurologist at Washington University in St. Louis who’s part of a research project examining that. While some are very accurate, “other tests are not much better than a flip of a coin.”

Demand for earlier Alzheimer’s diagnosis is increasing

More than 6 million people in the United States and millions more around the world  

have Alzheimer’s, the most common form of dementia. Its telltale “biomarkers” are brain-clogging amyloid plaques and abnormal tau protein that leads to neuron-killing tangles.

New drugs, Leqembi and Kisunla, can modestly slow worsening symptoms by removing gunky amyloid from the brain. But they only work in the earliest stages of Alzheimer’s and proving patients qualify in time can be difficult. Measuring amyloid in spinal fluid is invasive. A special PET scan to spot plaques is costly and getting an appointment can take months.

Even specialists can struggle to tell if Alzheimer’s or something else is to blame for a patient’s symptoms.

“I have patients not infrequently who I am convinced have Alzheimer’s disease and I do testing and it’s negative,” Schindler said.

New study suggests blood tests for Alzheimer’s can be simpler, faster

Blood tests so far have been used mostly in carefully controlled research settings. But a new study of about 1,200 patients in Sweden shows they also can work in the real-world bustle of doctors’ offices — especially primary care doctors who see far more people with memory problems than specialists but have fewer tools to evaluate them.

In the study, patients who visited either a primary care doctor or a specialist for memory complaints got an initial diagnosis using traditional exams, gave blood for testing and were sent for a confirmatory spinal tap or brain scan.

Blood testing was far more accurate, Lund University researchers reported Sunday at the Alzheimer’s Association International Conference in Philadelphia. The primary care doctors’ initial diagnosis was 61% accurate and the specialists’ 73% — but the blood test was 91% accurate, according to the findings, which also were published in the Journal of the American Medical Association.

Which blood tests for Alzheimer’s work best?

There’s almost “a wild West” in the variety being offered, said Dr. John Hsiao of the National Institute on Aging. They measure different biomarkers, in different ways.

Doctors and researchers should only use blood tests proven to have a greater than 90% accuracy rate, said Alzheimer’s Association chief science officer Maria Carrillo.

Today’s tests most likely to meet that benchmark measure what’s called p-tau217, Carrillo and Hsiao agreed. Schindler helped lead an unusual direct comparison of several kinds of blood tests, funded by the Foundation for the National Institutes of Health, that came to the same conclusion.

That type of test measures a form of tau that correlates with how much plaque buildup someone has, Schindler explained. A high level signals a strong likelihood the person has Alzheimer’s while a low level indicates that’s probably not the cause of memory loss.

Several companies are developing p-tau217 tests including ALZpath Inc., Roche, Eli Lilly and C2N Diagnostics, which supplied the version used in the Swedish study.

Who should use blood tests for Alzheimer’s?

Only doctors can order them from labs. The Alzheimer’s Association is working on guidelines and several companies plan to seek FDA approval, which would clarify proper use.

For now, Carrillo said doctors should use blood testing only in people with memory problems, after checking the accuracy of the type they order.

Especially for primary care physicians, “it really has great potential to help them in sorting out who to give a reassuring message and who to send on to memory specialists,” said Dr. Sebastian Palmqvist of Lund University, who led the Swedish study with Lund’s Dr. Oskar Hansson.

The tests aren’t yet for people who don’t have symptoms but worry about Alzheimer’s in the family — unless it’s part of enrollment in research studies, Schindler stressed.

That’s partly because amyloid buildup can begin two decades before the first sign of memory problems, and so far, there are no preventive steps other than basic advice to eat healthy, exercise and get enough sleep. But there are studies underway testing possible therapies for people at high risk of Alzheimer’s, and some include blood testing.

Can tech help solve the Los Angeles homeless crisis? Finding shelter may someday be a click away

LOS ANGELES — Billions of dollars have been spent on efforts to get homeless people off the streets in California, but outdated computer systems with error-filled data are all too often unable to provide even basic information like where a shelter bed is open on any given night, inefficiencies that can lead to dire consequences.

The problem is especially acute in Los Angeles, where more than 45,000 people — many suffering from serious mental illness, substance addictions or both — live in litter-strewn encampments that have spread into virtually every neighborhood, and where rows of rusting RVs line entire blocks.

Even in the state that is home to Silicon Valley, technology has not kept up with the long-running crisis. In an age when anyone can book a hotel room or rent a car with a few strokes on a mobile phone, no system exists that provides a comprehensive listing of available shelter beds in Los Angeles County, home to more than 1 in 5 unhoused people in the U.S.

Mark Goldin, chief technology officer for Better Angels United, a nonprofit group, described L.A.’s technology as “systems that don’t talk to one another, lack of accurate data, nobody on the same page about what’s real and isn’t real.”

The systems can’t answer “exactly how many people are out there at any given time. Where are they?” he said.

The ramifications for people living on the streets could mean whether someone sleeps another night outside or not, a distinction that can be life-threatening.

“They are not getting the services to the people at the time that those people either need the service, or are mentally ready to accept the services,” said Adam Miller, a tech entrepreneur and CEO of Better Angels.

The problems were evident at a filthy encampment in the city’s Silver Lake neighborhood, where Sara Reyes, executive director of SELAH Neighborhood Homeless Coalition, led volunteers distributing water, socks and food to homeless people, including one who appeared unconscious.

She gave out postcards with the address of a nearby church where the coalition provides hot food and services. A small dog bolted out of a tent, frantically barking, while a disheveled man wearing a jacket on a blistering hot day shuffled by a stained mattress.

At the end of the visit Reyes began typing notes into her mobile phone, which would later be retyped into a coalition spreadsheet and eventually copied again into a federal database.

“Anytime you move it from one medium to another, you can have data loss. We know we are not always getting the full picture,” Reyes said. The “victims are the people the system is supposed to serve.”

The technology has sputtered while the homeless population has soared. Some ask how can you combat a problem without reliable data to know what the scope is? An annual tally of homeless people in the city recently found a slight decline in the population, but some experts question the accuracy of the data, and tents and encampments can be seen just about everywhere.

Los Angeles Mayor Karen Bass has pinpointed shortcomings with technology as among the obstacles she faces in homelessness programs and has described the city’s efforts to slow the crisis as “building the plane while flying it.”

She said earlier this year that three to five homeless people die every day on the streets of L.A.

On Thursday, Gov. Gavin Newsom ordered state agencies to start removing homeless encampments on state land in his boldest action yet following a Supreme Court ruling allowing cities to enforce bans on sleeping outside in public spaces.

There is currently no uniform practice for caseworkers to collect and enter information into databases on the homeless people they interview, including notes taken on paper. The result: Information can be lost or recorded incorrectly, and it becomes quickly outdated with the lag time between interviews and when it’s entered into a database. 

The main federal data system, known as the Homeless Management Information System, or HMIS, was designed as a desktop application, making it difficult to operate on a mobile phone.

“One of the reasons the data is so bad is because what the case managers do by necessity is they take notes, either on their phones or on scrap pieces of paper or they just try to remember it, and they don’t typically input it until they get back to their desk” hours, days, a week or even longer afterward, Miller said.

Every organization that coordinates services for homeless people uses an HMIS program to comply with data collection and reporting standards mandated by the U.S. Department of Housing and Urban Development. But the systems are not all compatible.

Sam Matonik, associate director of data at L.A.-based People Assisting the Homeless, a major service provider, said his organization is among those that must reenter data because Los Angeles County uses a proprietary data system that does not talk to the HMIS system.  

“Once you’re manually double-entering things, it opens the door for all sorts of errors,” Matonik said. “Small numerical errors are the difference between somebody having shelter and not.”

Bevin Kuhn, acting deputy chief of analytics for the Los Angeles Homeless Services Authority, the agency that coordinates homeless housing and services in Los Angeles County, said work is underway to create a database of 23,000 beds by the end of the year as part of technology upgrades.

For case managers, “just seeing … the general bed availability is challenging,” Kuhn said.

Among other changes is a reboot of the HMIS system to make it more compatible with mobile apps and developing a way to measure if timely data is being entered by case workers, Kuhn said.

It’s not uncommon for a field worker to encounter a homeless person in crisis who needs immediate attention, which can create delays in collecting data. Los Angeles Homeless Services Authority aims for data to be entered in the system within 72 hours, but that benchmark is not always met.

In hopes of filling the void, Better Angels assembled a team experienced in building large-scale software applications. They are constructing a mobile-friendly prototype for outreach workers — to be donated to participating groups in Los Angeles County — that will be followed by systems for shelter operators and a comprehensive shelter bed database.

Since homeless people are transient and difficult to locate for follow-up services, one feature would create a map of places where an individual had been encountered, allowing case managers to narrow the search.

Services are often available, but the problem is linking them with a homeless person in real time. So, a data profile would show services the individual received in the past, medical issues and make it easy to contact health workers, if needed.

As a secondary benefit — if enough agencies and providers agree to participate — the software could produce analytical information and data visualizations, spotlighting where homeless people are moving around the county, or concentrations of where homeless people have gathered.

One key goal for the prototypes: ease of use even for workers with scant digital literacy. Information entered into the app would be immediately unloaded to the database, eliminating the need for redundant reentries while keeping information up to date.

Time is often critical. Once a shelter bed is located, there is a 48-hour window for the spot to be claimed, which Reyes says happens only about half the time. The technology is so inadequate, the coalition sometimes doesn’t learn a spot is open until it has expired.

She has been impressed with the speed of the Better Angels app, which is in testing, and believes it would cut down on the number of people who miss the housing window, as well as create more reliability for people trying to obtain services.

“I’m hoping Better Angels helps us put the human back into this whole situation,” Reyes said.