Pakistan launched a week-long nationwide polio vaccination campaign Monday, as the country remains one of only two around the world where the paralyzing virus still exists.

This year, so far, Pakistan has reported five cases of the highly infectious disease. The latest polio eradication campaign will target more than 4.4 million children across much of the country, as well as in Pakistani-administered Kashmir.  

The South Asian nation came close to eradicating polio in 2021 when it reported only one case of paralysis from the virus. However, last year the country saw a spike with 20 cases on the record. The virus generally spreads through the fecal matter of a carrier that has contaminated the water supply. 

Two of this year’s five cases were detected in the country’s most populous city Karachi in the southern province of Sindh. This came after the city recorded zero cases in the last two years.  

A spokesperson of the provincial Emergency Operation Center, Syed Nofil Naqvi, told VOA both cases are children from Afghan families settled in Pakistan for years.  

Naqvi blamed cross-border movement between Pakistan and Afghanistan for the disease. Afghanistan, the only other country fighting to eliminate the virus has reported six cases so far in 2023.  

“The environmental samples found across Pakistan are genetically linked to Afghanistan,” Naqvi said.  

To counter the spread of the virus through travelers, Naqvi said, polio teams vaccinate children at bus stops and other transit points.   

All of Pakistan’s remaining polio cases this year came from Bannu, a town in the northern province of Khyber Pakhtunkhwa. Muhammad Zeeshan Khan, deputy coordinator for the provincial Emergency Operation Center, told VOA all three families had refused to vaccinate their children.   

“We tried a lot to convince them. One child’s family agreed to giving polio drops but the child had not received an [initial] injection [to build immunity]. This [refusal] is the reason that all three children succumbed to paralysis.” Khan said the families worried the vaccine might harm their children.  

Parents’ refusal to give the oral polio vaccine to their children is one of the primary reasons polio virus still exists in Pakistan.   

Polio workers and the security personnel protecting them frequently come under lethal attacks from parents and militants who see the vaccination drive as part of a foreign conspiracy to render Pakistani children impotent or to give them ingredients not permissible for Muslims to consume.

Provincial officials in Khyber Pakhtunkhwa recorded more than 16,000 refusals in October. According to Khan, Peshawar, the provincial capital, recorded nearly 8000 refusals followed by Bannu, and North Waziristan where most of Pakistan’s polio cases were recorded last year.  

Khyber Pakhtunkhwa recorded 14 incidents of violence against polio teams this year.   

To counter such misconceptions, authorities have been engaging local clerics and influencers, and running expensive TV and radio campaigns to convince parents to vaccinate their children.   

Still, other parents refuse and bargain for unmet civic needs. The National Emergency Operation Center’s plans for the latest campaign show several communities in Khyber Pakhtunkhwa have refused to vaccinate their children until gas, roads or teachers are provided.  

“For us, the biggest concern is the child whose family has refused [to vaccinate],” said Khan.  

In any campaign cycle thousands of children are also “missed” because they are not home, or the family is unwilling to allow the vaccination team inside if a male member of the household is not present.  

Data shows over 13 percent of children in Quetta, Baluchistan’s provincial capital, missed getting the vaccine last time. In Khyber Pakhtunkhwa, nearly 1.2 percent of children or more than 90,000 were missed as well.  

However, Khan said many of the missed children get vaccinated as guests in whichever community they are temporarily present.   

In Quetta too, nearly half the children who were missed at one point were eventually covered, according to data.  

Still, in parts of Khyber Pakhtunkhwa and Balochistan that border Afghanistan the vaccination campaign will either be conducted later or postponed indefinitely, primarily due to security reasons.

As hundreds of thousands of polio workers and security personnel go door to door this week in areas facing a high risk of polio, Naqvi is hopeful Pakistan will get closer to eliminating the crippling disease.   

“We are using a positive way of giving the message,” Naqvi said. From posting signs that said “Caution! Your area has polio,” he said, we now say, “we can eliminate polio.”
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A surge in respiratory illnesses across China that has drawn the attention of the World Health Organization is caused by the flu and other known pathogens and not by a novel virus, the country’s health ministry said Sunday.

Recent clusters of respiratory infections are caused by an overlap of common viruses such as the influenza virus, rhinoviruses, the respiratory syncytial virus, or RSV, the adenovirus as well as bacteria such as mycoplasma pneumoniae, which is a common culprit for respiratory tract infections, a National Health Commission spokesperson said.

The ministry called on local authorities to open more fever clinics and promote vaccinations among children and the elderly as the country grapples with a wave of respiratory illnesses in its first full winter since the removal of COVID-19 restrictions.

“Efforts should be made to increase the opening of relevant clinics and treatment areas, extend service hours and increase the supply of medicines,” said ministry spokesman Mi Feng.

He advised people to wear masks and called on local authorities to focus on preventing the spread of illnesses in crowded places such as schools and nursing homes.

The WHO earlier this week formally requested that China provide information about a potentially worrying spike in respiratory illnesses and clusters of pneumonia in children, as mentioned by several media reports and a global infectious disease monitoring service.

The emergence of new flu strains or other viruses capable of triggering pandemics typically starts with undiagnosed clusters of respiratory illness. Both SARS and COVID-19 were first reported as unusual types of pneumonia.

Chinese authorities earlier this month blamed the increase in respiratory diseases on the lifting of COVID-19 lockdown restrictions. Other countries also saw a jump in respiratory diseases such as RSV when pandemic restrictions ended.

The WHO said Chinese health officials on Thursday provided the data it requested during a teleconference. Those showed an increase in hospital admissions of children due to diseases including bacterial infection, RSV, influenza and common cold viruses since October.

Chinese officials maintained the spike in patients had not overloaded the country’s hospitals, according to the WHO.

It is rare for the U.N. health agency to publicly ask for more detailed information from countries, as such requests are typically made internally. WHO said it requested further data from China via an international legal mechanism.

According to internal accounts in China, the outbreaks have swamped some hospitals in northern China, including in Beijing, and health authorities have asked the public to take children with less severe symptoms to clinics and other facilities.

WHO said that there was too little information at the moment to properly assess the risk of these reported cases of respiratory illness in children.

Both Chinese authorities and WHO have been accused of a lack of transparency in their initial reports on the COVID-19 pandemic, which started in the central Chinese city of Wuhan in December 2019.
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Growing calls for the world to come to grips with the many ways that global warming affects human health have prompted the first day dedicated to the issue at crunch UN climate talks starting next week.

Extreme heat, air pollution and the increasing spread of deadly infectious diseases are just some of the reasons why the World Health Organization has called climate change the single biggest health threat facing humanity.

Global warming must be limited to the Paris Agreement target of 1.5 degrees Celsius “to avert catastrophic health impacts and prevent millions of climate change-related deaths,” according to the WHO.

However, under current national carbon-cutting plans, the world is on track to warm up to 2.9C this century, the U.N. said this week.

While no one will be completely safe from the effects of climate change, experts expect that most at risk will be children, women, the elderly, migrants and people in less developed countries which have emitted the least planet-warming greenhouse gases.

On December 3, the COP28 negotiations in Dubai will host the first “health day” ever held at the climate negotiations.

Extreme heat

This year is widely expected to be the hottest on record. And as the world continues to warm, even more frequent and intense heatwaves are expected to follow.

Heat is believed to have caused more than 70,000 deaths in Europe during summer last year, researchers said this week, revising the previous number up from 62,000.

Worldwide, people were exposed to an average of 86 days of life-threatening temperatures last year, according to the Lancet Countdown report earlier this week.

The number of people over 65 who died from heat rose by 85 percent from 1991-2000 to 2013-2022, it added.

And by 2050, more than five times more people will die from the heat each year under a 2C warming scenario, the Lancet Countdown projected.

More droughts will also drive rising hunger. Under the scenario of 2C warming by the end of the century, 520 million more people will experience moderate or severe food insecurity by 2050.

Meanwhile, other extreme weather events such as storms, floods and fires will continue to threaten the health of people across the world.

Air pollution

Almost 99% of the world’s population breathes air that exceeds the WHO’s guidelines for air pollution.

Outdoor air pollution driven by fossil fuel emissions kills more than four million people every year, according to the WHO.

It increases the risk of respiratory diseases, strokes, heart disease, lung cancer, diabetes and other health problems, posing a threat that has been compared to tobacco.

The damage is caused partly by PM2.5 microparticles, which are mostly from fossil fuels. People breathe these tiny particles into their lungs, where they can then enter the bloodstream.

While spikes in air pollution, such as extremes seen in India’s capital New Delhi earlier this month, trigger respiratory problems and allergies, long-term exposure is believed to be even more harmful.

However it is not all bad news.

The Lancet Countdown report found that deaths from air pollution due to fossil fuels have fallen 16% since 2005, mostly due to efforts to reduce the impact of coal burning.

Infectious diseases

The changing climate means that mosquitoes, birds and mammals will roam beyond their previous habitats, raising the threat that they could spread infectious diseases with them.

Mosquito-borne diseases that pose a greater risk of spreading due to climate change include dengue, chikungunya, Zika, West Nile virus and malaria.

The transmission potential for dengue alone will increase by 36 percent with 2C warming, the Lancet Countdown report warned.

Storms and floods create stagnant water that are breeding grounds for mosquitoes, and also increase the risk of water-borne diseases such as cholera, typhoid and diarrhea.

Scientists also fear that mammals straying into new areas could share diseases with each other, potentially creating new viruses that could then jump over to humans.

Mental health

Worrying about the present and future of our warming planet has also provoked rising anxiety, depression and even post-traumatic stress — particularly for people already struggling with these disorders, psychologists have warned.

In the first 10 months of the year, people searched online for the term “climate anxiety” 27 times more than during the same period in 2017, according to data from Google Trends cited by the BBC this week.
…

In the Pacific Northwest, one U.S. state is trying a novel approach to combatting opioid abuse — decriminalizing small amounts of hard drugs. From Oregon, Deborah Bloom has our story.
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On the cusp of the COP28 climate talks, U.N. Secretary-General Antonio Guterres visited frozen but rapidly melting Antarctica and said that intense action must be taken at the conference where countries will address their commitments to lowering emissions of planet-warming gases.

“We are witnessing an acceleration that is absolutely devastating,” Guterres said Thursday about the rate of ice melt in Antarctica, which is considered to be a “sleeping giant.”

“The Antarctic is waking up, and the world must wake up,” he added.

Guterres was on a three-day official visit to Antarctica. Chilean President Gabriel Boric joined him for an official visit to Chile’s Eduardo Frei Air Force Base on King George Island.

Guterres also was scheduled to visit the Collins and Nelson glaciers by boat.

He described the U.N. climate change conference that begins in Dubai next week as an opportunity for nations to “decide the phase-out of fossil fuels in an adequate time frame” to prevent the world from warming 1.5 degrees Celsius (2.7 degrees Fahrenheit) above pre-industrial temperatures.

Guterres said the COP28 conference also gives nations the chance to commit to more renewable energy projects and to improve energy efficiency of existing grids and technologies.

The U.N. chief also said he thinks that Sultan al-Jaber, the president of the upcoming climate talks and head of the Abu Dhabi National Oil Company, has a “bigger responsibility” to encourage the fossil fuel industry to make more clean energy investments because of his ties to the sector.

“He needs to be able to explain to all those that are responsible in the fossil fuel industry, and especially to the oil and gas industry that is making obscene profits all over the world, that this is the moment to use those profits instead of doubling down on fossil fuels,” Guterres said.

Warming air and ocean temperatures are causing Antarctic ice to melt. The frozen continent plays a significant role in regulating Earth’s climate because it reflects sunlight away and drives major ocean currents.

For years, scientists and environmentalists have kept an eye on the West Antarctic Ice Sheet as an important indicator of global warming. A study published in Nature Climate Change last month said warming has increased to the point that the ice sheet will now experience “unavoidable” melting regardless of how much the world reduces emissions of planet-warming gases like carbon dioxide.

The study’s lead author, Kaitlin Naughten, estimated that melting ice in Antarctica’s most at-risk areas could raise global sea levels by about 1.8 meters (5.9 feet) over the next few centuries.

Another study published in Science Advances, also last month, reported that nearly 50 Antarctic ice shelves have shrunk by at least 30% since 1997 and 28 of those have lost more than half their ice in that short period of time.
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Japan detected the first case of highly pathogenic H5-type bird flu this season at a poultry farm in the south of the country, public broadcaster NHK reported Saturday.

The local government in Saga prefecture will cull about 40,000 birds on the farm, NHK said, citing agriculture ministry officials it did not name.

Ministry officials were not immediately available for comment outside of business hours.

Prime Minister Fumio Kishida will convene relevant Cabinet ministers to discuss measures to prevent spreading of the virus, NHK said.

The virus was detected as a result of genetic testing conducted after some poultry birds were found dead at the farm on Friday, the report said.

Highly pathogenic avian influenza has spread around the globe in recent years, leading to the culling of hundreds of millions of birds.

In Japan a record 17.7 million poultry birds were culled last season, prompting the authorities to stay on high alert.
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On the eve of international climate talks, U.N. Secretary-General Antonio Guterres visited globally important Antarctica, where ice that’s been frozen for millions of years is melting because of human-caused climate change, to send the message that “we absolutely need to act immediately.” 

“What happens in Antarctica doesn’t stay in Antarctica,” Guterres said. In addition to reflecting lots of sunlight away from the Earth, Antarctica regulates the planet’s climate because its ice and cold waters drive major ocean currents. When massive amounts of ice melt, it raises sea levels and changes things like salinity and the habitats of ocean animals. 

At the annual Conference of the Parties known as COP, nations are supposed to gather to make and strengthen commitments to addressing climate change, but so far these have not been nearly enough to slow the emissions causing the warming. 

Guterres is on a three-day official visit to the southern continent. Chilean President Gabriel Boric joined him for an official visit to Chile’s Eduardo Frei Air Force Base on King George Island. Scientists and members of the Chilean military gathered with Guterres aboard a ship where they viewed glaciers and sea birds, including penguins. 

Guterres described COP28, which begins next week in Dubai, as an opportunity for nations to “decide the phase-out of fossil fuels in an adequate time frame” to prevent the world from warming 1.5 degrees Celsius (2.7 degrees Fahrenheit) above pre-industrial temperatures. Scientists have considered that an important demarcation that could have avoided devastating climate change for millions of people. But such a phase-out has not found its way into the agreements that emerge from these conferences so far, and the influence of fossil fuel companies and countries has been strong. 

Guterres said the COP28 conference also gives nations the chance to commit to more renewable energy projects and improve the energy efficiency of existing electrical grids and technologies. 

Sultan al-Jaber, the head of the Abu Dhabi National Oil Co., is president of this year’s talks, and the U.N. chief said his ties to the sector give him a “bigger responsibility” to encourage the fossil fuel industry to make more clean energy investments. 

“He needs to be able to explain to all those that are responsible in the fossil fuel industry, and especially to the oil and gas industry that is making obscene profits all over the world, that this is the moment to use those profits instead of doubling down on fossil fuels,” Guterres said. 

Pope Francis will also be the first pontiff to attend the U.N. climate conference, and Guterres said he was “very hopeful” that the pope’s presence would convey to political leaders that “it is a moral imperative to put climate action as an absolute priority and to do everything that is necessary to move from the suicidal trajectory that we are having today.”
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The World Health Organization said it has confirmed sexual transmission of mpox in the Democratic Republic of Congo for the first time as the country experiences its biggest outbreak, a worrying development that African scientists warn could make it more difficult to stop the disease.

In a statement issued late Thursday, the U.N. health agency said a resident of Belgium traveled to Congo in March and tested positive for mpox, or monkeypox, shortly afterward. The WHO said the individual “identified himself as a man who has sexual relations with other men” and that he had gone to several underground clubs for gay and bisexual men.

Among his sexual contacts, five later tested positive for mpox, the WHO said.

“This is the first definitive proof of sexual transmission of monkeypox in Africa,” said Oyewale Tomori, a Nigerian virologist who sits on several WHO advisory groups. “The idea that this kind of transmission could not be happening here has now been debunked.”

Mpox has been endemic in parts of central and west Africa for decades, where it mostly jumped into humans from infected rodents and caused limited outbreaks. Last year, epidemics triggered mainly by sex among gay and bisexual men in Europe hit more than 100 countries. The WHO declared the outbreak as a global emergency, and it has caused about 91,000 cases to date.

The WHO noted there were dozens of discrete clubs in Congo where men have sex with other men, including members who travel to other parts of Africa and Europe. The agency described the recent mpox outbreak as unusual and said it highlighted the risk the disease could spread widely among sexual networks.

The WHO added that the mpox outbreak this year in Congo, which has infected more than 12,500 people and killed about 580, also marked the first time the disease has been identified in the capital, Kinshasa, and in the conflict-ridden province of South Kivu. Those figures are roughly double the mpox toll in 2020, making it Congo’s biggest outbreak, the WHO said.

Virologist Tomori said that even those figures were likely an underestimate and had implications for the rest of Africa, given the continent’s often patchy disease surveillance.

“What’s happening in Congo is probably happening in other parts of Africa,” he said. “Sexual transmission of monkeypox is likely established here, but [gay] communities are hiding it because of the draconian [anti-LGBTQ+] laws in several countries.”

He warned that driving people at risk for the virus underground would make the disease harder to curb.

The mpox virus causes fever, chills, rash and lesions on the face or genitals. Most people recover within several weeks without requiring hospitalization.

The WHO said the risk of mpox spreading to other countries in Africa and globally “appears to be significant,” adding that there could be “potentially more severe consequences” than the worldwide epidemic last year.

Tomori lamented that while the mpox outbreaks in Europe and North America prompted mass immunization campaigns among affected populations, no such plans were being proposed for Africa.

“Despite the thousands of cases in Congo, no vaccines have arrived,” he said. Even after mpox epidemics subsided in the West, few shots or treatments were made available for Africa.

“We have been saying for years in Africa that monkeypox is a problem,” he said. “Now that sexual transmission has been confirmed here, this should be a signal to everyone to take it much more seriously.”
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South Africa, Colombia and other countries that lost out in the global race for coronavirus vaccines are taking a more combative approach toward drugmakers and pushing back on policies that deny cheap treatment to millions of people with tuberculosis and HIV.

Experts see it as a shift in how such countries deal with pharmaceutical behemoths and say it could trigger more efforts to make lifesaving medicines more widely available.

In the COVID-19 pandemic, rich countries bought most of the world’s vaccines early, leaving few shots for poor countries and creating a disparity the World Health Organization called “a catastrophic moral failure.”

Now, poorer countries are trying to become more self-reliant “because they’ve realized after COVID they can’t count on anyone else,” said Brook Baker, who studies treatment-access issues at Northeastern University.

One of the targets is a drug, bedaquiline, that is used for treating people with drug-resistant versions of tuberculosis. The pills are especially important for South Africa, where TB killed more than 50,000 people in 2021, making it the country’s leading cause of death.

In recent months, activists have protested efforts by Johnson & Johnson to protect its patent on the drug. In March, TB patients petitioned the Indian government, calling for cheaper generics; the government ultimately agreed Johnson & Johnson’s patent could be broken. Belarus and Ukraine then wrote to the company, also asking it to drop its patents, but with little response.

In July, Johnson & Johnson’s patent on the drug expired in South Africa, but the company had it extended until 2027, enraging activists who accused it of profiteering.

The South African government then began investigating the company’s pricing policies.

It had been paying about 5,400 rand ($282) per treatment course, more than twice as much as poor countries that got the drug via a global effort called the Stop TB partnership.

In September, about a week after South Africa’s probe began, Johnson & Johnson announced that it would drop its patent in more than 130 countries, allowing generic-makers to copy the drug.

“This addresses any misconception that access to our medicines is limited,” the company said.

Christophe Perrin, a tuberculosis expert at Doctors Without Borders, called Johnson & Johnson’s reversal “a big surprise” because aggressive patent protection was typically a “cornerstone” of pharmaceutical companies’ strategy.

Meanwhile, in Colombia, the government declared last month that it would issue a compulsory license for the HIV drug dolutegravir without permission from the drug’s patent-holder, Viiv Health care. The decision came after more than 120 groups asked the Colombian government to expand access to the World Health Organization-recommended drug.

“This is Colombia taking the reins after the extreme inequity of COVID and challenging a major pharmaceutical to ensure affordable AIDS treatment for its people,” said Peter Maybarduk of the Washington advocacy group Public Citizen. He noted that Brazilian activists are pushing their government to make a similar move.

Still, some experts said much more needs to change before poorer countries can produce their own medicines and vaccines.

When the coronavirus pandemic hit, Africa produced fewer than 1% of all vaccines made globally but used more than half of the world’s supply, according to Petro Terblanche, managing director of Afrigen Biologics. The company is part of a WHO-backed effort to produce a COVID vaccine using the same mRNA technology as those made by Pfizer and Moderna.

Terblanche estimated about 14 million people died of AIDS in Africa from the late 1990s into the 2000s, when countries couldn’t get the necessary medicines.

Back then, President Nelson Mandela’s government in South Africa eventually suspended patents to allow wider access to AIDS drugs. That prompted more than 30 drugmakers to take it to court in 1998, in a case dubbed “Mandela vs. Big Pharma.”

Doctors Without Borders described the episode as “a public relations disaster” for the drug companies, which dropped the lawsuit in 2001.

Terblanche said that Africa’s experience during the HIV epidemic has proven instructive.

“It’s not acceptable for a listed company to hold intellectual property that stands in the way of saving lives and, so, we will see more countries fighting back,” she said.

Challenging pharmaceutical companies is just one piece to ensuring Africa has equal access to treatments and vaccines, Terblanche said. More-robust health systems are critical.

“If we can’t get [vaccines and medicines] to the people who need them, they aren’t useful,” she said.

Yet some experts pointed out that South Africa’s own intellectual property laws still haven’t been changed sufficiently and make it too easy for pharmaceutical companies to acquire patents and extend their monopolies.

While many other developing countries allow legal challenges to a patent or a patent extension, South Africa has no clear law that allows it to do that, said Lynette Keneilwe Mabote-Eyde, a health care activist who consults for the nonprofit Treatment Action Group.

The South African department of health didn’t respond to a request for comment regarding drug procurement and patents.

In its annual report on tuberculosis released earlier this month, the World Health Organization said there were more than 10 million people sickened by the disease last year and 1.3 million deaths. After COVID-19, tuberculosis is the world’s deadliest infectious disease, and it is now the top killer of people with HIV.
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Chinese officials say they did not detect any “unusual or novel diseases” in the country, the World Health Organization said Thursday, following an official request by the U.N. health agency for information about a potentially worrying spike in respiratory illnesses and clusters of pneumonia in children. 

WHO cited unspecified media reports and a global infectious-disease monitoring service as reporting clusters of undiagnosed pneumonia in children in northern China and formally requested more details from China earlier this week. 

Outside scientists said the situation warranted close monitoring, but they were not convinced that the recent spike in respiratory illnesses in China signaled the start of a new global outbreak. 

The emergence of new flu strains or other viruses capable of triggering pandemics typically starts with undiagnosed clusters of respiratory illness. Both SARS and COVID-19 were first reported as unusual types of pneumonia. 

WHO noted that authorities at China’s National Health Commission on November 13 reported an increase in respiratory diseases, which they said was the result of the lifting of COVID-19 lockdown restrictions. Other countries also saw a jump in respiratory diseases such as respiratory syncytial virus, or RSV, when pandemic restrictions ended. 

WHO said that about a week later, media reported clusters of undiagnosed pneumonia in children in northern China. 

The U.N. agency said it held a teleconference with Chinese health officials on Thursday, during which the data it requested were provided. Those showed an increase in hospital admissions of children due to diseases including bacterial infection, RSV, influenza and common cold viruses since October. 

“No changes in the disease presentation were reported by the Chinese health authorities,” WHO said. It added that Chinese officials said the spike in patients had not overloaded the country’s hospitals. 

New disease doubted

Dr. Paul Hunter, a professor of medicine at Britain’s University of East Anglia, doubted the wave of infections was sparked by a new disease. 

“If it was [a new disease], I would expect to see many more infections in adults,” he said in a statement. “The few infections reported in adults suggest existing immunity from a prior exposure.” 

Francois Balloux of University College London said China was probably experiencing a significant wave of childhood infections since this was the first winter since lockdown restrictions were lifted, which likely reduced children’s immunity to common bugs. 

WHO said that northern China has reported a jump in influenzalike illnesses since mid-October compared with the previous three years. It is rare for the U.N. health agency to publicly ask for more detailed information from countries, as such requests are typically made internally. WHO said it requested further data from China via an international legal mechanism. 

According to internal accounts in China, the outbreaks have swamped some hospitals in northern China, including in Beijing, and health authorities have asked the public to take children with less severe symptoms to clinics and other facilities. 

The average number of patients in the internal medicine department at Beijing Children’s Hospital topped 7,000 per day, exceeding the hospital’s capacity, state-owned China National Radio said in an online article earlier this week. 

China’s National Health Commission, in a written Q&A posted online by the official Xinhua News Agency, suggested Thursday that children with mild symptoms “first visit primary health care institutions or pediatrics departments of general hospitals” because large hospitals are crowded and have long waiting times. 

WHO said that there was too little information at the moment to properly assess the risk of these reported cases of respiratory illness in children. The agency has previously been stymied by a lack of cooperation from countries when new viruses have emerged, particularly in China. 

After SARS broke out in southern China in 2002, Beijing officials told doctors to hide patients, with some being driven around in ambulances while WHO scientists were visiting the country. That prompted WHO to threaten to close its office in China. 

Nearly two decades later, China stalled on sharing critical details about the coronavirus with the U.N. health agency after the new virus emerged in late 2019. WHO publicly applauded China’s commitment to stopping the virus — weeks before it started causing explosive epidemics worldwide. 

“While WHO seeks this additional information, we recommend that people in China follow measures to reduce the risk of respiratory illness,” the agency said, advising people to get vaccinated, isolate if they are feeling ill, wear masks if necessary and get medical care as needed. 
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Authorities in several West African countries are trying to manage their huge diphtheria outbreaks, including in Nigeria where a top health official said Thursday that millions are being vaccinated to cover wide gaps in immunity against the disease.

At least 573 people out of the 11,640 diagnosed with the disease in Nigeria have died since the current outbreak started in December 2022, though officials estimate the toll — now on the decline because of treatment efforts — could be much higher across states unable to detect many cases.

In Niger, 37 people had died out of the 865 cases as of October, while Guinea has reported 58 deaths out of 497 since its outbreak started in June.

“As far as the history that I am aware of, this is the largest outbreak that we have had,” Ifedayo Adetifa, head of the Nigeria Centre for Disease Control, told The Associated Press.

The highly contagious bacterial infection has been reported in 20 of Nigeria’s 36 states so far.

A major driver of the high rate of infection in the region has been a historically wide vaccination gap, the French medical organization Doctors Without Borders, or MSF, said in a statement on Tuesday.

In Nigeria, only 42% of children under 15 years old are fully protected from diphtheria, according to a government survey, while Guinea has a 47% immunization rate — both far below the 80-85% rate recommended by the World Health Organization to maintain community protection.

The fate of the affected countries is worsened by the global shortages of the diphtheria vaccine as demand has increased to respond to outbreaks, MSF said.

“We’re not seeing vaccination happen, not at the scale that is needed,” said Dr. Dagemlidet Tesfaye Worku, emergency medical program manager for MSF in Abidjan, Ivory Coast. “What is needed is a truly massive scale-up of vaccination, as soon as possible.”

The Nigerian government is ramping up vaccination for targeted populations while assisting states to boost their capacity to detect and manage cases, said Adetifa, the Nigeria CDC head.

But several states continue to struggle, including Kano, which accounts for more than 75% of cases in Nigeria but has only two diphtheria treatment centers, according to Abubakar Labaran Yusuf, the state’s top health official.

“Once people have to travel or move significant distances to access treatment, that becomes a challenge,” Adetifa said.
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A 14-year-old Ethiopian-born American in the U.S. state of Virginia has won the 3M Young Scientist Challenge, an annual science competition for U.S. students in grades five through eight. VOA’s Eden Geremew recently spoke with the winner in Fairfax County, Virginia, in this report narrated by Salem Solomon. Camera: Karina Choudhury
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For most of her life, Claudia Stearns dreaded Thanksgiving. As a person who struggled with obesity since childhood, Stearns hated the annual turmoil of obsessing about what she ate — and the guilt of overindulging on a holiday built around food. 

Now, after losing nearly 100 pounds using medications including Wegovy, a powerful new anti-obesity drug, Stearns says the “food noise” in her head has gone very, very quiet. 

“Last year, it felt so lovely to just be able to enjoy my meal, to focus on being with friends and family, to focus on the joy of the day,” says Stearns, 65, of Somerville, Massachusetts. “That was a whole new experience.” 

As millions of Americans struggling with obesity gain access to a new generation of weight-loss drugs, Stearns’ experience is becoming more common — and more noticeable at the times of year when cooking, eating and a sense of abundance can define and heighten gatherings of loved ones and friends. Medical experts and consumers say the drugs are shifting not only what users eat, but also the way they view food.

For some, it means greater mental control over their meals. Others say it saps the enjoyment from social situations, including traditionally food-centric holidays like Thanksgiving, Passover and Christmas.

“It’s something that really changes a lot of things in their life,” says Dr. Daniel Bessesen, chief of endocrinology at Denver Health, who treats patients with obesity. “They go from food being a central focus to it’s just not.”

Undermining the festivities?

The new obesity drugs, originally designed to treat diabetes, include semaglutide, used in Ozempic and Wegovy, and tirzepatide, used in Mounjaro and recently approved as Zepbound. Now aimed at weight loss, too, the drugs delivered as weekly injections work far differently than any diet. They mimic powerful hormones that kick in after people eat to regulate appetite and the feeling of fullness communicated between the gut and the brain. Users can lose as much as 15% to 25% of their body weight, studies show. 

“That’s how it works — it reduces the rewarding aspects of food,” explains Dr. Michael Schwartz, an expert in metabolism, diabetes and obesity at the University of Washington in Seattle. 

For Stearns, who started treatment in 2020, using the weight-loss medications means she can take a few bites of her favorite Thanksgiving pies — and then stop. “I would not feel full,” she says, “but I would feel satisfied.” 

Yet such a shift can have broader implications, both religious and cultural, because it alters the experience of festive and religious holidays that are often built around interactions with food — and lots of it.

“I’m Italian. For us, it’s like going to church, going to a table,” says Joe Sapone, 64, a retiree from Atlantic Highlands, New Jersey, who lost about 100 pounds with dieting and Mounjaro. He no longer needs what he called “the food orgy” of a holiday, but he acknowledges it was an adjustment.

“Part of succeeding at this is disconnecting a good time with what you eat,” he says.

Changes in enjoyment

Many users welcome what they say is greater control over what they eat, even during the emotionally charged holiday season. 

“I may be more selective of the items I put on my plate,” says Tara Rothenhoefer, 48, of Trinity, Florida. She lost more than 200 pounds after joining a clinical trial testing Mounjaro for weight loss in 2020. “I don’t care about the bread as much. I still eat what I enjoy.” 

But others on the drugs lose their appetites entirely or suffer side effects — nausea, vomiting, diarrhea — that undermine the pleasure of any food. 

“I’ve had a handful of patients over the years who were really miserable because they didn’t enjoy food in the same way,” says Dr. Katherine Saunders, an obesity expert at Weill Cornell Medicine and co-founder of Intellihealth, a clinical and software company that focuses on obesity treatment. 

But, she added, most people who have turned to weight-loss medications have spent years struggling with the physical and mental burdens of chronic obesity and are relieved to discover a decreased desire for food — and grateful to shed pounds. 

When people stop taking the drugs, their appetites return and they regain weight, often faster than they lost it, studies show. One early analysis found that two-thirds of patients who started taking weight-loss drugs were no longer using them a year later. 

Part of that may be due to the high cost and ongoing supply shortages. But the larger question of what it means to alter a basic human drive like appetite needs to be considered as well, says Dr. Jens Juul Holst of the University of Copenhagen. He is one of the researchers who first identified the gut hormone GLP-1, or glucagon-like peptide 1, which eventually led to the new class of obesity drugs. 

Speaking at an international diabetes conference this fall, Holst offered a philosophical critique of the new medications’ real-world impact. 

“Why is it that you’ve lost weight? That’s because you’ve lost your appetite. That’s because you’ve lost the pleasure of eating and the reward of having a beautiful meal,” Holst told his colleagues. “And how long can you stand that? That is the real, real question.” 
…

Rising sea levels, extreme weather and rising temperatures are threatening coastal communities in South Africa. For VOA, Derick Mazarura has the story from Eastern Cape, South Africa. Camera — Buhle Ndamase and Norah Chisa.
…

Growing up in Lahore — Pakistan’s cultural capital — fall used to be the perfect time for Mariam to enjoy outdoor activities after months of scorching summer heat. Now, she cannot imagine the same for her young daughters as Lahore’s air, ranked the most polluted globally, becomes unusually toxic in cooler months.

“You can just smell, sometimes you can taste it, and feel it as well,” said the mother of two describing what it is like to breathe the polluted air.

With an AQI reading of 345 early in the day, Lahore ranked second worst city in the world for air pollution on Tuesday, according to the Air Quality Index or AQI run by IQAir, a Swiss air purifier manufacturer.

An AQI above 151 is unhealthy, while above 301 the air is hazardous for breathing.

IQAir’s index ranked Lahore the most polluted city of 2022.

Smog emergency

The city, along with several other in Pakistan’s biggest province Punjab,is under a month-long smog emergency since early November.

Smog – a combination of smoke and fog – is a specific phenomenon that occurs when certain pollution particles mix with cold, moist air and hang close to the ground, reducing visibility.

In a bid to reduce traffic congestion and exposure to toxic air, the top court in Punjab on Monday ordered the closure of government-run educational institutions on Saturdays until the end of January 2024. The court also asked the provincial government to come up with a work-from-home plan for the private sector.

A year-long emergency

For a few weeks in fall, smoke in Punjab’s air increases as Pakistani and Indian farmers on both sides of the divided state burn agricultural residue to prepare fields for planting the next crop. Environmentalists, however, say the government is in denial about the extent of Pakistan’s pollution problem, which is primarily driven by low quality, high-Sulphur fuel.

“Air pollution has always been an issue in Pakistani cities, going back the better part of 15 odd years,” Ahmad Rafay Alam, a Lahore-based environmental lawyer told VOA. “We have a year-long regional air pollution emergency and we tend to think of it as a Lahore smog issue.”

According to the Air Quality Life Index developed by the Energy Policy Institute at the University of Chicago, 98.3 of Pakistanis breathe air that is below the country’s own national air quality standard.

In 2017 the provincial Environmental Protection Department came up with an 11-point policy, on court orders, focusing on controlling emissions from vehicles and factories.

The court was, however, dissatisfied and constituted a smog commission for detailed analysis and recommendations on improving air quality.

Speaking to VOA, Naseem-ur-Rehman Shah, secretary of the provincial Environment Commission claimed that 80% of factories were now monitoring their emissions while 70-percent of brick kilns had moved to an environmentally friendly design

Still, data paints a terrifying picture.

“Every figure is telling you that the air pollution in Lahore is about, on the lower end, like 30, 40 times higher than the WHO safe limits,” said Abid Omar, founder of Air Quality Pakistan Initiative, a network of volunteers who monitor air quality using IQAir monitors.

Omar is based in Karachi which routinely competes with Lahore and Delhi for the worst air quality in the world.

Monitoring

For the city of nearly 15 million people, Punjab’s environmental agency gathers data from only five air quality monitors in Lahore.

Omar’s Pakistan Air Quality Initiative has 50 monitors feeding into IQAir’s Air Quality Index.

Shah’s department does not use PAQI’s data over standardization concerns but it is planning to add several monitors of its own.

In 2019, the provincial environmental regulator was forced to revise its air quality standards after it emerged officials were underreporting pollution by using low standards.

Alam represented the complainants in taking the regulator to court.

Knee jerk reaction

With air quality declining dramatically this month, the provincial and city administration have ramped up crackdown on smoke-emitting factories, brick kilns, and vehicles.

Citing city administration, local media reported that more than 16,000 vehicles were ticketed and over $100,000 dollars in fines imposed since the beginning of the emergency.

Omar calls such administrative measures a knee jerk reaction lacking long-term impact.

“Because it’s very random and ad hoc implementation, it’s not going to be an effective policy,” Omar said.

Shah called such criticism unfair. “We are working to eliminate sources of pollution,” he said.

Policy shift

“What we need to do is improve the quality of our refineries, which don’t produce high quality fuels … you have to transition to renewable energies, which is expensive and time consuming,” said Alam, pointing to studies that show fuel and energy sector are among the primary polluters in the country.

In May this year, Pakistan’s Ministry of Climate Change introduced the National Clean Air Policy. It aims to reduce harmful emissions in the next 10 years by introducing interventions in transport, industry, agriculture, waste and household sectors.

Such an overhaul will take time, money, and political will.

For Mariam, who runs three air purifiers in her home, the only option at the moment is to keep her daughters indoors as much as possible.

“It actually feels like … you’re being deprived of something very basic … not being able to breathe in fresh air.”

According to the Air Quality Life Index at the University of Chicago, Pakistanis are losing 3.9 years of life expectancy because of breathing toxic air. In Lahore and the rest of Punjab, residents are on track to lose between 3.7 to 4.6 years of life expectancy.
…

Innovations in food production could alleviate hunger for millions of people, according to Britain, which hosted a global summit on food insecurity Monday, but critics say the focus on technology ignores the growing inequality of wealth.

The summit was a joint initiative between Britain, Somalia, the United Arab Emirates, the Children’s Investment Fund Foundation and the Bill and Melinda Gates Foundation, aimed at boosting food security through science and innovation.

Innovation hub

British Prime Minister Rishi Sunak said a renewed focus was needed to alleviate hunger.

“It can’t be right that today in 2023, almost 1 billion people across the world regularly do not have enough to eat, that millions face hunger and starvation, and over 45 million children under five are suffering acute malnutrition. In a world of abundance, no one should die from lack of food and no parent should ever have to watch their child starve,” Sunak told delegates in London.

He outlined Britain’s plans to host a “virtual hub” for innovation in food production, known as CGIAR (Consultative Group on International Agricultural Research), aimed at making global food systems more resilient to future shocks in a changing climate.

“We’ve already helped develop crops that are drought-resistant and even richer in vitamins, now feeding 100 million people across Africa. And we’re going further, launching a new U.K. CGIAR science center to drive cutting-edge research on flood-tolerant rice, disease-resistant wheat and much more. These innovations will reach millions across the poorest countries, as well as improving U.K. crop yields and driving down food prices,” Sunak said.

Somalia emergency

Somali President Hassan Sheikh Mohamud also addressed the summit, telling delegates that the country’s stabilization program, developed in partnership with Britain, was working on tackling his country’s humanitarian crisis.

Somalia is among the countries worst-hit by climate change and food insecurity. The government recently declared a state of emergency after 113,000 people were forced to flee their homes following extreme rainfall and extensive flooding, which also caused widespread damage to crops and farmland. The floods come a year after Somalia suffered its worst drought in 40 years.

Technological solutions

Can new technology end global food insecurity, like that endured by Somalia and many other poorer nations? It’s one tool in the box, said analyst Steve Wiggins, a food security specialist at the ODI development think tank.

“The fundamentals of global hunger are the fundamentals of poverty, marginalization, and people being in situations of extraordinary vulnerability. Those are the fundamentals of hunger and that’s what we have to drive towards,” he told VOA.

“Of course, there are technical advances that we get that we’re very happy for, which make things a little bit easier,” Wiggins added, highlighting innovations like solar-powered irrigation in Mali. “So, if you want to pump water onto your fields, it’s becoming increasingly easy without having to spend money on diesel to do so.”

Inequalities

Critics say the focus on technology ignores the main driver of food insecurity.

“This summit is welcome. I think some of the solutions are welcome. But I think it’s not going to be enough to tackle that huge problem of hunger, which has been with us for decades and which we seem to be going backwards in many steps,” said Nick Nisbett of the Institute of Development Studies.

“Technological solutions tend to focus on the supply side, so new tech for agriculture and supply chains and so on. But what we actually need to do is to tackle the inequalities that lie behind that hunger.”

“Possibly the simplest thing to do is actually to give people food or to give people the money to [go] out and buy and purchase food in [the] markets themselves,” Nisbett told VOA.
…

A federal judge in Nevada has dealt another legal setback to Native American tribes trying to halt construction of one of the biggest lithium mines in the world.

U.S. District Judge Miranda Du granted the government’s motion to dismiss their claims the mine is being built illegally near the sacred site of an 1865 massacre along the Nevada-Oregon line.

But she said in last week’s order the three tribes suing the Bureau of Land Management deserve another chance to amend their complaint to try to prove the agency failed to adequately consult with them as required by the National Historic Preservation Act.

“Given that the court has now twice agreed with federal defendants (and) plaintiffs did not vary their argument … the court is skeptical that plaintiffs could successfully amend it. But skeptical does not mean futile,” Du wrote Nov. 9.

She also noted part of their case is still pending on appeal at the 9th U.S Circuit Court of Appeals, which indicated last month it likely will hear oral arguments in February as construction continues at Lithium Nevada’s mine at Thacker Pass about 370 kilometers northeast of Reno.

Du said in an earlier ruling the tribes had failed to prove the project site is where more than two dozen of their ancestors were killed by the U.S. Cavalry Sept. 12, 1865.

Her new ruling is the latest in a series that have turned back legal challenges to the mine on a variety of fronts, including environmentalists’ claims it would violate the 1872 Mining Law and destroy key habitat for sage grouse, cutthroat trout and pronghorn antelope.

All have argued the bureau violated numerous laws in a rush to approve the mine to help meet sky-rocketing demand for lithium used in the manufacture of batteries for electric vehicles.

Lithium Nevada officials said the $2.3 billion project remains on schedule to begin production in late 2026. They say it’s essential to carrying out President Joe Biden’s clean energy agenda aimed at combating climate change by reducing dependence on fossil fuels.

“We’ve dedicated more than a decade to community engagement and hard work in order to get this project right, and the courts have again validated the efforts by Lithium Americas and the administrative agencies,” company spokesperson Tim Crowley said in an email to The Associated Press.

Du agreed with the government’s argument that the consultation is ongoing and therefore not ripe for legal challenge.

The tribes argued it had to be completed before construction began.

“If agencies are left to define when consultation is ongoing and when consultation is finished … then agencies will hold consultation open forever — even as construction destroys the very objects of consultation — so that agencies can never be sued,” the tribal lawyers wrote in recent briefs filed with the 9th Circuit.

Will Falk, representing the Reno-Sparks Indian Colony and Summit Lake Paiute Tribe, said they’re still considering whether to amend the complaint by the Dec. 9 deadline Du set, or focus on the appeal.

“Despite this project being billed as `green,’ it perpetrates the same harm to Native peoples that mines always have,” Falk told AP. “While climate change is a very real, existential threat, if government agencies are allowed to rush through permitting processes to fast-track destructing mining projects like the one at Thacker Pass, more of the natural world and more Native American culture will be destroyed.”

The Paiutes call Thacker Pass “Pee hee mu’huh,” which means “rotten moon.” They describe in oral histories how Paiute hunters returned home in 1865 to find the “elders, women, and children” slain and “unburied and rotting.”

The Oregon-based Burns Paiute Tribe joined the Nevada tribes in the appeal. They say BLM’s consultation efforts with the tribes “were rife with withheld information, misrepresentations, and downright lies.”
…

Oregon’s first-in-the-nation law that decriminalized the possession of small amounts of heroin, cocaine and other illicit drugs in favor of an emphasis on addiction treatment is facing strong headwinds in the progressive state after an explosion of public drug use fueled by the proliferation of fentanyl and a surge in deaths from opioids, including those of children.

“The inability for people to live their day-to-day life without encountering open-air drug use is so pressing on urban folks’ minds,” said John Horvick, vice president of polling firm DHM Research. “That has very much changed people’s perspective about what they think Measure 110 is.”

When the law was approved by 58% of Oregon voters three years ago, supporters championed Measure 110 as a revolutionary approach that would transform addiction by minimizing penalties for drug use and investing instead in recovery.

But even top Democratic lawmakers who backed the law, which will likely dominate the upcoming legislative session, say they’re now open to revisiting it after the biggest increase in synthetic opioid deaths among states that have reported their numbers.

The cycle of addiction and homelessness spurred by fentanyl is most visible in Portland, where it’s not unusual to see people using it in broad daylight on busy city streets.

“Everything’s on the table,” said Democratic state Sen. Kate Lieber, co-chair of a new joint legislative committee created to tackle addiction. “We have got to do something to make sure that we have safer streets and that we’re saving lives.”

Measure 110 directed the state’s cannabis tax revenue toward drug addiction treatment services while decriminalizing the possession of so-called “personal use” amounts of illicit drugs. Possession of under a gram of heroin, for example, is only subject to a ticket and a maximum fine of $100.

Those caught with small amounts of drugs can have the citation dismissed by calling a 24-hour hotline to complete an addiction screening within 45 days, but those who don’t do a screening are not penalized for failing to pay the fine. In the first year after the law took effect in February 2021, only 1% of people who received citations for possession sought help via the hotline, state auditors found.

Critics of the law say this doesn’t create an incentive to seek treatment.

Republican lawmakers have urged Democratic Gov. Tina Kotek to call a special session to address the issue before the Legislature reconvenes in February. They have proposed harsher sanctions for possession and other drug-related offenses, such as mandatory treatment and easing restrictions on placing people under the influence on holds in facilities such as hospitals if they pose a danger to themselves or others.

“Treatment should be a requirement, not a suggestion,” a group of Republican state representatives said in a letter to Kotek.

Law enforcement officials who have testified before the new legislative committee on addiction have proposed reestablishing drug possession as a class A misdemeanor, which is punishable by up to a year in jail or a $6,250 fine.

“We don’t believe a return to incarceration is the answer, but restoring a (class A) misdemeanor for possession with diversion opportunities is critically important,” Jason Edmiston, chief of police in the small, rural city of Hermiston in northeast Oregon, told the committee.

However, data shows decades of criminalizing possession hasn’t deterred people from using drugs. In 2022, nearly 25 million Americans, roughly 8% of the population, reported using illicit drugs other than marijuana in the previous year, according to the annual National Survey on Drug Use and Health.

Some lawmakers have suggested focusing on criminalizing public drug use rather than possession. Alex Kreit, assistant professor of law at Northern Kentucky University and director of its Center on Addiction Law and Policy, said such an approach could help curb visible drug use on city streets but wouldn’t address what’s largely seen as the root cause: homelessness.

“There are states that don’t have decriminalization that have these same difficult problems with public health and public order and just quality-of-life issues related to large-scale homeless populations in downtown areas,” he said, mentioning California as an example.

Backers of Oregon’s approach say decriminalization isn’t necessarily to blame, as many other states with stricter drug laws have also reported increases in fentanyl deaths.

But estimates from the U.S. Centers for Disease Control and Prevention show, among the states reporting data, Oregon had the highest increase in synthetic opioid overdose fatalities when comparing 2019 and the 12-month period ending June 30, a 13-fold surge from 84 deaths to more than 1,100.

Among the next highest was neighboring Washington state, which saw its estimated synthetic opioid overdose deaths increase seven-fold when comparing those same time periods, CDC data shows.

Nationally, overdose deaths involving synthetic opioids such as fentanyl roughly doubled over that time span. Roughly two-thirds of all deadly overdoses in the U.S. in the 12 months ending June 30 involved synthetic opioids, federal data shows.

Supporters of Oregon’s law say it was confronted by a perfect storm of broader forces, including the COVID-19 pandemic, a mental health workforce shortage and the fentanyl crisis, which didn’t reach fever pitch until after the law took effect in early 2021.

A group of Oregon lawmakers recently traveled to Portugal, which decriminalized the personal possession of drugs in 2001, to learn more about its policy. State Rep. Lily Morgan, the only Republican legislator on the trip, said Portugal’s approach was interesting but couldn’t necessarily be applied to Oregon.

“The biggest glaring difference is they’re still not dealing with fentanyl and meth,” she said, noting the country also has universal health care.

Despite public perception, the law has made some progress by directing $265 million dollars of cannabis tax revenue toward standing up the state’s new addiction treatment infrastructure.

The law also created what are known as Behavioral Health Resource Networks in every county, which provide care regardless of the ability to pay. The networks have ensured about 7,000 people entered treatment from January to March of this year, doubling from nearly 3,500 people from July through September 2022, state data shows.

The law’s funding also has been key for providers of mental health and addiction services because it has “created a sustainable, predictable funding home for services that never had that before,” said Heather Jefferis, executive director of Oregon Council for Behavioral Health, which represents such providers.

Horvick, the pollster, said public support for expanding treatment remains high despite pushback against the law.

“It would be a mistake to overturn 110 right now because I think that would make us go backwards,” Lieber, the Democratic state senator, said. “Just repealing it will not solve our problem. Even if we didn’t have 110, we would still be having significant issues.” 
…

SpaceX’s uncrewed spacecraft Starship, developed to carry astronauts to the moon and beyond, failed in space shortly after lifting off Saturday, cutting short its second test but making it further than an earlier attempt that ended in an explosion. 

The two-stage rocket ship blasted off from the Elon Musk-owned company’s Starbase launch site near Boca Chica in Texas, helping boost the Starship spacecraft as high as 90 miles (148 kilometers) above ground on a planned 90-minute test mission to space and back. 

But the rocket’s Super Heavy first stage booster, though it achieved a crucial maneuver to separate with its core Starship stage, exploded over the Gulf of Mexico shortly after detaching, a SpaceX webcast showed. 

Meanwhile, the core Starship stage boosted farther toward space, but a few minutes later a company broadcaster said that SpaceX mission control suddenly lost contact with the vehicle. 

“We have lost the data from the second stage… we think we may have lost the second stage,” SpaceX engineer and livestream host John Insprucker said. He added that engineers believe an automated flight termination command was triggered to destroy the rocket, though the reason was unclear. 

About eight minutes into the test mission, a camera view tracking the Starship booster appeared to show an explosion that suggested the vehicle failed at that time. The rocket’s altitude was 91 miles (148 kilometers). 

FAA will oversee investigation

The launch was the second attempt to fly Starship mounted atop its towering Super Heavy rocket booster, following an April attempt that ended in explosive failure about four minutes after lift-off. 

The U.S. Federal Aviation Administration, which oversees commercial launch sites, confirmed a mishap occurred that “resulted in a loss of the vehicle,” adding no injuries or property damage have been reported. 

The agency said it will oversee a SpaceX-led investigation into the testing failure and will need to approve SpaceX’s plan to prevent it from happening again. 

The mission’s objective was to get Starship off the ground in Texas and into space just shy of reaching orbit, then plunge through Earth’s atmosphere for a splashdown off Hawaii’s coast. The launch had been scheduled for Friday but was pushed back by a day for a last-minute swap of flight-control hardware. 

Testing failures 

Starship’s failure to meet all its test objectives could pose a setback for SpaceX. The FAA will need to review the company’s failure investigation and review its application for a new launch license. SpaceX officials have complained that such regulatory reviews take too long. 

On the other hand, the failure in a program for which SpaceX plans to spend roughly $2 billion this year was in line with the company’s risk-tolerant culture that embraces fast-paced testing and re-testing of prototypes to hasten design and engineering improvements. 

“More things were successful than in the previous test, including some new capabilities that were significant,” said Carissa Christensen, CEO of space analytics firm BryceTech. 

“There’s not money and patience for unlimited tests, but for a vehicle that is so different and so big, two, three, four, five tests — is not excessive,” Christensen said. 

At roughly 43 miles (70 kilometers) in altitude, the rocket system executed the crucial maneuver to separate the two stages — something it failed to do in the last test — with the Super Heavy booster intended to plunge into Gulf of Mexico waters while the core Starship booster blasts farther to space using its own engines. 

But the Super Heavy booster blew up moments later, followed by the Starship stage’s own explosion. SpaceX in a post on social media platform X said, “success comes from what we learn,” adding that the core Starship stage’s engines “fired for several minutes on its way to space.” 

A fully successful test would have marked a key step toward achieving SpaceX’s ambition producing a large, multi-purpose, spacecraft capable of sending people and cargo back to the moon later this decade for NASA, and to Mars. 

SpaceX’s worker safety culture underpinning its speedy development ethos is facing scrutiny by lawmakers after a Reuters investigation documented hundreds of injuries at the rocket company’s U.S. manufacturing and launch sites. 

Clock is ticking 

NASA, SpaceX’s primary customer, has a considerable stake in the success of Starship, which the U.S. space agency is counting on to play a central role of landing humans on the moon within the next few years under its human spaceflight program, Artemis, successor to the Apollo missions. 

NASA chief Bill Nelson, who has made competition with China a core need for speed in Artemis, said Saturday’s Starship test was an “opportunity to learn — then fly again.” 

Musk — SpaceX’s founder, chief executive and chief engineer — sees Starship as eventually replacing the company’s workhorse Falcon 9 rocket as the centerpiece of its launch business that already lifts most of the world’s satellites and other commercial payloads into space. 

“The clock is ticking,” said Chad Anderson, a SpaceX investor and managing partner of venture capital firm Space Capital. “NASA has a timeline where they’re trying to get to the moon, and this is their primary vehicle to do it. So, SpaceX needs to deliver on a timeline.” 

Jaret Matthews, CEO of lunar rover startup Astrolab that has booked space on a future Starship flight, toured SpaceX’s Starbase site this year and said he expects the company to resume tests after the Saturday flight, though such a pace is expected to be driven largely by the FAA’s review and the extent of Starship’s technical failures. 

“They have the next number of vehicles already lined up in the factory ready to go,” he said. “I think people will be shocked by the cadence that emerges next year.” 
…

U.S. President Joe Biden and Chinese President Xi Jinping agreed earlier this week that Beijing will crack down on companies in China that produce precursor chemicals for fentanyl, an agreement that Biden said would “save lives.”

In exchange, the Biden administration agreed to lift sanctions on China’s Physical Evidence Identification Center of the Ministry of Public Security and the National Drug Laboratory. In May 2020, the U.S. Department of Commerce sanctioned the lab for allegedly participating in human rights violations against Uyghurs and other ethnic minorities in Xinjiang.

China, which is the source of most fentanyl precursors used in the U.S., argued that U.S. export controls have “severely affected” China’s inspection and testing of fentanyl-related substances and impaired its “goodwill to help the U.S. in drug control,” according to the spokesperson of the Chinese Embassy in the United States.

Although a cooperative effort to curb the supply of fentanyl brought some results over the years, enthusiasm dampened as tensions grew between China and the U.S. On Aug. 5, 2022 — after then-House Speaker Nancy Pelosi visited Taiwan, a self-governing island Beijing considers its own — China officially announced the suspension of anti-drug cooperation with the U.S.

Here is some background to the Biden-Xi deal.

What is fentanyl?

According to the U.S. Centers for Disease Control and Prevention (CDC), fentanyl is 50 times more potent than heroin and 100 times more potent than morphine. It is a prescription drug in the United States used for treating severe pain.

Illegally manufactured fentanyl “is often added to other drugs because of its extreme potency, which makes drugs cheaper, more powerful, more addictive, and more dangerous,” according to the CDC.

Fentanyl sold on the black market is often mixed with heroin and/or cocaine to increase a user’s sense of euphoria, according to the CDC.

Why does the United States care about the fentanyl issue?

Fentanyl is now the leading cause of death among Americans ages 18 to 49, according to U.S. Department of Justice data.

What does the fentanyl problem in the United States have to do with China?

According to a report by the Congressional Research Service: “Prior to 2019, China was the primary source of U.S.-bound illicit fentanyl, fentanyl-related substances, and production equipment.” It said Chinese traffickers supplied fentanyl and fentanyl-related substances to the U.S. via international mail and express consignment operations.

Xi promised then-U.S. President Donald Trump to tighten regulation of fentanyl and related substances when the two met in 2018 on the sidelines of the G20 Summit in Buenos Aires, Argentina. This was seen as a move taken by China to ease trade disputes.

China then passed new laws that took effect on May 1, 2019, to put all fentanyl-related substances under national control.

In July 2022 testimony, a senior adviser to the Office of National Drug Control Policy stated that as a result, “the direct shipment of fentanyl and fentanyl-related substances from China to the United States went down to almost zero.”

What role does China play?

After China regulated fentanyl-related substances, Mexican transnational criminal organizations became the main operators in the production and distribution of illegal fentanyl in the U.S., according to data from the U.S. Drug Enforcement Administration (DEA).

“The cartels are buying precursor chemicals in the People’s Republic of China (PRC); transporting the precursor chemicals from the PRC to Mexico; using the precursor chemicals to mass produce fentanyl; pressing the fentanyl into fake prescription pills; and using cars, trucks, and other routes to transport the drugs from Mexico into the United States for distribution,” said Anne Milgram, administrator of DEA, at a Senate hearing in February.

Why does the US accuse China of lax cooperation?

Certain precursors used in the production of fentanyl are internationally classified as unscheduled chemicals and legal to produce in China and export. Beijing argues that it cannot restrict the export of precursors that are not illegal.

The U.S. has repeatedly called on China to adopt a “know-your-customer” approach such as identifying and verifying customer identities to ensure that these chemicals are not sold to likely drug traffickers and to alert authorities about such buyers.

However, in an interview with Newsweek in September 2022, Qin Gang, the then-Chinese ambassador to the U.S., said that approach “goes far beyond the obligations of countries under the United Nations Convention on Drug Control.”
…

Britain’s medicines regulator has authorized the world’s first gene therapy treatment for sickle cell disease, in a move that could offer relief to thousands of people with the crippling disease in the U.K.

In a statement Thursday, the Medicines and Healthcare Regulatory Agency said it approved Casgevy, the first medicine licensed using the gene editing tool CRISPR, which won its makers a Nobel prize in 2020.

The agency approved the treatment for patients with sickle cell disease and thalassemia who are 12 years old and older. Casgevy is made by Vertex Pharmaceuticals (Europe) Ltd. and CRISPR Therapeutics. To date, bone marrow transplants, extremely arduous procedures that come with very unpleasant side effects, have been the only long-lasting treatment.

“The future of life-changing cures resides in CRISPR based (gene-editing) technology,” said Dr. Helen O’Neill of University College London.

“The use of the word ‘cure’ in relation to sickle cell disease or thalassemia has, up until now, been incompatible,” she said in a statement, calling the MHRA’s approval of gene therapy “a positive moment in history.”

Both sickle cell disease and thalassemia are caused by mistakes in the genes that carry hemoglobin, the protein in red blood cells that carry oxygen. 

In people with sickle cell — which is particularly common in people with African or Caribbean backgrounds — a genetic mutation causes the cells to become crescent-shaped, which can block blood flow and cause excruciating pain, organ damage, stroke and other problems.

In people with thalassemia, the genetic mutation can cause severe anemia. Patients typically require blood transfusions every few weeks, and injections and medicines for their entire life. Thalassemia predominantly affects people of South Asian, Southeast Asian and Middle Eastern heritage.

The new medicine, Casgevy, works by targeting the problematic gene in a patient’s bone marrow stem cells so that the body can make properly functioning hemoglobin.

Patients first receive a course of chemotherapy, before doctors take stem cells from the patient’s bone marrow and use genetic editing techniques in a laboratory to fix the gene. The cells are then infused back into the patient for a permanent treatment. Patients must be hospitalized at least twice — once for the collection of the stem cells and then to receive the altered cells.

“This is so exciting. It’s a new wave of treatments that we can utilize for patients with sickle cell disease,” said Dr. James LaBelle, director of the pediatric stem cell and cellular therapy program at the University of Chicago. He said Britain’s approval suggested the U.S. authorization was likely “imminent.”

Casgevy is currently being reviewed by the U.S. Food and Drug Administration; the agency is expected to make a decision early next month, before considering another sickle cell gene therapy.

LaBelle said officials at the University of Chicago are “already moving forward to build not only the clinical infrastructure but also the reimbursement infrastructure to get these patients this treatment.”

Britain’s regulator said its decision to authorize the gene therapy for sickle cell disease was based on a study done on 29 patients, of whom 28 reported having no severe pain problems for at least one year after being treated. In the study for thalassemia, 39 out of 42 patients who got the therapy did not need a red blood cell transfusion for at least a year afterwards.

Gene therapy treatments can cost millions of dollars and experts have previously raised concerns that they could remain out of reach for the people who would benefit most.

Last year, Britain approved a gene therapy for a fatal genetic disorder that had a list price of £2.8 million ($3.5 million). England’s National Health Service negotiated a significant confidential discount to make it available to eligible patients.

Vertex Pharmaceuticals said it had not yet established a price for the treatment in Britain and was working with health authorities “to secure reimbursement and access for eligible patients as quickly as possible.”

In the U.S., Vertex has not released a potential price for the therapy, but a report by the nonprofit Institute for Clinical and Economic Review said prices up to around $2 million would be cost-effective. By comparison, research earlier this year showed medical expenses for current sickle cell treatments, from birth to age 65, add up to about $1.6 million for women and $1.7 million for men.

Medicines and treatments in Britain must be recommended by a government watchdog before they are made freely available to patients in the national health care system.

Millions of people around the world, including about 100,000 in the U.S., have sickle cell disease. It occurs more often among people from places where malaria is or was common, like Africa and India, and is also more common in certain ethnic groups, such as people of African, Middle Eastern and Indian descent. Scientists believe being a carrier of the sickle cell trait helps protect against severe malaria.
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The U.S. flu season is under way, with at least seven states reporting high levels of illnesses and cases rising in other parts of the country, health officials say.

The Centers for Disease Control and Prevention posted new flu data Friday, showing very high activity last week in Louisiana, and high activity in Alabama, Florida, Georgia, Mississippi, New Mexico and South Carolina. It was also high in the District of Columbia and Puerto Rico, the U.S. territory where health officials declared an influenza epidemic earlier this month.

“We’re off to the races,” said Dr. William Schaffner, a Vanderbilt University infectious diseases expert.

Traditionally, the winter flu season ramps up in December or January. But it took off in October last year, and is making a November entrance this year.

Flu activity was moderate but rising in New York City, Arkansas, California, Maryland, New Jersey, North Carolina, Tennessee and Texas. And while flu activity has been high in Alaska for weeks, the state did not report data last week, so it wasn’t part of the latest count.

Tracking during flu season relies in part on reports of people with flu-like symptoms who go to doctor’s offices or hospitals; many people with the flu are not tested, so their infections aren’t lab-confirmed. COVID-19 and other respiratory viruses can sometimes muddy the picture.

Alicia Budd, who leads the CDC’s flu surveillance team, said several indicators are showing “continued increases” in flu.

There are different kinds of flu viruses, and the version that’s been spreading the most so far this year usually leads to a lesser amount of hospitalizations and deaths in the elderly — the group on whom flu tends to take the largest toll.

So far this fall, the CDC estimates at least 780,000 flu illnesses, at least 8,000 hospitalizations and at least 490 flu-related deaths — including at least one child.

Budd said that it’s not yet clear exactly how effective the current flu vaccines are, but the shots are well-matched to the flu strains that are showing up. In the U.S., about 35% of U.S. adults and 33% of children have been vaccinated against flu, current CDC data indicates. That’s down compared to last year in both categories.

Flu vaccination rates are better than rates for the other two main respiratory viruses — COVID-19 and RSV. About 14% of adults and 5% of children have gotten the currently recommended COVID-19 shot, and about 13.5% of adults 60 and older have gotten one of the RSV shots that became available earlier this year.
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In the Arctic, the impact of climate change is happening at an accelerated pace, with temperatures rising two to four times faster than the global average.

“It’s called the polar amplification,” explains Vladimir Romanovsky, a geophysicist at the University of Alaska in Fairbanks. “Snow and ice reflect lots of energy back to space when ice and snow are melting, and the surface turns much darker. So this amount of energy will be absorbed by the surface, and it will make the surface warmer – at the same time making the atmosphere warmer as well.”

Communities in circumpolar regions of Alaska are dealing with a triple challenge of climate change: coastal erosion, thawing of permafrost on which buildings and infrastructure stand, and, for some communities, the challenge of managing encounters with apex predators — polar bears pushed onshore.

“An optimal habitat for polar bears now is basically absent, it’s disappeared,” says Todd Atwood, a wildlife biologist with the United States Geological Survey. He has been studying polar bears for the past 12 years and says melting sea ice makes it harder for bears to hunt seals.

“That tends to be the trigger for bears to either stay with the sea ice as it retreats further over those deeper waters, or, for a growing proportion of the population to make the swim to shore.”

In addition to the high risk of succumbing to sea conditions on a long swim, bears trying to adapt to life on land face an additional risk as they search for new sources of food.

“They’re coming ashore in areas where people are active, whether it’s near communities where people are engaged in subsistence activities, or whether it’s in the oil and gas industrial footprint where people are working [outdoors] on a daily basis,” Atwood says. “And that raises the likelihood of human-bear interactions and conflict.”

In the Inupiat village of Kaktovik on Alaska’s North Slope, posters warn people to be on the lookout for polar bears.

Six hundred kilometers from the nearest big city, Kaktovik hosted visitors on polar bear tours before the COVID pandemic. Those restrictions are now lifted, but it’s contractors, not tourists, occupying the main hotel as they work to complete repairs to the local school and maintain infrastructure before the harsh winter weather and darkness set in.

Lee Kyoutak picks up visitors from the landing strip where small planes carrying a few passengers and supplies land when the island’s frequently foggy weather allows it. He says not to worry about hearing shots or firecrackers. “There’s a polar bear patrol patrolling the village,” he said. “If you go out, just make sure you look around when you go out because there’s polar bears hanging around.”

Kaktovik is one of six communities in North Alaska where residents receive special training provided by the North Slope Borough and the U.S. Fish and Wildlife Service to join Polar Bear Patrols that use non-lethal deterrents to haze bears who sneak into areas where people live or work.

In traditional indigenous communities such as Nuiqsut, Utqiagvik (Barrow), and Kaktovik where there is seasonal whale hunting, polar bears attracted to bowhead whale bones discarded outside the village keep those patrols especially busy. Some encounters between bears and humans can be lethal — for either side.

Inupiat wildlife guide Robert Thompson says he rarely walks around the village unarmed, especially at night.

“I had to shoot two bears that came after me,” he said. “I don’t want to do it, but when bears come after you, you got to defend yourself. One was four to five feet from my doorway, and another one tried to jump into the house though my bedroom window.”

Thompson came to Kaktovik more than 50 years ago. Back then, he says “ice was visible all summer. Pack ice, meaning ice that doesn’t melt. And so, recently, we had 700 miles of open water toward the North Pole. So that’s affecting the polar bears. With the ice around us melting, they are trying to swim ashore. The cubs don’t make it.”

Scientists have recorded polar bears swimming as far as 350 kilometers over several days. Even strong swimmers may not survive the challenge.

Research led by the U.S. Geological Survey shows that in the first decade of the 21st century, the number of polar bears in the southern Beaufort Sea dropped 40%.

“One of the things that we’re pretty confident of as a polar bear research community is that without sea ice, you’re not going to have polar bears,” Atwood said. “They represent a kind of the canary in the cryosphere in the sense that they are the animal that is probably most associated with the threat of climate change to wildlife persistence.”

The International Union for Conservation of Nature lists the polar bear as a vulnerable species most threatened by the loss of sea ice. With an estimated 26,000 bears remaining worldwide, the group says all but a few of those bears could be lost by the end of the century without action on climate change.
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After a barrage of earthquakes that herald an impending volcanic eruption, some evacuated residents of the Icelandic town of Grindavik wonder if they will ever return.

“There are going to be a lot of people who don’t want to go there. My mother said, ‘I never want to go there again,’” Eythor Reynisson, who was born and raised in Grindavik, told AFP.

The fishing port of 4,000 people on Iceland’s south coast was evacuated on November 11 after magma shifting under the Earth’s crust caused hundreds of earthquakes — a warning of a likely volcanic eruption.

Thousands of smaller tremors have shaken the region since.

With massive crevices ripping roads apart and buildings’ concrete foundations shattered, the once picturesque Grindavik now resembles a war zone.

The damage to the town hall will take months to repair.

Long-term threat

Even if the magma flow stops and no eruption occurs, “there is the issue of whether one should live in a town like this,” Freysteinn Sigmundsson, a geophysicist at the University of Iceland, told AFP.

The Reykjanes peninsula had not experienced an eruption for eight centuries until 2021.

Since then, three eruptions have struck — all in remote uninhabited areas — and volcanologists believe this may be the start of a new era of activity in the region.

Sigmundsson warned that “a difficult period of uncertainty” lies ahead, as eruptions could happen in the coming years.

That has left residents wondering whether it is worth rebuilding their homes.

Sigmundsson said that for the region to be deemed safe, the current activity would first need to cease.

“There is a possibility that the activity will move to another area. And then it could be acceptable to go back to Grindavik,” he said.

Strong community

Despite the conditions, a resilient community spirit was evident as residents this week queued to enter Grindavik to collect belongings they left in their hurried evacuation. 

Residents embraced each other and shared moments of laughter.

“I am really emotional. That’s basically how I am feeling right now,” Johannes Johannesson told AFP.

For some, living around volcanoes comes with the territory.

“We are a strong community, so I think it’s possible to build it up again,” Reynisson said.

Iceland is home to 33 active volcano systems, the highest number in Europe. Towns have been hit before.

In 1973, a fissure erupted just 150 meters (164 yards) from the town center on the island of Heimaey, surprising locals at dawn.

A third of the homes were destroyed, and the 5,300 residents were evacuated. One person died.

In Grindavik, steam fills the air from burst hot water pipes and the electricity grid struggles to keep operating at night because of the infrastructure damage.

Locals are now seeking accommodation in hotels, with friends and family, and at emergency shelters while they wait for life to return to normal.

Authorities have organized occasional trips into the port town, escorting those with homes in the most perilous parts to rescue everything from cherished pets to photo albums, furniture and clothing.

But the operations proceed with utmost caution. On Tuesday the village was quickly emptied as sulfur dioxide measurements indicated the magma was moving closer to the surface.

“There was panic,” Reynisson acknowledged.

Today or in a month

For almost a week, Iceland has been on tenterhooks, prepared for an eruption at any moment.

“There is still a flow of new magma into this crack, and it is widening,” Sigmundsson explained.

As long as there is an inflow of magma into the crack, the likelihood of an eruption remains high.

“We need to be prepared for an eruption happening today or within the coming week or even up to a month,” the researcher said.

The most likely place for an eruption “is from the town of Grindavik northwards,” Sigmundsson said.

For residents, this means an extended and anxiety-filled time over the weeks to come.

“Plans now are to try to manage — try to just get the family into a routine and keep on going,” Johannesson said. 
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