YCLOAK

Deeply loved but wracked by crisis, Britain’s National Health Service (NHS) on Wednesday marks 75 years since it was founded as the Western world’s first universal, free health care system.

In a secular age, the NHS is the closest thing Britain has to a national religion — devoutly cherished, with levels of public support higher than the royal family or any other British institution.

It was founded three years after World War II by a pioneering Labour government on the principle that everyone should access top-quality health care funded by general taxation, free at the point of care.

Prime Minister Rishi Sunak, whose parents were an NHS doctor and a pharmacist, paid tribute last week as he outlined a 15-year plan aimed at recruiting hundreds of thousands of new health staff.

“For every minute of every day of every one of those 75 years, the NHS has been kept going by the millions of people who’ve worked for it. To them on behalf of a grateful nation, I want to say: thank you,” he said.

“I feel a powerful sense of responsibility to make sure that their legacy endures. And to make sure the NHS is there for our children and grandchildren, just as it was there for us.”

Like Sunak’s parents, immigrant staff were pivotal to the NHS’s early growth, helping to remake the face of Britain itself in the decades after the war.

Its centrality to national life was underscored in a memorable dance sequence featuring NHS staff and patients during the opening of the London Olympics in 2012.

Justin Bieber remixed his hit “Holy” with an NHS choir for Christmas 2020, in a year when the public, clapping on their doorsteps, paid tribute to medics battling the Covid pandemic.

Sickly state

Sunak’s new workforce plan, however, is recognition that the NHS is under unprecedented strain following the pandemic, even though the government spends nearly 12% of its budget on healthcare — by far its single biggest item.

Demoralized doctors and nurses have been striking for better pay, an ageing and unfit population needs ever-more complex treatment, cancers go undiagnosed for lack of scanners, and hospitals are crumbling.

Sumi Manirajan, deputy chair of the British Medical Association’s junior doctors committee, accused Sunak’s Conservative government of failing to value doctors.

“And what that leads to is doctors leaving the country, going abroad, Australia, New Zealand, Canada, and actually it’s the public that loses out,” she told AFP at a protest rally by striking doctors.

“The government [ministers], they may use private health care but the ordinary citizen in the UK uses the NHS, relies on the NHS.”

In a report for the 75th anniversary, the King’s Fund charity compared the health systems of 19 similar countries and found Britain’s in a sickly state.

It cited data showing the UK performed worst in fatality rates for strokes and second worst for heart attacks.

The UK has a “strikingly low number of both nurses and doctors per person compared to its peers” and four times fewer hospital and intensive care beds than Germany, the report said.

But opinion polls show scant support in Britain for radical reform such as switching to a mixed model of funding, with patients paying via insurance for some of their treatment, as is the norm elsewhere.

Fully 93% of more than 3,000 respondents believe the NHS should remain free at the point of care, based on general taxation, according to the annual British Social Attitudes Survey last year.

But the authoritative survey also found a record 51% were dissatisfied with their quality of care, especially with waiting times for appointments to see general practitioners and hospital doctors.

Terminal decline?

Sunak has been resisting the medics’ pay demands as he battles to get soaring UK inflation under control, while insisting his government is investing “record sums” in the NHS.

But the service needs to be modernized via better use of digital technology including artificial intelligence, he said on Friday.

Sunak argued that his workforce plan would make the NHS fit “for decades to come.” But some on the front lines give a far gloomier prognosis.

“Right now, as a functional, universal public service, the NHS is failing,” geriatrics consultant David Oliver wrote in The BMJ, a medical journal.

He warned: “It may not quite be in end-of-life care, or about to have its financial or political life support removed, but without immediate action and longer-term thinking it won’t see its 85th birthday.”
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London’s expansion of a fiercely debated scheme that charges the most polluting vehicles in the city should be blocked, local authorities bringing a legal challenge over the plan argued on Tuesday.

The British capital’s Ultra Low Emission Zone (ULEZ) levies a $16 daily charge on drivers of non-compliant vehicles, in order to tackle pollution and improve air quality.

London Mayor Sadiq Khan last year decided to extend the scheme to cover almost all of the Greater London area, encompassing an extra five million people in leafier and less-connected outer boroughs, from the end of next month.

The decision has pitched Khan and health campaigners against those who say they cannot tolerate another economic hit at a time of soaring living costs.

Khan, who is running for a third four-year term in the 2024 London mayoral election, has said he is determined to face down his critics.

But his plan, which echoes hundreds of others in place in traffic-choked cities across Europe, came under challenge at London’s High Court on Tuesday as five local authorities argued the decision to expand ULEZ into their areas was unlawful.

London’s transport authority – Transport for London (TfL) – had launched a public consultation on the plan, which said 91% of vehicles driven in outer London would not be affected.

However, the local authorities’ lawyers argue that TfL provided no detail on how it calculated the 91% figure, which they say was fundamental to justifying the expansion.

The local authorities are also challenging Khan’s decision to not extend a 110 million pound scrappage scheme to those living just outside the expanded ULEZ. The scheme subsidises the cost of buying a replacement vehicle for those affected.

Lawyers representing Khan and TfL argued in court filings that TfL provided sufficient information for the consultation and said that extending the scrappage scheme beyond London was rejected in order to target those directly affected.
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Maternal deaths across the United States more than doubled over the course of two decades, and the tragedy unfolded unequally. 

Black mothers died at the nation’s highest rates, while the largest increases in deaths were found in American Indian and Native Alaskan mothers. Some states — and racial or ethnic groups within them – fared worse than others. 

The findings were laid out in a new study published Monday in the Journal of the American Medical Association. Researchers looked at maternal deaths between 1999 and 2019 — but not the pandemic spike — for every state and five racial and ethnic groups. 

“It’s a call to action to all of us to understand the root causes — to understand that some of it is about health care and access to health care, but a lot of it is about structural racism and the policies and procedures and things that we have in place that may keep people from being healthy,” said Dr. Allison Bryant, one of the study’s authors and a senior medical director for health equity at Mass General Brigham. 

Among wealthy nations, the U.S. has the highest rate of maternal mortality, which is defined as a death during pregnancy or up to a year afterward. Common causes include excessive bleeding, infection, heart disease, suicide and drug overdose. 

Bryant and her colleagues at Mass General Brigham and the Institute for Health Metrics and Evaluation at the University of Washington started with national vital statistics data on deaths and live births. They then used a modeling process to estimate maternal mortality out of every 100,000 live births. 

Overall, they found rampant, widening disparities. The study showed high rates of maternal mortality aren’t confined to the South but also extend to regions like the Midwest and states such as Wyoming and Montana, which had high rates for multiple racial and ethnic groups in 2019. 

Researchers also found dramatic jumps when they compared maternal mortality in the first decade of the study to the second and identified the five states with the largest increases between those decades. Those increases exceeded: 

— 162% for American Indian and Alaska Native mothers in Florida, Illinois, Kansas, Rhode Island and Wisconsin; 

— 135% for white mothers in Georgia, Indiana, Louisiana, Missouri and Tennessee; 

— 105% for Hispanic mothers in Georgia, Illinois, Indiana, Minnesota and Tennessee; 

— 93% for Black mothers in Arkansas, Georgia, Louisiana, New Jersey and Texas; 

— 83% for Asian and Pacific Islander mothers in Georgia, Illinois, Kansas, Michigan and Missouri. 

“I hate to say it, but I was not surprised by the findings. We’ve certainly seen enough anecdotal evidence in a single state or a group of states to suggest that maternal mortality is rising,” said Dr. Karen Joynt Maddox, a health services and policy researcher at Washington University School of Medicine in St. Louis who wasn’t involved in the study. “It’s certainly alarming, and just more evidence we have got to figure out what’s going on and try to find ways to do something about this.” 

Maddox pointed to how, compared with other wealthy nations, the U.S. underinvests in things like social services, primary care and mental health. She also said Missouri hasn’t funded public health adequately, and during the years of the study hadn’t expanded Medicaid. They’ve since expanded Medicaid — and lawmakers passed a bill giving new mothers a full year of Medicaid health coverage. Last week, Missouri Gov. Mike Parson signed budget bills that included $4.4 million for a maternal mortality prevention plan. 

In neighboring Arkansas, Black women are twice as likely to have pregnancy-associated deaths as white women, according to a 2021 state report. 

Dr. William Greenfield, the medical director for family health at the Arkansas Department of Health, said the disparity is significant and has “persisted over time,” and that it’s hard to pinpoint exactly why there was an increase in the state’s maternal mortality rate for Black mothers. 

Rates among Black women have long been the worst in the nation, and the problem affects people of all socioeconomic backgrounds. For example, U.S. Olympic champion sprinter Tori Bowie, 32, died from complications of childbirth in May. 

The pandemic likely exacerbated all of the demographic and geographic trends, Bryant said, and “that’s absolutely an area for future study.” According to preliminary federal data, maternal mortality fell in 2022 after rising to a six-decade high in 2021 — a spike experts attributed mainly to COVID-19. Officials said the final 2022 rate is on track to get close to the pre-pandemic level, which was still the highest in decades. 

Bryant said it’s crucial to understand more about these disparities to help focus on community-based solutions and understand what resources are needed to tackle the problem. 

Arkansas already is using telemedicine and is working on several other ways to increase access to care, said Greenfield, who is also a professor of obstetrics and gynecology at the University of Arkansas Medical Center in Little Rock and was not involved in the study. 

The state also has a “perinatal quality collaborative,” a network to help health care providers understand best practices for things like reducing cesarean sections, managing complications with hypertensive disorders, and curbing injuries or severe complications related to childbirth. 

“Most of the deaths we reviewed and other places have reviewed … were preventable,” Greenfield said. 
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The head of the United Nations called Monday for maritime nations to agree on a course for the shipping industry to reduce its climate-harming emissions to net zero by the middle of the century at the latest.

The appeal by U.N. Secretary-General Antonio Guterres came at the start of a meeting of the International Maritime Organization in London that’s seen as key for helping achieve the international goal of limiting global warming to 1.5 degrees Celsius (2.7 Fahrenheit).

“Shipping, which accounts for almost 3% of global emissions, will be vital,” Guterres said.

He urged delegates to agree a new greenhouse gas strategy for shipping that includes “ambitious science-based targets starting in 2030 – both on absolute emissions reductions and the use of clean fuels.”

The IMO’s current target is for the shipping industry to cut its emissions by at least half from 2008 to 2050.

Guterres said the new targets should include all greenhouse gas emissions caused by the industry and backed the idea of introducing a carbon price for shipping. Campaigners have suggested that funds generated from a levy on emissions could be used to help poor nations tackle climate change, though the industry wants the money to go toward the development of clean technologies.
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Doctors Without Borders said Sunday that there is a suspected outbreak of measles in an internal displacement camp in Sudan.

The international humanitarian organization said 13 children have died recently in the suspected outbreak at the camp in Sudan’s White Nile state.

“We are receiving sick children with suspected measles every day, most with complications,” the organization posted in a tweet.

A steady stream of people is coming to the camp as they flee the fighting between the country’s two warring factions.

Doctors Without Borders has two clinics in White Nile. The organization says it had over 3,000 patients in June and needs to “increase assistance, scale up services like vaccinations, nutritional support, shelter, water and sanitation.”
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The head of the U.N.’s Food and Agriculture Organization, Qu Dongyu, was re-elected Sunday for a second term as head of the U.N. agency.

He was the only candidate standing for the role of FAO director-general and received 168 out of 182 votes in a ballot in Rome on Sunday.

Qu, a former Chinese government minister who was nominated for the post by Beijing, will serve a new four-year term from August 1.

His appointment is seen as a part of a drive by Beijing to get more Chinese figures into senior jobs at international bodies.

Qu, a biologist by training, was vice-minister of agriculture before taking over as head of the U.N. agency in 2019.

FAO directors can hold the role for a maximum of two consecutive terms.

The vote came during the FAO Conference, which runs until July 7.
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Following an outbreak of anthrax disease in the West African nation of Ghana, Nigerian authorities have urged citizens to halt consumption of cooked animal hides, a delicacy also known as “pomo” in the country. Gibson Emeka has this story from Abuja, Nigeria, narrated by Salem Solomon.
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The only break much of America can hope for soon from eye-watering, dangerous smoke from fire-struck Canada would be brief bouts of shirt-soaking, sweltering heat and humidity from a deadly, Southern heat wave, forecasters say.

And then the smoke will likely return to the Midwest and East.

Here’s why: Neither the 235 out-of-control Canadian wildfires nor the weather pattern that’s responsible for this mess of meteorological maladies are showing signs of relenting for the next week or longer, according to meteorologists at the National Oceanic and Atmospheric Administration’s Weather Prediction Center.

First, the weather pattern made abnormally hot and dry conditions for Canada to burn at off-the-chart record levels. Then it created a setup where the only relief comes when low pressure systems roll through, which means areas on one side get smoky air from the north and the other gets sweltering air from the south.

Smoke or heat.

“Pick your poison,” said prediction center forecast operations chief Greg Carbin. “The conditions are not going to be very favorable.

“As long as those fires keep burning up there, that’s going to be a problem for us,” Carbin said. “As long as there’s something to burn, there will be smoke we have to deal with.”

Take St. Louis. The city had two days of unhealthy air Tuesday and Wednesday, but for Thursday “they’ll get an improvement of air quality with the very hot and humid heat,” said weather prediction center meteorologist Bryan Jackson. The forecast is for temperatures that feel like 42.8 degrees Celsius (109 degrees Fahrenheit) — with 38.3 degrees Celsius (101 degrees Fahrenheit) heat and stifling humidity.

On Wednesday, the low pressure system was parked over New England and because winds go counter-clockwise, areas to the west – such as Chicago and the Midwest – get smoky winds from the north, while areas east of the low pressure get southerly hot winds, Jackson said.

As that low pressure system moves on and another one travels over the central Great Plains and Lake Superior, the Midwest gets temporary relief, Jackson said. But when low pressure moves on, the smoke comes back.

“We have this, this carousel of air cruising around the Midwest, and every once in a while is bringing the smoke directly onto whatever city you live in,” said University of Chicago atmospheric scientist Liz Moyer. “And while the fires are ongoing, you can expect to see these periodic bad air days and the only relief is either when the fires go out or when the weather pattern dies.”

The weather pattern is “awfully unusual,” said NOAA’s Carbin who had to look back in records to 1980 to see anything even remotely similar. “What gets me is the persistence of this.”

Why is the weather pattern stuck? This seems to be happening more often — and some scientists suggest that human-caused climate change causes more situations where weather patterns stall. Moyer and Carbin said it’s too soon to tell if that’s the case.

But Carbin and Canadian fire scientist Mike Flannigan said there’s a clear climate signal in the Canadian fires. And they said those fires aren’t likely to die down anytime soon, with nothing in the forecast that looks likely to change.

Nearly every province in Canada has fires burning. A record 80,000 square kilometers (30,000 square miles) have burned, an area nearly as large as South Carolina, according to the Canadian government.

And fire season usually doesn’t really get going until July in Canada.

“It’s been a crazy, crazy year. It’s unusual to have the whole country on fire,” said Flannigan, a professor at Thompson Rivers University in British Columbia. “Usually, it’s regional … not the whole shebang at once.”

Hotter than normal and drier air made for ideal fire weather, Flannigan said. Warmer weather from climate change means the atmosphere sucks more moisture out of plants, making them more likely to catch fire, burn faster and hotter.

“Fires are all about extremes,” he said.

And where there’s fire, there’s smoke.

High heat and smoky conditions are stressors on the body and can present potential challenges to human health, said Ed Avol, a professor emeritus at the Keck School of Medicine at University of Southern California.

But Avol added that while the haze of wildfire smoke provides a visual cue to stay inside, there can be hidden dangers of breathing in harmful pollutants such as ozone even when the sky looks clear. He also noted there are air chemistry changes that can happen downwind of wildfire smoke, which may have additional and less well-understood impacts on the body.

It’s still only June. The seasonal forecast for the rest of the summer in Canada “is for hot and mostly dry” and that’s not good for dousing fires, Flannigan said. “It’s a crazy year and I’m not sure where it’s going to end.”
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Researchers say they are detecting a dramatic spike in ocean surface temperatures around the world — reaching as much as 5 degrees Celsius (9 degrees Fahrenheit) above normal in the North Atlantic — and they could rise even higher.

“It is very alarming, and as temperatures keep spiking, this is not unexpected,” said Kim Cobb, a climate scientist and professor of earth, environmental and planetary sciences at Brown University in Rhode Island.

As the oceans get warmer each year, scientists say they are triggering chaotic weather patterns around the world, including torrential downpours and intense heat waves that cause flooding and severe drought.

Climate scientists attribute much of the warming to so-called greenhouse gases and say that to prevent the most severe consequences, the use of fossil fuels must be cut in half by 2030.

The most recent increase has caused the most extreme ocean heat wave in the British Isles in 170 years, according to the Met Office, the United Kingdom’s national weather service.

“This is an off-the-charts heat wave in the oceans,” said John Abraham, a climate change scientist at the University of St. Thomas in Minnesota. “The temperatures we are seeing this year are a remarkable excursion from normal temperatures.”

Oceans, which cover 70% of the Earth, have a huge impact on weather.

“When the air blows over the oceans, the air warms up and gets more humid and that drives storms,” Abraham told VOA.

“The water vapor amplifies warming by trapping outgoing radiation from escaping and that feeds the storms,” noted Kevin Trenberth, a global warming expert and a scholar at the National Center for Atmospheric Research. “So, there is a huge magnifying effect.”

A study in the journal Earth System Science Data published in April warns that oceans are heating-up more rapidly than previously thought, creating a greater risk for extreme weather, rising sea levels, and the loss of marine ecosystems.

Even a small increase in ocean temperature can have other profound effects, which include coral bleaching and more intense hurricanes.

“There is also the loss of ice, the disintegration of the Antarctic and Greenland ice sheets that are contributing to sea level rise earlier than we expected it to,” said Michael Mann, professor of environmental science at Pennsylvania State University.

There are many places in the world that will be warmer than usual this year, Abraham said.

“In South America, we expect both coasts to be warmer than average and the Caribbean and Central American regions to be both warm and dry. In large parts of Southeast Asia, we should expect drier conditions in the upcoming months.”

Adding to the already crucial situation, an El Niño has formed that is likely to bring extreme weather patterns later this year. An El Niño refers to a warming of the ocean surface in the central and eastern Pacific Ocean. Scientists say the phenomenon is not caused by global warming but may be exacerbated by it.

“It causes unprecedented but strong dry spells in many places, and droughts that may promote wildfires, such as those we’re seeing in Canada, and torrential rains in other places in the world,” said Trenberth.

“The temperatures will spike higher every time there is an El Niño,” said Abraham. “What we’re seeing now is a foretelling of our future unless we reduce our greenhouse emissions.”

“In a warmer world, we’re in for a very bumpy ride that includes extreme rainfall, mudslides, wildfires, drought and failed crop yields,” said Cobb of Brown University.

Mann said greenhouse gases need to be significantly reduced soon or the environmental consequences will become even worse.

“We need governments to provide incentives to move the energy and transportation industries away from fossil fuels and towards renewable energy,” he said.
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Need Plan B? Tap your credit card and enter B6. 

Since last November, a library at the University of Washington has featured a different kind of vending machine, one that’s become more popular on campuses around the country since the U.S. Supreme Court ended constitutional protections for abortion last year. It’s stocked with ibuprofen, pregnancy tests and the morning-after pill. 

With some states enacting abortion bans and others enshrining protections and expanding access to birth control, the machines are part of a push on college campuses to ensure emergency contraceptives are cheap, discreet and widely available. 

There are now 39 universities in 17 states with emergency contraceptive vending machines, and at least 20 more considering them, according to the American Society for Emergency Contraception. Some, such as the University of Tulsa in Oklahoma, are in states where abortion is largely banned. 

Over-the-counter purchase of Plan B and generic forms is legal in all 50 states. 

The 2022 ruling overturning Roe v. Wade “is putting people’s lives at stake, so it makes pregnancy prevention all the more urgent,” said Kelly Cleland, the ASEC’s executive director. “If you live in a state where you cannot get an abortion and you can’t get an abortion anywhere near you, the stakes are so much higher than they’ve ever been before.” 

Washington this year became first U.S. state to set aside money — $200,000 to fund $10,000 grants that colleges can obtain next year through an application process — to expand access to emergency contraceptives at public universities and technical colleges through the automatic dispensers. 

The University of Washington’s machine was installed after a student-led campaign. It offers boxes of generic Plan B for $12.60, about a quarter of what the name-brand versions sell for in stores, and more than 640 have been sold. 

The drug is even cheaper in some machines than it is in UW’s, as low as $7 per box. That’s because it is sold at just above wholesale cost, compared with pharmacy retail prices that might go up to $50. 

In Illinois and New York, lawmakers are developing legislation that would require at least one vending machine selling emergency contraceptives on state college campuses. 

In Connecticut, Yale had to drop plans to install an emergency contraceptive vending machine in 2019 after learning it would violate state law. 

But this year the state approved a measure allowing Plan B and other over-the-counter medications to be sold from vending machines on campuses and other locations. 

The machines can’t be placed in K-12 schools or exposed to the elements, and they must have temperature and humidity controls and include plans for power outages and expired items. 

“This just enables people to have better access and easier access,” said Rep. Nicole Klarides-Ditria, one of several Republicans in Connecticut’s Democratic-controlled General Assembly who supported the measure. “You may need Plan B, as we all know, in the middle of the night, and you won’t have access to a pharmacy until the morning.” 

Although the morning-after pill has been approved by the Food and Drug Administration for over-the-counter sale, many stores and pharmacies keep it behind the counter or locked up, require identification for purchase and make the experience of purchasing it intimidating. 

“There is a stigma associated with getting access to these medications,” said Zoe Amaris, a University of Washington pharmacy student and board member of UW Pharmacists for Reproductive Education and Sexual Health. “Having a vending machine is so easy. You don’t need to go to a pharmacy. You don’t need to go through your health care provider.” 

Plan B is more effective the sooner it is taken, and vending machine access could be particularly crucial for victims of rape when pharmacies are closed. The anonymity the machines afford may also be important to some assault victims. 
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WASHINGTON – Long time, no speak: NASA has re-established contact with the intrepid Ingenuity Mars Helicopter after more than two months of radio silence, the space agency said Friday. 

The mini rotorcraft, which hitched a ride to the Red Planet with the Perseverance rover in early 2021, has survived well beyond its initial 30-day mission to prove the feasibility of its technology in five test flights. 

Since then, it has been deployed dozens of times, acting as an aerial scout to assist its wheeled companion in searching for signs of ancient microbial life from billions of years ago, when Mars was much wetter and warmer than today.  

Ingenuity’s 52nd flight launched on April 26, but mission controllers at NASA’s Jet Propulsion Laboratory (JPL) in California lost contact as it descended to the surface following its two minute, 1,191-foot (363-meter) hop. 

The loss of communications was expected, because a hill stood between Ingenuity and Perseverance, which acts as a relay between the drone and Earth.  

Nonetheless, “this has been the longest we’ve gone without hearing from Ingenuity so far in the mission,” Joshua Anderson, Ingenuity team lead at JPL, told AFP. 

“Ingenuity is designed to take care of itself when communication gaps like this occur, but we all still had a sense of relief finally hearing back.” 

Data so far indicate that the helicopter is in good shape. If further health checks also come back normal, Ingenuity will be all set for its next flight, westward toward a rocky outcrop the Perseverance team is interested in exploring.  

It’s not the first time Ingenuity has experienced downed communications. The helicopter was scouring an ancient river delta when it went missing for around six days in April, “an agonizingly long time,” chief engineer Travis Brown wrote in a blog post.
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