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The World Health Organization warns that more than 40 percent of smokers globally die from lung diseases, such as cancer, chronic respiratory diseases and tuberculosis. The warning comes ahead of World No Tobacco Day this Friday, with the theme being, “Don’t let tobacco take your breath away.”

The World Health Organization says that every year, tobacco use kills at least eight million people. The U.N. agency reports 3.3 million users will die from lung-related diseases. This number includes people exposed to second-hand smoke, among them more than 60,000 children under age five who die of lower respiratory infections due to passive smoking.

Vinayak Prasad, the acting director of the WHO’s Department for the Prevention of Noncommunicable Diseases, says the global economic cost of using tobacco is $1.4 trillion. This is due to health expenditures, loss of productivity from illness and other expenses resulting from smoking-related diseases. He says both lives and money could be saved if people stopped smoking.

“What we see also is that if people who are smoking, almost 20 percent of the world is smoking, if they quit, some of the benefits actually come very quickly, especially the lung diseases. Within two weeks, the lung functions actually start to become normal,” he said.

The World Health Organization reports that globally, the prevalence of smoking has gone down from 27 percent in 2000 to 20 percent in 2016. But the WHO, notes that the number of tobacco users worldwide has remained stable at 1.1 billion because of population growth.

Kerstin Schotte, WHO technical officer in the same department as Prasad, notes a steeper decline in the prevalence of smoking in wealthier countries, compared to poorer ones.

“And, some low-and-middle income countries even have increasing smoking prevalence rates. This is where the tobacco industry is going at the moment,” she said. “They know a little bit that it is a lost cause in Europe and North America, so they are going into the low-and-middle-income countries, targeting especially women and children there.”

The World Health Organization recommends a number of effective, low-cost measures countries can adopt to reduce tobacco consumption.

These include the creation of smoke-free environments, imposing a ban on all forms of tobacco advertising, promotion and sponsorship. WHO also suggests putting a high tax on the sale of cigarettes and other tobacco products to make them unaffordable for many, especially young people.

 

 

 
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The World Health Organization says success in ending the Ebola epidemic in eastern Democratic Republic of Congo hinges upon improving security in North Kivu and Ituri provinces. The region has been engulfed in conflict for many years, and many locals do not trust outsiders, even the ones trying to stop the spread of the deadly virus.

The U.N. health agency reports security incidents in eastern DRC have increased dramatically in the past few months. So far this year, it reports 174 attacks by armed groups in North Kivu on health care facilities, workers and patients. These include five deaths and 51 injuries.

In mid-April, Cameroonian Dr. Richard Mouzoko was shot and killed while working in a hospital in Butembo, North Kivu. This incident was seen as a big setback to the Ebola operation.

This past Saturday, villagers killed a health worker in the health sector of Mabalako.

WHO Regional Director for Africa, Matshidiso Moeti, says health workers are being intimidated and threatened by armed men and live in fear, not knowing when the next violent attack may occur.

She says this insecurity is leading to a lack of access and driving the increase in cases.

“When the response cannot reach people,” she said, “they do not get the chance to be vaccinated or to receive life-saving treatment if they do fall ill.

“The technical means to stop this Ebola outbreak are available,” she added. “But without access or a secure operating environment, they cannot be deployed optimally and effectively enough. …This is why the response is one of the most complex health emergencies the world has faced.”

The latest WHO figures show 1,920 Ebola cases in the region, including 1,281 deaths. A new structure for coordinating and strengthening the Ebola response was presented at the World Health Assembly this week.

WHO Executive Director of Health Emergencies Michael Ryan says key partners will have to scale up their operations and take charge of crucial aspects of the new strategy.

“We believe the work on security, the work on non-humanitarian interventions and the work on sustainable financing are the things that need to happen to provide the environment in which public health operations can continue to progress and be successful,” he said.

However, he warns if there are further large-scale security incidents than all bets are off. He says the likely impact of this ongoing instability will have on the Ebola emergency operation is unpredictable, but worrisome.
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Roberta Boltz keeps her doors unlocked at night. The former coal mine worker says it is just one perk of living in the small Pennsylvania town of Hegins.

But last Christmas morning, she had her first epileptic seizure, and her only worry about rural life took center stage: access to health care. There is no hospital in her community of 812 residents, and she says she does not trust the one closest to her.

“I’ve heard people say they wouldn’t send their dog to that hospital,” Boltz said. “They’re so understaffed.”

Seated upright in a platinum nightgown, with gauze covering her thin forehead, Boltz recently made the one-hour commute to Danville, Pennsylvania’s, eight-story, 559-bed Geisinger Medical Center to receive care, as she has done during several critical life moments. Geisinger treated her son’s Crohn’s disease when he was a child, and more recently, after her husband suffered a heart attack. 

Located beside a 300-acre forest, Danville is not much more urban than Hegins. With a population of 4,631, it could not by itself support a hospital this size that serves all of central Pennsylvania and has grappled with its own issue of filling medical staff positions.

Geisinger has tried to solve its own staffing problem by hiring immigrants from Jamaica, India, the Philippines, South Korea, Kenya, Cameroon, Nigeria, Ghana and others — many of whom have come to live in a borough (town) that is 94% white. 

In interviews with VOA, Geisinger staff referred to the nursing shortage crisis as one of its biggest supply-and-demand challenges. Despite being the region’s “employer of choice,” they say local talent recruitment alone has fallen short of their needs.

Big shortage

The entire United States faces a massive shortage of health care professionals over the next decade, including up to 120,000 physicians by 2030. One-third of currently active doctors in the country will reach retirement age during that span.

Unless the health care workforce gap is addressed, rural areas are likely to bear the brunt of its effects, says Andrew Lim, director of quantitative research at New American Economy, a bipartisan research organization.

“If you look at urban areas, there are over 200 doctors per 100,000 people. But if you look at rural counties, the number of doctors to go around is much less — something like 82 for every 100,000,” Lim told VOA.

The population of Danville more than doubles when Geisinger — with its 6,200 employees — is fully staffed. Among the workers: 415 internationally trained physicians and 57 foreign-born registered nurses.

“Not only is Geisinger trying to recruit (international nurses), many other health systems are,” Julene Campion, vice president of human resources at Geisinger, told VOA. “We could probably use another 100 easily (across the Geisinger network), but there aren’t enough available.”

“We’ve outgrown our ability to supply,” added Crystal Muthler, Geisinger’s vice president of nursing — a 30-year veteran. 

The community’s needs, combined with an aging workforce, she says, are ultimately what led Geisinger to reevaluate its staffing model and implement an international nurse initiative in 2018.

“We have to look at how we attract people to the area,” Muthler said. 

According to U.S. Bureau of Labor statistics, health care is projected to be the largest-growing sector of new job creation over the next decade, accounting for more than 1.3 million new jobs, roughly one-third of them for registered nurses.

But for those looking to find opportunity in the United States, while helping fill a critical shortage, obstacles remain.

Doctors have been impacted by the Trump administration’s travel ban, while some health aides and nursing assistants could be barred from getting a green card.

It is unclear whether Trump’s new immigration plan, announced on May 16, will help health care staffing. The merit-based system would favor immigrants who fall into broad “high-skill” categories, including “professional and specialized vocations,” at the cost of family-based and humanitarian immigrant visas.

‘Kindness is my language’

Even now, foreign-born health care professionals represent more than their share of the overall U.S. population; 14.7% of nurses and 22.7% of health aides are immigrants, according to NAE, compared to 13.7% of the population as a whole.

Thirty-five-year-old Hemoy Drummond, a recent Geisinger hire from Jamaica, has an EB-3 employment-based immigrant visa. She has 13 years of experience as a registered nurse.

“I was very nervous. It was a new setting, new expectations,” Drummond said. “But when I got here, I realized that people are kind. … I said, ‘That’s my language.'”

Danville, with its lush hillsides and nearby cornfields, reminds her of the sugar cane fields her father harvested in her native Clarkstown, Jamaica. Her community is safe. The mother of two can walk home alone after a late shift.

The nursing work is easier in Danville than in a short-staffed Montego Bay hospital.

“It’s easier to care for four to six (patients at Geisinger) than 18 (in Jamaica),” Drummond said. “I love to talk with (patients) that extra minute.”

Willing to stay

In town, locals generally welcome — or at least tolerate — their new international neighbors. 

“They’re magnificent!” remarked one woman on Danville’s Mill Street. “We’d be stupid not to let them into our country.”

Two hours southeast of Danville, along the Susquehanna River in Chambersburg, Pennsylvania, views are more mixed. A foreign-born doctor described Chambersburg as “where blue meets red.” 

Yet Chambersburg Hospital, too, has been trying to solve its health care staffing problems with immigrants.

In Chambersburg, population 20,878, VOA spoke with 10 foreign-born doctors from India, Pakistan, Bangladesh, Nigeria, Poland and Hungary. Nine of them expressed a willingness to remain in rural Pennsylvania long term, including Indian physicians affected by a per-country green card backlog that has placed their families’ future in limbo. 

​U.S.-born physicians do not want to go to Chambersburg, much less stay, explained Dr. Golam Mostofa, chairman of the department of hospital medicine at Chambersburg Hospital.

“Fifty percent of our hospital medicine physicians are foreign graduates,” Mostofa said. “If we interview 10 American graduates, maybe one shows up.”

Dr. Muhammad Khokhar, a gastroenterologist from Lahore, Pakistan, has been in Chambersburg for 16 years. He remains committed to the town, even after his sixth grade daughter’s classmates at a Montessori school accused her of making bombs.

“(When) you have invested so much in the community, and you have built up relationships with your partners and the practice, it’s difficult,” Khokhar said. 

“I’m here,” he added. “This is my retirement place.”

 

 
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A civil lawsuit brought by the state of Oklahoma against drugmaker Johnson & Johnson went to trial Tuesday over the company’s alleged role in the U.S. opioid epidemic. 

The first-of-its-kind trial, which holds opioid manufacturers responsible for the drug crisis gripping the country, could have a large impact on other states seeking similar compensation.

In opening statements, Oklahoma Attorney General Mike Hunter called the prescription opioid epidemic the “worst man-made public health crisis in the history of our state and country.”

Hunter further characterized Johnson & Johnson as being motivated by greed and having been engaged in “a cynical, deceitful multimillion-dollar brainwashing campaign.”

Drugmakers named in the lawsuit denied claims made by the state, which is located in the U.S. Great Plains. Two of those companies settled with the state before the trial began.

In an opening statement, Larry Ottaway, a Johnson & Johnson defense lawyer, told the court that Janssen Pharmaceuticals, a subsidiary of Johnson & Johnson, advertised its drugs in compliance with a Food and Drug Administration consensus that said opioids “only rarely caused addiction.”

The state of Oklahoma alleges Johnson & Johnson created a surplus of painkillers and is responsible for creating a “public nuisance.”

“If you have an oversupply, people will die,” said Brad Beckworth, a private attorney hired by the state of Oklahoma. In explaining some of the numbers behind the crisis, he told the court there were 135 opioid pills available for every adult in Cleveland County, which has a population of about 280,000. Cleveland County is where the trial is being held.

County District Judge Thad Balkman will decide the case, in lieu of a jury.

On Sunday, Israel-based Teva Pharmaceuticals Ltd. reached an $85 million settlement with the state. Teva said in a statement, “The settlement does not establish any wrongdoing on the part of the company. Teva has not contributed to the abuse of opioids in Oklahoma in any way.”

In March, Purdue Pharma, the maker of OxyContin, settled with the state for $270 million.

Other lawsuits

Nationwide, states, cities and tribal governments have brought more than 1,600 lawsuits against drugmakers, seeking compensation for money spent addressing the opioid epidemic.

According to the National Institute on Drug Abuse, there were 388 overdose deaths involving opioids in Oklahoma in 2017, a rate of 10.2 deaths per 100,000 persons. The national rate was 14.6 deaths per 100,000 persons.

In his opening statement, Attorney General Hunter said opioid overdoses had killed 4,653 people in the state from 2007 to 2017.

According to the U.S. Centers for Disease Control and Prevention, drug overdose deaths involving prescription opioids rose from 3,442 in 1999 to 17,029 in 2017, the latest year for such data. Drug overdose deaths involving any opioid — prescription opioids (including methadone), synthetic opioids and heroin — rose from 18,515 deaths in 2007 to 47,600 deaths in 2017, according to the CDC.
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A joint rapid response team of experts from the United States and the U.N. World Health Organization arrived in Pakistan Tuesday to support the response to the country’s “biggest” outbreak of HIV infections in a southern district where more than 700 people, mostly children, have been diagnosed over the past month.

Nearly 22,000 individuals have been subjected to blood screening since the outbreak was first reported in Larkana on April 25. The district, with an estimated population of 1.5 million, is located in Sindh province and it has previously also experienced repeated, though limited, outbreaks of the virus, which causes AIDS.

The major testing program is ongoing and local officials say hundreds of people line up everyday outside screening camps to get tested voluntarily after watching news on television about the HIV epidemic in their area.

“More than 80% of those infected are children less than 15 years old,” said Dr. Maria Elena G. Filio-Borromeo, UNAIDS’ country director for Pakistan and Afghanistan. She spoke to VOA from the Pakistani province where her agency is leading the coordination and facilitation of support from U.N. agencies to help local partners effectively respond to the crisis.

Borromeo noted that more than half the children affected are under the age of 5. “This poses a particular challenge. It is likely that they got the virus through unclean needles and syringes, or through unsafe blood transfusion,” she said.

The UNAIDS country chief would not, however, speculate on exactly what might have caused the HIV outbreak. “It is a very different profile of outbreak, so a thorough investigation is needed,” Borromeo emphasized.

She said that the 11-member visiting team of experts from WHO and U.S. Centers for Disease Control and Prevention (CDC) landed in the provincial capital of Karachi.

Borromeo added the team is visiting the country at the request of the Pakistani government and they would work closely with local partners to carry out the investigation for up to three weeks to ascertain the source of the outbreak and controlling it.

After the outbreak investigation, she stressed, a “huge amount” of work is expected ensuring that the root cause of the outbreak will be addressed, and future outbreaks will be prevented.

“In most cases, parents of the infected children have been tested negative for HIV, which is a rare and extremely worrisome finding,” according to Zafar Mirza, who is the advisor on health to the federal government.

Mirza said that used syringes being repackaged and sold in Pakistan, contaminated blood transfusion as well as a “faulty” infection prevention and control system in hospitals could be the factors behind the outbreak in Larkana.

“Either unsafe injections are spreading the virus in children or there is another reason that we have been unable to determine so far,” the Pakistani advisor explained.

He said he was hopeful the international rapid response team would be able to ascertain the reasons, noting the ongoing efforts to control and investigate the underlying causes of the HIV outbreak in Larkana were not sufficient.

Critics say the outbreak demonstrated “public health failure” particularly in Sindh, though the health sector elsewhere in Pakistan also faces critical challenges stemming from a lack of funding and priority.

Pakistani and U.N. officials do not rule out the possibility that the HIV outbreak is the outcome of shady medical practices in private as well as public hospitals.

Out of an estimated 600,000 unqualified doctors unlawfully practicing in Pakistan, 270,000 of them are working in Sindh, according to UNAIDS.

Mirza cautioned that reported cases of HIV/AIDS in Pakistan are far less than the actual magnitude of the problem. He says that official estimates put the number of HIV/AIDS carriers in the country at around 163,000.

“But only 25,000 of them are registered with our national and provincial HIV/AIDS treatment centers, and out of them, merely 16,000 visit the programs routinely to receive their medicine,” the advisor noted.

 
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The idea of pumping excess carbon emissions underground has been around for a while. As the process gets cheaper and more practical scientists are testing new ways to lock away their greenhouse gases. VOA’s Kevin Enochs reports.
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Overfishing in Senegal is crippling a once-prodigious artisanal industry long relied on to help feed the West African nation’s population. Moreover, this crisis is happening at a time when climate change is reducing the amount of food grown on land. To learn more, VOA’s Salwa Jaafari met with traditional fishermen outside the capital, Dakar.
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A fluffy pink fungus that decorates itself with gold nanoparticles has been found in Western Australia. Researchers believe the fungus is an indicator of gold deposits and hope the discovery will help miners narrow down where to dig.

Scientists in Australia have found a fungus that can bond with gold particles. It releases a chemical called superoxide that can dissolve gold in the soil. It is then able to mix this dissolved metal with another chemical to turn it back into solid gold, in the form of tiny nanoparticles.

So why does this gold-loving fungus have an attraction to this precious metal? The research team believes by interacting with gold in this way it can grow faster and bigger relative to other fungi that do not.

The research has been carried out by Australia’s national science agency.

The Commonwealth Scientific and Industrial Research Organization, the CSIRO, believes the discovery could be a new way to mine gold. The fungi could be markers that indicate the presence of gold, and narrow down the area where exploratory drilling would be most beneficial.

The study’s author is Dr. Tsing Bohu, a CSIRO geo-microbiologist.

“I think this is probably very novel because gold is very inert generally speaking but we found actually this fungus can interact with gold by dissolving gold. So I think it is very novel and it is also very important for mining and other industrial [processes] like leaching, so [it] has some potential applications,” he said.

The fungus was found in soil at Boddington, 130 kilometers south-east of Perth in Western Australia.

The research has been published in the journal Nature Communications.

Australia is the world’s second-largest producer of gold, but its output is expected to fall unless more deposits are discovered.

In recent weeks, two Australians have stumbled upon large gold nuggets worth tens of thousands of dollars in Western Australia and the state of Victoria.

 

 

 
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New discoveries about what is inside the body are making scientists rethink what makes a person human and what makes people sick or healthy.

Less than half of the cells in the body are human. The rest belong to microorganisms that affect the health, mood and whether certain people respond better to certain medications.

“So to our 30 trillion human cells, we have on average about 39 trillion microbial cells. So by that measure, we’re only about 43% human,” said Rob Knight, director of the University of California San Diego Center for Microbiome Innovation and professor of pediatrics and computer science and engineering.

Microbes affecting health

It is common knowledge that bacteria, or even viruses and fungi, exist in areas of our body, including the mouth, skin and gut. However, it is only in recent years that scientists have discovered that each person’s gut bacteria is unique, and the collection of microbes can greatly impact a person’s health — such as their weight and whether they will develop ailments such as heart disease.

Microbes in the gut can even affect mood. Researchers are studying whether conditions such as autism, multiple sclerosis and Parkinson’s disease are linked to microbes.

“They changed the way we think about biology, and changed the way we think about what it means to be human,” Knight said.

The collection of microbes in each person is different, starting from when babies are born. How they enter the world, whether vaginally or through cesarean section (C-section), whether they drink breast milk or not, the animals they are exposed to and the medications they take, can all impact their development.

“The biggest problem with antibiotics is early in childhood, and especially the combination of C-section and antibiotics and bottle feeding is especially bad for kids. We’ll see impacts on that even at age 8 to 12, in terms of their weight, even in terms of the cognitive performance,” Knight said.

The cancer puzzle

Karen Sfanos, associate professor of pathology, oncology and urology at the Johns Hopkins University School of Medicine, said researchers think at least 70% of a human body’s immunity and immune cells exist in the gut.

She is studying the link between microbes and cancer.

“There’s still many cancers out there where we have no idea what even causes the cancer. We’ve been trying to solve this puzzle, and up until this point, half the pieces were missing because we didn’t even know half the pieces existed. There’s just a tremendous amount of knowledge that’s to be gained and to be researched to understand the profound influence that these microbes might have on both cancer initiation but also therapeutic response to certain cancer therapies,” she said.

What affects microbes in an adult body most is diet and how many different types of plants a person eats.

“By eating a high-fat diet or an unhealthy diet, (it) can lead to pro-inflammatory microbes. It can cause inflammation in the gut, in your GI tract, and, unfortunately, in that scenario, the inflammation that happens in your gut can have a really long-distance effect on many other organ systems in your body,” Sfanos said.

One company, DayTwo, is using the findings of gut microbe research to fight diabetes.

“The diversity and abundance of the bacteria in the gut are a very useful predictor in how people process food,” said Josh Stevens, president of DayTwo.

Since each person’s gut bacteria is different, how a body reacts to sugar is also different for each person.

“So by profiling the gut, we can actually help people get to a personalized prescription for food that works for them,” Stevens said.

Distinguishing the good from the bad

Microbes in the body are changing every day. A growing number of scientists are researching these microbes to learn which ones are good and bad. They are seeing promising results in treating a hospital-acquired infection called C. diff.

“You can treat C. diff by taking a stool from a healthy person and giving it to a sick person. And they typically recover in two or three days. And it has about (a) 90% cure rate, as opposed to 30% for antibiotics,” Knight said. This process is done by mixing a fecal sample from a healthy person into a liquid preparation and introducing it to a sick person via a feeding tube or colonoscopy.

Researchers are working toward a future where there is a more precise approach to weeding out the bad bacteria and introducing more good microbes into the body to improve health.
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