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Pakistan is registering approximately 20,000 new HIV infections annually, the highest rate of increase among all countries in the region, warns the World Health Organization (WHO).

The international body says mortality among Pakistanis living with the virus, which causes the deadly AIDS disease, is also rising, in spite of the availability of lifesaving antiretroviral therapy.

The latest government figures show that only 16 percent of the estimated 150,000 people living with HIV had been tested and only 9 percent have access to lifesaving treatment.

“The remaining 135,000 people are walking around in the communities as carriers of (HIV) infection who are ready to transmit infections to those who are not infected, even to their unborn babies,” Dr. Saima Paracha of the National AIDS Control Program, told VOA.

Officials say the HIV epidemic in Pakistan remains largely concentrated among the key populations, including people who inject drugs, the transgender community, sex workers and their clients and men who have sex with men.

“The drivers of infection are now the sexual networks and they are ready to spill the infection into the general public,” Dr. Paracha cautioned.

Paracha says the Pakistani government offers free HIV testing and treatment, but she notes the marginalized key populations continue face widespread stigma and discrimination in the society.

The fear of maltreatment, and punitive actions by law enforcers impacts the willingness of these populations to pursue testing, which remains a major challenge facing national efforts to treat and prevent the spread of HIV, she lamented.

Official estimates show that Pakistan has seen a 45 percent increase in new HIV infections since 2010.

“The number of new HIV infections will continue to increase dramatically if implementation rates of intervention remain at current levels,” said Dr. Nima Saeed Abid, country head of WHO.

An official statement issued in connection with World AIDS Day quoted him as saying that Pakistan has the lowest rate of all regional countries in diagnosing people who are infected and linking them to care and treatment.

Naila Bashir, who heads the HIV treatment center at Islamabad’s Pakistan Institute of Medical Sciences (PIMS), told VOA the facility receives up to 40 new HIV patients every month, underscoring the alarming increase in the number of infections.

The center was established in 2005 and the number of patients has since increased from 22 to more than 3,000, including men, women and children of all ages, said Dr. Bashir.

HIV has never been a priority program in the national health system and the recent abolition of the federal health ministry and the devolution of its functions to the provinces, which lacked preparedness and capacity, have led to the increase in infections, say WHO experts in the country. However, they acknowledge the new government of Prime Minister Imran Khan is giving priority to tackling health emergencies in Pakistan, including HIV.

Federal Minister for National Health Services Regulation and Coordination, Aamir Mehmood Kiyani, says the government is working on a strategy to remove barriers and challenges in protecting people from HIV infections.

Kiyani told a seminar in Islamabad that since taking office three months ago, the government has moved to established 12 new HIV treatment centers while overall 33 such facilities have been working throughout Pakistan.

U.N. officials say the Pakistan government urgently needs to redouble efforts to “de-stigmatize HIV testing, advocate for confidential, non-discriminatory, community based care models and raise awareness about disease transmission, prevention treatment” to achieve reductions in new infections in affected populations.
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Negotiators from around the world began two weeks of talks on curbing climate change Sunday, three years after sealing a landmark deal in Paris that set a goal of keeping global warming well below 2 degrees Celsius (3.6 degrees Fahrenheit).

Envoys from almost 200 nations gathered in Poland’s southern city of Katowice, a day earlier than originally planned, for the U.N. meeting that’s scheduled to run until Dec. 14.

Ministers and some heads of government are joining in Monday, when host Poland will push for a joint declaration to ensure a “just transition” for fossil fuel industries like coal producers who are facing closures as part of efforts to reduce greenhouse gas emissions.

The meeting received a boost over the weekend, after 19 major economies at the G-20 summit affirmed their commitment to the 2015 Paris climate accord. The only holdout was the United States, which announced under President Donald Trump that it is withdrawing from the climate pact.

“Despite geopolitical instability, the climate consensus is proving highly resilient,” said Christiana Figueres, a former head of the U.N. climate office.

“It is sad that the federal administration of the United States, a country that is increasingly feeling the full force of climate impacts, continues to refuse to listen to the objective voice of science when it comes to climate change,” Figures said.

She cited a recent expert report warning of the consequences of letting average global temperatures rise beyond 1.5 degrees C (2.7 degrees F).

“The rest of the G-20 have not only understood the science, they are taking actions to both prevent the major impacts and strengthen their economies,” said Figueres, who now works with Mission 2020, a group that campaigns to reduce greenhouse gas emissions.

The meeting in Katowice is regarded as a key test of countries’ willingness to back their lofty but distant goals with concrete measures, some of which are already drawing fierce protests . At the top of the agenda is the so-called Paris rulebook , which will determine how governments record and report their greenhouse emissions and efforts to cut them.

Separately, negotiators will discuss ramping up countries’ national emissions targets after 2020, and financial support for poor nations that are struggling to adapt to climate change.

The shift away from fossil fuels, which scientists say has to happen by 2050, is expected to require a major overhaul of world economies.

“The good news is that we do know a lot of what we need to be able to do to get there,” said David Waskow of the World Resources Institute.

Waskow, who has followed climate talks for years, said despite the Trump administration’s refusal to back this global effort the momentum is going in the right direction.

“It’s not one or two players anymore in the international arena,” he said. “It’s what I think you could call a distributed leadership, where you have a number of countries — some of them small or medium-sized — really making headway and doing it in tandem with cities and states and businesses.”

Later Sunday, protests were planned by environmental activists calling for an end to coal mining in Poland, which gets some 80 percent of its energy from coal. Katowice is at the heart of Poland’s coal mining region of Silesia and there are still several active mines in and around the city.

On Saturday, thousands of people marched in Berlin and Cologne to demand that Germany speed up its exit from coal-fired power plants.
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The World Bank has announced it is doubling its funding to help poor nations adjust to global warming to $200 billion over five years.

“If we don’t reduce emissions and build adaption now, we’ll have 100 million more people living in poverty by 2030,” the bank’s climate change chief John Roome told the French News Agency.

“And we also know that the less we address this issue proactively in just three regions – Africa, South Asia, and Latin America – we’ll have 133 million climate migrants, Roone cautioned.”

Helping poorer nations adapt to a warmer environment and the weather extremes that come with it include building sturdier homes, finding new sources of fresh water, and what the bank calls “climate smart agriculture.”

The bank’s announcement comes as delegates from 200 countries started a two week-long climate change conference in Katowice, Poland.

The threat posed by global warming “has never been worse,” U.N. climate chief Patricia Espinosa said Sunday.

The threat posed by global warming “has never been worse,” U.N. climate chief Patricia Espinosa said at the start of climate talks in Poland.

“This year is likely to be one of the four hottest years on record. Climate change impacts have never been worse. This reality is telling us that we need to much more,” she said Sunday.

Negotiators from nearly 200 nations are in the southern Polish city of Katowice for two weeks of talks on implementing the landmark 2015 Paris Accord. Signatories to that agreement pledged to cut greenhouse gas emissions and limit the rise in global temperatures to less than two degrees Celsius by 2030.

“Looking from the outside perspective, it’s an impossible task,” Poland’s Deputy Environment Minister Michal Kurtyka told the Associated Press last week.

“The United Nations secretary-general is counting on all of us to deliver. There is no ‘Plan B'”

The climate change talks got a boost when 19 of 20 G-20 nations meeting in Buenos Aires reaffirmed their commitment to fighting climate change.

The United States was the only holdout. President Donald Trump has threatened to pull the U.S. out of the Paris agreement because of what he says is the economic damage the treaty’s provisions would cause.

Trump is a promoter of fossil fuels and nuclear power and has proposed renegotiating the Paris Accord – an idea many dismiss as impractical.

Host country Poland is expected to propose what it calls a “just transition” for the oil, gas, and coal industries to ease the financial blow from the move away from such polluting sources of energy.

Negotiators are also expected to put forth plans to help developing nations adapt to a warming climate.

 
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Teacher Rishi Rawat has one student who is not human, but a machine.

Lessons take place at a lab inside the University of Southern California’s (USC) Clinical Science Center in Los Angeles, where Rawat teaches artificial intelligence, or AI.

To help the machine learn, Rawat feeds the computer samples of cancer cells.

“They’re like a computer brain, and you can put the data into them and they will learn the patterns and the pattern recognition that’s important to making decisions,” he explained.

AI may soon be a useful tool in health care and allow doctors to understand biology and diagnose disease in ways that were never humanly possible.

​Doctors not going away

“Machines are not going to take the place of doctors. Computers will not treat patients, but they will help make certain decisions and look for things that the human brain can’t recognize these patterns by itself,” said David Agus, USC’s professor of medicine and biomedical engineering, director at the Lawrence J. Ellison Institute for Transformative Medicine, and director at the university’s Center for Applied Molecular Medicine.

Rawat is part of a team of interdisciplinary scientists at USC who are researching how AI and machine learning can identify complex patterns in cells and more accurately identify specific types of breast cancer tumors.

Once a confirmed cancerous tumor is removed, doctors still have to treat the patient to reduce the risk of recurrence. The type of treatment depends on the type of cancer and whether the tumor is driven by estrogen. Currently, pathologists would take a thin piece of tissue, put it on a slide, and stain with color to better see the cells.

“What the pathologist has to do is to count what percentage of the cells are brown and what percentage are not,” said Dan Ruderman, a physicist who is also assistant professor of research medicine at USC.

The process could take days or even longer. Scientists say artificial intelligence can do something better than just count cells. Through machine learning, it can recognize complicated patterns on how the cells are arranged, with the hope, in the near future of making a quick and more reliable diagnosis that is free of human error.

“Are they disordered? Are they in a regular spacing? What’s going on exactly with the arrangement of the cells in the tissue,” described Ruderman of the types of patterns a machine can detect.

“We could do this instantaneously for almost no cost in the developing world,” Agus said.

​Computing power improves

Scientists say the time is ripe for the marriage between computer science and cancer research.

“All of a sudden, we have the computing power to really do it in real time. We have the ability of scanning a slide to high enough resolution so that the computer can see every little feature of the cancer. So it’s a convergence of technology. We couldn’t have done this, we didn’t have the computing power to do this several years ago,” Agus said.

Data is key to having a machine effectively do its job in medicine.

“Once you start to pool together tens and hundreds of thousands of patients and that data, you can actually [have] remarkable new insight, and so AI and machine learning is allowing that. It’s enabling us to go to the next level in medicine and really take that art to new heights,” Agus said.

Back at the lab, Rawat is not only feeding the computer more cell samples, he also designs and writes code to ensure that the algorithm has the ability to learn features unique to cancer cells.

The research now is on breast cancer, but doctors predict artificial intelligence will eventually make a difference in all forms of cancer and beyond.
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With the help of artificial intelligence and machine learning, doctors may soon have new ways of diagnosing and treating patients in ways that were never humanly possible. Scientists at the University of Southern California in Los Angeles are developing a way of using machine learning to identify specific types of breast cancer tumors, and they say it’s just the beginning of what the computer can do. VOA’s Elizabeth Lee has the details from Los Angeles.
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There’s been a lot of progress in the fight against AIDS over the past 30 years, but as the 30th World AIDS Day is observed on Dec. 1 — people still die from the disease. And others are newly infected every day even though the tools are available to end the epidemic.

Fear, stigma and ignorance. The World Health Organization says these are the reasons the AIDS epidemic is not over because doctors can treat HIV, the virus that causes AIDS. 

With treatment, no one needs to die from AIDS, and those with the virus can’t give it to someone else. In addition, with prevention therapy, no one needs to get infected.  

Dr. Jared Baeten, an HIV specialist at the University of Washington, spoke to us via Skype and says even with these tools we’re not there yet.

“… because the ability to deliver those at the scale and with the coverage needed to be able to get HIV to go away is not nearly where it should be,” said Baeten. 

Nearly a million people still die every year from AIDS. Professor Steffani Strathdee at the University of California San Diego says one of the biggest challenges is that HIV often affects people on the fringes of some societies around the world.  

“There are populations all over the world that are underserved and these include injection drug users and sex workers, in particular,” Strathdee said.

It also includes men who have sex with men, transgender people, prisoners and the sexual partners of these people. Professor Strathdee says people who are hungry or need shelter are more concerned about their immediate needs than they are about HIV.

“My research and research in this field really shows you have to address the whole person and their needs in order to address HIV as one of their health concerns,” Strathdee said.

Strathdee says unless this happens, countries will have to bear the heavy social and economic costs of AIDS.

In addition, Baeten says testing and treatment have to be available to everyone.    

“The biggest thing that we’ve learned for preventing HIV in the last decades is that there is no magic bullet, but when you put a whole bunch of really good things together and it has exactly the kind of impact that a magic bullet can give you,” Beaten said 

Scientists say using these tools, educating people and getting more people into treatment will reduce stigma, and then, when a vaccine comes along, we can finally put an end to AIDS.
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Tremendous progress has been made in efforts to wipe out polio around the world. Before a global eradication program began 30 years ago, about 350,000 children became paralyzed from polio each year. The figure dropped to 28 in 2018. 

Nevertheless, Helen Rees, chair of the World Health Organization’s emergency committee, said Friday that polio remained an international threat. She said every available health strategy must be used to prevent the wild polio virus from spreading across borders. 

“The fear is that we might well see a resurgence, that we could see exportation again and a reversal of all of the work and all of the country global efforts that have gone into trying to eradicate polio,” Rees said. “And we certainly cannot allow that to happen.” 

Polio remains endemic in Afghanistan, Pakistan and Nigeria. Rees said that over the last few months, there has been a worrying exportation of the wild polio virus to and from Pakistan and Afghanistan. 

“We have got widespread, positive environmental sampling in Pakistan,” she said. “And in Afghanistan, because of the more difficult situation there in terms of security, we are unable to access probably as many as a million children for vaccination.”  

Separately, there is good news from the African region. The director of WHO’s polio eradication program, Michel Zaffran, noted that the wild polio virus has not been seen in Nigeria since it was last detected more than two years ago. 

If this keeps up, he said, the regional certification commission could be able to declare the wild polio virus eradicated from the African region at the end of 2019 or early 2020. He said $4.2 billion would be needed over the next five years to see the last of this disease. 

Polio, which has no cure, invades the nervous system and can cause irreversible paralysis within hours. The WHO says polio is transmitted from one person to another through the fecal-oral route, or less frequently by a common vehicle like contaminated food and water. Fever, fatigue, headache, vomiting, stiffness in the neck and limb pain are among polio’s symptoms. 
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Ahead of World AIDS Day, Uganda is recruiting women to participate in a trial of an injectable antiretroviral drug to replace Truvada, a daily pill that has low adherence by users. The trial will assess if the new drug – Cabotegravir – can further reduce the risk of acquiring HIV. Halima Athumani has more from Kampala.
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Former New York Mayor Michael Bloomberg’s charity has announced a $50 million donation to help fight the nation’s opioid epidemic.

Bloomberg Philanthropies said over the next three years it will help up to 10 states address the causes of opioid addiction and strengthen prevention and treatment programs. Its initiative involves a partnership with the Centers for Disease Control and Prevention, The Pew Charitable Trusts, Johns Hopkins University and Vital Strategies.

Bloomberg, who has been considering a 2020 Democratic presidential bid, was expected to discuss the funding Friday during his keynote address at The Bloomberg American Health Summit in Washington. A spokeswoman said there was “no stated link” between his political aspirations and the $50 million investment to fight opioids.

Bloomberg’s charity said CDC data shows there were more than 70,000 U.S. drug overdose deaths last year, including more than 47,000 from opioids, the highest numbers on record. It said those numbers are a leading factor in the decline of U.S. life expectancy over the past three years.

Bloomberg called the sobering numbers part of “a national crisis.”

“For the first time since World War I, life expectancy in the U.S. has declined over the past three years — and opioids are a big reason why,” he said. “We cannot sit by and allow this alarming trend to continue — not when so many Americans are being killed in what should be the prime of their lives.”

He said in a statement he hoped his charity’s work in Pennsylvania, one of the states hardest hit by the opioids crisis, would lay the groundwork “for more effective action across the country.”

The partnership focuses on identifying new approaches to tackle opioids and plugging gaps in current treatment and prevention programs. Staff members from partner organizations will support state and local programs to reduce opioid-related deaths, and successful initiatives and guidelines will be replicated elsewhere, with the goal of creating a model for the rest of the nation.

Pennsylvania Governor Tom Wolf said he was “deeply grateful” for the financial and technical resources his state will receive through the partnership with Bloomberg Philanthropies.

“From our first responders and health care professionals to teachers and social service providers, heroes across our commonwealth are saving lives and protecting residents in our communities every day from this awful scourge,” Wolf, a Democrat, said in a statement issued by the Bloomberg charity. “We are doing everything we can to help them, and I am confident that this partnership will mark a turning point in our efforts.”

The Drug Enforcement Administration said this month in its National Drug Threat Assessment that heroin, fentanyl and other opioids continue to be the highest drug threat in the nation.

Bloomberg, who has been an independent, a Republican and a Democrat, declared lifetime allegiance to the Democratic Party and outlined an aggressive timeline for deciding whether to run for president in an interview with The Associated Press this month. He has regularly criticized President Donald Trump and spent a fortune to help elect Democrats in the midterm elections.
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Top administration officials are debating whether to create a stand-alone Space Force to handle space defense or a Space Force that falls within the Air Force, officials tell VOA.

Either option requires congressional approval, which could prove difficult with a Democratic-led House and a Republican-led Senate.

An Oct. 26 memo obtained by VOA directs that the Department of Defense create the “optimal organizational construct to meet (the president’s) intent.” 

The memo, signed by Executive Secretary of the National Space Council Scott Pace and National Security Council official Earl Matthews, instructs the Pentagon to focus on whether the Space Force is most efficient as a new independent department or as “a separate service within the Department of the Air Force, along the lines of the U.S. Marine Corps within the Department of the Navy or the U.S. Coast Guard within the Department of Homeland Security.”

Support in the House

This latter organizational structure has bipartisan support in the House, but the former has often been seen by Democrats as an expensive solution. 

Vice President Mike Pence and Deputy Secretary of Defense Patrick Shanahan met Thursday to discuss how to build the first new military branch since 1947, as President Donald Trump has directed. 

A National Space Council official told VOA Thursday the October memo does not represent a shift in White House guidance. 

“The direction to create the U.S. Space Force remains exactly the same, and the Space Council is continuing to work with the departments and agencies responsible for implementing the president’s direction to develop the sixth branch of the Armed Forces,” the official said.

Space Command next?

Officials say the president also intends to establish a U.S. Space Command, a move already directed by Congress.

The U.S. military is organized into 10 combatant commands based on either geography, such as Indo-Pacific Command and European Command, or unified functions, such a Transportation Command and Cyber Command.

This new, 11th combatant command would oversee space defense much like U.S. Cyber Command oversees cyber defense. Space Command is expected to start in mid-2019 with initial operation capability.

Officials familiar with Space Force deliberations have raised concerns to VOA that a new military branch could duplicate the work of the new combatant command. They say a separate military service may not be needed once the combatant command is fully operational. 

“You don’t see a Cyber Force in addition to Cyber Command,” one official said on condition of anonymity.

Cost estimates for the Space Command have been modeled after the creation of U.S. Strategic Command, which was set up in the early 1990s. The biggest expense will be the creation of a new headquarters for the combatant command in order to make room for providing new capabilities, according to one official.
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Three tiny rocks brought back from the moon in 1970 by the unmanned Soviet Luna-16 mission sold for $855,000 on Thursday at a New York auction. 

They’re the only documented lunar rocks in private hands, Sotheby’s auction house said. The U.S. collector who bought the rocks was not named. 

The sellers, also from the U.S., bought the rocks for $442,500 at a Sotheby’s Russian space history sale in 1993. That was the first time that a piece of a celestial body had been offered for sale to the public.

The rocks originally had been given to the widow of Sergei Pavlovich Korolev, the former director of the Soviet Union’s space program, by the Soviet government in recognition of her husband’s work.

It is extremely rare for authentic lunar samples to come on the market. All samples collected by American astronauts are deemed the property of the U.S. government — except one.

Last year, a bag used by Apollo 11 astronaut Neil Armstrong to collect moon dust was sold by Sotheby’s for $1.8 million, netting a hefty profit for its owner. 

A Chicago-area woman, Nancy Carlson, bought the bag, which had been misidentified, at an online government auction for $995. After she sent it to NASA for identification, the space agency confirmed that it had been used by Armstrong and still contained moon dust. 

NASA fought to keep the bag but lost a court fight in 2016. 
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