平特五不中

96 Global Health NOW: Measles鈥� Enduring Grip in the DRC; Persistent Threats to Pakistan鈥檚 Vaccination Efforts; and a We Are What Diverts Us DRC parents find themselves powerless to protect their children from measles. December 19, 2024 Measles鈥� Enduring Grip in the DRC 
In the DRC, many parents worry about their children contracting measles鈥攂ut find themselves powerless to protect them, with vaccines and treatment options all too often out of reach. 

Relentless threat: 311,000+ cases and 6,000 deaths were reported in the DRC last year. This year, ~97,000 cases have been logged; but the disease has become more lethal, killing 2,100+. 

• For ~4.5 million malnourished Congolese children, measles can be even more dangerous.

And vaccine coverage is low: Only 52% of children in the DRC are vaccinated, with as little as 13% coverage in some remote regions. 

Key obstacles: Logistics and infrastructure. Vaccines are difficult to distribute in the DRC due to the country鈥檚 vast size, poor roads, and unreliable refrigeration. 

Future solutions: Rapid diagnostic tests and vaccine patches may improve prevention efforts in the future.

Bigger picture: Measles cases globally rose by 20% in 2023, reaching 10.3 million cases and 107,000+ deaths, according to .

GLOBAL HEALTH VOICES EDITOR鈥橲 NOTE See You Next Year! 
This is the last GHN of 2024.

Thanks to all our readers who support our work in so many ways鈥攆rom opening the newsletter each morning to reading our exclusive reporting, sending tips and feedback, and contributing to our crowdfunding campaign. We appreciate you! 

We鈥檒l be back on Monday, January 6, with more news! 鈥� Annalies The Latest One-Liners
A viral illness dubbed "Dinga Dinga" is affecting women and girls in Uganda's Bundibugyo district; there have been reports of ~300 cases of the mysterious illness, which causes shaking, fever, and weakness. 

Microplastics in the air could be linked to colon and lung cancer, and may be contributing to infertility, finds a of published research in Environmental Science & Technology.

U.S. life expectancy has risen closer to pre-pandemic levels as deaths from COVID-19 and drug overdoses decline, per new from the CDC; life expectancy increased ~1 year to 78.4 years in 2023.

A state of emergency for bird flu has been by California Governor Gavin Newsom, as 300+ herds in the state have tested positive for the virus in the last 30 days alone; meanwhile, the first severe case of human bird flu has been reported in Louisiana. GHN鈥檚 BEST OF 2024: STAFF PICKS A man takes rest from selling water bottles on a hot afternoon near India Gate in Delhi. Cheena Kapoor Jackie's Picks
I鈥檓 a contributing editor with GHN, reviewing stories and summaries in the morning production process to include in the newsletter. I wrote some of the very first summaries for GHN way back in 2014. What a difference ten years鈥攁nd 50,000+ subscribers鈥攎akes! 鈥�Jackie Powder, contributing editor
Best GHN Exclusive India roasted in spring and summer as record-breaking temperatures soared to 126掳F, forcing impoverished residents into heat poverty. Independent journalist Cheena Kapoor describes a Delhi family of five who took on debt to buy an air conditioner so the children wouldn鈥檛 miss school because of heat-related sicknesses. Meanwhile, outside, air conditioners expelled hot air, exacerbating the 鈥渦rban heat island鈥� effect in Delhi, which is dominated by concrete, steel, and asphalt. 
Best News Article ProPublica reporters Annie Waldman, Maya Miller, Duaa Eldeib, and Max Blau interviewed more than 500 therapists to explore an aspect of the U.S. mental health crisis: therapists opting out of health insurance networks in droves. The providers described insurers urging them to reduce treatment for high-risk鈥攁nd more costly鈥攑atients, and withholding reimbursements. The result is a severe shortage of therapists who accept insurance and a lack of access to care for people with mental illness鈥攅ven if they are insured. 
Best Commentary POLIO Persistent Threats to Pakistan鈥檚 Vaccination Efforts
The bombing attack in northwest Pakistan that killed three police officers assigned to protect polio vaccine workers was just the latest in a long history of violence seeking to undermine the country鈥檚 vaccination efforts, . 

• The bombing came a day after gunmen opened fire on police escorting polio workers in the city of Karak, killing one police officer and injuring a health worker.

The violence has escalated as Pakistan launches its final nationwide polio vaccination campaign for 2024 in an effort to reach ~45 million children. 

Adding to obstacles: Health officials have postponed the vaccination drive in the country鈥檚 southwest Balochistan province after health workers there boycotted participation to oppose hospital privatization, .

Ongoing hostility: 200+ polio workers and police assigned to protect them have been killed since the 1990s, as militants claim the campaigns are a Western conspiracy.

• Other subversion tactics include falsifying vaccination records, explained WHO epidemiologist Zubair Mufti Wadood in a . 

Bigger picture: Pakistan has reported 63 polio cases this year. It and neighboring Afghanistan remain the only two countries where polio has not been eradicated. GLOBAL HEALTH VOICES HEALTH SYSTEMS Sierra Leone鈥檚 Surgical Advance  
People who need surgery in Sierra Leone, which has one of the world鈥檚 least developed health care systems, often must seek treatment abroad, with NGOs helping to cover costs.
 
But now, a new state-of-the art hospital has opened in Freetown, with support from Japan, offering surgical procedures and specialty care.

• The hospital is also training local medical personnel. 鈥淓very operation that takes place is another chance to train and maintain surgical knowledge within Sierra Leone,鈥� writes Jody Ray.

An ongoing challenge: The country still has only one pediatric surgeon and fewer than 10 anesthesiologists鈥攆or a population of 8.6 million. 
 
ALMOST FRIDAY DIVERSION Norbert, the beloved cat of GHN staffer Morgan Coulson, representing his species well.  Driven to Distraction 
Some say you are what you eat, but at GHN, we are what diverts us.
 
Weekly diversions are perhaps the clearest lens onto what makes us click, other than global health news. And after an audit of the year, it鈥檚 clear: We can鈥檛 resist an animal story.
 
So much so that at one point, it was suggested that we鈥攇asp!鈥攑ut a moratorium on cat content. Norbert (pictured) has thoughts. Readers: What do you all think?
 
Our animal instinct led us to:

• A prize-winning bear 鈥溾�濃�攁nd also robbing cars.

• This champion poodle styled as a came to much acclaim (鈥減erfection!鈥�)鈥攁nd this dog that had his record-breaking age (We blame the owners.)

• Moo Deng (duh) and the nemesis that came for her crown.

• Our favorite cat-egory: Felines. We learned about the , were horrified by , and had FOMO on a parade that tore through Minneapolis .

QUICK HITS Europe says flu, RSV on the rise and affecting health systems 鈥�

Syphilis microbe circulated in the Americas thousands of years before European contact 鈥�

Unified approach could improve nature, climate and health all at once 鈥� Thanks for the tip, Cecilia Meisner!

Cheap, smart and efficient: how giant rats are transforming the fight against TB 鈥� Issue No. 2833
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on and follow us on Instagram and X .

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  Copyright 2024 Johns Hopkins Bloomberg School of Public Health. All Rights Reserved. Views and opinions expressed in Global Health NOW do not necessarily reflect those of the Johns Hopkins Bloomberg School of Public Health or Johns Hopkins University.


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96 Global Health NOW: 鈥楳ystery Disease鈥� Solved鈥擝ut More Help Needed; Optum Takes Aim at ABA; and Dearth of Care for Gazans with Disabilities December 18, 2024 A mother holds her child while sitting on a bed at the Tudikolela hospital, on the outskirts of Mbuji-Mayi, in the Democratic Republic of Congo, on May 1, 2021. Arsene Mpiana/AFP via Getty 鈥楳ystery Disease鈥� Solved鈥擝ut More Help Needed 
An alarming illness circulating in a remote area of the DRC has been confirmed to be an acute form of malaria, exacerbated by malnutrition, .

• ~600 people have been sickened in the outbreak, and 143 have died鈥攎ostly children under 5. 

Background: The outbreak, which began in late October in the remote Panzi health zone of Kwango province, sparked widespread concern because of the illness鈥檚 flu-like symptoms.

• Difficult terrain and communication problems further hampered efforts to manage the outbreak.

The impact of malnutrition: ~40% of the population in the region is malnourished, 鈥攚hich health officials say contributed to the 6.2% case fatality rate.

What鈥檚 next: WHO-provided antimalarial drugs and health kits are being distributed throughout the region. New malaria vaccines have been rolled out in some African countries, but they have not reached the Panzi region, . 

Big picture: Malaria still kills ~600,000 people a year globally鈥攁nd 12% of those deaths occur in the DRC, where it is a leading cause of death. GLOBAL HEALTH VOICES EDITOR鈥橲 NOTE Small Contributions Make a Big Difference    While big-ticket donations are always welcome, it is our readers鈥� strength in numbers that has gotten us where we are today. Thank you to all of you who have donated so far! 

Your donations have powered GHN鈥檚 Local Reporting Initiative. Knowing that stories are better told by people who know their communities, we鈥檝e published dozens of articles by journalists around the world who鈥檝e illuminated topics including tiger attacks in the Sundarbans, barriers to health care for Amsterdam鈥檚 sex workers, and climate change鈥檚 threat to Pakistan鈥檚 transgender community.  

We鈥檙e excited to bring you more unique global health stories like these鈥攂ut we need your help to do it. . 

Thank you for joining us! 鈥�Morgan The Latest One-Liners   The notorious 2020 paper that popularized hydroxychloroquine as a COVID-19 treatment due to ethical concerns and methodological problems; the move follows years of campaigning by scientists who said the study contained major flaws.

As U.S. pertussis cases surge 6X from last year, public knowledge of the contagious disease remains low, finds a new from the Annenberg Public Policy Center of the University of Pennsylvania.

Long-term exposure to air pollution can lead to increased risks of hospitalization for mental health conditions as well as physical ailments, per from the University of St Andrews published in BMJ Open.

Most U.S. teens are not drinking, smoking tobacco, or using marijuana, per the annual Monitoring the Future of 24,000 students released yesterday; it is the largest proportion abstaining from those substances since the survey started in 2017. GHN鈥檚 BEST OF 2024: STAFF PICKS Eliud Wekesa speaks to visitors at his home and church compound in Tongaren, Bungoma County, Kenya, on February 29. Dominic Kirui Annalies鈥� Picks
Since starting as a freelancer in 2017 to becoming GHN鈥檚 associate editor鈥攚ith two children in between鈥攖ime with GHN has flown by. I鈥檓 up at dawn most Thursdays serving as GHN鈥檚 lead editor鈥攁 gigantic mug of English breakfast tea in one hand, the other scrolling for the top global health stories so our readers don鈥檛 have to. When I鈥檓 not doing that, I am researching GHN stories on everything from to . And most weeks, I get to cross over to the light side, bringing you our weekly diversions and, hopefully, a smile! 鈥�Annalies Winny, GHN associate editor
Best GHN Exclusive Eliud Wekesa is just one of many religious and cult leaders across Kenya blamed for encouraging followers to shun medicine, undermining health efforts. Journalist Dominic Kirui shows how health officials are involving religious leaders in government health strategies to help dispel these messages. Wekesa has publicly modeled acceptance of medical care, participating in a mass drug administration campaign to combat bilharzia and intestinal parasitic worms.
Best News Article Reporters Nick Thieme, Alissa Zhu, and Jessica Gallagher unveiled a tragic trend among Black men born from 1951 to 1970: The group makes up 7% of Baltimore鈥檚 population, but accounts for ~30% of drug fatalities. It鈥檚 a generation whose lives have been 鈥渟haped by forces that have animated the city鈥檚 drug crisis for decades.鈥�
Best Commentary HEALTH SYSTEMS Optum Takes Aim at ABA
Leaked internal documents reveal that Optum, a UnitedHealth subsidiary, is aggressively targeting applied behavior analysis (ABA) therapy鈥攚hich the company acknowledges is the 鈥渆vidence-based gold standard treatment for those with medically necessary needs鈥濃�攖o cut costs.

• Optum is scrutinizing providers who exceed certain cost thresholds, questioning the necessity of treatments, and denying coverage even for medically recommended ABA.

The approach violates autism treatment guidelines and the federal mental health parity law, which mandates equal access to mental health and physical care, autism advocates told ProPublica. 

• Inadequate early intervention may result in more severe challenges and long-term harm for children with autism, ultimately costing insurers more. 

Thanks for the tip, Chiara Jaffe! CONFLICT Dearth of Care for Gazans with Disabilities
Thousands of people in Gaza are facing devastating disabilities, with few resources or care to navigate their new reality.

• 106,000+ people have been injured since the war began, and ~25% of those injured require long-term rehabilitation, per the WHO.

But rehabilitation services are scarce. Gaza鈥檚 fragile health system is overwhelmed, and shortages of wheelchairs, prostheses, and essential medications make even basic rehabilitation nearly impossible. 

Psychological scars: Those injured are also coping with trauma, an inability to work, and societal rejection.

DROWNING Who is Most at Risk? 
The global drowning death rate has dropped 38% since 2000鈥斺�渁 significant health achievement,鈥� per the on drowning prevention.

• 300,000+ people drowned in 2021, and 7.2 million+ may die due to drowning by 2050.


• People under age 29 account for nearly half of all drowning deaths; a quarter involve children under 5鈥攁nd 9 in 10 drowning deaths take place in LMICs.

Recommendations: Installing barriers, teaching water safety and rescue skills, and improving regulations around boating and flood risks. 
 


Related: How to prevent drowning: a ground-breaking report that's startling yet hopeful 鈥� QUICK HITS 鈥業 want help鈥�: Behind bars, pleas for addiction medications often go nowhere 鈥�

Tracing fentanyl鈥檚 path into the US starts at this port. It doesn鈥檛 end there. 鈥�

Cheap, smart and efficient: how giant rats are transforming the fight against TB 鈥�

Health workers think COVID, flu vaccines safe and effective, but many remain hesitant, global survey shows 鈥�

'Cancer ghosting' can be more painful than treatment, survivors say 鈥�

Why cats are the new pigs 鈥� and could spark the next pandemic 鈥�

鈥楽illy and pompous鈥�: Official new names for viruses rile up researchers 鈥� Issue No. 2832
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on and follow us on Instagram and X .

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  Copyright 2024 Johns Hopkins Bloomberg School of Public Health. All Rights Reserved. Views and opinions expressed in Global Health NOW do not necessarily reflect those of the Johns Hopkins Bloomberg School of Public Health or Johns Hopkins University.


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96 Global Health NOW: Silence Ends for Syrian Victims; Michelle Morse: Protecting 8 Million New Yorkers' Health; and Screening for Pakistan鈥檚 Miners December 17, 2024 A Syrian child receives first aid after a chlorine gas attack on the town Hamuriya, outside Damascus, Syria, March 7, 2018. Anas Alkharboutli/picture alliance via Getty For Syrian Chlorine Victims, the Silence Ends  
In 2018, the Syrian air force dropped two yellow cylinders on the town of Douma, releasing a deadly chlorine gas that suffocated at least 43 people to death, reports.
 
鈥� 鈥�Their bodies turned to black, their clothes went green and were burnt, they crumbled and stuck to their bodies,鈥� reports survivor Abdulhadi Sariel. 鈥淲e threw out all of our clothes but [you can still see the effect] on the curtains.

• Syrian police later warned survivors to tell international investigators that smoke and dust inhalation, not chemicals, caused the deaths.

鈥淏ut I always kept the curtains [as evidence] for this moment,鈥� Sariel says. And now, just over a week after the fall of Syria鈥檚 former government, Syrians are finally free to talk.
 
鈥楧ire Conditions鈥� for Syria鈥檚 Displaced: 100,000+ people have been displaced from northern Aleppo to areas in northeast Syria, a region already facing an 鈥渁cute and longstanding鈥� humanitarian crisis. Many face wintry conditions without shelter, water, and basic health care, . 
 
Related: Former Syrian prisoners detail horrific conditions 鈥� GLOBAL HEALTH VOICES The Latest One-Liners   The vaccination gap is widening for children in England, per a that shows waning uptake of five key childhood vaccines among low-income children, leaving children in the poorest areas 20X more vulnerable to measles.
 
More than one-third of the world鈥檚 countries fail to monitor air quality, per an Open AQ assessment that found significant gaps in government tracking and sharing of air quality data, particularly for low- and middle-income countries.

The Italian government decided to scrap fines for refusing compulsory COVID-19 vaccines, drawing criticism from the medical community and opposition parties that accused the government of 鈥渞ewarding lawbreakers鈥� and ignoring health system needs.
 
After the Affordable Care Act was signed into law in the U.S., the number of uninsured Latinos fell from 33% to 18%鈥攂ut more than half (55%) of Hispanic/Latino adults in the U.S. are inadequately insured, , compared with ~ 42% of the non-Hispanic/Latino population. GHN EXCLUSIVE Michelle Morse鈥檚 global health experience has strongly influenced her work as NYC鈥檚 acting health commissioner. Courtesy: New York City Health Dept. Michelle Morse: How to Protect the Health of 8 Million New Yorkers  
After arriving in Haiti in 2009 to work with Partners in Health, Michelle Morse went on home visits with community health workers (CHWs) as they distributed medications, food, and other essentials.

• 鈥淪eeing that model in action鈥攏ot waiting in our Ivory Tower for people to come in and see us, but actually bringing the lifesaving health interventions that people needed to where they were through community health workers鈥攚as a massive frame shift for me,鈥� says Morse, the acting health commissioner for New York City.

In NYC: When she joined the city鈥檚 health department in 2021 as its first chief medical officer, she began working with CHWs providing COVID-19 test kits, masks, treatment, and reliable information on vaccines. 鈥淚 still see community health workers as one of the most critical public health foundations,鈥� she says.
 
In an interview with GHN earlier this month in the department鈥檚 Long Island City office, Morse shared insights on:

• The city鈥檚 efforts to recover from the nearly five-year drop in life expectancy during COVID-19.

• The department鈥檚 work to reduce Black maternal mortality.

• Her preparations for changes coming from the new presidential administration.

• The data she looks at daily.

GHN鈥檚 BEST OF 2024: STAFF PICKS Tablets of the antidepressant Prozac. Paul S. Howell/Liaison Agency Rin鈥檚 Picks
In my role, I read and break down key points of articles for story summaries. I鈥檓 fascinated by how things work鈥攚hether it鈥檚 a policy, a health care system, or the components of a vaccine. I have a special interest in women鈥檚 and reproductive health, and as the articles below show, I have a soft spot for stories that explain the 鈥渨hys鈥� behind health actions. 鈥�-Rin Swann
Best GHN Exclusive  Have you ever wondered why prescription drugs have baffling names? In this story, GHN's associate editor Annalies Winny explains why brand-name drugs need to meet strict naming requirements for patient safety.
Best News Article Despite multiple lawsuits and protests from therapists, the biggest insurance conglomerate in the U.S., UnitedHealth Group, has utilized algorithms to identify and revoke coverage to increase profits. Those most at risk include patients seeking mental health resources, Annie Waldman鈥檚 investigation reveals.
Best Commentary  TUBERCULOSIS Seeking Screening for Pakistan鈥檚 Miners
Pakistan already has a high tuberculosis burden, but the disease is especially prevalent among the ~100,000 miners who labor in the country's coal pits.

• Prevalence of tuberculosis is 10.3% higher among miners than the general population.

High risks: Damage the coal dust inflicts on their lungs makes them more vulnerable to TB bacteria鈥攚hich spread more easily in the miners鈥� overcrowded and unsanitary living conditions. 

Adding to the strain: Miners have limited access to health care, so often TB isn鈥檛 detected until the disease has progressed. 

Improving awareness: New battery-powered, AI-driven x-ray technology is being used to improve TB diagnosis in remote mining areas, allowing miners to seek treatment earlier than what has been typical. 

GLOBAL HEALTH VOICES QUICK HITS

Positive avian flu bulk-tank tests prompt another raw-milk recall in California 鈥�

Trump says there are 'problems' with vaccines, rejects mandates 鈥�

Trump's pick for health secretary, RFK Jr, supports polio vaccination, US senator says 鈥�

Missing and dismissing the impact of periods: Outcomes of focus groups of teens with period concerns 鈥�

Doctors seethe over insurance companies' 鈥榦ut of control鈥� tactics 鈥�

Should pharmacists be moral gatekeepers? 鈥�

A strange alliance: Oxygen companies and their Medicare patients want Congress to pay the companies more 鈥�

New insights into the vast diversity of nature's most abundant viruses 鈥�

Issue No. 2831
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on and follow us on Instagram and X .

Please send the Global Health NOW free sign-up link to friends and colleagues:

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  Copyright 2024 Johns Hopkins Bloomberg School of Public Health. All Rights Reserved. Views and opinions expressed in Global Health NOW do not necessarily reflect those of the Johns Hopkins Bloomberg School of Public Health or Johns Hopkins University.


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96 Global Health NOW: Does the Polio Vaccine Face Political Peril?; Mysteries at the Mpox Epicenter; and Portugal鈥檚 Practical Health Priorities December 16, 2024 Polio survivor Larry Montoya at the airport for the arrival of vaccines distributed as part of the KO Polio campaign. September 5, 1962. John McBride/San Francisco Chronicle via Getty Does the Polio Vaccine Face Political Peril?
Public health experts are increasingly worried about the threat to vaccination programs under a second Trump administration, as Department of Health and Human Services secretary nominee Robert F. Kennedy Jr. surrounds himself with anti-vaccine advocates鈥攊ncluding one who has fought the polio vaccine, . 

To help vet candidates for key jobs in the department, Kennedy has turned to attorney Aaron Siri鈥攚ho petitioned the FDA in 2022 to revoke approval of the polio vaccine, .

• Siri, known for challenging COVID vaccine mandates and questioning vaccine safety, works with the Informed Consent Action Network, a group critical of vaccines.

A preview? Public health experts fear that this alignment could be a signal of broader anti-vaccine efforts down the line, .

• 鈥淭here is much more behind this than just rhetoric,鈥� said Michael Osterholm, director of CIDRAP. 

McConnell鈥檚 warning: U.S. Senate minority leader and polio survivor Mitch McConnell condemned any attempts to undermine the polio vaccine as 鈥渄angerous鈥濃�攁nd warned that anyone seeking Senate confirmation 鈥渨ould do well to steer clear of even the appearance of association with such efforts,鈥� . GLOBAL HEALTH VOICES The Latest One-Liners   An attack on a hospital in the Sudanese town of Al Fasher on Friday killed nine people and wounded 20, according to WHO chief Tedros Adhanom Ghebreyesus, who called attacks on health care across Sudan 鈥渄eplorable.鈥�

A parvovirus B19 outbreak is spreading in Japan, bringing heightened risk to pregnant women, who face increased risk of miscarriage or complications in newborns from the respiratory disease.

RSV vaccine trials for children have been halted after two experimental RSV vaccines for babies failed to protect them鈥攁nd actually made some of the babies sicker, per researchers鈥� findings.

Expanding Canada鈥檚 needle exchange programs to cover 50% of people who inject drugs in the country鈥檚 prisons would prevent 15% of new hepatitis C cases and 8% of injection-related infections, per in the Canadian Medical Association Journal. GHN鈥檚 BEST of 2024: STAFF PICKS View of Freetown, Sierra Leone. Blessed Sheriff Dayna鈥檚 Picks 
As GHN鈥檚 resident morning lark, my main responsibilities include curating the news, planning production and matching assignments to writers, and editing exclusives. My favorite part of the job is getting to know our writers and readers and seeing how engaged and passionate they are about various global health priorities, which helps shape our coverage鈥攖hough there is never enough space to highlight everything that deserves a spotlight. 鈥�Dayna Kerecman Myers, GHN Managing Editor
Best Exclusive Sierra Leone鈥檚 only psychiatric hospital has just 10 psychiatrists tasked with the daunting challenge of providing mental health care for a country of 8 million people. Blessed Sheriff, a Johns Hopkins-Pulitzer Global Health Reporting Fellow, traveled to Freetown to report on efforts to transform mental health care in the country, interviewing the first class of psychiatry residents trained there and learning how they are helping to melt societal stigma and change the narrative around mental health.
Best News Article Dakar-based reporter Elian Peltier exposed how Kremlin-paid African influencers, news outlets, and Russian state-controlled media amplify each other in efforts to undermine Western-funded health care programs in Africa, spreading disinformation about scientists fighting malaria and other infectious diseases on the continent. It鈥檚 a chilling example of how pro-Russian propaganda capitalizes on weakened trust in the West while silencing independent journalists. 鈥� The New York Times (gift article)
  Best Commentary GLOBAL HEALTH VOICES MPOX Mysteries at the Epicenter
It has been 15 months since a new strain of mpox surfaced in the mining town of Kamituga in Eastern DRC. 

While the response now includes intensive interventions including vaccines, much remains unknown about the strain, clade Ib, and its origin, reports Stephanie Nolen in a deep dive from Kamituga.

Unanswered questions include:

• How is clade Ib transmitted? Is it truly sexually transmissible, or can it spread through close physical contact?


• Why are children disproportionately affected? Is it because the virus has already infected so many adults, or because children are so malnourished鈥攐r another reason? 


• And how did the virus come to Kamituga? Has a precursor been circulating in animals for years?  

HEALTH SYSTEMS Portugal鈥檚 Practical Health Priorities 
Portugal has a life expectancy nearly four years longer than the U.S.鈥攄espite spending just 20% of what the U.S. spends on health care per person. And the small country ranks third of 195 countries for access to affordable health care鈥攚hile the U.S. ranks 183rd.

The focus of its national health system? Not cutting-edge technology or expensive medical facilities but rather 鈥渙ld fashioned primary care and public health.鈥� 

Some key features:

• Free or low-cost health care for every resident 


• A network of 鈥渇amily health units,鈥� or clinics embedded in neighborhoods


• Robust electronic health records that allow doctors to track individual and population health in real time.

QUICK HITS This drug is the 'breakthrough of the year' 鈥� and it could mean the end of the HIV epidemic 鈥�

Texas鈥� abortion pill lawsuit against New York doctor marks new challenge to interstate telemedicine 鈥�

Outgoing CDC director girds against an overhaul, and tries to calm staff nerves 鈥�

Fired Baltimore health commissioner speaks out 鈥�

Will the FDA finally ban Red No. 3? A decision could come soon 鈥�

Egypt鈥檚 Hepatitis Programme Becomes a Model for African Countries 鈥�

Migrant children struggle to express themselves in words. Enter art and play. 鈥� Issue No. 2830
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on and follow us on Instagram and X .

Please send the Global Health NOW free sign-up link to friends and colleagues:

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  Copyright 2024 Johns Hopkins Bloomberg School of Public Health. All Rights Reserved. Views and opinions expressed in Global Health NOW do not necessarily reflect those of the Johns Hopkins Bloomberg School of Public Health or Johns Hopkins University.


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96 Global Health NOW: Living Longer, but Not Healthier; Afghanistan to Ban Women From Nursing, Midwifery; and Decrypt the Halls The gap between lifespan and healthspan has widened across the globe December 12, 2024 Joynal, 70, sits outside a hospital in Dhaka, Bangladesh, while taking in oxygen for the breathing difficulties, on January 31. Syed Mahamudur Rahman/NurPhoto via Getty Living Longer, but Not Healthier 
Lifespans are increasing worldwide, but those extra years are not necessarily healthier, finds a large new study published in .

The health span-lifespan gap鈥攖he difference between how long people live and how long they live in good health鈥攈as widened over the past two decades among 183 WHO member states, . 

• On average, people live 9.6 fewer healthy years than their total lifespan, with a larger gap for women. In the U.S., the gap is 12+ years. 

• The health span deficit is linked to the cumulative effects of aging itself, researchers say鈥攂ut also the uptick in chronic diseases like heart disease and diabetes, and mental health issues. 

A tale of two countries: Meanwhile, a new from the Bloomberg American Health Initiative finds that the U.S. trails England and Wales in life expectancy by 2.7 years鈥攁nd that four preventable causes of death drive the disparity: cardiovascular disease, overdoses, motor vehicle crashes, and gun violence, .  EDITOR'S NOTE Would You Give Up One Coffee for GHN?   
We hear all the time from readers who say they love reading GHN with their morning coffee.
 
Today, we present a challenge: ? Whether it鈥檚 an at-home filter coffee, a classic cuppa, a pricey pumpkin spice caramel latte ... we鈥檒l take it! 

And here鈥檚 your sweetener: Donations of any amount will help us unlock a special $2,000 challenge gift from longtime GHN supporter Ana Rita Gonzalez.  
 
So far, 72 readers have contributed. 28 more are needed to unlock the gift. Any amount is welcome!

Your contributions remind us of the global mission at the heart of our work, and our responsibility to use your donations wisely鈥攖o strengthen GHN and expand our global coverage. 鈥擜苍苍补濒颈别蝉 GLOBAL HEALTH VOICES The Latest One-Liners
Colorectal cancer is on the rise among people under 50 worldwide, published in the Lancet Oncology finds, with the greatest annual increases being seen in New Zealand, Chile, Puerto Rico, and England.

Health investigators in California have sent samples to the CDC to try to determine whether a toddler who鈥檇 consumed raw milk was infected with H5N1, but much about the case remains unclear.

Gender-affirming care in Montana will remain legal for minors after the state鈥檚 supreme court upheld a lower court ruling that blocked a new law banning care.

17 children in Mexico have died from bacterial infections related to contaminated IV feeding bags; 16 of the children were infants, and one was 14 years old. GHN'S BEST OF 2024: STAFF PICKS Zhou Pengcheng provides music therapy for a child with autism in Tianjin, north China, March 23, 2021. Zhao Zishuo/Xinhua via Getty Melissa鈥檚 Picks
As a morning editor on GHN, I review our summaries and analyses, trying to correct any ambiguities, errors, or typos before they land in your inbox. It鈥檚 intense work鈥攔acing against the clock while our small team smooths out the day鈥檚 edition鈥攂ut energizing, too. And, like our readers, I reap the benefit of GHN鈥檚 content as I start my workday, which for me includes editing and writing for our School鈥檚 magazine and website. 鈥擬elissa Hartman, GHN contributing editor
  Best GHN Exclusive Researchers were stunned by the results of a survey they conducted to learn about suicidal thoughts among young people with autism: Of nearly 400 autistic children who reported wanting to die over their lifetime, 35% experienced onset at 8 years old or younger. GHN鈥檚 Kate Harrison Belz spoke to the study鈥檚 lead author about the findings and what caregivers can do to help children at risk.   Best News Article Native Americans have the highest rate of death from liver disease in the U.S.鈥攂ut are less likely than other racial groups to secure a spot on the national liver transplant list. Journalist Annie Gilbertson and data scientist Ben Tanen shed light on causes that range from scarce IHS funding to federal agencies鈥� delays in collecting data on who receives transplants.    Best Commentary GLOBAL HEALTH VOICES HUMAN RIGHTS Afghanistan to Ban Women From Nursing, Midwifery
The Taliban is poised to ban women from training as nurses and midwives in a move that 鈥渨ill have a devastating long-term impact on the lives of millions of Afghans, especially women and girls,鈥� said Afghan activist Samira Hamidi. 

• The order was announced at a meeting of the Taliban public health ministry on Monday and relayed to training institutes soon after.

Maternal mortality was already high in Afghanistan even before the Taliban seized control鈥攚ith 620 women dying for every 100,000 live births in 2020, .

• Afghanistan needs an additional 18,000 skilled midwives for Afghan women to get adequate care, . 

ALMOST FRIDAY DIVERSION Decrypt the Halls 
Forget The Nutcracker. In the U.K., 鈥檛is the season for code crackers. 

Each year, Britain鈥檚 cyber-intelligence agency gift wraps 鈥渁 riddle wrapped in an enigma inside a mystery鈥� for the nation鈥檚 puzzle-hungry public, . 

Hark! The Herald Agents Sing: The annual Christmas Challenge was introduced by the 鈥渋n-house puzzlers鈥� at the Government Communications Headquarters (GCHQ) in 2015 and has since become a beloved, brain-boggling tradition.

O Come, All Ye Playful: The festive quest is designed for young people ages 11鈥�18, with the subversive hope they will discover a passion for puzzles鈥攁nd potentially 鈥渃onsider what a career in cybersecurity and intelligence might have to offer,鈥� said GCHQ Director Anne Keast-Butler. 

• A third of British secondary schools had downloaded the puzzle the morning of its release, . 

Have Yourself a Merry Little Cryptograph: , released yesterday, spotlights historical GCHQ bases in the U.K. and is designed 鈥渢o test a range of problem-solving skills and to encourage the use of teamwork.鈥� QUICK HITS Trial stops enrollment after Tpoxx fails to speed clade 2 mpox healing or pain relief 鈥�

Data shows global conflict surged in 2024 鈥�

An opioid settlement ruling could have far-reaching implications for other lawsuits 鈥�

Poliovirus keeps popping up in European wastewater, perplexing and worrying scientists 鈥� Issue No. 2829
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on and follow us on Instagram and X .

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96 Global Health NOW: Fighting Cholera Shame to Save Lives in Zambia; New Threats Hamper Game-Changing Malaria Gains; and Fieldwork and the Family December 11, 2024 Mary Kapaipi鈥檚 husband concealed his symptoms before dying the next day. Lusaka, Zambia, November 6. Freddie Clayton Fighting Cholera Shame to Save Lives in Zambia
LUSAKA鈥擬ary Kapaipi suspected that her husband might be suffering from cholera last January, amid a deadly outbreak in their neighborhood outside Zambia鈥檚 capital. But he insisted it was just a sore throat. By the time his symptoms worsened and she sent for help, it was too late to save his life.
 
Kapaipi later discovered signs of his illness鈥攕oiled underwear and patches of white vomit鈥攈idden around their house. If he hadn鈥檛 concealed his symptoms, he might have lived, she says.

This pattern of secrecy and shame is common among cholera patients, Kennedy Phiri and Freddie Clayton learned while reporting for this exclusive series that spotlights not only the need to improve water and sanitation infrastructure in the area, but the equally urgent need to address the stigma surrounding the disease.
 
Read their story to learn who is most affected by stigma and why鈥攁nd why some community members feel better prepared to face another potential outbreak as this year鈥檚 rainy season gets underway (hint: they are not relying on government interventions).


 
Ed. Note: This article is the second in a two-part series; read Part I,. The series is part of , made possible through the generous support of loyal GHN readers. GLOBAL HEALTH VOICES The Latest One-Liners   Dengue fever cases have tripled to a record high in Central and South America this year, with 12.6 million+ cases and 7,700 deaths; Argentina, Brazil, Colombia, and Mexico were hit especially hard.

Women in Iran could face execution, long jail times, or flogging for defying new morality laws effective this week that seek to penalize women for 鈥減romoting nudity, indecency, unveiling or improper dressing.鈥�

Human trafficking cases spiked 25% between 2019 and 2022, from the UN Office on Drugs and Crime; more children are being exploited, and forced labor cases have surged amidst conflict, poverty, and effects of the climate crisis.

Ultraprocessed foods account for more than half of calories consumed at home by U.S. adults, per a published in the Journal of Nutrition; the report highlights the 鈥減roliferation and ubiquity of ultraprocessed foods on grocery store shelves,鈥� said lead author Julia Wolfson. GHN鈥橲 BEST OF 2024: STAFF PICKS A sex worker waits for clients behind her window in the red-light district of Amsterdam, on December 8, 2008. Anoek De Groot/AFP via Getty Morgan鈥檚 Picks
You might call me GHN鈥檚 鈥渏ack of all trades.鈥� I write summaries for our newsletter and articles for our website, create our social media content, build web pages, collect metrics鈥攜ou name it. I am lucky enough to get to work on a publication that includes news as diverse as my skill set, and, in the face of a very uncertain future, I鈥檓 glad I鈥檓 helping get the health news that matters out there, to those who need it. 鈥�Morgan Coulson, GHN Editorial Associate 
Best GHN Exclusive Amsterdam is famous for its red-light districts, but many of the city鈥檚 thousands of sex workers lack access to health care. In this exclusive, journalist Gabriela Galvin investigates the web of immigration and labor policies, logistical hurdles, and stigma that obstructs workers鈥� pathway to care.
Best News Article Rising atmospheric carbon dioxide levels are making many foods鈥攊ncluding global staples like rice and wheat鈥攍ess nutritious by reducing protein, vitamins, and critical micronutrients like zinc and iron. Writer Kellie Schmitt shows how these eroding nutritional values threaten millions with hidden hunger.
  Best Commentary GLOBAL HEALTH VOICES MALARIA New Threats Hamper Game-Changing Gains
The global fight against malaria remains stalled as new threats emerge and under-resourced regions fall behind, per the new .

• Progress is being undermined by severe funding shortfalls, rising drug and insecticide resistance, and humanitarian disasters鈥攍eading to cases rising for the fifth consecutive year, .

The bad news: 597,000 malaria deaths were reported in 2023, and there were ~263 million malaria cases鈥�11 million more than in 2022.

• The overwhelming majority of fatalities occurred among children under age 5 in Africa, . Overall, ~95% of deaths occurred in the WHO African Region.


• 鈥淣o one should die of malaria; yet the disease continues to disproportionately harm people living in the African region, especially young children and pregnant women,鈥� said WHO chief Tedros Adhanom Ghebreyesus.

The good news: 44 countries and one territory have been certified malaria-free, and 鈥渕any more鈥� are nearing the goal.

• 17 countries have introduced malaria vaccines, and new-generation nets are more widely available. 

Meanwhile: Initial samples from a mystery outbreak in the DRC tested positive for malaria鈥攖hough more than one disease may be involved, . INFECTIOUS DISEASES Fieldwork and the Family
When epidemiologist Kristen Aiemjoy鈥檚 son came down with a strange illness that turned out to be scrub typhus, she identified it before doctors did.

How? Scrub typhus happens to be Aiemjoy鈥檚 research focus, and she recognized the scab where the infected insect had bitten her son.

• That scab, or eschar, appears on only 40%鈥�60% of those infected, so many are not diagnosed.

Her son鈥檚 blood tests revealed why early diagnosis is so difficult: Tests don鈥檛 detect antibodies until 9鈥�11 days after fever onset, according to Aiemjoy鈥檚 published in The American Journal of Tropical Medicine and Hygiene. 

Aiemjoy hopes her research will help to develop a low-cost test to improve early diagnosis and care. 

OPPORTUNITY QUICK HITS Africa: Decade-Long Study Reveals Key Drivers of Global Health Success 鈥�

Medical misogyny leaves women in pain for years, say MPs 鈥�

Genetic analysis finds H5N1 in California child most similar to cattle genotype 鈥�

The Ten Americas: How Geography, Race, and Income Shape U.S. Life Expectancy 鈥�

U.S. health panel draft recommendations would allow a self-testing option for cervical cancer 鈥�

Coronavirus FAQ: I didn't get the latest COVID vaccine. Should I? And if so ... when? 鈥�

A public health game plan grounded in the Golden Rule 鈥�

Tokyo government gives workers 4-day workweek to boost fertility, family time 鈥� Issue No. 2828
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on and follow us on Instagram and X .

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  Copyright 2024 Johns Hopkins Bloomberg School of Public Health. All Rights Reserved. Views and opinions expressed in Global Health NOW do not necessarily reflect those of the Johns Hopkins Bloomberg School of Public Health or Johns Hopkins University.


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96 Support GHN鈥檚 Second Decade Help us celebrate our 10th anniversary by supporting our future. December 10, 2024 Girls in India gather around an illuminated globe, hoping for a better world.
Pranab Basak, Courtesy of Photoshare Dear GHN Reader, 
Thank you for the many ways you support us every day鈥攊nspiring us, sharing stories and new perspectives, and spreading the word about GHN. 
  Over the last few years, many of you have also supported our mission in a new way鈥攂y making a gift. And this week, we鈥檙e asking you to consider .  
  Donations of any amount are welcome and will help us unlock a special $2,000 challenge gift from longtime GHN reader and supporter Ana Rita Gonzalez, ScD, CPA.
  You can also help us by advocating for the campaign:  

• within your social networks. 

• Inspire others with a or gift. 

If you value our newsletter and original reporting, we hope you鈥檒l consider . Your support makes a real difference and will help sustain our work into the future.  
With sincere thanks, 
Dayna Kerecman Myers  Managing Editor  Global Health NOW HELP US MEET THE CHALLENGE
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on and follow us on Instagram and X .

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96 Global Health NOW: Shaken by Cholera Outbreak, Zambians Fear the Coming Rains; American 鈥楻age鈥� over Health Insurance; and 鈥淲itch Hunts鈥� in Kenya December 10, 2024 A makeshift latrine built from wood and rags in the Garden House Compound in Lusaka. November 6. Freddie Clayton Shaken by Cholera Outbreak, Zambians Fear the Coming Rains   LUSAKA鈥擜 visit to Garden House Compound, a sprawling maze of makeshift shelters on the outskirts of Zambia鈥檚 capital, reveals clues to for the cholera outbreak that killed at least 740 people earlier this year.

• Some 50,000 people live without clean water or toilets鈥攆orcing many to share makeshift latrines overflowing with human waste or defecate in the open.


• When the water levels rise, human feces pour into the neighborhood, contaminating the shallow wells people depend on for water.

And now, the rains are starting up again鈥攁nd residents like Natasha Bwalya, whose 15-year-old son died of cholera last January, fear that heavy rains will once again create conditions ripe for the spread of disease.
 
Lessons learned from the last cholera outbreak have led to some improvements by the government and NGOs鈥攂ut it鈥檚 hard to see that progress on the ground; massive water tanks haven鈥檛 been filled and few public toilets have been built. 

Meanwhile, many of the largest investments focus on cholera treatment and research, rather than prevention. In the first part of a 2-part series, Phiri and Clayton delve into the reasons why鈥攍anding on the key missing ingredient that could determine whether this year鈥檚 rainy season will bring another outbreak.
 

 
Ed. Note: This article is part of , made possible through the generous support of loyal GHN readers. GLOBAL HEALTH VOICES The Latest One-Liners   The EPA banned two known carcinogens yesterday: trichloroethylene (TCE), used in degreasing agents, furniture care, and auto repair products, and tetrachloroethylene (PERC), used in dry cleaning and auto repair, following decades of advocacy.
 
Alcohol-related e-scooter and e-bike injuries among U.S. adolescents tripled between 2019 and 2022, from ~23,000 to ~66,000, according to that points to a need for better enforcement of underage drinking laws.

Pediatricians in Pakistan report high knowledge related to antibiotic usage, but limited training in antibiotic stewardship, ; only 15% reported receiving training on antibiotic usage and AMR, and only 25.3% confirmed awareness of antimicrobial stewardship.

Few adults without biological children who underwent permanent contraception procedures reported regret in a ; additionally, 47% of respondents reported difficulty finding a physician willing to perform the procedure. GHN鈥檚 Best of 2024: Staff Picks A woman molds bricks for a kiln in Rajasthan鈥檚 Ajmer district on March 26, 2023. Shreya Raman Brian鈥檚 Picks   My name may come first in the newsletter鈥檚 staff list, but in truth it鈥檚 my colleagues who take on the impossible daily task of finding and distilling global health鈥檚 essential news. They succeed because of their smarts, their commitment, and the help of loyal GHN readers like you.鈥擝rian Simpson, GHN Editor-in-Chief   Best GHN Exclusive The thousands of women who work in India鈥檚 brick kilns migrate from state to state to find work and often face massive barriers to health care. A lack of state health documents and paid sick time make it difficult for them to get care they need. Journalist Shreya Raman introduces us to kiln workers like Nirmala, who was forced to return to work 15 days after giving birth by cesarean section.
Best News Article The U.S. FDA has a tough challenge: Regulate nicotine products while facing nearly two dozen former FDA lawyers now working for Big Tobacco. Their inside knowledge gives the industry a big advantage. Reporter Kathryn Kranhold illuminates this dark corner of regulation.
  Best Commentary HEALTH SYSTEMS American 鈥楻age鈥� over Health Insurance
The man arrested in the killing of UnitedHealthcare鈥檚 chief executive was found carrying a manifesto 鈥渄ecrying the health care industry,鈥� . 

The killing has sparked a swell of public anger鈥攏ot at the shooting, but at the American health insurance industry.

• The reaction reflects 鈥渂oth the coarsening of public discourse and the degree of rage many Americans feel over the deficiencies of the U.S. health care system,鈥� writes Nicholas Florko for . 


• Gallup polling shows that just 31% of Americans have a positive view of the health care industry. 


• Costs, delays, payment denials, and prior authorization usage have all continued to rise, 鈥攍eading to delayed care and patients abandoning treatment, per the American Medical Association. 

Blame game: While the health industry鈥檚 executives 鈥渉ave become popular villains,鈥� the structure of America鈥檚 for-profit system means no one bears full responsibility for the problems, 鈥攍eading to endless finger pointing between insurers, providers, and drugmakers and 鈥渓eaving patients angry and confused鈥攁nd looking for someone, anyone, to blame, fairly or not.鈥� GLOBAL HEALTH VOICES AGING 鈥淲itch Hunts鈥� in Kenya
More than 250 murders of elderly women in Kenya between 2020 and 2022 have been linked to the increased use of 鈥渁nti-witchcraft鈥� laws. 

The laws, which allow murder in 鈥渟elf-defense鈥� from witchcraft, primarily affect elderly widows, who are frequently accused by their late husbands鈥� families of trying to gain property. The women are then shunned and lynched. 

However, behavior attributed to witchcraft may actually be symptoms of dementia鈥攁nd increased life expectancy has led to a rise in female-headed households and dementia cases.

Compounding factors: Kenya鈥檚 booming population and high unemployment rates often make elderly women targets for those seeking resources. Cultural beliefs about the evils of witchcraft mean that violators are rarely prosecuted.

QUICK HITS UN refugee chief urges patience as Syrian refugees weigh options 鈥�

Lonely graves, scattered bones: the stark reality of one of the most overlooked and fastest-growing migration routes 鈥�

Arizona confirms 2 avian flu infections as California probes second potential case in a child 鈥�

Can Congo contain its exploding mpox epidemic鈥攁nd curtail its international spread? 鈥�

Spying on Student Devices, Schools Aim to Intercept Self-Harm Before It Happens 鈥�

Why India Must Keep Covid-Era Oxygen Plants Running 鈥�

Safety Concerns Plague Humanitarian Aid Work 鈥�

On the Frontline with Lebanese Midwives 鈥� Issue No. 2827
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on and follow us on Instagram and X .

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96 Global Health NOW: Outbreak Investigation Launched in the DRC; Women on the Front Lines of Lymphatic Filariasis; and GHN鈥檚 Best of 2024: Staff Picks December 9, 2024 Outbreak Investigation Launched in the DRC
The WHO has dispatched rapid response teams to the DRC鈥檚 remote Panzi region to investigate and respond to an undiagnosed illness with a worryingly high mortality rate, as epidemiologists worldwide eye the outbreak with concern.

Despite fears of a novel illness, suggests that the culprit is likely an 鈥渦nknown known鈥� like pneumonia, influenza, COVID-19, malaria, or measles鈥攐r some combination of illnesses鈥攅xacerbated by severe malnutrition, .

Outbreak details: 406 cases of an undiagnosed illness with 31 deaths鈥攁 7.6% fatality rate鈥攚ere reported between Oct. 24 and Dec. 5.

• The illness primarily affects children under age 5, and symptoms include fever, headache, cough, runny nose, and body aches.

Unreachable region: The Panzi zone is extremely difficult to access, with unpaved roads nearly impassable during the rainy season, and threats from local militia groups further complicating travel, .

• The WHO convoy includes doctors, epidemiologists, lab technicians, and infection control experts to treat patients and collect data.

Related: How worried should we be about Disease X? 鈥� EDITOR鈥橲 NOTE We鈥檙e Asking for Your Support Today
Hey Readers,

Last week, we quietly launched our third crowdfunding campaign in our 10-year history.

Today, we have an exciting announcement:

• Longtime GHN reader and supporter Ana Rita Gonzalez, ScD, CPA, is challenging us all: When another 100 subscribers make a gift, she will give $2,000 to support GHN! 

We鈥檙e so grateful to Dr. Gonzalez, president and CEO of Policy Wisdom LLC, for her investment in GHN and this amazing challenge gift.

.

I hope you鈥檒l join me in contributing to GHN so we can continue to deliver essential global health news.
 
All best,
Brian GLOBAL HEALTH VOICES The Latest One-Liners   U.S. agriculture officials have issued a federal order requiring the testing of the nation's milk supply in an effort to increase surveillance of bird flu.

A single mutation in the protein found on the surface of the H5N1 influenza strain circulating in U.S. dairy cows could enable 鈥渆asier transmission among humans,鈥� per published in Science.

Morocco is producing mpox tests for the first time鈥攁nother step in Africa鈥檚 quest for independence when it comes to sourcing medical supplies.

Anthem Blue Cross Blue Shield has reversed a policy that would have tied reimbursements for anesthesia to time limits, after widespread outcry from anesthesiologists. GHN鈥橲 BEST OF 2024: STAFF PICKS For our annual 鈥淏est of鈥� series running daily for the next couple weeks, GHN team members share their picks for 2024's most memorable work. GHN鈥檚 ace morning writer and trusted news adviser Kate Harrison Belz kicks off our series.       A child at Nduru camp, Kisumu City, Kenya. August 16, 2024. Scovian Lillian Kate鈥檚 Picks   I distill articles for GHN's newsletter summaries, which involves a lot of caffeine and curiosity. I have long been intrigued by the ways public health, environment, and infrastructure intersect鈥攁n interest that has intensified after living through the devastation of Hurricane Helene in Asheville, N.C., where I live. As we begin recovery here, I find myself often mulling over articles like the ones below. How can we better steward our natural and built environments to strengthen our shared health? 鈥�Kate Harrison Belz, GHN writer   Best GHN Exclusive: Deadly floods in Kenya this spring left behind a wake of cholera and other infectious diseases. In this exclusive, reporter Scovian Lillian explores how weather surveillance and disease surveillance can be more closely linked鈥攁nd potentially save lives.   Best Must-Read: Planting trees in urban areas has well-established climate benefits: cooling, pollution control, and stormwater absorption. But trees鈥� impact on human health is becoming more clear, thanks to the University of Louisville鈥檚 Green Heart Louisville project: 鈥渁 clinical trial where trees are the medicine.鈥� 鈥�Bloomberg CityLab   Best Commentary: NEGLECTED DISEASES Women on the Front Lines of Lymphatic Filariasis
The mosquito-borne disease lymphatic filariasis鈥攃ommonly known as elephantiasis for the severe swelling it causes鈥攖akes an especially heavy toll on women in India, where the disease is endemic. 

More vulnerable: Women, especially in poor, rural regions, are more vulnerable due to daily outdoor chores. 

Bigger barriers: Women have less access to health care, with 15.5% of rural women in India reporting that they struggle to get permission for medical treatment, and 24.7% struggling to obtain money for treatment.

• While annual mass drug administration campaigns aim to reduce transmission, mistrust and lack of awareness keep the preventive medicines out of women鈥檚 reach.

ENVIRONMENTAL HEALTH Deadly Inaction on Formaldehyde 
  Formaldehyde is a ubiquitous chemical in the U.S.鈥攁 鈥渨orkhorse鈥� of commercial enterprises ranging from making furniture to sterilizing food. 

But it is incredibly toxic:

• Formaldehyde causes more cancer than any other chemical air pollutant, and can increase risk of miscarriages, fertility problems, and asthma. 


• It pollutes air even inside homes as it leaks from household products. 

Despite decades of awareness of the dangers, companies that rely on formaldehyde have 鈥渞epeatedly thwarted government efforts鈥� to curb its usage.

• The EPA was poised to make some initial reforms this year鈥攂ut those efforts will likely be suspended under the new presidential administration. 

Thanks for the tip, Cecilia Meisner! QUICK HITS Amnesty International accuses Israel of genocide; Israeli official calls claim "entirely false and based on lies" 鈥�

Hundreds more migrants have died in Rio Grande crossings than U.S., Mexico reported 鈥�

鈥楳y right side was paralysed, I was so sick鈥�: the pesticide poisonings in Brazil that lead back to the UK 鈥�

Increases in U.S. life expectancy forecasted to stall by 2050, poorer health expected to cause nation鈥檚 global ranking to drop鈥�

CTE Evident in Brains of Deceased Ice Hockey Players 鈥� Thanks for the tip, Chiara Jaffe

How the Messy Process of Milking Cows Can Spread Bird Flu 鈥�

Latin American journals are open-access pioneers. Now, they need an audience 鈥� Issue No. 2826
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on and follow us on Instagram and X .

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  Copyright 2024 Johns Hopkins Bloomberg School of Public Health. All Rights Reserved. Views and opinions expressed in Global Health NOW do not necessarily reflect those of the Johns Hopkins Bloomberg School of Public Health or Johns Hopkins University.


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96 Global Health NOW: When Famine Warnings Falter; SCOTUS Case Has 鈥楳ajor Implications鈥� for Transgender Care; and 鈥嬧�嬧�榊ou Know Who You Look Like鈥�?鈥� Global famine warning system is often obstructed and undermined, a Reuters investigation found December 5, 2024 Palestinians gather to receive food cooked by a charity kitchen amid the hunger crisis that continues in Khan Yunis in the Gaza Strip, December 1. Saeed Jaras/Middle East Images/AFP via Getty Images When Famine Warnings Falter 
To prevent mass starvation in any country, alarms must be sounded early about food crises, and on-the-ground famine conditions monitored closely. 

That鈥檚 the work of the Integrated Food Security Phase Classification (IPC)鈥攁n independent global partnership designed to issue warnings of impending food crises and activate interventions.

But increasingly, the effectiveness of this warning system is obstructed and undermined, finds an . 

Obstacles include: 

Conflict: Long and brutal fighting in places like Gaza and Sudan blocks the collection of critical malnutrition and mortality data. 

• 鈥淭he single largest driver of hunger in the world is conflict. This means that people who are most desperately in need are in the hardest-to-reach areas,鈥� said Deepmala Mahla, chief humanitarian officer for CARE. 

Government interference: Instead of cooperating with the IPC, governments often resist or interfere with IPC assessments to prevent famine from being declared鈥攐r to manipulate the influx of aid.  GLOBAL HEALTH VOICES The Latest One-Liners
Childhood exposure to lead in gasoline has been linked to 150 million+ excess psychiatric disorder cases over the last 75 years, estimates a published in the Journal of Child Psychology and Psychiatry, which analyzed childhood blood lead levels from 1940 to 2015.

Chikungunya outbreaks have become "explosive鈥� and 鈥渦npredictable" as climate change and urbanization enable its spread into new regions鈥攄isabling millions and costing billions, per a new in BMJ Global Health.

An Ebola vaccination campaign is launching in Sierra Leone, with 20,000 frontline health workers receiving a preventive vaccine a decade after the deadliest Ebola outbreak in history.

Daytime TV ads for junk food and sugary snacks will be banned from daytime television in the UK, as the government tries to battle high rates of obesity and tooth decay among children. LGBTQ RIGHTS In SCOTUS Case, 鈥楳ajor Implications鈥� for Transgender Care
A case argued yesterday before the U.S. Supreme Court could shape the future of transition care for minors in the U.S.鈥攁nd shape other areas of health care policy across the country. 

Background: The case, U.S. v. Skrmetti, challenges a 2023 Tennessee law that prohibits medical providers from prescribing puberty blockers, starting hormone therapy, or performing gender-affirming surgery for patients under 18, . 

• But those same treatments are permitted for minors for other conditions. So the question at the core of the case is whether Tennessee鈥檚 ban on gender-affirming care for youth unconstitutionally discriminates against people on the basis of sex. 

Insights from arguments: Members of the court鈥檚 conservative majority signaled an inclination to uphold the law,   

Wider ramifications: The Court鈥檚 decision could have 鈥渕ajor implications鈥� for transgender people of all ages in terms of states鈥� attempts to restrict other areas of health care, particularly reproductive health,  

What鈥檚 next: The justices are expected to rule in the case next spring. 

Related: For Families of Transgender Children, Tennessee鈥檚 Ban Forces Hard Choices GLOBAL HEALTH VOICES SEXUAL AND REPRODUCTIVE HEALTH RIGHTS New Protections for Sex Workers in Belgium 
Sex workers in Belgium will have new labor protections and rights under a law that goes into effect this week. The rules, which advocates described as a 鈥渞evolution,鈥� follow the country鈥檚 2022 decision to decriminalize sex work. 

New protections include: 

• Formal employment contracts.

• Regulated pay and hours.

• Health insurance, paid leave, maternity benefits, and pensions.

• The right to refuse clients and stop activities at any point. 

The law also sets rules for employers, including: 

• Background checks for human trafficking and sex assault convictions.

• Strict safety protocols including emergency buttons in workspaces and provision of hygiene products. 

ALMOST FRIDAY DIVERSION 鈥嬧�嬧�榊ou Know Who You Look Like 鈥� ?鈥�
 Low-stakes debates are a balm in unsettling times.
 
Today, it鈥檚 an onslaught of lookalike contests for Hollywood 鈥渋t鈥� boys like Timoth茅e Chalamet鈥攚ho showed up to his own lookalike contest, but somehow didn鈥檛 win.
 
Paltry prizes: Paul Mescal鈥檚 Dublin double raked in 鈧�20, 鈥渙r three pints鈥�; Jeremy Allen White鈥檚 lookalike got $50 and a pack of Marlboro Reds, the .
 
But lookalike life is a lucrative gig for some. This rakes in 拢30,000 a year when his doppelganger has an album out鈥攁nd much less when he doesn鈥檛.
 
The trend has inspired many a think piece about the contests鈥� genderedness, their value to society鈥� and who gets to participate. It鈥檚 all fun and games for cheek-boney A-listers, but 鈥淲here are the celebrity lookalike competitions for bald middle-aged men like me?鈥� one . QUICK HITS Report highlights danger of splash pads for waterborne diseases 鈥�

The quest for a longer-lasting whooping cough vaccine 鈥�

Middle-school student scientists discover cancer-fighting compound in goose poop 鈥�

Tuberculosis Bacteria Vulnerable to Substances from Peat Bog Fungi 鈥�

Britain drug-cost watchdog says it will recommend Lilly obesity drug 鈥�

A few bursts of vigorous movement a day may cut women's heart risks, study says 鈥�

Ancient Germanic Warriors Took Drugs When Preparing for Battle, Study Suggests 鈥� Issue No. 2825
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on and follow us on Instagram and X .

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96 Global Health NOW: Global Aid 鈥極verstretched, Underfunded, Under Attack鈥�; Valley Fever on the Rise; and Pork Pollution Poisoning Mexican Villages December 4, 2024 Displaced Sudanese queue for food aid at a camp in the eastern city of Gedaref, on September 23. Ebrahim Hamid/AFP via Getty Global Aid 鈥極verstretched, Underfunded, Under Attack鈥�
As global crises compound and aid funding shrinks, a 鈥渞uthless鈥� reallocation of funds will be required to meet the most dire needs, warns the UN鈥檚 new humanitarian chief Tom Fletcher, . 

• The humanitarian sector 鈥渋s overstretched, it鈥檚 underfunded and it鈥檚 literally under attack,鈥� Fletcher said, .

Too many crises, too few funds: ~305 million people worldwide will need humanitarian assistance next year amid a 鈥減olycrisis鈥� of prolonged conflicts, climate disasters, and 鈥済laring disregard鈥� for humanitarian law, .

• But realistically, just ~190 million people can be reached with the $47.4 billion it is seeking.


• The UN鈥檚 funding appeal for 2024 was only 43% fulfilled.

Key appeals include $8.7 billion for Syria, $6 billion for Sudan, $4 billion for Gaza, and $3.3 billion for Ukraine. 

Shifting political landscape: Fletcher acknowledged the need to win over the incoming Trump administration in the U.S.鈥攖he UN鈥檚 biggest single donor鈥攁long with a 鈥渘umber of governments who will be more questioning鈥� of the UN. 

Meanwhile: ~281 humanitarian workers have been killed in 2024, 鈥攎ore than in any other year. 

Related: Live updates: Global Humanitarian Overview launch 鈥� GLOBAL HEALTH VOICES The Latest One-Liners   Children seen playing in hazardous floodwaters in Malaysia raised concerns that waterborne illnesses could spread following torrential floods that killed dozens and displaced thousands last week; relief centers have reported nearly 5,000 cases of infectious diseases so far.  
 
Ambassador John Nkengasong, head of the U.S. President鈥檚 Emergency Plan for AIDS Relief, said that as a political appointee, he will be obliged to offer his resignation when President-elect Donald Trump is inaugurated in January鈥攂ut he expressed hope that PEPFAR, a bipartisan program since its launch in 2003, will be reauthorized.

A U.S. House COVID-19 panel has released its final report on the pandemic, criticizing the public health response and common mitigation efforts, and concluding that the virus most likely emerged from a laboratory鈥攁 theory disputed by federal agencies.

Animals at a Wuhan market were infected with a virus around the time COVID-19 emerged, per a new analysis of genomic data collected from the market that has not yet been peer reviewed. DATA POINT INFECTIOUS DISEASES Valley Fever on the Rise
As more cases of the fungal infection Valley fever are being reported across the Southwest, researchers are looking at two key risk factors鈥攂oth impacted by climate change and land development.

• Environment: With ramped-up development and increased drought from a rapidly warming climate, dust storms have intensified. Spores that lead to Valley fever can be inhaled with the dust, with construction and agriculture workers especially vulnerable. 

• Animal hosts: As small mammals see their habitats disrupted and move into areas closer to humans, they could carry Valley fever鈥攊ncreasing the risk of zoonotic disease. 

Protecting ecosystems where the fungal reservoirs reside and restoring animal habitats are critical to preventing future outbreaks, researchers say. 

GLOBAL HEALTH VOICES ENVIRONMENTAL HEALTH Pork Pollution Poisoning Mexican Villages
Yucat谩n residents say hundreds of pig 鈥渕ega-farms鈥濃�攈olding up to 50,000 pigs each鈥攑ollute the local water supply with waste, hormones, and antibiotics, contaminating drinking water and spreading harmful bacteria like E. coli.

• Many of these farms operate without environmental permits and have caused significant deforestation and destruction of ecosystems important for local communities, particularly Maya villages.

Residents have protested the farms, citing severe impacts on their health and the environment. But Mexican leaders have indicated they do not support closing the farms, emphasizing instead the need for compliance with existing regulations and better use of pollution-mitigating technology.



ICYMI: The Many Costs of Cheap Chicken 鈥� OPPORTUNITY QUICK HITS 鈥楳y screams went unheard鈥�: Women and girls suffer in Kenya鈥檚 worst drought in 40 years 鈥�

Beatriz v El Salvador: the abortion case that could set a precedent across Latin America 鈥�

How Soweto is fighting ill health from gold mine dumps 鈥�

Ferret study suggests connection between H5N1 shedding in air and transmissibility 鈥�

Burning old TVs to survive: The toxic trade in electrical waste 鈥�

Trump's immigration crackdown could reduce caregiving workforce 鈥�

How a scandal over sanitary pads is shaping feminist activism in China 鈥�

I got malaria on purpose and so can you 鈥� Issue No. 2824
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on and follow us on Instagram and X .

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96 Global Health NOW: Who Controls U.S. Public Health?; A Major Shift in UK鈥檚 End-of-Life Legislation; and Cartels Recruiting Chemistry Students December 3, 2024 A tour group lies on the decorative rotunda floor in the Nebraska State Capitol in Lincoln. June 13, 2019. Joel Sartore Photography/Design Pics Editorial/Universal Images Group via Getty Who Controls U.S. Public Health鈥攖he Feds or the States?
The U.S. government鈥檚 approach to public health seems certain to change when the second Trump administration begins on January 20, 2025. But what powers do states have to act on their own public health priorities?
 
Reporter Joanne Silberner investigates the complicated, constantly evolving public health powers of states and the U.S. government, detailing:

• The USG鈥檚 immense power of the purse.


• The legal mandates and Congressional appropriations that could make it harder to cut CDC funding for state and local vaccination programs.


• States鈥� abilities to counterpunch against federal requirements with lawsuits.

Plus: How advocates in conservative Indiana used careful messaging and avoided trigger terms like climate change鈥攁nd even 鈥減ublic health鈥濃�攖o persuade state legislators to approve $225 million in health-related grants to counties. 
 
EDITOR鈥橲 NOTE Celebrate 10 Years of GHN With a Gift Today
Hey Readers, 

Today, we鈥檙e celebrating Giving Tuesday by announcing our . Your generosity in previous campaigns鈥攖he last was two years ago鈥攈as fueled incredible achievements: publishing 2,823 newsletter issues and launching the Local Reporting Initiative, which has delivered dozens of exclusive stories from around the globe. 

Today, please help us launch the next decade of our newsletter and independent reporting on critical global public health challenges and solutions.

Please join me in supporting GHN.  

All best, 

Brian GLOBAL HEALTH VOICES The Latest One-Liners   A mystery illness with flu-like symptoms killed 143 people in southwest DRC in November, and infections are still rising; the country鈥檚 public health ministry is investigating with WHO support.
 
Injections of benralizumab, a monoclonal antibody treatment for asthma and COPD patients, proved more effective than steroid tablets in a , cutting the need for further treatment by 30%鈥攁nd introducing the first asthma treatment breakthrough in 50 years.

Intra-abdominal fat in midlife can predict risk for Alzheimer鈥檚 disease in later years, per Washington University School of Medicine-led research that assessed the impact of different types of fat on amyloid levels in the brain (an early indicator of risk).
 
Depression significantly affects period pain, or dysmenorrhea, that also identified key genes and proteins involved, underlining the need for depression screening for women presenting with period pain. SUBSTANCE USE Cartels Recruiting Chemistry Students
As Mexican cartels seek to dominate the fentanyl market, they are increasingly turning to a new source for recruits: university chemistry labs. 

The goal: Cartels are awarding chemistry students high salaries and other incentives in hopes of building a motivated workforce that can help make fentanyl more potent. 

The bigger ambition: Cartels are trying to synthesize chemical compounds known as 鈥減recursors鈥� that are key to making fentanyl, which would free them from being dependent on China for production. 

If they succeed: Mexico could control the fentanyl supply chain鈥攎aking it more difficult for law enforcement in both Mexico and the U.S. to stop the flow of the deadly drug.

• 鈥淚t would make us the kings of Mexico,鈥� said one chemistry student turned cook. 

GLOBAL HEALTH VOICES ASSISTED DYING 鈥楶rofound Social Change鈥� in UK鈥檚 End-of-Life Legislation 
British lawmakers have advanced legislation that gives some terminally ill patients a pathway to end their lives鈥攁 major shift in a years-long cultural debate, . 

Details: In a 330 to 275 vote last Friday, the House of Commons approved a bill that would grant the option of assisted dying to people over 18 in England and Wales with a terminal diagnosis and a life expectancy of six months or less.

Background: The bill signals 鈥渙ne of the most profound social changes in the country in decades,鈥� . The last time an assisted dying bill came before the House in 2015, it was defeated 330 to 118. 

Concerns: Bill opponents are worried that the legislation will lead to coercion of vulnerable people such as older people or people with disabilities.

What鈥檚 next: The measure goes to parliamentary committees before returning to the House of Commons for another vote.

Related: 

How assisted dying has spread across the world and how laws differ 鈥嬧�嬧��

What It Means to Legalize Assisted Death 鈥� QUICK HITS Malaria vaccine rolled out in world's worst-affected country 鈥�

Supreme Court justices question block on flavored vapes, but don鈥檛 appear convinced FDA was unfair 鈥�

New Report: Life Expectancy Years Shorter in the United States Compared to the United Kingdom 鈥�

En route to a 鈥渇unctional cure鈥� for HIV 鈥�

Eliminating Rabies in Africa Must Begin with Quality Data 鈥�

Why every medic needs to know basic sign language 鈥�

Disability rights: UN chief calls for amplified leadership roles to shape more inclusive future 鈥�

How a middle schooler found a new compound in a piece of goose poop 鈥� Issue No. 2823
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on and follow us on Instagram and X .

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You can or .

96 Global Health NOW: AIDS at a Juncture; November Recap; and Foodborne Pathogens Flourishing December 2, 2024 Young children with face paint pose for a photo during the World AIDS Day program in Kolkata, India, on December 1, 2021. Avishek Das/SOPA Images/LightRocket via Getty AIDS at a Juncture
The AIDS epidemic is at a 鈥渉istoric crossroads.鈥�

The end of AIDS as a pandemic is in sight, with effective treatments and a revolutionary new vaccine on deck. Yet discrimination keeps lifesaving treatment out of reach for too many, and critical gains remain under threat. 

Those are findings of the new released for World AIDS Day, which called for a 鈥渞ights-based approach鈥� to fighting the epidemic, . 

Key points of the report:

• One-quarter of people living with HIV鈥�9 million+ people鈥攍ack access to lifesaving treatment. 


• LGBTQ+ people are underserved in 63 countries that still criminalize them. 


• Women and girls are especially vulnerable, accounting for 62% of new HIV infections in sub-Saharan Africa last year. 


• Children remain unreached, with just 57% of children with HIV and 65% of adolescents having access to antiretroviral therapy.

Ground-shifting shot: A twice-yearly shot from Gilead was 100% effective in preventing HIV infections in a study of women and works nearly as well in men, .

• The shot, lenacapavir, is already sold under the brand name Sunlenca to treat HIV infections, but Gilead is now seeking authorization to use it for prevention.

Rights at risk: Advocates say such gains are fragile in the face of persistent disparities and a 鈥渄isturbing rollback in protections鈥� for stigmatized groups, .

• And in the U.S., fear is especially acute that the incoming Trump administration will sow AIDS disinformation and denialism, writes Jason Rosenberg in a . 

GLOBAL HEALTH VOICES The Latest One-Liners   In Afghanistan, women arrested for begging say they鈥檝e endured sexual abuse, torture, and forced labor and witnessed children being beaten and abused while in prison.

COVID-19 pneumonia is more likely to develop in men than women, per a new in Scientific Reports that found that 12% of men in Mexico were likely to develop the condition during the early days of the pandemic, compared with 7% of women.

Trump鈥檚 pick for NIH head is health economist Jay Bhattacharya, who criticized pandemic lockdowns and vaccine mandates and promoted 鈥渉erd immunity,鈥� the idea that people at low risk should live normally while building up immunity to COVID-19 through infection.  

Indigenous groups are among the speakers at global negotiations to curb plastic pollution, saying the entire life cycle of plastic鈥攆rom oil production to pollution to microplastics in water鈥攑oses health threats to Indigenous communities worldwide. NOVEMBER鈥橲 MUST-READS Fading Fear of HIV Tied to Rise in STIs  
In South Africa鈥檚 wealthy Gauteng province, HIV infections are falling鈥攚ith condoms, PrEP, PEP, and antiretroviral drugs credited for slashing new infections. But other sexually transmitted infections, including syphilis and gonorrhea, are on the rise amid an apparent false sense of security鈥攚ith sex workers reporting that younger clients in particular resist condoms, arguing they are safe because of anti-HIV treatments.
Superbugs Thriving in War
A 鈥済rowing and dire鈥� crisis of antimicrobial resistance is taking hold in Gaza, as attacks on hospitals and blockades leave doctors with few tools to fight infections. Critical antibiotics remain unavailable, and many infections are unresponsive to the limited antibiotics at hand鈥攔esulting in amputations and death. With so few drugs, 鈥渘urses have a bottle of vinegar on the wound-dressing shelf鈥� to treat infections, said Gaza physician Khaled al Shawwa.
  LGBTQ Afghans Targeted by the Taliban
Since the Taliban regained power in Afghanistan in 2021, LGBTQ citizens have endured 鈥渨idespread鈥� physical and sexual violence in detention centers, human rights groups report. One group, Roshaniya, has documented 825 instances of violence against LGBTQ people in Afghanistan, including beatings, arrests, and detention鈥攁nd emphasized the number was likely an undercount.
How 鈥楥lick鈥� Cigarettes Hook Latin American Teens  
A dizzying array of cigarette flavors鈥攍emonade, apple, lollipop, strawberry鈥攁re enticing young people across Latin America to try smoking, and keeping them hooked. Despite promises to phase out traditional tobacco products, Philip Morris International and British American Tobacco have made these 鈥渇lavor capsule鈥� or 鈥渃lick鈥� cigarettes a staple in countries including Chile, Peru, Argentina, and Bolivia while fighting regional efforts to ban the products, a joint investigation by The Examination, Per煤鈥檚 Salud con lupa, and Chile鈥檚 LaBot news outlets reveals.
UnitedHealth鈥檚 Punishing Playbook  
UnitedHealth Group, the U.S.鈥檚 biggest insurance conglomerate, has deployed algorithms and other strategies to identify those 鈥渙verusing鈥� mental health services鈥攁nd then limited or revoked coverage for some of the nation鈥檚 most vulnerable patients. This investigative story details the company鈥檚 playbook for coverage denials鈥攄espite a series of lawsuits, and regardless, therapists say, of the severity of their patients鈥� issues. NOVEMBER鈥橲 EXCLUSIVES An NG Biotech employee manufactures "Carba" tests, an antibiotic resistance test in Guipry, western France. April 6, 2020. Damien Meyer / AFP via Getty Report:

• By Annalies Winny

ASTMH Coverage:

• By Brian W. Simpson

• By Brian W. Simpson

• By Dayna Kerecman Myers

Commentaries:

• Walter Orenstein:

• Kristi Saporito:

NOVEMBER鈥橲 BEST NEWS Rwanda鈥檚 Robust Outbreak Response
Rwanda鈥檚 rapid-fire efforts to contain its first-ever Marburg outbreak won praise as 鈥渦nprecedented.鈥�

Key success factors:

• Extensive testing and contact tracing.


• Solid and well-connected health infrastructure and well-trained health professionals.


• Experimental vaccines and treatments.

鈥淚t鈥檚 not yet time to declare victory, but we think we are headed in a good direction,鈥� said health minister Yvan Butera.

GLOBAL HEALTH VOICES CLIMATE CRISIS Foodborne Pathogens Flourishing
Higher temperatures and shifting precipitation patterns are creating prime conditions for foodborne illnesses to proliferate, researchers are warning.

• For every 1掳C rise in temperature, the risk of bacterial infection from Salmonella and Campylobacter increases by 5%, published in October in eBiomedicine. 

Among the impacts:

• Extreme heat makes food supplies vulnerable to pathogens including Salmonella spp., E. coli, and Campylobacter jejuni, per a review published in June in Climatic Change. 


• Meanwhile, runoff from more frequent flooding is contaminating agricultural produce meant to be consumed raw.

In India鈥檚 Maharashtra state, community health worker Sumitra Sutar has become an 鈥渆vangelist鈥� about the issue: 鈥溾�嬧�婭 ask people not only to observe the changing climatic patterns but also carefully consider what鈥檚 on their plate.鈥�

RESOURCES QUICK HITS Africa CDC launches continental blueprint to combat endemic, neglected tropical diseases 鈥�

Long a 鈥楥rown Jewel鈥� of Government, N.I.H. Is Now a Target 鈥�

Why Fluoride Is Necessary for Public Health 鈥�

Starlink roll-out across Africa could transform digital health services 鈥�

Dengue: a hidden threat in blood transfusions amidst Brazil's largest outbreak? 鈥�

Measuring the Impact of Training the Trainers: Lessons From Pilots and Plastic Surgeons 鈥�

What鈥檚 the secret to living to 100? Centenarian stem cells could offer clues 鈥�

Ed Sheeran and Fuse ODG rebuke Band Aid charity song. We ask Kenyans to weigh in 鈥�

Libraries are offering free health and wellness classes across the US 鈥� November 2024
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on and follow us on Instagram and X .

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  Copyright 2024 Johns Hopkins Bloomberg School of Public Health. All Rights Reserved. Views and opinions expressed in Global Health NOW do not necessarily reflect those of the Johns Hopkins Bloomberg School of Public Health or Johns Hopkins University.


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96 A Strong Future for Global Health NOW You鈥檙e among the first to know about this year鈥檚 fundraising campaign. December 2, 2024 Students at a vaccination event Don Det, Laos, on April 27, 2023. Antoine Lassalle/Getty) Dear Reader,
As one of our most loyal Global Health NOW subscribers and a valued donor, we want you to be among the first to know about this year鈥檚 fundraising campaign celebrating our 10th anniversary.  
Tomorrow, we'll ask our readers to make a gift to support Global Health NOW.鈥� 
Your generosity in Global Health NOW鈥檚 previous campaigns鈥攖he last was two years ago鈥攈as helped us to publish 2,822 newsletter issues and launch the Local Reporting Initiative, which has published dozens of exclusive articles from all over the world.鈥�    Please give today to support our next decade of important, independent reporting.  We鈥檙e committed to keeping GHN free to all. With your support, we will embark on another 10 years of sharing critical, timely knowledge on a global scale and publishing articles and commentaries available nowhere else.    I hope you鈥檒l in giving to Global Health NOW.      With gratitude,    Brian    Brian W. Simpson, MPH  Editor-in-Chief   Global Health NOW  bsimpso1@jhu.edu 
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, and Jackie Powder. Write us: dkerecm1@jhu.edu, like us on and follow us on X .

Please send the Global Health NOW free sign-up link to friends and colleagues:

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  Copyright 2024 Johns Hopkins Bloomberg School of Public Health. All Rights Reserved. Views and opinions expressed in Global Health NOW do not necessarily reflect those of the Johns Hopkins Bloomberg School of Public Health or Johns Hopkins University.


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96 Global Health NOW: AIDS at a Juncture; November Recap; and Foodborne Pathogens Flourishing December 2, 2024 Young children with face paint pose for a photo during the World AIDS Day program in Kolkata, India, on December 1, 2021. Avishek Das/SOPA Images/LightRocket via Getty AIDS at a Juncture
The AIDS epidemic is at a 鈥渉istoric crossroads.鈥�

The end of AIDS as a pandemic is in sight, with effective treatments and a revolutionary new vaccine on deck. Yet discrimination keeps lifesaving treatment out of reach for too many, and critical gains remain under threat. 

Those are findings of the new released for World AIDS Day, which called for a 鈥渞ights-based approach鈥� to fighting the epidemic, . 

Key points of the report:

• One-quarter of people living with HIV鈥�9 million+ people鈥攍ack access to lifesaving treatment. 


• LGBTQ+ people are underserved in 63 countries that still criminalize them. 


• Women and girls are especially vulnerable, accounting for 62% of new HIV infections in sub-Saharan Africa last year. 


• Children remain unreached, with just 57% of children with HIV and 65% of adolescents having access to antiretroviral therapy.

Ground-shifting shot: A twice-yearly vaccine from Gilead was 100% effective in preventing HIV infections in a study of women and works nearly as well in men, .

• The shot, lenacapavir, is already sold under the brand name Sunlenca to treat HIV infections, but Gilead is now seeking authorization to use it for prevention.

Rights at risk: Advocates say such gains are fragile in the face of persistent disparities and a 鈥渄isturbing rollback in protections鈥� for stigmatized groups, .

• And in the U.S., fear is especially acute that the incoming Trump administration will sow AIDS disinformation and denialism, writes Jason Rosenberg in a . 

GLOBAL HEALTH VOICES The Latest One-Liners   In Afghanistan, women arrested for begging say they鈥檝e endured sexual abuse, torture, and forced labor and witnessed children being beaten and abused while in prison.

COVID-19 pneumonia is more likely to develop in men than women, per a new in Scientific Reports that found that 12% of men in Mexico were likely to develop the condition during the early days of the pandemic, compared with 7% of women.

Trump鈥檚 pick for NIH head is health economist Jay Bhattacharya, who criticized pandemic lockdowns and vaccine mandates and promoted 鈥渉erd immunity,鈥� the idea that people at low risk should live normally while building up immunity to COVID-19 through infection.  

Indigenous groups are among the speakers at global negotiations to curb plastic pollution, saying the entire life cycle of plastic鈥攆rom oil production to pollution to microplastics in water鈥攑oses health threats to Indigenous communities worldwide. NOVEMBER鈥橲 MUST-READS Fading Fear of HIV Tied to Rise in STIs  
In South Africa鈥檚 wealthy Gauteng province, HIV infections are falling鈥攚ith condoms, PrEP, PEP, and antiretroviral drugs credited for slashing new infections. But other sexually transmitted infections, including syphilis and gonorrhea, are on the rise amid an apparent false sense of security鈥攚ith sex workers reporting that younger clients in particular resist condoms, arguing they are safe because of anti-HIV treatments.
Superbugs Thriving in War
A 鈥済rowing and dire鈥� crisis of antimicrobial resistance is taking hold in Gaza, as attacks on hospitals and blockades leave doctors with few tools to fight infections. Critical antibiotics remain unavailable, and many infections are unresponsive to the limited antibiotics at hand鈥攔esulting in amputations and death. With so few drugs, 鈥渘urses have a bottle of vinegar on the wound-dressing shelf鈥� to treat infections, said Gaza physician Khaled al Shawwa.
  LGBTQ Afghans Targeted by the Taliban
Since the Taliban regained power in Afghanistan in 2021, LGBTQ citizens have endured 鈥渨idespread鈥� physical and sexual violence in detention centers, human rights groups report. One group, Roshaniya, has documented 825 instances of violence against LGBTQ people in Afghanistan, including beatings, arrests, and detention鈥攁nd emphasized the number was likely an undercount.
How 鈥楥lick鈥� Cigarettes Hook Latin American Teens  
A dizzying array of cigarette flavors鈥攍emonade, apple, lollipop, strawberry鈥攁re enticing young people across Latin America to try smoking, and keeping them hooked. Despite promises to phase out traditional tobacco products, Philip Morris International and British American Tobacco have made these 鈥渇lavor capsule鈥� or 鈥渃lick鈥� cigarettes a staple in countries including Chile, Peru, Argentina, and Bolivia while fighting regional efforts to ban the products, a joint investigation by The Examination, Per煤鈥檚 Salud con lupa, and Chile鈥檚 LaBot news outlets reveals.
UnitedHealth鈥檚 Punishing Playbook  
UnitedHealth Group, the U.S.鈥檚 biggest insurance conglomerate, has deployed algorithms and other strategies to identify those 鈥渙verusing鈥� mental health services鈥攁nd then limited or revoked coverage for some of the nation鈥檚 most vulnerable patients. This investigative story details the company鈥檚 playbook for coverage denials鈥攄espite a series of lawsuits, and regardless, therapists say, of the severity of their patients鈥� issues. NOVEMBER鈥橲 EXCLUSIVES An NG Biotech employee manufactures "Carba" tests, an antibiotic resistance test in Guipry, western France. April 6, 2020. Damien Meyer / AFP via Getty Report:

• By Annalies Winny

ASTMH Coverage:

• By Brian W. Simpson

• By Brian W. Simpson

• By Dayna Kerecman Myers

Commentaries:

• Walter Orenstein:

• Kristi Saporito:

NOVEMBER鈥橲 BEST NEWS Rwanda鈥檚 Robust Outbreak Response
Rwanda鈥檚 rapid-fire efforts to contain its first-ever Marburg outbreak won praise as 鈥渦nprecedented.鈥�

Key success factors:

• Extensive testing and contact tracing.


• Solid and well-connected health infrastructure and well-trained health professionals.


• Experimental vaccines and treatments.

鈥淚t鈥檚 not yet time to declare victory, but we think we are headed in a good direction,鈥� said health minister Yvan Butera.

GLOBAL HEALTH VOICES CLIMATE CRISIS Foodborne Pathogens Flourishing
Higher temperatures and shifting precipitation patterns are creating prime conditions for foodborne illnesses to proliferate, researchers are warning.

• For every 1掳C rise in temperature, the risk of bacterial infection from Salmonella and Campylobacter increases by 5%, published in October in eBiomedicine. 

Among the impacts:

• Extreme heat makes food supplies vulnerable to pathogens including Salmonella spp., E. coli, and Campylobacter jejuni, per a review published in June in Climatic Change. 


• Meanwhile, runoff from more frequent flooding is contaminating agricultural produce meant to be consumed raw.

In India鈥檚 Maharashtra state, community health worker Sumitra Sutar has become an 鈥渆vangelist鈥� about the issue: 鈥溾�嬧�婭 ask people not only to observe the changing climatic patterns but also carefully consider what鈥檚 on their plate.鈥�

RESOURCES QUICK HITS Africa CDC launches continental blueprint to combat endemic, neglected tropical diseases 鈥�

Long a 鈥楥rown Jewel鈥� of Government, N.I.H. Is Now a Target 鈥�

Why Fluoride Is Necessary for Public Health 鈥�

Starlink roll-out across Africa could transform digital health services 鈥�

Dengue: a hidden threat in blood transfusions amidst Brazil's largest outbreak? 鈥�

Measuring the Impact of Training the Trainers: Lessons From Pilots and Plastic Surgeons 鈥�

What鈥檚 the secret to living to 100? Centenarian stem cells could offer clues 鈥�

Ed Sheeran and Fuse ODG rebuke Band Aid charity song. We ask Kenyans to weigh in 鈥�

Libraries are offering free health and wellness classes across the US 鈥� Issue No. 2822
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on and follow us on Instagram and X .

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96 Global Health NOW: Manila鈥檚 Massive Fire; How 鈥楥lick鈥� Cigarettes Hook Latin American Teens; and (Mostly) Defying Gravity November 26, 2024 A man watches houses on fire at Tondo, in Manila, on November 24. Jam Sta Rosa/AFP via Getty Manila鈥檚 Massive Fire  
Fire raced through a crowded, informal settlement in Manila, Philippines, on Sunday, leaving up to 10,000 people homeless, .

• News reports estimate 1,000 to 2,000 families are now homeless.


• Manila鈥檚 Mayor Honey Lacuna said the city would provide evacuees with 鈥渃ash aid, food, and materials for rebuilding their homes.鈥�

Houses in the Isla Puting Bato residential area, next to the capital city鈥檚 port, were built with scavenged wood and other materials and were built on stilts, .
 
Drone video shared by shows a wall of flame engulfing a large portion of the neighborhood and later, twisted black tin sheets and ash.
 
The Quote: 鈥淚 feel bad because we have no livelihood and no home. We don鈥檛 know how we can eat,鈥� resident Elvira Valdemoro told a reporter in the video.
 
No deaths have been reported from the fire, and the cause hasn鈥檛 been determined. EDITORS鈥� NOTE Thanksgiving Break
GHN will not be published from tomorrow, Wednesday, November 27, through Friday, November 29, for the observance of the U.S. Thanksgiving holiday.
 
On the topic of thanks: We鈥檙e very thankful for all of our readers and the many ways you strengthen GHN. Special shout-out to all of you who submitted ideas for our Untold Stories contest; we hope to announce the winners within a couple of weeks.
 
We鈥檒l be back on Monday, December 2, with more news! 鈥�The Editors DATA POINT The Latest One-Liners   Pesticide-tainted food in small convenience shops in South Africa may be to blame for a spate of food poisoning deaths in recent months, including at least 23 children; the country has declared a national disaster to address the crisis.
 
Queensland, Australia is in the throes of its worst recorded whooping cough outbreak, with the death of one baby, 23X as many cases as this point last year, and rising hospital admissions鈥攑articularly among infants; vaccination rates among pregnant women plunged 6.5% between 2020 and 2023.

The U.S. Supreme Court yesterday declined to hear a challenge by major tobacco sellers to an FDA rule mandating the inclusion of graphic anti-smoking images on cigarette packs and ads.

Drugmaker Cassava Sciences halted all ongoing studies of its controversial Alzheimer鈥檚 drug, simufilam, after it showed no signs of working in a phase 3 clinical trial. The Latest: US Trump Transition Health News
鈥榃e learned the hard way鈥�: Samoa remembers a deadly measles outbreak and a visit from RFK Jr 鈥�

How RFK Jr. could use levers of HHS to shape vaccine and drug outcomes 鈥�

In the MAHA-verse, ex-Bernie die-hards and conservative moms find a political home 鈥�

CDC chief urges focus on health threats as agency confronts political changes 鈥�

Trump's Medical 'Contrarians' Herald New Era of Vaccine Scrutiny 鈥� GLOBAL HEALTH VOICES TOBACCO How 鈥楥lick鈥� Cigarettes Hook Latin American Teens
A dizzying array of cigarette flavors鈥攍emonade, apple, lollipop, strawberry鈥攁re enticing young people across Latin America to try smoking, and keeping them hooked. 

Despite promises to phase out traditional tobacco products, Philip Morris International and British American Tobacco have made these 鈥渇lavor capsule鈥� or 鈥渃lick鈥� cigarettes a staple. 

Crawford Moodie, a researcher with the University of Stirling in Scotland who studies flavored cigarettes, calls them 鈥渁 huge, global public health threat.鈥�

• In Chile, flavored brands like Lucky Strike Fresh Wild account for 42% of cigarette sales. 

• In Peru, flavored cigarettes make up more than half of sales. 

• In Argentina, Bolivia, Colombia, Costa Rica, Guatemala, and M茅xico, more than a fifth of cigarettes sold contain flavor capsules.

Related: The huge stakes in a Supreme Court case about vaping 鈥� CHILD AND ADOLESCENT HEALTH Behind the Child Mortality Reversal 
Child death rates in the U.S. dropped for decades due to medical advances and public health policies. But a sharp reversal occurred from 2019 to 2021, with the mortality rate surging more than 10%.

The driver: Injuries. Gun violence鈥攏ow the leading cause of death among children鈥攁ccounted for nearly half of the increase. Overdoses more than doubled, and fatal car accidents spiked 16%

Disproportionately affected: Black and Native American children, who have been dying at much higher rates than white children. 

Behind the data: Studies into gun violence have stalled for years due to political interference. While congressional funding in 2019 brought about a resurgence of research, a shifting political climate could jeopardize that work. 

THANKSGIVING DIVERSION (Mostly) Defying Gravity
This Thursday, 60-foot giants will once again stalk the streets of Manhattan鈥攁nd crowds of adoring fans will cheer them on. 

The balloons of the annual Macy鈥檚 Thanksgiving Day Parade seem to amble through New York City without a care in the world. But walking on air takes tremendous groundwork, : 

Floating numbers: Bringing the 17 鈥渃haracter balloons,鈥� 15 鈥渉eritage and novelty balloons,鈥� and 22 parade floats to life requires 18 months of prep and 60 artisans working thousands of hours.

• Each new balloon creation takes about six months, and balloons are tested in New Jersey at the in the weeks before the parade. 

When balloon dreams burst: Even the most calculated planning can鈥檛 prevent certain disasters鈥攍ike a fateful face-off between a tree and Kermit the Frog which left Kermit faceless, and a deluge unleashed from a rain-drenched Popeye鈥檚 cap, . 

Related: Macy's Thanksgiving Day Parade Boss Takes Us Behind the Scenes of This Year's Spectacle - QUICK HITS A triple emergency in Kenya amid malaria and measles outbreaks 鈥�

It's a virus you may not have heard of. Here's why scientists are worried about it 鈥�

In search of a vaccine for leishmaniasis 鈥�

America's Alarming Bird-Flu Strategy: Hope for the Best 鈥�

Drugs like Wegovy, Ozempic would be covered by Medicare, Medicaid under Biden proposal 鈥�

A pathway for skin NTD diagnostic development 鈥�

Could games help people stick to HIV treatment? 鈥�

The disappearance of empathetic touch in medicine 鈥�

Do not wash your turkey and other Thanksgiving tips to keep your food safe 鈥� Issue No. 2821
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on and follow us on Instagram and X .

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96 Global Health NOW: Mpox Still an Emergency; Neglected Diseases Are Fierce, But So Is Monique Wasunna; A Multipronged Assault on Mosquitoes November 25, 2024 Patients wait for consultations in the mpox isolation ward at the Kavumu hospital in DRC's South Kivu region. September 3. Arlette Bashizi/Bloomberg via Getty Mpox Still an Emergency 
Mpox is still a public health emergency of international concern, a WHO committee decided Friday, due to rising cases, continued geographic spread, and 鈥渙ngoing challenges in the field,鈥� . 

Vaccine impact emerging: The decision comes as the agency confirmed that new cases appear to be 鈥減lateauing鈥� in the epicenter DRC since the first batch of vaccinations was rolled out鈥攂ut officials cautioned that the disease is still spreading across the continent, and that it remains too early to ascertain the vaccine鈥檚 overall impact, .

• The WHO will publish the emergency committee鈥檚 full report this week, along with its updated recommendations, . 

Children remain unvaccinated: While children are most vulnerable to the effects of mpox, they remain ineligible for current vaccines鈥攁 decision opposed by a growing number of local doctors and international agencies, .

• That could be changing, as a DRC immunization official said a vaccination plan for children has been drafted. 

Related: Protecting Kids: Mpox Guidelines for Schools 鈥� GLOBAL HEALTH VOICES The Latest One-Liners
Fatal attacks on health workers in Lebanon have reached a 鈥渉igher percentage than in any active conflict today across the globe,鈥� 鈥攚ith 47% of all attacks on health facilities causing the death of a health worker.

M茅decins Sans Fronti猫res has in Port-au-Prince for the first time in 30+ years after repeated attacks and violent threats against staff by the national police and armed vigilantes; the charity was one of the last health providers in the besieged city.
Scientists are bracing for the impact of president-elect Trump鈥檚 promised travel bans, which stand to stress an already shrinking academic workforce, stymie collaborations, and stall progress on research; at least two U.S. universities have advised international students to return to campus before Jan. 20, when Trump will be able to issue executive orders.
  Smoking could cause ~300,000 cancer cases in the UK over the next five years, per a new analysis from Cancer Research UK, which said the 鈥渕agnitude of damage鈥� from smoking warrants further government intervention. GHN EXCLUSIVE Monique Wasunna delivering a keynote address at the ASTMH annual meeting in New Orleans, November 13. Brian W. Simpson Neglected Diseases Are Fierce, But So Is Monique Wasunna
NEW ORLEANS鈥擬onique Wasunna鈥檚 dramatic efforts as a young doctor in Kenya to save an 11-year-old boy with visceral leishmaniasis鈥攔acing him in her own car to a referral hospital鈥攕haped her career.
  鈥淚 said to myself 鈥� I will do anything in my power to help other patients. I will be their advocate. My mind was made up. Leishmaniasis it was, NTDs it was,鈥� the DNDi Africa Ambassador told GHN in a . She reflected on her efforts to fight visceral leishmaniasis and other neglected diseases and shared insights on the work ahead, touching on:

• The NTD most likely to hit the global elimination milestone next (hint: the earlier treatment was an arsenic compound that patients said feels like 鈥渇ire in the veins鈥�).


• Critical obstacles that donors are neglecting.


• The little-discussed ingredient needed to combat brain drain.

She summed up with encouraging words for emerging leaders exploring the neglected diseases space: 鈥淚f young people reflect upon what their contributions will be, and ask how they can make a difference, we can succeed."

GLOBAL HEALTH VOICES MALARIA A Multipronged Assault on Mosquitoes  
At Ifakara Health Institute in Tanzania, researchers know there is no silver bullet for malaria. 

That鈥檚 why scientists and engineers there are busy crafting an arsenal against the disease and the mosquitoes that carry it鈥攁ll from a network of labs that would 鈥渕ake James Bond鈥檚 Q green with envy.鈥�

The inventory of interventions鈥攆rom the simple to highly sophisticated鈥攊ncludes:

• Mosquito-proof sandals: Simple leather sandals fitted with a woven strap treated with insecticide, which reduced mosquito landings by 48%. 


• Eaves ribbons: Strips of insecticide-treated fabric created to hang at ventilation gaps in mud and brick housing.


• Genetic modification: Ifakara has launched an effort to modify mosquito genes so that the insects cannot transmit the malaria parasite. 

MENTAL HEALTH UnitedHealth鈥檚 Punishing Playbook to Restrict Coverage   
UnitedHealth Group, the U.S.鈥檚 biggest insurance conglomerate, has deployed algorithms and other strategies to identify those 鈥渙verusing鈥� mental health services. 

• It then limits or revokes coverage for some of the nation鈥檚 most vulnerable patients. 

ProPublica鈥檚 must-read investigative story details the company鈥檚 playbook for coverage denials鈥攄espite a series of lawsuits, and regardless, therapists say, of the severity of their patients鈥� issues.

• Federal law blocks companies from making mental health care coverage harder to obtain than physical health coverage, but a regulatory patchwork allows UnitedHealth and other insurance companies to skirt scrutiny鈥攆orcing regulators into a 鈥淲hac-A-Mole鈥� scenario.

One former UnitedHealth employee said he felt like 鈥渁 cog in the wheel of insurance greed.鈥�

OPPORTUNITY QUICK HITS CDC confirms H5N1 in California child as Hawaii details testing results 鈥�

How recent flooding crisis could fuel neglected topical diseases in Kenya 鈥�

Moscow bans adoption of Russian children to countries that allow gender transition 鈥�

It took years for my Black son to be diagnosed with cystic fibrosis. Then it happened to my family again 鈥�

Fold paper. Insert lens. This $2 microscope changes how kids see the world 鈥�

鈥楢 place of joy鈥�: why scientists are joining the rush to Bluesky 鈥� Issue No. 2820
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on and follow us on Instagram and X .

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96 Global Health NOW: Taliban Targets LGBTQ Afghans; Better Road Safety Journalism; and A Human in Bear鈥檚 Clothing LGBTQ people in Afghanistan face beatings, arrests, and detention. November 21, 2024 Yahya, an Afghan who identifies as gay speaks during an interview at an undisclosed location, on September 28, 2021. AFP via Getty LGBTQ Afghans Targeted by the Taliban
Since the Taliban regained power in Afghanistan in 2021, LGBTQ citizens have endured 鈥渨idespread鈥� physical and sexual violence in detention centers, human rights groups report.

One group, Roshaniya, has documented 825 instances of violence against LGBTQ people in Afghanistan, including beatings, arrests, and detention鈥攁nd emphasized the number was likely an undercount. 

• And transgender and gender non-conforming people are being 鈥渃onsistently鈥� targeted at Taliban checkpoints. 

The Quote: 鈥淚 am a prisoner in a country called Afghanistan,鈥� said Abdul, a 22-year-old gay man. 鈥淚 have to hide from everyone, hide from family, hide from friends, hide from the government, hide from life.鈥�

GLOBAL HEALTH VOICES The Latest One-Liners
60% of Americans say they will 鈥減robably not鈥� get an updated COVID-19 vaccine, ; reasons given include concerns of potential side effects and belief that the booster is not necessary.

Poliovirus detected in Warsaw wastewater is prompting Poland鈥檚 health authorities to urge that children be vaccinated; about 86% of the country鈥檚 3-year-olds have been vaccinated against the virus.  

Women with endometriosis or growths in their uterus have a slightly higher risk of dying before age 70, .  

A new malaria vaccination strategy involves boosting immunity via genetically engineered parasites, ; the strategy protected ~90% of study participants from 鈥渃ontracting the disease after being bitten by malaria mosquitoes.鈥�   GHN EXCLUSIVE COMMENTARY Police in Bogota conduct speeding checkpoints a key part of a comprehensive road safety strategy in 2022. Bogota Secretariat of Mobility Language Reform Drives Change in Road Safety Journalism
With a staggering global toll of  deaths per year, road crashes are the leading cause of death for people age 鈥攁nd they are almost always preventable.
 
Yet many people consider road traffic crashes happenstances鈥撯�揳nd media messaging reinforces that narrative, often depicting them as 鈥渁ccidents,鈥� 鈥渂ad luck,鈥� and or the victim鈥檚 fault, writes Vital Strategies鈥� Kristi Saporito.
 
Framing crashes as isolated and inevitable 鈥渁ccidents鈥� beyond our control implies that they鈥檙e inevitable鈥攂ut solutions, including protective policies, exist.
 
Words matter: By communicating that road safety is a public health issue and that crashes are largely preventable, the media has the power to shift attitudes, Saporito writes.

• Journalism trainings in Colombia, supported by  and the , advised reporters on neutral road-incident vocabulary and placing traffic crashes in the context of broader road safety issues鈥攁nd led to measurable improvements in reporting language. 

Next steps: Improving road safety media coverage will require sustained discourse between journalists, road safety stakeholders, and public health experts.

GLOBAL HEALTH VOICES U.S. ELECTION What Does Dr. Oz鈥檚 Appointment Mean for Medicare? 
Dr. Oz鈥攖he heart surgeon, turned TV star, turned Trump appointee to run the Centers for Medicare and Medicaid Services鈥攊s a familiar face for his daytime television persona as 鈥淎merica鈥檚 Doctor.鈥�

Less familiar? His policy positions regarding the federal agency that oversees coverage for 145 million Americans, its $1 trillion budget, and what kind of influence he could bring to coverage decisions, drug price negotiations, and the Affordable Care Act, . 

Puzzling positions: 

• Oz has championed healthy lifestyle habits and criticized Big Pharma鈥攁nd he has also spread misinformation about Covid-19, promoted unproven supplements, and profited from the pharmaceutical industry he鈥檚 criticized. 

• He has previously expressed support for Medicare privatization. He has not revealed his views on Medicaid鈥攖hough some Republicans in Congress have called for changes that shrink the program鈥檚 budget, . 

ALMOST FRIDAY DIVERSION A Human in Bear鈥檚 Clothing
It鈥檚 hard to be funny. But you know what鈥檚 even harder? Taking something objectively hilarious and pretending it isn鈥檛. So, a big GHN kudos to whoever does the press releases for the California Department of Insurance.
 
The staffer : Four suspects were arrested on charges of insurance fraud after claiming their luxury vehicles were vandalized by bears鈥斺�渂ut it was actually a person in a bear costume.鈥�
 
It bears (ahem) mentioning: Video footage  effortlessly opening car doors and rifling about in a suspiciously sapiens manner.
 
Still, investigators needed to be sure, so they enlisted a biologist who 鈥渙pined it was clearly a human in a bear suit.鈥�
 
Further confirming the obvious: A was found in a suspect鈥檚 home. QUICK HITS US CDC expects COVID and RSV levels to increase in coming weeks 鈥�

New study finds climate change is increasing the power of hurricanes 鈥�

鈥業ncreasing risk鈥� of tropical infections as new blood donor monitoring launched 鈥�

Less-potent fentanyl pills may be playing a role in decrease of US overdose deaths, DEA says 鈥�

Scientists taught rats to drive 鈥� now they love getting behind the wheel 鈥� Issue No. 2819
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on and follow us on Instagram and X .

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96 Global Health NOW: Superbugs Thriving in War; Growing Older Solo鈥擶ith Support; and Envisioning Greener Health Care in SA November 20, 2024 Superbugs Thriving in War
A 鈥済rowing and dire鈥� crisis of antimicrobial resistance is taking hold in Gaza, as attacks on hospitals and blockades leave doctors with few tools to fight infections, . 

Open wounds: Amid a constant backlog of patient care, many patients鈥� wounds are left open for long periods of time, leading to acute infections, say researchers with M茅decins Sans Fronti猫res.

• Critical antibiotics remain unavailable, and many infections are unresponsive to the limited antibiotics at hand鈥攔esulting in amputations and death. 


• With so few drugs, 鈥渘urses have a bottle of vinegar on the wound-dressing shelf鈥� to treat infections, said Gaza physician Khaled al Shawwa. 

A longer war: Superbugs have long been a . Data collected by MSF from 2019 to 2023 showed that 70%+ of Staphylococcus aureus infections in wounded patients involved a MRSA superbug strain.

Meanwhile, an overconsumption crisis: Global antibiotic usage has climbed 20%+ globally since 2016鈥攄espite a pandemic-era disruption, a new of pharmaceutical sales published in PNAS finds, . 

• Higher consumption levels are largely being driven by LMICs, where weak health care and hygiene systems have exacerbated illnesses and 鈥渋ndiscriminate鈥� antibiotic use.

GLOBAL HEALTH VOICES The Latest One-Liners
A second mpox vaccine has been granted emergency use designation ; Japan鈥檚 stockpiled doses of its LC16m8 mpox vaccine will be sent to the DRC and Burundi, and will be the first mpox vaccine available for children.

53 days post-Hurricane Helene, potable water has been restored in Asheville, North Carolina, after storm damage required extensive repair of the city鈥檚 water treatment and distribution system.

A new nasal vaccine to prevent whooping cough could help slow the disease鈥檚 spread; the vaccine, developed by Tulane University, works to clear bacteria from the upper respiratory tract, limiting contagion. WORLD CHILDREN'S DAY DATA POINT AGING Growing Older Solo鈥擶ith Support
As more Americans face aging alone and far from family, support networks are being redefined as neighbors, friends, and fellow 鈥渟olo agers鈥� step in to help with daily care needs.

• In 2015, 15 million Americans ages 50+ had no nearby family; this number is expected to rise to 21 million by 2060.

Weaving webs of support: Many older adults without a spouse or nearby children have adapted by creating local networks to support their independence, per a . 

Still a challenge: A 2022 AARP survey showed only 25% of solo agers had help with household tasks, and just 38% had support for ongoing care needs.

GLOBAL HEALTH VOICES ENVIRONMENTAL HEALTH Envisioning Greener Health Care in SA
The environmental impact of South Africa鈥檚 health care system is massive鈥攂ut so are the opportunities for change.
 
Reconsidering single-use: Although manufacturers and regulators typically designate medical devices for single use, research shows that some could be safely sterilized and reused.

Smaller carbon footprints: Some new hospitals in SA have been designed with energy-efficient features like solar power, and energy-saving measures in Western Cape pilot projects have eliminated thousands of tons of CO2.

Big opportunity: South Africa could join the WHO鈥檚 Alliance for Transformative Action on Climate and Health, which aims to help countries make health care greener. 

OPPORTUNITY QUICK HITS Amid record year for dengue infections, study finds climate change responsible for 19% of rising dengue burden 鈥�

Nationwide IV fluid shortage changing how hospitals manage patient hydration 鈥�

California child tests positive for bird flu with no known exposure to infected animals 鈥�

Djibouti experiments with GM mosquito against malaria 鈥�

60% of Americans say they probably won't get an updated COVID-19 vaccine 鈥�

New FDA rules for TV drug ads: Simpler language and no distractions 鈥�

Elon Musk Asked People to Upload Their Health Data. X Users Obliged. 鈥� Issue No. 2818
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on and follow us on Instagram and X .

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96 Superbug Fight Needs a Better Business Model; Leading Cause of Maternal Deaths: Homicide; and Dr. ChatBot Is In鈥攁nd Often Right November 19, 2024 GHN EXCLUSIVE REPORT An NG Biotech employee manufactures "Carba" tests, an antibiotic resistance test in Guipry, western France. April 6, 2020. Damien Meyer / AFP via Getty The Superbug Fight Needs a Better Business Model
Antimicrobial resistance is already a leading cause of death worldwide鈥攂ut as AMR deaths spiral, the pipeline for new antibiotics is drying up, not ramping up.   As WHO marks , leading researchers explain why:

• For one, small antibiotic makers can鈥檛 stay in business. Governments and public health programs closely guard novel antibiotics, deploying them as little as possible to avoid resistance, says Kevin Outterson, executive director of CARB-X, a nonprofit that supports antibiotics R&D.

鈥淭hat鈥檚 a perfect public health strategy, but a terrible business strategy.鈥�
 
What鈥檚 the Solution?

• Invest in incentives: Countries are starting to get behind 鈥減ush鈥� incentives that fund antibiotics R&D, and 鈥減ull鈥� incentives designed to keep the makers of novel antibiotics afloat.


• Antibiotics for all: It鈥檚 key that these incentives be designed to ensure that research and new drugs reach high-risk populations in LMICs.   


• Not just new drugs: Improving diagnostics and basic hospital hygiene are indispensable tools to protect antibiotics from resistance, says AMR researcher Caline Mattar. 

鈥淲hen you have hospitals that don鈥檛 have electricity or running water, and health care workers cannot even wash their hands before going from one patient to the other鈥攖his is an issue that would not be solved with new antibiotics.鈥�
  GLOBAL HEALTH VOICES The Latest One-Liners   Approximately 1 in 6 war-wounded trauma patients treated at Bashair Teaching Hospital in south Khartoum, Sudan, so far in 2024 are children under 15; many arrive with wounds from gunshots, blasts, or shrapnel, x-rays show.

Genetic sequencing of the H5N1 bird flu virus that infected a British Columbia teenager reveals that the virus underwent mutational changes that would make it easier to infect humans; there鈥檚 no evidence the teen infected anyone else, but the source of infection is unclear.

President Putin signed a decree today to allow for Russia鈥檚 use of nuclear weapons in response to an attack by a nonnuclear actor backed by a nuclear power, days after U.S. President Biden reportedly gave Ukraine permission to use U.S.-supplied long-range missiles on targets deep inside Russia.

A state judge struck down Wyoming's overall abortion ban, including an explicit ban (the nation鈥檚 first) on the use of pregnancy-ending medication. VIOLENCE Leading Cause of Maternal Deaths: Homicide
More pregnant women and new mothers in the U.S. die at the hands of intimate partners than from medical causes, published in in JAMA Network Open. 

Going deeper: The study, which analyzed CDC data from 2018 to 2021, found that laws that restrict access to divorce and abortion during pregnancy can raise the risk of intimate partner violence.

• Researchers also emphasized a vital need for safe housing, protective orders, and additional resources for pregnant women in abusive relationships. 

Most at risk: Individuals younger than 25 and Black women. 

GLOBAL HEALTH VOICES TECH & INNOVATION Dr. ChatBot Is In鈥攁nd Often Right 
ChatGPT outperformed human physicians in assessing a series of medical case histories, a published in JAMA Network Open found鈥攄emonstrating the power of A.I. systems to be 鈥渄octor extenders,鈥� providing niche insights or second opinions.

The study: 50 doctors and ChatGPT鈥攁nd some doctors equipped with ChatGPT鈥� were all fed the same medical case details and asked to provide a diagnosis. Each was graded on their ability to diagnose correctly, and on their ability to explain why they landed on potential diagnoses. 

The results: The doctors operating alone had an average score of 74%. ChatGPT scored an average of 90%. Doctors using the chatbot got an average score of 76%鈥攗nderscoring how doctors are often wedded to their own conclusions, despite the chatbot鈥檚 suggestions.

CORRECTION The 鈥楴ever-Before-Seen Virus鈥� 鈥� Except in 2019  
We'd received a Google Alert about the MSN story that we shared in a one-liner yesterday, about a mysterious malaria-like illness in Peru caused by a previously unknown phlebovirus; the case, however, was detected in 2019 and reported in 2023. We aim to limit one-liners to news stories that are not more than a day or two old, so that definitely did not meet our editorial guidelines鈥攁nd we apologize for the oversight. Thanks to GHN reader Rebecca Wurtz for flagging our error! QUICK HITS

They fled war in Sudan. Now, women in refugee camps say they鈥檙e being forced to have sex to survive 鈥�

Urban mosquito sparks malaria surge in East Africa 鈥�

Abortion pills may be FDA's first test under Trump 鈥�

How Trump's reelection could impact reproductive health in low income countries 鈥�

Effect of health education on knowledge, perception, and intended contraceptive use for family planning among university students in Pakistan 鈥�

Falls, assaults, accidental poisoning among leading causes of injury hospitalisations and deaths in Australia 鈥�

Biden administration backs away from plastic production limits in UN treaty 鈥�

Over 4 tonnes of batteries collected to reduce environmental, health impacts 鈥�

Issue No. 2817
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

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