96 Global Health NOW: New Mpox Lineage Raises Alarm in DRC; UK Advances ‘Smoke-Free Generation’ Plan; and A ‘New Era’ in the Drug-Resistant TB Fight View this email in your browser April 17, 2024 Forward Share Post People gather at the entrance of a mine in Kamituga, a town grappling with an mpox outbreak. South Kivu, DRC, September 12, 2020. STRINGER/AFP via Getty New Mpox Lineage Raises Alarm in DRC

As the DRC struggles to contain a deadly mpox outbreak, a “sudden and unusual” mutation is worrying researchers who warn it could spread internationally, reports The Telegraph.

The stage: The DRC is already battling the deadly clade 1 mpox strain, which has led to 4,500+ cases and 300 deaths this year, per CIDRAP.

The new lineage, “clade 1b,” has led to 241 suspected cases primarily in the densely populated mining town of Kamituga near the Rwandan border, according to a preprint paper.

• It appears to be better at spreading between people, primarily via sexual contact. It can also evade detection by some tests.

A need for close monitoring: While further research is needed, the paper’s authors say the strain has “pandemic potential,” reports the CBC.

• The paper was at the center of an Africa CDC meeting convened last week. 

• “This is not just a Congo-centric issue, this is not just a sub-Saharan Africa issue, this is a global issue,” said Jason Kindrachuk, the paper’s co-author.

GLOBAL HEALTH VOICES The Latest One-Liners   More than half of all preventable maternal deaths occur in countries in a state of crisis or distress—with African women 130X more likely to die from complications of pregnancy or childbirth than European and Northern American women, per a new UN Population Fund report. UN News

China’s government is subsidizing the manufacturing of fentanyl materials, making them “prime movers” in the illicit drug trade that is fueling the U.S. overdose crisis, per a new U.S. congressional committee report. Axios

Nestlé adds sugar and honey to its infant milk and cereal products distributed in many poorer countries—going against international guidelines that seek to prevent obesity, per a new report from Swiss investigative organization Public Eye. The Guardian

New limits on silica exposure have been announced by U.S. officials in an attempt to make conditions safer for miners and stone cutters; government estimates show the new rules could prevent 1,000+ deaths and ~4,000 cases of silica-related illness. STAT SMOKING UK Advances ‘Smoke-Free Generation’ Plan  
U.K. lawmakers voted to advance a landmark tobacco ban that would be one of the world’s strictest—essentially making it illegal to sell tobacco or vapes to anyone born in 2009 or later, the BBC reports.
 
The bill, aimed at creating Britain’s “first smoke-free generation,” is similar to New Zealand’s law that was repealed in February after a change in government, Axios reports.

• Once it takes effect in 2027, no sales will be allowed to anyone born after Jan. 1, 2009, and the smoking age will rise by one year each year.


• The plan also bans the sale of disposable vapes and limits flavor options.

More steps are needed before it becomes law, such as votes in the House of Lords—but the bill could become law within the year, per the BBC.
 
Several members of the House of Commons who voted against the bill argued that it would fuel black market sales and limit personal freedom—but Health Secretary Victoria Atkins said, “There is no liberty in addiction,” adding, “The vast majority of smokers start when they are young, and three quarters say that if they could turn back the clock they would not have started.” GLOBAL HEALTH VOICES TUBERCULOSIS A ‘New Era’ in the Drug-Resistant TB Fight
BPaL—with its 90%+ cure rate against drug-resistant tuberculosis after six months—is rolling out in the Philippines, Vietnam, and Indonesia.

Why this matters: Most of the world’s 10.6 million TB cases in 2022—and more than half of that year’s 1.3 million deaths—were in the Asia-Pacific region.

Until recently, treating the 3% of new TB cases that resist commonly prescribed drugs has been difficult. 

• A full course of daily injections and pills takes 18 months or more, and many patients don’t stick with it, due to financial burden and side effects.

Challenges remain: Social stigma of TB and access to BPaL are two major ones.

France24 OPPORTUNITY QUICK HITS Will Africa be the next continent to abolish the death penalty? – The Telegraph

Sudan’s unsung heroes: Protecting people living with and affected by HIV amidst conflict and famine – UNAIDS

Common HIV treatments may aid Alzheimer's disease patients – Sanford-Burnham Prebys via ScienceDaily

US FDA warns of harmful reactions to fake Botox injections – Reuters

Nunavut sets up mobile tuberculosis clinic in Naujaat as outbreak grows – CBC

A blood test to detect cancer? Some patients are using them already. – The Washington Post (gift article)

Obesity drugs aren’t always forever. What happens when you quit? – Nature

DeSantis signs bill banning local heat protections for workers – The Hill Thanks for the tip, Cecilia Meisner! 

One scientist neglected his grant reports. Now U.S. agencies are withholding grants for an entire university – The Chronicle of Higher Education (free registration required) Issue No. 2518
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 Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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African women are 130 times more likely to die due to pregnancy or childbirth complications than women in Europe and Northern America, the UN sexual and reproductive health agency (UNFPA) said in a new report published on Wednesday.

96 Global Health NOW: Two Maternal Mortality Fails; Vietnam's Unvaccinated Animal Crisis; and Kenya’s Struggle to Make Motorcycles Safer View this email in your browser April 16, 2024 Forward Share Post Midwife Topchin Job Goro checks Maryam Mohammed—who was 38 weeks pregnant with her eighth child—in a Ngala, Nigeria, clinic. October 11, 2018. Lynsey Addario via Getty Two Maternal Mortality Fails
It’s stunning and tragic: ~82,000 Nigerian women died from pregnancy-related complications in 2020.

The causes, writes Kasia Strek in a must-read Guardian article, are familiar:

• Severe hemorrhage.

• High blood pressure (pre-eclampsia and eclampsia).

• Unsafe abortion.

• Obstructed labor.

Why are so many Nigerian women dying? “…A lack of trust in a broken public healthcare system and little political will to fix it,” per doctors and activists.

• Nigeria has just one doctor for every 4,000–5,000 people (far below WHO guidelines that advise one doctor per 600 people).

• The government allocates just 5% of the federal budget to health care, while the UN recommends 15%.

• Few Nigerians live near well-resourced medical centers and many are forced to pay in advance for care—so many women don’t bother with prenatal check-ups.   

Meanwhile in the U.S.:

• Maternal deaths are lower (at 1,205 in 2021), but unlike other wealthy countries, the deaths are increasing, according to Vox.

• Nationwide, the maternal mortality ratio for Blacks is 2.6X higher than for whites. In New York, it’s 9X.

• ~90% of maternal deaths in Georgia from 2018 to 2020 were preventable, per a Georgia Department of Health study.

Solutions include greater access to doulas, Black doctors, group prenatal care, and Medicaid. GLOBAL HEALTH VOICES The Latest One-Liners   Tanzania, Rwanda, and Zimbabwe are joining three other African countries in recalling Johnson & Johnson children’s cough syrup after Nigerian regulators found it contained dangerous levels of diethylene glycol, which has been linked to dozens of child deaths since 2022. Reuters

The Biden administration announced plans to help 50 countries identify and respond to infectious diseases, including developing better testing, surveillance, communication, and preparedness aimed at preventing pandemics. AP
 
New Pregnant Workers Fairness Act protections finalized yesterday will give most U.S. employees access to unpaid time off to recover from childbirth or to access an abortion, along with other pregnancy-related conditions including miscarriage, gestational diabetes, and lactation. The 19th
 
U.S. melatonin makers were asked to voluntarily add child-deterrent packaging and stronger cautionary labeling within two years, per the Council for Responsible Nutrition, following a sharp jump in children ending up in the ER after accidentally ingesting the over-the-counter sleep aid. CNN DATA POINT RABIES Vietnam's Unvaccinated Animal Crisis
In Vietnam, a surge in rabies has killed 29 people this year—and health officials warn more deaths are likely as the disease “flourishes” in Vietnam’s dog meat trade. Driving factors: 

Unvaccinated animals: Vietnam has low dog vaccination rates, per the WHO; and the nation’s dog and cat meat trade “encourages this mass production of dogs who aren’t vaccinated,” said Lola Webber, director of Humane Society International’s Ending Dog Meat campaign.

• 5 million dogs and 1 million cats are trafficked and slaughtered in Vietnam each year.

Lack of interventions: In remote areas, people who are bitten often can’t access vaccines or lifesaving therapeutics.

The Telegraph GLOBAL HEALTH VOICES ROAD SAFETY Kenya’s Struggle to Make Motorcycles Safer
Across Kenya’s urban areas, motorcycles have become the primary mode of transport for millions:

• The number of boda-boda motorcycle taxis has doubled since 2017—now up to 2.2 million. 

But with that increase has come a surge of motorcycle fatalities—accounting for 35% of Kenya’s road fatalities last year. 

A lack of helmet-wearing is a primary factor, doctors say.

• On high-risk roads in Nairobi just 63% of riders and 15% of passengers wore helmets.

Potential interventions:

• Kenya’s first helmet-testing lab is currently in the works. 


• Advocates are working with manufacturers to make high quality helmets for a lower cost. 

The Telegraph CHOLERA Vaccines Can’t Keep Up
Doses of cholera vaccine are being “allotted before they are even produced” as the global stockpile evaporates amid ongoing outbreaks. 

The stockpile has been low for years—and outbreaks have now spread to 17 countries, including Syria, Afghanistan, and Zambia.

• As of February, ~9,300 cases and ~1,100 deaths were reported globally—likely a “gross underestimate.” 

The good news: The only company currently making the vaccine, South Korea’s EuBiologics, has worked at a “heroic” pace to expand offerings; and three new vaccine makers are setting up production lines. 

And yet: The total global supply of vaccines available this year will be, at best, a quarter of what is needed.

The New York Times (gift link) OPPORTUNITY QUICK HITS Is brain drain limiting Africa’s genomics potential? – Devex

Biden expands gun background checks, a critical step toward curbing gender-based violence – The 19th

Even after successful TB treatment, evidence found of lasting lung damage – CIDRAP

More than 250 websites selling fake weight-loss drugs reported by anti-counterfeit firm – Reuters

Teasing children about weight increases risk of self-stigma as adults, study finds – The Guardian

In Bangladesh, a new way to map typhoid promises to aid vaccination strategy design – Gavi

In Two States, Transforming the Model for Palliative Care – Undark

Pets pass antibiotic-resistant 'superbugs' to humans – UPI Issue No. 2517
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 Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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96 Global Health NOW: One Year into Sudan’s ‘Forgotten’ War; Outbreak Prep for All; and Alcohol Label Debate ~10,000 deaths a day could occur within months if famine takes hold. View this email in your browser April 15, 2024 Forward Share Post Smoke billows from a fire at a lumber warehouse in southern Khartoum amid ongoing fighting on June 7, 2023. AFP via Getty One Year into Sudan’s ‘Forgotten’ War 
In the year since civil war erupted in Sudan, the country has spiraled into “one of the worst crises the world has seen for decades”—with hunger, mass displacement, and violence leading to “extreme levels of suffering,”  said Médecins Sans Frontières President Christos Christou.

And yet: “The humanitarian response is deeply inadequate,” Christou said. 

Among the crises unfolding across the country: 

Famine: ~10,000 deaths a day could occur in the coming months if famine takes hold, analysts say—putting it on course to “rival some of the world’s worst humanitarian disasters of recent memory,” reports The Telegraph.

Aid cut off: Aid and food distribution agencies are unable to reach regions in acute crisis, including Darfur, according to the AP.

Mass displacement: The war has led to one of the world’s “largest and most complex,” displacement emergencies, notes Al Jazeera, with ~8.6 million people forced from their homes. 

Health care collapse: Only 20–30% of the nation’s health facilities are functional, per MSF.

Atrocities: There continue to be widespread reports of “rampant sexual violence,” particularly in the area of the capital and the western region of Darfur—where the International Criminal Court said it was investigating crimes against humanity.

Related:

France, Germany and EU mark anniversary of Sudan war with funding push – Reuters

Sudan conflict: A front-row seat to my country falling apart – BBC (commentary)

For a full year, the bodies have piled up in Sudan – and still the world looks away – ​The Guardian (commentary) GLOBAL HEALTH VOICES The Latest One-Liners   Nigeria, a meningitis hotspot, has become the first country to introduce a “revolutionary” five-in-one vaccine that protects against five major strains of the meningococcal bacteria. WHO
 
Children’s younger nose cells may be better at fighting off SARS-CoV-2, a new study in Nature Microbiology suggests; researchers analyzing nose lining cells from healthy people from different age groups—under-12s, 30-50 year olds, and over 70s—found that aging adult nose cells contained 100X more virus in the first few days after an infection. BBC
 
China’s fur farms carry “a high risk” of animal-to-human disease transmission, per a Humane Society International investigation of five fur farms housing foxes, raccoon dogs, and mink. Reuters

Researchers documented an abrupt post-Dobbs increase in permanent contraception procedures among adults aged 18 to 30 years—but the new study shows that the increase in women getting tubal ligations was 2X that of men having vasectomies. Salon GHN EXCLUSIVE Q&A Officials deposit a bat they caught into a plastic bag. Kozhikode, India, September 7, 2021. C.K. Thanseer/DeFodi Images via Getty Outbreak Preparedness for All
At the height of the COVID-19 pandemic, the global population got a crash course in public health for the first time in living memory. 

Problem: Public health processes and roles were not always explained well, and terms were often misused, revealing how much still needed to be learned.

New book: The Outbreak Atlas, uses plain language and case studies from across the globe to clarify and demystify outbreak preparedness, response, and recovery for “armchair epidemiologists” and public health professionals alike.

GHN spoke with co-authors Rebecca Katz, director of the Center for Global Health Science and Security at Georgetown University Medical Center, and Mackenzie Moore, a PhD candidate and Wellcome Trust Scholar at University of Edinburgh, about their quest to make outbreak knowledge accessible, how COVID was like the “Twilight Zone,” and the rewards of an effective outbreak response, whether it’s against a Campylobacter outbreak at a mountain biking race in Canada, or containing cases of Ebola.  

The Quote: “It’s exciting because it saves lives,” says Katz.

Annalies Winny, Global Health NOW
  READ THE FULL Q&A GLOBAL HEALTH VOICES HEALTH EQUITY Vaccine Hub Pivots 
The WHO’s mRNA hub was launched in 2021 to promote COVID-19 vaccine equity—allowing manufacturers in 15 middle-income countries to produce mRNA vaccines for their own regions.   

But as demand for the COVID-19 vaccine dries up, vaccine-making efforts are now being turned to other targets, explains Amy Maxmen in the first of a series of articles that she guest edits about efforts to boost pharmaceutical production in developing countries. 

One example: Afrigen Biologics & Vaccines in Cape Town, South Africa, developed an mRNA COVID-19 vaccine within a year of the hub’s launch—but since the market has stalled for that vaccine, the company is now working to develop mRNA vaccines for tuberculosis and HIV.

Long road: Researchers say that it could take a decade for such new vaccines to come to market—making the economics of the hub uncertain. 

Think Global Health POLICY A Label Debate
Starting in 2026, alcohol sold in Ireland will be required to have warning labels stating that drinking is linked to cancer and liver disease. And other countries are considering similar approaches. 

• Only one in three Americans know drinking alcohol increases the risk of cancer.


• One in four countries requires health warning labels for alcohol. 

Efficiency: During a study in Yukon, Canada, the sale of alcohol with warning labels fell by 7%. 

Opposition: Alcohol businesses are fighting back against the Irish labeling system.

• Additionally, 11 alcohol export countries, including the U.S., have also questioned the credibility of the warning and whether it infringes on free trade. 

The New York Times QUICK HITS Trafficked war babies of El Salvador search for their long-lost families – BBC

German commission recommends legalizing abortion – DW

EU probe of weight loss and diabetes drugs like Wegovy, Ozempic finds no link to suicidal thoughts – CNBC

Houston hospital halts liver and kidney transplants as it investigates ‘inappropriate changes’ to patient records – CNN

Tobacco firms lobbying MPs to derail smoking phase-out, charity warns ​​– The Guardian

Childhood verbal abuse costs global society $300 billion annually, study finds ​​– News Medical

Virginia bill would give alternate licensing path to foreign doctors – The World

Younger people in wealthy New York City areas snatched up COVID vaccine reserved for seniors – CIDRAP Issue No. 2516
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 Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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96 Global Health NOW: Desperate Dilemmas in Blood Deserts; Hair Relaxers Remain Popular Despite Risks; and Ah, Paris! Where Dreams and Day Jobs Collide View this email in your browser April 12, 2024 Forward Share Post Fatuma Haji (2nd R) donates blood following Friday prayer at the Jamia Mosque, in Nairobi, Kenya. January 18, 2019. Yasuyoshi CHIBA/AFP via Getty Desperate Dilemmas in Blood Deserts
Hospitals depend on blood as an essential medicine. But in the world’s “blood deserts,” treatable conditions like postpartum bleeding and trauma can be fatal.

• Billions of people worldwide live in such deserts—where there's not enough blood in at least 75% of medical cases, per a report published last month in Lancet Global Health. 


• Nearly every country in sub-Saharan Africa and South Asia struggles with blood deficits.

That leaves doctors weighing desperate measures to save lives, including the most popular—but controversial—method:

• Walking blood banks, in which blood is drawn from pre-identified community members—sometimes the patients’ own doctors. However, the practice is still illegal in many countries, and the WHO also recommends against it except in acute situations.

Other methods being adopted:

• Blood delivery by drone.


• Autotransfusion, which uses a patient’s own blood that pools during procedures instead of discarding it.

“Extreme blood scarcity in much of the world is not an impending, catastrophic event, but the current status quo,” said Nobhojit Roy, a retired rural surgeon from India.

NPR Goats and Soda GLOBAL HEALTH VOICES The Latest One-Liners   Dengue deaths in Peru have tripled this year—with 117 deaths attributed to the virus this year compared with 33 in the same period of 2023. Reuters

A spike in U.S. measles cases this year threatens the disease’s elimination status, the CDC warned in its most recent Morbidity and Mortality Weekly Report; infections rose 17X compared to the first-quarter average from 2020 to 2023. CIDRAP

Timor-Leste—a country otherwise classified as rabies-free—reported its first fatal human case of rabies in March, the WHO confirmed Wednesday; the country has seen nearly 30 suspected human cases this year. Precision Vaccinations
 
Nearly a quarter of K-12 teachers reported experiencing a gun-related lockdown last year, per a new Pew Research Center survey; 69% said that improving mental health screening and treatment would be the best way to prevent school shootings. Axios ENVIRONMENTAL HEALTH Hair Relaxers Remain Popular Despite Risks
In the U.S., thousands of lawsuits have been filed against manufacturers who make hair relaxers—citing the use of chemicals linked to cancer. 

But throughout Africa, chemical hair straightening has continued to surge in popularity:

• Tunisia, Kenya, and Cameroon were among countries leading worldwide sales growth for perms and relaxers from 2017 to 2022, per market research firm Euromonitor. 

• Sales in Tunisia and Kenya jumped 10% over the same five years, and South Africa and Nigeria also saw increased usage. 

Worrisome ingredients, no warnings: Many relaxers contain the carcinogen formaldehyde, along with endocrine disruptors like phthalates, parabens, and bisphenol A that are correlated with uterine and breast cancer. 

The Guardian GLOBAL HEALTH VOICES CHILD & ADOLESCENT HEALTH Are ‘Obesity Letters’ Effective?
In the U.S., where ~20% of children were considered obese as of 2020, schools have struggled with interventions. 

One tool 24 states have adopted since the early aughts is screening every child’s BMI and sending results home to parents in a letter. 

• Advocates argue that such screening could be critical for families who do not have access to a pediatrician. 

But: Studies show that such letters have little to no effect on weight loss.

• Arkansas was the first state to use such BMI reports, starting in 2003. But over 20 years, the state's childhood obesity rates have risen to nearly 24% from 21%.

And yet: Health practitioners and parents continue to advocate for the letters, saying they are critical to increasing awareness of obesity.

KFF Health News via NPR Shots FRIDAY DIVERSION Ah, Paris! Where Dreams and Day Jobs Collide  
While music was Germano Cecere’s first love, his family urged him to do something more sensible. So, he settled for studying epigenetics at a place where “world-altering discoveries” are made: the Pasteur Institute in Paris, The New York Times reports.
 
Turns out, many Institute peers harbor similar dreams of a rock ‘n’ roll lifestyle. Its cafeteria now throws down for concerts featuring music nerds from across the scientific community. It’s a welcome respite for researchers “disappointed with science,” one doctoral student/crooner pointed out.
 
Also in Paris—the Tour des Garçons! The race for waiters who’ve always dreamed of … walking really fast. In the event, for some reason sponsored by the city’s water utility, hundreds of participants race through the City of Lights holding trays of croissants and glasses—no running, no two-handed carries, and no lost pastries allowed, the Times also reports. 

Tickets to this summer’s Olympics are one prize, but the one every waiter likely covets the most: the gift certificate to a fancy restaurant where someone else serves them. QUICK HITS The Push for a Better Dengue Vaccine Grows More Urgent – The New York Times (gift article)

Nigeria: 10 Years After Chibok, Schoolchildren Still at Risk – Human Rights Watch

COVID vaccines not linked to cardiac death in young people: CDC study – The Hill

HIV Inequities, the Therapeutic Alliance, Moral Injury, and Burnout: A Call for Nurse Workforce Participation and Action – Journal of the Association of Nurses in AIDS Care

How Ohio’s GOP governor sells public health: Don’t call it that. – The Washington Post (gift article)

Tom Frieden: To rebuild trust in public health: Better communication, fewer mandates, and small wins – STAT (commentary)
 
The Sober-Curious Movement Has Reached an Impasse – The Atlantic

Is ChatGPT corrupting peer review? Telltale words hint at AI use – Nature Issue No. 2515
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 Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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Nigeria has become the first country to roll out a “revolutionary” five-in-one vaccine against meningitis, the World Health Organization (WHO) said in a statement on Friday.  

96 Global Health NOW: Climate Extremes Linked to Stroke Deaths; ‘Landmark’ Environmental Legal Wins; and Depression Surges Among Iranian Doctors Strokes linked to high and low temperatures have been increasing worldwide since 1990 View this email in your browser April 11, 2024 Forward Share Post An auto-rickshaw driver wets his head at a roadside tap to get relief from a heatwave in Dhaka, Bangladesh, on April 6. Rehman Asad/NurPhoto via Getty Climate Extremes Linked to Stroke Deaths  
500,000+ stroke deaths in 2019 have been connected to extreme temperatures worsened by climate change, according to a study published yesterday in Neurology.

• Strokes attributed to high and low temperatures have been increasing worldwide since 1990, according to the study by researchers from Xiangya Hospital Central South University of 204 countries and territories from 1990 to 2019, CNN reports.

• A hotter world caused by climate change may lead to more stroke deaths.

• Low temperatures led to more stroke deaths: 474,000 in 2019, per the study. 

Location is important:

• Stroke deaths are more common in areas with higher levels of poverty and weak health systems.

• The study also noted a surge in stroke deaths in Central Asia linked to higher temperatures.

Caution: The study doesn’t prove that climate change causes stroke; it only shows an association, The Independent notes.
 
The Quote: “I really think that group did a very nice job of taking a global approach looking at historic data and to draw attention to a health issue that I think [is] not really getting a lot of attention,” said Harvard Medical School’s Mary Rice.
 
Related: Searing heat is back across Southeast Asia and it’s not going away anytime soon – CNN GLOBAL HEALTH VOICES The Latest One-Liners
Canada looks set for another “catastrophic” wildfire season following a warmer-than-usual winter and with drought and more warm temperatures forecasted for the months ahead, officials warned yesterday. CBC

Whooping cough cases in China reached 32,000+ in January and February, a 20X increase over the same period last year; while China provides free whooping cough vaccines, booster shots are not required. TIME
 
Moderna has put on hold plans to build mRNA vaccine plants in Kenya amid dwindling demand for COVID-19 shots; the company announced plans in 2022 to invest some $500 million in the Kenyan facility and supply some 500 million doses of its mRNA vaccines to Africa each year. Yahoo! Finance
 
Cuban officials warned of rising illegal drug use yesterday, especially among youth, amid the country’s economic crisis; Cuba has long prided itself on a zero-tolerance policy for drug use and tight controls on narcotics trafficking and use. Reuters CLIMATE JUSTICE ‘Landmark’ Environmental Legal Wins 
Two major wins in international courts are forcing governments to take accountability for environmental inaction—and are setting new precedent for litigation’s role in climate justice. 

A Peruvian city prevails: The Inter-American Court of Human Rights last month ruled that Peru was responsible for the physical and mental harm inflicted by a metallurgical plant’s pollution on people in La Oroya, Peru—one of the “most polluted cities on Earth,” reports Undark. 

A win for Swiss women: The European Court of Human Rights ruled that the Swiss government’s inaction made citizens vulnerable to climate change-fueled heat waves, in a human rights case brought by more than 2,000 Swiss women, reports CNN. 

Wider implications: Advocates say both rulings set key precedent for communities around the world impacted by environmental contamination, and that climate litigation will be an increasingly important tool to force governments and corporations to enact climate protections.  GLOBAL HEALTH VOICES MENTAL HEALTH Depression Surges Among Iranian Doctors
In Iran, resident doctors (medical school graduates in training) face high rates of depression and suicide. 

• 30% consider suicide, according to Vahdat Shariat of the Iranian Psychiatric Association.

• And in Tehran, 25% suffer from severe depression.

During their three- to five-year residency, the young doctors report working 30-hour shifts, receiving low and delayed payment, and encountering “humiliation” from supervisors.

Worse still: Residents often must work a second job in a different field to support themselves.

Emigration: 50% of doctors seek to leave Iran and one-third would be willing to take jobs abroad unrelated to medicine. 

RFE QUICK HITS A simple policy change could ‘eliminate’ snakebite deaths in the Amazon – The Telegraph

A rare fungal infection was found in two cats in Kansas. The vet tech also got sick. – NBC News

Three studies spotlight long-term burden of COVID in US adults – CIDRAP

Researchers call for a revamped fungal priority list to combat regional disease burdens – News Medical

CDC expected to alert doctors about fake Botox – NBC News

About one-third of socially vulnerable women missing recommended mammograms, CDC says – ABC News

Bernie Sanders calls for $1 billion for long-COVID moonshot – CIDRAP Issue No. 2514
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 Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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96 Global Health NOW: Arizona’s Antiquated Abortion Ban; Cameroon’s ‘Epilepsy Warriors’ Battle Stigma; and A Chilly Start View this email in your browser April 10, 2024 Forward Share Post Abortion rights protesters chant during a rally at the Tucson Federal Courthouse in Tucson, Arizona, on July 4, 2022. Sandy Huffaker/AFP via Getty Arizona’s Antiquated Abortion Ban
The Arizona Supreme Court’s decision yesterday to effectively revive a 19th-century abortion ban further reshapes the landscape of U.S. reproductive rights—and raises the stakes in an election year where abortion access is set to play a key role.

The basics: The near-total ban, which dates back to 1864, allows exceptions only to save the mother's life—placing Arizona among the states with the strictest abortion laws, reports Axios. 

• The ruling came down in favor of an anti-abortion obstetrician and a county prosecutor, who sought to have the statute enforced after Arizona’s Democratic attorney general declined to do so.

An ongoing battle: Abortion rights advocates have collected signatures to create a November ballot measure, which would amend the state constitution to allow abortions up to fetal viability at 24 weeks, per Reuters.

• Abortion rights measures have succeeded each time they have been put on the ballot since 2022. 

The bigger picture: The ruling could have major implications for the presidential and U.S. Senate elections, as Arizona is a key battleground state, reports CNN. 

Related: The Supreme Court will decide if states can ban lifesaving abortions – Vox GLOBAL HEALTH VOICES The Latest One-Liners   Contaminated cattle feed made from ground-up chicken waste could be the source of the H5N1 bird flu outbreak in the U.S., which has affected herds in six states. The Telegraph 

43.3% of people with a prior COVID-19 infection reported new long-term symptoms, compared with 22.1% without a history of infection, per a new study of 238,828 blood donors published in JAMA Internal Medicine. CIDRAP

Limits on “forever chemicals” in U.S. drinking water have been announced for the first time by the EPA, which called the PFAS chemicals “harmful to our health and our environment.” NPR Shots

Using salt substitutes in cooking has been linked with improving cardiovascular health and a lower risk of death, per a new systematic review of trials—mainly in China—published in journal Annals of Internal Medicine. CNN NONCOMMUNICABLE DISEASES Cameroon’s ‘Epilepsy Warriors’ Battle Stigma
Epilepsy has high prevalence in Cameroon—but those who live with the condition are still often stigmatized as people who are “cursed.”

• “Lack of understanding as to why people suffer epilepsy makes them think that it is a spiritual problem,” said human rights advocate Leo Igwe. 

Challenging the narrative: Volunteers with the Bamenda-based nonprofit Epilepsy Awareness, Aid and Research Foundation are seeking to shift cultural understandings of the condition by providing education and resources across Cameroon.

• Many of the volunteer “epilepsy warriors” live with the condition themselves. 

The Guardian GLOBAL HEALTH VOICES GENOCIDE Learning From Rwanda’s Tragedy
Thirty years after the genocide in Rwanda, researchers are gaining insights that could help to prevent future atrocities and enable healing.
 
Some hard-won lessons:

• Involve and support local researchers: Rwanda’s genocide nearly erased its academic community; new programs aim to elevate local scholars’ voices.

• Analyze the history behind the conflict to identify common themes among genocides.

• Document and address intergenerational trauma and provide long-term support to survivors.

• Elevate the voices of survivors, given that judicial inquiries focused so much on perpetrators.

Researchers are hopeful these findings can provide guidance for first responders, as well as those involved in peacebuilding and supporting survivors of other systematic mass murders and war.

Nature VACCINES A Chilly Start 
This year, millions of doses of malaria vaccines will be administered across the tropical belt of sub-Saharan Africa with the help of solar-power refrigerators. 

The vaccines must be kept between 2C and 8C (36–46F)—a challenge in remote areas with inconsistent electrical grids. 

A cool development: Solar-powered, ice-lined fridges keep vaccines chilled without electricity for up to 115 hours in 43C (109.4F) heat. 

Impact: Thousands of fridges have been placed across sub-Saharan Africa, in preparation for the malaria immunization effort. 

Reuters OPPORTUNITY QUICK HITS ‘Children are being used as a football’: Hilary Cass on her review of gender identity services – The Guardian

Surveys spotlight pregnant women's drop in confidence over COVID vaccines – CIDRAP

High burden of noma in the Gambella region of Ethiopia: a 12-year retrospective study on noma cases from the Facing Africa database – Tropical Medicine & Hygiene

Could South Korea’s maternity retreats solve its population crisis? – The Telegraph

An Academic Lifeline for Rural Hospitals – Think Global Health (commentary)

Giant viruses played a key role in early life, study in Yellowstone hot spring suggests – Science

Baylor wins 2024 STAT Madness with ‘smoke alarm’ for viral disease outbreaks – STAT Issue No. 2513
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 Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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96 Global Health NOW: Viral Hepatitis Deaths Increasing; Public Health School Rankings; and the Explosive Toll of Landmines in Burma Viral hepatitis kills 3,500 people daily, despite better, cheaper tools. View this email in your browser April 9, 2024 Forward Share Post 12-year-old Atyrgul Tagaibekova receives treatment for hepatitis at Zhugushtun Hospital, in Bishkek, Kyrgyzstan, on October 13, 2016. Jodi Hilton/SOPA Images/LightRocket via Getty Viral Hepatitis Deaths Increasing  
Viral hepatitis is killing 3,500 people every day, despite the fact there are better options than ever for preventing, diagnosing, and treating the disease, according to a WHO report released today.

• 254 million: people living with hepatitis B.


• 50 million: people living with hepatitis C.


• 1.2 million: new hepatitis B infections in 2022.


• ~1 million: new hepatitis C infections in 2022.

TB’s rival: Viral hepatitis caused 1.3 million deaths in 2022, claiming as many lives as tuberculosis, per WHO.
 
The problem: Even with better tools and falling product prices, deaths are increasing because too few people are getting diagnosed and treated, said WHO Director-General Tedros Adhanom Ghebreyesus.

Treatment lags:

• Just 3% of those with chronic hepatitis B were receiving antiviral treatment by the end of 2022, MedicalXpress reports.


• Just 20% of people with hepatitis C were being treated by then.

Stigma’s role: Half of Europeans who have hepatitis B or C say they have difficulty telling others about it because of stigma, per a new survey that will be shared this week at the World Hepatitis Summit in Lisbon, according to EuroNews. GLOBAL HEALTH VOICES The Latest One-Liners   Russia’s military strikes on Ukraine’s Zaporizhzhya Nuclear Power Plant on Sunday didn’t cause obvious damage to critical nuclear safety or security systems but mark a “major escalation” in the level of danger facing the plant, the International Atomic Energy Agency warned. UN News
 
Rising temperatures in Argentina are inducing mosquitoes to hatch earlier and reach cooler regions than before, driving the country's worst-yet outbreak of dengue fever, with 232,996 cases recorded so far this season—5X the same point a year ago. Reuters
 
An experimental liquid biopsy test detected 97% of stage I and II pancreatic cancers in 984 volunteers from China, Japan, South Korea, and the U.S.; the test zeros in on markers shed by tumors and could boost much-needed, earlier detection efforts—but the early results, presented yesterday at the American Association for Cancer Research annual meeting, have not yet been published in a peer-reviewed journal. CNN
 
U.S. patients from rural counties had higher post-COVID-19 hospitalization death rates and trended toward higher readmission rates than those from urban counties, per a new Mayo Clinic analysis of 9,325 patients hospitalized from March 2020 to July 2022. CIDRAP EDUCATION Johns Hopkins Tops Rankings of U.S. Public Health Schools   
The Johns Hopkins Bloomberg School of Public Health has again been named the top public health school in the U.S., based on peer-assessment rankings unveiled this morning by U.S. News & World Report.  
 
This year’s top 10 schools:
 
1. Johns Hopkins University
2. University of North Carolina–Chapel Hill
3. Emory University
3. Harvard University
5. Columbia University
5. University of Michigan–Ann Arbor
7. Boston University
7. University of Washington
9. University of California–Los Angeles
10. University of California–Berkeley

This year’s rankings include 213 schools and programs of public health accredited by the Council on Education for Public Health. 
  
U.S. News & World Report  GLOBAL HEALTH VOICES LANDMINES An Explosive Toll in Burma
Landmine casualties nearly tripled in Burma (Myanmar) last year as the nation’s civil war escalated, a new UNICEF report finds.

• That means Burma now ranks among the world’s nations “most heavily contaminated” with landmines.

Children are especially vulnerable, making up 20% of victims. 

By the numbers:

• 188 people were killed and 864 wounded from buried bombs—compared to 390 casualties in 2022. 

Ubiquitous usage: Landmines are being used by “all sides in the conflict,” and are in every region except the nation’s capital, Naypyitaw.

 The Telegraph NONCOMMUNICABLE DISEASES ‘Accelerated Aging’ and Cancer
As researchers struggle to understand why more young people are being diagnosed with cancer, they’re exploring a possible contributor: accelerated biological aging. 

Cancer is an “aging disease”—but age is more than accumulated years, explains Yin Cao, the lead author of a new study that examined the records of 148,724 people ages 37-54 in the U.K. 

Biological aging measures the physiological effect of genetics and “wear and tear” on the body—measured by looking at factors like white blood cell count, glucose levels, and levels of certain proteins and waste products in the body.

• Accelerated aging was associated with an increased risk of lung, uterine, and gastrointestinal cancers. 

CNN CORRECTION Bird Flu Fail
A one-liner in yesterday’s GHN about a U.S. CDC advisory to health workers incorrectly said they should look for H1N1 bird flu infections in people who have contact with cattle. It should have said H5N1. We regret the error. RESOURCES QUICK HITS Sickened by U.S. Nuclear Program, Communities Turn to Congress for Aid – The New York Times (gift article)

Efforts to support Palestinian scientists struggle with the realities of war – Science

Unauthorized ACA plan switches drive call for action against rogue agents – NPR Shots

A paramedic was skeptical about this Rx for stopping repeat opioid overdoses. Then he saw it help. – CNN

Pfizer’s RSV vaccine shows potential to protect high-risk adults ages 18-59, widening possible use – CNBC

New WIC rules include more money for fruits and veggies. They also expand food choices – AP

ICYMI: Why isn’t dental health considered primary medical care? – Knowable

How mosquito larva guts could help create highly specific insecticides – American Chemical Society via ScienceDaily

So You Looked Directly Into the Sun – The Atlantic Issue No. 2512
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 Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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The number of lives lost due to viral hepatitis infections is increasing and already accounts for 3,500 deaths daily, according to a report by the World Health Organization (WHO) released on Tuesday.

McGill Translational Platform in Autism Research will help uncover the disorders’ neural foundations

 

A new project at The Neuro, McGill University and the Research Institute of the McGill University Health Centre (RI-MUHC) has been awarded $10.6M in financial support as part of the Canada Foundation for Innovation’s (CFI) Innovation Fund.

96 Global Health NOW: The ‘Narrow Window’ to Confront AMR; Hospitals Brace for Eclipse; and South Sudan’s Sight Saver Global life expectancy will fall by 1.8 years by 2035, if nothing is done about antimicrobial resistance. View this email in your browser April 8, 2024 Forward Share Post A container of EnCiprox sits on the ground at a poultry farm in Ranga Reddy district, Telangana, India. November 7, 2015. Dhiraj Singh/Bloomberg via Getty Images Getty The ‘Narrow Window’ to Confront Antimicrobial Resistance
World leaders must act now to address the major threat of drug-resistant infections—or the world faces a “devastating future,” according to a new report by The Global Leaders Group on Antimicrobial Resistance.

• The report calls for a coordinated global response that is akin to agreements around climate change, reports CIDRAP—including an independent UN panel, targets in reducing AMR-related deaths and antibiotic usage; and increased surveillance.

The toll, if the status quo continues: An average loss of 1.8 years of global life expectancy by 2035—with some low- and middle-income countries a 2.5-year drop.  

The Quote: “We now have a narrow window of opportunity to mount a coordinated and multisectoral response to AMR,” said Mia Amor Mottley, prime minister of Barbados and the chair of Global Leaders Group on Antimicrobial Resistance. 

Meanwhile, in India: One of the county’s major poultry producers, Venky’s, is selling antibiotics to be used by farmers in ways that contribute to AMR, reports The Bureau of Investigative Journalism. 

Related: 

Surveillance study finds high levels of drug-resistant gonorrhea in Cambodia – CIDRAP

Pioneering vaccine strategy promises to outmaneuver antimicrobial resistance ​​– News Medical EDITOR’S NOTE GHN’s Late Delivery Friday   We apologize to loyal readers who were looking for GHN at the regular time on Friday; we had a technical issue that prevented us sending until afternoon Baltimore time.—Dayna GLOBAL HEALTH VOICES The Latest One-Liners
Most cancer drugs on an accelerated approval track with the U.S. FDA do not demonstrate life-extending or life-improving benefits after five years, according to a new JAMA article. AP 

A new U.S. CDC advisory warns that health workers should be on alert for H1N1 bird flu in people who may have contracted it from cows; the advisory urges state health departments to rapidly analyze human cases—as outbreaks have now been detected in 16 dairy herds in six states. STAT

A pineapple-flavored, oral-spray vaccine prevented recurrent urinary tract infections from returning for up to nine years in more than half of participants, per initial results of a safety and effectiveness follow-up study shared recently at the European Association of Urology Congress in Paris. New Atlas
 
Malawi received a shipment of cholera rapid diagnostic test kits on Friday—becoming the first country to benefit from a global program led by Gavi, WHO, UNICEF, and FIND to distribute 1.2 million kits to 14 high-risk countries; Ethiopia, Somalia, Syria, and Zambia are also on the list. WHO (news release) DATA POINT ECLIPSE In the Path of Totality, Hospitals Brace Themselves
As millions of people in North America look to the skies for today’s total solar eclipse, hospitals are keeping a close eye on their staff lists and admissions numbers. 

What they’re worried about: Eye damage but also increased traffic accidents and potential for mass casualty events as an estimated 4 million people descend on cities and towns in the path of totality.

• Hospitals located in these hotspots have spent months running emergency drills and coordinating with local officials. 


• They have also struggled to bolster staff, as schools have been canceled and medical personnel have been dispatched to events to offer onsite assistance. 

Check out: HHS’s 17-page eclipse preparedness booklet. 

Axios

Related: 

Eclipse eye safety: How to safely see Monday's eclipse – Axios

Johns Hopkins Experts Discuss the Upcoming Total Solar Eclipse – The Hub GLOBAL HEALTH VOICES VISION South Sudan’s Sight Saver
South Sudan has the highest prevalence of active trachoma in Central Africa—and it only has four ophthalmologists to serve the population of 12 million people. 

That’s why Aja Kuol never stops moving—crisscrossing the country by car and plane to restore the vision to people beset with trachoma and cataracts.

• The nation’s first female ophthalmologist, Kuol is committed to traveling to isolated regions: “We can’t wait for people to come to us,”  she said. 

By the numbers: 4,700 people received sight-saving treatment from Kuol and her team In 2023. 

The Telegraph QUICK HITS Trump releases video outlining his stance on abortion – The 19th

Quitting smoking could redirect £11bn a year into local economies, study says – The Guardian

‘I’m a smoker — and I want stricter tobacco control’ – Bhekisisa

A new AI app that claims to detect sexually transmitted infections is being widely panned – Los Angeles Times

NHS testing initiative to eliminate hepatitis C in England by 2025 – The Guardian

The time has come for over-the-counter antidepressants – STAT (commentary)

Africa: Gender Equality Takes Center Stage at WomenLift Health Conference – AllAfrica

Merck Continues the Fight against Schistosomiasis in a Storytelling Lab – AFP Issue No. 2511
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 Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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A young mother in Madagascar has been describing how she was forced to make a 200km emergency journey on challenging rural roads to a specialist regional hospital after she experienced difficulties giving birth at home.

With the largest hospital in Gaza largely destroyed and out of action, access to healthcare has now become “totally inadequate” following six months of brutal fighting between Israeli forces and Palestinian militants, said the World Health Organization (WHO) on Saturday.

96 Global Health NOW: A ‘Tidal Wave’ of Cancer Diagnoses; Decisive Action Needed to Stop Cervical Cancer Deaths; and Why Do Teens Smell Like Goats? View this email in your browser April 5, 2024 Forward Share Post A woman is prepped for a lung scan in Ajaccio, on the French Mediterranean island of Corsica. December 16, 2021. Pascal Pochard-Casabiana/AFP via Getty A ‘Tidal Wave’ of Cancer Diagnoses
Global cancer diagnoses are projected to rise sharply in coming years—with a 77% increase expected by 2050, according to new data from the American Cancer Society.

• ~1/5 people who are alive now will develop cancer in their lifetime.


• ~1/9 men and 1/12 women will die from the disease, reports CNN.

Key drivers are population growth and increasing longevity, researchers say.

• In low- and middle-income countries, an increase in tobacco usage and obesity could also contribute to a cancer surge akin to a “tidal wave coming into their communities,” said oncologist Harold Burstein. 

Most common cancer types include lung, female breast, colorectal, prostate, stomach, liver, thyroid, cervical, bladder, and non-Hodgkin lymphoma, reports USA Today.

• The number of men diagnosed with prostate cancer globally is projected to double to 2.9 million a year by 2040, a new report in The Lancet finds—with deaths rising 85%, per The Guardian. 

Cervical cancer was the leading cause of cancer death in 37 countries. (See GHN’s Exclusive Commentary about cervical cancer below.) GLOBAL HEALTH VOICES The Latest One-Liners   An insect repellent shortage has Argentina, in the throes of a dengue outbreak that has already infected hundreds of thousands, on edge; the government says the “bottleneck” will be fixed soon, but for now, many stores have posted “no repellent” signs and where available, prices are sky-high. BBC
 
A federal judge in California ruled last night that the U.S. government is required to “expeditiously” process migrant children who cross into the country unlawfully and relocate them from makeshift open-air sites in Southern California. CBS
 
The maker of a drug for ALS, or Lou Gehrig’s disease, announced yesterday that it will pull Relyvrio from the market after the much-debated drug failed to prove efficacy in a large clinical trial; new patients in the U.S. and Canada will no longer be able to get a prescription. AP

Paxlovid’s effectiveness is limited for those fully vaccinated against COVID-19 who have at least one risk factor for severe COVID, per a new study in the New England Journal of Medicine, which found the drug did little to reduce symptom duration among this population—though the findings may not apply to older patients. CIDRAP GHN EXCLUSIVE COMMENTARY Boxes of vaccine used to prevent certain strains of HPV, pictured in Caracas on April 28, 2023. Yuri Cortez/AFP via Getty Decisive Action Needed to Stop Cervical Cancer Deaths   “Although we have the tools to prevent cervical cancer, a woman dies every two minutes from this devastating disease. These deaths are a needless tragedy,” write H.E. Rossana Maria Briceño and H.E. Neo Jane Masisi, First Ladies of Belize and Botswana, respectively.

In a GHN commentary, the authors call for decisive action to reduce the expected cervical cancer deaths of 410,000+ women annually by 2030—the vast majority of which will occur in low- and middle-income countries.

• Mortality rates in Latin America and the Caribbean are triple those in North America.


• Sub-Saharan Africa has the world’s highest burden of cervical cancer.

The call: Briceño and Masisi call on governments to make HPV vaccines, screening, and treatment affordable and accessible to all communities. They also urge community leaders and civil society to increase awareness and acceptance of HPV vaccines and screening programs.

The Quote: “Knowing we have the tools to prevent these illnesses and deaths is heartening. Realizing these tools are unavailable or underused in so many countries is tragic,” write Briceño and Masisi, who both have witnessed “a loved one suffer from this terrible disease, knowing it could have been prevented.”

H.E. Rossana Maria Briceño and H.E. Neo Jane Masisi for Global Health NOW READ THE FULL COMMENTARY GLOBAL HEALTH VOICES GUN SAFETY Physicians Can Help Reduce Firearm Injuries
Researchers are testing ways of discussing safe gun ownership in health care settings—from emergency rooms to pediatricians’ offices.

Why it’s important: At least 30% of U.S. adults own a firearm.

Finding the most effective approach: Ongoing studies will help refine when, where, and how to broach the topic.

• Just as a doctor might recommend you reduce sugar intake to reduce your risk of diabetes, they can offer you a gun lock to prevent firearm injury.

Available now: The American Academy of Pediatrics offers a curriculum to pediatricians on how to discuss secure firearm storage with every family.

The Atlantic

Related: 

Listening to the Voices of Gun Violence Survivors – Duke Global Health Institute

A Striking New Work From the Artist Behind the Covid Flags on the Mall – Washingtonian 

From the archives: How Pediatricians Can Promote Gun Safety – Hopkins Bloomberg Public Health Magazine FAMILY PLANNING A Future Investment
Despite a declining birthrate in Italy, the Alto Adige-South Tyrol area has maintained a steady natality by investing in government-provided family support.

• Parents are provided with extended benefits, including discounts for baby products, health care, and transportation, etc.


• Parents receive 200 additional euros monthly per child, in addition to Italy’s standard 1,900 euros incentive. 

Day-caring: Certified educators can host small nurseries in their apartments, extending affordable childcare options. 

Long-term effects: Experts say that these benefits have helped preserve the region’s birthrate for decades. 

The New York Times FRIDAY DIVERSION Why Do Teens Smell Like Goats?  
Ever wonder why babies smell like the world’s best apothecary shop and teens smell like … a combination of a farm and a toilet?
 
A new study explains why, enlisting babies and teens to sleep with special armpit pads to decode the scents of youth.
 
As it turned out, the recipe for “eau de teen” is a cocktail of chemical compounds that smell of sweat, urine, cheese, and goat—but also musk and sandalwood, suggesting the teen body is already trying to mask its pungency with self-made perfume.
 
The researchers didn’t say the teen smell was bad per se, just that the oratory assault left parents “unable to identify their own child.”
 
The compounds present in babies gave notes of flowers and soap, with a hint of violet—a beautiful B.O. that “probably” facilitates parental affection.
 
Which one would you bottle?
 
The Guardian QUICK HITS Crisis in Haiti worsens after month-long siege on Port-au-Prince – UN News

Trump's surgeon general urges red states to support needle exchanges – Axios

Why very few people who are eligible for a cochlear implant actually get one – STAT

US FDA issues warning letters to retailers against underage sale of ZYN nicotine pouches – Reuters

Interview: Puncturing Misconceptions About Vaccine Hesitancy – Undark

Wastewater testing near homeless camps shows COVID-19 viral mutations – CIDRAP

‘Maybe I was never meant to be in science’: how imposter syndrome seizes scientist mothers – Nature Issue No. 2510
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 Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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The UN Security Council on Friday strongly condemned the latest rise in attacks by the M23 rebel group in the Democratic Republic of the Congo’s restive east, which has undermined security and exacerbated an already dire humanitarian situation.

Two aid convoys carrying lifesaving supplies have reached Sudan’s Darfurs for the first time in months, the UN World Food Programme (WFP) said on Friday, as humanitarians try to avert a “hunger catastrophe”, after nearly a year of heavy fighting.

96 Global Health NOW: Global Life Expectancy Gains, But…; Under-the-Radar Abortions in Africa; and Bringing Saw Safety to a New Level View this email in your browser April 4, 2024 Forward Share Post A health worker talks to a patient during a free dental service event in Kampala, Uganda, March, 26, 2022. Nicholas Kajoba/Xinhua via Getty Global Life Expectancy Gains, But…
The latest global burden of disease study published yesterday in The Lancet offers some good news—and serious cautions.

• Big gain: Life expectancy increased by 6.2 years from 1990 to 2021, per IHME.


• Biggest gain: Eastern sub-Saharan Africa saw the biggest increase in life expectancy: 10.7 years. Success against diarrheal disease was the primary reason behind the extended life expectancy.


• Biggest impact: The global reductions in diarrheal deaths alone accounted for a 1.1- year increase in life expectancy, STAT reports.

COVID’s impact: Global inequities led to extreme differences in life expectancies from 2020–2021:

• Latin America experienced a nearly 5-year loss in life expectancy.


• In southern sub-Saharan Africa, it fell by 3.4 years.


• But in high-income countries, the drop was about one year.

The Quote: “With all our innovations in health and health care and vaccines… we’re just not doing the work on a global scale equitably. And I think this data shows that,” said Debra Furr-Holden, dean of NYU’s School of Global Public Health.
 
Still the top killers: Ischemic heart disease, stroke, COPD, and lower respiratory infections were the top four leading causes of death in 2019, just as they had been in 1990.

But: COVID-19 broke into the top two in 2021, per IHME. GLOBAL HEALTH VOICES The Latest One-Liners
Executions in Iran hit an eight-year high in 2023 with 853—more than half for drug-related convictions, per a new Amnesty International report that underscores the “disproportionate impact” of the government’s renewed war on drugs on poor and marginalized communities. RFE/RL
 
The U.K.’s NHS is experiencing an “avalanche of need” over autism and ADHD with an “obsolete” system unable to cope with the surging demand for assessments and treatments, according to the Nuffield Trust, a think tank that calls for a “radical rethink” to address the need. The Guardian
 
New hepatitis C infections in the U.S. dipped 6% in 2022, following a decade of steadily climbing cases—but continued to rise in Black, Latino, and Native American communities, per new federal data shared yesterday. AP
 
Lixisenatide showed early potential against Parkinson’s disease in a Phase 2 trial in France; patients given the older Ozempic-like drug over a year experienced no worsening of motor symptoms, while patients receiving a placebo declined, according to a small study published in the New England Journal of Medicine yesterday. STAT REPRODUCTIVE HEALTH RIGHTS Under-the-Radar Abortions in Africa
Across Africa, 20+ countries have expanded abortion rights in recent years. But many women still may not know they have a legal right to the procedure.

Why?

Lack of advertising: Many physicians say they choose to stay quiet about their ability to offer the service because they are worried about being targeted by anti-abortion groups.

• “We’ve found that people are OK with our clinic providing abortions, as long as we don’t make it too obvious what we are doing,” said Esi Asare Prah, who works at a clinic in Ghana. 

Lack of resources: Poorer countries like Benin and Ethiopia permit abortions in some instances—but may not always have the resources to make them available. 

 AP

Related:

Florida’s 6-week abortion ban could displace thousands each month in a region where access is already severely limited – AP

California colleges provide abortion pills but many fail to make students aware – NPR Shots GLOBAL HEALTH VOICES INJURIES Bringing Saw Safety to a New Level
Table saws are considered “far and away” the most dangerous power tool Americans buy, leading to:

• ~30,000 blade-contact injuries that require medical treatment each year.


• 4,000 amputations.


• Injuries that can lead to a societal cost of $500,000+ per injury (including ongoing medical care and lost work time).

Despite these harms, efforts to mandate the installation of a safety brake on all such saws have come up against federal roadblocks for years. 

But that may be about to change: The federal Consumer Product Safety Commission is now seeking to mandate a safety brake on all new table saws sold in the U.S., with approval set for later this year. 

NPR OPPORTUNITY QUICK HITS Scotland's new hate crime law comes into force – BBC

Messenger RNA technology shows first promise against a rare and deadly disease – Science

Study shows no link between remdesivir, cardiac events – CIDRAP

Sperm counts fall as temperatures rise, new research suggests – The Telegraph

WHO Calls for More Data on Violence Against Older Women and Women With Disabilities – IPS

These twin brothers are identical, but their autism isn't – NPR Shots

The Coming Birth-Control Revolution – The Atlantic

Pig kidney transplants are cool. They shouldn’t be necessary. – Vox (commentary)

New evidence suggests dogs may ‘picture’ objects in their minds, similarly to people – Popular Science Thanks for the tip, Xiaodong Cai! Issue No. 2509
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 Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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96 Global Health NOW: In Gaza, ‘No Safe Space Left’; No Clear Answers on Nodding Syndrome; and A Formula for Profits View this email in your browser April 3, 2024 Forward Share Post People gather around the carcass of a car used by World Central Kitchen that was hit by an Israeli strike the previous day in Deir al-Balah in the central Gaza Strip on April 2. AFP via Getty In Gaza, ‘No Safe Space Left’ 
The deaths of seven humanitarian workers from World Central Kitchen—“killed while trying to feed starving people”—has led to widespread condemnation and growing demands for aid workers’ protection, even as they continue to struggle to gain access to Gaza, reports UN News.

• Israel’s military issued an apology for the attack—calling it a “grave mistake,” reports The New York Times (gift link).


• At least 196 humanitarian workers were killed in Gaza between October 2023 and mid-March—3X the death toll in any single conflict in a year, say UN officials. 

Meanwhile, Al-Shifa Hospital is “in ruins” following the Israeli Defense Forces’ two-week siege of the facility and is “no longer able to function in any way, shape or form,” said WHO spokesperson Margaret Harris.

• While Israeli officials said the military was routing a “terrorist base” reestablished by Hamas, stranded patients and staff at the hospital suffered “horrific” conditions, with no access to water, food, medicines, or hygiene, reports CNN. 

Furthermore, danger of famine is “imminent,” finds a UN-backed report.

• More babies are being born “too underweight to survive,” and more children are being admitted to hospitals for malnourishment. 

Related: Inside the ruins of Gaza’s al-Shifa Hospital – The Washington Post  GLOBAL HEALTH VOICES The Latest One-Liners   Uganda’s Constitutional Court today rejected a petition by two Makerere University professors to annul an anti-homosexuality law, despite agreeing that parts of the law—which imposes harsh penalties including life in prison for consensual same-sex relations and possible death for “aggravated homosexuality”—violate health rights. France24

A third of LGBT adults report experiencing unfair or disrespectful treatment from a doctor or other health care provider in a new KFF survey—2X the rate reported by people who don’t identify as LGBT. KFF Health News
​​
Stressful experiences in midlife may lead to a higher risk of developing Alzheimer's disease, while adverse experiences during childhood have been linked with increased neuroinflammation according to a study published in Annals of Neurology. ISGlobal 

The largest egg distributor in the U.S., Cal-Maine Foods Inc., has paused production at a Texas facility after a bird flu outbreak there killed 1.6 million laying hens and 337,000 pullets—or about 3.6% of its flock. NPR NEGLECTED DISEASES No Clear Answers on Nodding Syndrome 
In the past five years, cases of the neurological disease known as nodding syndrome have been increasingly reported throughout sub-Saharan Africa.

• The neurological disorder typically affects children ages 3 and older, leading to seizures and head-nodding convulsions. Long-term effects include brain damage, mental impairment, and stunted growth. 

As new cases are identified, doctors look for the cause in places like South Sudan, where the disorder has been seen since the 1990s, but answers remain elusive.

Hypotheses, but few answers: Researchers have found a link between the disorder and exposure to black-fly bites and onchocerciasis infection, but the cause of nodding syndrome remains unknown. 

Treatments: Epilepsy drugs are the most effective way of managing seizures—but there is no cure. 

The Guardian GLOBAL HEALTH VOICES NUTRITION A Formula for Profits 
For decades, developing countries have tried to protect children’s health by limiting the marketing of baby and toddler formula.

However, a ProPublica investigation reveals that the U.S. government has intervened in at least 17 countries, in the interest of large baby formula companies.

Marketing restrictions work: Rates of breastfeeding—with its measurable benefits to child and mother—have risen in countries that ban baby formula marketing.

New products: Formula manufacturers responded to slow sales growth with new products for older babies and toddlers. But health experts warn these are not regulated by the FDA, are advertised using unsupported claims, and contribute to obesity.

ProPublica

Related: What You Should Know About “Toddler Milk” and How It’s Marketed to Parents – ProPublica CLIMATE CRISIS Scorching Heat Leaves No Harvest
Since late 2023, severe drought has enveloped huge swaths of southern Africa, scorching crops that tens of millions of people grow and rely on to survive. The region has been lurching between storms and floods and heat and drought throughout the past year.
 
Thanks to the most recent drought:

• 2.7 million people in rural Zimbabwe are threatened with hunger.


• Approximately 9 million people—half of the population—need aid in Malawi.


• Over 6 million people in Zambia, 3 million of them children, are impacted.

Scientists attribute the swings in extreme weather to climate change and El Niño, which has exacerbated the effects of regional climate patterns.
 
Without this year’s harvest, millions in Zimbabwe, southern Malawi, Mozambique, and Madagascar won't be able to feed themselves well into 2025.
 
AP OPPORTUNITY QUICK HITS Taiwan: Rescue efforts continue after 700 injured in earthquake – BBC

Mpox: Is The World Failing The Next Pandemic Preparedness Litmus Test? – Health Policy Watch

Colombia, Panama Fail to Protect Migrants in Darién Gap – Human Rights Watch

What we know about H5N1 bird flu in cows — and the risk to humans – STAT

Lawsuit seeks to force ban on menthol cigarettes after months of delays by Biden administration – AP

Africa’s PhDs: study shows how to develop strong graduates who want to make a difference – The Conversation (commentary)

#SliceOfLife: I get R7 for every ARV parcel I deliver to patients on my bike – Bhekisisa Issue No. 2508
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 Facebook and follow us on X @GHN_News.

Please send the Global Health NOW free sign-up link to friends and colleagues: http://www.globalhealthnow.org/subscribe

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ABOUT
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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 Bloomberg School.


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