96 Global Health NOW: New Rule Strengthens U.S. Abortion Privacy Protections; Inside a South African Soup Kitchen; & #1 in Pandemic Potential: Influenza View this email in your browser April 23, 2024 Forward Share Post Demonstrators protest outside the U.S. Supreme Court, on March 26. Michael Nigro/Pacific Press/LightRocket via Getty New Rule Strengthens U.S. Abortion Privacy Protections
The Biden administration rolled out a final rule banning the release of reproductive health information in an effort to bolster privacy protections for women seeking abortions.
 
Why is this important?

• The administration is seeking to protect women living in states where abortion is illegal who travel to get a legal abortion in another state, per Reuters.


• ~92,000 women traveled out of state to get an abortion in the first six months of 2023, according to the Guttmacher Institute.


• Alabama, Texas, and other states have criminalized helping or paying for such travel.

Protection: Biden said a person’s medical records shouldn’t be “used against them, their doctor, or their loved one just because they sought or received lawful reproductive health care.”
 
Meanwhile at the Supreme Court: The Biden administration will argue tomorrow that it has the right to penalize hospitals that don’t provide abortions in emergency situations, The Washington Post reports.

• The administration says a four-decade-old emergency-care law gives it the authority to enforce rights to emergency abortions in states that have banned the procedure after the Supreme Court overturned Roe v. Wade in June 2022.


• Opponents argue that the law the administration is relying on doesn’t mention abortion.

GLOBAL HEALTH VOICES The Latest One-Liners  
Alcohol deaths in the U.K. increased by 33% to 10,048 in 2022, up from 7,565 in 2019; research shows that people already consuming a lot of alcohol were most likely to have increased their drinking during the pandemic. The Guardian

A new oral medication to treat visceral leishmaniasis, developed by Drugs for Neglected Diseases initiative (DNDi) and its partners, has moved into a Phase II clinical trial in Ethiopia; the current treatment includes 17 painful daily shots at a hospital. The National Tribune

Taking race out of a metric that determines placement on the U.S. kidney transplant waitlist has meant that some Black people will get transplants sooner; the previous version of the “eGFR” calculation included a race-based score that assumed “Black patients had differences in kidney function compared with other groups.” ABC

The new HeatRisk warning system developed by the CDC and the National Oceanic and Atmospheric Administration will be used to provide warnings a week in advance of dangerous heat in the U.S.; the National Weather Service will launch the color-coded scale from zero (green) to five (magenta). NPR GHN EXCLUSIVE Children from Alexandra township, South Africa line up to collect their meals from the Foundation for Special Needs Children & Youth Development soup kitchen. Marcia Zali A South African Soup Kitchen Brings Relief to Caregivers
  ALEXANDRA, South Africa—In a white shipping container that has been converted into a kitchen, Vusi Msomi, a retired nurse, provides meals for children in need.
  Initially, he started a project for children with special needs, but upon realizing that other children from the community would also line up for meals, he expanded—providing meals at least 2X a week to children ages 2 and older and bringing relief to struggling parents and caregivers.
 
While this helps, it’s not enough to address community hunger—which worsened after the pandemic started.

• Up to 19% of children in the country went hungry during the pandemic’s first wave.


• Now, over half of South Africa’s ~20 million children under age 18 receive the Child Support Grant (CSG), a government relief program.

The CSG isn’t enough to lift a family above the food poverty line—resulting in high rates of child malnutrition and causing caregivers to struggle emotionally as a result.
 
“I don’t usually eat supper because I have to save the food for my daughter,” said one mother.
 
What could help: NGOs are calling on the government to increase the CSG, and to introduce a maternity support grant as well.
 
Marcia Zali for Global Health NOW
 
Ed. Note: The research for this article was supported by the Early Childhood Global Reporting fellowship from the Dart Center for Journalism and Trauma, a project of Columbia University. READ THE FULL STORY GLOBAL HEALTH VOICES INFECTIOUS DISEASES Number One in Pandemic Potential: Influenza
An influenza virus will cause the next deadly pandemic, if 57% of senior disease experts polled in a soon-to-be-published international survey are right.
 
Why influenza?

• “Constantly evolving and mutating” flu viruses are more or less controlled for now, but “that will not necessarily be the case for ever,” says study lead Cologne University’s Jon Salmanton-García.

Other top concerns, rated by the 187 experts:

• 21% of the scientists cited a still-unknown virus dubbed Disease X as the most likely cause of the next pandemic.

• SARS-CoV-2 still tops the list of concerns for 15%.

• Just 1–2% rated Lassa, Nipah, Ebola, and Zika viruses as serious global threats.

Wait for it: Complete survey results will be revealed next weekend at the European Society of Clinical Microbiology and Infectious Diseases congress in Barcelona.    
 
The Guardian QUICK HITS Dengue surges in war-torn Sudan as healthcare system nears collapse – The Telegraph

At Spring Meetings, alarm bells sound over global health finance – Devex

Infected blood scandal: Children were used as 'guinea pigs' in clinical trials – BBC

‘Where can you hide from pollution?’: cancer rises 30% in Beirut as diesel generators poison city – The Guardian

Amid Water Crisis, Mexico City’s Metro System Is Sinking Unevenly – Undark

Epistemic disobedience–Undoing coloniality in global health research – PLOS Global Public Health (commentary)

Rural jails turn to community health workers to help the newly released succeed – KFF Health News

Why is TB called the ‘disease of paper’ in Eastern Cape villages? – Bhekisisa

Children of Flint water crisis make change as young environmental and health activists – Los Angeles Times Issue No. 2522
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: Earth Day Edition: Baking Europe; Arsenic in U.S. Water; and China’s Sinking Cities Heat-related deaths in Europe have increased about 30% in 20 years. View this email in your browser April 22, 2024 Forward Share Post A large wildfire at the border of Miren, Slovenia and Rupa, Italy on July 20, 2022. Luka Dakskobler/SOPA Images/LightRocket via Getty Heat-Stressed Europe’s ‘New Normal’
Record-breaking temperatures led to “extreme heat stress” across Europe last year, the World Meteorological Organization reported today.

• Greenhouse gas emissions fueled heat waves, wildfires, and flooding that countries must accept as “a new normal,” per UN News. 


• 2023 was confirmed as the warmest or second-warmest year on record for the continent, depending on the dataset. 

What this looked like:

• Land temperatures in Europe were above average for 11 months of 2023.

• The continent endured an “extended summer” from June to September—leading to wildfires in Greece, floods in Slovenia, and a 10% loss of Alpine glaciers’ volume. 

The bigger picture: The findings are significant because Europe is the fastest-warming continent, reports Reuters.

• Heat-related deaths on the continent have gone up ~30% in the past 20 years. 

The Quote: "Some of the events of 2023 took the scientific community by surprise because of their intensity, their speed of onset, extent and duration," said Carlo Buontempo, director of the EU’s Copernicus climate monitoring service. GLOBAL HEALTH VOICES The Latest One-Liners   The U.S. Department of Agriculture released genetic sequences late last night of the H5N1 bird flu virus behind multiple outbreaks among dairy cows; the agency has been criticized for being slow to release the sequence data. STAT
 
At least 435 attacks by Israeli forces have targeted health care in Gaza in the past six months; the average of 73 attacks per month is the highest in any war-torn country since 2018. Save the Children International

Pepsico, maker of Cheetos and Gatorade, has used suppliers that have sourced palm oil from deforested lands claimed by the Shipibo-Konibo people in eastern Peru; palm oil plantations have spurred deforestation in the Amazon since 2012. The Bureau of Investigative Journalism
 
Synthetic opioids responsible for dozens of deaths in the U.K. in the last six months are being openly advertised on social media; a Guardian investigation found nearly 3,000 SoundCloud and 700 X posts hawking nitazenes, “an illegal group of drugs several times more powerful than heroin.” The Guardian ENVIRONMENTAL HEALTH Watered Down Safety
For the last 16 years, drinking water in Sunland Park, New Mexico, has contained levels of arsenic that are up to 5X the legal limit.

• But nothing is being done, leading to growing frustration and fear that the arsenic is contributing to health problems including cancer, heart disease, and diabetes. 

Zoom out: 50 years after the Safe Drinking Water Act set legal limits for toxins in drinking water, communities across the U.S. repeatedly exceed those levels.

• 7,400+ public utilities reported a violation every quarter for the last three years, per EPA data. 

Most impacted: Low-income areas and communities of color like Sunland Park, which is 94% Latino.

• Latinos are exposed to arsenic in their drinking water at higher rates than any other racial or ethnic group, per a 2023 study in Nature. 

The Washington Post (gift article) Thanks for the tip, Chiara Jaffe! GLOBAL HEALTH VOICES CLIMATE CRISIS China’s Sinking Cities   
Nearly half of China’s major cities, including Beijing, are sinking—and one in 10 residents of some coastal cities could be living below sea level within a century, according to a new study in Science.
 
Why it’s happening: Groundwater depletion, the weight of buildings and transport systems, underground mining, and natural factors like the depth of a city’s bedrock. 

• Meanwhile, climate change fuels sea-level rise.

What can be done: Long-term, sustained control of groundwater extraction, Nature reports.
 
Success story: Tokyo slowed its sinking from a rapid 240 mm to 10 mm a year between the 1960s and 2000s, thanks to laws limiting groundwater pumping.
 
Other countries facing similar threats include the Netherlands, the U.S., and Indonesia—which is replacing Jakarta, the world’s most rapidly subsiding capital, with a new capital city, Nusantara.

• By 2040, almost one-fifth of the world’s population is projected to be living on sinking land.

OPPORTUNITY QUICK HITS Why Nations Need to Prepare for Climate-Fueled Dengue – Think Global Health (commentary)

Humans and elephants are struggling to coexist. Both are dying at alarming rates – CNN

Hospital emissions reporting proposal is a "game changer" – Axios

How Western food imports are fuelling obesity in Pacific nations – The Telegraph

He thinks his wife died in an understaffed hospital. Now he’s trying to change the industry – KFF Health News

Scotland pauses prescriptions of puberty blockers for transgender minors – NBC 

Former CDC Director Rochelle Walensky speaks on career and critical juncture in public health – Student Life (Washington University in St. Louis)

Lasers, Inflatable Dancers and the Fight to Fend Off Avian Flu – The New York Times (gift article) Issue No. 2521
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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Climate change shocks caused record levels of disruption and misery for millions in Europe in 2023 with widespread flooding and severe heatwaves – a new normal which countries must adapt to as a priority, the UN weather agency said on Monday. 

96 Global Health NOW: Expanding the Meaning of ‘Airborne’; No “Wasted” Data; and Real Cicadas of the U.S. WHO and ~500 experts have reached a consensus about what it means for a disease to spread “through the air.” View this email in your browser April 19, 2024 Forward Share Post People wearing protective masks and face shields queue to receive a shot of the AstraZeneca COVID-19 vaccine at the University of Santo Tomas on July 27, 2021. Basilio H. Sepe/Universal Images Group via Getty Expanding the Meaning of ‘Airborne’
For the first time, the WHO and ~500 experts have reached a consensus about what it means for a disease to spread “through the air”—following years of bitter disagreements over technical questions and confusing public health conundrums, explains STAT. 

Up until now, the WHO reserved the term “airborne” for select pathogens—like those that cause measles and tuberculosis—that are capable of floating through the air and infecting people across long distances. 

• Most respiratory pathogens were categorized as spreading via “droplet transmission.”  

Consequences: As COVID-19 first emerged in 2020, health agencies were reluctant to use the term “airborne” due to its technical definition, explains CIDRAP.

• That led to confusion about how the virus spread—and critical delays in adopting masks and air filtration to prevent transmission. 

Updated terms: In a new report, the WHO concludes that the term "through the air" can be used for infectious diseases where the main type of transmission involves "infectious respiratory particles" becoming airborne—regardless of droplet size or distance traveled, reports Reuters. 

• The umbrella term now applies to COVID—but also influenza, MERS-CoV, and SARS.

Implications: The update will likely lead to significant changes around public health messaging—and could reset standards for prevention measures at health facilities, including the use of respirators or air filters.  GLOBAL HEALTH VOICES The Latest One-Liners
10 million teenage girls in some of the world’s poorest countries will miss HPV shots this year, after Merck announced that it cannot deliver millions of expected vaccine doses due to a manufacturing problem. The New York Times (gift link)

15 out of every 100 children in the Americas lack full vaccination coverage, as regional health officials say “more must be done” to improve vaccination rates—especially to protect against highly contagious diseases like measles. PAHO (news release) 

Free school meals in Ukraine could “significantly boost” children’s health and nutrition amid ongoing military conflict, per a new WHO/Europe policy brief. ReliefWeb

85 pathogens accounted for 704 million years of life lost from ill health, disability, or early deaths globally in 2019, with TB, malaria, and HIV having the biggest impact, per a new study published in The Lancet Infectious Diseases. CIDRAP  DISEASE SURVEILLANCE No “Wasted” Data
As the wave of COVID-19 broke over the world in 2020, public health agencies were desperate for new ways to track the fast-moving virus.
 
Cue wastewater testing, which allowed scientists to successfully track SARS-CoV-2 in sewage and pinpoint the origin of outbreaks, informing interventions like mask mandates and vaccination efforts.
 
Today, wastewater collection for SARS-CoV-2 testing is in place at 4,600+ sites globally, but researchers see the tool’s broader potential. Some are now testing wastewater to track a range of diseases and health indicators, like:

• Influenza, rotavirus, norovirus, mpox, measles, cholera, and typhoid.

• Lead levels.

• Opioids and other drugs with a risk of misuse.

• Zoonotic diseases including anthrax, brucellosis, and Rift Valley fever.

Nature GLOBAL HEALTH VOICES OCCUPATIONAL HEALTH Quartz Countertops’ Lethal Threat
Quartz countertops are in millions of homes worldwide, but they’ve left many workers in the supply chain with silicosis, an incurable and often deadly lung disease. 

A persistent danger: Silicosis is caused by breathing dust from silica-laden materials like quartz. The body responds by producing mucus, which can eventually clog the lungs, leading to suffocation. 

Case studies:

• In Turkey, mining companies regularly scan workers’ lungs and fire them from their jobs before they receive a formal diagnosis.

• In Spain, 300+ people are sick in a mining town of 3,000. 

• In Australia, the engineered stone will be banned entirely on July 1, due to a lack of compliance with safety regulations.

The World FRIDAY DIVERSION Real Cicadas of the U.S. 
Still suffering from eclipse FOMO? There’s a much, much rarer event on the horizon that for some reason isn’t garnering the same fanfare and inflated hotel prices.
 
A trillion cicadas getting it on!
 
The “raucous mating ritual” of broods XIII and XIX is a once-in-two-centuries event that maybe you do want to miss, but can’t if you live in the Midwest or Southeastern U.S, NBC News reports.
 
What to expect: The sound of “1,000 chainsaws going off and they’re all being used at the same time,” says cicada enthusiast Jim Louderman. And with a name like that, we trust his judgment.
 
Think of it as a truly epic Tinder matchup. The broods’ geo-locations will overlap in a narrow sliver of Illinois, where they’ll have “a few chaotic weeks” to meet someone, mate, then die—and that’s if they don’t catch an STD that turns them into a zombie and makes their privates fall off, AP reports.
 
A reality show waiting to happen. QUICK HITS Bird flu jumping to humans is ‘enormous concern’, says WHO – The Telegraph

Bacteria found in mosquito guts could help scientists fight dengue, Zika – Science

HIV among refugee youth in Uganda: unmasking the crisis – The Lancet

How the US failed people in prisons during Covid: ‘Really important to learn from what happened’ – The Guardian

Which scientists get mentioned in the news? Mostly ones with Anglo names, says study – NPR Shots Issue No. 2520
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: Malaria Win: More Effective Bed Nets; AI’s Dusty Forecasting; and Bans Target Books About Sexual Violence View this email in your browser April 18, 2024 Forward Share Post A young boy rolls up a mosquito net covering bedding at a camp for displaced people on November 29, 2023, in Rotriak, South Sudan. Luke Dray/Getty Malaria Win: More Effective Bed Nets  
Two new types of insecticide-treated mosquito bed nets are up to 50% more effective in reducing exposure to mosquitoes in malaria-endemic countries, STAT reports.

• The new nets reduced the risk of malaria infection by up to 55%.


• They prevented up to 13 million malaria cases, saving nearly 25,000 lives.

Massive trials: 56 million nets were distributed in 17 sub-Saharan countries from 2019 to 2022 in two clinical trials and five pilot studies that are part of the New Nets Project, funded by Unitaid and the Global Fund, per a Global Fund news release.
 
Why is this important news? Anopheles mosquitoes, which transmit malaria, have been acquiring resistance to pyrethroid insecticides on traditional bed nets. The new nets seek to solve this problem:

• The Interceptor G2 net from BASF is coated with a new pyrrole insecticide called chlorfenapyr as well as pyrethroid insecticide. It always bested traditional nets.


• The Royal Guard net by Disease Control Technologies uses pyriproxyfen and pyrethroid insecticides. Results for this net weren’t as definitive.

Malaria rising: Case numbers increased to 249 million in 2022, up from 244 million in 2021, per the World Malaria Report. GLOBAL HEALTH VOICES The Latest One-Liners   Italian lawmakers advanced an amendment that, if approved by the Senate as expected, would allow antiabortion activists to enter into family planning clinics that provide abortion services. The Washington Post
 
The WHO prequalified a simplified version of an oral cholera vaccine from South Korean-based EuBiologics that can streamline formulation and manufacturing—paving the way for the UN and Gavi to buy the Euvichol-S vaccine for countries experiencing outbreaks amid a severe vaccine shortage. CIDRAP

Every U.S. state has significant racial and ethnic-based health inequities as measured by health care systems’ performance, per a Commonwealth Fund report released today; white and Asian people had the best health outcomes in each state. STAT

Declining confidence in major institutions—a COVID-19 pandemic legacy—pushed more people to trust themselves or their friends to assess health information, leaving them more vulnerable to health misinformation. Axios AI Dusty Forecasting  
As annual dust storms roll through East Asia, scientists have started using AI and climate modeling to create more accurate forecasts. 

Dust storms—caused by strong winds sweeping over dry areas—can carry dust particles, along with bacteria and toxic metal particles, up to 1,500 meters in the air. 

Dust storm health effects:

• 25% increase in mortality from cardiovascular diseases.


• 18% increase in respiratory problems. 

Model predictions: Atmospheric scientists have developed forecast systems that use AI to break down large amounts of past data.

• One system can predict an incoming dust storm up to 12 hours in advance in 13 countries.

Nature GLOBAL HEALTH VOICES Thanks for the tip, Chiarra Jaffe! INDIGENOUS PEOPLE Saving Lives Through Community Empowerment  
Native Americans have a much lower life expectancy than white Americans—in part because of their historic lack of access to health care. But according to Indigenous health experts, social and economic forces play a key role in many of the common causes of early Native American deaths—from chronic diseases and disproportionately high rates of infant and maternal mortality to drug overdoses.
 
One solution: Along with bolstering medical care and fully funding the Indian Health Service, experts recommend greater investment in community-based preventions, like case management, parenting classes, and home visits.
 
Another recommendation: Tribes negotiate contracts to manage their own health care facilities with federal dollars—opening funding streams unavailable to the IHS.
 
CBS
 
Related: 
 
Reclaiming Health in Indigenous Communities –  Hopkins Bloomberg Public Health CENSORSHIP Bans Target Books About Sexual Violence  
Amy Reed’s The Nowhere Girls. Toni Morrison’s The Bluest Eye. Rupi Kaur’s poetry collections.

School officials across the U.S. are banning these and other books from school libraries, often by labeling them “obscene,” “pornographic,” or “disgusting,” according to a new PEN AMERICA report.
 
Why that’s a problem:

• The bans feed the common misconception that these books are about sex—when they’re really about violence.

• Literature that addresses sexual violence can help survivors understand that the abuse they suffered wasn’t their fault, aiding their recovery.

• ~Half of people who seek help from the Rape, Abuse & Incest National Network are minors.

The Quote: “Pretending that sexual violence is just an adult topic might make some people feel better, but kids know the truth,” says RAINN’s Scott Berkowitz.

The 19th QUICK HITS Guns are killing more U.S. children. Shooting survivors can face lifelong challenges – NPR Shots

Women in Menopause Are Getting Short Shrift – The Atlantic

Plan to control rare Ebola outbreak in Uganda could be blueprint for others – Healio

USDA scientists weigh avian flu vaccine for cows; virus may be spreading from cattle to poultry – CIDRAP

Miracle’ weight-loss drugs could have reduced health disparities. Instead they got worse – Los Angeles Times

She was fired after not endorsing Splenda-filled salads to people with diabetes. Why? – The Guardian

Sweltering Lagos Has 25 Million People and Zero Free Public Beaches – Bloomberg CityLab

Deadly diseases and inflatable suits: how I found my niche in virology research – Nature Issue No. 2519
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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The ongoing global spread of “bird flu” infections to mammals including humans is a significant public health concern, senior UN medics said on Thursday, as they announced new measures to tackle airborne diseases.

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.

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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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.