The top UN health official gave a sobering reality check as the Fourth Global High-Level Ministerial Meeting on Antimicrobial Resistance began Friday in Jeddah: “AMR doesn't just threaten to make the medicines on which we depend less effective; it’s happening now.”

Researchers’ outstanding contributions to science and society celebrated by the Fonds de recherche du Québec 

$13.8 million in federal funding for McGill’s cohort of 10 new, five renewed Canada Research Chairs 

96 Global Health NOW: Rising Resistance Threatens a Key Malaria Drug; Uncontrolled Diabetes Reaches New Heights; and Fun, Games—and Fame The malaria parasite is acquiring partial resistance to a key medication used to care for children experiencing severe malaria. View this email in your browser November 14, 2024 Forward Share Post Employees transfer barrels of artemisinin at a pharmaceutical company in southern China on Aug. 27. Huang Xiaobang/Xinhua via Getty Images Rising Resistance Threatens a Key Malaria Drug
In yet another ominous sign for malaria treatment’s prospects, the malaria parasite is acquiring partial resistance to a key medication used to care for children experiencing severe malaria, according to a study published today in JAMA and presented at the annual meeting of the American Society of Tropical Medicine & Hygiene.
 
Major findings:

• The study, led by Ugandan researchers Ruth Namazzi and Robert Opoka from Makerere University in Kampala, found partial resistance to the malaria drug artemisinin in 11 of 100 children treated for severe malaria.

• They found that 10 patients “cured” of severe malaria experienced a resurgence of the same strain of the parasite within 28 days of the original infection—which implies the first treatment didn’t fully eliminate the parasite, said study coauthor Chandy John.

• They also noted that it took more than 72 hours to clear the parasites in two children—a duration that the WHO defines as early treatment failure. 

The Quote: “We need studies to confirm whether other places are finding these elevated rates of artemisinin partial resistance,” John said. “We’ll need to see what happens over the next couple of years to see just how bad this problem is in Africa.”
 
Brian W. Simpson, Global Health NOW EDITORS' NOTE GHN in NOLA  
We’re thrilled to be in New Orleans this week for the American Society of Tropical Medicine & Hygiene annual meeting.
 
If you’re here too, please stop by GHN’s exhibit, #114. We’re right across from our friends at the DNDi/MSF booth, which you should also visit!
 
We’d also like to welcome new GHN subscribers who visited our booth and signed up last night—from countries including Austria, Bangladesh, Brazil, Eswatini, Kenya, Mali, Mozambique, Sri Lanka, Uganda, and Zambia. Thanks for subscribing!
 
If you enjoy Global Health NOW, please share the free-subscribe page with colleagues and friends. —Dayna Kerecman Myers, dkerecm1@jhu.edu; and Brian W. Simpson, bsimpso1@jhu.edu. GLOBAL HEALTH VOICES The Latest One-Liners
Weight loss drugs may help curb alcohol addiction, new research published in JAMA Psychiatry suggests, with GLP-1 drugs like Ozempic and Wegovy cutting risk for hospitalization. USA Today 

State medical boards almost never discipline doctors who spread misinformation about COVID-19, an analysis from the University of North Carolina School of Law has found. CIDRAP

The bird flu infection that has left a Canadian teen in critical condition is not the version of H5N1 found in cows and currently circulating in the U.S., genetic sequencing has found; it is instead of a genotype found in wild birds. STAT

A new diagnostic test uses genetic sequencing to ID pathogens from a range of possible culprits—viruses, bacteria, parasites, and fungi—which could help doctors more effectively diagnose and treat hard-to-identify infections like meningitis. NBC News  NONCOMMUNICABLE DISEASES Uncontrolled Diabetes Reaches New Heights 
The number of adults globally living with diabetes has soared 4X since 1990—surpassing 800 million, finds a new Lancet study released on World Diabetes Day, per the WHO.

Extra troubling: 445+ million people with diabetes—59% of the global total—are not receiving treatment, reports Reuters. 

• The problem is most acute in LMICs, where treatment rates are as low as 10%, reports The Telegraph. India, Pakistan, and Indonesia have especially high rates of untreated diabetes. 

Behind the rise: The “alarming” uptick stems from factors including a lack of physical activity, unhealthy food marketing, and economic hardship, said WHO chief Tedros Adhanom Ghebreyesus. 

• Tedros called for countries to “urgently take action”—particularly to equip health systems to meet the crisis. 

• The WHO also launched new guidance on global monitoring of diabetes today. 

GLOBAL HEALTH VOICES POLLUTION Smog Shrouds Pakistan
Daily activities have come to a standstill in Pakistan’s populous Punjab province, as thick smog envelops the region, reports the AP. 

Outdoor activities have been banned, schools closed, and markets shuttered as the wave of pollution debilitates millions of residents living in Lahore, Multan, and surrounding areas. 

• Air quality index readings have surpassed ~1,000; 300+ is considered hazardous to health, per NPR Goats and Soda.

Officials have deployed 200+ mobile clinics and added hospital beds to treat ~70,000 patients daily reporting respiratory distress. 

• UNICEF has warned that 11+ million children are at risk. In January, 240+ children in Punjab province died of pneumonia.

Sources: The “apocalyptic smog” is a product of vehicle emissions, construction and industrial work, and seasonal crop burning. 

Most vulnerable: “It’s poor people that are facing the brunt of the air pollution crisis because they have no means to protect themselves from it,” environmental lawyer Ahmad Rafay Alam told NPR. ALMOST FRIDAY DIVERSION Fun, Games—and Fame
You might have thought a toy’s value is measured by asking: “Do I like playing with it?”
 
But you’d be wrong.
 
This week, anyway, the question is: Is it among the elite?

• Three 1980s icons—Phase 10, Transformers, and My Little Pony—have joined the National Toy Hall of Fame in Rochester, New York.

And for a contest we learned about just yesterday, we suddenly feel very strongly about it.
 
No longer a bridesmaid: The honor was “extra validating” for seven-time finalist My Little Pony, USA Today reports. 

• But how did lush-maned mini ponies—whose chief function is hairstyling—edge out the humble stick horse behind this epic competition? Why were balloons and trampolines bounced out of the running?

And might we spare a nomination for the beloved playthings not even in contention—say, mud, the spoon-and-pot duo, the kitchen sink, and buttons (literally any buttons)? QUICK HITS Many long COVID patients adjust to slim recovery odds as world moves on – Reuters

Kenya's new health insurance rollout sparks challenges and concerns – Devex

Scientific breakthrough to prevent negative side effects of weight loss drugs like Ozempic – The Independent

The Making Of A New American Epidemic – Noēma

The people cracking the world's toughest climate words – BBC Issue No. 2815
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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Insecurity and overlapping crises afflicting Haiti are continuing to fuel a dire humanitarian situation across the Caribbean nation, the UN Spokesperson said on Thursday.

Antimicrobial resistance initiatives are back in the spotlight as stakeholders gather in Jeddah, on the Saudi Arabian coast, a few months after a high-level meeting in New York led to the unanimous adoption of a political declaration by the UN General Assembly. With that declaration the 193-member body pledged concerted action against the under-recognized but serious health concern.

Global diabetes cases have quadrupled since 1990, affecting over 800 million adults worldwide, according to a World Health Organization (WHO) study released to coincide with World Diabetes Day. 

96 Global Health NOW: Haiti Isolated and Imperiled; Stopping Polio in Gaza and Why It Matters; and STIs Slow Down in the U.S. Hospitals in Haiti face “indescribable” surge of traumatic injuries View this email in your browser November 13, 2024 Forward Share Post After being injured in a tanker truck explosion, people recover in a hospital in Port-au-Prince, Haiti, on September 17. Clarens Siffroy/AFP via Getty Haiti Isolated and Imperiled
A surge of gang violence in Haiti puts the country at further risk of isolation, as airlines halt flights to the country and as hospitals and medical groups like Médecins Sans Frontières describe untenable working conditions. 

No flights: Haiti’s main international airport in Port-au-Prince remains closed after three U.S. commercial passenger planes were hit by suspected gang gunfire, and the FAA has now banned all U.S. airlines from operating in Haiti for 30 days, reports Al Jazeera. 

• Even UN helicopters are unable to land in the capital, and the closure has raised questions about the arrival of 600 Kenyan police officers, deployed to reinforce a UN-backed security mission.

Ambushed ambulance: At least two patients in an MSF ambulance in Port-au-Prince were executed by members of a vigilante group in a “shocking display of violence” that “seriously calls into question” MSF’s ability to continue delivering medical care there, reported the charity. 

Hospitals are struggling to cope with an “indescribable” surge of traumatic injuries, as doctors and medical facilities buckle under the pressures of an already devastating year, reports The Guardian.  GLOBAL HEALTH VOICES The Latest One-Liners
Global temperatures may be closer to the “crucial” 1.5C warming threshold than previously thought, according to a new study of Antarctic ice cores suggesting that, in 2023, human-driven warming reached 1.49C above pre-industrial levels. Nature

Children in Somalia face perilously high rates of pneumonia and diarrhea—two leading killers of children under age 5 globally—as well as the added risk of low immunization rates, per a new report by the Johns Hopkins Bloomberg School of Public Health. Hiraan

Pathogens on microplastics can survive wastewater treatment and can quickly form protective microbial biofilms—allowing them to form colonies of “plastispheres” that pose a threat to human and environmental health, finds a new study from the Norwegian University of Life Sciences. CIDRAP

​​Women are stockpiling emergency contraception pills in the week since Donald Trump was re-elected as U.S. president, with one company’s sales of morning-after pills rising 966% as of Friday compared with three days before the election. CNN GHN EXCLUSIVE COMMENTARY A child is vaccinated during the polio vaccination campaign in Deir al Balah, Gaza, on September 1. Abed Rahim Khatib/Anadolu via Getty Images Stopping Polio in Gaza and Why It Matters  
Last week’s conclusion of a two-month effort to protect over half a million children from polio was an important advance for Gaza—and the world, writes vaccine expert Walter Orenstein in an exclusive commentary for GHN. 
 
Gaza’s challenge: The polio strain circulating in Gaza is type 2 variant poliovirus, which 31 countries are currently battling.
 
The vaccine used in Gaza is the novel oral polio vaccine type 2 (nOPV2). It’s less likely than a previous version of the oral polio vaccine to revert to a form that can cause paralysis. 
 
Encouraging record: Over the three and half years of nOPV2’s use, the number of type 2 variant poliovirus cases has been reduced, providing hope that the end of type 2 variant polio is in sight, writes Orenstein. 
 
The future: Polio anywhere is a risk to communities everywhere. All children everywhere need to be fully vaccinated against polio. This will require overcoming hurdles like war, climate disasters, political instability, and vaccine misinformation. 
 
We’ve seen the result of such commitment in Gaza. It’s now essential to get the same cooperation, resources, and determination everywhere. 
 
Walter Orenstein for Global Health NOW  READ THE FULL COMMENTARY GLOBAL HEALTH VOICES SEXUAL AND REPRODUCTIVE HEALTH STIs Slow Down in the U.S.
Some good news for sexually active Americans: The STI epidemic lost steam in 2023, according to new CDC data.

• Overall, syphilis increased by only 1% after years of double-digit increases.

• Cases of the most infectious stages of syphilis fell 10% from 2022.

• Gonorrhea cases dropped 7%, falling below pre-COVID levels.

What’s behind the improvement?

• Growing use of the antibiotic doxycycline as a “morning-after pill” to reduce the risk of bacterial STIs.

• Changes in sexual behavior and testing habits among high-risk populations after the 2022 mpox outbreak.

• More funding into health departments following the pandemic, meaning more health workers conducting testing and contact tracing and connecting people to treatment.

The New York Times QUICK HITS ‘More mortality, more illness’: Global health community braces for impact of U.S. election – Science

Mpox vaccination shortage delays Kinshasa's drive against outbreak – Reuters

WikiGuidelines group publishes first new UTI guidance in 14 years – Healio

This scientist treated her own cancer with viruses she grew in the lab – Nature Issue No. 2814
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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Adolescents across Europe, Central Asia and Canada say they face rising school pressure and diminishing support from families and friends, according to a new report from the World Health Organization (WHO) and the Health Behaviour in School-aged Children (HBSC) survey.

YCharOS antibody characterization platform addresses the “reproducibility crisis” in research

An innovative research project led by researchers at The Neuro has been awarded $1.5M by the Government of Quebec through CQDM.

YCharOS is an innovative platform led by neuroscientists Peter McPherson and Carl Laflamme that validates antibody reagents for human proteins.

96 Global Health NOW: Malaria in Children Surges in South Sudan; Seeking Suicide Intervention in Japan; and America’s Covid-19 Hangover View this email in your browser November 12, 2024 Forward Share Post Malaria in Children Surges in South Sudan
An upsurge in malaria cases in South Sudan, fueled by recent floods, is overwhelming the country’s health system, Al Jazeera reports.

• Pediatric patients with severe malaria have swamped a Médecins Sans Frontières-supported hospital in Northern Bahr el Ghazal state, the agency reports, forcing doctors to treat some patients in halls.


• 400 children with severe malaria are admitted weekly—2X last year’s numbers.

Another Impact: Oil-Contaminated Water

Years of unprecedented flooding have left large swaths of South Sudan’s Unity State submerged, allowing pollution from mismanaged oil production facilities to seep into drinking water sources—causing digestive illnesses and birth defects, the BBC reports.
 
No recourse: Reliance on the oil industry means little has been done to hold companies accountable, advocates say—with one former oil engineer describing the spreading oil as a “silent killer.” DATA POINT The Latest One-Liners
Refugees and asylum seekers are nearly 3X as likely to be colonized or infected with drug-resistant bacteria as the host-country population, per a Lancet Infectious Diseases study that explored case studies in nine current humanitarian settings. CIDRAP

Dengue death rates are 2X higher for women (1.86%) than men (0.61%) in Chattogram, Bangladesh, this year; doctors say delayed hospitalization, anemia, and low blood pressure—all more common among women—explain the disparity. The Daily Star

The American Stroke Association’s new guidelines on stroke prevention—the first in 10 years—recommend that doctors consider a new class of drugs that can drastically reduce weight, and screen for non-medical risk factors like economic stability and racism. AP

Online e-cigarette retailers are failing to comply with restrictions on sales for minors, including regulations on age verification, shipping methods, and flavor restrictions per a study in JAMA; delivery services only scanned IDs for 1% of buyers. Medical Xpress MENTAL HEALTH Seeking Suicide Intervention in Japan
Advocates in Japan are calling for a greater focus on youth mental health after suicides among schoolchildren in the country remained “alarmingly high” in 2023.

• 513 deaths were reported in Japan last year—marking the second consecutive year above 500, per Japan’s Ministry of Health, and a sharp increase from 300 in 2010. 

Contributing factors: Family economic stress, bullying, school pressures, reduced in-person socialization, and disillusion about the future are all contributing to the crisis, researchers said.

• “One of the biggest problems among young people today is that they find it difficult to be optimistic about their future,” said Izumi Tsuji, a sociologist at Chuo University and member of the Japan Youth Study Group.

South China Morning Post GLOBAL HEALTH VOICES ALCOHOL America’s Covid-19 Hangover
Drinking in the U.S. increased sharply during the pandemic and still hasn’t returned to pre-COVID-19 levels, according to an Annals of Internal Medicine study published today.

• Americans who reported drinking heavily increased to 6.29% in 2022, up from 5.1% in 2018.


• 69.3% said they had consumed alcohol in the past year, up from 66.34% in 2018.


• 6.45% of women reported having drunk heavily, while the men’s reported rate was 6.12%.

The Quote: “People assumed this [drinking] was caused by acute stress, like what we saw with 9/11 and Katrina, and typically it goes back to normal after these stressful events are over,” said principal investigator Brian P. Lee. “But that’s not what we’re seeing.”

The New York Times (gift article) OPPORTUNITY QUICK HITS Rwanda discharges last patient of Marburg virus disease: WHO – Anadolu Agency

Paxlovid cuts COVID hospitalization, death risk and speeds symptom relief, studies find – CIDRAP

US FDA lifts clinical hold on Novavax's combo COVID-flu shot – Reuters

Mpox Cases Plateau in Congo's Epicenter But Rise in Other Countries – Newsweek

'More mortality, more illness': Global health community braces for impact of U.S. election – Science

No Pandemic Agreement By December As Negotiators Need 'More Time' – Health Policy Watch

More young people are surviving cancer. Then they face a life altered by it – NPR

Easy-fit prosthetics offer hope to thousands of Gaza amputees – BBC Issue No. 2813
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: Putting ‘Health at the Core’ of Climate Action; Iraq Set to Lower Girls’ Age of Consent to 9; and The (Global) Power of Plastic WHO says human health and well-being should be the “top measure of climate success” View this email in your browser November 11, 2024 Forward Share Post Attendees at the COP29 climate conference in Baku, Azerbaijan, on November 11. Hollie Adams/Bloomberg via Getty Putting ‘Health at the Core’ of Climate Action
Human health and well-being should be the “top measure of climate success” and should be “at the core of all climate negotiations, strategies, policies and action plans,” the WHO stressed ahead of the UN COP29 climate conference, which launched today in Baku, Azerbaijan.

• “Health is the lived experience of climate change,” said Maria Neira, the WHO’s director for environment, climate change, and health. 

While health has been a feature of past COPs, the conference is shifting to “prioritize health on a permanent basis,” per Health Policy Watch. 

A special report released for the conference covered a wide range of health-related recommendations, per ReliefWeb, including: 

• Putting more focus on cities to drive initiatives like sustainable urban design and housing, clean energy, urban agriculture, and improved sanitation. 

• Creating resilient health systems to protect health and save lives.

• Investing in interventions like heat-health warning systems and clean household energy.

• Improving biodiversity, recognizing the “synergistic health benefits” of clean air, water, and food security.

GLOBAL HEALTH VOICES The Latest One-Liners
Canada has detected its first “presumptive” case of human bird flu: a teenager in British Columbia who likely caught the virus from a bird or animal, per an alert from province health officials. Reuters

Testing for bird flu should be expanded at U.S. farms, says the CDC—after a new study revealed that some dairy workers had H5N1-related antibodies in their blood despite not showing symptoms of the virus. AP

Abortion pills and gender-affirming medications are in unprecedented demand post-election, suppliers report—with people “trying to plan for the reproductive apocalypse” feared under another Trump presidency. The Guardian

The WHO will convene its International Health Regulations Emergency Committee next week to determine whether mpox remains a global health crisis; the disease continues to spread in Africa, which has seen 46,000+ cases so far this year. U.S. News & World Report HUMAN RIGHTS Iraq Set to Lower Girls’ Age of Consent to 9 
  Iraq’s parliament appears poised to lower the legal age of marriage from 18 to 9. 

The dominant coalition of conservative Shia Muslim parties claims that the change would protect young girls from “immoral relationships”; women’s rights activists counter that the government is attempting to “legalise child rape.” 

The change would also erase women’s rights to divorce, child custody, and inheritance. 

Athraa Al-Hassan, of Model Iraqi Woman, said she fears that Iraq’s governance system could be replaced with a system that puts religious rule above the state—as in Afghanistan and Iran.

The Telegraph GLOBAL HEALTH VOICES POLLUTION The (Global) Power of Plastic
Plastic pollution is affecting all pressing global environmental problems, including climate change, biodiversity loss, ocean acidification, and freshwater and land use, according to a study published last week in One Earth.

• In 2022, over 500 metric tons of plastic were produced worldwide, but just ~9% of it was recycled. The rest is burned or dumped.

The study’s authors are urging delegates to the UN Environment Assembly to consider the entire life cycle of plastics—from raw material extraction to production, use, and environmental impact.

The warning comes before final talks begin in South Korea to agree to a legally binding global treaty to cut plastic pollution.

The Guardian OPPORTUNITY QUICK HITS Suspected poisoning kills dozens in besieged Sudanese town – Sudan Tribune

WHO calls for urgent action in Africa to eliminate Cervical Cancer amid high burden – Nile Post

Africa CDC launches trial of smallpox drug for mpox – CIDRAP

Research suggests no need for yellow fever vaccine booster after initial dose – News Medical

New research from Philly ER doctors shows the ‘excruciating’ effect of xylazine withdrawal, and how to manage it – WHYY

Three states had paid leave on the ballot. Voters in each one overwhelmingly approved them – PBS News

America Has an Onion Problem – The Atlantic Issue No. 2812
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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Amid the ongoing turmoil in the Middle East, the World Health Organization (WHO) continues efforts to keep hospitals up and running and to evacuate patients requiring specialized treatment, a senior official with the UN agency said in Cairo on Monday. 

$1M grant from The Weston Family Foundation will pave the way for earlier intervention in REM sleep behaviour disorder and Parkinson’s disease

REM sleep behaviour disorder (RBD) is an often debilitating condition that causes people to act out in their sleep, sometimes violently. What’s worse, people with the disorder often go on to develop Parkinson’s disease.

An alarming surge in ransomware attacks is putting the world’s healthcare infrastructure at critical risk, endangering patient safety and destabilising health systems, the head of the UN World Health Organization (WHO) warned on Friday, as the Security Council convened to discuss strategies to counter the growing threat.

96 Global Health NOW: The Coming Cancer Wave; Ketamine’s Surge Among Gen Z; and A Moment That Calls for Cuteness View this email in your browser November 7, 2024 Forward Share Post A breast cancer patient speaks with doctors at a hospital in Herat, Afghanistan, on April 2, 2014. Behrouz Mehri/AFP via Getty The Coming Cancer Wave
Cancer deaths worldwide will nearly double by 2050, driven mostly by large increases in LMICs, according to a new JAMA Network Open article.

• Annual cancer deaths are expected to increase by 90% to 18.5 million cancer deaths by 2050 from 9.7 million in 2022.


• Cancer deaths in LMICs by 2050 will increase by 146%, while the increase in high-income countries will be 57%, according to the estimates.


• Cancer cases and deaths in Africa are projected to increase at a rate 5X that of Europe.

What’s behind the global increase? Among the multiple factors is the fact that people are living longer (which raises cancer risk), Massachusetts General Hospital’s Andrew Chan told New Scientist.
 
And the much greater surge in LMICs? Chan blames the “Westernisation of populations,” including rising obesity rates and poor diets.
 
What’s needed? “Higher-quality health care and universal health insurance coverage would help prevent, diagnose and treat cancer around the world,” the researchers noted, per Axios.
 
Study details: An international team led by University of Queensland researchers drew on cases and death rates for 36 types of cancer across 185 countries and used UNDP population projections to estimate future cases and deaths. GLOBAL HEALTH VOICES The Latest One-Liners
The first cluster of illnesses outside of Africa caused by the new, more infectious mpox variant has been identified in the U.K.; four members of the same household are being treated in a London hospital. AP
  Major global food companies peddle less-healthy products in low-income countries than those sold in high-income countries, per a new report from the Access to Nutrition Initiative—which split the assessment into low- and high-income countries for the first time this year. Reuters
 
Eight countries made commitments to ban corporal punishment ahead of today’s UN conference on the issue; Panama, Kyrgyzstan, Uganda, Burundi, Sri Lanka, and the Czech Republic have pledged total bans, while Gambia and Nigeria said they would enforce a ban in schools. The Guardian

The UN has launched the first-ever Pan African Action Plan for Active Mobility to improve infrastructure for walking and cycling across the continent—which accounts for 19% of global road traffic deaths—and prevent 41 million tons of carbon emissions over the next decade. UNEP U.S. Election News R.F.K. Jr. Lays Out Possible Public Health Changes Under Trump – The New York Times (gift article)

‘Go wild, Robert’: what Trump’s victory means for global health – The Telegraph

Election reveals voters' abortion disconnect – Axios

Trump won. Is the NIH in for a major shake-up? – Science SUBSTANCE USE Ketamine’s Surge Among Gen Z 
In England and Wales, ketamine usage among 16–24-year-olds has more than tripled, mirroring trends in the U.S. and U.K.

• Compared to drugs like cocaine, ketamine is widely available and cheap—costing as little as $30 per gram.


• Long-term use leads to frequent urination, incontinence, and a shrinking bladder, as well as potential renal and liver failure.

Many people who use ketamine seek it out to manage mental health. But while the drug has shown promise for treating depression, clinical settings are key, as providers are still determining optimal doses and delivery—and ketamine obtained on the streets may also be mixed with other toxins.
  
The Guardian
 
Related: We checked up on the states that promise transparency on opioid settlement funds – NPR Shots GLOBAL HEALTH VOICES HUMAN RIGHTS Ending ‘Sex Normalization’ Surgeries in Serbia 
Kristian Randjelovic was born intersex, but underwent “sex normalization” surgery as an infant. After a childhood spent grappling with the fallout of his doctors’ decision, he received sex reassignment surgery at age 19.

• Such “normalization” surgeries affected many intersex infants in Serbia until as recently as a decade ago; the country’s laws still enforce binary classification at birth.


• The UN estimates that up to 1.7% of the world's population is intersex, which would translate to about 110,000 in Serbia alone.

Today, Randjelovic is Serbia's only publicly declared intersex individual and an activist for intersex rights—an experience with implications for millions of others “born into societies with evolving understandings of sex and gender.” 

Radio Free Europe / Radio Liberty ALMOST FRIDAY DIVERSION A Moment That Calls for Cuteness  
In a week ruled by election anxiety for many, it seems the pachyderm gods knew just what was needed: another insanely cute pygmy hippo named after a meat product.

• A pink-cheeked Moo Deng (meaning “bouncy pork” in Thai) kicked off an internet sensation when she was born at Thailand’s Khao Kheow Open Zoo in July. 


• Coming for Moo Deng’s viral crown is Haggis (a mound of miscellaneous sheep meat), a pygmy hippo born at Scotland’s Edinburgh Zoo last week, sparking debate about who’s the hippest lil’ hippo, The Herald reports.

“Moo Deng? Who deng?” Edinburgh Zoo has apologized for initially pitting the pygmies against each other because after all, both births are great news for the endangered species, and for our collective mood.
 
We may not know where the world is headed right now, but if it’s in the direction of more Moo Dengs … well, that’s no bad thing.

Related: He’s fast, feisty and could play Quidditch. Meet the bat that won a beauty contest – AP QUICK HITS Beyond Burns International leads campaign on burn awareness in Ghana – Joy Online

An Improved Alert System for Emerging Infectious Diseases – JAMA Network (commentary)

U.S. diabetes burden grew since 2000 – Axios

South African study finds high risk of TB infection in kids – CIDRAP

Are Schools With Armed Police Actually Safer? – Undark

Snakebite envenoming in Africa remains widely neglected and demands multidisciplinary attention – Nature (commentary)

In Vermont, where almost everyone has insurance, many can't find or afford care – KFF Health News

Phone therapy aids refugee children, study shows – BBC Issue No. 2811
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: What Trump’s Victory Means for U.S. Health; Taming an Isolating Tropical Disease; and Ditching HIV Meds Due to Stigma What are Trump’s health priorities? View this email in your browser November 6, 2024 Forward Share Post Donald Trump takes the stage during a campaign rally at the J.S. Dorton Arena on November 4 in Raleigh, North Carolina. Chip Somodevilla/Getty Images What Trump’s Victory Means for U.S. Health
Donald Trump’s return to power heralds potentially huge changes in the U.S. health care system, public health, and the federal agencies overseeing vaccines and medications.
 
After promising to let vaccine skeptic Robert F. Kennedy Jr. “go wild” on health policies, Trump’s victory speech promised that Kennedy would “help make America healthy again,” STAT reports.
 
Trump’s health priorities, according to Trump:

• He’s against a national abortion ban.

• He won’t try again to repeal the Affordable Care Act but said he will try to reduce costs within the ACA and “possibly let the current enhanced tax credits expire,” per STAT.

• He will block federal funds for gender-affirming care and ban it entirely for minors.

• He proposed tax credits for long-term caregivers.

• “Sounds OK to me” was Trump’s response to RFK Jr.’s proposal to remove fluoride from water supplies, per CNN. (The CDC “recommends community water fluoridation as a cost-effective way to improve Americans’ oral health,” CNN also reports.)

The Quote: “My first reaction is that a Trump administration would be the most anti-public health, anti-science administration in history,” Lawrence Gostin, of the O’Neill Institute for National & Global Health Law at Georgetown Law School, told The Guardian.  
 
Other election news: Supporters of abortion rights scored victories in ballot measures in states like Missouri, New York, Colorado, and Maryland, but ballot items expanding rights in Florida, Nebraska, and South Dakota fell short, The Guardian reports.
 
Related:

Where Trump stands on abortion – PBS  
 
What’s at Stake for Public Health in the 2024 U.S. Election? – The Johns Hopkins Bloomberg School of Public Health GLOBAL HEALTH VOICES The Latest One-Liners
36% of Americans mistrust the science behind COVID vaccines, according to a study in Vaccine: X, which also showed that people who lost a loved one to the disease were nearly 4X more likely to trust vaccine experts. U.S. News & World Report

G20 leaders have launched a global coalition to strengthen countries’ capacity to manufacture medicines, with projects selected based on two criteria: the diseases they target and how they leverage technology to promote equitable access, according to a declaration signed in Rio de Janeiro. Health Policy Watch

Scientists in China, the U.S., and Switzerland have figured out a way to study coronaviruses that are hard to grow in the lab, per a new Nature article; they have added specially designed receptors to human cells that the viruses can bind to and invade the cell. Science

A “substantial” proportion of infants in LMICs were colonized with antimicrobial-resistant bacteria, according to a new JAMA study, suggesting that health care settings and neonatal antibiotic administration may be key factors in the acquisition of these infections. CIDRAP NEGLECTED DISEASES Taming an Isolating Tropical Disease
Today, at least 36 million people live with the effects of lymphatic filariasis (LF), which is transmitted by mosquitoes and manifests later in life in conditions like elephantitis and extreme swelling of tissue (lymphoedema) or the scrotum (hydrocele).

• Efforts to combat LF in at-risk populations through preventive drug administration began in the 1990s; 21 countries have eliminated it so far, with 23 more expected to do so by 2030.

Suffering in the shadows: There is no cure for LF, but self-care and surgery to drain fluid can help. The challenge is finding people already affected, as the swelling—disabling and sometimes seen as a sign of witchcraft—keeps people from leaving home.

The Guardian GLOBAL HEALTH VOICES SEXUAL AND REPRODUCTIVE HEALTH Ditching HIV Meds Due to Stigma
Nearly a million Malawians, ~8% of the East African nation’s population, live with HIV—one of the highest rates globally. 

Despite achieving the UN’s 95-95-95 target (95% aware of their HIV status, 95% receiving treatment, and 95% with suppressed viral loads), Malawi struggles to reach the remaining 5%. 

Stigma remains a major barrier: Myths about HIV persist, particularly in rural areas, leading some patients to discard their medications rather than risk social ostracism.

The financial burden of managing HIV treatment—including transportation costs and the need for family “guardians” to care for patients in under-resourced hospitals—is another barrier. The fear of losing income can also deter people from seeking care.

The Telegraph QUICK HITS Highly potent synthetic opioids are already in Europe’s drug supply chains – Global Initiative Against Transnational Organized Crime

How cigarettes and chocolates helped to tackle a TB epidemic – BBC

FDA requires manufacturers facilitate return of unused opioids – Healio

UK findings suggest RSV vaccination could reduce antibiotic prescribing – CIDRAP

Impossible, you say? Try asking a toddler – NPR Shots Issue No. 2810
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: Fading Fear of HIV Tied to Rising STIs; Rwanda’s Robust Outbreak Response; and The ‘Low-Tech’ Therapy That Saved Millions of Lives View this email in your browser November 5, 2024 Forward Share Post Peer educators of the Wits Reproductive Health Institute Sex Worker Programme sit in the waiting area of the clinic in Hilbrow, Johannesburg on July 20, 2017. Gulshan Khan/AFP via Getty Fading Fear of HIV Tied to Rise in STIs  
In South Africa’s wealthy Gauteng province, HIV infections are falling—with condoms, PrEP, PEP, and antiretroviral drugs credited for slashing new infections—but other sexually transmitted infections are on the rise.
 
“The ugly news is clinics are treating so many syphilis and gonorrhea cases,” says sexual health counselor Sithembile Nale.

• ~1,255 of 66,377 pregnant women seeking antenatal care between April and December 2023 tested positive for syphilis.


• Men being treated for urethritis (an inflammation usually caused by gonorrhea or chlamydia) jumped from 12% to 15% in three years.

A false sense of security: Johannesburg sex worker Abi Dlodlo says that before PrEP and PEP were widely available, clients didn’t pressure her to have unprotected sex because they feared HIV—but now, her younger clients in particular resist condoms, arguing they are safe because of anti-HIV treatments.
 
What’s needed: Earlier STI education, testing, and treatment efforts.

The Telegraph GLOBAL HEALTH VOICES The Latest One-Liners   Sudan launched a malaria vaccination campaign yesterday—a first for the country with the WHO Eastern Mediterranean Region’s highest malaria incidence rates; the effort aims to reach ~148,000 children under the age of 12 months. UNICEF (news release)

The CDC has shared details of four U.S. cases of an emerging, sexually transmitted fungal infection caused by Trichophyton mentagrophytes type VII, a fungus that causes genital tinea (ringworm); the patients were diagnosed between April and July of this year. CIDRAP
 
Road deaths in Warsaw—previously one of Europe’s deadliest cities in traffic safety terms—fell 55% in the last ~10 years; safety advocates credit steps like laws prioritizing pedestrians and hefty fines for driver violations. Bloomberg CityLab
   
The WHO named 17 pathogens as top priorities for new vaccine development, in a new study in eBioMedicine—including HIV, malaria, and tuberculosis as well as pathogens like Group A streptococcus and Klebsiella pneumoniae that are increasingly resistant to antimicrobials. WHO (news release) MARBURG Rwanda’s Robust Outbreak Response
A month into Rwanda's first-ever Marburg outbreak, the country’s rapid-fire efforts to contain the deadly virus are being hailed as “unprecedented” and “very, very encouraging.”

Case fatality rates for Marburg virus have been known to reach 90%, but Rwanda’s rate is 22.7%, said Yvan Butera, Rwandan Minister of State for Health. The number of new cases has also dropped dramatically, from several a day to just four reported in the last two weeks. 

Key success factors:

• Extensive testing and contact tracing.


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


• Experimental vaccines and treatments.

“It's not yet time to declare victory, but we think we are headed in a good direction,” said Butera.

NPR Goats and Soda

Related: 

Rwanda marks 3 weeks without Marburg deaths amid containment efforts – Xinhua

Rwanda gets additional 1,000 Marburg vaccine doses – The New Times GLOBAL HEALTH VOICES RIP, RICHARD CASH The ‘Low-Tech’ Therapy That Saved Millions of Lives 
Oral rehydration therapy—a “simple” mixture of clean water, salt, and sugar—is a well known, highly effective remedy used worldwide to treat cholera and other diarrheal diseases. 

ORT has saved ~50 million lives—and was described by The Lancet as “potentially the most significant medical advance of the century,” reports NPR in a remembrance of Richard Cash, the researcher who helped develop ORT in the 1960s and 70s. 

The problem: 50 years ago, diarrheal diseases were responsible for ~5 million child deaths per year, reports The New York Times (gift link).

The solution: Responding to a 1967 cholera outbreak in Bangladesh, Cash and his medical partner, David Nalin, devised the ORT mixture, which made water more absorbable. Dehydration deaths in children began to plummet. 

• “We’re enamored by high technology,” Cash said in 2019. “And we’re not in love with low-tech. …And I would argue [for] just the opposite.”

OPPORTUNITY Coming Up: The Global Health Landscape Symposium 
2024 is a watershed year for elections—in more than 40 nations around the world, including the U.S. presidential election today.
 
How will the changes in governance impact global health investments and policies?
 
The 2024 Global Health Landscape Symposium, November 18–21, will explore the implications for the global health community, with a mix of virtual and in-person discussions on using the power of our collective voice, working across disease areas, and fighting for sustainable funding and equitable policies.

• November 18–21, 2024
• Online or in Washington, D.C.
• Learn more and register

QUICK HITS Negotiators Have A Week To Decide If Pandemic Agreement Possible By December – Health Policy Watch

A Q&A with the FDA's top vaccine regulator amid a fresh wave of disinformation – STAT 

No more fluoride in the water? RFK Jr. wants that and Trump says it 'sounds OK' – NPR Shots

Cost of Mpox Shot Deters Americans at Risk, Critics Say – The New York Times (gift article)

CDC warns of spike in whooping cough cases – Becker's Hospital Review

Screen Time Before 2 Years of Age and Risk of Autism at 12 Years of Age – JAMA Pediatrics

Novel way to beat dengue: Deaf mosquitoes stop having sex – BBC Issue No. 2809
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.

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

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


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In a historic health milestone, Sudan has launched its first malaria vaccination campaign amid 18 months of civil conflict, aiming to protect thousands of children from the deadly disease.

A new study by the World Health Organization (WHO) lists 17 bacteria, viruses and parasites that regularly cause disease as top priorities for new vaccine development.