96 Global Health NOW: How a ‘Safer’ Opioid Caused a New Devastation; How to Keep Doing Global Health; and Rootsy Music German drugmaker Grünenthal promoted tapentadol as “less addictive” than other opioids. View this email in your browser March 20, 2025 Forward Share Post A building on the premises of the pharmaceutical company Grünenthal in Aachen, Germany, on December 10, 2020. Oliver Berg/picture alliance via Getty How a ‘Safer’ Opioid Caused a New Devastation 
Across the globe, prescriptions of the painkiller tapentadol have spiked over the last five years—eclipsing oxycodone in some countries—as the drug’s German maker Grünenthal promotes the drug as a “less addictive” option to other opioids.

But as prescriptions have increased, so have reports of addiction, overdose, and death. And the claims the company has made about the drug’s safety have “no convincing evidence,” finds an investigation by The Examination and journalistic partners in 10+ countries. 

Background: Grünenthal’s efforts to promote tapentadol have involved:

• Funding studies in medical journals to support its claim of relative safety

• Paying millions to doctors, medical organizations, and patient groups across Latin America and Europe

• Educational messaging about the drug’s “minimum potential of abuse” that downplayed respiratory side effects, and marketing the drug as “highly effective” for chronic pain—a tactic that flouts safety guidelines from the WHO, US, and UK

Global impact: 

• In Australia: Coroners have reported dozens of tapentadol-related overdose deaths.

• In India: Psychiatrists are seeing a trend of teenage boys injecting tapentadol.

• In the U.S.: Addiction doctors warn of an uptick in tapentadol dependency.

Blind spot: Many countries are not tracking tapentadol-related dependency, meaning the true scope of the problem remains largely unknown. 

The Examination 

Related: Trump administration extends opioid emergency as fentanyl deaths drop – NPR  GLOBAL HEALTH VOICES The Latest One-Liners
Extreme heat last year has “reshaped the planet,” inflicting permanent damage on glaciers, oceans, and ecosystems, and signaling a near future filled with devastating heat waves, details from the World Meteorological Organization’s State of the Global Climate report show. The Independent

As bird flu spreads on commercial poultry farms, the USDA today announced two new biosecurity assessment programs—one offering onsite surveying of wildlife hazards and the other reviewing farms’ biosecurity plans; meanwhile, the agency provided more details about “highly pathogenic” H7N9 avian flu detected at a Mississippi farm. CIDRAP

Uganda’s Ministry of Health has started a 42-day countdown to declare the country Ebola-free after two more patients recovered from the virus and were discharged from treatment facilities; of 12 patients with confirmed cases, 10 have recovered and two have died. NilePost

The Jynneos mpox vaccine was 58% effective against mpox infection overall after one dose, and 84% effective in people without HIV—but was only 35% effective in those with HIV, per an observational combined study published in The Lancet Infectious Diseases. CIDRAP GHN EXCLUSIVE COMMENTARY Sunitha, an Accredited Social Health Activist (ASHA), checks on a pregnant woman outside her house on May 18, 2021, in Mysuru, India. Abhishek Chinnappa/Getty How to Keep Doing Global Health: Tips from the Global South
In the face of U.S. cuts to global health initiatives, two global health researchers from India share three experience-based strategies in a GHN commentary. 

Change who you work for. 

• At times, global health researchers can forget who they should work for because of a system and a culture that forces researchers to think about “fundable” ideas, write Siddhesh Zadey and Dhananjaya Sharma.

• “If you’re in global health, you work for the underprivileged, underserved people … [not] the funders,” they write.

Change what you work on. 

• When you do not have money, you have to be creative about what you work on. Researchers should ask themselves, do we truly need another randomized controlled trial to answer the question?

Walk the talk. 

• “Perhaps, the crisis is an opportunity for the ‘topmost’ to rekindle their volunteering spirit by lending their expertise and time to those most adversely affected by the defunding initiatives,” write Zadey and Sharma.

Siddhesh Zadey and Dhananjaya Sharma for Global Health NOW GLOBAL HEALTH VOICES NEUROLOGICAL ILLNESSES A Mysterious ALS Cluster 
A decade ago, neurologists were startled when they discovered a cluster of 16 ALS cases around the tiny mountain village of Montchavin in France. 

Elusive origin: ALS is rare, and its underlying causes are still being researched. Hereditary genetic factors figure in 10-15% of cases—but none of the Montchavin patients had a family history of ALS. 

• Researchers have also looked into environmental factors like industrial chemicals and air pollution, but found no links. 

Focus on fungi: One researcher eventually found that all of the patients had eaten false morels, a toxic mushroom sometimes sought and eaten as a delicacy. 

• While some scientists say the theory needs further study, others say it is similar to a cluster in Guam, which was linked to ingestion of a cycad plant. 

El País ALMOST FRIDAY DIVERSION Rootsy Music
We all did some wacky things during pandemic lockdown days. So it’s not exactly surprising to hear that in 2020 biologist-turned-musician Tarun Nayar connected his synthesizer to a salmonberry bush. What is surprising: The plant was alive with the sound of music.

“I could actually ‘listen’ to the salmonberry bush,” says the Montreal-based Nayar—who describes the process of converting natural (and non-audible to human ears) bioelectric signals into hypnotic electronic music as “biodata sonification,” per Atlas Obscura. 

Mic check: In the past five years, Nayar has tuned into the everyday symphonies emitting from plants and fungi—enjoyed by his growing audience across YouTube and TikTok—with mushrooms like chanterelles and amanitas serving as especially compelling muses.

And the fandom goes both ways: Mushrooms, apparently, make for an enthusiastic audience, finds a study published last year in Biology Letters: Researchers found that playing sound to a green microscopic fungus, Trichoderma harzianum, led to growth rates 7X faster than fungus grown in silence, reports The New York Times (gift link).  QUICK HITS Trump administration weighing future of CDC's HIV prevention division – Reuters

US evangelical groups urge Trump to spare HIV/Aids program from aid cuts – The Guardian

Toxic ‘sea foam’ kills animals and leaves surfers with breathing problems and blurred vision – The Telegraph

Popular ADHD TikTok videos often do not accurately reflect symptoms, experts say – Euronews

How will ‘Little Scandinavia’ experiment play out in U.S. prisons? – Science Issue No. 2694
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on 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 2025 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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Three cities that share a healthy vision for their residents won UN World Health Organization awards on Thursday for their smoke-free parks, clean air initiatives and obesity-busting school lunch initiatives.

96 Global Health NOW: Strategies Diverge as Bird Flu Spreads; Interrupted Agent Orange Cleanup; and Factory Farms and the Rise of Superbugs Bird flu is a “transboundary threat,” says UN View this email in your browser March 19, 2025 Forward Share Post Lohmann Brown chickens stand outside a barn at Meadow Haven Farm, in Sheffield, Illinois, on August 4, 2015. Daniel Acker/Bloomberg via Getty Images Strategies Diverge as Bird Flu Spreads 
As bird flu continues to ravage U.S. poultry farms, UN officials warn that the virus has reached “unprecedented” scale and requires a coordinated global response, reports The Hill. 

• In a briefing held yesterday, UN Food and Agriculture Organization leaders outlined H5N1’s mounting toll: hundreds of millions of lost poultry, ~300 newly affected wild bird species in the last four years, increasing spillover into mammals, and food security risk, per UN News.

Call to action: Describing the virus as a “transboundary threat,” the agency called on countries to improve surveillance, expand lab capacity, consider vaccination plans, and promote risk management through biosecurity.

Kennedy’s tack: Meanwhile, health secretary Robert F. Kennedy Jr. has floated a strategy to let H5N1 “run through the flock” to identify immune birds, reports The New York Times (gift link)—which veterinary scientists say would pose a wide range of hazards: 

• Every infection is an opportunity for H5N1 to evolve into a more virulent form dangerous to mammals and humans. 

• Farmed poultry have low genetic diversity and weak immune systems, resulting in painful deaths in ~100% of infected flocks. 

• Such a strategy would also mean longer quarantines and lost revenue.

The Quote: “It’s a recipe for disaster,” said Gail Hansen, a former state veterinarian for Kansas. GLOBAL HEALTH VOICES The Latest One-Liners
The measles outbreak in western Texas has grown to 279 cases—nearly reaching the total number confirmed for all of 2024 (285 cases), according to new state data published yesterday, ABC News reports; Texas public health officials say the outbreak could take a year to contain, according to STAT.

Ongoing dengue transmission in parts of the U.S. led the CDC to issue a Health Alert Network notice yesterday with updated testing guidance; infections have been increasing globally for the past five years, with the Americas region seeing pronounced surges. CIDRAP

Smoking rates have risen in some regions of England for the first time since 2006, finds a new study published in the journal Addiction; researchers found that smoking increased 10% in southern England between 2020 and 2024. The Guardian

Climate change is accelerating, finds the new State of the Global Climate report—with global temperatures, greenhouse gas emissions, and sea levels reaching record highs in 2024, reports CBS News; meanwhile, researchers say heart disease could double or triple in the next 25 years if current heat trends continue, per a study published in the European Heart Journal, reports Al Jazeera. FOREIGN AID CUTS Interrupted Agent Orange Cleanup
Efforts to clean up an enormous chemical spill at an air base in Vietnam have been halted by USAID cuts—putting hundreds of thousands of people at risk of poisoning, U.S. diplomats and human rights groups say. 

Background: Remediation efforts at the Bien Hoa air base were started in 2019, when the U.S. government committed $430 million+ to help clean up widespread dioxin contamination that dates back to the Vietnam War—when the U.S. brought the toxin to the country. 

Halted work: The sudden USAID shutdown meant work immediately stopped, leaving pits with dioxin-contaminated soil exposed at the cusp of the country’s rainy season. 

High risk: With enough rain, dioxin could flood into nearby communities’ food supply and contaminate a major river flowing into Ho Chi Minh City. 

ProPublica GLOBAL HEALTH VOICES ANTIMICROBIAL RESISTANCE Factory Farms and the Rise of Superbugs
Conditions at factory farms across Europe “paint a bleak picture of animal welfare,” with animals living in cramped grassless pens coated with filth.

Such farming practices are also fueling the rise of antibiotic-resistant superbugs on the continent, including MRSA.

How? Animals in poor feedlot conditions are more likely to contract infections, which has led to a decades-long overdependence on antibiotics. Now, once easily treatable illnesses don’t respond to drugs. 

• The meat industry is responsible for 73% of global antibiotic use.

The stakes: ~700,000 people globally die every year from infections caused by resistant bacteria. By 2050, this number could rise to 10 million.

The Bureau of Investigative Journalism

Related: The Many Costs of Cheap Chicken – Hopkins Bloomberg Public Health magazine OPPORTUNITY QUICK HITS What will happen if Trump cuts the US’s Global Fund contributions? We work it out – Bhekisisa

‘It’s back to drug rationing’: the end of HIV was in sight. Then came the cuts – The Guardian

Trump dministration considers plan to eliminate CDC's HIV prevention division – NBC

Private equity ‘gobbling’ up care facilities for people with disabilities – STAT

What’s in store for US science as funding bill averts government shutdown – Nature

Epilepsy Patients in Africa Fight Stigma and Neglect – IPS Issue No. 2693
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on 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 2025 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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Since becoming only the second Alzheimer’s-modifying drug to gain American FDA approval in 2023, sales of lecanemab, known by its brand name Leqembi, have risen steadily, reaching $87-million USD in the last quarter of 2024.

Since becoming only the second Alzheimer’s-modifying drug to gain American FDA approval in 2023, sales of lecanemab, known by its brand name Leqembi, have risen steadily, reaching $87-million USD in the last quarter of 2024.

Since becoming only the second Alzheimer’s-modifying drug to gain American FDA approval in 2023, sales of lecanemab, known by its brand name Leqembi, have risen steadily, reaching $87-million USD in the last quarter of 2024.

Since becoming only the second Alzheimer’s-modifying drug to gain American FDA approval in 2023, sales of lecanemab, known by its brand name Leqembi, have risen steadily, reaching $87-million USD in the last quarter of 2024.

Since becoming only the second Alzheimer’s-modifying drug to gain American FDA approval in 2023, sales of lecanemab, known by its brand name Leqembi, have risen steadily, reaching $87-million USD in the last quarter of 2024.

Since becoming only the second Alzheimer’s-modifying drug to gain American FDA approval in 2023, sales of lecanemab, known by its brand name Leqembi, have risen steadily, reaching $87-million USD in the last quarter of 2024.

Since becoming only the second Alzheimer’s-modifying drug to gain American FDA approval in 2023, sales of lecanemab, known by its brand name Leqembi, have risen steadily, reaching $87-million USD in the last quarter of 2024.

Since becoming only the second Alzheimer’s-modifying drug to gain American FDA approval in 2023, sales of lecanemab, known by its brand name Leqembi, have risen steadily, reaching $87-million USD in the last quarter of 2024.

Since becoming only the second Alzheimer’s-modifying drug to gain American FDA approval in 2023, sales of lecanemab, known by its brand name Leqembi, have risen steadily, reaching $87-million USD in the last quarter of 2024.

Since becoming only the second Alzheimer’s-modifying drug to gain American FDA approval in 2023, sales of lecanemab, known by its brand name Leqembi, have risen steadily, reaching $87-million USD in the last quarter of 2024.

Since becoming only the second Alzheimer’s-modifying drug to gain American FDA approval in 2023, sales of lecanemab, known by its brand name Leqembi, have risen steadily, reaching $87-million USD in the last quarter of 2024.

NeuRo Genomics Initiative will help better understand rare and aging-related neurological disorders affecting Canadians

 

A project led by Ziv Gan-Or, MD, PhD, at The Neuro (Montreal Neurological Institute-Hospital) of McGill University and Martine Tétreault, PhD, at Université de Montréal has received more than $8 million to sequence the genomes of 8,700 people, to map the role of genetics in neurological disorders.

NeuRo Genomics Initiative will help better understand rare and aging-related neurological disorders affecting Canadians

 

A project led by Ziv Gan-Or, MD, PhD, at The Neuro (Montreal Neurological Institute-Hospital) of McGill University and Martine Tétreault, PhD, at Université de Montréal has received more than $8 million to sequence the genomes of 8,700 people, to map the role of genetics in neurological disorders.

NeuRo Genomics Initiative will help better understand rare and aging-related neurological disorders affecting Canadians

 

A project led by Ziv Gan-Or, MD, PhD, at The Neuro (Montreal Neurological Institute-Hospital) of McGill University and Martine Tétreault, PhD, at Université de Montréal has received more than $8 million to sequence the genomes of 8,700 people, to map the role of genetics in neurological disorders.

NeuRo Genomics Initiative will help better understand rare and aging-related neurological disorders affecting Canadians

 

A project led by Ziv Gan-Or, MD, PhD, at The Neuro (Montreal Neurological Institute-Hospital) of McGill University and Martine Tétreault, PhD, at Université de Montréal has received more than $8 million to sequence the genomes of 8,700 people, to map the role of genetics in neurological disorders.

NeuRo Genomics Initiative will help better understand rare and aging-related neurological disorders affecting Canadians

 

A project led by Ziv Gan-Or, MD, PhD, at The Neuro (Montreal Neurological Institute-Hospital) of McGill University and Martine Tétreault, PhD, at Université de Montréal has received more than $8 million to sequence the genomes of 8,700 people, to map the role of genetics in neurological disorders.

NeuRo Genomics Initiative will help better understand rare and aging-related neurological disorders affecting Canadians

 

A project led by Ziv Gan-Or, MD, PhD, at The Neuro (Montreal Neurological Institute-Hospital) of McGill University and Martine Tétreault, PhD, at Université de Montréal has received more than $8 million to sequence the genomes of 8,700 people, to map the role of genetics in neurological disorders.