96 Global Health NOW: Health Workers Killed as Sudan Marks 2 Years of Civil War; Ghana Grapples With a Deadly Outbreak; and India’s Global Warming Enigma View this email in your browser April 14, 2025 Forward Share Post People who fled the Zamzam for the internally displaced camp after it fell under RSF control commiserate in a makeshift encampment near the town of Tawila, Sudan. April 13. AFP via Getty Health Workers Killed as Sudan Marks 2 Years of Civil War
The last medical clinic in Sudan’s famine-gripped Zamzam camp in Darfur came under fire this weekend, with Rapid Support Forces paramilitaries killing the entire clinical staff, reports The New York Times (gift link). 

• Nine clinic employees were killed in the attacks, per Relief International, which runs the facility. 


• The broader assault has killed 100+ people, including ~20 children at the camp, home to ~500,000. 

“Death is everywhere,” a camp resident told the BBC. “People are wounded, and there is no medicine or hospital to save them.”

Even before the attacks, conditions at Zamzam camp were “catastrophic,” the UN’s Sudan humanitarian coordinator told UN News. 

The attacks come at the two-year mark of Sudan’s conflict, which has led to the world’s largest humanitarian crisis and “suffering of industrial proportions,” per UN officials.

• ~150,000 Sudanese have been killed, and ~13 million have been displaced. There have been 156 confirmed attacks on health, per the WHO.


• ~25 million people now face extreme hunger. And sexual violence is pervasive, reports the AP.

And aid efforts continue to be stymied by both “systematic obstruction” by the warring armies and deep funding cuts, per The New Humanitarian. 

Related: 

Children of war: six orphans’ 1,000-mile journey across Sudan in search of safety – The Guardian

Sudanese Refugees’ Lives at Risk as UNHCR Suspends Medical Help – Egyptian Streets

Sudan needs $2.2 bln for first year of health sector rehab, minister says – Sudan Tribune GLOBAL HEALTH VOICES The Latest One-Liners   3 million+ children worldwide died from antimicrobial resistance-related infections in 2022, per new research presented at ESCMID Global 2025 in Vienna; deaths were highest in Southeast Asia and Africa. Clinton Health Access Initiative

New mpox cases are averaging ~3,000 per week in African countries, with Uganda accounting for 50% of those in the past week; the region has received 1 million+ vaccine doses but needs 6.4 million doses over the next six months to slow the virus’s spread. CIDRAP

More than a dozen cases of invasive meningococcal disease, a life-threatening bacterial infection caused by Neisseria meningitidis, have been linked to religious pilgrimages to Mecca in Saudi Arabia amid declining compliance with vaccination requirements over the past two years. WHO

Whooping cough cases have surged 1,500%+ in the U.S. since hitting a low in 2021; there were 10 pertussis-related deaths last year, compared with two to four in previous years. ProPublica Health, Foreign Aid, and Science Cuts USDA’s $1B bird flu plan uses money intended for schools, food banks – Politico

NOAA Scientists Are Cleaning Bathrooms and Reconsidering Lab Experiments After Contracts for Basic Services Expire – ProPublica

Dozens of USAID contracts were canceled last weekend. Here's what happened – NPR Goats and Soda

Why CDC cuts are being called ‘the greatest gift to tobacco industry in the last half-century’ – STAT

After Trump grant cuts, some universities give researchers a lifeline – Science

OCHA, the UN’s emergency aid coordination arm, to cut staff by a fifth – The New Humanitarian

Fearing paper on evolution might get them deported, scientists withdrew it – The Washington Post (gift link)

Hopkins trailblazer scrambles to protect cancer research as Trump cuts hit home – The Baltimore Banner MENINGITIS Ghana Grapples With a Deadly Outbreak
A lethal meningitis outbreak is escalating in Ghana’s Upper West region, upending an already strained health system.

A closer look: 

• The region has reported 200+ cases and ~17 deaths. 


• Ghana is in Africa’s “meningitis belt”—a stretch of 26 countries where dry seasonal winds allow further bacterial spread.

Already overwhelmed: The outbreak comes as Ghana’s health system struggles with understaffed hospitals, supply shortages, and slashed USAID funding.

• Ghana faces a $156 million funding shortfall due to the aid freeze—a major setback to the country’s health programs.


• There is no vaccine for the rare Streptococcus strain causing the outbreak, and officials say economic turmoil means that hopes for developing one have dimmed. 

Pulitzer Center / The World  GLOBAL HEALTH VOICES CLIMATE India’s Global Warming Enigma
As India increasingly grapples with punishing heat waves, scientists are puzzling over a strange phenomenon: The country is warming more slowly than many others—amounting to half the global average over the last decade. 

Why? Scientists aren’t sure. But theories include: 

• The shroud of air pollution: India’s air pollution may be reflecting solar radiation, which could help with cooling. 


• Shifting winds: Warming over the Middle East has pulled monsoon winds northward, leading to an increase in extreme rains—and, potentially, cooling. 


• Impact of irrigation: The expansion of irrigation in northern India could also be a factor; as water evaporates, it absorbs heat from the air, reducing warming. 

Scientists say understanding the trend will allow more accurate forecasts and help the country better prepare for future warming.

Science

Related: India races to beat the smog with an electric mobility revolution in Kashmir – The Telegraph OPPORTUNITY QUICK HITS Somalia: Frontline hospitals under pressure as fighting escalates – ICRC (news release)

Measles outbreaks spark concern over rare 'horrific' neurological disorder – CBC

Africa's Plan to Fill Health Funding Gaps Amidst Declining Coffers – Africa CDC

Tuberculosis could end if there’s more US public health funding, experts say – The Guardian

Educate to Empower: Protecting Reproductive Rights in Texas – O’Neill Institute / Georgetown Law (commentary)

CDC denies Milwaukee's request for help with unsafe lead levels in public schools – CNN

Recent hospital violence fuels effort to create workplace protections – Axios

Dogs could help predict valley fever spread in humans – University of California, Davis via ScienceDaily Issue No. 2707
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.

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More than 12.4 million people have been forced from their homes across Sudan – including over 3.3 million refugees who have fled to neighbouring countries – as two years of civil war fuel famine, disease outbreaks and the collapse of the health system.

The Israeli bombardment of Al-Ahli, a Gaza City hospital, has put even more pressure on the remaining health facilities in the occupied Palestinian territory, where the delivery of aid and movement of humanitarian workers is highly restricted by the Israeli authorities.

96 Global Health NOW: RFK’s Muddled Messaging; Burmese Doctors Face Relentless Devastation; and Upper-Class Clown RFK encourages MMR vaccination, but continues to qualify the endorsement. View this email in your browser April 10, 2025 Forward Share Post One year-old River Jacobs is held by his mother while he receives an MMR vaccine at a vaccine clinic in Lubbock, Texas, on March 1. Jan Sonnenmair/Getty Images RFK’s Muddled Messaging
As the U.S. measles outbreak continues to widen, Health Secretary Robert F. Kennedy Jr.’s messaging on the crisis has been unpredictable, reports The Guardian. 

Vacillating on vaccination: One one hand, Kennedy has encouraged MMR vaccination during his most recent tour through the Southwest, which included attending the funeral of an 8-year-old girl who died of measles. 

• But he continues to qualify the endorsement, questioning safety studies and government mandates in his first sit-down TV interview, and continuing to promote unproven alternative therapies, reports The New York Times (gift link). 

Equivocating on severity: While Kennedy is promising to deploy more CDC staff to the outbreak, which has sickened 600+ people in the U.S. and killed three, he continues to downplay its threat—calling the U.S. response a global “model,” reports ABC News.

• Misleading comparison: Kennedy contrasted U.S. numbers to those in the WHO’s European region, which has reported 127,000 cases and 37 deaths. But those numbers are not comparable, global health experts say, because of the large number of countries included in the European region and the wide disparities among them. 

• And health officials continue to caution that the U.S. numbers of actual cases are likely to be greatly undercounted.

Toll of confusion: Doctors and disease experts say Kennedy’s mixed messaging is undermining a cohesive response, reports Reuters. 

• “Our work is becoming harder by the minute,” said Rana Alissa, president of the American Academy of Pediatrics’ Florida chapter.

Related:

National public health group calls for RFK Jr. to resign, citing ‘complete disregard for science’ – STAT

New measles dashboard allows public to track vaccination rates in Illinois schools – ABC 7 Chicago GLOBAL HEALTH VOICES The Latest One-Liners
In a genetics milestone, scientists have sequenced the complete genomes of six ape species, with the research, published in Nature, providing key new insights into human evolution, health, and genetic disease. Penn State (news release)

Long COVID affected ~1 in 7 working-age adults in the U.S. by late 2023, with socioeconomically disadvantaged adults 150%+ more likely to have ongoing symptoms, finds two new studies—one study published in Communications Medicine, and another published in BMC Medicine. CIDRAP

An at-home spit test for prostate cancer could outperform current testing methods for assessing prostate cancer risk—a breakthrough that could improve early detection, a new study published in the New England Journal of Medicine suggests. The Independent

Additional NIH funding for Columbia University has been frozen by the Trump administration, which cut off $250 million for research grants in addition to $400 million frozen last month. Inside Higher Ed CONFLICT Burmese Doctors Face Relentless Devastation 
Amid Burma’s ongoing civil war, health care providers have become increasingly vilified as enemies of the state, as they defy junta orders to treat people wounded in the resistance.

• The junta has closed ~7 private hospitals in Mandalay, the country’s second-largest city. 

Now, as Mandalay reels from the March 28 earthquake that killed ~3,500 people, health workers describe harrowing conditions and scant resources.

Ongoing health threats: Doctors say survivors now face threats of disease and a lack of food, water, and shelter. They also blame the junta for delays and restrictions of aid distribution. 

• “The junta cares more about shutting down hospitals and blocking doctors than saving lives after the earthquake,” said one physician, Dr. Min—who lost four colleagues in the earthquake. 

The New York Times (gift link) 

Related: Earthquake Pushes Myanmar's Health System to Verge of Collapse – Think Global Health GLOBAL HEALTH VOICES NEGLECTED TROPICAL DISEASES A Gutting End to ‘The Greatest Thing You’ve Never Heard Of’
USAID’s program to combat neglected tropical diseases through drug distribution has always been a relatively small effort—requiring a fraction of the agency’s budget.

But the effort had a massive impact: Treatments for diseases like trachoma and intestinal worms have been delivered to 1.7 billion people across 31 countries, and at least one NTD has been eliminated in almost half of those countries.

• “For such a little amount, we’ve been able to reach so many people,” said Angela Weaver, at Helen Keller Intl—who called the USAID drug distribution program “the greatest thing you’ve never heard of.”

Now, USAID cuts mean programs are ending, and their future progress is imperiled. 

• Across Africa, tens of thousands of NTD-related community health worker positions have been cut, and pharmaceutical companies that previously donated drugs are hesitating to ship them.

The Guardian

Related: Silent Killers: Neglected Tropical Diseases in South Sudan – The Borgen Project (commentary) ALMOST FRIDAY DIVERSION Upper-Class Clown  
He may be divisive as a political figure, but Boris Johnson will forever be our Prime Minister of Comedy.
 
Most recently, while on vacation in Texas, BoJo was nipped in the face by a feisty ostrich while his toddler giggled hysterically, the Independent reports.
 
Far from his best bungled photo op, this was merely a helpful reminder of all his other gaffes. Some of our faves:

• The time he struggled to glove up at a Welsh vaccination center. “Like OJ Simpson!” he exclaimed. “Absolutely,” his minder agreed, seeming to have no other choice.  

• When he not only rode a zip line holding two Union Jacks, but got stuck mid-zip. 

• Or when he wrestled with an umbrella at a drizzly memorial service. Even King Charles (then merely a Prince) had a chuckle.

• When he ducked an interview by hiding inside an industrial fridge at a dairy farm. “Right heʼs been taken inside … into the freezer,” a reporter explained. Chilly reception indeed!

QUICK HITS Heavy drinking linked with lasting impact on the brain, study finds – CNN 

USAID enabled 208 Afghan women to defy the Taliban ban on college — until now – NPR Goats and Soda

Preventable ‘meningitis belt’ deaths targeted in health agency action plan – UN News

New reports suggest diabetes weight loss drugs could reduce Alzheimer's risk – Medical Xpress

Ukraine: Stark increase in civilian casualties in March, UN Human Rights Monitors say – OHCHR

Road deaths fell below 40,000 in 2024, the lowest since 2019 – Ars Technica

A biotech company says it has bred three pups with traits of the extinct dire wolf – NPR Issue No. 2706
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.

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Recent funding cuts have caused “severe disruptions” to health services in almost three-quarters of all countries, according to the head of the UN World Health Organization (WHO), Tedros Adhanom Ghebreyesus.

Millions of deaths could be avoided from meningitis if countries are able to adopt new guidelines designed to diagnose and treat the disease more effectively, the UN World Health Organization (WHO) said on Thursday. 

96 Global Health NOW: Breakthrough Clues in an Mpox Mystery; Afghanistan’s Escort Rules Fuel Maternal Deaths; and San Francisco Rethinks Harm Reduction View this email in your browser April 9, 2025 Forward Share Post A fire-footed rope squirrel (Funisciurus pyrropus) in southern Mali, in 2010. Laurent Granjon/Jean-Marc Duplantier via iNaturalist Breakthrough Clues in an Mpox Mystery 
Researchers have been trying to unravel one of the “great mysteries” of mpox: What are its animal reservoir hosts?

Now, a team of scientists say they have landed on a key culprit: a squirrel. And their preprint research could have significant implications for tracking and preventing future spillovers, reports Nature. 

Background: The name “monkeypox” comes from the 1958 discovery of the virus in lab monkeys. But researchers have long suspected small mammals of being sources for cross-species spillover.

Surveillance sleuthing: The latest discovery started with an mpox outbreak in sooty mangabey monkeys in Taï National Park in Côte d’Ivoire, reports Science.

• Scientists then located the identical virus in a sample from a fire-footed rope squirrel found dead three months before the outbreak started. 


• Researchers pinpointed the squirrel DNA in fecal samples from the mangabeys, suggesting the monkeys became infected after eating the squirrels. 

Implications: “This study is a landmark contribution to understanding mpox dynamics and guiding proactive prevention efforts across Africa and beyond,” said Yap Boum, a biologist at the Africa CDC.

More work needed: More evidence is needed to determine whether the squirrels can carry and shed the virus long-term without getting sick—a key feature of a reservoir host, scientists say. 

Related: 

Fears new mpox strain spreading in UK after case with no travel history – The Telegraph 

China’s first monkeypox vaccine enters phase I clinical trials, planning to recruit volunteers – Global Times GLOBAL HEALTH VOICES The Latest One-Liners   Cholera cases in Kenya have risen to nearly 100, with six reported fatalities, per the nation’s health ministry, which is redoubling its surveillance efforts. The Nation

Teen gun license applicants in Canada spiked 11% between 2023 and 2024—raising concerns that as teens reach voting age, there will be greater calls for loosening gun restrictions. CBC

Floods in Queensland have led to 10 new infections of melioidosis, a soil-borne bacterial disease that has killed 26 people in the Australian state this year; more infections are expected, health experts say. ABC Australia

Invasive Streptococcus A infections more than doubled in the U.S. between 2013 and 2022, per a surveillance study of 10 states published in JAMA that linked the rise to “increasing prevalence of underlying health conditions,” and found growing levels of antibiotic resistance. CIDRAP U.S. Policy News NSF slashes prestigious PhD fellowship awards by half – Nature

Trump has blown a massive hole in global health funding—and no one can fill it – Science

Dr. Oz Pushed for AI Health Care in First Medicare Agency Town Hall – Wired

What do Americans think of Trump's foreign policies? – BBC

It's sexual assault awareness month and HHS just gutted its rape prevention unit – NPR

Trump administration says it cut funding to some life-saving UN food programs by mistake – AP

A closer look at the nationwide impact of NIH cuts – Axios MATERNAL MORTALITY Escort Rules Lead to Maternal Deaths 
Under the Taliban in Afghanistan, women and girls are prevented from accessing medical care without a male escort, leading to rising mortality rates for women and infants.

• Before the Taliban took power, maternal mortality was already 3X higher than the world average.


• By 2026, a woman’s estimated risk of death during childbirth will rise by 50%.


• Every day, 24 mothers and 167 infants die in Afghanistan. 

Barriers: In December 2024, the Taliban also stopped medical training for women. Poor access to health care, a shortage of doctors and midwives, and rising rates of early marriage also contribute to increased risks.

The Guardian 

Related: USAID enabled 208 Afghan women to defy the Taliban ban on college — until now – NPR Goats and Soda GLOBAL HEALTH VOICES HARM REDUCTION A Policy Shift in San Francisco
San Francisco has long prioritized harm reduction in its drug policies, such as with programs to distribute on the streets free, clean paraphernalia for fentanyl smoking, no questions asked.

But the city’s new mayor, Daniel Lurie, says the city’s policies have become too permissive and will scale them back in an effort to steer more people into treatment.

• “We are no longer going to sit by and allow people to kill themselves on the streets,” said Lurie. 

New rules starting April 30:

• Paraphernalia can be distributed only to people who undergo lengthy counseling sessions.


• Nonprofits will be able to distribute smoking supplies only in city-sanctioned buildings. 

Clean needles can still be provided on the street, and naloxone distribution will not be affected. 

The New York Times (gift link) QUICK HITS Ontario's measles outbreak is so big, even New York health officials are taking notice – CBC

Man whose blood helped develop measles vaccine weighs in on recent outbreak – PBS NewsHour (video)

State lawmakers are weighing bills that would treat abortion as homicide ​​– The 19th

Achieving gender justice for global health equity: the Lancet Commission on gender and global health – The Lancet

Menopause makes it on the policy map – Axios

Improving the Global Health Workforce Is a Bipartisan Imperative – Newsweek (commentary)

How the Alcohol Industry Steers Governments Away From Effective Strategies to Curb Drink Driving – Vital Strategies 

A new BEACON for global health set to launch in Boston – The Daily Free Press

Meet Siku, the itchy polar bear: How allergies are affecting animals – BBC Thanks for the tip, Xiaodong Cai! Issue No. 2705
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.

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96 Global Health NOW: High Costs for Kids of PEPFAR’s Demise; China’s Older HIV Population; and South Africa’s Struggle to Protect Women View this email in your browser April 8, 2025 Forward Share Post Sister Sally Naidoo administers an HIV test on a young boy at the Right To Care AIDS clinic in Johannesburg, South Africa, on January 27, 2012. Foto24/Gallo Images/Getty High Costs for Kids of PEPFAR’s Demise  
If PEPFAR programs do not continue, an additional 1 million children will become infected with HIV, 500,000 additional children will die of AIDS, and another 2.8 million children will become orphans because of AIDS by 2030, according to models in a Lancet study published today.
 
The authors, from African countries and elsewhere, argue for a five-year transition to country-led sustainability, noting that PEPFAR-supported countries had already increased their share of support from $13.7 billion per year in 2004 to $42.6 billion in 2021.
 
Benefits of the successful transition of PEPFAR programs include better health security for both African countries and the U.S. by:

• Cutting forced migration.


• Boosting control of emerging infectious disease threats.

Currently: AIDS is estimated to kill one child under 15 every 7 minutes.

Bleak future: As part of the reorganization of HHS in the U.S., CDC officials responsible for the care of 500,000+ children and 600,000+ pregnant women with HIV in low-income countries have been fired or reassigned, The New York Times reports (gift link).

• Their programs sought to prevent mother-to-child transmission of HIV and to deliver treatment for children living with HIV.


• The officials had been helping direct medications to areas where stocks were running low.

Related: 
 
UCLA professor loses millions in funding for HIV research project – ABC7 / Los Angeles
 
Is This the End of Progress on H.I.V.? – The New York Times (commentary)
 
The global fight against HIV/AIDS, in chaos – The Washington Post (podcast) GLOBAL HEALTH VOICES The Latest One-Liners   U.S. health secretary RFK Jr. called for an end to adding fluoride to public drinking water supplies, saying "It makes no sense to have it in our water supply,” and praising Utah’s plans for a ban; the EPA has now launched a new review of fluoride's health effects. CBS 
 
Health systems implementing the “Zero Suicide Model” saw a fall in suicides and attempts, per a study published in JAMA Network Open; the model, developed by Detroit-based Henry Ford Health, emphasizes patient screening, safety planning, and mental health counseling. AP
 
Children born to mothers with diabetes in pregnancy showed a 28% higher risk of having any neurodevelopmental disorder compared to children born to mothers without the condition, according to a large meta-analysis in The Lancet led by Chinese researchers who cautioned that while more research is needed, diligent monitoring of blood sugar levels in pregnancy is merited. The Independent
 
A newly developed blood test for Alzheimer’s disease can help diagnose the condition with up to 83% accuracy—and indicate how far it has progressed—years before symptoms begin, according to a study in Nature Medicine led by Swedish researchers. Medical Xpress U.S. Policy News How will the deep cuts at the Centers for Disease Control affect global programs? – NPR Goats and Soda

Long COVID activists fought Trump team’s research cuts and won ― for now – Nature

Trump Said Cuts Wouldn’t Affect Public Safety. Then He Fired Hundreds of Workers Who Help Fight Wildfires. – ProPublica

Transfer to Alaska? Offer to health leaders called 'insult' to Indian Health Service – NPR Shots EDUCATION Johns Hopkins Tops Rankings of U.S. Public Health Schools 

The Johns Hopkins Bloomberg School of Public Health again ranks #1 among public health schools and programs in the U.S., based on peer-assessment ratings released this morning by U.S. News & World Report.  
 
This year’s top 10 schools: 
 
1. Johns Hopkins University 
2. Emory University 
2. Harvard University  
2. University of Michigan - Ann Arbor 
2. University of North Carolina - Chapel Hill 
6. Columbia University 
7. Boston University 
8. University of California - Berkeley 
8. University of California - Los Angeles 
10. Tulane University 
 
This year’s rankings include 219 schools and programs of public health accredited by the Council on Education for Public Health. 
  
U.S. News & World Report 

VIOLENCE South Africa’s Struggle to Protect Women
Over three decades, South Africa has seen significant progress in curbing femicide and violence against women.

• Between 1999 and 2017, the intimate partner femicide rate fell from 9.5 per 100,000 women in 1999 to 4.9, with researchers pointing to women’s economic empowerment and a groundswell of vocal anti-violence advocacy contributing to the shift. 

But rates remain the highest reported in the world, and a recent uptick of violence has been described as a “national crisis” by President Cyril Ramaphosa.

• Femicide has increased 30%+ since 2021. 


• Last year, 36% of South African women reported experiencing physical or sexual violence at some time.

Reasons include pervasive misogynist beliefs among men, a failure to enforce gun policy, and a lack of judicial accountability, advocates say. 

The Telegraph RESOURCES How to Introduce Kids to Health Policy
Policy Wisdom’s collection of Athena’s Adventures in Health Policy—all 15 books—is now available online for free.
 
The series aims to inspire the next generation of public health professionals and show them the importance and impact of health policies. These engaging books bring health policy to life, making complex topics accessible and thought-provoking for young readers.
 
Download the complete collection now—for free! 
 
Prefer a printed copy? The books are also available to purchase on Amazon. $1 from the sale of each book is donated to Global Health NOW. HIV/AIDS China’s Older HIV Population
In China, a growing number of studies are signaling an impending health crisis: Older people are quickly becoming a high-risk group for HIV infection.

• Some studies have predicted that by 2035, nearly 33% of HIV-positive people in China will be aged 60+. 

Risk factors: 

• Because HIV prevention and testing campaigns are focused on young people, older patients usually don’t find out they’re HIV positive until the disease is “very advanced,” said Chinese AIDS expert Wan Yanhai. 


• A growing number of older men across China are engaging in commercial sex, research shows. 


• Little is being done to address seniors’ sexual health, with surveys revealing a pervasive cultural assumption that seniors have little if any sex—a belief that does not bear out in research. 

Radio Free Asia OPPORTUNITY QUICK HITS Ukraine: Mine contamination is lethal legacy of Russia’s invasion – UN News

Scientists identify Nigeria hotspots where malaria, STH overlap, indicating high co-morbidity – DownToEarth

Court tosses Biden nursing home staffing standard – Axios

In Final Days of Pandemic Talks, Countries Urged to Budget for ‘Both Bombs and Bugs’ – Health Policy Watch

From the hospital to the lab: How we reported the snakebite scandal – The Bureau of Investigative Journalism

Transparency in government is good for global health – The Current /UC Santa Barbara 

Public Health in the Age of AI and Climate Change – Department of Medicine News / Stanford University

AI for research: the ultimate guide to choosing the right tool – Nature Issue No. 2704
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.

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96 Global Health NOW: A Crossroads for Maternal Mortality; March Recap; and Insurance Executives Pull Back the Curtain View this email in your browser April 7, 2025 Forward Share Post A health worker performs an ultrasound on a pregnant woman at a health center in the Ramechhap district, east of Kathmandu, Nepal, on June 8, 2018. Bikram Rai/AFP via Getty A Crossroads for Maternal Mortality
More women face risk of death in pregnancy and childbirth, as drastic U.S. aid cuts threaten hard-won gains in maternal survival, and could have “pandemic-like effects” on maternal services worldwide, the WHO is warning, per The Guardian.

“Fragile” progress: Deaths due to complications in pregnancy and childbirth declined 40% globally between 2000 and 2023, but gains have slowed since 2016, per the WHO. And rates are off track to meet 2030 maternal survival targets. 

• ~260,000 women died in 2023 from pregnancy-related causes, a new UN report has found—a reality that one WHO official described as a “real travesty of justice.” 


• Most vulnerable: Pregnant women in conflict zones, who already face a 5X greater risk of death than elsewhere. 


• Poor countries reported a maternal mortality rate nearly 35X the rate in rich countries.

“Increasing headwinds”: U.S. funding cuts have quickly led to shuttered clinics, reductions in health workers, and disrupted supplies of critical medications for conditions like preeclampsia and hemorrhage.

Pandemic preview: Maternal deaths rose by 40,000 in 2021 due to pandemic-related disruptions, new data in the report show. 

• This year’s funding cuts could cause a similar “acute shock to the system”—especially as countries didn’t have time to prepare for the cuts. 

Related: 

World Health Day: Focusing on women’s physical and mental health around the world – UN News

Trump administration eviscerates maternal and child health programs – The Guardian GLOBAL HEALTH VOICES More Measles News RFK: MMR vaccine is the "most effective way" to prevent measles spread – Axios

RFK Jr. visits epicenter of Texas measles outbreak after death of second child who was infected – AP

U.S. may be reverting to a time when measles deaths were not very rare, experts warn – STAT

As measles spreads, some doctors are seeing the virus for the first time – The New York Times The Latest One-Liners   The NIH may not cap funding for indirect costs associated with its grants at 15%, a U.S. federal judge ruled Friday, making permanent a temporary order issued in February; the Trump administration had asked for this verdict so it could move forward with an appeal. The New York Times (gift link)

350,000+ U.S. health workers face a risk of deportation in the country’s immigration crackdown, per new research published in JAMA, which found that ensuing worker shortages could affect hospitals and other clinical settings. MedPage Today

Mobile health care units providing ART and PrEP medications reduced the risk for death by ~70% among people who inject drugs, per a study presented at the Conference on Retroviruses and Opportunistic Infections. Healio

Unsanitary practices continue at Abbott Laboratories, one of the largest baby formula factories in the U.S., workers report; the factory’s 2022 shutdown led to severe formula shortages, and now oversight is in question due to mass FDA layoffs. ProPublica MARCH MUST-READS Moving Beyond Stigma in Mexico
For years, Mexico has taken a “prohibitionist, hardline approach” to drug use, reinforcing a stigma that ties drug use to other criminal activities. But recently, health advocates have been taking a different tack—toward harm reduction. 

• One example: Checa tu Sustanciae (Check Your Substance) provides a way for people at events like music festivals to test drugs for fentanyl and other adulterants, and also equips those people with naloxone and practical information. 

AP
Interrupted Agent Orange Cleanup
USAID cuts abruptly halted efforts to clean up an enormous chemical spill at Vietnam’s Bien Hoa air base—leaving pits with dioxin-contaminated soil exposed at the cusp of the country’s rainy season and putting hundreds of thousands of people at risk of poisoning. 

• A $430 million+ U.S. government remediation effort had begun in 2019 to clean up widespread dioxin contamination that dates back to the Vietnam War—when the U.S. brought the toxin to the country.

 ProPublica  
The Bureaucrat Bridging Gaps
Consider this maddening prospect: A 5-year-old girl in Texas is diagnosed with a rare, brain-eating amoeba, but her doctors haven’t heard about an effective antibiotic remedy discovered by California researchers—a tragic disconnect that all too frequently leads to preventable suffering and death. 

• Michael Lewis examines the mission of an FDA worker “buried under six layers on an agency organizational chart” who is seeking to solve the problem by creating a database for rare diseases and treatments, called CURE ID. A big question: Will anyone use it? 

The Washington Post (gift link)  MARCH EXCLUSIVES Adolescents in a classroom raising their hands, photographed from behind. Klaus Vedfelt/Getty Creative What Do American Kids Learn About Sex? It Depends Who You Ask.  
Over 90% of U.S. parents and guardians support their children receiving comprehensive sexuality education (CSE) in school—but there is no national requirement, and only 38% of all high schools and 14% of middle schools in the U.S. cover all of the CDCʼs priority sexual health topics, including condom use and STD prevention.
 
Compare that to the Netherlands, where sex ed is mandated in primary through lower secondary schools. And, at 2.1 births per 1,000 women ages 15–19, the Netherlandsʼ teen birth rate is the lowest in the EU—and far lower than the U.S. teen birth rate of 13.2 births per 1,000.
 
“Chilling effect”: While there haven't been direct attacks on U.S. sex education, policy recommendations targeting DEI, gender identity, and restroom access for trans people raise concerns about the funding future for CSE providers—but advocates remain determined to broaden access to CSE.
 
Annalies Winny, Global Health NOW
March Commentaries:

• It’s Time for PEPFAR to Embrace Reform – Jirair Ratevosian


• How to Keep Doing Global Health: Tips From the Global South – Siddhesh Zadey and Dhananjaya Sharma

Revisiting Extraordinary Journeys
If you werenʼt able to join GHN in March for Extraordinary Journeys: Stories of Refugees Fleeing Conflict and Shaping Global Health, you can now view recordings of each story from this special event, co-hosted by GHN and the Johns Hopkins Center for Humanitarian Health, spotlighting the remarkable experiences of public health practitioners from Afghanistan, Burma (Myanmar), South Sudan, Sudan, and Syria with lived experience as refugees. WATCH HERE MARCH'S BEST NEWS Lifesaving Ultrasounds 
New ultrasound technology is reshaping prenatal care in sub-Saharan Africa, allowing improved access to the critical scan at hundreds of health facilities.

• Portable point-of-care ultrasound devices are designed specifically for providers in low-resource areas who may not have access to radiology equipment.

Instant impact: In 2022, 500 such devices were deployed to providers across Kenya—and a Kenyatta University follow-up study found that within one month of training, 90% of health care workers used the machines to identify high-risk conditions such as placenta previa or multiple gestations. 

MedCity News  GLOBAL HEALTH VOICES HEALTH POLICY Insurance Executives Pull Back the Curtain  
Amid sharper public criticism of the U.S. health insurance system, former industry executives turned whistleblowers are speaking out about unethical practices they say are baked into the for-profit system. 

Some of the industry tenets they described: 

Patients are the lowest priority, as their needs are “fundamentally at odds” with Wall Street demands and financial incentives. 

“Execute a few hostages” mentality: One executive described decisions to arbitrarily terminate doctors out of network without cause “to show them who’s boss.” 

Champagne during COVID-19: Another executive described how his company had champagne delivered to leaders’ homes during the lockdown to celebrate financial gains accrued while people were forced to forgo elective care. 

Intelligencer OPPORTUNITY QUICK HITS Mexico confirms country's first human case of bird flu in a 3-year-old girl – Medical Xpress

'I could live 30 years but plan to die': How assisted dying law is dividing Canadians – BBC

Major endometriosis study reveals impact of gluten, coffee, dairy and alcohol – The Guardian

In banning ‘Glock switches,’ red and blue states find common ground on gun law – The Washington Post (gift link)

Understanding the resurgence of mpox: key drivers and lessons from recent outbreaks in Africa – Tropical Medicine and Health / BioMed Central

Tariffs hit science labs: Trump levies raise cost of supplies – Nature

Behind the Plate: Keeping Our Food Safe – Contagious Conversations (CDC Foundation podcast)

An antiviral chewing gum to reduce influenza and herpes simplex virus transmission – University of Pennsylvania via ScienceDaily Issue No. 2703
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.

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Unprecedented aid cuts are putting global progress to end maternal deaths at risk, three UN agencies warned in a new report that calls for greater investment in midwives and other health workers.

Monday’s World Health Day highlights a critical issue for global health: the particular vulnerabilities faced by women and girls.

A global surge in cholera is threatening vulnerable people from Angola to Myanmar, fuelled by conflict, natural disasters and climate change, the World Health Organization (WHO) said on Friday.

96 Global Health NOW: Taking Cuts to Court; Beijing+30: A New Generation Needed to Advance Women’s Rights; and Minding the Lexical Gap View this email in your browser April 3, 2025 Forward Share Post Demonstrators protest funding cuts outside of the National Institutes of Health in Bethesda, Maryland, on March 8. Michael Mathes/AFP via Getty Taking Cuts to Court 
The Trump administration is facing a new wave of litigation from scientists, unions, and health advocacy groups, alleging that the administration’s cuts to research are illegal—and that the “ideological purge” behind them poses an existential threat to American scientific enterprise, reports the AP. 

Details: The latest lawsuit filed by the ACLU argues that NIH grant cuts were not guided by federal funding rules, which include a science-based review process designed to insulate the grant process from politicization. Such cuts have been “extremely rare” in previous administrations. 

• “To have it undermined in this way is really to give ourselves a black eye as a country,” said plaintiff Peter Lurie, president of the Center for Science in the Public Interest, per CNN.


• The suit also argues that ending projects midstream could put patients undergoing NIH-funded treatment at risk, and waste taxpayer money. 

Meanwhile, the reckoning over widespread cuts to federal health offices is ongoing:

• The Trump administration is demanding the CDC—which has laid off one-fifth of its workforce—to now cut $2.9 billion of contract spending, per The New York Times (gift link)—a move one CDC scientist described as “cutting off our arms and legs.”

Related: 

Trump’s cruel calculus on public health is slashing lifelines for the most vulnerable – Salon (commentary)

C.D.C. Cuts Threaten to Set Back the Nation’s Health, Critics Say – The New York Times (gift link)

The USAID List of Terminated Global Health Awards – What Does it Tell Us? – KFF Global Health Policy

Doctor Behind Award-Winning Parkinson’s Research Among Scientists Purged From NIH – WIRED

Slashing the public health workforce hurts the U.S. economy – The Washington Post (commentary and gift link) GLOBAL HEALTH VOICES The Latest One-Liners   More than half of the world’s pediatric cancer deaths occur in war-torn countries, which St. Jude Children’s Research Hospital and Duke researchers tied to disruptions in diagnosis and treatment in a new study in The Lancet Oncology that analyzed three decades of data. Duke Global Health Institute

A two-year-old girl in Andhra Pradesh, India, died after contracting H5N1, marking India’s first death from the virus since 2021; the child, whose family members all tested negative for the virus, may have been infected by consuming raw chicken. Times of India

The latest COVID variant on the rise is LP.8.1, an offshoot of Omicron that features genetic changes allowing it to spread more easily; it is swiftly becoming dominant in the U.K. The Independent

The shingles vaccine is linked to reduced dementia risk, finds a study in Nature that analyzed health records of 280,000+ older adults in Wales; those who received the shingles vaccine were 20% less likely to develop dementia over the next seven years than those who did not receive the vaccine. CBC GHN EXCLUSIVE COMMENTARY A Marie Stopes International mobile clinical outreach team on a site visit to Laniar health center in Senegal. August 14, 2014. Jonathan Torgovnik for The Hewlett Foundation/Reportage by Getty Beijing+30: A New Generation Needed to Advance Women’s Rights
Despite notable advances in women’s rights in the last 30 years since the adoption of the Beijing Platform for Action, gender-based violence, maternal mortality, and other issues still need to be addressed, writes Consolata Chikoti, a lawyer and global health scholar from Tanzania.
 
Successes include:

• A +30% reduction in maternal mortality.


• 162 countries have criminalized gender-based violence (GBV).


• A significant increase in access to modern family planning methods.

But:

• 800 women lose their lives every day to preventable maternal causes.


• GBV continues to be a critical concern, with one in three women having experienced physical or sexual violence, often by an intimate partner. 

Chikoti calls for a “commitment to mentoring and empowering young women to [foster] a new generation of leaders who will continue to challenge systemic barriers and drive transformative change for all women.” READ CONSOLATA CHIKOTI’S FULL COMMENTARY REPRODUCTIVE HEALTH India’s Push to End Cervical Cancer
Tens of thousands of doctors across India are being trained to promote the HPV vaccine, in an effort to eliminate cervical cancer in the country.

• One in five cervical cancer cases worldwide occur in India—nearly all of which are caused by HPV.

Health care providers will encourage mothers attending medical appointments to vaccinate their children, and will visit schools and community centers to counter vaccine disinformation.

• HPV vaccination has been privately available in India since 2008, but uptake has been low: Until recently, imported vaccines were expensive and misinformation surrounding deaths during an HPV vaccine trial left citizens distrustful.


• India recently started manufacturing its own HPV vaccine, with plans to make it part of the national vaccination program by early 2026.

The Guardian GLOBAL HEALTH VOICES OPPORTUNITY Atlantic Fellows: One Week Left to Apply!
George Washington University’s Atlantic Fellows for Health Equity program is a one-year, non-residential program that allows early- to mid-career professionals to develop their leadership skills and build their capacity through support for a health equity project to be completed at a fellow’s professional organization.

Fellows benefit from in-person and virtual training opportunities, coaching and mentoring from health equity experts, and integration into a lifelong senior fellowship network.

• Deadline: April 10, 2025
• Learn more and apply  

ALMOST FRIDAY DIVERSION Minding the Lexical Gap  
It can easily take a dozen English words—and frantic gesturing of clenched hands and gritted teeth—to describe the sensation of “cute aggression” toward, say, an adorable kitten.
 
Tagalog has it boiled down to one word: gigil (ghee-gill). Itʼs among dozens of non-English words now inducted into the Oxford English Dictionary, helping to fill a “lexical gap” with untranslatable words found in one language but not others, per BBC.
 
Lost for words no more! Thanks to the new additions, one neednʼt clutch at verbal straws trying to evoke the joy of drinking a beer outside (utepils, thanks Norway!), or seeing sunlight dappling through leaves (komorebi, h/t Japan).
 
In-kind donation: As a gesture of thanks, might we offer up some choice English words in exchange? Surely acersecomicke—“one whose hair was never cut”—deserves broader use. Or what about flingee, a handy term to describe “one at whom anything is flung”—be it a snowball, or a barrage of new words. QUICK HITS They were forced to scam others worldwide. Now thousands are detained on the Myanmar border – AP 

Africa's Quiet Response to U.S. Realignment of Foreign Aid – Think Global Health (commentary)

Farm workers avoiding bird flu testing because of deportation threat, officials fear – The Telegraph

World is ‘failing’ people with disabilities: UN deputy chief – UN News

Two infants die of whooping cough in Louisiana as cases climb nationally – CNN

Supreme Court rules in favor of FDA in dispute over flavored vapes – The Hill

Do smartphones and social media really harm teens’ mental health? – Nature

Why we study shrimp on treadmills: The case for curiosity-driven research – STAT (commentary) Issue No. 2702
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.

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96 Global Health NOW: Deep, ‘Degrading’ Cuts to U.S. Health Offices; Sierra Leone Weighs Abortion Bill; and Zambia’s ‘Most Contaminated Site’ View this email in your browser April 2, 2025 Forward Share Post Employees of the Department of Health and Human Services stand in line to enter the Mary E. Switzer Memorial Building yesterday in Washington, D.C. Kevin Dietsch/Getty Deep, ‘Degrading’ Cuts to U.S. Health Offices 
Mass layoffs are underway in America’s federal health offices, with thousands of positions cut yesterday in a chaotic process described by one FDA employee as a “bloodbath,” reports CNN. 

Included in the layoffs were thousands of scientists, doctors, senior leaders, and support staff—including entire teams that track disease outbreaks, conduct medical research, work to reduce injuries, monitor food and medicine safety, and administer health insurance programs for nearly half of the U.S. population, reports STAT. 

Scope of the cuts, per the AP:

• The CDC will eliminate ~ 2,400 workers, slashing divisions focused on workplace safety, violence and injury prevention, drug use, and asthma. 


• The FDA is set to lose ~3,500 staffers, including those who set policy for tobacco products and who review new drugs.


• The NIH will cut ~1,200 additional employees, including scientists, computer specialists, and nearly the entire communications staff.


• Centers for Medicare & Medicaid Services will lay off ~300 staffers.

“Humiliating and degrading” day: The layoffs were haphazardly administered, with many workers finding out they had been fired when their key cards did not work, per Federal News Network. The elimination of support staff in some cases meant offices could not operate. 

• “This is a sad and inhumane way to treat people,” said former FDA commissioner Robert Califf, who described the agency as “finished.”

Impact: The cuts will “leave our country less safe, less prepared and without the necessary talent and resources to respond to health threats,” said Mandy Cohen, former CDC director. 

Related:

RFK Jr. purges CDC and FDA's public records teams, despite "transparency" promises – CBS 

States sue Trump administration for rescinding billions in health funding –  AP GLOBAL HEALTH VOICES The Latest One-Liners   Middle East and North Africa HIV cases more than doubled over the last decade amid ongoing conflicts, displacement, and high levels of stigma for vulnerable populations, per a new Frontline AIDS report; infections in Jordan, Tunisia, Egypt, Morocco, and Lebanon soared by 116% since 2010 and are expected to keep rising. The Telegraph

Mpox presents a growing epidemic and pandemic risk, as human interaction with the virus reshapes its “entire endemic range” and as knowledge gaps on its biologic makeup hamper virus control. Nature Medicine (commentary)

A dearth of antifungal treatments is making invasive fungal diseases a greater threat, especially as they become more drug-resistant, per a WHO analysis released yesterday that described “an urgent need for innovative research and development.” Health Policy Watch

Family planning grants have been paused in the U.S., with the federal government withholding $27.5 million from organizations that provide contraception, cancer screenings, and STI services as officials investigate whether they’re complying with laws and executive orders. AP REPRODUCTIVE HEALTH Sierra Leone Weighs Abortion Bill
Sierra Leone could soon decriminalize abortion in some cases pending a parliamentary vote in the coming weeks. If passed, it would make Sierra Leone the second West African country (after Benin) to legalize the procedure.
 
Sierra Leone’s numbers:

• An estimated 90,000 abortions are performed each year.


• Tens of thousands of women and girls attempt to self-terminate pregnancies each year.


• Over 20% of girls ages 15–19 become pregnant.


• Unsafe abortions account for ~10% of the country’s maternal deaths; health workers say that’s likely a vast undercount.

A long battle: Following opposition from religious groups and some government officials, the initial bill has been amended to allow abortion only in cases of rape, incest, life-threatening risk, and fatal fetal abnormalities. 
 
AP GLOBAL HEALTH VOICES ENVIRONMENTAL HEALTH The Future of Zambia’s ‘Most Contaminated Site’ 
For decades, residents of Kabwe, Zambia, have grown severely sick—especially children. Many have died far too young. 

Hundreds of blood samples from residents over the decades have clearly identified the problem: severe lead poisoning. 

Behind the pollution: From 1906 to 1994, Kabwe was home to one of the world's largest lead and zinc mines. Lead particles infiltrated soil and waterways, and the pervasive dust continues to affect residents. 

• A 2022 U.N. report identified the site as a “sacrifice zone”—one of the most polluted places on the planet. 

Zambia received a World Bank loan to support cleanup efforts—but human rights groups say little has been done and that efforts have not addressed the former mine itself. 

NPR Goats and Soda DEMENTIA Lack of Deep Sleep Increases Alzheimer’s Risk
One in three American adults don’t get enough sleep—and according to a new study, a lack of REM sleep may speed the decline in parts of the brain associated with Alzheimer’s.

• Adults need an average of 7–8 hours of sleep. 


• 20%–25% should be spent in deep sleep and the same amount in REM sleep.

The two deep stages of sleep, slow-wave and REM, are vital to brain function, as toxins and dead cells are cleared and memories and other information are processed and consolidated. Without adequate slow-wave and REM sleep, the inferior parietal region of the brain shrunk, according to the study.

CNN

Related: 

Latest Alzheimer's lab tests focus on memory loss, not brain plaques – NPR Shots

Lowering bad cholesterol may cut risk of dementia by 26%, study suggests – The Guardian

WHO calls for urgent action on dementia among refugees and migrants – WHO

European committee says Lilly Alzheimer’s drug shouldn’t get marketing approval – AP OPPORTUNITY QUICK HITS Guterres calls for greater equality and inclusion as world marks Autism Awareness Day – UN News

Communities in crisis: The collapse of HIV lifelines in Eastern Europe and Central Asia – UNAIDS

A Prison Death Highlights an L.G.B.T.Q. Crackdown in Russia – The New York Times (gift link)

How Houston's mayor kept Texas prisons hot as 'living hell,' – Chron

Analysis: Tariffs on Canadian drugs will strain US supply chain – CIDRAP

Long COVID Showed Me the Bottom of American Health Care – The Atlantic

The Role of Clinicians in the Climate Crisis – JAMA Network Open (commentary)

How Dating Apps Could Unlock At-Home HIV Testing – Think Global Health (commentary)

The Sound of Science – The Hub / Johns Hopkins Magazine Issue No. 2701
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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Amid alarming reports of sexual violence being used as a weapon of terror across Sudan, UN reproductive health agency, UNFPA, is warning that over 12 million women and girls – and increasingly men and boys – are estimated to be at risk.