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96 Global Health NOW: ‘Hell on Earth’ in Saudi Detention Centers; A Voice for Hispanic Health; and Coverage Graveyards and Ghost Networks Detainees packed into sweltering rooms with no access to basic hygiene or outside air October 28, 2024 ‘Hell on Earth’ in Saudi Detention Centers
Tens of thousands of people have been forced to live in inhumane, “degrading” conditions inside Saudi detention centers: packed into sweltering rooms with no access to basic hygiene or outside air, . 

• “It’s no exaggeration to say that place was hell on earth. They never let us outside during my nine-month stay. They never let anyone experience fresh air or sunlight,” said Zaro Gebre, an Ethiopian detainee who smuggled out footage from inside the detention centers. 

Crackdown on migrants: Ethiopians fleeing war and poverty for the Gulf make up a significant proportion of those in the detention centers, .

Reforms promised, unfulfilled: New footage of the centers was released yesterday as part of an that followed up on The Telegraph’s into the centers’ human rights abuses four years ago.

• Yet conditions remain unchanged since then, or worse: Detainees sleep packed together on floors with trash bags, toilets overflow, and violence erupts between detainees. 

• The Saudi government faces little pushback from the global community, as the country seeks to burnish its image as an international soccer hub, argues one investigative reporter in a .  

GLOBAL HEALTH VOICES The Latest One-Liners
A gene editing therapy for chronic hepatitis B will be tested in human trials in Moldova after the nation’s regulators approved Precision BioSciences’ study of the treatment.

Ozempic may reduce Alzheimer’s risk, per a published in Alzheimer's & Dementia last week that showed semaglutide was associated with a 40%–70% lower risk of a first-time Alzheimer’s diagnosis in patients with type 2 diabetes compared with seven other diabetes medications.

Opioid makers and marketers misused scientific evidence to support inaccurate claims about the drugs—including that they were not addictive—per a new published in Health Affairs Scholar.

McDonald’s has ruled out beef patties as the source of the E. coli outbreak linked to its Quarter Pounder hamburgers, which has killed at least one and sickened ~75 others; instead, onions are believed to be the source of the outbreak. INSURANCE Coverage Graveyards and Ghost Networks
In the U.S., having health insurance is no guarantee that essential medical care will be covered—or even available as advertised. 

Two obstacles gaining more attention: 

• Denial for dollars: It has become common for insurers to outsource medical reviews to large companies like one called EviCore, which uses algorithms that increase denial rates, . 

• “Ghost networks”: Far too often, patients purchase health coverage promising access to therapists and other mental health professionals listed in provider directories—only to find them out-of-date and inaccurate, . 

COMMUNITY HEALTH A Voice for Hispanic Health
During the COVID-19 pandemic, journalist Tibisay Zea noticed something in Boston’s Hispanic community: Its members were poorly informed on health issues. To help close that information gap, she launched the Salud podcast in 2022.

• The show covers culturally relevant health information on topics like COVID-19, diabetes, cancer, and workplace accidents, all of which disproportionately affect Latino people. 

Zea focuses on connecting health experts with personal stories from the Latino community—an approach that not only informs but also resonates emotionally with listeners, many of whom face socioeconomic challenges and barriers to health care.

GLOBAL HEALTH VOICES WATER How Women Suffer When Wells Go Dry
Water insecurity comes with major health risks—and women often bear the burden. 

Recent in water-scarce areas of Peru and Indonesia included interviews with women who reported: 

• Extreme physical exertion from carrying heavy water buckets that led multiple women to go into premature labor and miscarry.

• Struggling to secure water for sanitary births. 

• Barriers to menstrual hygiene, which prevented young women and girls from attending school.

Increased violence: Indonesian women in water-insecure households were more than twice as likely to report experiencing gender-based violence in the last year.

QUICK HITS Some people with ADHD thrive in periods of stress, new study shows –

HIV-Infected Patient Refused Care In Armenia –

Remembering Dr. Richard Cash: How a 'simple' intervention helped save millions of lives –

The Final Push: Overcoming the Last Barriers to Global Polio Eradication –

Gas-powered leaf blowers are noisy, polluting and harmful to our health. But are bans the best way to go? – Issue No. 2804
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 and follow us on Instagram and X .

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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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Reports of Israeli troops storming one of the last functioning hospitals in northern Gaza are deeply concerning, while ongoing hostilities are hampering polio vaccination in the area, the World Health Organization (WHO) said on Friday. 

Children and disabled people are facing ever more horrific conditions in war-torn Gaza, with some dying as they wait for medical evacuations, as the year-long war grinds on, UN officials and rights experts said on Friday.

96 Global Health NOW: A Widening E. coli Investigation; The Silence of the Feds; and Hospital Gown … But Don’t Make it Fashion October 24, 2024 A Widening E. coli Investigation
A multistate outbreak of E. coli infections has prompted an expansive, by the CDC and U.S. agencies that have linked the infections to McDonald’s restaurants. 

Outbreak details, : The food poisoning has sickened at least 49 people in 10 states, including 10 who were hospitalized and one person who .

• But the number of people affected by the outbreak is likely much higher, . 

Zeroing in on a source: Of 18 sickened people interviewed, all reported eating at McDonald’s.

• A specific ingredient has not been confirmed as the source of the outbreak, but the that the onions or beef patties used for Quarter Pounders are the likely source of contamination, . 


• McDonald’s has taken Quarter Pounders in about a fifth of its stores, and the onion supplier, Taylor Farms Colorado, issued a broader recall of yellow onions—though the company said that it has found no traces of E. coli in tests. 

Bigger picture: The outbreak, which comes on the heels of the Boar’s Head listeria contamination linked to 10 deaths, has prompted larger questions about U.S. food safety, .

Related: Why food recalls are everywhere right now – GLOBAL HEALTH VOICES The Latest One-Liners   Rifaximin, a common antibiotic used to treat liver disease, is fueling bacterial resistance to daptomycin—one of the few treatments effective against the superbug vancomycin-resistant enterococcus faecium (VRE), .

People 50 and older should get pneumococcal vaccines to protect against pneumonia and other dangerous illnesses, a CDC advisory panel recommended yesterday, replacing earlier guidance aimed at people ages 65+.  

A second dose of the 2024–25 COVID-19 vaccine is now for people ages 65+ and for people with moderate or severe immunocompromising conditions, per a CDC vaccine advisory group.

Single-use vapes will be banned in England starting next June, as the British government tries to curb rising vape usage among children and teens. VIOLENCE ‘Shocking, Staggering’ Sexual Violence in DRC
The Democratic Republic of the Congo has seen an “acute escalation” of sexual violence in recent years, per a from Physicians for Human Rights.

• ~90,000 documented sexual assaults were reported in 2023 in DRC—up from 40,000 in 2021. The group believes it is a “severe undercount.”

“The level of sexual violence is shocking. It's staggering,” said PHR director Saman Zia-Zarifi.

Other organizations echo the findings:

• A recent described an “explosion of sexual violence,” with MSF teams treating 25,000+ sexual assault survivors in 2023 compared to a previous average of 10,000 victims per year. 

• UNICEF’s chief of child protection in the DRC, Ramatou Toure, described a ”skyrocketing” crisis in camps—where “almost every girl or every woman has experienced sexual violence.” 

Driving the surge: Armed rebel and militia groups have gained strength, and the UN’s 2023 withdrawal of its peacekeeping forces at the request of DRC’s government has led to a “vacuum” of protection. 



Related: Four in 10 deaths in war zones last year were women, UN report finds – GLOBAL HEALTH VOICES SUBSTANCE USE What Makes ‘Pink Cocaine’ So Dangerous
A designer drug called tusi has been in the news lately due to its connections with Sean “Diddy” Combs and the recent death of Liam Payne.

• It’s a bright pink powder combining any number of substances. Common ingredients include ketamine and ecstasy, but usually not cocaine.

Users are led to believe that tusi is safer than street drugs, but without knowing the exact ingredients of a given batch—which could even include fentanyl or xylazine—the effects can be unpredictable and even fatal.

• The drug has been linked to at least nine deaths so far, including four suicides and four accidental overdoses.

AVIAN FLU The Silence of the Feds
When U.S. farm veterinarians began to sound the alarm about avian influenza detected in cows, they were expecting a full-blown response from the U.S. Department of Agriculture, including widespread testing and surveillance. 

Instead, they got silence: “Nobody came. When the diagnosis came in, the government stood still,” said one veterinarian. 

Conflict of interest: The USDA’s sometimes conflicting mandates to oversee the safety of the nation’s food animals while also protecting the nation’s agriculture trade has resulted in a “‘don’t test, don’t tell’ policy among dairy farmers.”

The result? There is no nationwide surveillance or accurate sense of H5N1’s scope as the virus continues to spread.

• “We are repeating every single mistake” of the COVID-19 pandemic, said Keith Poulsen, director of the Wisconsin Veterinary Diagnostic Laboratory. 

ALMOST FRIDAY DIVERSION Hospital Gown … But Don’t Make it Fashion
Iconic is usually a compliment in the fashion world. Not this time.
 
The hospital “gown” is an affront to formalwear everywhere. An insult to our tastes and our figures. And really more of a glorified sheet than a garment.
 
Why the sartorial shame? The New York Times’ fashion critic

• This wretched wearable was designed to accommodate IVs and provide easy access to the body, resulting in the “dehumanizing” fronts-in, butts-out design behind (ahem!) countless hospital humiliations.


• Even Diane von Furstenberg couldn’t make it chic. The designer reimagined her iconic wrap dress as a patient gown for the Cleveland Clinic. And it’s .

Another idea: “You might as well just walk around naked,” Timothy Andrews, a health industry analyst and frequent hospital outpatient, said to . “It’s probably easier—just give us a belt and a loincloth.” QUICK HITS Tens of thousands of UK dementia patients to be enrolled in clinical trials –

U.S. Study on Puberty Blockers Goes Unpublished Because of Politics, Doctor Says –

Crackdown on Homeless Encampments Raises Public Health Questions –

World’s first vaccine for norovirus the ‘winter vomiting bug’ begins final stage trial –

Perspectives on Medical School Admission for Black Students Among Premedical Advisers at Historically Black Colleges and Universities –

Youth cheerleading is getting more athletic — and riskier –

Surgical Centers Urged to Nix Mandatory Pre-Op Pregnancy Tests – Thanks for the tip, Chiara Jaffe!

Drinking is cheaper than it’s been in decades. Lobbyists are fighting to keep it that way –

How breast milk can help fight climate change – Issue No. 2803
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 and follow us on Instagram and X .

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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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$1.14 million from CIHR will resolve treatment roadblocks for rare brain disorders

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Gene therapy for rare neurological disorders will move one step forward thanks to a $1.14 million grant from the Canadian Institutes of Health Research (CIHR).

$1.14 million from CIHR will resolve treatment roadblocks for rare brain disorders

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Gene therapy for rare neurological disorders will move one step forward thanks to a $1.14 million grant from the Canadian Institutes of Health Research (CIHR).

96 Global Health NOW: Lebanese Hospitals on Alert; Malaria Becomes ‘Ancient History’ in Egypt; and Switching Sides on the Tobacco Fight October 23, 2024 Lebanese forces take security measures around Rafik Hariri University Hospital in Beirut on October 22, after an Israeli attack near the area. Houssam Shbaro/Anadolu via Getty Lebanese Hospitals on Alert as Strikes Intensify 
  UN officials are urging protections for health care facilities in Lebanon after an Israeli airstrike Tuesday near the Rafik Hariri University Hospital—the largest public hospital in Lebanon—led to “significant damage,” .

Another hospital, the Al-Sahel Hospital in Dahiyeh, was evacuated amid “horror and tears” after Israel claimed that Hezbollah is stockpiling cash and gold in a bunker under the hospital, increasing fears that Lebanon’s health sector could face the same destruction as Gaza’s, .

Other mounting health risks: 400,000+ displaced Lebanese children face growing risk of cholera, scabies, and waterborne diseases due to unsanitary conditions in shelters, .

• Last week, health authorities Northern Lebanon’s first case of cholera. 

Meanwhile in Gaza: Escalating violence across northern Gaza has forced the postponement of the polio vaccination campaign’s final phase, .

• And the WHO led a “high risk” in northern Gaza to transfer patients to Gaza City this week amid intense hostilities and the denial of deliveries of critical medical supplies, blood, and fuel.

GLOBAL HEALTH VOICES The Latest One-Liners   New stroke prevention guidelines from the American Stroke Association for the first time call out specific risks faced by women and gender-diverse individuals taking the hormone estrogen; also call for screening for and addressing social determinants of health.

Girls and young women may be more susceptible to the clade Ib mpox subvariant, that found a higher percentage of cases and a much earlier average age of infection—6 years—among girls, compared with 17.5 years for boys.
 
An E. coli outbreak linked to McDonald’s Quarter Pounder hamburgers has sickened at least 49 people in 10 U.S. states, leading to one death and 10 hospitalizations, the yesterday; investigators are focused on onions and beef as potential sources of contamination.

The U.S. Department of Agriculture weakened its bird flu emergency order last spring in response to pushback from state and industry officials—potentially contributing to disease transmission across state lines, records show. GOOD NEWS Malaria Becomes ‘Ancient History’ in Egypt   
After three years of interruption to the transmission chain in Egypt, the country malaria-free.

• The country had a prevalence of ~40% in 1930—but public health officials made strides over the last century, . 

How they did it, :

• Free diagnosis and treatment, regardless of legal status. 


• Malaria detection training for health professionals.


• Malaria screenings provided at the country’s borders. 

Vigilance to continue: The health ministry pledges to guard its malaria-free status through surveillance, integrated vector management, and rapid response to imported cases.
 
The Quote: "Malaria is as old as Egyptian civilization itself, but the disease that plagued pharaohs now belongs to its history,” said WHO chief Tedros Adhanom Ghebreyesus. GLOBAL HEALTH VOICES BIG TOBACCO Switching Sides on the Tobacco Fight 
As the FDA fights an “epic struggle” against the tobacco industry over next-generation nicotine products, the agency is contending with a particularly galling dynamic: lawyers who have shifted alliances. 

Nearly two dozen FDA lawyers have left the FDA’s tobacco regulation arm to advise, litigate for, or work with the tobacco and vaping industry over the last 15 years, according to a review by The Examination.

Insider advantage: The lawyers often helped craft and defend the same regulations the industry is fighting—giving them a powerful upper hand in litigation.

• “It seems like every time we get sued in the tobacco industry, a former FDA lawyer is leading the lawsuit,” FDA Commissioner Robert Califf told an oversight organization last year. 

CLIMATE CRISIS Climate Change’s Psychological Toll
Climate-related changes threaten more than people’s physical safety and livelihoods. These changes also act as a “threat multiplier,” increasing risks for mental health problems. 

• Survivors of California’s 2018 Camp wildfire were diagnosed with PTSD at a rate comparable to war veterans.


• Slower-onset changes like drought, land cover change, rising sea levels, etc., can cause stress over time that erupts into violence like 2019’s Ogossagou massacre in Mali.

A hefty price tag: Mental disorders due to climate, pollution, and environment-related causes could cost the global economy $47 billion annually by 2030. 

To address these issues, researchers are pushing for mental health to be a focus in climate policy and interventions, such as in countries’ Paris Accord climate action plans.

OPPORTUNITY QUICK HITS Polio Anywhere is a Threat Everywhere: Why the UK Must Act –

Dengue fever: with a record 12.4m cases in 2024 so far, what is driving the world’s largest outbreak? –

Ukraine: Population drops by 10 million since Russia invaded in 2014, UNFPA reports –

Elderly Americans with dementia have become some of the GOP’s top donors without even realizing it –

Beyond Longevity: The Critical Role of Mental Health in Japan’s Well-Being –

How one woman set up a mental health helpline for the whole of South Africa –

How does the brain react to birth control? A researcher scanned herself 75 times to find out –

Coke, Twinkies, Skittles, and … Whole-Grain Bread? – Issue No. 2802
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 and follow us on Instagram and X .

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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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Countries facing conflict, natural disasters and humanitarian crises are struggling to provide routine childhood immunisations leaving many children vulnerable to the resurgence of polio, the UN Children’s Fund (UNICEF) warned in new report. 

Intense bombardments, mass displacements and lack of access in northern Gaza have forced the postponement of a polio vaccination campaign, the World Health Organization (WHO) warned on Wednesday.

96 Global Health NOW: The Push to Prevent Drownings in Uganda; Switching Sides on the Tobacco Fight; and Heeding Africa’s Hearing Loss October 22, 2024 GHN EXCLUSIVE Bystanders watch rescuers search the site of a capsized cruise boat on Lake Victoria near Mutima village, south of Kampala, Uganda. November 25, 2018. Isaac Kasamani/AFP/Getty The Push to Prevent Drownings in Uganda
KAMPALA, Uganda—Every year, —people like Owen Ntanda, an 18-year-old boat operator who drowned in the lake last summer, despite being a good swimmer—giving the lake a reputation as one of the “” in the world.

• by researchers at Makerere University and the CDC estimated Uganda’s drowning death rate to be 8.5 per 100,000 population per year—~2,942 drowning deaths a year. 


• Worldwide, . But in Uganda, young adults aged 20–39 years are most affected, —and men in Uganda are 3X more likely to drown than women. 

Behind Uganda’s high drowning rate:

• A lack of safety gear like life jackets—most of which are substandard.


• Overloaded cargo boats—which are not well-policed.


• Supercharged floods fueled by climate change.

Steps toward change:

• Uganda will become one of the first countries to implement a national drowning intervention strategy—expected to launch this fall—giving each stakeholder ministry a mandate and drowning prevention activities.

• The Ministry of Health has established emergency response services focused on water emergencies, boosting first aid training, and procuring water boat ambulances.

Ed. Note: This article is part of , made possible through the generous support of loyal GHN readers. Kyra Guy of USC’s Keck School of Medicine won an honorable mention for entering the idea for this story in the 2024 Untold Global Health Stories contest, co-sponsored by GHN and CUGH, which is now accepting nominations for the 2025 round. ! GLOBAL HEALTH VOICES The Latest One-Liners   A large proportion of sub-Saharan African teens with severe asthma are missing out on diagnosis and treatment, of 27,000 students from urban areas in Malawi, South Africa, Zimbabwe, Uganda, Ghana, and Nigeria; of ~3,000+ reporting symptoms, just ~600 had a formal diagnosis.

School administrators in Mexico have six months to implement a government-sponsored ban on junk foods like sugary fruit drinks and chips or face heavy fines between $545 and $5,450, which could double for a second offense.

Washington state its first suspected avian flu infections in people—four agricultural workers who tested positive after working with infected poultry at a facility that culled ~800,000 birds that tested positive for avian flu last week.

U.S. infant mortality was higher than expected in the months following the Supreme Court decision that eliminated federal abortion protections, , corresponding with a 7% absolute increase in infant mortality overall, representing 247 excess deaths. DATA POINT VIOLENCE A Public Health Approach to Political Violence 
As political rhetoric grows more incendiary leading up to the first U.S. presidential election since the January 6, 2021 insurrection, the at the University of California at Davis has begun to study the threat of political violence in earnest. 

A key goal of their research: Identify risk factors and interventions that could deescalate potential unrest before it arises. 

“Openness to change”: According to a from the program released last month, just 3.7% respondents said it was “very likely” that they would participate as a combatant in a large-scale civil conflict—but ~44% said they would be “not likely” to join if they were dissuaded by family members, and ~30% said they could be deterred from participating if a respected religious leader urged them not to.

Such findings can “guide prevention efforts,” the survey concluded.

HEALTH DISPARITIES Heeding Africa’s Hearing Loss
54 million people in Africa are facing hearing loss by 2030, due to factors including a shortage of hearing specialists and a limited budget for ear and hearing care (EHC).

• Up to 75% of child hearing loss in LMICs is preventable.

• Only 10% of the 33 million people who need hearing aids have access and can afford them. 

• Hearing loss costs Africa an estimated $27 billion per year, in terms of the impact on human lives and economies. 

Solutions: pushes for EHC policies and implementation—urging more dedicated funding, better-equipped facilities, and exploration of public-private partnerships. 
 
OPPORTUNITY QUICK HITS Committee reviewing euthanasia in Canada finds some deaths driven by homelessness fears, isolation –

A Maine Law Could Have Forced the Lewiston Mass Shooter Into Mental Health Treatment. Why Wasn’t It Used? –  

China unveils first diagnosis guidelines to battle escalating obesity crisis –

Medicaid will cover traditional healing practices for Native Americans in 4 states –

Ending “domestic helicopter research” –

As Ukraine's birth rate plunges, here's what one doctor is doing to reverse the trend –

The Perverse Consequences of Tuition-Free Medical School – Issue No. 2801
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 and follow us on Instagram and X .

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96 Global Health NOW: Barriers to Polio Vaccination; The Overdose Vaccine ‘Moon Shot’ and Where Early Education is Enshrined October 21, 2024 A child looks on before receiving a vaccination for polio in Khan Yunis, in the southern Gaza Strip, on September 5. Bashar Taleb/AFP via Getty Barriers to Polio Vaccination ‘Leaving Children Vulnerable’
While health workers in Pakistan battle a growing polio outbreak, polio vaccination teams in Gaza are also contending with widening obstacles.

In Pakistan: Health officials have confirmed six more cases of wild poliovirus type 1, bringing the total number of infected children this year to 39—after just six cases last year, .  

• Vaccine hesitancy and attacks against vaccination teams have increased as hardline clerics and militants spread misinformation about the vaccine’s safety, “leading to missed opportunities for immunization and leaving children vulnerable,” said Melissa Corkum, chief of UNICEF’s polio team in Pakistan. 


• Pakistan will launch a nationwide vaccination campaign next week to vaccinate 45 million+ children. 

In Gaza: Today the UN and WHO launched the second round of a widespread polio vaccination campaign in Gaza, targeting 590,000 children with booster doses, .

• But conditions have deteriorated in the enclave since the first round of vaccinations—making it more difficult for families to travel to vaccination sites amid destroyed infrastructure and increased safety concerns. 


• And health workers are concerned polio vaccines won’t reach Gaza’s northern communities because of ongoing fighting and fears for health workers’ safety, .

GLOBAL HEALTH VOICES The Latest One-Liners   The global oral cholera vaccine stockpile has been depleted, the WHO said Friday, jeopardizing outbreak response amid a 126% rise in cholera mortality from January 1 to September 29 across five WHO regions.

Whooping cough cases in the U.S. have hit their highest number—18,506—since 2014; outbreaks of the disease, which can be prevented by vaccination, are hitting mostly older kids and teens.

Women seeking pain relief at emergency departments can wait 30 minutes longer than men, per a published in PNAS that assessed 22,000 discharge notes from emergency departments in the U.S. and Israel.

Over-the-counter contraceptives could be required to be covered by U.S. health insurers without cost-sharing, according to a new proposal the Biden administration unveiled today. OPIOID CRISIS The Overdose Vaccine ‘Moon Shot’ 
Efforts to prevent opioid overdose with a vaccine have largely been fruitless—until now. A number of opioid overdose vaccines are currently being tested, all relying on the same basic strategy:

• Stimulate the immune system to protect against an opioid’s ability to overwhelm the brain and shut down the breathing process.

How it works: Portions of the fentanyl molecule are linked to proteins the body recognizes in order to trigger an immune response.

Also underway: The first fentanyl monoclonal antibody is undergoing human trials, with initial published in Nature Communications showing that monkeys treated with the antibody survived a lethal dose of fentanyl.

The Quote: “It’s a moon shot, but a moon shot is what the country needs right now,” said JR Rhan, co-founder of startup Ovax, which is developing an opioid overdose vaccine.

GLOBAL HEALTH VOICES WEST NILE VIRUS Ukraine’s Viral Threat
West Nile virus has killed 11 people and sickened 88 in Ukraine over the last three months—marking a “serious” new threat to the country that will likely become more common with climate change, said Ukraine's Deputy Health Minister.

• “We probably have to get used to the fact that this fever will be in even greater numbers in Ukraine,” Ihor Kuzin said.

Growing hotspot: Outbreaks are typically found on bird migratory routes, and Ukraine is a stop along several such flight paths, explained Kuzin.

CHILD & ADOLESCENT HEALTH Where Early Education is Enshrined 
In Norway, the “intrinsic value” of childhood is upheld in the 63-page Kindergarten Act of 2006, a law guaranteeing every child’s right to attend kindergarten.

These schools, serving children 5 and under, are seen “as an investment for society and the child,” said Kristin Aasta Morken, a program leader in Oslo.

As such, Norwegian kindergartens are:

• Publicly funded: National funds cover 85% of operating costs.


• Inclusive: Children with disabilities are not segregated, and non-Norwegian speakers are given communication aids.


• Embracing nature: Children spend 70% of their kindergarten time outside, in all weather—in keeping with the Norwegian saying: “There is no bad weather, just bad clothes.”

RESOURCE QUICK HITS ‘One-man anti-abortion army’: shadow of US global gag rule looms over Nepal’s family planning services –

China ends international adoption. Reactions range from shock to relief –

Under a L.A. Freeway, a Psychiatric Rescue Mission –

Tobacco Sponsorship of F1 Could Put Children on a Fast Track to Addiction –

Nut bans little help to allergic air passengers –

Life-saving spongelike 'bandage' rapidly stops hemorrhaging and mitigates risk of infection – Issue No. 2800
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 and follow us on Instagram and X .

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The World Health Organization (WHO) has officially certified Egypt as malaria-free. The achievement marks the culmination of a century-long effort to eradicate a disease that has plagued the nation since ancient times.

96 Global Health NOW: Rwanda’s Marburg Vaccine Quandary; War-Torn Sudan’s Medical Training Nightmare; and A ‘Conker’-Versial Victory October 17, 2024 Sabin Vaccine Institute delivered 700 doses of its Marburg vaccine to Rwanda on Oct. 5.
Photo Courtesy of the Sabin Vaccine Institute Rwanda’s Marburg Vaccine Quandary 
As Rwanda rushes to contain the third biggest outbreak of the fatal Marburg virus ever, it has quickly greenlit experimental vaccines and treatments.

But officials have taken divergent routes in deploying those, approving the first-ever clinical trial for a Marburg treatment, while rejecting a similar trial for vaccines, . 

This reflects an “agonizingly difficult” debate:

• Marburg outbreaks are rare and small—Rwanda has confirmed 62 cases and 15 deaths—meaning there are few opportunities to test vaccine efficacy.


• Yet the virus is lethal, with ~80% of cases affecting health care workers, which “weakens the area’s overall health infrastructure,” virologist Kari Debbink explained to “Public Health on Call.”

Ultimately, the government elected to “move fast to protect the front-line workers” by rejecting the trial and giving them access to the vaccine—but some public health leaders see this as a missed opportunity in overall vaccine development.

The vaccine: Rwanda has received 1,700 doses of an experimental vaccine from the Sabin Vaccine Institute, and ~700 people have been vaccinated—primarily health care workers and contacts of those infected.

The therapy trial: The Rwandan government has agreed to proceed with a WHO-led randomized clinical trial to test the antiviral drug remdesivir and a monoclonal antibody against Marburg, . GLOBAL HEALTH VOICES The Latest One-Liners  

The U.S. FDA put a hold on Novavax’s application to advance its combination COVID-19 and influenza vaccine after a trial participant reported a serious adverse event—a form of nerve damage—last month; the patient received the combination shot in a phase two trial that finished in July last year.

 
Italy has criminalized surrogacy overseas, levying jail time and steep fines for citizens who go abroad to have children via surrogate in a move opponents described as “medieval” and discriminatory to same-sex couples.

Breast cancer risk is “slightly higher” for women with hormonal IUDs, finds a large study published in ; the findings align with similar risks tied to taking long-term hormonal birth control pills.

Western Pacific nations are failing to meet UN targets to reduce premature deaths from lifestyle-related diseases like cancer and diabetes by 2030, —largely due to a slow decline in tobacco and alcohol consumption. GHN EXCLUSIVE COMMENTARY Doctors consult with patients in a clinic in a camp for internally displaced people in South Kordofan, Sudan, on June 17. Guy Peterson / AFP via Getty War-Torn Sudan’s Medical Training Nightmare   The ongoing conflict in Sudan has not only pushed public services beyond the point of collapse, it has disrupted medical training and licensing, with lasting consequences for the country’s health care workforce, write three Sudanese medical professionals in an .

• Medical education in much of the country has halted because of the destruction of medical schools and hospitals.


• Medical students and interns have emigrated—worsening the long-standing brain drain of medical professionals.

Remarkable resilience:

• Physicians are still training interns and students.


• Displaced physicians are establishing specialty units in neurosurgery and orthopedics, for example, in remote hospitals.

But:

• Disruptions in medical training have compromised the national public health infrastructure, exacerbating the country’s overwhelming health needs.


• Broken health systems will continue to undermine public health even after the war ceases.

What needs to happen now:

• International agencies and organizations need to join now with Sudanese partners to revitalize medical training in the country.


• Sudan must act as soon as possible to avoid future physician shortages by facilitating resident transfers to other in-country residency programs with better security and additional capacity.

GLOBAL HEALTH VOICES CLIMATE CRISIS Disparities in South Africa Extend to Heat Impacts
In a country with income inequality, a recent temperature-mapping study found that heat also impacts neighborhoods very differently: Overall, townships were 6?C (42.8?F) hotter than wealthier suburbs.

Environmental factors: Under the hot sun, tree cover allows for evaporative cooling. The suburb of Waterkloof has 54.1% tree cover—compared to only 2.6% in the neighboring township of Mamelodi.

Structural inequality: Township residents often live in makeshift steel shacks that trap heat and can reach up to 48.5?C (119?F) inside.

Extreme heat can cause heat stroke, dehydration, and heat exhaustion, and exacerbate respiratory problems.

ALMOST FRIDAY DIVERSION A ‘Conker’-Versial Victory  
An English town—and chestnut enthusiasts everywhere—has been roiled by a spot of scandal after the winner of the World Conker Championships was accused of cheating.
 
The beloved autumn tradition in the village of Southwick involves stringing up chestnuts and hurling them at one another until one competitor is obliterated. But this year, “King Conker”—82-year-old David Jakins—was caught with a steel conker in his pocket after winning the contest.

• According to , Jakins’ opponent claimed that his own conker “disintegrated in one hit" when he faced Jakins. “That doesn’t just happen.”

• The case will be a tough nut to crack: Jakins claims he carries the steel conker as a joke. That old chestnut…

But if he is indeed a chestnut cheater, Jakins is more than welcome in the conker battle royale of South London—a lawless, “anything-goes” competition where cheating is actively encouraged, . QUICK HITS Imperial modelling shows 100 Days Mission could have saved 8 million lives –

Six people sought new organs. They ended up with HIV. –

Kidney transplantation between donors and recipients with HIV is safe –

War’s Public Health Impacts Are Vast. Tallying Them Is Difficult. –

People are catching avian flu from wild birds, study suggests –

South Australia’s upper house narrowly rejects ‘Trumpian’ bill to wind back abortion care –

CDC issues interim recommendations to prevent sexual Oropouche virus spread –

‘Smart’ insulin prevents diabetic highs — and deadly lows –

6 Things to Eat to Reduce Your Cancer Risk – Issue No. 2799
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 and follow us on Instagram and X .

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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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The UN health agency has warned that a first case of highly infectious cholera virus has been detected in northern Lebanon, raising fears that those displaced by Israeli bombardment may already be at risk from the potentially deadly disease.

Thomas Durcan’s project will dissect the role of microglia in degenerative conditions, to identify new therapeutic strategies for Alzheimer's treatment

An innovative new program based at The Neuro has received $2.6 million from the CQDM and the Brain Canada Foundation.

Thomas Durcan’s project will dissect the role of microglia in degenerative conditions, to identify new therapeutic strategies for Alzheimer's treatment

An innovative new program based at The Neuro has received $2.6 million from the CQDM and the Brain Canada Foundation.

96 Global Health NOW: Halving Premature Mortality Rates; Thalassemia’s Strain on Blood Supplies; and Enter the Untold Global Health Stories Contest! October 16, 2024 A Sudanese patient with kidney failure undergoing dialysis at the Soba Hospital in southern Khartoum. June 3, 2023. AFP via Getty Halving Premature Mortality Rates: ‘A Prize Within Reach’
All countries—even those afflicted by poverty and conflict—can cut their premature death rates in half by 2050 through a series of policy priorities, posits a new Lancet presented at the closing of the in Berlin.

The roadmap, dubbed “50 by 50,” argues that steady focus on 15 “priority conditions”—including infectious diseases like tuberculosis, noncommunicable diseases, and other issues such as accidents and suicide—is the key to dramatically improved mortality rates.

• “It’s a prize within reach,” said the report’s lead author, Gavin Yamey of the .

Other high-impact efforts:

• Tackling tobacco: High tobacco taxes are “by far” the most crucial policy tool for reducing premature deaths.


• Improving medical access: Subsidizing essential medicines and vaccines and expanding childhood immunizations can lead to “significant gains.”

If the global goal is met, a person born in 2050 would have a 15% chance of dying before age 70—down from 31% for someone born in 2019, “meaning dramatic improvements for billions,” . GLOBAL HEALTH VOICES The Latest One-Liners   23 attacks on hospitals and health workers in Lebanon have led to 72 deaths and 43 injuries among health workers and patients since mid-September—putting health facilities “under massive strain.”

Five new suspected human cases of bird flu have been , adding to six confirmed cases in the state, the U.S.’s largest dairy supplier.

Novo Nordisk is halting its insulin pen production, the company told governments and nonprofit organizations—a move critics say was made to scale up the production of more profitable injectable weight-loss drugs.

Vaccine-derived poliovirus type 3 has been detected in wastewater samples in French Guiana, per a that urged nearby countries to keep vaccination levels above 95% to minimize the risk of outbreaks. GHN EXCLUSIVE OPPORTUNITY Workers collect freshly picked marigold flowers to sell. August 13, Qujing, China. Wang Yong/VCG via Getty Send Us Your Story Ideas! 
Do you know of a global health story that the media is overlooking? The , co-sponsored by the Consortium of Universities for Global Health and GHN, is open and ready for your entries!
 
How it works:

• you feel deserves urgent attention, describing the story and why it deserves more coverage and support in 150 words or less.


• The best nominations focus on a specific issue in a specific location (i.e., not global chronic disease) and include available data, evidence, and contact information.

The win-win: If we choose your issue, we’ll provide a platform to expand the audience for your issue in GHN and through CUGH’s network.
 
Bonus: The grand-prize winner will receive a free registration to CUGH’s annual meeting in February in Atlanta.

Deadline: Enter by November 15, 2024, at 11:59 p.m. EST. BLOOD DISORDERS Thalassemia’s Strain on Blood Supplies
  People with the genetic blood disorder thalassemia are not able to produce a sufficient amount of hemoglobin and require regular blood transfusions to prevent debilitating anemia. 

In Southeast Asia, the condition is so prevalent that more than a third of blood supplies go toward such transfusions.

• In Thailand and Laos, 30%–40% of donated blood is used to treat thalassemia patients. 

“We need blood banks for accidents, for childbirth, for dengue fever, hemodialysis, cancer and other diseases. But treating thalassemia is the single biggest use,” said Chanthala Souksakhone, head of the National Blood Institute at the Lao Red Cross.

GLOBAL HEALTH VOICES CLIMATE CRISIS In Defense of Biodiversity
Zoonotic diseases—caused by pathogens that spill over from animals to humans, like Ebola, mpox, and Lyme—sicken 2.5 billion people and kill 2.7 million every year. As global temperatures rise and humans disrupt ecosystems, the risk of these diseases is expected to rise.

• Deforestation, for instance, increases human encounters with animals acting as disease reservoirs, while climate change makes new regions hospitable to disease vectors like mosquitoes and ticks.

Natural barriers: Diverse ecosystems safeguard humans against a panoply of zoonotic illnesses by diluting the intensity of pathogen transmission among many species.

“We need to appreciate the value that the natural world offers to humanity, from an infectious disease-mitigation standpoint,” says University of Notre Dame professor Jason Rohr.

QUICK HITS Female Genital Mutilation Happens in America, Too – Thanks for the tip, Chiara Jaffe!

Millions of aging Americans are facing dementia by themselves –

France's Airports Report Increased Odyssean Malaria Cases –

State supreme court races could determine abortion access in several states –

Employers should be fined for unhealthy workplaces, says think tank –

Ukraine: Time to recognise ‘tremendous potential’ of demining –

Using genomics to find solutions to malaria –

A new way to support grandparents raising kids affected by the addiction epidemic – ?? Issue No. 2798
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 and follow us on Instagram and X .

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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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SCSD’s Distinguished Alumni Award ceremony will take place on Friday, October 25th?2024 from 4:30pm to 7pm

Kindly RSVP to (admin.scsd [at] mcgill.ca) before October 21st.

Refreshments will be served following the talk.

?

96 Global Health NOW: Russian Propaganda Targets Anti-Malaria Efforts; South Africa’s Femicide Crisis; and How DEI Hostility Affects Health Research October 15, 2024 Russian Propaganda Takes Aim at West African Anti-Malaria Programs
Pro-Russian propagandists are targeting Western-funded health care programs in Africa, spreading disinformation aimed at undermining scientists fighting malaria and other infectious diseases on the continent. 

A must-read New York Times report details a chilling example: Egountchi Behanzin, a French-Togolese activist, claimed on social media that malaria and dengue fever cases increased in Bana, Burkina Faso, after Target Malaria—a Gates Foundation-backed nonprofit—released genetically modified mosquitoes in the village in 2019.

• Village elders say they were consulted on the experiment, designed to create a species of mosquito that is unable to transmit malaria—and that malaria cases have actually fallen since the study’s launch.


• Behanzin—who denies receiving Russian funding, but often posts pro-Russian content—couldn’t provide any evidence to support his claims.

Part of a pattern: According to the U.S. State Department, Kremlin-paid African influencers and news outlets and Russian state-controlled media amplify each other—capitalizing on weakened trust in the West while silencing independent journalists.

• Russia has sponsored 80 documented disinformation campaigns in 22 African countries since 2022, per the Africa Center for Strategic Studies.

Lives at stake: “Any claims that our initiatives contribute to the spread of diseases are unfounded and detract from the critical goal of saving lives,” says Paulin Basinga, the Gates Foundation’s director for Africa.

GLOBAL HEALTH VOICES The Latest One-Liners   Nearly two million severely malnourished children are at risk of dying due to therapeutic food shortages in 12 hard-hit countries: Mali, Nigeria, Niger, and Chad have already run out of the high-protein ready-to-use food, or will soon; 8 more countries including Sudan, South Sudan, and DRC could run out by mid-2025.

Massive regional flooding has kept ~10 million children across Nigeria, Mali, Niger, and the DRC out of school this fall; the floods have displaced nearly one million people.

10 million pounds of ready-to-eat meat and poultry products made at an Oklahoma plant have been recalled by the company BrucePac of Oregon, after routine testing by U.S. Agriculture Department officials detected listeria bacteria, which can cause illness and death.

Adolescents between 12 and 18 with obesity given GLP1R treatments had a 33% lower risk of suicidal ideation or attempts compared to those treated with behavioral interventions in a study of 6,912 young people in Israel. DATA POINT VIOLENCE South Africa’s Femicide Crisis 
South Africa continues to have some of the highest femicide rates in the world—with intimate partner violence continuing to take a “devastating” toll, according to findings from the South African Medical Research Council’s new on femicide and intimate partner violence.

By the numbers:

• South Africa’s rate for intimate partner femicide is at 5.5 — almost 5X higher than in the rest of the world. 


• 60% of women murdered in 2020-2021 were killed by an intimate partner. 


• The Eastern Cape province has the highest rates for femicide, at almost 2X the country’s overall rate. 

No justice: The study also found “significant gaps” in convictions for such killings.

GHN EXCLUSIVE: TRANSLATED A statue to remember the victims in Bhopal, India. August 25, 2022. Pallava Bagla/Corbis via Getty Read “Bhopal: A Tale of Two Tragedies” in Chinese
We’re pleased to share another installment of GHN articles translated into Chinese, courtesy of our collaboration with the translation program at Queen’s University Belfast.
 
of Pranab Chatterjee’s piece, Bhopal: A Tale of Two Tragedies, on February 28, 2024.

Special thanks to: Chen-En (Ted) Ho, FHEA, senior lecturer at the Centre for Translation and Interpreting; Queen’s University Belfast translators Xinchen Li and Zhiwen Liu (翻译：李昕辰、刘至文); and reviewers: Yingren Wang and Yifan Wang (审校：王英人、王怡凡). GLOBAL HEALTH VOICES RACISM How DEI Hostility Affects Health Research 
U.S. institutes and initiatives created to research racism’s effects on health have increasingly found themselves under attack as the conservative backlash to DEI efforts leads to lawsuits, threats, and imperiled funding. 

Among the impacts:

• Researchers and instructors have found themselves on right wing “watchlists” for teaching on racism and public health.

• Some grant-making organizations are now asking some researchers to stop using the word “racism” when investigating public health inequities. 

• State lawmakers have introduced at least 85 anti-DEI bills since 2023.

• The Medical Board of California has been sued for requiring continuing medical education courses to include implicit-bias training.

“It’s very taxing. This anti-DEI movement creates a climate of fear,” said Chandra L. Ford, founding director of the Center for the Study of Racism, Social Justice & Health.

QUICK HITS US$ 1 billion in new and reaffirmed funding commitments announced for WHO’s ongoing Investment Round –

130,000 U.S. cancer cases went undiagnosed in Covid pandemic, study finds –

Hurricanes set new normal for hospital disaster prep –

CDC details 2023 trichinellosis outbreak linked to undercooked bear meat –

How Overdose Prevention Centers Became Political Scapegoats –

AI scans RNA ‘dark matter’ and uncovers 70,000 new viruses –

From Hurricane Milton to world hunger: How to make your donations count –

Public Health Has a Blueberry-Banana Problem – Issue No. 2797
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 and follow us on Instagram and X .

Please send the Global Health NOW free sign-up link to friends and colleagues:

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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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Nearly two million children suffering from severe wasting are at risk of death due to funding shortages for life-saving Ready-to-use-Therapeutic-Food (RUTF) to treat the condition, which is the most dangerous form of malnutrition.