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96 Global Health NOW: Revisiting Stockpiles as Mpox Spreads; The Power of the Promotoras Model; and DIY Injections September 25, 2024 Health workers walk between wards at the mpox treatment center at Nyiragongo General Referral Hospital, north of Goma, on August 17. Guerchom Ndebo/AFP via Getty Revisiting Stockpiles as Mpox Spreads
  The WHO is urging wealthy countries with smallpox vaccine stockpiles to give some of those doses to African countries that are still battling mpox empty-handed, .

• Smallpox vaccines have been shown effective against mpox, and an estimated hundreds of millions are in global stockpiles. They could help fight the outbreak as efforts to get mpox vaccines to the region continue to stall. 


• 鈥淩ight now we have an immediate need,鈥� said the WHO鈥檚 Maria Van Kerkhove. 

Closer to home: In addition to the need for international aid, empowering African leadership is critical right now, wrote a group of African authors in a .

• 鈥淯ltimately, successfully eliminating human-to-human transmission of mpox in Africa will come down to local public health action,鈥� the group wrote. 

Gaining traction: Meanwhile, there are worrying signs that mpox is making inroads in Kinshasa, the DRC鈥檚 capital city of 17 million, after a sharp uptick in cases鈥攍eading scientists to warn of a larger outbreak, .

And in India: Health officials confirmed the country鈥檚 first case of clade 1b mpox in a 38-year-old man who had recently traveled to Dubai, . 

Related: CDC Alerts on Mpox Prevention for Patients Heading to Areas With Clade I Outbreaks 鈥� GLOBAL HEALTH VOICES The Latest One-Liners   At least 210 women were charged with pregnancy-related crimes since Roe v. Wade was overturned in 2022鈥攎ore than in any other 12-month period since 1973, ; in most of the cases, women were accused not of violating abortion bans, but of child abuse, neglect, or fetus endangerment.

More than 1 in 3 children around the world are shortsighted, that points to excessive screen time and too little time outdoors; Asian children were most affected, with a prevalence rate of 85% in Japan and 73% in South Korea, versus 1% in Paraguay and Uganda.
 
Many hospitalized COVID-19 patients show worse cognitive function more than a year after their illness compared with those who weren't hospitalized, published in Nature Medicine.

Outbreak detection efforts in South and Southeast Asia remain 鈥渦nder-resourced鈥濃�攚ith only about half the countries studied currently including genomic surveillance initiatives in their national plans, published in Nature Microbiology. REPRODUCTIVE HEALTH The Power of the Promotoras Model
The landscape of reproductive rights in the U.S. is already byzantine鈥攂ut for newly arrived immigrants, it is even more confounding.

• For example: A recent community survey in New Jersey found that nearly 70% of Latinx immigrants did not know that abortion was legal in the state.

That is why more advocates are encouraging a public health outreach model for Latinx immigrants based on the 鈥減romotora de salud鈥濃�攐r community health worker.

• In the promotoras model, developed in Latin America in the 1960s, local residents serve as 鈥渢rusted messengers鈥� to share and gather health information. 

In New Jersey, the state鈥檚 Abortion Justice Committee has begun training and deploying promotoras to help provide immigrant communities information about reproductive and sexual health services. 

GLOBAL HEALTH VOICES TECH AND INNOVATIONS DIY Injections
In some regions where people struggle to access critical medicines, the problem is not a lack of drugs鈥攂ut the lack of medical providers to dispense them. 

That鈥檚 why new attention is focusing on medication delivery, and in particular: the syringe. 

Breakthrough delivery: Marc Koska, who invented the single-use auto-disable syringe in 1987, hopes to take that creation to the next level in the form of self-injectable syringes, preloaded with the exact dose of medication.

• 鈥淲e need to get to the point where people can say 鈥榓ll right, I can do this myself,鈥欌�� said Koska. 

Optimizing for access: While self-injectable syringes are already used for some medications like Ozempic, they are difficult to produce鈥攁nd only economically viable in the West. Koska鈥檚 model takes a different manufacturing tack to make the process more cost-effective. 

QUICK HITS 鈥榃e are not testing enough鈥�: new US bird flu cases stoke fears over poor response 鈥�

Will the UNGA meeting on AMR deliver results for the global south? 鈥�

A lead poisoning mystery: How 2 detectives fingered a surprising culprit 鈥�

Senate chairman demands answers from emergency rooms that denied care to pregnant patients 鈥�

Ozempic maker's CEO blames insurance companies for weight-loss drug prices 鈥�

Top Chinese vape firms research nicotine alternatives 鈥�

These Maternity Homes Offer Sanctuary, but It Can Feel Oppressive 鈥�

1 in 7 scientific papers is fake, suggests study that author calls 鈥榳ildly nonsystematic鈥� 鈥�

Health warning over face-slap fighting 鈥� Issue No. 2786
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: Holding the Polio Eradication Effort Hostage; Cancer Care Inequities Are Costing Kids' Lives; and A Refuge from Relentless Threats September 24, 2024 Holding the Polio Eradication Effort Hostage  
In northwestern Pakistan, village leaders frustrated by government neglect are boycotting polio immunization campaigns鈥攁llowing vaccinations only in exchange for services like electricity, water, paved roads, health care, or jobs鈥攗nwinding Pakistan鈥檚 progress against the virus.

• Two years ago, Pakistan appeared close to defeating polio, with no cases for over a year; this year so far, the country has identified 18 cases.

Global eradication effort at risk: The boycotters are aware of international pressure on Pakistan鈥攐ne of the last two countries where the disease is still endemic鈥攖o wipe out the disease. But it鈥檚 a misconception that some of the money spent on polio could be allocated to address other problems, says Abdul Sattar, a doctor who has worked on the polio campaign.
 
The Quote: 鈥淲e do care for our children, but we also know that the government concedes to our demands only when we stay away from polio drops,鈥� says Zeeshan Ali, a Kuki Khel tribesman who participated in a polio boycott that secured a government promise to repatriate people displaced by war.
 
GLOBAL HEALTH VOICES The Latest One-Liners   The Biden Administration plans to announce a donation today of 1 million mpox vaccine doses and at least $500 million to African countries in a bid to halt the spread.  

California cow herds infected with H5N1 bird flu doubled last weekend鈥攇oing from 17 last Thursday to 34 yesterday morning, making California second only to Colorado, which has confirmed 64 infected herds, among all affected states.
 
African countries鈥� longer life expectancies鈥攁nd the fastest growing senior population in the world鈥攈erald a sharp increase in dementia cases in coming decades; challenges include outdated detection technologies, insufficient research, and inadequate data.

The U.S. obesity rate is 鈥渉igh and holding steady鈥� at ~40%, per a of ~6,000 people, but the proportion of Americans with severe obesity has ticked up from a decade ago鈥攆rom ~8% to ~10%鈥攚ith women nearly 2X as likely as men to be affected. GHN EXCLUSIVE Q&A A boy who has cancer sits on a bed as he receives treatment at the Oncology Centre in Sanaa, Yemen, on November 10, 2020. Hani Al-Ansi/picture alliance via Getty Cancer Care Inequities Are Costing Kids Their Lives
An estimated 400,000 children and adolescents worldwide develop cancer each year. But only half are ever diagnosed鈥攁nd . More than 80% of children with cancer in high-income countries are cured, compared to less than 30% in many LMICs, . 

Compared to children in wealthier nations, kids in LMICs are more likely to experience:

• Delays in diagnosis.


• Lack of access to imaging, diagnostic testing, and medications.


• A scarcity of high-volume centers鈥攊mpeding access to specialized oncology, surgery, and radiotherapy expertise.


• Inadequate support services.

鈥淎ll of these barriers negatively impact survival rates,鈥� Andrew Kung, chair of the Department of Pediatrics at Memorial Sloan Kettering (MSK), says in a GHN exclusive Q&A.

Overcoming them requires global health care collaboration, adds Andreas Dracopoulos, co-president of the Stavros Niarchos Foundation (SNF). 

Looking forward: Kung and Dracopoulos are currently working with the , an MSK Cancer Center and SNF initiative, that aims 鈥渢o optimize outcomes for young patients globally by expanding clinical care expertise, educational and specialized training, and collaborative translational research,鈥� says Kung. DATA POINT MENTAL HEALTH A Refuge from Relentless Threats
Across Latin America, Indigenous environmental advocates seeking to protect ancestral lands from outside industries have faced ruthless repercussions: intimidation, incarceration, assassinations, or forced disappearances. 

鈥淚nvisible traumas鈥�: But targeted advocates also face profound mental suffering under such constant duress, including insomnia, panic attacks, depression, and suicidal ideation.

Places of healing: In response, a network of safe houses and temporary shelters is being created by groups of psychologists, social workers, and lawyers to support advocates鈥� mental health.

• The havens use different forms of therapy, arts and crafts, and educational workshops to help residents 鈥渂reathe, sleep and rest鈥濃�攁nd build resilience. 

Thanks for the tip, Cecilia Meisner! GLOBAL HEALTH VOICES VACCINES Lessons from Louisville  
Louisville, Kentucky, has been held up as a vaccination success by offering vaccinations through school clinics and raising vaccination rates 4% for kindergartners during the 2022鈥�2023 school year. 
 
But numbers have slipped once again鈥攁nd remain below the national threshold, part of a growing trend.

• 40% of American parents said vaccinating their child was 鈥渆xtremely important鈥濃��18% less than 2018. 

Louisville鈥檚 approach: Local officials believe they can get to herd immunity thresholds, citing support from the local health department, nursing schools, and city leaders鈥攂ut they have to overcome challenges including tight funding, misinformation, and bureaucratic rules that hamper doctors providing vaccines.



Thanks for the tip, Dave Cundiff! QUICK HITS The mosquito-bourne virus that's spreading without a cure 鈥�

The Downstream Effects of Fixing a Racist Lung Test 鈥�

Racism, other social factors may affect Asian Americans鈥� heart health 鈥嬧�嬧��

鈥嬧�婽he human cost of ghost networks 鈥�

Surrogates face higher risk of pregnancy complications, study finds 鈥�

Why climate change means more blood shortages: Q&A with HHS鈥� Rachel Levine 鈥�

The Secret to Getting Men to Wear Hearing Aids 鈥� Issue No. 2785
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: The Toll of Traumatic Injuries in Gaza; Strengthening Systems to Ready for a Pandemic Agreement; and Intelligent Infrastructure September 23, 2024 The Toll of Traumatic Injuries in Gaza
Life-changing injuries to people in Gaza are being severely undertreated, 鈥攍eaving them vulnerable to further physical and mental deterioration as the war there continues. 

A found that ~22,500 people are likely to have 鈥渁cute and ongoing rehabilitation needs鈥� that include extremity injuries, amputations, spinal cord injuries, and burns.

• But rehabilitation services 鈥渄o not come close to meeting the enormous surge in needs,鈥� the report found.


• Meanwhile, MSF estimates ~4,000 people in Gaza need reconstructive surgery. The organization has been able to treat only a fraction of those people in its specialized hospital in Amman. 

And yet: ~60% of requests for medical evacuations from Gaza are turned down, per the WHO鈥攊ncluding requests to evacuate wounded children. 

Adolescents are especially vulnerable to the 鈥渁cute stress鈥� from injuries they have suffered and will require long-term psychotherapy.

• 鈥淭his is a huge, tormenting catastrophe, and psychologically their minds are unable to bear all of this stress,鈥� said Ahmad Mahmoud Al Salem, an MSF psychiatrist in Amman. 

Related: 

鈥楩ear of war鈥� causing speech problems in Gaza 鈥�

UN to add nutrients to second round of Gaza polio vaccinations 鈥� GLOBAL HEALTH VOICES The Latest One-Liners   Whooping cough is surging in the U.S., which has reported over 4X as many cases compared with last year; unvaccinated teens and tweens are driving the surge in many states.

A second Missouri health worker who had contact with a hospitalized avian flu patient developed 鈥渕ild respiratory symptoms鈥� but was not tested for the virus, U.S. officials have reported.

U.S. trade regulators have sued the three largest pharmacy benefit managers for allegedly engaging in 鈥渁nticompetitive practices鈥� that boosted profits while inflating the list price of insulin.

A nasal spray flu vaccine will be available for home use starting next fall after the FDA expanded its approval of AstraZeneca鈥檚 FluMist; it will be the first flu vaccine that doesn't need to be administered by a health provider and will be sold direct to consumers. GHN EXCLUSIVE COMMENTARY A woman enters a pharmacy damaged in a Russian drone attack in Kharkiv, Ukraine, on January 31. Ivan Samoilov / Gwara Media / Global Images Ukraine via Getty Pandemic Agreement May Happen Eventually ... But Is the World Ready?    After the latest round of pandemic accord discussions wrapped up last week, 鈥攊ncluding in research and development, regulatory systems strengthening, and pandemic prevention and technology. Discussions will resume in November.
 
But countries don鈥檛 need to wait until WHO member states reach consensus to begin the essential, though perhaps less exciting, behind-the-scenes system-strengthening work to prepare for the accord鈥檚 implementation, .
 
He offers three ways that global health professionals and donors can help strengthen LMIC pharmaceutical systems now:

• Ensure adequate financing of national medicines regulatory authorities (NMRAs) tasked with ensuring new product safety.


• Strengthen pharmaceutical supply chains with an eye to long-term resilience.
  
  Example: Ukraine鈥檚 supply chain program for HIV and TB drugs that uses a network of local, private-sector logistics providers has been twice repurposed: for vaccine delivery during COVID, and again to move emergency medical supplies during the invasion.


• Establish pharmacovigilance to ensure newly introduced products remain safe.
  
  Example: A few years ago, Bangladesh鈥檚 NMRA established a web-based surveillance system to monitor the safety of a novel TB treatment, which is now used to monitor adverse reactions for all medical products.

GLOBAL HEALTH VOICES COVID-19: ORIGINS A Closer Look at Wuhan Market鈥檚 Wildlife 
Newly published research explores the possibility that wild animals brought to the Wuhan market were at the 鈥渆picenter鈥� of the COVID-19 pandemic. 

The , published last week in Cell, traces 鈥渨ith unprecedented granularity鈥� how SARS-CoV-2 was present at a specific part of the market where wildlife鈥攊ncluding raccoon dogs, palm civets, Himalayan marmots, and other creatures鈥攚ere kept and sold.

The genetic data used for the analysis were drawn from swabs taken at the market by Chinese scientists on Jan. 1 and Jan. 12, 2020, as the market was shut down. 

Ongoing controversy: Critics say the analysis depends on flawed and biased data, as 鈥淐hinese scientists were preferentially collecting data鈥� from areas where live animals were sold. 

ROAD SAFETY Intelligent Infrastructure
In the global quest to reduce traffic deaths, safety advocates are increasingly looking beyond driver behavior鈥攚ith more focus on cars and roads. 

Reactive roadways: One big-picture tool getting more attention is wireless technology known as 鈥渧ehicle to everything,鈥� or V2X, which allows vehicles to transmit information about speed, road conditions, and emergencies鈥攑rompting traffic signals to adapt accordingly to improve safety and flow.

• The goal: 鈥淓xtending a car鈥檚 perception 鈥� through communication with traffic infrastructure and other vehicles.鈥�

The challenge: Implementing the tech requires a 鈥渟ubstantial鈥� number of cars and infrastructure to be equipped with V2X for it to work effectively. 



Related:

14 children injured in accidents every day going to or from school 鈥�

California鈥檚 Anti-Speeding Bill Can Be a Traffic Safety Breakthrough 鈥� OPPORTUNITY QUICK HITS Jordan becomes first country to receive WHO verification for eliminating leprosy 鈥�

Nigeria's frontliners are learning fast to get ahead of mpox 鈥�

Why Big Tobacco is betting on Trump 鈥�

Doctors Said These Women鈥檚 Mutated Genes Wouldn鈥檛 Harm Them 鈥�

Tackling period poverty in Lebanon鈥檚 refugee camps 鈥�

Could an Old Drug Protect Against a New Pandemic? 鈥�

Scientists are building giant 鈥榚vidence banks鈥� to create policies that actually work 鈥�

Time for a noodle tax?: Doctor who sounded alarm on ultra-processed food urges tougher action 鈥�

Long-overlooked scientist shares Lasker Award with other GLP-1 researchers 鈥� Issue No. 2784
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: The Sharp Bite of Inequity; Anesthesia Without Capnography: 鈥楲ike Flying Blind鈥�; and Drunk Worms and Pigeon-Led Weapons September 19, 2024 A man extracts venom from a poisonous snake at Queen Saovbha Memorial Institute, in Bangkok, on February 17, 2022. Matt Hunt/SOPA Images/LightRocket via Getty The Sharp Bite of Inequity
Each year, ~5.4 million people worldwide are bitten by snakes鈥攌illing ~80,000, and leaving ~240,000 people with long-term or permanent disabilities, , recognizing today as International Snakebite Awareness Day.
 
The poorest and most isolated are particularly at risk: Most snakebites occur in rural areas of Asia, Africa, and Latin America, where antivenoms are scarce, .
 
Gross inequities: MSF鈥檚 Matthieu Chevallier of the gross inequities at play鈥攆rom the likelihood of encountering a venomous snake and being bitten to having protection like basic shoes and adequate shelter. There鈥檚 also the question of access to treatment.
 
鈥淎s soon as you are bitten, the clock starts ticking,鈥� he writes. Fast care is crucial鈥攂ut in places like northeastern , it takes ~12 hours to get to a clinic. And even if a victim makes it there, many facilities don鈥檛 have treatments available. In Kenya, Uganda, and Zambia less than a third of the facilities had antivenom on hand.
 
The details an ambitious plan to tackle the problem鈥攂ut it is still grossly underfunded. Support from the , one of the few funding sources, is set to end soon and no new donors have stepped up.
 
Why the funding shortage? For one thing, snakebite is not a health security threat for donor countries; there鈥檚 no risk of cross-border contamination. GLOBAL HEALTH VOICES The Latest One-Liners   The U.S. health system ranked dead last among 10 peer nations, 鈥攄espite the fact that Americans pay nearly double the amount that people in other nations pay.
 
Humor can be an effective way to reach people who would otherwise avoid life-saving information about colorectal cancer screening or other health messaging, .

The only two manufacturers still producing formula for premature infants are threatening to leave the market amid hundreds of lawsuits over safety labeling; the companies are being sued by families whose infants got sick or died after being given one of the formulas involved in a U.S. recall two and a half years ago.
 
The Los Angeles area is seeing more cases of dengue fever in people who haven鈥檛 left the U.S. mainland; public health officials said at least three people apparently became ill with dengue this month after being bitten by mosquitoes. GHN EXCLUSIVE A capnograph surgical monitoring device in a facility in Uganda. Muhwezi Davis, courtesy of SmileTrain / Lifebox. Anesthesia Without Capnography: 鈥楲ike Flying Blind鈥�   鈥淭he color of her blood darkened. That鈥檚 how I knew that my patient was starved of oxygen,鈥� , recounting a harrowing incident when she was an anesthesia resident in Kenya, back in 2001, and the surgical team had trouble intubating the patient.
 
A simple device could have helped: Had the operating room been equipped with a capnograph鈥攁 noninvasive device that monitors how adequately a patient is breathing鈥攊t would have been clear immediately that the intubation tube wasn鈥檛 placed correctly. Administering anesthesia without it, says Gathuya, is 鈥渓ike flying blind.鈥�

• Capnography has been widely used in operating rooms in high-income countries for over 30 years; it helped lower anesthesia-related complications and deaths dramatically after it was introduced in the U.S. in 1991.


• However, most operating rooms in Kenya still do not have a capnograph; in many low-income countries, the device is not available at all.

How to close the gap: The WHO must answer the call to include capnography as essential monitoring in anesthesia guidelines鈥攁s detailed in a by global health organizations at the , which closes today in South Africa. GLOBAL HEALTH VOICES VACCINES Vaccine Catch Up in North Korea 
After a four-year lapse in routine vaccinations, a major catch-up campaign is underway in North Korea to protect against measles, rubella, tetanus, diphtheria, tuberculosis, hepatitis B, and polio.

The country鈥檚 low vaccine coverage rate leaves kids vulnerable to severe illness and death from disease. It also greatly increases the risk of vaccine-preventable disease outbreaks.

• By the numbers: 7,200 UNICEF-trained health workers will administer vaccines to 800,000 children and 120,000 pregnant women.

UNICEF is also sending fridges and freezers to local health centers to store ~2 million additional doses for continued routine vaccinations.

ALMOST FRIDAY DIVERSION Drunk Worms and Pigeon-Led Weapons: The Iggys Are Back!
Only one scientific awards ceremony feels like 鈥渁 mixture between Monty Python and The Muppet Show鈥�: .

The annual gala鈥攁lso known as 鈥淭he Iggys鈥濃�� aims to spur interest in science by making 鈥減eople laugh, then think,鈥� . While winners鈥� contributions are unusual, they are 鈥渘ot to be laughed at鈥�or, not to be exclusively laughed at,鈥� explained organizer Karen Hopkin. 

Among this year鈥檚 laureates, :

• A Japanese team that discovered many mammals can breathe through their anuses.

• A Dutch-French team that used chromatography to separate drunk and sober worms. 

• American psychologist B.F Skinner, posthumously awarded for attempting to use pigeons to guide missile flight paths. 

The prizes: Actual Nobel laureates presented winners with a range of trophies, including an 鈥渙bsolete Zimbabwean ten trillion-dollar bill,鈥� . QUICK HITS A gold mining town in Congo has become an mpox hot spot as a new strain spreads 鈥� 

From dodgy deterrence deals to drug cartels: Aid barriers in the Dari茅n 鈥� 

Bulletproofing America鈥檚 Classrooms 鈥� 

MomConnect turns 10: Why the state could soon send flood and heatwave warnings to pregnant women 鈥� 

Today is the first Disabled Women鈥檚 Equal Pay Day 鈥� 

Q&A: Former NIH director Francis Collins on a Trump administration, science, and God 鈥� 

How do you help young Afghan refugees heal? A new program in Maine offers a way 鈥� Issue No. 2783
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: The Purdue Playbook鈥檚 International Influence; Hope Amid South Africa鈥檚 Heroin Epidemic; and Risk Reduction Starts at Home September 18, 2024 The Purdue Playbook鈥檚 International Influence
While Purdue Pharma is bankrupt and facing a torrent of litigation in the U.S., its global counterparts are still profiting in the hundreds of millions from opioid sales, a joint investigation by a collaboration of journalistic publications in eight countries has found, . 

Overview: The multinational company Mundipharma made $531 million in profits from nine of its companies in Europe and Australia between 2020 and 2022 alone.

• Among the beneficiaries: The Sackler family, which owns Mundipharma鈥攁nd which faces ongoing litigation over Purdue鈥檚 alleged role in the U.S. opioid crisis.

Old playbook: The investigation found that the company has adapted its old tactics used in the U.S. to persuade international doctors to prescribe painkillers, .

• In Germany: Mundipharma sponsored a patients group that encourages opioid use.


• In Brazil: The company paid doctors to hold classes on treating pain.


• In China: An internal company investigation raised concerns that scientific advisory boards were promoting products.


• In Italy: Prosecutors have accused Mundipharma managers of paying kickbacks to doctors. 

The Quote: 鈥淲e are entering into the same situation in Europe as in the United States 15 years ago,鈥� said Andrea Burden at ETH Zurich university. GLOBAL HEALTH VOICES The Latest One-Liners   Cancer cases are rising and affecting people at younger ages in the U.S., but survivorship is also up: Death rates fell by a third between 1991 and 2021, per a new .

The XEC COVID variant is quickly gaining traction and could become the dominant subvariant over the winter months, scientists project.

Trachomatous trichiasis鈥攁 condition where inward-turned eyelashes scratch the front of the eye and potentially cause blindness鈥攃an successfully be treated by two common types of eyelid surgery, a published in PLOS Neglected Tropical Diseases has found.

Moderate caffeine consumption was found to be associated with a lower risk of developing cardiometabolic multimorbidity (the coexistence of at least two cardiometabolic diseases), per a new published in the Journal of Clinical Endocrinology & Metabolism. OPIOID CRISIS Hope Amid South Africa鈥檚 Heroin Epidemic
Heroin usage has exploded across South Africa, with ~400,000 using the drug every day.

• Between 2011 and 2020, the rate of opioid-related disorders rose by 12% a year, found. 

Seeking new solutions: In Pretoria, a locally focused methadone and social support program is showing promise.

• Instead of a rehab model, the (COSUP) offers drop-in centers, where people who use heroin can access methadone and counseling. 

Gaining traction: Since its launch in 2016, COSUP has administered methadone to 2,400 people, and 70% of patients who started treatment at the centers were still coming for doses six months later.

GLOBAL HEALTH VOICES WILDFIRES Risk Reduction Starts at Home  
Wildfire risk reduction often focuses on forests鈥攂ut houses are sources of fuel for fires, too, and better building practices could lower risk.

• Older homes with wooden roofs, decks, or framing are more likely to catch fire and ignite surrounding houses.

What could help: Implementing new building codes for wildfire-prone areas and adapting older homes and neighborhoods. But retrofitting efforts face a lack of funding and policy support.

• New homes built after 2008 in California were 40% less likely to burn down.


• Currently, California, Nevada, and Utah are the only states with mandatory wildfire risk building codes.

OPPORTUNITY QUICK HITS This preventive drug could be a 'game changer' in ending the HIV epidemic 鈥�

The United States Isn't Ready for a Bird Flu Epidemic 鈥�

Evidence growing for COVID antivirals to cut poor outcomes, long COVID, experts say 鈥�

Chronic Illness and Quality of Life 5 Years After Displacement Among Rohingya Refugees in Bangladesh 鈥�

Second vote, same result: Senate Republicans block IVF protection bill 鈥�

FIFA teams up with WHO on global concussion campaign 鈥�

Should young kids take the new anti-obesity drugs? What the research says 鈥�

鈥業mmortal鈥� creatures may reveal clues to contagious cancers 鈥� Issue No. 2782
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 Join HHS Asst. Secretary Micky Tripathi at a Hopkins-Harvard Event: AI in D.C. September 17, 2024 You鈥檙e Invited: Making AI a Lifesaver / A Hopkins-Harvard Event in D.C.
Please join U.S. Health and Human Services Assistant Secretary Micky Tripathi and other experts for a thought-provoking discussion about creating the best possible artificial intelligence for public health.    You鈥檙e invited on October 8 to an evening of insights, conversation, and refreshments at the new Johns Hopkins University Bloomberg Center in Washington, D.C., sponsored by Hopkins Bloomberg Public Health magazine, Global Health NOW, and Harvard Public Health.     
Policy, research, and private sector experts will explore AI鈥檚 astonishing potential to transform how we confront public health challenges鈥攁nd its technical, ethical, and privacy risks.  

• Micky Tripathi, assistant secretary for Technology Policy; national coordinator for Health Information Technology; and acting chief artificial intelligence officer, U.S. Department of Health and Human Services.

• Jesse M.鈥疎hrenfeld, immediate past president, American Medical Association. 

• Elizabeth Stuart, PhD, Frank Hurley and Catharine Dorrier Professor and Chair, Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health. 

• John Auerbach, senior vice president, ICF; and former commissioner, Massachusetts Department of Public Health.  

• Moderator: Alison Snyder, managing editor, Axios.

Hopkins Bloomberg Public Health magazine, Global Health NOW, and Harvard Public Health invite you to an evening of enlightening discussion, networking, and refreshments at the new Johns Hopkins University Bloomberg Center in Washington, D.C. 
Details:  Tuesday, October 8 

• 6鈥�7 p.m.: Networking reception  
• 7鈥�8 p.m.: Panel and Q&A 
• 8鈥�8:30 p.m.: Dessert 

Hopkins Bloomberg Center  555 Pennsylvania Avenue NW  Washington, D.C.  * Attendees must register separately.    More information: Contact Executive Editor Brian W. Simpson  
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 Bloomberg School.


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96 Global Health NOW: Early Warning Systems Vital for Kenya; Immunizations Halted in Afghanistan; and Looking to Soccer to Solve Scientist Compensation September 17, 2024 GHN EXCLUSIVE REPORT Children at Nduru camp are often left alone during the day as their parents look for food. Nduru camp, Kisimu City, Kenya. August 16, 2024. Scovian Lillian Early Warning Systems Vital for Climate Risk Preparedness in Kenya  
KISIMU CITY, Kenya鈥擬onths after last April鈥檚 floods, clusters of white tarp shelters, crammed onto an acre of land in southwestern Kenya, still house ~1,000 families displaced by the disaster.

• The floods left a trail of death, displacement, and disease across large swaths of the country, .


• Flooding destroyed latrines and created poor water and sanitation conditions that fueled the spread of infectious diseases; Tana River County alone .

Could a stronger early warning system have saved lives? last May identified a significant gap in the integration of environmental factors into Kenya鈥檚 EWS and disease surveillance systems.

• Including early warning weather indicators, especially during flooding, would allow authorities to better anticipate outbreaks of waterborne diseases like cholera and vector-borne diseases like malaria following disasters, the authors say.

More EWS-strengthening recommendations:

• Shore up labs, equipment, health information systems, and networks.


• Train local health workers to detect early signs of health crises caused by flooding and respond swiftly鈥攅.g., by preemptively distributing cholera kits, mosquito nets, and other resources to reduce the impact of potential outbreaks.

Ed. Note: Scovian Lillian is an independent journalist focused on science and health in Nairobi, Kenya. This article is part of , made possible through the generous support of loyal GHN readers. DATA POINT The Latest One-Liners   Climate change will intensify the child malnutrition crisis, ; between now and 2050, 40 million more children will have stunted growth and 28 million more will suffer from wasting as a result of climate change.
 
Critical gender gaps persist in all 17 of the Sustainable Development Goals, that says governments are missing out on massive economic gains by failing to invest in women and girls; e.g., the global cost of inadequately educating young people exceeds $10 trillion a year.
 
UC Santa Barbara researchers mapped the changes to a woman鈥檚 brain during pregnancy and post-partum, finding major changes including reductions in gray matter (not necessarily bad); the study kicks off a larger project the researchers hope could yield important clues about post-partum depression.

There is evidence of human exposure to at least 3,600 chemicals that leach into food in the manufacturing, processing, packaging, and storage of food supply, 鈥攖he first to systematically link the chemicals used in materials to package and process foods to human exposure. VACCINES Immunizations Halted in Afghanistan
The Taliban have suspended polio vaccination campaigns in Afghanistan鈥攁 devastating setback that could undo years of progress toward polio eradication, UN officials said Monday. The move comes at a time when groups of unvaccinated children have been exposed to an outbreak.

• Afghanistan and Pakistan are currently the only countries in which the paralyzing has never been eliminated.


• The WHO confirmed 18 polio cases in Afghanistan this year鈥攗p from six in 2023.

A WHO official said discussions are underway to start vaccinating in locations like mosques鈥攁lthough the mosque-to-mosque approach as house-to-house campaigns.

The Taliban鈥檚 decision will likely have major repercussions for neighboring countries. In August, the WHO warned that setbacks in Afghanistan pose a risk to Pakistan鈥檚 program, due to high population movement.



Related: 

Two killed in attack on Pakistani polio vaccination team 鈥�

Taliban begins enforcing new draconian laws, and Afghan women despair 鈥� GLOBAL HEALTH VOICES PANDEMIC PREPAREDNESS Looking to Soccer to Solve Scientist Compensation
As the Paris Peace Forum began rethinking pandemic preparedness, it hit on a glaring disparity: 

Scientists in South Africa and Botswana who first identified the omicron variant of COVID-19 ended up 鈥渓ast in line鈥� to obtain the medical tools that resulted from their research. 

To fix that, the Forum suggests looking to an unlikely model: FIFA.

• The international soccer federation has a benefit-sharing plan that 鈥渞ewards grassroots contributions and redistributes benefits, promoting a fair balance of interests across diverse economic contexts,鈥� a of the model鈥檚 potential explains. 

A global health equivalent: The Forum suggests creating a 鈥渃entralized clearinghouse鈥� used to incentivize data sharing and reward scientists for their contributions.

QUICK HITS For people with opioid addiction, Medicaid overhaul comes with risks 鈥� Thanks for the tip, Dave Cundiff!

Abortion bans have delayed emergency medical care. In Georgia, experts say this mother's death was preventable 鈥�

The plan to give WHO's snake venom strategy more bite 鈥�

Arizona cracked down on Medicaid fraud that targeted Native Americans. It left patients without care. 鈥�

Mpox and breastmilk: for once, can we act in time? 鈥�

Why global health organizations are hiring chief AI officers 鈥� Issue No. 2781
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: Missouri H5N1: More Questions Than Answers; Compounding Crisis in the Dari茅n Gap; and The (Gorilla) Doctor Is In September 16, 2024 University of Massachusetts Boston assistant professor Nichola Hill, who studies infectious diseases, including bird flu, on May 7, in Boston. Suzanne Kreiter/The Boston Globe via Getty Missouri H5N1: More Questions Than Answers
The source of a human H5 avian flu case in Missouri is still unknown鈥攖hough initial genetic testing suggests it's related to the strain of virus currently affecting dairy cattle in the U.S., CDC officials have said, . 

• The investigation has shown no evidence of human-to-human spread and no link to raw dairy products. So far, there has been no unusual rise in Missouri鈥檚 flu activity.


• But: The CDC Friday that a household contact of the H5-positive Missouri patient also became ill on the same day鈥攖hough the second person was not tested, and the cause of the illness is unknown, . 

More coordination needed: Meanwhile, a WHO official said the situation in the U.S. points to a need for better collaboration between the agricultural sector and public health organizations to establish 鈥渁 complete picture,鈥� .

• A lack of universal testing of dairy farms means scientists still don鈥檛 know the true scope of the spread, .

Among animals: California reported two more H5N1 outbreaks in dairy cows. Since March, the USDA has confirmed H5N1 in 203 herds across 14 states. GLOBAL HEALTH VOICES EDITOR'S NOTE Beyond Back-to-School   GHN is a great tool for students and professors鈥攂ut the career-boosting benefits last long after graduation. Our community of 50,000+ readers from 170+ countries includes many 鈥渓ifelong learners鈥� fascinated by global health.
 
If you鈥檙e one of them, the best way you can show your support is by sharing our . Let colleagues and friends know that GHN can help them:

• Keep up with essential global health news.


• Learn from global health leaders around the world and get ideas for advancing global health causes.


• Network and learn about career-advancing opportunities.

We love hearing from you, too! Let me know what topics you think deserve more attention. Thanks for sharing! 鈥�Dayna The Latest One-Liners   A Nipah virus death in Kerala, India, is the region鈥檚 second reported since July; five other people have developed primary symptoms of the virus, and 151 contacts are being monitored.

A wild poliovirus case has been detected in Pakistan, and 15 additional positive environmental samples were reported in the country鈥攕uggesting 鈥渨idespread circulation鈥� of the virus and that Pakistan is 鈥渘ot on track鈥� to interrupt transmission.

The WHO prequalified its , MVA-BN, and established an 鈥渁ccess and allocation mechanism鈥� to ensure that countermeasures including vaccines, treatments, and tests are distributed 鈥渆ffectively and equitably.鈥�

An Austrian court has found a 54-year-old woman guilty of grossly negligent homicide after infecting her neighbor with a fatal case of COVID-19. ENVIRONMENTAL HEALTH Compounding Crisis in the Dari茅n Gap
The dense rainforest of the Dari茅n Gap has long been considered inaccessible, shielding Indigenous communities and the region鈥檚 rich biodiversity from outside impact. 

But the surge of migration through the region over the last five years has brought unprecedented pollution to the rainforest鈥攖hreatening the local ecosystem and the health of people who depend on it, community leaders say.

• 鈥淪uddenly we found ourselves flooded with trash. It鈥檚 worrying because we depend on our local ecosystem for everything. It鈥檚 our source of life,鈥� said Yenairo Aji, a community leader in the village of Nueva Vig铆a. 

Not just trash: Critical waterways have become contaminated with human waste and gasoline鈥攚hich could take decades to remediate.  

GLOBAL HEALTH VOICES CLIMATE Trees as Treatment   
Planting trees in urban areas has known climate benefits: cooling, pollution control, and stormwater absorption. 

But what does it do for human health? 

University of Louisville researchers are starting to answer that question, with the recently released 鈥斺�渁 clinical trial where trees are the medicine.鈥�

• Researchers followed 700+ residents across a four-square-mile area where ~8,000 trees and shrubs were planted. 


• Residents of greened neighborhoods had 13%鈥�20% lower levels of a blood marker of general inflammation compared to residents of neighborhoods without new greenery.

Up next: This fall, researchers will plant a 鈥渕icroforest鈥� downtown that will serve as a field site to investigate a variety of health and environmental metrics.

PHARMACEUTICALS The (Gorilla) Doctor Is In   
Plants consumed by 鈥渟elf-medicating鈥� gorillas in Gabon have antibacterial and antioxidant properties and may yield promising clues to developing new drugs,. 

• The researchers focused on four trees consumed by western lowland gorillas that local healers highlighted for potential medicinal benefits. 


• All four trees showed antibacterial activity against E. coli strains, as well as high levels of antioxidants. 

Biodiversity lessons: The research demonstrates how scientists might learn from these critically endangered gorillas as well as other under-studied animals and plants in Central Africa鈥檚 richly diverse, little-explored forests.
 
QUICK HITS Nurses working in fear: BBC visits mpox epicentre 鈥�  

Breaking the conformity of global health 鈥�

1 in 7 moms in SA are teens. We dive into the numbers 鈥�

New Report Highlights U.S. 2022 Gun-Related Deaths: Firearms Remain Leading Cause of Death for Children and Teens, and Disproportionately Affect People of Color 鈥�

She Ate a Poppy Seed Salad Just Before Giving Birth. Then They Took Her Baby Away. 鈥� Thanks for the tip, Cecilia Meisner!

Gas stoves may soon come with a tobacco-style health warning label in California 鈥�

HHS updates rules for probing research misconduct 鈥�

New Version of Reth茅 Project to Promote African Scientific Writing 鈥�

Barcelona children find safety in numbers as they bike to school in herds 鈥� Issue No. 2780
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: Pesticide Bans Slow Suicides in Nepal; New Tickborne Virus Discovered in China; and Nacho Average Side Effect September 12, 2024 Pesticide Bans Slow Suicides in Nepal
A few years ago, pesticides鈥攐r 鈥減lant medicines,鈥� as the locals called them鈥攚ere used in roughly a third of Nepal鈥檚 suicides.
 
鈥淲hat if the pesticide had not been on the market?鈥� wondered one doctor, Rakesh Ghimire, recognizing that most suicides are impulsive, and the chemicals were too easily available.
 
The eye-opening turning point: Ghimire helped launch a ban on the sale and import of eight pesticides in 2019. Deaths began to fall鈥攂y as much as 30% by 2023.
 
It鈥檚 not just Nepal: Globally, pesticide consumption is linked to ~140,000 suicide deaths each year鈥攎ost in LMICs, 鈥渨here the toxins can still be bought in small bottles for just a few pence in local shops.鈥�

• After phasing out or banning dangerous pesticides, Sri Lanka, Bangladesh, and South Korea all saw suicides linked to the hazardous products fall dramatically鈥攚ithout damaging agricultural yields.


• Most countries in the West鈥攚here most pesticide manufacturers are based鈥攈ave already banned or restricted use of potentially lethal pesticides.

But 鈥渂ans alone will not solve the problem,鈥� Ghimire says.

• Ghimire and others developed the country鈥檚 first treatment guidelines, which led to Nepal鈥檚 first Poison Information Center鈥攁 Brown University-funded effort that provides a 24/7 advice hotline for health workers across Nepal.


• Also needed: more mental health services鈥攁nd erasing stigma.

GLOBAL HEALTH VOICES The Latest One-Liners   A quarter of those injured in Gaza by July 23鈥攁bout 22,500 people鈥攁re estimated to have life-changing injuries that require rehabilitation services, per a new WHO analysis.
 
More women opted for tubal ligations after the 2022 overturning of Roe v. Wade, based on insurance claims data鈥攁nd states that banned abortion showed the largest rise in the procedure, 3% each month.

India鈥檚 expanded health coverage will provide people 70 and older with annual coverage of $6,000 per family鈥攁 plan expected to benefit 60 million citizens.

An NIH-funded database is slated to shut down this weekend, cutting off access to molecular information on parasites and fungi that cause a range of infectious diseases, from malaria to Chagas disease; parasitologists and vector biologists say planned replacements are inadequate and critical research will suffer. TICKBORNE ILLNESSES New Tickborne Virus Discovered in China
In June 2019, a patient with a fever and organ dysfunction reported being bitten by a tick in a wetland park in Inner Mongolia, in northeastern China.
 
Researchers conducted next-generation sequencing to determine the origin, revealing a new tickborne illness called Wetland virus (WELV), earlier this month.

• People infected with WELV most commonly 鈥減resented with nonspecific symptoms, including fever, dizziness, headache, malaise, myalgia, arthritis, and back pain,鈥� the researchers report, per .

• Since identifying the new virus, researchers have collected and analyzed thousands of ticks and tested hundreds of animals and people for the virus.

Experiments in mice lead researchers to believe WELV can also infect the brain and cause serious nervous system infections.

Thanks for the tip, Cecilia Meisner! GLOBAL HEALTH VOICES MATERNAL HEALTH Delivering with Dignity ... for All
Despite policies to safeguard the rights of people with disabilities in Malawi, pregnant women with disabilities suffer extra challenges鈥攚ith mistreatment, miscommunication, and discrimination affecting their access to care.

• Myths, such as women with disabilities having different biology, perpetuate false stereotypes.

• Patients with disabilities鈥攅specially speech and hearing impairments鈥攐ften must rely on friends and guardians to communicate due to a lack of medical professionals trained to meet their needs.

• Infrastructure such as bathrooms, ambulances, and labor wards are not special needs-friendly, providing little privacy. 

鈥淭his is a serious problem in Africa 鈥� It can lead to risks of complications, maternal morbidity and mortality for pregnant women with disabilities,鈥� says Mussa Chiwaula, director general of the Southern Africa Federation of the Disabled, an organization lobbying for an inclusive health care system. 



Related: I'm Embarrassed to Admit I Have No Idea How to Care for Patients With Disabilities 鈥� ALMOST FRIDAY DIVERSION Nacho Average Side Effect
The magical powers of Doritos dust are well-known to those of us who have polished off a bag鈥檚 finger-licking orange remnants鈥攂ut 鈥渪-ray vision鈥� has not typically been on the list. 

Until now: In a head-spinning (and stomach-spinning) new published in Science, scientists demonstrated how the same dye used in Doritos and other snacks鈥擸ellow No. 5, also known as tartrazine鈥攃an render mice skin temporarily transparent, giving scientists a window into pulsing vessels and organs beneath.

• 鈥淚t鈥檚 not magic, but it鈥檚 still very powerful,鈥� said biophotonics researcher Christopher Rowlands. 

How does it work? While the clarifying phenomenon may sound preposterous to all parents who have laundered their children鈥檚 post-picnic t-shirts, it works because of optical physics.

• When skin absorbs the dye, it changes how blue wavelengths are refracted by the animal tissues.

Something to chew on: The discovery of such a simple, reversible, and potentially non-toxic tool could transform medical and scientific imaging, researchers say.

Thanks for the tip, Xiaodong Cai!

Related: US cave system鈥檚 bats and insects face existential threat: discarded Cheetos 鈥� QUICK HITS The midwives who stopped murdering girls and started saving them 鈥�

How a Maine County Jail Helped Prisoners Blunt Opioid Cravings 鈥�

How a Video Game Community Became a Mental Health Support System for Military Veterans 鈥�
  Estimate: COVID vaccines saved up to 2.6 million lives in Latin America, Caribbean 鈥�

Suspicious phrases in peer reviews point to referees gaming the system 鈥�

The clown doctor will see you now 鈥� and you鈥檒l get better, quicker 鈥� Issue No. 2779
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: Abortion Takes Center Stage in U.S. Presidential Debate; Tragic Consequences of 鈥楾he Switch鈥�; and Baaa-d Lettuce to Blame September 11, 2024 Former U.S. President Donald Trump and U.S. Vice President Kamala Harris at last night's presidential debate in Philadelphia. Doug Mills/The New York Times/Bloomberg via Getty Abortion Takes Center Stage in U.S. Presidential Debate
Reproductive rights were a central鈥攁nd incendiary鈥攖opic at the first presidential debate between Vice President Kamala Harris and former President Donald Trump Tuesday night, . 

Harris roundly criticized Trump for his role in overturning Roe v. Wade and condemned state-level abortion bans, sharing stories of pregnant women unable to access critical care, .

• She pledged that if Congress passed a bill reviving abortion protections, she would 鈥減roudly sign it into law鈥� if elected president. 

Trump refused to answer whether he would veto a federal abortion ban鈥攊nsisting it wasn鈥檛 an issue because Congress would not pass such a bill.

• He falsely claimed that most legal scholars wanted Roe overturned.

Key context: 10 states are set to vote on abortion rights on Nov. 5, and a range of polls show that Americans access to abortion. 

Other health points: 

On the Affordable Care Act: While Trump again expressed interest in overturning the health law, he described having only 鈥渃oncepts of a plan鈥� to replace it, .

• Harris, meanwhile, pledged to expand drug pricing reforms and to 鈥渕aintain and grow the Affordable Care Act,鈥� . 

On the pandemic: COVID-19 got brief attention as Trump said his administration 鈥渄id a phenomenal job with the pandemic,鈥� and Harris said the former president 鈥渓eft us the worst public health epidemic in a century,鈥� . GLOBAL HEALTH VOICES The Latest One-Liners   U.S. maternity care deserts are growing, according to a ; half of all U.S. counties lack a hospital equipped to offer obstetric care, and more than a third do not have a single obstetric clinician.

Healthy Black women in the U.S. were ~20% more likely to receive unnecessary, unscheduled C-sections than white women with similar medical histories鈥攅specially when operating rooms were unbooked鈥攑er based on 1 million births in New Jersey hospitals.

Most people over age 70鈥攅ven those without a history of cardiovascular disease鈥攕hould consider taking statins, according to that linked the cost-effective treatment to better health outcomes for that age group.

Early puberty in girls may be triggered by an endocrine-disrupting chemical compound found in a wide variety of cosmetic and cleaning products, according to published in Endocrinology. POLIO Tragic Consequences of 鈥楾he Switch鈥� 
The polio outbreak now prompting an emergency vaccination campaign in Gaza stemmed from 鈥渁 fateful decision鈥� in 2016 by global health organizations to change the oral polio vaccine. 

The intent: The move, dubbed 鈥渢he switch,鈥� involved removing the Type 2 virus from the vaccine to prevent the rare risk of vaccine-derived polio.

How it backfired: Problems in the execution of the vaccine鈥檚 rollout left more children vulnerable to poliovirus Type 2. Cases of vaccine-derived Type 2 polio have increased 10X since before 2016, affecting dozens of countries and paralyzing 3,300+ children.

A formal evaluation has now called the move 鈥渁n unqualified failure.鈥�

 

Related: Polio vaccination starts in north Gaza despite obstacles 鈥� GLOBAL HEALTH VOICES CANCER Tribes Seek Answers 
As cancer cases proliferate on the remote Duck Valley Indian Reservation, leaders of the Shoshone-Paiute tribes living there are demanding answers from the U.S. government about chemicals that could have contributed to 鈥渨idespread illness.鈥�

Questions About Agent Orange: Toxins have been found in the reservation鈥檚 soil, and petroleum is in the groundwater. But the recent discovery of a decades-old document has raised more fears:

• In the 1997 document, government officials mention using Agent Orange chemicals to clear foliage along widely used reservation canals. 

While federal agencies have promised an investigation, details remain scarce. 

Meanwhile: The tribal health clinic has logged 500+ illnesses since 1992 that could be cancer. 

CLIMATE CRISIS & FOOD SAFETY Baaa-d Lettuce to Blame
Lettuce contaminated by sheep feces was the likely source of a 2022 outbreak of Shiga toxin-producing E. coli, U.K. public health officials say.

A found that climate change鈥搑elated heavy rainfall and flooding washed the feces into lettuce fields. Investigators found no failures by the lettuce grower.

• The tainted lettuce sickened 259 people, 75 of them requiring hospitalization, in August and September 2022.

The investigation鈥檚 authors wrote that climate change will fuel more outbreaks like this one, but added:

• 鈥淣ew techniques could help to predict and prevent future outbreaks and inform risk assessments and risk management for farmers growing fresh produce for people to eat.鈥�

OPPORTUNITY QUICK HITS

Bird Flu Is Quietly Getting Scarier 鈥�

Deadlier drugs, younger addiction and no help in sight 鈥�

White House announces rule that would cut insurance red tape over mental health and substance use disorder care 鈥�

Perceptions of HIV self-testing promotion in black barbershop businesses: implications for equitable engagement of black-owned small businesses for public health programs 鈥�

Diabetes drug helps the immune system recognize reservoirs of HIV, study discovers 鈥�

Apple Will Sell Air Pods With Hearing Aids Built In 鈥�

Whatever happened to ... the Brazilian besties creating an mRNA vaccine as a gift to the world 鈥�

Issue No. 2778
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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96 Global Health NOW: Lockdowns鈥� Effects on Teenage Brain Development; 鈥楧eadliest Year鈥� for Aid Workers; and Dangers Percolating at Fur Farms September 10, 2024 A teenager unable to attend school because of COVID-19 tries to entertain herself on April 11, 2020, in New Canaan, CT. Andrew Lichtenstein/Corbis via Getty Lockdowns鈥� Effects on Teenage Brain Development
During pandemic lockdowns, teenage brains鈥攅specially girls鈥� brains鈥攁ged much faster than expected, per a Proceedings of the National Academy of Sciences .

• University of Washington researchers used MRI scans from 160 nine- to 17-year-olds to measure cortical thinning鈥攌nown to accelerate in stressful times, and linked to depression and anxiety, .


• Comparing 2018 scans to follow-up scans from the same cohort in 2021 and 2022, boys showed cortical thinning 1.4 years faster than expected鈥攂ut girls were 4.2 years ahead of expectations, .

Behind the difference: Girls may be more dependent on social groups and interaction for their well-being, senior author Patricia Kuhl of the University of Washington theorizes.
 
Caveats and questions: The study size was small. And, the accelerated thinning could have been caused by many other conditions during that time鈥攁 rise in screen time, social media usage, less physical activity, and more family stress, Bradley S. Peterson, a Children鈥檚 Hospital Los Angeles psychiatrist and brain researcher not involved in the study, told the NYT. GLOBAL HEALTH VOICES The Latest One-Liners   Abortion policies and legislation in states with the most severe restrictions on the procedure also have the least access to reproductive health care and support programs for pregnant women, a new finds; Northwestern University School of Medicine researchers analyzed insurance data for the study.

A South Korean commission that hospitals, maternity wards, and adoption agencies in the country colluded to coerce parents鈥攎ostly single mothers鈥攊nto giving up their children for adoption to Australia, Denmark, and the U.S., among other countries.
 
COVID survivors with disabilities experienced 2X the rates of long COVID compared to those without disabilities鈥攐ver 40% compared to 19%, by University of Kansas researchers in the American Journal of Public Health.
 
More Americans are inclined to believe COVID-19 vaccination misinformation, and are less willing to vaccinate, according to a new Annenberg Public Policy Center health survey that found over 20% of Americans incorrectly believe that getting a COVID-19 infection is safer than getting the vaccine鈥攗p from 10% in April 2021. ANTIMICROBIAL RESISTANCE Nobody Is Safe
Deaths from drug-resistant infections are predicted to number over 10 million a year by 2050. 

In most immediate danger: The ill, young, elderly, and those living in poverty.

But everyone is at risk, as a troubling set of profiles reveals:

• In Pakistan, 25-year-old Naveed contracted a hospital-acquired infection following  emergency surgery; and 47-year-old Malik faced amputation after a roadside cut on his foot left him with an infection that would not heal. 


• In Nigeria, 9-day-old Ahamba fought a life-threatening infection that started hours after birth. 


• In the U.S., 39-year-old Tamara developed a series of urinary tract infections that no longer responded to antibiotics. 

Such infections are 鈥渁 preventable burden of disease that is a consequence of a misuse of resources,鈥� said the WHO鈥檚 Yvan Hutin.

GLOBAL HEALTH VOICES ATTACKS ON AID WORKERS 鈥楧eadliest Year鈥� for Humanitarian Workers
An ambulance driver in Ethiopia, shot while driving to the hospital. 

A volunteer in Sudan gunned down while collecting data. 

A paramedic killed while evacuating wounded civilians from the West Bank.

These workers are among the killed globally in 2024 in what is tracking toward the 鈥渄eadliest year ever for aid workers鈥� amid growing disregard for international protections.

• 101 aid workers have been wounded and 68 have been kidnapped. 

Most vulnerable: Local aid workers鈥攚ho often do not have the same level of security and training as international staff鈥攁re the most likely victims.

Areas of high risk: Gaza, Sudan, and South Sudan accounted for most of the deaths.

SPILLOVER Dangers Percolating at Fur Farms 
A host of novel viruses have been detected at fur farms in China鈥攊ncluding a 鈥渃oncerning鈥� new bat coronavirus, a new published in Nature finds.

A closer look: After analyzing samples from 461 dead animals, including raccoon dogs, mink, and guinea pigs.

• The scientists identified 125 different virus species, including 36 new pathogens. 


• Of the viruses detected, 39 were deemed to have 鈥渉igh spillover potential.鈥�


• Among those: A dangerous new bat coronavirus called HKU5, found in a mink. 

The Quote: 鈥淔ur farms represent a far richer zoonotic soup than we thought,鈥� said the study鈥檚 co-author Eddie Holmes, of the University of Sydney鈥攚ho added that such farms present 鈥渁 clear epidemic or pandemic risk.鈥�
 
OPPORTUNITY QUICK HITS Polio vaccination starts in north Gaza despite obstacles 鈥�

Poliovirus that infected a Chinese child in 2014 may have leaked from a lab 鈥�

More support is needed for more than 4.2 million refugees and migrants who seek safety and stability in the Americas 鈥�

Officials await testing clues from Missouri H5 avian flu case as Michigan reports more affected cows 鈥�

Dobbs Has Fundamentally Changed Obstetric Care, Study Finds 鈥�

Native-led suicide prevention program focuses on building community strengths 鈥� Issue No. 2777
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: Sudan鈥檚 Widening 鈥楴ightmare鈥�; No Known Animal Contact in Missouri Bird Flu Case; and Bat Declines Linked to Infant Mortality September 9, 2024 Sudanese families carrying their belongings arrive at a transit center for refugees in Renk, South Sudan, on February 14. Luis Tato/AFP via Getty Sudan鈥檚 Widening 鈥楴ightmare鈥�
Eighteen months of brutal civil war in Sudan have left the nation trapped in a 鈥渘ightmare of conflict鈥� that the world continues to ignore, WHO Director-General Tedros Adhanom Ghebreyesus said yesterday, . 

Additionally, a from the latest UN fact-finding mission cataloged 鈥渉arrowing鈥� human rights abuses committed by both sides of the conflict and called for independent peacekeepers to intervene, .

The toll 500 days in:

• 20,000+ people have been killed; 12+ million people have been displaced.


• The nation鈥檚 health system is 鈥渘ear collapse,鈥� with 70%鈥�80% of facilities affected.


• ~25 million people are 鈥渋n dire need of humanitarian aid.鈥�

Ongoing atrocities: Both Sudan鈥檚 army and the paramilitary Rapid Support Forces have attacked civilians, committed torture and rape, and made arbitrary arrests, the UN鈥檚 fact-finding mission found.

• But: Sudan鈥檚 government said it 鈥渞ejects in their entirety鈥� the UN鈥檚 recommendations, demanding that the body support its 鈥渘ational process,鈥� . 

On top of this:

• 25.6 million people鈥攈alf the population鈥攁re facing acute food insecurity. 


• Outbreaks of cholera are on the rise, . 


• Disease surveillance has been impossible in areas under RSF control, . 


• Floods have destabilized infrastructure. 

Renewed call to action: UN officials are calling for more protection for health workers and facilities, an expanded arms embargo, more humanitarian funding鈥攁nd an immediate ceasefire. 

鈥淭he best medicine is peace,鈥� said Tedros. GHN FOR FREE Share GHN With a Student   What do global health students need? I mean, besides coffee.
 
They need to know what鈥檚 going on in global health鈥攑ractical examples of global health issues and solutions IRL. There鈥檚 no better source than Global Health NOW. 

Please share with students you know. It will help them:

• Stay on top of current issues in global health.

• Enrich their theoretical learning with real-world examples.

• Explore careers and learn about opportunities like webinars, fellowships, and travel grants.

Seal the deal: GHN鈥檚 smartly curated global health news is still every student鈥檚 favorite price: free. 鈥�Brian GLOBAL HEALTH VOICES The Latest One-Liners   The African CDC and the WHO launched a Friday to boost the mpox outbreak response amid an escalation of cases鈥攊ncluding in DRC, which now has 20,000+ cases; Guinea鈥檚 report of a confirmed case brings the total number of African countries affected to 14.

Texas is suing the Biden administration to overturn a federal rule that protects the medical records of women from criminal investigation if they cross state lines to seek legal abortion.  

Hair and skin care products expose kids to endocrine-disrupting chemicals called phthalates, per a published in the journal Environmental Health Perspectives, which found that Black children had the highest levels of phthalates in their urine.

Teen vaping has dropped to a 10-year low, CDC officials 鈥攁ttributing the 鈥渕onumental public health win鈥� to recent age restrictions and aggressive enforcement against retailers and manufacturers. RADAR: AVIAN FLU Missouri鈥檚 First Case
The the first case of H5 bird flu in a person with no known animal contact, .

• The case, in Missouri, was detected through the state鈥檚 seasonal flu surveillance system.


• The patient, who was hospitalized in August and has been released, had underlying medical conditions.


• At least 13 other people in the U.S. have been infected with bird flu this year, but all had occupational exposure to infected animals.

Missouri has not reported any H5 outbreaks in dairy cattle, , adding that additional testing will be important to confirm whether this is the same strain of the H5 virus causing the cattle outbreak.

• The CDC said the risk to the general public remains low.

Related: 5 burning questions about Missouri鈥檚 mysterious H5 bird flu case: Could raw milk 鈥� or a cat 鈥� help explain how a person who had no contact with animals caught the virus? 鈥� GLOBAL HEALTH VOICES BIODIVERSITY Bat Declines Linked to Infant Mortality
A 鈥済roundbreaking鈥� study showing the connection between bats鈥� decline in the U.S. and infant mortality is the latest to demonstrate the stark toll of imbalanced ecosystems. 

According to the research, , a decline in bat populations due to a fungal disease led farmers in 245 counties to increase their use of insecticides by 31% to combat an increase in insect activity.

• In those same counties, infant mortality rose by ~8%鈥攁ccounting for 1,334 infant deaths鈥攆rom 2006 to 2017. 

鈥淚t is a sobering result,鈥� said environmental economist Eli Fenichel. 

Other possible factors鈥攍ike unemployment and drug use鈥攚ere ruled out as causes. 

A warning: 52% of bat species in North America are at risk of severe declines over the next 15 years. 

CORRECTION Not 鈥楯abbed鈥�
Our Sept. 3 lead summary on the polio vaccination campaign in Gaza incorrectly said that 161,000+ children under 10 had been 鈥渏abbed鈥� during the drive鈥檚 first two days. The campaign is distributing the oral polio vaccine. We regret the error. Thanks, Alexandra Brown for pointing out our mistake! OPPORTUNITY QUICK HITS Hundreds of thousands of parents died from drugs. Their kids need more help, advocates say. 鈥�

US is beefing up mpox testing, vaccine access against new strain, officials say 鈥�

India records first suspected mpox case, male patient in isolation 鈥�

Determinants of the desire to avoid pregnancy after the disaster of the century in T眉rkiye 鈥�

Strengthening surgical systems in LMICs: data-driven approaches 鈥嬧�嬧��

New polio strain threatens setback to eradication in Nigeria 鈥�

Light pollution at night may increase risk of Alzheimer鈥檚, study finds 鈥�

Off-Broadway musical warns of deadly threat of antibiotic resistance 鈥� Issue No. 2776
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: Deaths from Cholera Up Sharply; Paraguay鈥檚 Sex Ed Controversy; and If You Like Pi帽a Coladas, and Getting Caught in Aisle 9 September 5, 2024 A health care worker tends to a new patient at a temporary cholera treatment centre at Bwaila District hospital in Lilongwe, Malawi, on February 21, 2023. Fredrik Lerneryd/AFP via Getty Global Cholera Deaths Up Sharply 
Cholera deaths shot up 71% last year, according to shared yesterday鈥攁mounting to 4,000+ deaths last year from a disease that is preventable and treatable, .

• Cases were up 13% in the same period (2022-2023), with 45 countries reporting cases last year.


• 38% of the reported cases were among children under 5.


• 32% less cases reported in the Middle East and Asia and a 125% increase in Africa; top hot spots included Afghanistan, the DRC, Malawi, and Somalia.

Reasons for the rise: Conflict, climate change, and a lack of safe water and sanitation.
 
A new monitoring metric: Many African countries reported a high proportion of community deaths鈥攖hose that occurred outside hospitals鈥攁n indication of 鈥渟erious gaps in access to treatment,鈥� per the WHO.
 
Vaccines: The cholera vaccine supply hasn鈥檛 been able to keep up with demand; WHO chief Tedros Adhanom Ghebreyesus has asked other vaccine manufacturers to help boost the supply. GLOBAL HEALTH VOICES The Latest One-Liners  
Moderna鈥檚 mRNA mpox vaccine candidate proved more effective at preventing severe disease in monkeys than the dominant Jynneos vaccine, according to a new ; in lab tests researchers found that the vaccine also neutralizes other orthopox viruses, like camelpox, rabbitpox and multiple mpox strains.

The DRC is set to receive its first batch of 100,000 mpox vaccines鈥攎anufactured by Bavarian Nordic鈥攆rom the European Union today, and a second delivery should arrive soon.
 
Men aged 30 to 45 exposed to air pollution over ~five years had a 24% higher risk of being diagnosed with infertility, per a large new that also found a previously unknown association between road traffic noise pollution and infertility among women aged 35 to 45.
 
YouTube plans to restrict teenagers鈥� exposure to videos about weight and fitness, tweaking its algorithms to stop pushing 13-17-year-olds down 鈥渞abbit holes鈥� of related content after they view an initial video. DATA POINT GLOBAL HEALTH VOICES FAMILY PLANNING Paraguay鈥檚 Sex Ed Curriculum Stirs Controversy
鈥淢en conquer, not seduce.鈥� 鈥淕irls have smaller and lighter brains.鈥� 鈥淏oys don鈥檛 cry easily.鈥� 鈥淕irls don鈥檛 like taking risks.鈥�
 
Those phrases are lifted from Paraguay鈥檚 first national sex ed curriculum鈥攅ndorsed by the Ministry of Education, which left-leaning senator Esperanza Mart铆nez called 鈥渁n affront to science.鈥�

• The text promotes abstinence, deems sex 鈥淕od鈥檚 invention for married people,鈥� discourages condom use, and ignores sexual orientation or identity, to the approval of conservative forces and dismay of sexual health educators.


• Many mothers in the country鈥攚hich has South America鈥檚 highest rate of teenage pregnancy鈥攂lame their teen pregnancies on norms that kept them in the dark about sex.

ALMOST FRIDAY DIVERSION If You Like Pi帽a Coladas, and Getting Caught in Aisle 9
Police were recently called to a grocery store in Bilbao, northern Spain, after it became "overwhelmed" with young people emptying the produce shelves. 

Their crime? Looking for love. And hijacking pineapples for the purpose, . 

The pine-apple of your eye: According to the TikTok-driven rules of engagement, hopeful romantics are to arrive at the Mercadona grocery store between 7鈥�8 p.m.鈥斺�渓a hora de ligar鈥� (the hour of flirting)鈥攖hen place an upside-down pineapple in their cart and head to the wine section. 

A-peel-ing prospects?: Instead of swiping right, potential matches bump carts, . 

Pineapples > apps: The trend鈥檚 popularity tracks with Gen Z鈥檚 growing frustration with dating apps, . 

A fruitless search: One Telegraph columnist flew from England to Spain to try her luck鈥攂ut left empty-carted and brokenhearted, : 鈥淪urely there鈥檚 no sadder sight than a woman, at the end of la hora de ligar, returning her pineapple. Alone.鈥� QUICK HITS Doctors grapple with how to save women鈥檚 lives amid 鈥榗onfusion and angst鈥� over new Louisiana law 鈥�

It Matters If It鈥檚 COVID 鈥�

Alarming HIV/AIDS rates among Black people in Georgia 鈥�

Preventing the next 鈥楩ukushima鈥� 鈥�

Russia's Growing Footprint on the African Health Landscape 鈥�

Fake Ozempic: How batch numbers help criminal groups spread dangerous drugs 鈥�

In a rural small town, a group of locals steps up to support senior health 鈥� Issue No. 2776
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: Indian Doctors鈥� 鈥楬arrowing鈥� Plight; Everyday Poisoning in Afghanistan; and A Chemical Crackdown in China September 4, 2024 Indian Doctors鈥� 鈥楬arrowing鈥� Plight
Doctors across India are demanding safer working conditions at government hospitals, saying the killing of a junior doctor in Kolkata underscores daily perils faced on the job. 

Background: Doctors鈥� 鈥渉arrowing working conditions鈥� have been put in the spotlight this month after a 31-year-old junior doctor was raped and murdered while she was resting after a 36-hour shift. 

Everyday threats: Young doctors say the crime speaks to daily dangers they face while working grueling shifts in overwhelmed wards often lacking in safety and hygiene, and where practitioners have little to no security against frequent verbal and physical abuse from patients鈥� families.

• 鈥淸Doctors] are either seen as supra-human, or not human at all,鈥� said anesthesiologist Richa Sharma, who moved to the U.S. after becoming disillusioned with the Indian medical system.

Nationwide protests have since erupted, with students, doctors, and advocates demanding justice for the victim, as well as better protection and safer workplaces for doctors.

GLOBAL HEALTH VOICES EDITOR鈥橲 NOTE Four-Day Success
Hey Readers,  
After this summer鈥檚 successful pilot of a four-day per week GHN newsletter, we鈥檙e making the no-Friday schedule permanent this fall.
 
We鈥檙e doing this for two main reasons:

• In the 10 years since we founded GHN, news production has shifted into hyperdrive. There are too many blips of news, factoids, and events鈥攁nd not enough context. Moving to four days per week allows us a bit more time to consider global health issues and put them in context.


• And, publishing a newsletter as comprehensive as GHN is not easy. It can be a grueling pace, especially for a lean team that has multiple responsibilities beyond GHN. 

Please know we still have the same passion for sharing the essential global health news with you via our newsletter and our exclusive news articles and commentaries .
 
We鈥檒l still be here for you. Thanks for reading and sharing GHN. As always, let me know what you think.
 
All best,

Brian The Latest One-Liners   African drugmaker Aspen is in talks to manufacture mpox vaccines on two protective conditions: a commitment to a predetermined volume of orders and coverage of costs to transfer the technology into the facility.
 
The WHO published the 鈥攁ddressing all steps of the manufacturing process, from the production of pharmaceutical ingredients to the finished products and packaging鈥攁head of the UN General Assembly High-Level Meeting on antimicrobial resistance to take place later this month.
 
The U.S. Supreme Court declined to restore millions in federal family planning funds to Oklahoma; the funds were pulled after state officials refused to offer a hotline number for patients to call and receive information on abortion.
 
Over half of the world鈥檚 population isn鈥檛 getting enough essential micronutrients including calcium, iron, and vitamins C and E, from the Harvard T.H. Chan School of Public Health, UC Santa Barbara, Tel Aviv University, and others. LEAD Everyday Poisoning in Afghanistan
Afghanistan has one of the world鈥檚 highest rates of lead exposure. In recent years, researchers have been trying to understand why鈥攅specially as Afghan refugee children arriving in the U.S. showed 鈥渄ramatically elevated blood lead levels.鈥� 

The culprit: In 2022, researchers in Washington state screened dozens of aluminum cooking pots donated by Afghan refugee families, and found that each one exceeded the FDA鈥檚 limit for the maximum lead intake from food.

• The worst offenders were kazans, commonly used cooking pots made from recycled aluminum鈥攐ne of which 鈥渓eached sufficient lead to exceed the childhood limit by 650-fold.鈥�

No recourse: Taliban health ministry officials said they were unfamiliar with the problem and had no plans to deal with it.

GLOBAL HEALTH VOICES OPIOID CRISIS A Chemical Crackdown in China
Chinese officials have debuted new regulations increasing government oversight on seven chemicals, including three compounds used to make illicit fentanyl鈥攁n opioid that kills tens of thousands of people in the U.S. every year.

• Chemical plants in China have emerged as major suppliers for criminal drug cartels producing synthetic drugs, including fentanyl and methamphetamines.

The Biden Administration hailed the change as a 鈥溾�濃�攂ut some question whether the policies will be backed by meaningful enforcement.

John Coyne, a drug expert with the Australia Strategic Policy Institute, described them as 鈥渓ittle more than a public-relations stunt鈥� amid evidence suggesting Chinese officials are complicit in the fentanyl trade.

OPPORTUNITY QUICK HITS New UN report details Nicaragua鈥檚 ongoing human rights crisis 鈥�

Gender equality stalling or going backwards for 1bn women and girls 鈥�

African countries leverage China鈥檚 expertise in collaborative fight against malaria 鈥�

Newly discovered antibody protects against all COVID-19 variants 鈥�

Former Argentine president sued for extending Covid-19 lockdowns beyond sanitary needs 鈥�

Diary of a day in Syria鈥檚 extreme summer heat 鈥�

How a Leading Chain of Psychiatric Hospitals Traps Patients 鈥�

What Texas can learn from Italy鈥檚 big bet on tiny community health homes 鈥� Issue No. 2775
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: Polio Vaccination Reaching Young Gazans; Safety Violations at Plant Linked to Listeria Outbreak; and Your August Recap September 3, 2024 Health workers carry containers filled with polio vaccines in Deir Al-Balah, in the central Gaza Strip, on September 1. Majdi Fathi/NurPhoto via Getty Polio Vaccination Reaching Young Gazans
The urgent polio vaccination campaign in Gaza has jabbed 161,000+ children under 10 in its first two days, surpassing its goal of 150,000, .

• That number represents a quarter of the targeted population in the campaign. The effort to stem disease ramped up after the first case was documented in a Gazan child late last month.


• The campaign鈥檚 success depends upon eight-hour pauses in fighting between Israel and Hamas in designated areas. The vaccination drive will take another 10 days, per Rik Peeperkorn, WHO鈥檚 representative for the Occupied Palestinian territories.


• Negotiations are continuing about vaccinations reaching children in southern Gaza who appear to be outside areas already agreed upon.

The challenge: To succeed, the oral polio vaccine needs to reach at least 90% of Gaza鈥檚 640,000 children under 10 in two rounds separated by four weeks, .

In lieu of cold chain facilities (which have been destroyed), generators are needed to keep vaccine doses cool, but ongoing fuel shortages make that difficult.

The Quote: 鈥淧olio is just one of the many problems the children of Gaza are facing,鈥� said Jose Lainez Kafati, a Unicef Palestine social and behavior change specialist.
 
Related:
 
Children in Gaza who need medical care are not being allowed to evacuate, say aid groups 鈥� EDITOR'S NOTE Pro Tip for Professors

Is GHN on your syllabus? 

Faculty often let us know they rely on GHN to help spark classroom discussion and get students thinking about critical global health issues.

• Introduce your students to key global health issues鈥攁nd leading voices鈥攊n our free, easy-to-scan newsletter.


• See what other universities are doing in the global health space.


• Learn about opportunities to get involved鈥攆rom courses, conferences, and webinars to fellowships and networking events. 

Just forward this email or share our with your students and colleagues. And please let us know when you do! 鈥�Dayna

GLOBAL HEALTH VOICES The Latest One-Liners  

DRC hospital workers are overstretched trying to care for mpox patients without enough beds, medicine, and food in the outbreak鈥檚 epicentre; vaccines are expected to arrive within days to fight the new strain of the virus.
 
Mpox cases detected in an Iowa prison are clade 2鈥攁 more common, less serious form of the virus than clade 1, the virulent strain fueling the outbreak in DRC and other countries that led the WHO to declare a global health emergency; the number of people infected in the prison has not been confirmed.
 
Avian flu was confirmed in three central California dairies last Friday; no human cases have been confirmed in the state.

A UK survey reveals that many young adults struggle to access ADHD treatment once they turn 18 and transition from pediatric to adult services.

AUGUST MUST-READS A Scourge of Counterfeit Medicines 
A fifth of medicines on the market in Africa could be substandard or fake, by Ethiopia鈥檚 Bahir Dar University researchers鈥攑otentially contributing to ~500,000 deaths a year in sub-Saharan Africa, .

Why? Inefficient, fragmented pharma supply chains that undermine quality and fuel exploitative practices, per Claudia Mart铆nez, the head of research at the Access to Medicine Foundation.



Related: - Hopkins Bloomberg Public Health 

Chinese Women Rejecting 鈥楶ro-Birth Culture鈥�
China鈥檚 efforts to address its looming population crisis have resulted in stunning policy reversals over just a few years鈥攔eplacing penalties for having more than one child with a host of 鈥減ro-birth culture鈥� incentives like cash handouts and real estate subsidies. 
 
But these efforts are failing to gain traction with a generation of women deeply scarred by coercive family planning鈥攚omen who grew up watching their parents sacrifice and struggle under the one-child policy, and who remain staunchly reluctant to pursue parenthood. 


 
The 鈥楢merican Arms Race鈥� 
At the height of the pandemic, millions more Americans acquired guns as 鈥渁 grim kind of logic鈥� drove them into a self-protective 鈥渁rms race,鈥� writes Marin Cogan in a must-read report about the long-term ramifications of that shift. 

Deeper implications: The spike in gun-owning households will change 鈥渁ll kinds of policy and political calculations鈥� for generations, said John Roman, author of a survey鈥攃iting lasting impacts on crime, medical care, and public health. 


 
Why U.S. Therapists Leave Insurance Networks
In the U.S., finding a mental health therapist who takes insurance can seem impossible. 

Insurers say it鈥檚 because there aren鈥檛 enough therapists鈥攂ut a growing number of mental health providers say they鈥檝e opted out of insurance networks altogether, pushed by 鈥渁 system set up to squeeze them out鈥� by interfering with patient care; delaying, diminishing, or denying payments; and requiring byzantine claims processes.

Thanks for the tip, Cecilia Meisner! GLOBAL HEALTH VOICES AUGUST'S BEST NEWS Drastically Reducing Dementia Risk  
Almost half of dementia cases worldwide could be delayed or prevented by addressing 14 modifiable risk factors, . 

Risk factors: The report adds two new dementia-linked risk factors to dementia cases: high cholesterol in midlife, and untreated vision loss in later life, 鈥攋oining 12 other modifiable risk factors identified in a 2020 Lancet report.

• Addressing these risk factors throughout life could prevent or delay 45% of dementia cases, the study found.

FOOD SAFETY Dozens of Violations at Plant Linked to Listeria Outbreak
  A Boar鈥檚 Head deli meat plant in Jarratt, Virginia鈥攚hich has been linked to a that has killed and hospitalized about 50 others鈥攔epeatedly violated federal regulations. Violations included instances of mold, insects, liquid dripping from ceilings, and meat and fat residue on walls, floors, and equipment.

• Government inspectors logged 69 instances of 鈥渘oncompliance鈥� with federal rules in the past year,


• Boar鈥檚 Head officials halted production at the plant in late July, and the company recalled more than of meat last month after tests confirmed the products were contaminated. 

The plant will remain closed 鈥渦ntil the establishment is able to demonstrate it can produce safe products,鈥� USDA officials said in a statement Thursday. 

QUICK HITS Measles cases are up and childhood vaccinations are down 鈥�

The Covid Vaccine Just Got a Lot More Expensive鈥擨f You鈥檙e Uninsured 鈥�

Doctors use problematic race-based algorithms to guide care every day. Why are they so hard to change? 鈥�

China's economic malaise may accelerate obesity rates 鈥�

Long COVID is a "public health crisis for kids," experts say 鈥�

HIV: how close are we to a vaccine 鈥� or a cure? 鈥� Issue No. 2774
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: Rising Vax Misinformation; Mosquitoes Don鈥檛 Care About Political Boundaries; and The Real HouseWolves of Beverly Hills August 29, 2024 A person looks at anti-vaccine "pure blood" movement websites and Facebook groups in Los Angeles, on January 20, 2023. Chris Delmas/AFP via Getty Rising Vax Misinformation
Even as COVID-19 cases in the U.S. are increasing, vaccine misinformation is duping a growing number of Americans, .

• Just 66% of those surveyed in mid-July think COVID-19 vaccines鈥� benefits outweigh the risks.


• 27% of participants say they are 鈥渘ot at all likely鈥� to get a trivalent mRNA vaccine against flu, COVID-19, and RSV, but almost half say they are likely to get one.


• While 55%-65% of those surveyed mostly held science-consistent positions, science-inconsistent responses are increasing. Example: Those who believe the COVID-19 vaccine changes people鈥檚 DNA increased to 15% in July, up from 8% 2021.

Eroding vax confidence: 28% of respondents said incorrectly that COVID-19 vaccines have caused thousands of deaths, , increasing from 22% in June 2021.
 
Changing views: Public perceptions of COVID-19 have shifted to normalizing the disease as it edges into endemic status, .

• Fewer people are testing, isolating after exposure, and wearing masks.

The Quote: 鈥淲e鈥檝e decided, 鈥榃ell, the risk is OK.鈥� But nobody has defined 鈥榬isk,鈥� and nobody has defined 鈥極K,鈥欌�� said Michael Osterholm, director of the University of Minnesota鈥檚 Center for Infectious Disease Research and Policy.

Related:
 
More Studies Won鈥檛 Solve the Masking Debate 鈥�
 
Experts say COVID-19 is endemic. What does that mean? 鈥�
  
A New York county banned face masks in public. Disabled people are suing. 鈥� GLOBAL HEALTH VOICES EDITOR'S NOTE No GHN Monday, September 2   We鈥檒l be taking a break from GHN Monday, to observe the Labor Day holiday in the U.S. But we鈥檒l be back Tuesday with more news and your monthly recap! 鈥�Dayna The Latest One-Liners   The World Food Programme halted operations in Gaza yesterday after a 鈥渃learly marked UN humanitarian vehicle ... was struck 10 times by IDF gunfire, including shots that targeted front windows.鈥�
 
Tanzania鈥檚 Faustine Ndugulile has been nominated to succeed Botswana鈥檚 Matshidiso Moeti as the next regional director for the WHO African Region; the former deputy health minister and ICT minister is expected to take office in February 2025.

9 people have died in connection with a listeria outbreak among Boar's Head deli products in the U.S., ; there are now 57 cases total across 18 states, and all of those infected have been hospitalized.
 
Sleep-deprived people who catch up on sleep over weekends may reduce their heart disease risk by a fifth, according to a British study of 90,000 people . MALARIA Mosquitoes Don鈥檛 Care About Political Boundaries
Malaria cases rose dramatically in South Korea last year, despite the country鈥檚 decades-long efforts to reach 鈥渕alaria-free鈥� status.

South Korea鈥檚 health care systems are equipped to diagnose and treat cases, but some factors that exacerbate disease spread are beyond the country鈥檚 control鈥攁nd its borders.

In North Korea, malnourishment, poverty, and poor sanitation make people more vulnerable to diseases like malaria, and outdated medical equipment delays diagnoses. And in the demilitarized zone, standing water grows mosquito populations, which feed on the blood of an abundance of wild animals living in the forested DMZ. 

The Quote: 鈥淭he DMZ is not an area where pest control can be carried out,鈥� says Kim Dong-gun, an environmental biology professor at Sahmyook University.



Related: Malaria mountain: the pathogen鈥檚 last stronghold in the Philippines 鈥� and the fight to wipe it out 鈥� GLOBAL HEALTH VOICES ETHICS Compensation for Kidneys? 
  In the U.S. alone, 90,000+ people are waiting for a kidney donation鈥攂ut the shortage is a solvable problem, according to Waitlist Zero, a coalition seeking to increase living kidney donations.
 
Legislation proposed by the group, the End Kidney Deaths Act, would offer a $50,000 refundable tax credit, split across five years, to people who volunteer to donate a kidney to a stranger.

• Out of 6,000 living donors a year, only 300 to 400 are 鈥渁ltruistic donors鈥� who give a kidney to someone they do not know. 

Ethics debate: Incentivization opponents argue that compensating donors could impair efforts to end illegal organ trade globally. 
 


Related: Donating a kidney is even safer now than long thought, US study shows 鈥� THURSDAY DIVERSION The Real HouseWolves of Beverly Hills
The most addictive reality TV show could just be the real drama unfolding in your backyard.

That鈥檚 the discovery made by a growing cohort of 鈥渃ritter cam鈥� devotees, who use trail cameras to capture the secret lives of skunks, rabbits, coyotes, wolves, and foxes鈥攖hen share those sagas with other wildlife watchers via social media and YouTube. 

Zooming in: The backyard wildlife footage isn鈥檛 just for fun: It鈥檚 giving scientists new insights into urban wildlife behavior, and even bolstering conservation efforts. 

But it is fun, too: A found that watching a nature video can be just as beneficial for reducing stress and elevating mood as a walk outside.

Home sweet habitat: Some cinematographers dial up the production value鈥攍ike one LA couple that installed a teensy hot tub and a petite picnic table around their bird feeders. Cue the Godzilla-like incursions from coyotes and possums! 

QUICK HITS Mpox is spreading rapidly. Here are the questions researchers are racing to answer 鈥�

Wasn鈥檛 polio wiped out? Why it is still a problem in some countries 鈥�

"On the Move": How Climate Migration Will Remake America 鈥�

Cutting pollution worldwide could add two years to average person鈥檚 life, says study 鈥�

The WHO regional director elections must be reformed 鈥�

New NSF rule requires tribal approval for research affecting their interests 鈥�

This ancient disease still kills 1 million people every year 鈥� Issue No. 2773
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: Mpox Response Mired in Bureaucracy; Start with the Parents; and Public Housing鈥檚 Systemic Sickness August 28, 2024 A man shows a health worker the mpox lesions on a child at the Munigi mpox treatment center in Nyiragongo territory, North Kivu, DRC, on August 20. Arlette Bashizi/Bloomberg via Getty Mpox Response Mired in Bureaucracy 
While the DRC desperately awaits its first shipment of vaccines to combat mpox, scientists across Africa say they are 鈥渨orking blindly鈥� without critical testing resources, research materials, or therapeutics as the virus continues to mutate and spread, .

Latest updates:

• Yesterday, the U.S. donated 10,000 doses of mpox vaccines to Nigeria鈥攖he first vaccines to arrive in Africa since the global emergency was declared, . 


• DRC had expected its first mpox vaccines this week, but officials say they now face regulatory delays, per a separate . 


• Spain announced yesterday it would donate ~500,000 doses鈥攎ore than the E.U. and the U.S. have pledged. 

Why the vaccine delay? The vaccines, while readily available, are 鈥渢rapped in a byzantine drug regulatory process鈥� at the WHO, .

Historic negligence: The growing outbreak stems from 鈥渄ecades of neglect鈥� when it comes to mpox, leading African scientists said Tuesday, . 

Rising toll: 4,000 new mpox cases were reported in Africa this past week, along with 81 new deaths, . GLOBAL HEALTH VOICES The Latest One-Liners   Attacks on health workers during the first three years of the COVID-19 pandemic included violence against 255 health care workers鈥攊ncluding 147 who were injured and 18 who were killed, per a published last week in Health Security.

A New Hampshire resident has died after contracting the mosquito-borne eastern equine encephalitis virus, health officials confirmed yesterday.

The CDC has pledged $118.5 million to investigate and prevent maternal deaths, the HHS announced yesterday鈥攁long with a $440 million investment to expand voluntary maternal, infant, and early childhood home visiting services.

Vapes in the U.K. should be sold 鈥渂ehind the counter鈥� as cigarettes are, the British Medical Association advised in a new , as the doctors鈥� union called on the government to do more to address the country鈥檚 鈥済rowing epidemic鈥� of vaping. MENTAL HEALTH Start with the Parents
  U.S. Surgeon General Vivek Murthy today about the impact of stress on parents鈥� mental health, calling for governments, businesses, and communities to boost support services.

• Nearly half of the nation鈥檚 ~63 million parents and caregivers report feeling completely overwhelmed.

The advisory includes recommendations for:

• Governments: Expand funding supporting parents, establish national paid family and medical leave, ensure paid sick time, and improve mental health care options.


• Employers: Provide training programs for managers on stress management and work-life balance.


• Health professionals: Screen parents for mental health conditions.

The Quote: 鈥淚f you really want to help kids, one of the things you鈥檝e got to do is actually help parents,鈥� Murthy says.
 

Related:

A new poll reveals the worries of Gen Z kids 鈥� and how parents can support them 鈥�

Paid family leave tied to fewer acute-care respiratory tract infections in infants 鈥�

GLOBAL HEALTH VOICES HOUSING Public Housing鈥檚 Systemic Sickness
Desaray Gilliard was a high school freshman when she was shot and killed in May 2022. She lived in one of the nation鈥檚 oldest public housing projects, Yamacraw Village, in Savannah, Georgia.

Chronic gun violence, which has taken a heavy toll on Black neighborhoods and kids like Desaray, has been linked to . 

But federal lawmakers have failed to fund repairs to , leaving tenants鈥攎ostly people of color and low-income families鈥攍iving with mold, gun violence, and severe health consequences鈥攕ome of the 鈥渓ife-threatening鈥� deficiencies documented in a federal inspection of Yamacraw last April.

OPPORTUNITY QUICK HITS With Only Gloves To Protect Them, Farmworkers Say They Tend Sick Cows Amid Bird Flu 鈥�

Vaccine hesitancy eats into back-to-school shots 鈥�

鈥業 wasn鈥檛 sure I鈥檇 make it鈥�: how a new mother鈥檚 brush with TB could mean better treatment for pregnant women 鈥�

As Rural Hospitals Shutter Maternity Wards, Urban Ones Follow 鈥�

Obesity raises risk of COVID infection by 34%, study estimates 鈥�

Nudge Theory Is Making Inroads in Health Care, With Mixed Results 鈥�

For men only? Lack of women winners for million-euro science prize draws protests 鈥�

Living in tree-filled neighborhoods may reduce risk of heart disease, study shows 鈥� Issue No. 2772
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: Gaza鈥檚 Deepening Crisis; Why U.S. Therapists Leave Insurance Networks; and To Make Childbirth Safer in the U.S., Look to Europe August 27, 2024 Abdel Rahman Abu al-Jedian, who contracted polio a month ago, sleeps surrounded by family members in a tent in Deir al-Balah, in the Gaza Strip, on August 27. Eyad Baba/AFP via Getty A 鈥楧esperate鈥� and Deepening Crisis  
Attacks on water and health care infrastructure in Gaza by the Israeli military are elevating the spread of infectious disease鈥攁nd potentially leading to a major polio outbreak in the Middle East.

• The UN halted aid deliveries to Gaza yesterday because of safety concerns, .


• The decision complicates plans for a campaign to vaccinate 640,000 children following last week鈥檚 first reported case of polio in 25 years in Gaza.

Absent rapid progress in truce talks and the vaccination campaign, the poliovirus could spread into Israel, Lebanon, Syria, Egypt, and Jordan, said Hamid Jafari, WHO鈥檚 polio eradication director in the eastern Mediterranean, .
 
Perilous water situation:

• ~ 70% of all water and sanitation facilities in Gaza have been destroyed or damaged, the UN-led WASH Cluster reported in July. 


• Just ~4.74 liters/1 gallon of water per person, per day is available to Gazans, in July.
   
• Meanwhile, 1.7+ million cases of infectious diseases have been recorded in Gaza, sewage spills into streets, and children resort to drinking from puddles,

And: Extreme summer heat is worsening the crisis, with this June marking the hottest on record in Israel. 
 
Related: One of Gaza鈥檚 last functioning hospitals is emptying out as Israeli forces draw near 鈥� GLOBAL HEALTH VOICES The Latest One-Liners   500+ children a day in England鈥攐ne every three minutes鈥攁re being referred to NHS mental health services for anxiety; there were 204,526 new referrals of patients aged 17 or younger in 2023-2024, compared with 98,953 in 2019-2020.

India is grappling with its largest Chandipura virus outbreak in two decades, with 245 acute encephalitis syndrome cases reported since July, including 82 fatalities; so far, 鈥攖ransmitted by vectors that include sandflies, mosquitoes, and ticks鈥攊n 64 of the cases.   

An oral cholera vaccine developed by India's Bharat Biotech cleared a late-stage trial; the company announced plans to produce up to 200 million doses a year and apply for WHO prequalification to supply UNICEF and other major buyers to help ease a global shortage of the doses.

People in France who were hospitalized with vaccine-related myocarditis were half as likely to be readmitted for myocarditis or heart-related events than those with myocarditis related to COVID-19 infection or other causes, per a study from Dec. 2020 to June 2022 . MENTAL HEALTH Why U.S. Therapists Leave Insurance Networks
In the U.S., finding a mental health therapist who takes insurance can seem impossible.

• Although almost all Americans are insured, about with mental illness are unable to access treatment.

While insurers say it鈥檚 because there aren鈥檛 enough therapists, a growing number of mental health providers say they鈥檝e opted out of insurance networks altogether, after the companies made it impossible for them to do their work. 

In a must-read analysis by ProPublica, 500+ psychologists, psychiatrists, and therapists describe 鈥渁 system set up to squeeze them out鈥� by:

• Interfering with patient care. 


• Delaying, diminishing, or denying payments.


• Requiring byzantine claims processes.

Thanks for the tip, Cecilia Meisner!

Related: Insurers can restrict mental health care. What laws protect patients in your state? 鈥� GLOBAL HEALTH VOICES MATERNAL MORTALITY To Make Childbirth Safer in the U.S., Look to Europe
The U.S. has one of the highest maternal death rates of any wealthy nation: around 20 per 100,000 live births overall鈥攁nd 50 for Black moms.

Several European countries, meanwhile, have rates in the single digits鈥攚hich is why increasingly, American doctors and researchers are looking abroad for solutions. 

Key takeaways:

• Access to regular prenatal checkups is critical: meaning the U.S. needs to boost its numbers of both OB-GYNs and midwives.


• Reducing cesarean sections can help to prevent complications.


• Improving paid leave has been linked to better postpartum health.

The Quote: 鈥淢aternal mortality is an entirely preventable event providing you have access to basic health care. Not high-tech health care but basic health care,鈥� said Roosa Sofia Tikkanen at the Center for Global Health Inequalities Research in Norway.



Related: Second global call for data on postpartum haemorrhage 鈥� OPPORTUNITY QUICK HITS Inside the camp on the frontline of the DRC鈥檚 mpox epidemic 鈥� in pictures 鈥�

Could Vaccine Misinformation Lead to a Worldwide Health Crisis? 鈥�

New Covid Shots Were Approved. But Who Will Get Them? 鈥�

The rape and murder of a female doctor in India sets off an outcry over women's safety 鈥�

Malaria mountain: the pathogen鈥檚 last stronghold in the Philippines 鈥� and the fight to wipe it out 鈥�

Diabetes took over her life, until a stem cell therapy freed her 鈥�

Survey finds more than 3 in 4 Americans don't feel they could help someone suffering an opioid overdose 鈥�

Brazilian moms are leading the charge to secure medical marijuana for sick kids 鈥� Issue No. 2771
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: The Rush to Suppress EEE; Wild Fisheries vs. Hidden Hunger; and Miscarriage Information Gap 10 Massachusetts counties are on alert for Eastern equine encephalitis. August 26, 2024 The Rush to Suppress EEE
The spread of a rare but devastating mosquito-borne virus has placed 10 Massachusetts counties at 鈥渉igh or critical risk鈥濃�攑rompting officials to consider curfews and discourage evening activities, .

Eastern equine encephalitis has been detected in mosquitoes throughout the region, and this year's first human case, a man in his 80s, was announced earlier this month.

A closer look: Only a few cases of EEE are reported in the U.S. each year, and there are no vaccines or medicines available against the disease鈥攚hich has a 30% fatality rate, .

• In 2019, there were 12 human cases of EEE in Massachusetts, and six people died, .  


• Symptoms include fever, headache, vomiting, diarrhea, drowsiness, and seizures. 


• EEE has also been detected in horses in New York state, . 

Rigorous response: Regional officials have discouraged dusk-to-dawn activity鈥斺�漰eak biting times鈥濃�攁nd have closed city parks and canceled public events. State officials have started an aerial spraying campaign. 

Bigger picture: The U.S. has seen a sharp increase of 鈥渕osquito days鈥濃�攄ays with warmer temperatures amenable to mosquito activity.

•  Massachusetts alone has 14 more mosquito days now compared with 2009.

GLOBAL HEALTH VOICES The Latest One-Liners   Open sewage has contaminated Gaza鈥檚 coastline as overcrowded camps for displaced people have begun routing sewage into the Mediterranean.

Mpox vaccines will finally arrive in Africa this week鈥攚ith 10,000 shots donated by the U.S. arriving weeks after they have been made available in other parts of the world.

Chikungunya cases in Brazil are on the rise, with 375,000 confirmed cases so far this year; the state of S茫o Paulo has emerged as a new hot spot.

HPV vaccination has stalled among U.S. teens in the years since the COVID-19 pandemic, 鈥攁 trend that could hamper cancer prevention efforts. GHN EXCLUSIVE COMMENTARY Small fish like these sardines are a nutritional powerhouse full of essential nutrients. Sept. 11, 2023. Damir Sagolj/Getty How Wild Fisheries Can Reduce Hidden Hunger  
To address hidden hunger afflicting , we need to introduce more fish into the diets of the world鈥檚 poorest populations, .
 
The challenge: Doing that will require confronting the many causes of the depletion of the Earth鈥檚 wild fish stocks.

• About 35% of marine fish stocks are overfished, up from 10% in the 1970s, .


• Almost a third of freshwater fish species face extinction, a .

Solutions include:

• Expanding marine-protected areas by 5% to increase the future fish catch by at least 20%, .


• Improving how fish harvests are used to increase the amount of seafood available, . Example: ~11% of all seafood caught is discarded because of small size and other undesirable features. 

Get involved: Interested in integrating wild fisheries into strategies to improve nutrition? See for more info. GLOBAL HEALTH VOICES MATERNAL HEALTH The Miscarriage Information Gap
A lack of standardized systems, underfunding, and limited research in the U.S. has led to insufficient data about miscarriage鈥攅specially when compared to other industrialized countries.

• 10% to 25% of U.S. pregnancies result in miscarriage. 


• Unlike in Europe, there are no national statistics on the economic or emotional impact of fetal loss. 


• The CDC does not publish miscarriage data.

A data chasm: State laws vary on what gestational age to report miscarriages and reporting is often inconsistent. 

Solutions: New reporting requirements, standardized definitions of pregnancy loss, and national clinical trials could help, but substantial increases in funding are needed.  

OPPORTUNITY QUICK HITS Five children a week killed or injured in Haiti鈥檚 gang warfare 鈥�

What to Know About the Updated COVID Vaccine for Fall, Winter 2024鈥�25 鈥�

Coronavirus FAQ: I'm a NOVID and don't want to catch COVID. Can you guide me? 鈥�

Maybe She鈥檚 Just Tired, Maybe It鈥檚 Undiagnosed Iron Deficiency 鈥�

Fauci recovering at home after being hospitalized with West Nile virus, spokesperson says 鈥�

How to harness AI's potential in research 鈥� responsibly and ethically 鈥�

A harm-reduction approach to eating out 鈥�

Mini-Dune! Soil viruses hitchhike on tiny worms to infect new victims 鈥� Issue No. 2770
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: Don鈥檛 Catch Covid鈥檚 Summer Wave; Marketing Tactic Banned in the West Boosts Cigarette Sales in China; and Eau鈥攐r Ew?鈥攄e Parfum August 22, 2024 A masked commuter is seen on the metro in Washington, D.C., on May 25. Rosem Morton for The Washington Post via Getty Don鈥檛 Catch Covid鈥檚 Summer Wave
A summer of surging COVID-19 cases in the U.S. and other countries delivers yet another reminder that the restless, ever-evolving SARS-CoV-2 virus is far from done. The latest wave is also refocusing attention on vaccine options.
 
How bad is the current spike?

• Most countries are no longer regularly reporting cases, but wastewater testing in the U.S. shows that levels a couple weeks ago haven鈥檛 been seen since January 13, . Other countries report similar findings from wastewater.

• The percentage of positive PCR tests in the U.K. peaked in July with levels that matched October 2023鈥檚.

Coming soon: The U.S. FDA is expected to approve a new vaccine as early as today, .

• The new Pfizer and Moderna shots should roll out within days of the approval.

• The jabs target the KP.2 strain, which emerged from the highly contagious JN.1 variant.

But: A new variant, KP.3.1.1, has eclipsed KP.2 and JN.1 and accounts for 31%鈥�43% of COVID-19 clinical specimens, .

• While it鈥檚 not known how effective the new vaxes will be against KP.3.1.1, they are expected to protect against severe illness, per NBC.

Related:

Impact of COVID-19 on Healthy Life Expectancy of Older Adults in the Region of the Americas 鈥�  

Researchers find increased mental illnesses incidence following severe COVID-19, especially in unvaccinated people 鈥�

Why COVID Surges in the Summer 鈥�

In kids, long-COVID symptoms differ by age-group, find scientists who built research index 鈥� GLOBAL HEALTH VOICES The Latest One-Liners   Female doctors have a 76% higher suicide risk than the general population, according to an analysis of 39 studies from 20 countries that found no overall increase among male physicians compared with the general public.
 
2X the recommended limit of flouride is linked with lower IQs in children, according to a new U.S. government analysis of previously published research; it鈥檚 the first time a federal agency has acknowledged potential neurological risks from high fluoride levels.
 
Expanding routine treatment of infants in sub-Saharan Africa with azithromycin to all children up to age 5鈥攏ot just babies under 11 months, as the WHO currently recommends鈥攊s necessary to maximize the potential of the treatment, which could cut child mortality by 14%, new shows.
 
Nearly 60% of U.S. baby food does not meet WHO standards set for Europe, according to a new study of the nutritional content of 651 commercial food products marketed for children between 6 months and 3 years in American stores. BIG TOBACCO Marketing Tactic Banned in the West Boosts Cigarette Sales in China
In the 1960s, U.S. tobacco companies told smokers that 鈥渓ow tar鈥� cigarettes were safer than traditional cigarettes. In fact, science eventually showed, they weren鈥檛.

• In 2003, the WHO鈥檚 Framework Convention on Tobacco Control banned deceptive marketing terms like 鈥渓ow tar鈥� and outlawed most tobacco advertising.

But China Tobacco鈥攑roducing low-tar cigarettes and serving as the tobacco policy regulator for the country鈥攈as found ways around the rules. 

• And its 鈥榣ow tar鈥�-heavy strategy is working: Cigarette sales in China increased 50% from 2016 to 2022.

GLOBAL HEALTH VOICES PHARMACEUTICALS Demand for ADHD Meds
After two years of increased demand for ADHD medications like Adderall, some drugs have finally been removed from shortage lists. Yet the struggle to refill medications continues鈥攅specially as the new school year begins.

• From 2020 to 2021, demand for ADHD medications increased 20%. 


• Adderall prescriptions rose during the pandemic due to increased ADHD diagnoses from telehealth visits.

A problem for patients: Many pharmacies are still out of these medications. Even so, patients cannot move prescriptions between pharmacies because these drugs are controlled substances. 

THURSDAY DIVERSION Eau鈥攐r Ew?鈥攄e Parfum 
Every successful athlete has to have some 鈥渟pecial sauce鈥� that makes them stand out. 

For Tennessee Titans quarterback Will Levis, there鈥檚 a literal sauce: Mayonnaise. 

Levis relishes mayo so much that he鈥檚 spreading the love, concocting a new signature fragrance with the Hellmann鈥檚 brand that is based on the condiment. 

Aioli advocate: While at the University of Kentucky, Levis went viral for a in which he doctored his coffee with a generous dollop of his favorite condiment鈥攁 gambit that earned him a lifetime supply of Hellmann鈥檚.

A new emulsification: The perfume, dubbed 鈥淲ill Levis No. 8鈥� (Levis鈥� jersey number), combines hints of tart lemon, coffee, musk, vanilla鈥攑lus a mysterious ingredient the company describes as 鈥渕ayonnaise accord.鈥�

• In the product鈥檚 moody , Levis runs through the mist, watches a thunderstorm, and devours a mayo-coated slice of bread while whispering: 鈥淟uscious鈥�Eggy鈥�Smell like greatness.鈥�

QUICK HITS

Yes there is famine in Sudan. So why isn't 'famine' being declared? 鈥�

Border closures and intensifying conflict worsen Myanmar鈥檚 healthcare crisis 鈥�

A California Medical Group Treats Only Homeless Patients 鈥� And Makes Money Doing It 鈥� 

It鈥檚 not just IUDs. Gynecologists and patients are focused on making procedures less painful 鈥�

Microplastics are infiltrating brain tissue, studies show: 鈥楾here鈥檚 nowhere left untouched鈥� 鈥�

Indoor house cats have died of bird flu. How did they get it? 鈥�

Traveling to die: The latest form of medical tourism 鈥�

LGBTQ+ asylum seekers detail harsh conditions and abuse in ICE custody 鈥�

Heat sensors in mosquito antennae may help them hunt us from afar 鈥�

Issue No. 2769
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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