Dangerous New Strain of Mpox Virus Reported in Goma, Eastern DRC’s Capital – Increasing Risks of Cross Border Spread 11/07/2024 Elaine Ruth Fletcher Dr Tedros Adhanom Ghebreyesus warns about the growing threat of mpox and other infectious diseases as well as conflict-related health emergencies at a WHO press briefing Wednesday The outbreak of a new and dangerous strain of mpox in the eastern Democratic Republic of Congo has now spread to Goma, eastern DRC’s largest city with 25 cases reported, mostly in the city’s displaced persons camps, WHO officials confirmed on Thursday. And with person-to-person transmission occurring, particularly within communities on the move after fleeing attacks by Congo’s M23 rebel forces, there is a rising risk of cross border spread of the new strain, WHO officials warned at a press conference Thursday. The wide-ranging WHO press briefing also touched upon half a dozen other health emergencies and threats, including the soaring worldwide rate of dengue virus cases and evidence of an ever-widening outbreak of H5N1 avian flu amongst dairy cattle in the United States. WHO Director General Dr Tedros Adhanom Ghebreyesus also touched upon the continuing toll of war in Sudan; Gaza and Ukraine, including the recent Russian bombing of a children’s hospital in Kiev and Israel’s recent order to Gaza City Palestinian residents to move southward again in a grinding war against Hamas that just entered its ninth month. Goma cases could fuel more cross-border infections WHO mpox specialist Dr Rosamund Lewis. In the case of DRC’s mpox outbreak, the risk of cross border infection is growing, insofar as Goma sits astride a busy transport hub, right alongside the border with Rwanda. “There is a risk of cross border infection as the virus continues to move because the borders are very porous with neighboring countries – Rwanda, Burundi, even perhaps Uganda. There’s clearly a lot of population movements across those borders,” said WHO mpox specialist Dr Rosamund Lewis. “Large scale population movements, internally displaced population movements, insecure settings – these all bring associated risks, but also the facts that not all cases are reported, not necessarily detected. “The strain that is transmitting, so far, is exclusively person-to-person,” she added, ruling out any connection between the new outbreak and animal hosts that historically harboured the disease in the wild. “It is largely through sexual contact, initially, including amongst sex workers, and increasingly in the community.” WHO working to expand access to diagnostics and, eventually, immunization Both Clade I and II strains of mpox are circulating in DRC – but a new strain of Clade I transmitted by sexual contact is worrying health officials the most. She said that comparatively high rates of laboratory testing of cases confirms that the dominant mpox strain being transmitted is part of the more severe Clade 1 family of mpox virus – which has up to a 10% fatality rate. However, in the case of the new strain, many people still experience only mild symptoms, which then pass under the wire of detection. “The proportion of cases that are laboratory confirmed is very high, and the proportion of those that are tested that turned out to be Clade 1 mpox is also very high. So we’re confident in the data that we’re seeing and need to continue to support the Ministry of Health for a robust response in that region.” Current efforts are focused mostly on expanding diagnosis and treatment, she said. Although the DRC recently approved the emergency use of mpox vaccines, rollout has yet to begun – and Lewis provided no strategy or timeline for how and when the vaccines might eventually be deployed. Largest ever mpox outbreak in DRC Father of six, sought safety for his family at a displacement site near Goma after his wife was killed by a bombing in North Kivu province. Congo has seen 20,000 cases and more than 1,000 deaths from mpox since the start of 2023, according to WHO and national Congolese authorities – the largest ever mpox outbreak to be recorded. “More than 11,000 cases have been reported this year and 445 deaths, with children the most affected,” said WHO’s Director General Dr Tedros, speaking at the briefing. He noted that South Africa, as well, has recently reported 20 cases of mpox to WHO, including three deaths – the first cases seen in the country since 2022. “The cases were all men and most self-identified as men who have sex with men. None had reported any history of international travel, which suggests that the confirmed cases are a small proportion of all cases, and that community transmission is ongoing,” Dr Tedros said. As with DRC, WHO is supporting South Africa to respond to the outbreak, to engage the affected communities and to develop immunization strategies, he said. Regional conflicts fueling more hunger, disease and despair Aicha Madar fled to Chad with daughter Fatima after armed men set fire to her village in Sudan. Photo In terms of conflict related emergencies, WHO officials said it was providing medical supplies to Ukrainian hospitals that are receiving children evacuated from a Children’s hospital in Kiev on Monday, just minutes before a large part of the complex took a direct hit – apparently from a Russian missile, according to the UN. WHO was also assessing damage to medical equipment at the Okhmatdyt hospital, where the intensive care, oncology and surgery wards were most heavily damaged. More than 600 children were in the hospital just before the missile struck. A rapid evacuation meant that only two people, including one child, were killed – despite massive infrastructure damage to what is the largest children’s hospital in the country. In Sudan, meanwhile, the number of displaced people has now grown to 12.7 million including 10.5 million internally displaced and 2.2 million who have sought refuge in neighboring countries. At the same time, “access to health services continues to be severely constrained due to insecurity and shortages of medicines, medical supplies and health workers. Almost 15 million people need urgent health assistance,” said Tedros adding that “the risk of famine is growing with more than half of Sudan’s populations facing crisis levels of food security or worse.” Chad, in particular, has been overwhelmed with refugees. “Most communities in Chad have been very hospitable, offering food, water and shelter for refugees. But the needs are overwhelming,” he said, noting that a recent WHO joint mission to the refugee areas assessed the potential fo scale up cross border operations to meet needs of those refugees and build health system capacity – “Despite the increasing needs in both Chad and Sudan, WHO has only 18% of the funds we need to meet those needs,” Tedros warned, saying that “the international community must do better than that. Gaza – hunger, displacement … and trash Trash and sewage accumulated due to months of war exacerbate infectious disease risks in Gaza. In terms of Gaza, more than 10,000 seriously ill Palestinian patients remained trapped in the enclave awaiting evacuation since the closure of the Gaza-Egypt Rafah crossing following Israel’s military occupation of the area in early May, Dr Tedros said. Almost the entire population of Gaza still faces acute food insecurity, with one in four facing starvation, Tedros added, saying: “At the same time, very few supplies are getting into Gaza with only five WHO trucks allowed into Gaza last week, and more than 34 trucks still waiting at Egypt’s Al Arish crossing into Gaza.” A further 40 trucks are waiting at other crossings, he noted. And the already desperate situation may only get worse following Israel’s recent order to Gaza City residents to evacuate south – for the second time since Israel’s invasion of Gaza nine months ago. Israel attacked following the 7 October attack by Hamas on nearby Israeli communities that left 1200 Israelis dead and some 240 taken hostage. Since then, some 38,000 Gazan Palestinians have since been killed, according to Palestinian health authorities, while Hamas continues to hold 120 Israeli and foreign nationals hostages – of which less than half may still be alive. On a trip to Gaza last week, Hanan al Balkhy, WHO’s Regional Director for the Eastern Mediterranean Region said she saw “first hand the scale of devastation, lives and homes in ruins, hospitals overwhelmed and a fully destroyed city. “The lack of fuel is compromising all health and humanitarian operations. Running sewage and garbage litter demolished streets with the smell of fermenting waste permeating the area. “This situation is providing the perfect breeding ground for diseases to spread, leading to an increase in cases of acute watery diarrhoea and acute respiratory infections among many others. “Ongoing violence and the breakdown of law and order are devastating in an already crippled city, creating an extremely high risk environment, not just for aid workers, but for everyone. The breakdown of law and order also makes it nearly impossible to manage gender-based violence exposing displaced Palestinians to additional life threatening risks. “As a result of increasing hostilities and soaring needs, WHO has expanded its medical supply chain. However much of this aid remains stuck on the wrong side of the borders. With only a fraction reaching, Gaza. And even when supplies do, the breakdown, again, I repeat of law and order makes it challenging for our teams to deliver them to hospitals that urgently need them.” Image Credits: © UNHCR/Blaise Sanyila, National Foundation for Infectious Diseases , WFP/Jacques David, UNRWA . Biosecurity Guide Warns of Risks from AI, Cyber-attacks and Amateur Experiments 11/07/2024 Zuzanna Stawiska A recent cyberattack on South Africa’s labs has showcased the importance of adequate biosecurity measures. Artificial Intelligence (AI) technologies, cyberattacks, genetic engineering, and amateur-led biology experiments could all pose threats to a country, according to the World Health Organisation’s (WHO) updated guidance on lab biosecurity. The guidance aims to help national regulatory bodies and other institutions “establish or strengthen frameworks for handling high-consequence pathogens”. It features a comprehensive set of rules, best practices, and recommendations for managing laboratory biosecurity risks and procedures at laboratory, institutional, and national levels. The guidance needed to be updated as “rapid technological developments and advances in methods manipulating biological material in the past decade have redefined the biological threat landscapes,” according to the guidance’s authors. The WHO identified biosafety and biosecurity awareness as one of member states’ “weakest core capacities” after a review in 2022. This year’s World Health Assembly adopted a resolution on ‘Strengthening laboratory biological risk management’ which calls on member states to enhance laboratory biosafety “by including essential elements of biological risk mitigation and management within their national laboratory biosafety and laboratory biosecurity strategies, policies, programmes, and mechanisms”. It also called on the WHO to guide member states, particularly on how to deal with “high-consequence biological agents, that would, in case of release or exposure, cause significant harm or potentially catastrophic consequences”. New technologies, institutional monitoring, and risk assessment methods A distribution of regulatory, review, and monitoring responsibilities between agencies Biosecurity aims to prevent “intentional or accidental unauthorized access to, and loss, theft, misuse, diversion or release or even weaponization” of biological material, but also equipment, information, or technology, according to the guide. Developed in consultation with the WHO Technical Advisory Group on Biosafety (TAG-B) and other stakeholders, the lab biosecurity guidance covers threats to lab biosecurity and methods of managing them. It describes emerging technologies that could present a threat to lab security. Next to the well-known disinformation, AI technologies, or genetic engineering, it also puts into focus other potentially risky domains: amateur-led biology experiments or making high-consequence research publically available. The guide also offers a review of risk control measures, including staff screening and training, auditing, and cybersecurity, as well as a step-by-step guide to developing risk assessment procedures. A step-by-step instruction on developing context-appropriate biosecurity risk assessment framework, as featured in the guidance It also proposes setting up national and international institutions tasked with approving and overseeing research involving biohazards. Cyberattacks affect South Africa, UK labs There has been a 72% increase in data breaches between 2021 and 2023, highlighting the importance of resilient laboratory systems. In the past month, for example, both the UK and South African laboratory services have suffered from cyberattacks affecting patients’ test results. The British National Health Service suffered from a hacker attack in early June, setting back the waiting time for blood test results by up to six months, The Guardian reported. In late June, the South African National Health Laboratory Service (NHLS) was hacked causing a near-paralysis of the public healthcare system as no test results were available. “We recognise the magnitude of the situation and the concerns it may generate,” said South Africa’s NHLS, in a Daily Maverick report. “It has been established that sections of our system have been deleted, including in our backup server and this will require rebuilding the affected parts. Unfortunately, this will take time,” the organisation’s representatives added. Image Credits: WHO. Date Proposed for Special Session to Adopt Pandemic Agreement – But Strictly in Pencil for Now 10/07/2024 Kerry Cullinan The ninth meeting of the Intergovernmental Negotiating Body (INB) meeting in May in Geneva A day during the week of 16 December has been suggested for a World Health Assembly (WHA) special session to consider the pandemic agreement – but that is to remain strictly in pencil until there is clarity about the progress made in negotiations. After two years of talks, including weeks of late-night meetings in the run-up to the WHA, World Health Organization (WHO) member states failed to meet the May deadline for the pandemic agreement. But they are soldiering on from next week when the Intergovernmental Negotiating Body (INB) meets next Tuesday and Wednesday (16-17 July) for the 10th time. The agenda of this meeting is largely concerned with process rather than content, as member states contemplate a pathway that may finally clinch an agreement. New co-chairs? Top of the agenda is the proposal to “rotate” members of the INB Bureau – and the possible election of two new co-chairs. The Bureau, which runs the negotiations, consists of six regional representatives, including co-chairs Roland Driece from The Netherlands and South Africa’s Precious Matsoso. Some member states have blamed the Bureau for the slow pace of talks, and there have also been complaints that some iterations of the draft agreements failed to reflect key positions and agreements. The African Group has indicated that it wants to retain Matsoso and the agenda leaves the decision of the rotation of other Bureau members to the WHO regions. At 11:32 CEST, the @WHO secretariat transmitted the advance unedited English versions of the provisional Agenda, draft programme of work, and Proposed workplan, meeting schedule and proposed updates, as appropriate, to the method of work to NSAs in official relations for #INB10 pic.twitter.com/3ETvojiikc — Balasubramaniam (@ThiruGeneva) July 10, 2024 The second agenda item deals with the work plan, meeting schedule and proposed updates. This will take the bulk of the two-day meeting, bar a section on the consideration of other entities to be added as official stakeholders. The work plan proposes a meeting from 9-20th September. This will focus on Article 12, with discussion on w Articles 4, 5, 9, 10, 11, 13, 13bis, 14 and relevant sections of Article 1. The meeting will also discuss the relationship between the WHO Pandemic Agreement and its legal instruments. This will be followed by another meeting on 4-15 November “focusing on the preamble, relevant sections of Article 1, Articles 3, 19, 20, 21, 24, 26, 31, 32, 33 and 34”, according to documentation sent this week to non-state actors in official relations with the WHO. These articles cover, amongst others, the sticky issues of pathogen access and benefit sharing (PABS), One Health and access to health products during a pandemic. The deadline for calling the WHA special session to discuss and adopt the pandemic agreement will be 15 November. If there is no evident agreement by then, member states will need to agree on “an updated work plan and meeting schedule, depending on progress made,” according to the WHO documentation. The 13th meeting of the INB will take place from 2 – 6 December and, all going well, will proceed to the WHA special session. If there is no agreement and no special session, a 14th NB meeting has been scheduled for 24 – 28 February 2025. The WHA gave negotiators up to a year – the next WHA in May 2025 – to reach agreement. Civil society demands a place at INB table WHO member states are also under pressure from civil society to open the talks up – at the very least to allow civil society organisations recognised as stakeholders in the pandemic preparation process to be present during negotiations. More than 140 civil society organisations (CSO) and supporters from 40 countries issued an open call this week to the INB and WHO member states to “demand the official involvement of CSOs in all remaining negotiations in the INB process for a new pandemic agreement.” CSOs that are identified as relevant stakeholders in the INB process – including patient advocacy groups, humanitarian organisations and pharmaceutical company representatives – have relied on “brief, piecemeal” interactions with negotiators for information. The “failure to facilitate” their meaningful participation in the negotiation process “risks rolling back on best practice in global negotiations,” according to the call. They want member states to “use the opportunity of the renewed INB mandate” to include CSOs, communities and academics in all INB meetings, and provide them with all documentation “in a timely manner”. Meanwhile, a letter to the INB from The Elders, The Global Preparedness Monitoring Board, The Independent Panel for Pandemic Preparedness and Response, Pandemic Action Network, The Panel for a Global Public Health Convention, and Spark Street Advisors issued Wednesday also called for the process to be opened up. Aside from opening that talks up to relevant CSOs and independent experts, the group proposes that co-chairs build trust by “explaining why certain texts were proposed”, ensure the “full representation of all member states” in working groups and provide timely information about the negotiations. These measures will improve “effectiveness, transparency, and counter misinformation,” they note. Image Credits: WHO . From Depression to Hypertension: Heat and Air Pollution Exert Heavy Toll on India’s Farmers 09/07/2024 Sanket Jain Farmer Kusum Gaikwad finds it increasingly difficult to work in the fields and finish daily chores because air pollution has severely impacted her health. JAMBHALI, India – Farmer Kusum Gaikwad’s work start at 4 am daily. First, she burns the firewood and farm residue to heat water for 10 family members. By 7 am, she reaches the fields, manoeuvring through thousands of sugarcane plants, removing weeds, and checking for pests and diseases that could hamper their growth. This is followed by tremendous backbreaking labor, where she collects and lifts over 100kg of cattle fodder in the relentless heat. This has been her routine for the past two decades. But in 2017, Gaikwad started to get frequent headaches. Dizziness and severe pain in the chest and abdomen followed. “It was unbearable, but I kept working for four months,” she says. Eventually, when it became difficult for her to even move out of bed, she consulted a doctor and was diagnosed with hypertension. She returned to the same routine within a week. Two years later, she was diagnosed with type 2 diabetes and also reported weakening of her bones. ‘Mountains of smoke’ With the rising exposure to extreme heat and air pollution, Kusum Gaikwad was first diagnosed with hypertension and then type 2 diabetes. Perplexed, Gaikwad, now 66 years old, was determined to find the causes of her illnesses. When she went to the fields again in Jambhali village in India’s Maharashtra state, she met over 20 women who complained of similar symptoms. “Everyone was coughing throughout the day, and that’s when I realized it was the air pollution,” she told Health Policy Watch. Soon, Gaikwad found that almost every family in her village was burning at least 50 kg kilograms of firewood, agricultural residues, plastic bags, and seedling trays every day to heat water and cook food. “Every morning, you can see a mountain of smoke here,” she says. Over the years, a growing number of studies have found air pollution to be a risk factor for several noncommunicable diseases (NCDs), some of which include cardiovascular and respiratory diseases, heart attacks, and lower respiratory infections. A paper published in 2020 analyzed the impact of air pollution on the health of 39,259 Chinese adults, finding that long-term exposure to air pollutants increased blood pressure and hypertension. Similarly, a study from India found that both short and long-term exposure to ambient PM2.5, fine particulate matter smaller than 2.5 micrometers that penetrate deep into the lungs, was associated with increased hypertension. In India, deaths from NCDs have increased from 38% of total mortality in 1990 to 62% in 2016. The annual particulate pollution in India has increased by almost 68% from 1998 to 2021, reducing the average life expectancy by 2.3 years. Extreme heat exacerbates air pollution When chronic asthma becomes severe at night, Rajakka Tasgave leans against the wall, waiting for her labored breathing to ease. Rajakka Tasgave, 65, has become scared of going to the fields, something she has done for over five decades. “Every day, I see at least one woman collapsing because of the extreme heat. Someday, even I can be one of them,” she shared earlier this year. It didn’t take long for her turn, though. After collapsing in the fields in March, when the temperature topped 40 degrees Celsius in Jambhali, the doctor advised her to stop working in extreme heat. “From April to May, I didn’t step out of the house from 10am till evening,” she said. But this meant that she lost a significant chunk of her earnings as most of the farmwork happens during the day. Every day after returning from the fields, she experiences tremendous body aches. “Every week, I visit a doctor and take an injection (epidural steroid injection). Otherwise, I won’t be able to work.” Alongside the unbearable heat, Tasgave frequently comes in contact with air pollutants from the nearby industries and firewood emissions. She has tried covering her face with the end drape of her saree, but that didn’t help. A few years back, she was diagnosed with chronic asthma. “If I forget to carry my inhaler, I will die of an attack,” she confides. During extreme heat, her asthma becomes unbearable. She became breathless in May this year when the night temperatures didn’t drop as normal. “With no one to take me to the hospital, I leaned against the wall in the hope of easing my pain,” she shares. She found relief only the next day when a doctor administered medicines. Heart attacks and pulmonary diseases Researchers have stepped up efforts to understand the combined effects of air pollution and extreme heat in the past few years. In one such paper published in Environment International, they investigated the impact of heat and air pollution on mortality in 36 countries. The study found that heat-related mortality also increased with higher levels of air pollutants like PM, NO2, and O3. Moreover, they also saw an increase in PM—and O3-related mortality for higher air temperature levels. Extreme temperatures and higher concentrations of particulate matter significantly increase the risk of heart attacks, according to a study published in the American Heart Association’s journal, Circulation. The researchers examined 202,678 heart attacks from China’s Jiangsu province between 2015 and 2020. Also, they found that during extreme heat, women were at a greater risk of heart attack than men. In the presence of rising temperatures and high solar radiations, volatile organic compounds react with nitrogen oxides to form ozone, considered a harmful pollutant in the lower atmosphere. Ozone exposure can lead to respiratory infections. As a result, many people from Jambhali are now suffering from chronic obstructive pulmonary disease (COPD), which restricts the airflow and causes breathing issues. The problem is so severe that this year’s State of Global Air Report found that 50% of global ozone-related COPD deaths were reported in India. Many Indian families still rely on open fires to cook food, risking their health. Anxiety and stress rise with air pollution Jambhali’s community healthcare worker Kamal Kore was always curious about why people like Gaikwad, Tasgave and many others have felt anxious and stressed over the past five years. “Year after year, the number of people complaining of anxiety and stress disorders has risen. A few cases had even culminated in cardiovascular ailments and deaths,” she says. After tracking over a thousand such cases, she found that, as air pollution increased, so did the number of people suffering from mental health issues. Her observation isn’t a one-off case. A study published in April 2024 looked at more than 3,000 US counties, spanning over 315 million people, and found PM2.5 to be linked with depression and stress. These mental health issues, in turn, put people at risk of dying from cardiovascular diseases. Its lead author, Dr Shady Abohashem of Massachusetts General Hospital, explains, “Biologically, PM2.5 can enter the bloodstream and induce systemic inflammation, oxidative stress, and neuroinflammation, all known to affect brain function and mood regulation.” The combined effect of PM2.5 and deteriorating mental health amplify the risk of premature cardiovascular mortality. “High PM2.5 exposure leads to systemic inflammation and endothelial dysfunction, critical factors in the development of cardiovascular diseases. When combined with poor mental health, which independently contributes to adverse cardiovascular outcomes through mechanisms like heightened stress response, disrupted sleep, and poor health behaviors, the risk is significantly magnified,” Abohashem explains. Air pollution disrupts sleep, causes depression So severe was the impact that in counties with higher levels of PM2.5, people struggling with poor mental health experienced a threefold rise in premature cardiovascular mortality compared to those with better mental health in areas of lower pollution. The problem isn’t restricted to the outdoor workers. Besides crop residue burning and industrial pollution, another source of PM2.5 is indoor air pollution caused by burning firewood. Many Indian families still rely on burning firewood for cooking. A study from India published in BMC Geriatrics this year found that indoor pollution led to sleep disorders and depression among older adults. “Ambient air pollutants can travel from the nose through the olfactory nerve and reach crucial brain areas like the striatum, frontal cortex, and cerebellum, which are involved in various functions including movement, decision-making, and coordination,” says one of its authors, Dr Aparajita Chattopadhyay, a professor at the International Institute for Population Sciences in Mumbai. These pollutants trigger an inflammatory response which can lead to changes in the levels of neurotransmitters and, hence, disrupt an individual’s sleep and mood. “Sleep plays an important role in maintaining good health, failing which NCDs, including mental health issues, may crop up,” she adds. Limited air quality warnings The health problems caused by air pollution are mounting, as evident from community health worker Kamal Kore’s call records. The past five years have sent a jump in health issues – largely NCDs, especially since the temperature started rising rapidly. “Every day, I get at least 10 calls from the villagers with complaints of cardiovascular and respiratory issues,” she shares, adding that she now spends most of her time making people aware of the harmful effects of air pollution. “Every day, I tell people to switch to clean energy sources for cooking and work during the hours when the pollution is comparatively lesser,” she says. “We don’t have any resources to deal with this.” A major problem healthcare workers like her face is the lack of adequate, real-time data on air pollution to warn patients about peaks. People currently simply observe the times of day when air pollution becomes severe and try to avoid these. Farmer Narayan Gaikwad who is exposed to a lot of air pollution daily says that the lack of real time data on air pollution in the village is a big hindrance to make people aware of air pollution and the hours they shouldn’t work out in the fields. Gaikwad’s husband, Narayan Gaikwad, 77, has written several letters to the district authorities demanding strict measures to curb air pollution. “People don’t understand how much unhealthy air they are breathing because there’s no one monitoring air pollution in the village,” he says. “I am now asking people to stop working during those hours.”. Chattopadhyay suggests that older people avoid major sources of indoor air pollutants, ensure proper ventilation, and use clean fuel. “A positive and strong social circle is also necessary to be mentally fit. Adults must be made aware of cues of contentment in life much before they get old — financial stability, strong social circle, and remaining active daily in various tasks,” she adds. Given Gaikwad’s declining health, her family is considering a solar water heating system despite its crippling cost. While this will help her somewhat, she is worried about the smoke from the neighborhoods. “A solution can never work in isolation. It has to happen at the community level,” she warns. Image Credits: Sanket Jain. Record-Breaking Dengue Infection Persists in the Caribbean 09/07/2024 Sophia Samantaroy Aedes aegypti mosquitoes are the main vectors of dengue virus. Dengue virus cases have reached an all-time high since January in the US territory of Puerto Rico, with 1,729 people infected so far – a more than 300% increase compared to last year. The uptick in the mosquito-borne disease, which causes mild to severe illness, follows a trend across the Caribbean region. The total number of reported cases for the Caribbean has reached nearly 57,000 – a 469% increase as compared to the same period in 2023. Climate change, the El Nino effect, and unplanned urban growth have fueled this year’s surge. While dengue tends to hit Brazil, Argentina, Paraguay and Uruguay the worst, the Caribbean, the Central American isthmus, and Mexico continue to see above-average transmission. Further complicating efforts to control the mosquito-borne disease is the premature start to the hurricane season. Hurricane Beryl has already devastated several small island nations in the Caribbean, damaging water and health infrastructure, thus making residents even more vulnerable to dengue. Halfway into 2024, the total burden of dengue cases in the Americas has exceeded 10.1 million, more than twice the 4.7 million cases in 2023. The Puerto Rican Department of Health recently extended its dengue epidemic alert until December, after this year’s season brought the highest proportion of severe dengue in the Americas. Of the nearly 2,000 cases reported to the territory’s health officials, 92 are severe, meaning patients may suffer from painful symptoms including fever, headaches and vomiting. Three of the dengue serotypes – DENV 1, 2, and 3 – are currently circulating. This alert comes just two weeks after the US Centers for Disease Control and Prevention (CDC) issued a health advisory warning of the increased risk of dengue virus infections in the US. While most cases in the continental US come from overseas travelers, Florida has reported a handful of locally-transmitted cases. Hurricane Beryl sets back health response Debris, abundant rainfall, and inadequate shelter are all hurricane by-products that increase the risk of dengue virus infection. The first category 5 hurricane of the season, Beryl devastated much of Saint Vincent and the Grenadines, Grenada, Dominica, Barbados, and Jamaica. The destruction left in the hurricane’s wake highlights small island nations’ vulnerabilities to climate change and its health effects. The Caribbean region is particularly susceptible to healthcare disruptions from natural disasters. Studies of cyclones in China and hurricanes in Puerto Rico found increases in dengue virus infections in the weeks following hurricanes. “Pre-existing environmental health risk magnified after the pass of Hurricanes Irma and María,” said researcher José Pérez-Ramos, Assistant Professor of Public Health Sciences at the University of Rochester. He notes that in the aftermath of 2017’s devastating hurricanes, participants in the study were worried about frequent dengue outbreaks. While the International Federation of the Red Cross (IFRC) and other relief organizations active in the Caribbean nations are in the early days of response and assessment, the confluence of the hurricane’s destruction and peak dengue season may spell out an increased case burden. “Hygiene kits, cleaning kits, tool kits, kitchen sets, tarpaulins, blankets and mosquito nets have already been dispatched to the hardest hit islands to meet the immediate needs of the affected population,” said Rhea Pierre, IFRC Disaster Manager for the English and Dutch-speaking Caribbean. “Still, rapid damage assessments show that the devastation is massive.” ‘A notable increase’ in cases, but low fatality rate Removing standing water sources is a key tactic in controlling for dengue. Despite this year’s record number of cases, the World Health Organisation’s (WHO) regional office in the Americas, the Pan-American Health Organization (PAHO), notes that the fatality rate for the Americas has not exceeded the regional benchmark of 0.05%. “While we are seeing a notable increase in the number of dengue cases in the region this year, it is important to highlight that the proportion of cases that progress to death remains low thanks to countries’ efforts and the support of PAHO,” said Jarbas Barbosa, PAHO Director, in a recent press release. “This situation highlights the importance of sustaining surveillance, strengthening prevention and control measures, and ensuring timely medical care,” he added. Standing water, seen here in the aftermath of Hurricane Otis, is needed for mosquitoes to breed. Few studies have assessed what causes some patients to progress to severe dengue. The WHO notes that ensuring access to sufficient medical care should remain at the forefront of countries’ priorities to treat severe dengue. PAHO’s Caribbean Mosquito Awareness Week, which took place in May, aimed to raise public awareness about the connection between mosquitoes and the diseases they transmit, such as dengue, chikungunya, and Zika, and to involve the community to prevent mosquito breeding. “The population and household members should be encouraged to eliminate sources of mosquito breeding, both household and peri-household. This is everyone’s task: the family, the community, the public and private sector,” said PAHO in a recent alert on increased cases in Central America, Mexico, and the Caribbean regions. Aedes aegypti, the main mosquito vector, typically breeds in sites such as water containers as well as in urban waste, including plastic wrapping that can accumulate rainwater. As the virus doesn’t have a cure and repeat infections can even be more severe, surveillance and control of mosquito breeding sites is critical to reduce dengue transmission and illness, particularly the most severe form of the disease, dengue hemorrhagic fever. Dengue cases expected to rise in Mexico, Central America and Caribbean Cases have yet to peak fully in the Caribbean, Central America and Mexico. Farther north of the equator, cases have yet to peak in the PAHO regions of the Caribbean, Central America Isthmus and Mexico. “Although there has been a decrease in dengue cases in the Southern Cone [Brazil, Argentina, Paraguay, and Uruguay] and Andean sub-regions in recent epidemiological weeks, the subregions of the Central American isthmus and Mexico, and the Caribbean subregion are entering the period of increased dengue circulation, which could significantly increase the number of cases reported in the Region during the second half of 2024,” said PAHO in their May epidemiological alert. Cases decreasing at tail-end of season Brazil, which accounts for more than 80% of the Americas’ dengue cases, is at the tail-end of its season. The number of dengue cases is finally tapering off for the South American countries hardest hit – Brazil in particular saw an explosive growth in cases earlier this year. PAHO attributes the country’s epidemic conditions to prolonged heat, higher rainfall levels, as well as decreased population immunity following COVID-19-related restrictions. In response, and to avoid losing vaccine stock to expiration, the Brazilian government recently expanded the population eligible for dengue vaccination. Now, children six to sixteen are eligible, rather than just ten to fourteen year-olds. Image Credits: Direct Relief/Felipe Luna, James Gathany/ PHIL, CDC, Public Domain, IFRC, PAHO , PAHO , PAHO. WHO Launches Platform for Standardised Medical Device Information 09/07/2024 Zuzanna Stawiska An online WHO platform gathers information about various medical devices: from simple syringes to complex hospital equipment. To help countries and organisations navigate a complex pool of over 10,000 different medical devices, the World Health Organization (WHO) launched an online platform on Monday that will collect and standardise the information about medical equipment. Medical Devices Information System, or MeDevIS, is inspired by the WHO Priority Medical Devices List (MDL) and the Essential Medicines List, the latter of which will soon have existed for 50 years, serving as an important support for health progress globally. MeDevIS includes 2,301 types of medical devices of varying levels of complexity: from single-use syringes, medical masks, and pulse oximeters, to imaging radiology technologies, implantable prostheses, or defibrillators. “The number of medical technologies used in health care is growing, as is their complexity, which can make it challenging for health care practitioners and patients to navigate,” said Dr Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products. The aim is for a “one-stop shop of international information” to help stakeholders to find appropriate equipment. The new platform references both major naming systems for medical devices, renowned internationally: the European Medical Device Nomenclature (EMDN) and the Global Medical Device Nomenclature (GMDN), used in some countries outside of the European region. Both systems facilitate handling specific types of equipment on the regulatory and logistics levels. MeDivIS also features information about the infrastructure required for the device, the healthcare facility level where it is typically used, and links to thematic WHO guidelines connected with the branch of care for which the equipment is made. “The MeDevIS platform can be useful for national policy-makers to develop or update their own national lists for the procurement of health technologies and devices and can contribute to the progress towards universal health coverage,” said Dr Deus Mubangizi, WHO Director for Health Products Policy and Standards. Image Credits: Unsplash. Russia’s Bombing of Ukraine Children Hospital is ‘Abominable’ 08/07/2024 Kerry Cullinan Children with cancer outside Okhmatdyt Hospital after the attack. Russia’s bombing of a children’s hospital and women’s health centre in Ukraine’s capital Kiev on Monday is “abominable”, said UN High Commissioner for Human Rights Volker Türk. “Civilians must be protected, and the laws of war strictly adhered to,” added Türk. “There must be prompt, thorough and independent investigations into these latest grave attacks on civilians and civilian infrastructure, and those responsible must be held to account.” “Shockingly, one of the strikes severely damaged the intensive care, surgical and oncology wards of Okhmatdyt, which is Ukraine’s largest children’s referral hospital, and destroyed its children’s toxicology department, where children receive dialysis,” said Türk. Okhmatdyt Hospital serves more than 20,000 children annually. Monday’s missile attack struck a medical building at the hospital where children were receiving dialysis, while also damaging the intensive care, operating, and oncology departments, according to the Minister of Health of Ukraine. The entire hospital is without electricity, preventing the use of ventilators and other urgent care. Dr Tedros Adhanom Ghebreyesus, Director General of the World Health Organisation (WHO), said that “several floors of the largest children’s hospital in Kyiv were severely impacted today, disrupting the hospital’s operations and affecting its ability to provide critical care to the young patients.” Several floors of the largest children’s hospital in Kyiv were severely impacted today, disruptng the hospital’s operations and affecting its ability to provide critical care to the young patients.@WHO has been working closely with the hospital before and since the war in… pic.twitter.com/9ReGcov71F — Tedros Adhanom Ghebreyesus (@DrTedros) July 8, 2024 Meanwhile, Türk said that OHCHR staff visiting the scene shortly after the attack had “observed children receiving treatment for cancer in hospital beds set up in parks and on streets, where medical workers had quickly established triage areas, amongst chaos, dust and debris.” Health officials said the entire hospital was now without electricity, preventing the use of ventilators and other urgent care. It was not immediately clear how many people were killed in the strike. The ISIDA Medical Centre, one of the largest women’s health and family planning centres in Ukraine, was also affected by the attack, with several casualties. The attack comes the day before a NATO summit in Washington DC. Russia has attacked Ukraine’s health care workers, facilities, and other medical infrastructure at least 1,442 times since its invasion of Ukraine in February 2022 and 13 April 2024,according to data from a partnership made up of the Ukrainian Health Center, Physicians for Human Rights (PHR) and others. Russian attacks on Ukraine health care since February 2022. “Russia’s strategy in Ukraine includes attacking babies and children. Domestic and international actors should intensify efforts to hold perpetrators accountable for these war crimes,” said Uliana Poltavets, PHR’s Ukraine emergency response coordinator in a statement. Researchers have documented 79 attacks that affected children’s health care, including 54 attacks that destroyed or damaged children’s hospitals. “Today’s devastating attack on the largest children’s hospital is emblematic of Russia’s onslaught against Ukraine’s health care system. Again and again, we have witnessed Russian forces attack vulnerable patients, health workers, and hospitals across the country,” said Poltavets. PHR called on “domestic and international prosecutors, including the International Criminal Court, to prioritise the investigation and prosecution of attacks on health care.” Image Credits: Twitter. Sierra Leone Outlaws Child Marriage 08/07/2024 Kerry Cullinan Sierra Leone First Lady Fatima Bio Sierra Leone’s President Julius Maada Bio signed into law the Prohibition of Child Marriage Act last week, introducing a penalty of at least 15 years and a fine of around $4,000 for any man who marries a girl under 18. The law also prohibits cohabiting with a child, and fines for anyone arranging, aiding or attending such marriage ceremonies. First Lady Fatima Bio’s “Hands Off Our Girls” campaign has been instrumental in advocating against child marriage in Sierra Leone. Sierra Leone has one of the highest rates of child marriages in Africa, alongside Niger and Nigeria. According to the 2019 Sierra Leone Demographic and Health Surveys, 30% of girls in Sierra Leone are married before their 18th birthday. In 2020, there were 800,000 child brides, half of whom were married before they turned 15, according to UNICEF. The country of slightly over eight million people also has a high rate of female genital mutilation. “Child marriages fuel the high adolescent pregnancy rate in Sierra Leone where, tragically, pregnancy complications are the leading cause of death for girls aged 15-19,” according to Human Rights Watch (HRW). In 2021, the country introduced a policy of “radical inclusion” in schools, targeting and marginalised groups including girls, particularly pregnant girls and parent learners. Last year, Sierra Leone passed an education law that guarantees children free education, including one year of pre-primary. “The legislation is a milestone in Sierra Leone’s journey towards gender equality and child protection. It also sets a pathway forward for other African nations, such as Tanzania and Zambia, to revoke laws that permit child marriage, and ensure girls can complete primary and secondary education,” said HRW. FDA Approves Eli Lilly’s Kisunla for Early-Stage Alzheimer’s Patients 08/07/2024 Maayan Hoffman Neurons with tau protein highlighted in red. Eli Lilly’s Alzheimer’s therapy, donanemab, has received FDA approval, offering new hope for patients with early symptomatic Alzheimer’s disease. The newly approved treatment, branded Kisunla, is set to challenge existing therapies from Eisai and Biogen. Clinical trials have shown Kisunla to be effective for individuals in the mild cognitive impairment or mild dementia stages of the disease, potentially marking a significant advancement in Alzheimer’s care. The drug is administered as an intravenous infusion every four weeks. Alzheimer’s disease is a degenerative condition of the brain that impacts over 6.5 million Americans and over 55 million people worldwide. It causes a gradual decline in memory, cognitive functions, and, eventually, the ability to perform daily activities. The disease is marked by structural changes in the brain, such as the buildup of amyloid beta plaques and neurofibrillary tangles made of tau protein, which is supposed to help stabilize the internal skeleton of neurons in the brain. The Alzheimer’s Association celebrated the FDA’s decision. “This is real progress,” said Joanne Pike, Alzheimer’s Association president and CEO, in a statement. “Today’s approval allows people more options and greater opportunity to have more time. Having multiple treatment options is the kind of advancement we’ve all been waiting for — all of us who have been touched, even blindsided, by this difficult and devastating disease.” Slows cognitive decline by at least 22% The approval was based on an extensive double-blind, placebo-controlled, parallel-group study evaluating the efficacy of Kisunla in slowing cognitive decline in participants with varying levels of tau protein in the brain. Tau is a protein that helps to stabilise the neurons in the brain. The study, conducted over 72 weeks with 1,736 patients averaging 73 years old, revealed that those receiving Kisunla experienced a 35% reduction in cognitive decline compared to those on placebo among individuals with low to medium tau levels. Even among participants with higher tau levels, the treatment demonstrated a meaningful but slightly reduced effect. Overall, including all tau levels, Kisunla slowed cognitive decline by 22% and reduced the likelihood of progressing to the next stage of the disease by 39% compared to placebo. Additionally, the study monitored amyloid plaque levels using positron emission tomography (PET) scans throughout the treatment period. Results showed substantial reductions in amyloid plaques over time among patients receiving Kisunla, with reductions of 61% at six months, 80% at 12 months, and 84% at 18 months compared to baseline levels. These findings suggest that Kisunla not only targets cognitive decline but also effectively reduces the hallmark amyloid pathology associated with Alzheimer’s disease progression. Potential side effects For some patients, there is a risk of amyloid-related imaging abnormalities (ARIA) developing, the FDA said. ARIA typically manifests as temporary brain swelling, sometimes accompanied by small areas of bleeding on or in the brain. While ARIA often resolves on its own and may not cause symptoms, rare instances of severe and potentially life-threatening events have been reported. ARIA is a recognized side effect of antibody therapies targeting amyloid. Infusion-related reactions are also a concern, including flu-like symptoms, nausea, vomiting, changes in blood pressure, and hypersensitivity reactions such as anaphylaxis (a severe allergic reaction) and angioedema (swelling). Kisunla joins Leqembi, on market since 2023 Kisunla is the third drug to receive FDA approval, although only the second is now available for use. Leqembi, a collaboration between Biogen of the United States and Eisai of Japan, gained approval in July 2023. In an 18-month Phase III trial, Leqembi demonstrated a 27% reduction in cognitive decline among early-stage Alzheimer’s patients compared to those receiving a placebo. Another drug, aducanumab, also developed by Biogen and Eisai, was granted accelerated approval by the FDA in June 2021. However, due to some side effects, the therapy was pulled from the market. The Alzheimer’s Association emphasized the importance of early detection and diagnosis now that multiple FDA-approved treatments for Alzheimer’s are available. The organization stressed that timely access to these treatments is crucial for maximizing their benefits, asserting that no stage or entity should hinder or delay such access. “Too many roadblocks have prevented individuals from getting equitable access to these beneficial treatments for far too long,” said Pike. “It is equally important that clinicians and health care systems are informed and prepared to help the individuals who could benefit. The Alzheimer’s Association is working with health systems and providers to ensure they have the tools and resources to meet the needs of their patients.” Image Credits: Gerry Shaw/ EnCor Biotechnology Inc. Earliest Ever Hurricane Tears Through Caribbean, Highlighting Need for Speedier Climate Action 05/07/2024 Kerry Cullinan Fishing vessels at the Bridgetown Fisheries Complex in Barbados damaged by Hurricane Beryl. Hurricane Beryl, which has destroyed homes and infrastructure in large parts of the eastern Caribbean, is the first first-ever Category 4 hurricane recorded in the region in June – and a portend of devastating changes in weather patterns. It also underscores the need for urgent international assistance to Small Island Developing States (SIDS) to strengthen early warning systems and the climate resilience of key infrastructure – notably water, sanitation and health services, according to experts. The hurricane reached peak speed of 265 km per hour at times as it whipped though Barbados, Grenada, St Vincent and the Grenadines, Haiti, northern Venezuela, the Dominician Republic, Cayman Islands, and Jamaica. “The storm first impacted Barbados, causing severe damage to the south coast and significantly affecting the fishing industry with over 200 fishing vessels damaged or destroyed,” according to the International Federation of Red Cross and Red Crescent Societies (IFRC). On Union Island, part of Saint Vincent and the Grenadines, 90% of infrastructure has been damaged, including houses, roads and the airport. Some 95% of homes in Grenada’s Carriacou and Petite Martinique islands, are damaged, and around 3,000 people are shelters, the IFRC added. Parts of Jamaica’s St Elizabeth region in the south east were also devastated, with around 1,000 people taking refuge in shelters. The Dominican Republic, Cayman Islands reported damage. Venezuela’s President Nicolas Maduro said that 8,000 houses had been destroyed, according to Reuters. More to still come? “Hurricane Beryl, the first hurricane of the 2024 Atlantic hurricane season, rapidly strengthened to a Category 5 storm unusually early in the year,” according to a report from the National Ocean and Atmospheric Administration (NOAA), which is part of the US Department of Commerce “This explosive strengthening was fuelled in part by exceptionally warm ocean temperatures. That heat was one of the factors behind NOAA’s prediction in May of an 85% chance that the 2024 Atlantic hurricane season would be above normal.” Sea surface temperatures were close to those usually found in mid-September, the peak of hurricane season, added NOAA. In late May, NOAA weather forecasters predicted an 85% chance of above-normal hurricane for the 2024 Atlantic hurricane season, which runs from 1 June 1 to 30 November. It also forecast eight to 13 hurricanes, with four to seven likely to be “major” hurricanes (winds of over 178km per hour) in coming months. Early warning systems “The unprecedented hurricane demonstrates the importance of effective multi-hazard early warning systems to save lives,” according to United Nations Disaster Risk Reduction (UNDRR). “Globally, the sustained investments in those systems are making progress in reducing the loss of life in disasters. But economic losses are escalating. Every year millions of households lose their livelihood and risk being pushed into poverty. Ensuring that infrastructure is resilient and that communities ‘build back better’ in the face of future hazards is essential,” added UNDRR. Damage sustained to the airport and surrounding areas on Union Island in the Grenadines during Hurricane Beryl. In late May, the Fourth International Conference on SIDS adopted the Antigua and Barbuda Agenda for SIDS, a 10-year development agenda that appeals for international assistance to address climate change. The Agenda notes that “SIDS are facing the unrelenting and compounding impacts of climate change, biodiversity loss, pollution, disasters and natural hazards, health and other social related challenges and economic vulnerabilities.” Key climate change challenges include “erratic precipitation, increasingly frequent and extreme weather phenomena, more frequent and severe tropical cyclones, floods and drought, diminishing fresh water resources, desertification, coastal erosion, land degradation and sea-level rise.” However, there has been a “progressive deterioration” in SIDS’ ability to “withstand external shocks and enhance their resilience” – largely as a result of the economic impact of COVID-19 and climate challenges. Financial reform to build resilience Protestors call on wealth countries to pay for climate-related loss and damage at COP27. “In the wake of Hurricane Beryl, it is clear that we must redouble our efforts to build resilience and preparedness in the face of growing disaster risk, especially for small island developing states, which have contributed the least to the climate crisis but suffer the greatest costs,” said UNDRR head Kamal Kishore. Kishore appealed for international support for the Antigua and Barbuda Agenda, which “integrates disaster risk reduction as central to climate change adaptation and sustainable development in SIDS with clear calls to action on enhancing multi-hazard early warning systems and resilient infrastructure.” There have also been numerous calls for reform of the international financial architecture to assist developing countries most affected by climate change who are being forced to borrow money to address climate crises largely caused by wealthy nations. The most significant of these is the 2022 Bridgetown Initiative, spearheaded by Prime Minister Mia Mottley of Barbados. This called for key actions including new loan mechanisms, reform of the world’s development banks, and a loss and damages fund to enable developing countries to access to resilient finance to address climate and development crises. The UN climate change conference, COP27, agreed to establish a loss and damage fund during the UN Climate Change Conference (COP27) in 2022. However, there is resistance from a number of wealthier countries to this as the world continues to experience record-breaking extreme weather events. Meanwhile, the International Cort of Justice (ICJ) is expected to hold public hearings and issue an advisory later this year on the international legal obligations countries have to safeguard people against climate change. This follows the adoption last year of a landmark UN resolution to seek such an advisory opinion from the ICJ. While not legally binding, the advisory opinion holds legal and moral weight and will spotlight the human rights impacts of climate policy. Image Credits: UNDP, AfricaNews. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Biosecurity Guide Warns of Risks from AI, Cyber-attacks and Amateur Experiments 11/07/2024 Zuzanna Stawiska A recent cyberattack on South Africa’s labs has showcased the importance of adequate biosecurity measures. Artificial Intelligence (AI) technologies, cyberattacks, genetic engineering, and amateur-led biology experiments could all pose threats to a country, according to the World Health Organisation’s (WHO) updated guidance on lab biosecurity. The guidance aims to help national regulatory bodies and other institutions “establish or strengthen frameworks for handling high-consequence pathogens”. It features a comprehensive set of rules, best practices, and recommendations for managing laboratory biosecurity risks and procedures at laboratory, institutional, and national levels. The guidance needed to be updated as “rapid technological developments and advances in methods manipulating biological material in the past decade have redefined the biological threat landscapes,” according to the guidance’s authors. The WHO identified biosafety and biosecurity awareness as one of member states’ “weakest core capacities” after a review in 2022. This year’s World Health Assembly adopted a resolution on ‘Strengthening laboratory biological risk management’ which calls on member states to enhance laboratory biosafety “by including essential elements of biological risk mitigation and management within their national laboratory biosafety and laboratory biosecurity strategies, policies, programmes, and mechanisms”. It also called on the WHO to guide member states, particularly on how to deal with “high-consequence biological agents, that would, in case of release or exposure, cause significant harm or potentially catastrophic consequences”. New technologies, institutional monitoring, and risk assessment methods A distribution of regulatory, review, and monitoring responsibilities between agencies Biosecurity aims to prevent “intentional or accidental unauthorized access to, and loss, theft, misuse, diversion or release or even weaponization” of biological material, but also equipment, information, or technology, according to the guide. Developed in consultation with the WHO Technical Advisory Group on Biosafety (TAG-B) and other stakeholders, the lab biosecurity guidance covers threats to lab biosecurity and methods of managing them. It describes emerging technologies that could present a threat to lab security. Next to the well-known disinformation, AI technologies, or genetic engineering, it also puts into focus other potentially risky domains: amateur-led biology experiments or making high-consequence research publically available. The guide also offers a review of risk control measures, including staff screening and training, auditing, and cybersecurity, as well as a step-by-step guide to developing risk assessment procedures. A step-by-step instruction on developing context-appropriate biosecurity risk assessment framework, as featured in the guidance It also proposes setting up national and international institutions tasked with approving and overseeing research involving biohazards. Cyberattacks affect South Africa, UK labs There has been a 72% increase in data breaches between 2021 and 2023, highlighting the importance of resilient laboratory systems. In the past month, for example, both the UK and South African laboratory services have suffered from cyberattacks affecting patients’ test results. The British National Health Service suffered from a hacker attack in early June, setting back the waiting time for blood test results by up to six months, The Guardian reported. In late June, the South African National Health Laboratory Service (NHLS) was hacked causing a near-paralysis of the public healthcare system as no test results were available. “We recognise the magnitude of the situation and the concerns it may generate,” said South Africa’s NHLS, in a Daily Maverick report. “It has been established that sections of our system have been deleted, including in our backup server and this will require rebuilding the affected parts. Unfortunately, this will take time,” the organisation’s representatives added. Image Credits: WHO. Date Proposed for Special Session to Adopt Pandemic Agreement – But Strictly in Pencil for Now 10/07/2024 Kerry Cullinan The ninth meeting of the Intergovernmental Negotiating Body (INB) meeting in May in Geneva A day during the week of 16 December has been suggested for a World Health Assembly (WHA) special session to consider the pandemic agreement – but that is to remain strictly in pencil until there is clarity about the progress made in negotiations. After two years of talks, including weeks of late-night meetings in the run-up to the WHA, World Health Organization (WHO) member states failed to meet the May deadline for the pandemic agreement. But they are soldiering on from next week when the Intergovernmental Negotiating Body (INB) meets next Tuesday and Wednesday (16-17 July) for the 10th time. The agenda of this meeting is largely concerned with process rather than content, as member states contemplate a pathway that may finally clinch an agreement. New co-chairs? Top of the agenda is the proposal to “rotate” members of the INB Bureau – and the possible election of two new co-chairs. The Bureau, which runs the negotiations, consists of six regional representatives, including co-chairs Roland Driece from The Netherlands and South Africa’s Precious Matsoso. Some member states have blamed the Bureau for the slow pace of talks, and there have also been complaints that some iterations of the draft agreements failed to reflect key positions and agreements. The African Group has indicated that it wants to retain Matsoso and the agenda leaves the decision of the rotation of other Bureau members to the WHO regions. At 11:32 CEST, the @WHO secretariat transmitted the advance unedited English versions of the provisional Agenda, draft programme of work, and Proposed workplan, meeting schedule and proposed updates, as appropriate, to the method of work to NSAs in official relations for #INB10 pic.twitter.com/3ETvojiikc — Balasubramaniam (@ThiruGeneva) July 10, 2024 The second agenda item deals with the work plan, meeting schedule and proposed updates. This will take the bulk of the two-day meeting, bar a section on the consideration of other entities to be added as official stakeholders. The work plan proposes a meeting from 9-20th September. This will focus on Article 12, with discussion on w Articles 4, 5, 9, 10, 11, 13, 13bis, 14 and relevant sections of Article 1. The meeting will also discuss the relationship between the WHO Pandemic Agreement and its legal instruments. This will be followed by another meeting on 4-15 November “focusing on the preamble, relevant sections of Article 1, Articles 3, 19, 20, 21, 24, 26, 31, 32, 33 and 34”, according to documentation sent this week to non-state actors in official relations with the WHO. These articles cover, amongst others, the sticky issues of pathogen access and benefit sharing (PABS), One Health and access to health products during a pandemic. The deadline for calling the WHA special session to discuss and adopt the pandemic agreement will be 15 November. If there is no evident agreement by then, member states will need to agree on “an updated work plan and meeting schedule, depending on progress made,” according to the WHO documentation. The 13th meeting of the INB will take place from 2 – 6 December and, all going well, will proceed to the WHA special session. If there is no agreement and no special session, a 14th NB meeting has been scheduled for 24 – 28 February 2025. The WHA gave negotiators up to a year – the next WHA in May 2025 – to reach agreement. Civil society demands a place at INB table WHO member states are also under pressure from civil society to open the talks up – at the very least to allow civil society organisations recognised as stakeholders in the pandemic preparation process to be present during negotiations. More than 140 civil society organisations (CSO) and supporters from 40 countries issued an open call this week to the INB and WHO member states to “demand the official involvement of CSOs in all remaining negotiations in the INB process for a new pandemic agreement.” CSOs that are identified as relevant stakeholders in the INB process – including patient advocacy groups, humanitarian organisations and pharmaceutical company representatives – have relied on “brief, piecemeal” interactions with negotiators for information. The “failure to facilitate” their meaningful participation in the negotiation process “risks rolling back on best practice in global negotiations,” according to the call. They want member states to “use the opportunity of the renewed INB mandate” to include CSOs, communities and academics in all INB meetings, and provide them with all documentation “in a timely manner”. Meanwhile, a letter to the INB from The Elders, The Global Preparedness Monitoring Board, The Independent Panel for Pandemic Preparedness and Response, Pandemic Action Network, The Panel for a Global Public Health Convention, and Spark Street Advisors issued Wednesday also called for the process to be opened up. Aside from opening that talks up to relevant CSOs and independent experts, the group proposes that co-chairs build trust by “explaining why certain texts were proposed”, ensure the “full representation of all member states” in working groups and provide timely information about the negotiations. These measures will improve “effectiveness, transparency, and counter misinformation,” they note. Image Credits: WHO . From Depression to Hypertension: Heat and Air Pollution Exert Heavy Toll on India’s Farmers 09/07/2024 Sanket Jain Farmer Kusum Gaikwad finds it increasingly difficult to work in the fields and finish daily chores because air pollution has severely impacted her health. JAMBHALI, India – Farmer Kusum Gaikwad’s work start at 4 am daily. First, she burns the firewood and farm residue to heat water for 10 family members. By 7 am, she reaches the fields, manoeuvring through thousands of sugarcane plants, removing weeds, and checking for pests and diseases that could hamper their growth. This is followed by tremendous backbreaking labor, where she collects and lifts over 100kg of cattle fodder in the relentless heat. This has been her routine for the past two decades. But in 2017, Gaikwad started to get frequent headaches. Dizziness and severe pain in the chest and abdomen followed. “It was unbearable, but I kept working for four months,” she says. Eventually, when it became difficult for her to even move out of bed, she consulted a doctor and was diagnosed with hypertension. She returned to the same routine within a week. Two years later, she was diagnosed with type 2 diabetes and also reported weakening of her bones. ‘Mountains of smoke’ With the rising exposure to extreme heat and air pollution, Kusum Gaikwad was first diagnosed with hypertension and then type 2 diabetes. Perplexed, Gaikwad, now 66 years old, was determined to find the causes of her illnesses. When she went to the fields again in Jambhali village in India’s Maharashtra state, she met over 20 women who complained of similar symptoms. “Everyone was coughing throughout the day, and that’s when I realized it was the air pollution,” she told Health Policy Watch. Soon, Gaikwad found that almost every family in her village was burning at least 50 kg kilograms of firewood, agricultural residues, plastic bags, and seedling trays every day to heat water and cook food. “Every morning, you can see a mountain of smoke here,” she says. Over the years, a growing number of studies have found air pollution to be a risk factor for several noncommunicable diseases (NCDs), some of which include cardiovascular and respiratory diseases, heart attacks, and lower respiratory infections. A paper published in 2020 analyzed the impact of air pollution on the health of 39,259 Chinese adults, finding that long-term exposure to air pollutants increased blood pressure and hypertension. Similarly, a study from India found that both short and long-term exposure to ambient PM2.5, fine particulate matter smaller than 2.5 micrometers that penetrate deep into the lungs, was associated with increased hypertension. In India, deaths from NCDs have increased from 38% of total mortality in 1990 to 62% in 2016. The annual particulate pollution in India has increased by almost 68% from 1998 to 2021, reducing the average life expectancy by 2.3 years. Extreme heat exacerbates air pollution When chronic asthma becomes severe at night, Rajakka Tasgave leans against the wall, waiting for her labored breathing to ease. Rajakka Tasgave, 65, has become scared of going to the fields, something she has done for over five decades. “Every day, I see at least one woman collapsing because of the extreme heat. Someday, even I can be one of them,” she shared earlier this year. It didn’t take long for her turn, though. After collapsing in the fields in March, when the temperature topped 40 degrees Celsius in Jambhali, the doctor advised her to stop working in extreme heat. “From April to May, I didn’t step out of the house from 10am till evening,” she said. But this meant that she lost a significant chunk of her earnings as most of the farmwork happens during the day. Every day after returning from the fields, she experiences tremendous body aches. “Every week, I visit a doctor and take an injection (epidural steroid injection). Otherwise, I won’t be able to work.” Alongside the unbearable heat, Tasgave frequently comes in contact with air pollutants from the nearby industries and firewood emissions. She has tried covering her face with the end drape of her saree, but that didn’t help. A few years back, she was diagnosed with chronic asthma. “If I forget to carry my inhaler, I will die of an attack,” she confides. During extreme heat, her asthma becomes unbearable. She became breathless in May this year when the night temperatures didn’t drop as normal. “With no one to take me to the hospital, I leaned against the wall in the hope of easing my pain,” she shares. She found relief only the next day when a doctor administered medicines. Heart attacks and pulmonary diseases Researchers have stepped up efforts to understand the combined effects of air pollution and extreme heat in the past few years. In one such paper published in Environment International, they investigated the impact of heat and air pollution on mortality in 36 countries. The study found that heat-related mortality also increased with higher levels of air pollutants like PM, NO2, and O3. Moreover, they also saw an increase in PM—and O3-related mortality for higher air temperature levels. Extreme temperatures and higher concentrations of particulate matter significantly increase the risk of heart attacks, according to a study published in the American Heart Association’s journal, Circulation. The researchers examined 202,678 heart attacks from China’s Jiangsu province between 2015 and 2020. Also, they found that during extreme heat, women were at a greater risk of heart attack than men. In the presence of rising temperatures and high solar radiations, volatile organic compounds react with nitrogen oxides to form ozone, considered a harmful pollutant in the lower atmosphere. Ozone exposure can lead to respiratory infections. As a result, many people from Jambhali are now suffering from chronic obstructive pulmonary disease (COPD), which restricts the airflow and causes breathing issues. The problem is so severe that this year’s State of Global Air Report found that 50% of global ozone-related COPD deaths were reported in India. Many Indian families still rely on open fires to cook food, risking their health. Anxiety and stress rise with air pollution Jambhali’s community healthcare worker Kamal Kore was always curious about why people like Gaikwad, Tasgave and many others have felt anxious and stressed over the past five years. “Year after year, the number of people complaining of anxiety and stress disorders has risen. A few cases had even culminated in cardiovascular ailments and deaths,” she says. After tracking over a thousand such cases, she found that, as air pollution increased, so did the number of people suffering from mental health issues. Her observation isn’t a one-off case. A study published in April 2024 looked at more than 3,000 US counties, spanning over 315 million people, and found PM2.5 to be linked with depression and stress. These mental health issues, in turn, put people at risk of dying from cardiovascular diseases. Its lead author, Dr Shady Abohashem of Massachusetts General Hospital, explains, “Biologically, PM2.5 can enter the bloodstream and induce systemic inflammation, oxidative stress, and neuroinflammation, all known to affect brain function and mood regulation.” The combined effect of PM2.5 and deteriorating mental health amplify the risk of premature cardiovascular mortality. “High PM2.5 exposure leads to systemic inflammation and endothelial dysfunction, critical factors in the development of cardiovascular diseases. When combined with poor mental health, which independently contributes to adverse cardiovascular outcomes through mechanisms like heightened stress response, disrupted sleep, and poor health behaviors, the risk is significantly magnified,” Abohashem explains. Air pollution disrupts sleep, causes depression So severe was the impact that in counties with higher levels of PM2.5, people struggling with poor mental health experienced a threefold rise in premature cardiovascular mortality compared to those with better mental health in areas of lower pollution. The problem isn’t restricted to the outdoor workers. Besides crop residue burning and industrial pollution, another source of PM2.5 is indoor air pollution caused by burning firewood. Many Indian families still rely on burning firewood for cooking. A study from India published in BMC Geriatrics this year found that indoor pollution led to sleep disorders and depression among older adults. “Ambient air pollutants can travel from the nose through the olfactory nerve and reach crucial brain areas like the striatum, frontal cortex, and cerebellum, which are involved in various functions including movement, decision-making, and coordination,” says one of its authors, Dr Aparajita Chattopadhyay, a professor at the International Institute for Population Sciences in Mumbai. These pollutants trigger an inflammatory response which can lead to changes in the levels of neurotransmitters and, hence, disrupt an individual’s sleep and mood. “Sleep plays an important role in maintaining good health, failing which NCDs, including mental health issues, may crop up,” she adds. Limited air quality warnings The health problems caused by air pollution are mounting, as evident from community health worker Kamal Kore’s call records. The past five years have sent a jump in health issues – largely NCDs, especially since the temperature started rising rapidly. “Every day, I get at least 10 calls from the villagers with complaints of cardiovascular and respiratory issues,” she shares, adding that she now spends most of her time making people aware of the harmful effects of air pollution. “Every day, I tell people to switch to clean energy sources for cooking and work during the hours when the pollution is comparatively lesser,” she says. “We don’t have any resources to deal with this.” A major problem healthcare workers like her face is the lack of adequate, real-time data on air pollution to warn patients about peaks. People currently simply observe the times of day when air pollution becomes severe and try to avoid these. Farmer Narayan Gaikwad who is exposed to a lot of air pollution daily says that the lack of real time data on air pollution in the village is a big hindrance to make people aware of air pollution and the hours they shouldn’t work out in the fields. Gaikwad’s husband, Narayan Gaikwad, 77, has written several letters to the district authorities demanding strict measures to curb air pollution. “People don’t understand how much unhealthy air they are breathing because there’s no one monitoring air pollution in the village,” he says. “I am now asking people to stop working during those hours.”. Chattopadhyay suggests that older people avoid major sources of indoor air pollutants, ensure proper ventilation, and use clean fuel. “A positive and strong social circle is also necessary to be mentally fit. Adults must be made aware of cues of contentment in life much before they get old — financial stability, strong social circle, and remaining active daily in various tasks,” she adds. Given Gaikwad’s declining health, her family is considering a solar water heating system despite its crippling cost. While this will help her somewhat, she is worried about the smoke from the neighborhoods. “A solution can never work in isolation. It has to happen at the community level,” she warns. Image Credits: Sanket Jain. Record-Breaking Dengue Infection Persists in the Caribbean 09/07/2024 Sophia Samantaroy Aedes aegypti mosquitoes are the main vectors of dengue virus. Dengue virus cases have reached an all-time high since January in the US territory of Puerto Rico, with 1,729 people infected so far – a more than 300% increase compared to last year. The uptick in the mosquito-borne disease, which causes mild to severe illness, follows a trend across the Caribbean region. The total number of reported cases for the Caribbean has reached nearly 57,000 – a 469% increase as compared to the same period in 2023. Climate change, the El Nino effect, and unplanned urban growth have fueled this year’s surge. While dengue tends to hit Brazil, Argentina, Paraguay and Uruguay the worst, the Caribbean, the Central American isthmus, and Mexico continue to see above-average transmission. Further complicating efforts to control the mosquito-borne disease is the premature start to the hurricane season. Hurricane Beryl has already devastated several small island nations in the Caribbean, damaging water and health infrastructure, thus making residents even more vulnerable to dengue. Halfway into 2024, the total burden of dengue cases in the Americas has exceeded 10.1 million, more than twice the 4.7 million cases in 2023. The Puerto Rican Department of Health recently extended its dengue epidemic alert until December, after this year’s season brought the highest proportion of severe dengue in the Americas. Of the nearly 2,000 cases reported to the territory’s health officials, 92 are severe, meaning patients may suffer from painful symptoms including fever, headaches and vomiting. Three of the dengue serotypes – DENV 1, 2, and 3 – are currently circulating. This alert comes just two weeks after the US Centers for Disease Control and Prevention (CDC) issued a health advisory warning of the increased risk of dengue virus infections in the US. While most cases in the continental US come from overseas travelers, Florida has reported a handful of locally-transmitted cases. Hurricane Beryl sets back health response Debris, abundant rainfall, and inadequate shelter are all hurricane by-products that increase the risk of dengue virus infection. The first category 5 hurricane of the season, Beryl devastated much of Saint Vincent and the Grenadines, Grenada, Dominica, Barbados, and Jamaica. The destruction left in the hurricane’s wake highlights small island nations’ vulnerabilities to climate change and its health effects. The Caribbean region is particularly susceptible to healthcare disruptions from natural disasters. Studies of cyclones in China and hurricanes in Puerto Rico found increases in dengue virus infections in the weeks following hurricanes. “Pre-existing environmental health risk magnified after the pass of Hurricanes Irma and María,” said researcher José Pérez-Ramos, Assistant Professor of Public Health Sciences at the University of Rochester. He notes that in the aftermath of 2017’s devastating hurricanes, participants in the study were worried about frequent dengue outbreaks. While the International Federation of the Red Cross (IFRC) and other relief organizations active in the Caribbean nations are in the early days of response and assessment, the confluence of the hurricane’s destruction and peak dengue season may spell out an increased case burden. “Hygiene kits, cleaning kits, tool kits, kitchen sets, tarpaulins, blankets and mosquito nets have already been dispatched to the hardest hit islands to meet the immediate needs of the affected population,” said Rhea Pierre, IFRC Disaster Manager for the English and Dutch-speaking Caribbean. “Still, rapid damage assessments show that the devastation is massive.” ‘A notable increase’ in cases, but low fatality rate Removing standing water sources is a key tactic in controlling for dengue. Despite this year’s record number of cases, the World Health Organisation’s (WHO) regional office in the Americas, the Pan-American Health Organization (PAHO), notes that the fatality rate for the Americas has not exceeded the regional benchmark of 0.05%. “While we are seeing a notable increase in the number of dengue cases in the region this year, it is important to highlight that the proportion of cases that progress to death remains low thanks to countries’ efforts and the support of PAHO,” said Jarbas Barbosa, PAHO Director, in a recent press release. “This situation highlights the importance of sustaining surveillance, strengthening prevention and control measures, and ensuring timely medical care,” he added. Standing water, seen here in the aftermath of Hurricane Otis, is needed for mosquitoes to breed. Few studies have assessed what causes some patients to progress to severe dengue. The WHO notes that ensuring access to sufficient medical care should remain at the forefront of countries’ priorities to treat severe dengue. PAHO’s Caribbean Mosquito Awareness Week, which took place in May, aimed to raise public awareness about the connection between mosquitoes and the diseases they transmit, such as dengue, chikungunya, and Zika, and to involve the community to prevent mosquito breeding. “The population and household members should be encouraged to eliminate sources of mosquito breeding, both household and peri-household. This is everyone’s task: the family, the community, the public and private sector,” said PAHO in a recent alert on increased cases in Central America, Mexico, and the Caribbean regions. Aedes aegypti, the main mosquito vector, typically breeds in sites such as water containers as well as in urban waste, including plastic wrapping that can accumulate rainwater. As the virus doesn’t have a cure and repeat infections can even be more severe, surveillance and control of mosquito breeding sites is critical to reduce dengue transmission and illness, particularly the most severe form of the disease, dengue hemorrhagic fever. Dengue cases expected to rise in Mexico, Central America and Caribbean Cases have yet to peak fully in the Caribbean, Central America and Mexico. Farther north of the equator, cases have yet to peak in the PAHO regions of the Caribbean, Central America Isthmus and Mexico. “Although there has been a decrease in dengue cases in the Southern Cone [Brazil, Argentina, Paraguay, and Uruguay] and Andean sub-regions in recent epidemiological weeks, the subregions of the Central American isthmus and Mexico, and the Caribbean subregion are entering the period of increased dengue circulation, which could significantly increase the number of cases reported in the Region during the second half of 2024,” said PAHO in their May epidemiological alert. Cases decreasing at tail-end of season Brazil, which accounts for more than 80% of the Americas’ dengue cases, is at the tail-end of its season. The number of dengue cases is finally tapering off for the South American countries hardest hit – Brazil in particular saw an explosive growth in cases earlier this year. PAHO attributes the country’s epidemic conditions to prolonged heat, higher rainfall levels, as well as decreased population immunity following COVID-19-related restrictions. In response, and to avoid losing vaccine stock to expiration, the Brazilian government recently expanded the population eligible for dengue vaccination. Now, children six to sixteen are eligible, rather than just ten to fourteen year-olds. Image Credits: Direct Relief/Felipe Luna, James Gathany/ PHIL, CDC, Public Domain, IFRC, PAHO , PAHO , PAHO. WHO Launches Platform for Standardised Medical Device Information 09/07/2024 Zuzanna Stawiska An online WHO platform gathers information about various medical devices: from simple syringes to complex hospital equipment. To help countries and organisations navigate a complex pool of over 10,000 different medical devices, the World Health Organization (WHO) launched an online platform on Monday that will collect and standardise the information about medical equipment. Medical Devices Information System, or MeDevIS, is inspired by the WHO Priority Medical Devices List (MDL) and the Essential Medicines List, the latter of which will soon have existed for 50 years, serving as an important support for health progress globally. MeDevIS includes 2,301 types of medical devices of varying levels of complexity: from single-use syringes, medical masks, and pulse oximeters, to imaging radiology technologies, implantable prostheses, or defibrillators. “The number of medical technologies used in health care is growing, as is their complexity, which can make it challenging for health care practitioners and patients to navigate,” said Dr Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products. The aim is for a “one-stop shop of international information” to help stakeholders to find appropriate equipment. The new platform references both major naming systems for medical devices, renowned internationally: the European Medical Device Nomenclature (EMDN) and the Global Medical Device Nomenclature (GMDN), used in some countries outside of the European region. Both systems facilitate handling specific types of equipment on the regulatory and logistics levels. MeDivIS also features information about the infrastructure required for the device, the healthcare facility level where it is typically used, and links to thematic WHO guidelines connected with the branch of care for which the equipment is made. “The MeDevIS platform can be useful for national policy-makers to develop or update their own national lists for the procurement of health technologies and devices and can contribute to the progress towards universal health coverage,” said Dr Deus Mubangizi, WHO Director for Health Products Policy and Standards. Image Credits: Unsplash. Russia’s Bombing of Ukraine Children Hospital is ‘Abominable’ 08/07/2024 Kerry Cullinan Children with cancer outside Okhmatdyt Hospital after the attack. Russia’s bombing of a children’s hospital and women’s health centre in Ukraine’s capital Kiev on Monday is “abominable”, said UN High Commissioner for Human Rights Volker Türk. “Civilians must be protected, and the laws of war strictly adhered to,” added Türk. “There must be prompt, thorough and independent investigations into these latest grave attacks on civilians and civilian infrastructure, and those responsible must be held to account.” “Shockingly, one of the strikes severely damaged the intensive care, surgical and oncology wards of Okhmatdyt, which is Ukraine’s largest children’s referral hospital, and destroyed its children’s toxicology department, where children receive dialysis,” said Türk. Okhmatdyt Hospital serves more than 20,000 children annually. Monday’s missile attack struck a medical building at the hospital where children were receiving dialysis, while also damaging the intensive care, operating, and oncology departments, according to the Minister of Health of Ukraine. The entire hospital is without electricity, preventing the use of ventilators and other urgent care. Dr Tedros Adhanom Ghebreyesus, Director General of the World Health Organisation (WHO), said that “several floors of the largest children’s hospital in Kyiv were severely impacted today, disrupting the hospital’s operations and affecting its ability to provide critical care to the young patients.” Several floors of the largest children’s hospital in Kyiv were severely impacted today, disruptng the hospital’s operations and affecting its ability to provide critical care to the young patients.@WHO has been working closely with the hospital before and since the war in… pic.twitter.com/9ReGcov71F — Tedros Adhanom Ghebreyesus (@DrTedros) July 8, 2024 Meanwhile, Türk said that OHCHR staff visiting the scene shortly after the attack had “observed children receiving treatment for cancer in hospital beds set up in parks and on streets, where medical workers had quickly established triage areas, amongst chaos, dust and debris.” Health officials said the entire hospital was now without electricity, preventing the use of ventilators and other urgent care. It was not immediately clear how many people were killed in the strike. The ISIDA Medical Centre, one of the largest women’s health and family planning centres in Ukraine, was also affected by the attack, with several casualties. The attack comes the day before a NATO summit in Washington DC. Russia has attacked Ukraine’s health care workers, facilities, and other medical infrastructure at least 1,442 times since its invasion of Ukraine in February 2022 and 13 April 2024,according to data from a partnership made up of the Ukrainian Health Center, Physicians for Human Rights (PHR) and others. Russian attacks on Ukraine health care since February 2022. “Russia’s strategy in Ukraine includes attacking babies and children. Domestic and international actors should intensify efforts to hold perpetrators accountable for these war crimes,” said Uliana Poltavets, PHR’s Ukraine emergency response coordinator in a statement. Researchers have documented 79 attacks that affected children’s health care, including 54 attacks that destroyed or damaged children’s hospitals. “Today’s devastating attack on the largest children’s hospital is emblematic of Russia’s onslaught against Ukraine’s health care system. Again and again, we have witnessed Russian forces attack vulnerable patients, health workers, and hospitals across the country,” said Poltavets. PHR called on “domestic and international prosecutors, including the International Criminal Court, to prioritise the investigation and prosecution of attacks on health care.” Image Credits: Twitter. Sierra Leone Outlaws Child Marriage 08/07/2024 Kerry Cullinan Sierra Leone First Lady Fatima Bio Sierra Leone’s President Julius Maada Bio signed into law the Prohibition of Child Marriage Act last week, introducing a penalty of at least 15 years and a fine of around $4,000 for any man who marries a girl under 18. The law also prohibits cohabiting with a child, and fines for anyone arranging, aiding or attending such marriage ceremonies. First Lady Fatima Bio’s “Hands Off Our Girls” campaign has been instrumental in advocating against child marriage in Sierra Leone. Sierra Leone has one of the highest rates of child marriages in Africa, alongside Niger and Nigeria. According to the 2019 Sierra Leone Demographic and Health Surveys, 30% of girls in Sierra Leone are married before their 18th birthday. In 2020, there were 800,000 child brides, half of whom were married before they turned 15, according to UNICEF. The country of slightly over eight million people also has a high rate of female genital mutilation. “Child marriages fuel the high adolescent pregnancy rate in Sierra Leone where, tragically, pregnancy complications are the leading cause of death for girls aged 15-19,” according to Human Rights Watch (HRW). In 2021, the country introduced a policy of “radical inclusion” in schools, targeting and marginalised groups including girls, particularly pregnant girls and parent learners. Last year, Sierra Leone passed an education law that guarantees children free education, including one year of pre-primary. “The legislation is a milestone in Sierra Leone’s journey towards gender equality and child protection. It also sets a pathway forward for other African nations, such as Tanzania and Zambia, to revoke laws that permit child marriage, and ensure girls can complete primary and secondary education,” said HRW. FDA Approves Eli Lilly’s Kisunla for Early-Stage Alzheimer’s Patients 08/07/2024 Maayan Hoffman Neurons with tau protein highlighted in red. Eli Lilly’s Alzheimer’s therapy, donanemab, has received FDA approval, offering new hope for patients with early symptomatic Alzheimer’s disease. The newly approved treatment, branded Kisunla, is set to challenge existing therapies from Eisai and Biogen. Clinical trials have shown Kisunla to be effective for individuals in the mild cognitive impairment or mild dementia stages of the disease, potentially marking a significant advancement in Alzheimer’s care. The drug is administered as an intravenous infusion every four weeks. Alzheimer’s disease is a degenerative condition of the brain that impacts over 6.5 million Americans and over 55 million people worldwide. It causes a gradual decline in memory, cognitive functions, and, eventually, the ability to perform daily activities. The disease is marked by structural changes in the brain, such as the buildup of amyloid beta plaques and neurofibrillary tangles made of tau protein, which is supposed to help stabilize the internal skeleton of neurons in the brain. The Alzheimer’s Association celebrated the FDA’s decision. “This is real progress,” said Joanne Pike, Alzheimer’s Association president and CEO, in a statement. “Today’s approval allows people more options and greater opportunity to have more time. Having multiple treatment options is the kind of advancement we’ve all been waiting for — all of us who have been touched, even blindsided, by this difficult and devastating disease.” Slows cognitive decline by at least 22% The approval was based on an extensive double-blind, placebo-controlled, parallel-group study evaluating the efficacy of Kisunla in slowing cognitive decline in participants with varying levels of tau protein in the brain. Tau is a protein that helps to stabilise the neurons in the brain. The study, conducted over 72 weeks with 1,736 patients averaging 73 years old, revealed that those receiving Kisunla experienced a 35% reduction in cognitive decline compared to those on placebo among individuals with low to medium tau levels. Even among participants with higher tau levels, the treatment demonstrated a meaningful but slightly reduced effect. Overall, including all tau levels, Kisunla slowed cognitive decline by 22% and reduced the likelihood of progressing to the next stage of the disease by 39% compared to placebo. Additionally, the study monitored amyloid plaque levels using positron emission tomography (PET) scans throughout the treatment period. Results showed substantial reductions in amyloid plaques over time among patients receiving Kisunla, with reductions of 61% at six months, 80% at 12 months, and 84% at 18 months compared to baseline levels. These findings suggest that Kisunla not only targets cognitive decline but also effectively reduces the hallmark amyloid pathology associated with Alzheimer’s disease progression. Potential side effects For some patients, there is a risk of amyloid-related imaging abnormalities (ARIA) developing, the FDA said. ARIA typically manifests as temporary brain swelling, sometimes accompanied by small areas of bleeding on or in the brain. While ARIA often resolves on its own and may not cause symptoms, rare instances of severe and potentially life-threatening events have been reported. ARIA is a recognized side effect of antibody therapies targeting amyloid. Infusion-related reactions are also a concern, including flu-like symptoms, nausea, vomiting, changes in blood pressure, and hypersensitivity reactions such as anaphylaxis (a severe allergic reaction) and angioedema (swelling). Kisunla joins Leqembi, on market since 2023 Kisunla is the third drug to receive FDA approval, although only the second is now available for use. Leqembi, a collaboration between Biogen of the United States and Eisai of Japan, gained approval in July 2023. In an 18-month Phase III trial, Leqembi demonstrated a 27% reduction in cognitive decline among early-stage Alzheimer’s patients compared to those receiving a placebo. Another drug, aducanumab, also developed by Biogen and Eisai, was granted accelerated approval by the FDA in June 2021. However, due to some side effects, the therapy was pulled from the market. The Alzheimer’s Association emphasized the importance of early detection and diagnosis now that multiple FDA-approved treatments for Alzheimer’s are available. The organization stressed that timely access to these treatments is crucial for maximizing their benefits, asserting that no stage or entity should hinder or delay such access. “Too many roadblocks have prevented individuals from getting equitable access to these beneficial treatments for far too long,” said Pike. “It is equally important that clinicians and health care systems are informed and prepared to help the individuals who could benefit. The Alzheimer’s Association is working with health systems and providers to ensure they have the tools and resources to meet the needs of their patients.” Image Credits: Gerry Shaw/ EnCor Biotechnology Inc. Earliest Ever Hurricane Tears Through Caribbean, Highlighting Need for Speedier Climate Action 05/07/2024 Kerry Cullinan Fishing vessels at the Bridgetown Fisheries Complex in Barbados damaged by Hurricane Beryl. Hurricane Beryl, which has destroyed homes and infrastructure in large parts of the eastern Caribbean, is the first first-ever Category 4 hurricane recorded in the region in June – and a portend of devastating changes in weather patterns. It also underscores the need for urgent international assistance to Small Island Developing States (SIDS) to strengthen early warning systems and the climate resilience of key infrastructure – notably water, sanitation and health services, according to experts. The hurricane reached peak speed of 265 km per hour at times as it whipped though Barbados, Grenada, St Vincent and the Grenadines, Haiti, northern Venezuela, the Dominician Republic, Cayman Islands, and Jamaica. “The storm first impacted Barbados, causing severe damage to the south coast and significantly affecting the fishing industry with over 200 fishing vessels damaged or destroyed,” according to the International Federation of Red Cross and Red Crescent Societies (IFRC). On Union Island, part of Saint Vincent and the Grenadines, 90% of infrastructure has been damaged, including houses, roads and the airport. Some 95% of homes in Grenada’s Carriacou and Petite Martinique islands, are damaged, and around 3,000 people are shelters, the IFRC added. Parts of Jamaica’s St Elizabeth region in the south east were also devastated, with around 1,000 people taking refuge in shelters. The Dominican Republic, Cayman Islands reported damage. Venezuela’s President Nicolas Maduro said that 8,000 houses had been destroyed, according to Reuters. More to still come? “Hurricane Beryl, the first hurricane of the 2024 Atlantic hurricane season, rapidly strengthened to a Category 5 storm unusually early in the year,” according to a report from the National Ocean and Atmospheric Administration (NOAA), which is part of the US Department of Commerce “This explosive strengthening was fuelled in part by exceptionally warm ocean temperatures. That heat was one of the factors behind NOAA’s prediction in May of an 85% chance that the 2024 Atlantic hurricane season would be above normal.” Sea surface temperatures were close to those usually found in mid-September, the peak of hurricane season, added NOAA. In late May, NOAA weather forecasters predicted an 85% chance of above-normal hurricane for the 2024 Atlantic hurricane season, which runs from 1 June 1 to 30 November. It also forecast eight to 13 hurricanes, with four to seven likely to be “major” hurricanes (winds of over 178km per hour) in coming months. Early warning systems “The unprecedented hurricane demonstrates the importance of effective multi-hazard early warning systems to save lives,” according to United Nations Disaster Risk Reduction (UNDRR). “Globally, the sustained investments in those systems are making progress in reducing the loss of life in disasters. But economic losses are escalating. Every year millions of households lose their livelihood and risk being pushed into poverty. Ensuring that infrastructure is resilient and that communities ‘build back better’ in the face of future hazards is essential,” added UNDRR. Damage sustained to the airport and surrounding areas on Union Island in the Grenadines during Hurricane Beryl. In late May, the Fourth International Conference on SIDS adopted the Antigua and Barbuda Agenda for SIDS, a 10-year development agenda that appeals for international assistance to address climate change. The Agenda notes that “SIDS are facing the unrelenting and compounding impacts of climate change, biodiversity loss, pollution, disasters and natural hazards, health and other social related challenges and economic vulnerabilities.” Key climate change challenges include “erratic precipitation, increasingly frequent and extreme weather phenomena, more frequent and severe tropical cyclones, floods and drought, diminishing fresh water resources, desertification, coastal erosion, land degradation and sea-level rise.” However, there has been a “progressive deterioration” in SIDS’ ability to “withstand external shocks and enhance their resilience” – largely as a result of the economic impact of COVID-19 and climate challenges. Financial reform to build resilience Protestors call on wealth countries to pay for climate-related loss and damage at COP27. “In the wake of Hurricane Beryl, it is clear that we must redouble our efforts to build resilience and preparedness in the face of growing disaster risk, especially for small island developing states, which have contributed the least to the climate crisis but suffer the greatest costs,” said UNDRR head Kamal Kishore. Kishore appealed for international support for the Antigua and Barbuda Agenda, which “integrates disaster risk reduction as central to climate change adaptation and sustainable development in SIDS with clear calls to action on enhancing multi-hazard early warning systems and resilient infrastructure.” There have also been numerous calls for reform of the international financial architecture to assist developing countries most affected by climate change who are being forced to borrow money to address climate crises largely caused by wealthy nations. The most significant of these is the 2022 Bridgetown Initiative, spearheaded by Prime Minister Mia Mottley of Barbados. This called for key actions including new loan mechanisms, reform of the world’s development banks, and a loss and damages fund to enable developing countries to access to resilient finance to address climate and development crises. The UN climate change conference, COP27, agreed to establish a loss and damage fund during the UN Climate Change Conference (COP27) in 2022. However, there is resistance from a number of wealthier countries to this as the world continues to experience record-breaking extreme weather events. Meanwhile, the International Cort of Justice (ICJ) is expected to hold public hearings and issue an advisory later this year on the international legal obligations countries have to safeguard people against climate change. This follows the adoption last year of a landmark UN resolution to seek such an advisory opinion from the ICJ. While not legally binding, the advisory opinion holds legal and moral weight and will spotlight the human rights impacts of climate policy. Image Credits: UNDP, AfricaNews. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Date Proposed for Special Session to Adopt Pandemic Agreement – But Strictly in Pencil for Now 10/07/2024 Kerry Cullinan The ninth meeting of the Intergovernmental Negotiating Body (INB) meeting in May in Geneva A day during the week of 16 December has been suggested for a World Health Assembly (WHA) special session to consider the pandemic agreement – but that is to remain strictly in pencil until there is clarity about the progress made in negotiations. After two years of talks, including weeks of late-night meetings in the run-up to the WHA, World Health Organization (WHO) member states failed to meet the May deadline for the pandemic agreement. But they are soldiering on from next week when the Intergovernmental Negotiating Body (INB) meets next Tuesday and Wednesday (16-17 July) for the 10th time. The agenda of this meeting is largely concerned with process rather than content, as member states contemplate a pathway that may finally clinch an agreement. New co-chairs? Top of the agenda is the proposal to “rotate” members of the INB Bureau – and the possible election of two new co-chairs. The Bureau, which runs the negotiations, consists of six regional representatives, including co-chairs Roland Driece from The Netherlands and South Africa’s Precious Matsoso. Some member states have blamed the Bureau for the slow pace of talks, and there have also been complaints that some iterations of the draft agreements failed to reflect key positions and agreements. The African Group has indicated that it wants to retain Matsoso and the agenda leaves the decision of the rotation of other Bureau members to the WHO regions. At 11:32 CEST, the @WHO secretariat transmitted the advance unedited English versions of the provisional Agenda, draft programme of work, and Proposed workplan, meeting schedule and proposed updates, as appropriate, to the method of work to NSAs in official relations for #INB10 pic.twitter.com/3ETvojiikc — Balasubramaniam (@ThiruGeneva) July 10, 2024 The second agenda item deals with the work plan, meeting schedule and proposed updates. This will take the bulk of the two-day meeting, bar a section on the consideration of other entities to be added as official stakeholders. The work plan proposes a meeting from 9-20th September. This will focus on Article 12, with discussion on w Articles 4, 5, 9, 10, 11, 13, 13bis, 14 and relevant sections of Article 1. The meeting will also discuss the relationship between the WHO Pandemic Agreement and its legal instruments. This will be followed by another meeting on 4-15 November “focusing on the preamble, relevant sections of Article 1, Articles 3, 19, 20, 21, 24, 26, 31, 32, 33 and 34”, according to documentation sent this week to non-state actors in official relations with the WHO. These articles cover, amongst others, the sticky issues of pathogen access and benefit sharing (PABS), One Health and access to health products during a pandemic. The deadline for calling the WHA special session to discuss and adopt the pandemic agreement will be 15 November. If there is no evident agreement by then, member states will need to agree on “an updated work plan and meeting schedule, depending on progress made,” according to the WHO documentation. The 13th meeting of the INB will take place from 2 – 6 December and, all going well, will proceed to the WHA special session. If there is no agreement and no special session, a 14th NB meeting has been scheduled for 24 – 28 February 2025. The WHA gave negotiators up to a year – the next WHA in May 2025 – to reach agreement. Civil society demands a place at INB table WHO member states are also under pressure from civil society to open the talks up – at the very least to allow civil society organisations recognised as stakeholders in the pandemic preparation process to be present during negotiations. More than 140 civil society organisations (CSO) and supporters from 40 countries issued an open call this week to the INB and WHO member states to “demand the official involvement of CSOs in all remaining negotiations in the INB process for a new pandemic agreement.” CSOs that are identified as relevant stakeholders in the INB process – including patient advocacy groups, humanitarian organisations and pharmaceutical company representatives – have relied on “brief, piecemeal” interactions with negotiators for information. The “failure to facilitate” their meaningful participation in the negotiation process “risks rolling back on best practice in global negotiations,” according to the call. They want member states to “use the opportunity of the renewed INB mandate” to include CSOs, communities and academics in all INB meetings, and provide them with all documentation “in a timely manner”. Meanwhile, a letter to the INB from The Elders, The Global Preparedness Monitoring Board, The Independent Panel for Pandemic Preparedness and Response, Pandemic Action Network, The Panel for a Global Public Health Convention, and Spark Street Advisors issued Wednesday also called for the process to be opened up. Aside from opening that talks up to relevant CSOs and independent experts, the group proposes that co-chairs build trust by “explaining why certain texts were proposed”, ensure the “full representation of all member states” in working groups and provide timely information about the negotiations. These measures will improve “effectiveness, transparency, and counter misinformation,” they note. Image Credits: WHO . From Depression to Hypertension: Heat and Air Pollution Exert Heavy Toll on India’s Farmers 09/07/2024 Sanket Jain Farmer Kusum Gaikwad finds it increasingly difficult to work in the fields and finish daily chores because air pollution has severely impacted her health. JAMBHALI, India – Farmer Kusum Gaikwad’s work start at 4 am daily. First, she burns the firewood and farm residue to heat water for 10 family members. By 7 am, she reaches the fields, manoeuvring through thousands of sugarcane plants, removing weeds, and checking for pests and diseases that could hamper their growth. This is followed by tremendous backbreaking labor, where she collects and lifts over 100kg of cattle fodder in the relentless heat. This has been her routine for the past two decades. But in 2017, Gaikwad started to get frequent headaches. Dizziness and severe pain in the chest and abdomen followed. “It was unbearable, but I kept working for four months,” she says. Eventually, when it became difficult for her to even move out of bed, she consulted a doctor and was diagnosed with hypertension. She returned to the same routine within a week. Two years later, she was diagnosed with type 2 diabetes and also reported weakening of her bones. ‘Mountains of smoke’ With the rising exposure to extreme heat and air pollution, Kusum Gaikwad was first diagnosed with hypertension and then type 2 diabetes. Perplexed, Gaikwad, now 66 years old, was determined to find the causes of her illnesses. When she went to the fields again in Jambhali village in India’s Maharashtra state, she met over 20 women who complained of similar symptoms. “Everyone was coughing throughout the day, and that’s when I realized it was the air pollution,” she told Health Policy Watch. Soon, Gaikwad found that almost every family in her village was burning at least 50 kg kilograms of firewood, agricultural residues, plastic bags, and seedling trays every day to heat water and cook food. “Every morning, you can see a mountain of smoke here,” she says. Over the years, a growing number of studies have found air pollution to be a risk factor for several noncommunicable diseases (NCDs), some of which include cardiovascular and respiratory diseases, heart attacks, and lower respiratory infections. A paper published in 2020 analyzed the impact of air pollution on the health of 39,259 Chinese adults, finding that long-term exposure to air pollutants increased blood pressure and hypertension. Similarly, a study from India found that both short and long-term exposure to ambient PM2.5, fine particulate matter smaller than 2.5 micrometers that penetrate deep into the lungs, was associated with increased hypertension. In India, deaths from NCDs have increased from 38% of total mortality in 1990 to 62% in 2016. The annual particulate pollution in India has increased by almost 68% from 1998 to 2021, reducing the average life expectancy by 2.3 years. Extreme heat exacerbates air pollution When chronic asthma becomes severe at night, Rajakka Tasgave leans against the wall, waiting for her labored breathing to ease. Rajakka Tasgave, 65, has become scared of going to the fields, something she has done for over five decades. “Every day, I see at least one woman collapsing because of the extreme heat. Someday, even I can be one of them,” she shared earlier this year. It didn’t take long for her turn, though. After collapsing in the fields in March, when the temperature topped 40 degrees Celsius in Jambhali, the doctor advised her to stop working in extreme heat. “From April to May, I didn’t step out of the house from 10am till evening,” she said. But this meant that she lost a significant chunk of her earnings as most of the farmwork happens during the day. Every day after returning from the fields, she experiences tremendous body aches. “Every week, I visit a doctor and take an injection (epidural steroid injection). Otherwise, I won’t be able to work.” Alongside the unbearable heat, Tasgave frequently comes in contact with air pollutants from the nearby industries and firewood emissions. She has tried covering her face with the end drape of her saree, but that didn’t help. A few years back, she was diagnosed with chronic asthma. “If I forget to carry my inhaler, I will die of an attack,” she confides. During extreme heat, her asthma becomes unbearable. She became breathless in May this year when the night temperatures didn’t drop as normal. “With no one to take me to the hospital, I leaned against the wall in the hope of easing my pain,” she shares. She found relief only the next day when a doctor administered medicines. Heart attacks and pulmonary diseases Researchers have stepped up efforts to understand the combined effects of air pollution and extreme heat in the past few years. In one such paper published in Environment International, they investigated the impact of heat and air pollution on mortality in 36 countries. The study found that heat-related mortality also increased with higher levels of air pollutants like PM, NO2, and O3. Moreover, they also saw an increase in PM—and O3-related mortality for higher air temperature levels. Extreme temperatures and higher concentrations of particulate matter significantly increase the risk of heart attacks, according to a study published in the American Heart Association’s journal, Circulation. The researchers examined 202,678 heart attacks from China’s Jiangsu province between 2015 and 2020. Also, they found that during extreme heat, women were at a greater risk of heart attack than men. In the presence of rising temperatures and high solar radiations, volatile organic compounds react with nitrogen oxides to form ozone, considered a harmful pollutant in the lower atmosphere. Ozone exposure can lead to respiratory infections. As a result, many people from Jambhali are now suffering from chronic obstructive pulmonary disease (COPD), which restricts the airflow and causes breathing issues. The problem is so severe that this year’s State of Global Air Report found that 50% of global ozone-related COPD deaths were reported in India. Many Indian families still rely on open fires to cook food, risking their health. Anxiety and stress rise with air pollution Jambhali’s community healthcare worker Kamal Kore was always curious about why people like Gaikwad, Tasgave and many others have felt anxious and stressed over the past five years. “Year after year, the number of people complaining of anxiety and stress disorders has risen. A few cases had even culminated in cardiovascular ailments and deaths,” she says. After tracking over a thousand such cases, she found that, as air pollution increased, so did the number of people suffering from mental health issues. Her observation isn’t a one-off case. A study published in April 2024 looked at more than 3,000 US counties, spanning over 315 million people, and found PM2.5 to be linked with depression and stress. These mental health issues, in turn, put people at risk of dying from cardiovascular diseases. Its lead author, Dr Shady Abohashem of Massachusetts General Hospital, explains, “Biologically, PM2.5 can enter the bloodstream and induce systemic inflammation, oxidative stress, and neuroinflammation, all known to affect brain function and mood regulation.” The combined effect of PM2.5 and deteriorating mental health amplify the risk of premature cardiovascular mortality. “High PM2.5 exposure leads to systemic inflammation and endothelial dysfunction, critical factors in the development of cardiovascular diseases. When combined with poor mental health, which independently contributes to adverse cardiovascular outcomes through mechanisms like heightened stress response, disrupted sleep, and poor health behaviors, the risk is significantly magnified,” Abohashem explains. Air pollution disrupts sleep, causes depression So severe was the impact that in counties with higher levels of PM2.5, people struggling with poor mental health experienced a threefold rise in premature cardiovascular mortality compared to those with better mental health in areas of lower pollution. The problem isn’t restricted to the outdoor workers. Besides crop residue burning and industrial pollution, another source of PM2.5 is indoor air pollution caused by burning firewood. Many Indian families still rely on burning firewood for cooking. A study from India published in BMC Geriatrics this year found that indoor pollution led to sleep disorders and depression among older adults. “Ambient air pollutants can travel from the nose through the olfactory nerve and reach crucial brain areas like the striatum, frontal cortex, and cerebellum, which are involved in various functions including movement, decision-making, and coordination,” says one of its authors, Dr Aparajita Chattopadhyay, a professor at the International Institute for Population Sciences in Mumbai. These pollutants trigger an inflammatory response which can lead to changes in the levels of neurotransmitters and, hence, disrupt an individual’s sleep and mood. “Sleep plays an important role in maintaining good health, failing which NCDs, including mental health issues, may crop up,” she adds. Limited air quality warnings The health problems caused by air pollution are mounting, as evident from community health worker Kamal Kore’s call records. The past five years have sent a jump in health issues – largely NCDs, especially since the temperature started rising rapidly. “Every day, I get at least 10 calls from the villagers with complaints of cardiovascular and respiratory issues,” she shares, adding that she now spends most of her time making people aware of the harmful effects of air pollution. “Every day, I tell people to switch to clean energy sources for cooking and work during the hours when the pollution is comparatively lesser,” she says. “We don’t have any resources to deal with this.” A major problem healthcare workers like her face is the lack of adequate, real-time data on air pollution to warn patients about peaks. People currently simply observe the times of day when air pollution becomes severe and try to avoid these. Farmer Narayan Gaikwad who is exposed to a lot of air pollution daily says that the lack of real time data on air pollution in the village is a big hindrance to make people aware of air pollution and the hours they shouldn’t work out in the fields. Gaikwad’s husband, Narayan Gaikwad, 77, has written several letters to the district authorities demanding strict measures to curb air pollution. “People don’t understand how much unhealthy air they are breathing because there’s no one monitoring air pollution in the village,” he says. “I am now asking people to stop working during those hours.”. Chattopadhyay suggests that older people avoid major sources of indoor air pollutants, ensure proper ventilation, and use clean fuel. “A positive and strong social circle is also necessary to be mentally fit. Adults must be made aware of cues of contentment in life much before they get old — financial stability, strong social circle, and remaining active daily in various tasks,” she adds. Given Gaikwad’s declining health, her family is considering a solar water heating system despite its crippling cost. While this will help her somewhat, she is worried about the smoke from the neighborhoods. “A solution can never work in isolation. It has to happen at the community level,” she warns. Image Credits: Sanket Jain. Record-Breaking Dengue Infection Persists in the Caribbean 09/07/2024 Sophia Samantaroy Aedes aegypti mosquitoes are the main vectors of dengue virus. Dengue virus cases have reached an all-time high since January in the US territory of Puerto Rico, with 1,729 people infected so far – a more than 300% increase compared to last year. The uptick in the mosquito-borne disease, which causes mild to severe illness, follows a trend across the Caribbean region. The total number of reported cases for the Caribbean has reached nearly 57,000 – a 469% increase as compared to the same period in 2023. Climate change, the El Nino effect, and unplanned urban growth have fueled this year’s surge. While dengue tends to hit Brazil, Argentina, Paraguay and Uruguay the worst, the Caribbean, the Central American isthmus, and Mexico continue to see above-average transmission. Further complicating efforts to control the mosquito-borne disease is the premature start to the hurricane season. Hurricane Beryl has already devastated several small island nations in the Caribbean, damaging water and health infrastructure, thus making residents even more vulnerable to dengue. Halfway into 2024, the total burden of dengue cases in the Americas has exceeded 10.1 million, more than twice the 4.7 million cases in 2023. The Puerto Rican Department of Health recently extended its dengue epidemic alert until December, after this year’s season brought the highest proportion of severe dengue in the Americas. Of the nearly 2,000 cases reported to the territory’s health officials, 92 are severe, meaning patients may suffer from painful symptoms including fever, headaches and vomiting. Three of the dengue serotypes – DENV 1, 2, and 3 – are currently circulating. This alert comes just two weeks after the US Centers for Disease Control and Prevention (CDC) issued a health advisory warning of the increased risk of dengue virus infections in the US. While most cases in the continental US come from overseas travelers, Florida has reported a handful of locally-transmitted cases. Hurricane Beryl sets back health response Debris, abundant rainfall, and inadequate shelter are all hurricane by-products that increase the risk of dengue virus infection. The first category 5 hurricane of the season, Beryl devastated much of Saint Vincent and the Grenadines, Grenada, Dominica, Barbados, and Jamaica. The destruction left in the hurricane’s wake highlights small island nations’ vulnerabilities to climate change and its health effects. The Caribbean region is particularly susceptible to healthcare disruptions from natural disasters. Studies of cyclones in China and hurricanes in Puerto Rico found increases in dengue virus infections in the weeks following hurricanes. “Pre-existing environmental health risk magnified after the pass of Hurricanes Irma and María,” said researcher José Pérez-Ramos, Assistant Professor of Public Health Sciences at the University of Rochester. He notes that in the aftermath of 2017’s devastating hurricanes, participants in the study were worried about frequent dengue outbreaks. While the International Federation of the Red Cross (IFRC) and other relief organizations active in the Caribbean nations are in the early days of response and assessment, the confluence of the hurricane’s destruction and peak dengue season may spell out an increased case burden. “Hygiene kits, cleaning kits, tool kits, kitchen sets, tarpaulins, blankets and mosquito nets have already been dispatched to the hardest hit islands to meet the immediate needs of the affected population,” said Rhea Pierre, IFRC Disaster Manager for the English and Dutch-speaking Caribbean. “Still, rapid damage assessments show that the devastation is massive.” ‘A notable increase’ in cases, but low fatality rate Removing standing water sources is a key tactic in controlling for dengue. Despite this year’s record number of cases, the World Health Organisation’s (WHO) regional office in the Americas, the Pan-American Health Organization (PAHO), notes that the fatality rate for the Americas has not exceeded the regional benchmark of 0.05%. “While we are seeing a notable increase in the number of dengue cases in the region this year, it is important to highlight that the proportion of cases that progress to death remains low thanks to countries’ efforts and the support of PAHO,” said Jarbas Barbosa, PAHO Director, in a recent press release. “This situation highlights the importance of sustaining surveillance, strengthening prevention and control measures, and ensuring timely medical care,” he added. Standing water, seen here in the aftermath of Hurricane Otis, is needed for mosquitoes to breed. Few studies have assessed what causes some patients to progress to severe dengue. The WHO notes that ensuring access to sufficient medical care should remain at the forefront of countries’ priorities to treat severe dengue. PAHO’s Caribbean Mosquito Awareness Week, which took place in May, aimed to raise public awareness about the connection between mosquitoes and the diseases they transmit, such as dengue, chikungunya, and Zika, and to involve the community to prevent mosquito breeding. “The population and household members should be encouraged to eliminate sources of mosquito breeding, both household and peri-household. This is everyone’s task: the family, the community, the public and private sector,” said PAHO in a recent alert on increased cases in Central America, Mexico, and the Caribbean regions. Aedes aegypti, the main mosquito vector, typically breeds in sites such as water containers as well as in urban waste, including plastic wrapping that can accumulate rainwater. As the virus doesn’t have a cure and repeat infections can even be more severe, surveillance and control of mosquito breeding sites is critical to reduce dengue transmission and illness, particularly the most severe form of the disease, dengue hemorrhagic fever. Dengue cases expected to rise in Mexico, Central America and Caribbean Cases have yet to peak fully in the Caribbean, Central America and Mexico. Farther north of the equator, cases have yet to peak in the PAHO regions of the Caribbean, Central America Isthmus and Mexico. “Although there has been a decrease in dengue cases in the Southern Cone [Brazil, Argentina, Paraguay, and Uruguay] and Andean sub-regions in recent epidemiological weeks, the subregions of the Central American isthmus and Mexico, and the Caribbean subregion are entering the period of increased dengue circulation, which could significantly increase the number of cases reported in the Region during the second half of 2024,” said PAHO in their May epidemiological alert. Cases decreasing at tail-end of season Brazil, which accounts for more than 80% of the Americas’ dengue cases, is at the tail-end of its season. The number of dengue cases is finally tapering off for the South American countries hardest hit – Brazil in particular saw an explosive growth in cases earlier this year. PAHO attributes the country’s epidemic conditions to prolonged heat, higher rainfall levels, as well as decreased population immunity following COVID-19-related restrictions. In response, and to avoid losing vaccine stock to expiration, the Brazilian government recently expanded the population eligible for dengue vaccination. Now, children six to sixteen are eligible, rather than just ten to fourteen year-olds. Image Credits: Direct Relief/Felipe Luna, James Gathany/ PHIL, CDC, Public Domain, IFRC, PAHO , PAHO , PAHO. WHO Launches Platform for Standardised Medical Device Information 09/07/2024 Zuzanna Stawiska An online WHO platform gathers information about various medical devices: from simple syringes to complex hospital equipment. To help countries and organisations navigate a complex pool of over 10,000 different medical devices, the World Health Organization (WHO) launched an online platform on Monday that will collect and standardise the information about medical equipment. Medical Devices Information System, or MeDevIS, is inspired by the WHO Priority Medical Devices List (MDL) and the Essential Medicines List, the latter of which will soon have existed for 50 years, serving as an important support for health progress globally. MeDevIS includes 2,301 types of medical devices of varying levels of complexity: from single-use syringes, medical masks, and pulse oximeters, to imaging radiology technologies, implantable prostheses, or defibrillators. “The number of medical technologies used in health care is growing, as is their complexity, which can make it challenging for health care practitioners and patients to navigate,” said Dr Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products. The aim is for a “one-stop shop of international information” to help stakeholders to find appropriate equipment. The new platform references both major naming systems for medical devices, renowned internationally: the European Medical Device Nomenclature (EMDN) and the Global Medical Device Nomenclature (GMDN), used in some countries outside of the European region. Both systems facilitate handling specific types of equipment on the regulatory and logistics levels. MeDivIS also features information about the infrastructure required for the device, the healthcare facility level where it is typically used, and links to thematic WHO guidelines connected with the branch of care for which the equipment is made. “The MeDevIS platform can be useful for national policy-makers to develop or update their own national lists for the procurement of health technologies and devices and can contribute to the progress towards universal health coverage,” said Dr Deus Mubangizi, WHO Director for Health Products Policy and Standards. Image Credits: Unsplash. Russia’s Bombing of Ukraine Children Hospital is ‘Abominable’ 08/07/2024 Kerry Cullinan Children with cancer outside Okhmatdyt Hospital after the attack. Russia’s bombing of a children’s hospital and women’s health centre in Ukraine’s capital Kiev on Monday is “abominable”, said UN High Commissioner for Human Rights Volker Türk. “Civilians must be protected, and the laws of war strictly adhered to,” added Türk. “There must be prompt, thorough and independent investigations into these latest grave attacks on civilians and civilian infrastructure, and those responsible must be held to account.” “Shockingly, one of the strikes severely damaged the intensive care, surgical and oncology wards of Okhmatdyt, which is Ukraine’s largest children’s referral hospital, and destroyed its children’s toxicology department, where children receive dialysis,” said Türk. Okhmatdyt Hospital serves more than 20,000 children annually. Monday’s missile attack struck a medical building at the hospital where children were receiving dialysis, while also damaging the intensive care, operating, and oncology departments, according to the Minister of Health of Ukraine. The entire hospital is without electricity, preventing the use of ventilators and other urgent care. Dr Tedros Adhanom Ghebreyesus, Director General of the World Health Organisation (WHO), said that “several floors of the largest children’s hospital in Kyiv were severely impacted today, disrupting the hospital’s operations and affecting its ability to provide critical care to the young patients.” Several floors of the largest children’s hospital in Kyiv were severely impacted today, disruptng the hospital’s operations and affecting its ability to provide critical care to the young patients.@WHO has been working closely with the hospital before and since the war in… pic.twitter.com/9ReGcov71F — Tedros Adhanom Ghebreyesus (@DrTedros) July 8, 2024 Meanwhile, Türk said that OHCHR staff visiting the scene shortly after the attack had “observed children receiving treatment for cancer in hospital beds set up in parks and on streets, where medical workers had quickly established triage areas, amongst chaos, dust and debris.” Health officials said the entire hospital was now without electricity, preventing the use of ventilators and other urgent care. It was not immediately clear how many people were killed in the strike. The ISIDA Medical Centre, one of the largest women’s health and family planning centres in Ukraine, was also affected by the attack, with several casualties. The attack comes the day before a NATO summit in Washington DC. Russia has attacked Ukraine’s health care workers, facilities, and other medical infrastructure at least 1,442 times since its invasion of Ukraine in February 2022 and 13 April 2024,according to data from a partnership made up of the Ukrainian Health Center, Physicians for Human Rights (PHR) and others. Russian attacks on Ukraine health care since February 2022. “Russia’s strategy in Ukraine includes attacking babies and children. Domestic and international actors should intensify efforts to hold perpetrators accountable for these war crimes,” said Uliana Poltavets, PHR’s Ukraine emergency response coordinator in a statement. Researchers have documented 79 attacks that affected children’s health care, including 54 attacks that destroyed or damaged children’s hospitals. “Today’s devastating attack on the largest children’s hospital is emblematic of Russia’s onslaught against Ukraine’s health care system. Again and again, we have witnessed Russian forces attack vulnerable patients, health workers, and hospitals across the country,” said Poltavets. PHR called on “domestic and international prosecutors, including the International Criminal Court, to prioritise the investigation and prosecution of attacks on health care.” Image Credits: Twitter. Sierra Leone Outlaws Child Marriage 08/07/2024 Kerry Cullinan Sierra Leone First Lady Fatima Bio Sierra Leone’s President Julius Maada Bio signed into law the Prohibition of Child Marriage Act last week, introducing a penalty of at least 15 years and a fine of around $4,000 for any man who marries a girl under 18. The law also prohibits cohabiting with a child, and fines for anyone arranging, aiding or attending such marriage ceremonies. First Lady Fatima Bio’s “Hands Off Our Girls” campaign has been instrumental in advocating against child marriage in Sierra Leone. Sierra Leone has one of the highest rates of child marriages in Africa, alongside Niger and Nigeria. According to the 2019 Sierra Leone Demographic and Health Surveys, 30% of girls in Sierra Leone are married before their 18th birthday. In 2020, there were 800,000 child brides, half of whom were married before they turned 15, according to UNICEF. The country of slightly over eight million people also has a high rate of female genital mutilation. “Child marriages fuel the high adolescent pregnancy rate in Sierra Leone where, tragically, pregnancy complications are the leading cause of death for girls aged 15-19,” according to Human Rights Watch (HRW). In 2021, the country introduced a policy of “radical inclusion” in schools, targeting and marginalised groups including girls, particularly pregnant girls and parent learners. Last year, Sierra Leone passed an education law that guarantees children free education, including one year of pre-primary. “The legislation is a milestone in Sierra Leone’s journey towards gender equality and child protection. It also sets a pathway forward for other African nations, such as Tanzania and Zambia, to revoke laws that permit child marriage, and ensure girls can complete primary and secondary education,” said HRW. FDA Approves Eli Lilly’s Kisunla for Early-Stage Alzheimer’s Patients 08/07/2024 Maayan Hoffman Neurons with tau protein highlighted in red. Eli Lilly’s Alzheimer’s therapy, donanemab, has received FDA approval, offering new hope for patients with early symptomatic Alzheimer’s disease. The newly approved treatment, branded Kisunla, is set to challenge existing therapies from Eisai and Biogen. Clinical trials have shown Kisunla to be effective for individuals in the mild cognitive impairment or mild dementia stages of the disease, potentially marking a significant advancement in Alzheimer’s care. The drug is administered as an intravenous infusion every four weeks. Alzheimer’s disease is a degenerative condition of the brain that impacts over 6.5 million Americans and over 55 million people worldwide. It causes a gradual decline in memory, cognitive functions, and, eventually, the ability to perform daily activities. The disease is marked by structural changes in the brain, such as the buildup of amyloid beta plaques and neurofibrillary tangles made of tau protein, which is supposed to help stabilize the internal skeleton of neurons in the brain. The Alzheimer’s Association celebrated the FDA’s decision. “This is real progress,” said Joanne Pike, Alzheimer’s Association president and CEO, in a statement. “Today’s approval allows people more options and greater opportunity to have more time. Having multiple treatment options is the kind of advancement we’ve all been waiting for — all of us who have been touched, even blindsided, by this difficult and devastating disease.” Slows cognitive decline by at least 22% The approval was based on an extensive double-blind, placebo-controlled, parallel-group study evaluating the efficacy of Kisunla in slowing cognitive decline in participants with varying levels of tau protein in the brain. Tau is a protein that helps to stabilise the neurons in the brain. The study, conducted over 72 weeks with 1,736 patients averaging 73 years old, revealed that those receiving Kisunla experienced a 35% reduction in cognitive decline compared to those on placebo among individuals with low to medium tau levels. Even among participants with higher tau levels, the treatment demonstrated a meaningful but slightly reduced effect. Overall, including all tau levels, Kisunla slowed cognitive decline by 22% and reduced the likelihood of progressing to the next stage of the disease by 39% compared to placebo. Additionally, the study monitored amyloid plaque levels using positron emission tomography (PET) scans throughout the treatment period. Results showed substantial reductions in amyloid plaques over time among patients receiving Kisunla, with reductions of 61% at six months, 80% at 12 months, and 84% at 18 months compared to baseline levels. These findings suggest that Kisunla not only targets cognitive decline but also effectively reduces the hallmark amyloid pathology associated with Alzheimer’s disease progression. Potential side effects For some patients, there is a risk of amyloid-related imaging abnormalities (ARIA) developing, the FDA said. ARIA typically manifests as temporary brain swelling, sometimes accompanied by small areas of bleeding on or in the brain. While ARIA often resolves on its own and may not cause symptoms, rare instances of severe and potentially life-threatening events have been reported. ARIA is a recognized side effect of antibody therapies targeting amyloid. Infusion-related reactions are also a concern, including flu-like symptoms, nausea, vomiting, changes in blood pressure, and hypersensitivity reactions such as anaphylaxis (a severe allergic reaction) and angioedema (swelling). Kisunla joins Leqembi, on market since 2023 Kisunla is the third drug to receive FDA approval, although only the second is now available for use. Leqembi, a collaboration between Biogen of the United States and Eisai of Japan, gained approval in July 2023. In an 18-month Phase III trial, Leqembi demonstrated a 27% reduction in cognitive decline among early-stage Alzheimer’s patients compared to those receiving a placebo. Another drug, aducanumab, also developed by Biogen and Eisai, was granted accelerated approval by the FDA in June 2021. However, due to some side effects, the therapy was pulled from the market. The Alzheimer’s Association emphasized the importance of early detection and diagnosis now that multiple FDA-approved treatments for Alzheimer’s are available. The organization stressed that timely access to these treatments is crucial for maximizing their benefits, asserting that no stage or entity should hinder or delay such access. “Too many roadblocks have prevented individuals from getting equitable access to these beneficial treatments for far too long,” said Pike. “It is equally important that clinicians and health care systems are informed and prepared to help the individuals who could benefit. The Alzheimer’s Association is working with health systems and providers to ensure they have the tools and resources to meet the needs of their patients.” Image Credits: Gerry Shaw/ EnCor Biotechnology Inc. Earliest Ever Hurricane Tears Through Caribbean, Highlighting Need for Speedier Climate Action 05/07/2024 Kerry Cullinan Fishing vessels at the Bridgetown Fisheries Complex in Barbados damaged by Hurricane Beryl. Hurricane Beryl, which has destroyed homes and infrastructure in large parts of the eastern Caribbean, is the first first-ever Category 4 hurricane recorded in the region in June – and a portend of devastating changes in weather patterns. It also underscores the need for urgent international assistance to Small Island Developing States (SIDS) to strengthen early warning systems and the climate resilience of key infrastructure – notably water, sanitation and health services, according to experts. The hurricane reached peak speed of 265 km per hour at times as it whipped though Barbados, Grenada, St Vincent and the Grenadines, Haiti, northern Venezuela, the Dominician Republic, Cayman Islands, and Jamaica. “The storm first impacted Barbados, causing severe damage to the south coast and significantly affecting the fishing industry with over 200 fishing vessels damaged or destroyed,” according to the International Federation of Red Cross and Red Crescent Societies (IFRC). On Union Island, part of Saint Vincent and the Grenadines, 90% of infrastructure has been damaged, including houses, roads and the airport. Some 95% of homes in Grenada’s Carriacou and Petite Martinique islands, are damaged, and around 3,000 people are shelters, the IFRC added. Parts of Jamaica’s St Elizabeth region in the south east were also devastated, with around 1,000 people taking refuge in shelters. The Dominican Republic, Cayman Islands reported damage. Venezuela’s President Nicolas Maduro said that 8,000 houses had been destroyed, according to Reuters. More to still come? “Hurricane Beryl, the first hurricane of the 2024 Atlantic hurricane season, rapidly strengthened to a Category 5 storm unusually early in the year,” according to a report from the National Ocean and Atmospheric Administration (NOAA), which is part of the US Department of Commerce “This explosive strengthening was fuelled in part by exceptionally warm ocean temperatures. That heat was one of the factors behind NOAA’s prediction in May of an 85% chance that the 2024 Atlantic hurricane season would be above normal.” Sea surface temperatures were close to those usually found in mid-September, the peak of hurricane season, added NOAA. In late May, NOAA weather forecasters predicted an 85% chance of above-normal hurricane for the 2024 Atlantic hurricane season, which runs from 1 June 1 to 30 November. It also forecast eight to 13 hurricanes, with four to seven likely to be “major” hurricanes (winds of over 178km per hour) in coming months. Early warning systems “The unprecedented hurricane demonstrates the importance of effective multi-hazard early warning systems to save lives,” according to United Nations Disaster Risk Reduction (UNDRR). “Globally, the sustained investments in those systems are making progress in reducing the loss of life in disasters. But economic losses are escalating. Every year millions of households lose their livelihood and risk being pushed into poverty. Ensuring that infrastructure is resilient and that communities ‘build back better’ in the face of future hazards is essential,” added UNDRR. Damage sustained to the airport and surrounding areas on Union Island in the Grenadines during Hurricane Beryl. In late May, the Fourth International Conference on SIDS adopted the Antigua and Barbuda Agenda for SIDS, a 10-year development agenda that appeals for international assistance to address climate change. The Agenda notes that “SIDS are facing the unrelenting and compounding impacts of climate change, biodiversity loss, pollution, disasters and natural hazards, health and other social related challenges and economic vulnerabilities.” Key climate change challenges include “erratic precipitation, increasingly frequent and extreme weather phenomena, more frequent and severe tropical cyclones, floods and drought, diminishing fresh water resources, desertification, coastal erosion, land degradation and sea-level rise.” However, there has been a “progressive deterioration” in SIDS’ ability to “withstand external shocks and enhance their resilience” – largely as a result of the economic impact of COVID-19 and climate challenges. Financial reform to build resilience Protestors call on wealth countries to pay for climate-related loss and damage at COP27. “In the wake of Hurricane Beryl, it is clear that we must redouble our efforts to build resilience and preparedness in the face of growing disaster risk, especially for small island developing states, which have contributed the least to the climate crisis but suffer the greatest costs,” said UNDRR head Kamal Kishore. Kishore appealed for international support for the Antigua and Barbuda Agenda, which “integrates disaster risk reduction as central to climate change adaptation and sustainable development in SIDS with clear calls to action on enhancing multi-hazard early warning systems and resilient infrastructure.” There have also been numerous calls for reform of the international financial architecture to assist developing countries most affected by climate change who are being forced to borrow money to address climate crises largely caused by wealthy nations. The most significant of these is the 2022 Bridgetown Initiative, spearheaded by Prime Minister Mia Mottley of Barbados. This called for key actions including new loan mechanisms, reform of the world’s development banks, and a loss and damages fund to enable developing countries to access to resilient finance to address climate and development crises. The UN climate change conference, COP27, agreed to establish a loss and damage fund during the UN Climate Change Conference (COP27) in 2022. However, there is resistance from a number of wealthier countries to this as the world continues to experience record-breaking extreme weather events. Meanwhile, the International Cort of Justice (ICJ) is expected to hold public hearings and issue an advisory later this year on the international legal obligations countries have to safeguard people against climate change. This follows the adoption last year of a landmark UN resolution to seek such an advisory opinion from the ICJ. While not legally binding, the advisory opinion holds legal and moral weight and will spotlight the human rights impacts of climate policy. Image Credits: UNDP, AfricaNews. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
From Depression to Hypertension: Heat and Air Pollution Exert Heavy Toll on India’s Farmers 09/07/2024 Sanket Jain Farmer Kusum Gaikwad finds it increasingly difficult to work in the fields and finish daily chores because air pollution has severely impacted her health. JAMBHALI, India – Farmer Kusum Gaikwad’s work start at 4 am daily. First, she burns the firewood and farm residue to heat water for 10 family members. By 7 am, she reaches the fields, manoeuvring through thousands of sugarcane plants, removing weeds, and checking for pests and diseases that could hamper their growth. This is followed by tremendous backbreaking labor, where she collects and lifts over 100kg of cattle fodder in the relentless heat. This has been her routine for the past two decades. But in 2017, Gaikwad started to get frequent headaches. Dizziness and severe pain in the chest and abdomen followed. “It was unbearable, but I kept working for four months,” she says. Eventually, when it became difficult for her to even move out of bed, she consulted a doctor and was diagnosed with hypertension. She returned to the same routine within a week. Two years later, she was diagnosed with type 2 diabetes and also reported weakening of her bones. ‘Mountains of smoke’ With the rising exposure to extreme heat and air pollution, Kusum Gaikwad was first diagnosed with hypertension and then type 2 diabetes. Perplexed, Gaikwad, now 66 years old, was determined to find the causes of her illnesses. When she went to the fields again in Jambhali village in India’s Maharashtra state, she met over 20 women who complained of similar symptoms. “Everyone was coughing throughout the day, and that’s when I realized it was the air pollution,” she told Health Policy Watch. Soon, Gaikwad found that almost every family in her village was burning at least 50 kg kilograms of firewood, agricultural residues, plastic bags, and seedling trays every day to heat water and cook food. “Every morning, you can see a mountain of smoke here,” she says. Over the years, a growing number of studies have found air pollution to be a risk factor for several noncommunicable diseases (NCDs), some of which include cardiovascular and respiratory diseases, heart attacks, and lower respiratory infections. A paper published in 2020 analyzed the impact of air pollution on the health of 39,259 Chinese adults, finding that long-term exposure to air pollutants increased blood pressure and hypertension. Similarly, a study from India found that both short and long-term exposure to ambient PM2.5, fine particulate matter smaller than 2.5 micrometers that penetrate deep into the lungs, was associated with increased hypertension. In India, deaths from NCDs have increased from 38% of total mortality in 1990 to 62% in 2016. The annual particulate pollution in India has increased by almost 68% from 1998 to 2021, reducing the average life expectancy by 2.3 years. Extreme heat exacerbates air pollution When chronic asthma becomes severe at night, Rajakka Tasgave leans against the wall, waiting for her labored breathing to ease. Rajakka Tasgave, 65, has become scared of going to the fields, something she has done for over five decades. “Every day, I see at least one woman collapsing because of the extreme heat. Someday, even I can be one of them,” she shared earlier this year. It didn’t take long for her turn, though. After collapsing in the fields in March, when the temperature topped 40 degrees Celsius in Jambhali, the doctor advised her to stop working in extreme heat. “From April to May, I didn’t step out of the house from 10am till evening,” she said. But this meant that she lost a significant chunk of her earnings as most of the farmwork happens during the day. Every day after returning from the fields, she experiences tremendous body aches. “Every week, I visit a doctor and take an injection (epidural steroid injection). Otherwise, I won’t be able to work.” Alongside the unbearable heat, Tasgave frequently comes in contact with air pollutants from the nearby industries and firewood emissions. She has tried covering her face with the end drape of her saree, but that didn’t help. A few years back, she was diagnosed with chronic asthma. “If I forget to carry my inhaler, I will die of an attack,” she confides. During extreme heat, her asthma becomes unbearable. She became breathless in May this year when the night temperatures didn’t drop as normal. “With no one to take me to the hospital, I leaned against the wall in the hope of easing my pain,” she shares. She found relief only the next day when a doctor administered medicines. Heart attacks and pulmonary diseases Researchers have stepped up efforts to understand the combined effects of air pollution and extreme heat in the past few years. In one such paper published in Environment International, they investigated the impact of heat and air pollution on mortality in 36 countries. The study found that heat-related mortality also increased with higher levels of air pollutants like PM, NO2, and O3. Moreover, they also saw an increase in PM—and O3-related mortality for higher air temperature levels. Extreme temperatures and higher concentrations of particulate matter significantly increase the risk of heart attacks, according to a study published in the American Heart Association’s journal, Circulation. The researchers examined 202,678 heart attacks from China’s Jiangsu province between 2015 and 2020. Also, they found that during extreme heat, women were at a greater risk of heart attack than men. In the presence of rising temperatures and high solar radiations, volatile organic compounds react with nitrogen oxides to form ozone, considered a harmful pollutant in the lower atmosphere. Ozone exposure can lead to respiratory infections. As a result, many people from Jambhali are now suffering from chronic obstructive pulmonary disease (COPD), which restricts the airflow and causes breathing issues. The problem is so severe that this year’s State of Global Air Report found that 50% of global ozone-related COPD deaths were reported in India. Many Indian families still rely on open fires to cook food, risking their health. Anxiety and stress rise with air pollution Jambhali’s community healthcare worker Kamal Kore was always curious about why people like Gaikwad, Tasgave and many others have felt anxious and stressed over the past five years. “Year after year, the number of people complaining of anxiety and stress disorders has risen. A few cases had even culminated in cardiovascular ailments and deaths,” she says. After tracking over a thousand such cases, she found that, as air pollution increased, so did the number of people suffering from mental health issues. Her observation isn’t a one-off case. A study published in April 2024 looked at more than 3,000 US counties, spanning over 315 million people, and found PM2.5 to be linked with depression and stress. These mental health issues, in turn, put people at risk of dying from cardiovascular diseases. Its lead author, Dr Shady Abohashem of Massachusetts General Hospital, explains, “Biologically, PM2.5 can enter the bloodstream and induce systemic inflammation, oxidative stress, and neuroinflammation, all known to affect brain function and mood regulation.” The combined effect of PM2.5 and deteriorating mental health amplify the risk of premature cardiovascular mortality. “High PM2.5 exposure leads to systemic inflammation and endothelial dysfunction, critical factors in the development of cardiovascular diseases. When combined with poor mental health, which independently contributes to adverse cardiovascular outcomes through mechanisms like heightened stress response, disrupted sleep, and poor health behaviors, the risk is significantly magnified,” Abohashem explains. Air pollution disrupts sleep, causes depression So severe was the impact that in counties with higher levels of PM2.5, people struggling with poor mental health experienced a threefold rise in premature cardiovascular mortality compared to those with better mental health in areas of lower pollution. The problem isn’t restricted to the outdoor workers. Besides crop residue burning and industrial pollution, another source of PM2.5 is indoor air pollution caused by burning firewood. Many Indian families still rely on burning firewood for cooking. A study from India published in BMC Geriatrics this year found that indoor pollution led to sleep disorders and depression among older adults. “Ambient air pollutants can travel from the nose through the olfactory nerve and reach crucial brain areas like the striatum, frontal cortex, and cerebellum, which are involved in various functions including movement, decision-making, and coordination,” says one of its authors, Dr Aparajita Chattopadhyay, a professor at the International Institute for Population Sciences in Mumbai. These pollutants trigger an inflammatory response which can lead to changes in the levels of neurotransmitters and, hence, disrupt an individual’s sleep and mood. “Sleep plays an important role in maintaining good health, failing which NCDs, including mental health issues, may crop up,” she adds. Limited air quality warnings The health problems caused by air pollution are mounting, as evident from community health worker Kamal Kore’s call records. The past five years have sent a jump in health issues – largely NCDs, especially since the temperature started rising rapidly. “Every day, I get at least 10 calls from the villagers with complaints of cardiovascular and respiratory issues,” she shares, adding that she now spends most of her time making people aware of the harmful effects of air pollution. “Every day, I tell people to switch to clean energy sources for cooking and work during the hours when the pollution is comparatively lesser,” she says. “We don’t have any resources to deal with this.” A major problem healthcare workers like her face is the lack of adequate, real-time data on air pollution to warn patients about peaks. People currently simply observe the times of day when air pollution becomes severe and try to avoid these. Farmer Narayan Gaikwad who is exposed to a lot of air pollution daily says that the lack of real time data on air pollution in the village is a big hindrance to make people aware of air pollution and the hours they shouldn’t work out in the fields. Gaikwad’s husband, Narayan Gaikwad, 77, has written several letters to the district authorities demanding strict measures to curb air pollution. “People don’t understand how much unhealthy air they are breathing because there’s no one monitoring air pollution in the village,” he says. “I am now asking people to stop working during those hours.”. Chattopadhyay suggests that older people avoid major sources of indoor air pollutants, ensure proper ventilation, and use clean fuel. “A positive and strong social circle is also necessary to be mentally fit. Adults must be made aware of cues of contentment in life much before they get old — financial stability, strong social circle, and remaining active daily in various tasks,” she adds. Given Gaikwad’s declining health, her family is considering a solar water heating system despite its crippling cost. While this will help her somewhat, she is worried about the smoke from the neighborhoods. “A solution can never work in isolation. It has to happen at the community level,” she warns. Image Credits: Sanket Jain. Record-Breaking Dengue Infection Persists in the Caribbean 09/07/2024 Sophia Samantaroy Aedes aegypti mosquitoes are the main vectors of dengue virus. Dengue virus cases have reached an all-time high since January in the US territory of Puerto Rico, with 1,729 people infected so far – a more than 300% increase compared to last year. The uptick in the mosquito-borne disease, which causes mild to severe illness, follows a trend across the Caribbean region. The total number of reported cases for the Caribbean has reached nearly 57,000 – a 469% increase as compared to the same period in 2023. Climate change, the El Nino effect, and unplanned urban growth have fueled this year’s surge. While dengue tends to hit Brazil, Argentina, Paraguay and Uruguay the worst, the Caribbean, the Central American isthmus, and Mexico continue to see above-average transmission. Further complicating efforts to control the mosquito-borne disease is the premature start to the hurricane season. Hurricane Beryl has already devastated several small island nations in the Caribbean, damaging water and health infrastructure, thus making residents even more vulnerable to dengue. Halfway into 2024, the total burden of dengue cases in the Americas has exceeded 10.1 million, more than twice the 4.7 million cases in 2023. The Puerto Rican Department of Health recently extended its dengue epidemic alert until December, after this year’s season brought the highest proportion of severe dengue in the Americas. Of the nearly 2,000 cases reported to the territory’s health officials, 92 are severe, meaning patients may suffer from painful symptoms including fever, headaches and vomiting. Three of the dengue serotypes – DENV 1, 2, and 3 – are currently circulating. This alert comes just two weeks after the US Centers for Disease Control and Prevention (CDC) issued a health advisory warning of the increased risk of dengue virus infections in the US. While most cases in the continental US come from overseas travelers, Florida has reported a handful of locally-transmitted cases. Hurricane Beryl sets back health response Debris, abundant rainfall, and inadequate shelter are all hurricane by-products that increase the risk of dengue virus infection. The first category 5 hurricane of the season, Beryl devastated much of Saint Vincent and the Grenadines, Grenada, Dominica, Barbados, and Jamaica. The destruction left in the hurricane’s wake highlights small island nations’ vulnerabilities to climate change and its health effects. The Caribbean region is particularly susceptible to healthcare disruptions from natural disasters. Studies of cyclones in China and hurricanes in Puerto Rico found increases in dengue virus infections in the weeks following hurricanes. “Pre-existing environmental health risk magnified after the pass of Hurricanes Irma and María,” said researcher José Pérez-Ramos, Assistant Professor of Public Health Sciences at the University of Rochester. He notes that in the aftermath of 2017’s devastating hurricanes, participants in the study were worried about frequent dengue outbreaks. While the International Federation of the Red Cross (IFRC) and other relief organizations active in the Caribbean nations are in the early days of response and assessment, the confluence of the hurricane’s destruction and peak dengue season may spell out an increased case burden. “Hygiene kits, cleaning kits, tool kits, kitchen sets, tarpaulins, blankets and mosquito nets have already been dispatched to the hardest hit islands to meet the immediate needs of the affected population,” said Rhea Pierre, IFRC Disaster Manager for the English and Dutch-speaking Caribbean. “Still, rapid damage assessments show that the devastation is massive.” ‘A notable increase’ in cases, but low fatality rate Removing standing water sources is a key tactic in controlling for dengue. Despite this year’s record number of cases, the World Health Organisation’s (WHO) regional office in the Americas, the Pan-American Health Organization (PAHO), notes that the fatality rate for the Americas has not exceeded the regional benchmark of 0.05%. “While we are seeing a notable increase in the number of dengue cases in the region this year, it is important to highlight that the proportion of cases that progress to death remains low thanks to countries’ efforts and the support of PAHO,” said Jarbas Barbosa, PAHO Director, in a recent press release. “This situation highlights the importance of sustaining surveillance, strengthening prevention and control measures, and ensuring timely medical care,” he added. Standing water, seen here in the aftermath of Hurricane Otis, is needed for mosquitoes to breed. Few studies have assessed what causes some patients to progress to severe dengue. The WHO notes that ensuring access to sufficient medical care should remain at the forefront of countries’ priorities to treat severe dengue. PAHO’s Caribbean Mosquito Awareness Week, which took place in May, aimed to raise public awareness about the connection between mosquitoes and the diseases they transmit, such as dengue, chikungunya, and Zika, and to involve the community to prevent mosquito breeding. “The population and household members should be encouraged to eliminate sources of mosquito breeding, both household and peri-household. This is everyone’s task: the family, the community, the public and private sector,” said PAHO in a recent alert on increased cases in Central America, Mexico, and the Caribbean regions. Aedes aegypti, the main mosquito vector, typically breeds in sites such as water containers as well as in urban waste, including plastic wrapping that can accumulate rainwater. As the virus doesn’t have a cure and repeat infections can even be more severe, surveillance and control of mosquito breeding sites is critical to reduce dengue transmission and illness, particularly the most severe form of the disease, dengue hemorrhagic fever. Dengue cases expected to rise in Mexico, Central America and Caribbean Cases have yet to peak fully in the Caribbean, Central America and Mexico. Farther north of the equator, cases have yet to peak in the PAHO regions of the Caribbean, Central America Isthmus and Mexico. “Although there has been a decrease in dengue cases in the Southern Cone [Brazil, Argentina, Paraguay, and Uruguay] and Andean sub-regions in recent epidemiological weeks, the subregions of the Central American isthmus and Mexico, and the Caribbean subregion are entering the period of increased dengue circulation, which could significantly increase the number of cases reported in the Region during the second half of 2024,” said PAHO in their May epidemiological alert. Cases decreasing at tail-end of season Brazil, which accounts for more than 80% of the Americas’ dengue cases, is at the tail-end of its season. The number of dengue cases is finally tapering off for the South American countries hardest hit – Brazil in particular saw an explosive growth in cases earlier this year. PAHO attributes the country’s epidemic conditions to prolonged heat, higher rainfall levels, as well as decreased population immunity following COVID-19-related restrictions. In response, and to avoid losing vaccine stock to expiration, the Brazilian government recently expanded the population eligible for dengue vaccination. Now, children six to sixteen are eligible, rather than just ten to fourteen year-olds. Image Credits: Direct Relief/Felipe Luna, James Gathany/ PHIL, CDC, Public Domain, IFRC, PAHO , PAHO , PAHO. WHO Launches Platform for Standardised Medical Device Information 09/07/2024 Zuzanna Stawiska An online WHO platform gathers information about various medical devices: from simple syringes to complex hospital equipment. To help countries and organisations navigate a complex pool of over 10,000 different medical devices, the World Health Organization (WHO) launched an online platform on Monday that will collect and standardise the information about medical equipment. Medical Devices Information System, or MeDevIS, is inspired by the WHO Priority Medical Devices List (MDL) and the Essential Medicines List, the latter of which will soon have existed for 50 years, serving as an important support for health progress globally. MeDevIS includes 2,301 types of medical devices of varying levels of complexity: from single-use syringes, medical masks, and pulse oximeters, to imaging radiology technologies, implantable prostheses, or defibrillators. “The number of medical technologies used in health care is growing, as is their complexity, which can make it challenging for health care practitioners and patients to navigate,” said Dr Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products. The aim is for a “one-stop shop of international information” to help stakeholders to find appropriate equipment. The new platform references both major naming systems for medical devices, renowned internationally: the European Medical Device Nomenclature (EMDN) and the Global Medical Device Nomenclature (GMDN), used in some countries outside of the European region. Both systems facilitate handling specific types of equipment on the regulatory and logistics levels. MeDivIS also features information about the infrastructure required for the device, the healthcare facility level where it is typically used, and links to thematic WHO guidelines connected with the branch of care for which the equipment is made. “The MeDevIS platform can be useful for national policy-makers to develop or update their own national lists for the procurement of health technologies and devices and can contribute to the progress towards universal health coverage,” said Dr Deus Mubangizi, WHO Director for Health Products Policy and Standards. Image Credits: Unsplash. Russia’s Bombing of Ukraine Children Hospital is ‘Abominable’ 08/07/2024 Kerry Cullinan Children with cancer outside Okhmatdyt Hospital after the attack. Russia’s bombing of a children’s hospital and women’s health centre in Ukraine’s capital Kiev on Monday is “abominable”, said UN High Commissioner for Human Rights Volker Türk. “Civilians must be protected, and the laws of war strictly adhered to,” added Türk. “There must be prompt, thorough and independent investigations into these latest grave attacks on civilians and civilian infrastructure, and those responsible must be held to account.” “Shockingly, one of the strikes severely damaged the intensive care, surgical and oncology wards of Okhmatdyt, which is Ukraine’s largest children’s referral hospital, and destroyed its children’s toxicology department, where children receive dialysis,” said Türk. Okhmatdyt Hospital serves more than 20,000 children annually. Monday’s missile attack struck a medical building at the hospital where children were receiving dialysis, while also damaging the intensive care, operating, and oncology departments, according to the Minister of Health of Ukraine. The entire hospital is without electricity, preventing the use of ventilators and other urgent care. Dr Tedros Adhanom Ghebreyesus, Director General of the World Health Organisation (WHO), said that “several floors of the largest children’s hospital in Kyiv were severely impacted today, disrupting the hospital’s operations and affecting its ability to provide critical care to the young patients.” Several floors of the largest children’s hospital in Kyiv were severely impacted today, disruptng the hospital’s operations and affecting its ability to provide critical care to the young patients.@WHO has been working closely with the hospital before and since the war in… pic.twitter.com/9ReGcov71F — Tedros Adhanom Ghebreyesus (@DrTedros) July 8, 2024 Meanwhile, Türk said that OHCHR staff visiting the scene shortly after the attack had “observed children receiving treatment for cancer in hospital beds set up in parks and on streets, where medical workers had quickly established triage areas, amongst chaos, dust and debris.” Health officials said the entire hospital was now without electricity, preventing the use of ventilators and other urgent care. It was not immediately clear how many people were killed in the strike. The ISIDA Medical Centre, one of the largest women’s health and family planning centres in Ukraine, was also affected by the attack, with several casualties. The attack comes the day before a NATO summit in Washington DC. Russia has attacked Ukraine’s health care workers, facilities, and other medical infrastructure at least 1,442 times since its invasion of Ukraine in February 2022 and 13 April 2024,according to data from a partnership made up of the Ukrainian Health Center, Physicians for Human Rights (PHR) and others. Russian attacks on Ukraine health care since February 2022. “Russia’s strategy in Ukraine includes attacking babies and children. Domestic and international actors should intensify efforts to hold perpetrators accountable for these war crimes,” said Uliana Poltavets, PHR’s Ukraine emergency response coordinator in a statement. Researchers have documented 79 attacks that affected children’s health care, including 54 attacks that destroyed or damaged children’s hospitals. “Today’s devastating attack on the largest children’s hospital is emblematic of Russia’s onslaught against Ukraine’s health care system. Again and again, we have witnessed Russian forces attack vulnerable patients, health workers, and hospitals across the country,” said Poltavets. PHR called on “domestic and international prosecutors, including the International Criminal Court, to prioritise the investigation and prosecution of attacks on health care.” Image Credits: Twitter. Sierra Leone Outlaws Child Marriage 08/07/2024 Kerry Cullinan Sierra Leone First Lady Fatima Bio Sierra Leone’s President Julius Maada Bio signed into law the Prohibition of Child Marriage Act last week, introducing a penalty of at least 15 years and a fine of around $4,000 for any man who marries a girl under 18. The law also prohibits cohabiting with a child, and fines for anyone arranging, aiding or attending such marriage ceremonies. First Lady Fatima Bio’s “Hands Off Our Girls” campaign has been instrumental in advocating against child marriage in Sierra Leone. Sierra Leone has one of the highest rates of child marriages in Africa, alongside Niger and Nigeria. According to the 2019 Sierra Leone Demographic and Health Surveys, 30% of girls in Sierra Leone are married before their 18th birthday. In 2020, there were 800,000 child brides, half of whom were married before they turned 15, according to UNICEF. The country of slightly over eight million people also has a high rate of female genital mutilation. “Child marriages fuel the high adolescent pregnancy rate in Sierra Leone where, tragically, pregnancy complications are the leading cause of death for girls aged 15-19,” according to Human Rights Watch (HRW). In 2021, the country introduced a policy of “radical inclusion” in schools, targeting and marginalised groups including girls, particularly pregnant girls and parent learners. Last year, Sierra Leone passed an education law that guarantees children free education, including one year of pre-primary. “The legislation is a milestone in Sierra Leone’s journey towards gender equality and child protection. It also sets a pathway forward for other African nations, such as Tanzania and Zambia, to revoke laws that permit child marriage, and ensure girls can complete primary and secondary education,” said HRW. FDA Approves Eli Lilly’s Kisunla for Early-Stage Alzheimer’s Patients 08/07/2024 Maayan Hoffman Neurons with tau protein highlighted in red. Eli Lilly’s Alzheimer’s therapy, donanemab, has received FDA approval, offering new hope for patients with early symptomatic Alzheimer’s disease. The newly approved treatment, branded Kisunla, is set to challenge existing therapies from Eisai and Biogen. Clinical trials have shown Kisunla to be effective for individuals in the mild cognitive impairment or mild dementia stages of the disease, potentially marking a significant advancement in Alzheimer’s care. The drug is administered as an intravenous infusion every four weeks. Alzheimer’s disease is a degenerative condition of the brain that impacts over 6.5 million Americans and over 55 million people worldwide. It causes a gradual decline in memory, cognitive functions, and, eventually, the ability to perform daily activities. The disease is marked by structural changes in the brain, such as the buildup of amyloid beta plaques and neurofibrillary tangles made of tau protein, which is supposed to help stabilize the internal skeleton of neurons in the brain. The Alzheimer’s Association celebrated the FDA’s decision. “This is real progress,” said Joanne Pike, Alzheimer’s Association president and CEO, in a statement. “Today’s approval allows people more options and greater opportunity to have more time. Having multiple treatment options is the kind of advancement we’ve all been waiting for — all of us who have been touched, even blindsided, by this difficult and devastating disease.” Slows cognitive decline by at least 22% The approval was based on an extensive double-blind, placebo-controlled, parallel-group study evaluating the efficacy of Kisunla in slowing cognitive decline in participants with varying levels of tau protein in the brain. Tau is a protein that helps to stabilise the neurons in the brain. The study, conducted over 72 weeks with 1,736 patients averaging 73 years old, revealed that those receiving Kisunla experienced a 35% reduction in cognitive decline compared to those on placebo among individuals with low to medium tau levels. Even among participants with higher tau levels, the treatment demonstrated a meaningful but slightly reduced effect. Overall, including all tau levels, Kisunla slowed cognitive decline by 22% and reduced the likelihood of progressing to the next stage of the disease by 39% compared to placebo. Additionally, the study monitored amyloid plaque levels using positron emission tomography (PET) scans throughout the treatment period. Results showed substantial reductions in amyloid plaques over time among patients receiving Kisunla, with reductions of 61% at six months, 80% at 12 months, and 84% at 18 months compared to baseline levels. These findings suggest that Kisunla not only targets cognitive decline but also effectively reduces the hallmark amyloid pathology associated with Alzheimer’s disease progression. Potential side effects For some patients, there is a risk of amyloid-related imaging abnormalities (ARIA) developing, the FDA said. ARIA typically manifests as temporary brain swelling, sometimes accompanied by small areas of bleeding on or in the brain. While ARIA often resolves on its own and may not cause symptoms, rare instances of severe and potentially life-threatening events have been reported. ARIA is a recognized side effect of antibody therapies targeting amyloid. Infusion-related reactions are also a concern, including flu-like symptoms, nausea, vomiting, changes in blood pressure, and hypersensitivity reactions such as anaphylaxis (a severe allergic reaction) and angioedema (swelling). Kisunla joins Leqembi, on market since 2023 Kisunla is the third drug to receive FDA approval, although only the second is now available for use. Leqembi, a collaboration between Biogen of the United States and Eisai of Japan, gained approval in July 2023. In an 18-month Phase III trial, Leqembi demonstrated a 27% reduction in cognitive decline among early-stage Alzheimer’s patients compared to those receiving a placebo. Another drug, aducanumab, also developed by Biogen and Eisai, was granted accelerated approval by the FDA in June 2021. However, due to some side effects, the therapy was pulled from the market. The Alzheimer’s Association emphasized the importance of early detection and diagnosis now that multiple FDA-approved treatments for Alzheimer’s are available. The organization stressed that timely access to these treatments is crucial for maximizing their benefits, asserting that no stage or entity should hinder or delay such access. “Too many roadblocks have prevented individuals from getting equitable access to these beneficial treatments for far too long,” said Pike. “It is equally important that clinicians and health care systems are informed and prepared to help the individuals who could benefit. The Alzheimer’s Association is working with health systems and providers to ensure they have the tools and resources to meet the needs of their patients.” Image Credits: Gerry Shaw/ EnCor Biotechnology Inc. Earliest Ever Hurricane Tears Through Caribbean, Highlighting Need for Speedier Climate Action 05/07/2024 Kerry Cullinan Fishing vessels at the Bridgetown Fisheries Complex in Barbados damaged by Hurricane Beryl. Hurricane Beryl, which has destroyed homes and infrastructure in large parts of the eastern Caribbean, is the first first-ever Category 4 hurricane recorded in the region in June – and a portend of devastating changes in weather patterns. It also underscores the need for urgent international assistance to Small Island Developing States (SIDS) to strengthen early warning systems and the climate resilience of key infrastructure – notably water, sanitation and health services, according to experts. The hurricane reached peak speed of 265 km per hour at times as it whipped though Barbados, Grenada, St Vincent and the Grenadines, Haiti, northern Venezuela, the Dominician Republic, Cayman Islands, and Jamaica. “The storm first impacted Barbados, causing severe damage to the south coast and significantly affecting the fishing industry with over 200 fishing vessels damaged or destroyed,” according to the International Federation of Red Cross and Red Crescent Societies (IFRC). On Union Island, part of Saint Vincent and the Grenadines, 90% of infrastructure has been damaged, including houses, roads and the airport. Some 95% of homes in Grenada’s Carriacou and Petite Martinique islands, are damaged, and around 3,000 people are shelters, the IFRC added. Parts of Jamaica’s St Elizabeth region in the south east were also devastated, with around 1,000 people taking refuge in shelters. The Dominican Republic, Cayman Islands reported damage. Venezuela’s President Nicolas Maduro said that 8,000 houses had been destroyed, according to Reuters. More to still come? “Hurricane Beryl, the first hurricane of the 2024 Atlantic hurricane season, rapidly strengthened to a Category 5 storm unusually early in the year,” according to a report from the National Ocean and Atmospheric Administration (NOAA), which is part of the US Department of Commerce “This explosive strengthening was fuelled in part by exceptionally warm ocean temperatures. That heat was one of the factors behind NOAA’s prediction in May of an 85% chance that the 2024 Atlantic hurricane season would be above normal.” Sea surface temperatures were close to those usually found in mid-September, the peak of hurricane season, added NOAA. In late May, NOAA weather forecasters predicted an 85% chance of above-normal hurricane for the 2024 Atlantic hurricane season, which runs from 1 June 1 to 30 November. It also forecast eight to 13 hurricanes, with four to seven likely to be “major” hurricanes (winds of over 178km per hour) in coming months. Early warning systems “The unprecedented hurricane demonstrates the importance of effective multi-hazard early warning systems to save lives,” according to United Nations Disaster Risk Reduction (UNDRR). “Globally, the sustained investments in those systems are making progress in reducing the loss of life in disasters. But economic losses are escalating. Every year millions of households lose their livelihood and risk being pushed into poverty. Ensuring that infrastructure is resilient and that communities ‘build back better’ in the face of future hazards is essential,” added UNDRR. Damage sustained to the airport and surrounding areas on Union Island in the Grenadines during Hurricane Beryl. In late May, the Fourth International Conference on SIDS adopted the Antigua and Barbuda Agenda for SIDS, a 10-year development agenda that appeals for international assistance to address climate change. The Agenda notes that “SIDS are facing the unrelenting and compounding impacts of climate change, biodiversity loss, pollution, disasters and natural hazards, health and other social related challenges and economic vulnerabilities.” Key climate change challenges include “erratic precipitation, increasingly frequent and extreme weather phenomena, more frequent and severe tropical cyclones, floods and drought, diminishing fresh water resources, desertification, coastal erosion, land degradation and sea-level rise.” However, there has been a “progressive deterioration” in SIDS’ ability to “withstand external shocks and enhance their resilience” – largely as a result of the economic impact of COVID-19 and climate challenges. Financial reform to build resilience Protestors call on wealth countries to pay for climate-related loss and damage at COP27. “In the wake of Hurricane Beryl, it is clear that we must redouble our efforts to build resilience and preparedness in the face of growing disaster risk, especially for small island developing states, which have contributed the least to the climate crisis but suffer the greatest costs,” said UNDRR head Kamal Kishore. Kishore appealed for international support for the Antigua and Barbuda Agenda, which “integrates disaster risk reduction as central to climate change adaptation and sustainable development in SIDS with clear calls to action on enhancing multi-hazard early warning systems and resilient infrastructure.” There have also been numerous calls for reform of the international financial architecture to assist developing countries most affected by climate change who are being forced to borrow money to address climate crises largely caused by wealthy nations. The most significant of these is the 2022 Bridgetown Initiative, spearheaded by Prime Minister Mia Mottley of Barbados. This called for key actions including new loan mechanisms, reform of the world’s development banks, and a loss and damages fund to enable developing countries to access to resilient finance to address climate and development crises. The UN climate change conference, COP27, agreed to establish a loss and damage fund during the UN Climate Change Conference (COP27) in 2022. However, there is resistance from a number of wealthier countries to this as the world continues to experience record-breaking extreme weather events. Meanwhile, the International Cort of Justice (ICJ) is expected to hold public hearings and issue an advisory later this year on the international legal obligations countries have to safeguard people against climate change. This follows the adoption last year of a landmark UN resolution to seek such an advisory opinion from the ICJ. While not legally binding, the advisory opinion holds legal and moral weight and will spotlight the human rights impacts of climate policy. Image Credits: UNDP, AfricaNews. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Record-Breaking Dengue Infection Persists in the Caribbean 09/07/2024 Sophia Samantaroy Aedes aegypti mosquitoes are the main vectors of dengue virus. Dengue virus cases have reached an all-time high since January in the US territory of Puerto Rico, with 1,729 people infected so far – a more than 300% increase compared to last year. The uptick in the mosquito-borne disease, which causes mild to severe illness, follows a trend across the Caribbean region. The total number of reported cases for the Caribbean has reached nearly 57,000 – a 469% increase as compared to the same period in 2023. Climate change, the El Nino effect, and unplanned urban growth have fueled this year’s surge. While dengue tends to hit Brazil, Argentina, Paraguay and Uruguay the worst, the Caribbean, the Central American isthmus, and Mexico continue to see above-average transmission. Further complicating efforts to control the mosquito-borne disease is the premature start to the hurricane season. Hurricane Beryl has already devastated several small island nations in the Caribbean, damaging water and health infrastructure, thus making residents even more vulnerable to dengue. Halfway into 2024, the total burden of dengue cases in the Americas has exceeded 10.1 million, more than twice the 4.7 million cases in 2023. The Puerto Rican Department of Health recently extended its dengue epidemic alert until December, after this year’s season brought the highest proportion of severe dengue in the Americas. Of the nearly 2,000 cases reported to the territory’s health officials, 92 are severe, meaning patients may suffer from painful symptoms including fever, headaches and vomiting. Three of the dengue serotypes – DENV 1, 2, and 3 – are currently circulating. This alert comes just two weeks after the US Centers for Disease Control and Prevention (CDC) issued a health advisory warning of the increased risk of dengue virus infections in the US. While most cases in the continental US come from overseas travelers, Florida has reported a handful of locally-transmitted cases. Hurricane Beryl sets back health response Debris, abundant rainfall, and inadequate shelter are all hurricane by-products that increase the risk of dengue virus infection. The first category 5 hurricane of the season, Beryl devastated much of Saint Vincent and the Grenadines, Grenada, Dominica, Barbados, and Jamaica. The destruction left in the hurricane’s wake highlights small island nations’ vulnerabilities to climate change and its health effects. The Caribbean region is particularly susceptible to healthcare disruptions from natural disasters. Studies of cyclones in China and hurricanes in Puerto Rico found increases in dengue virus infections in the weeks following hurricanes. “Pre-existing environmental health risk magnified after the pass of Hurricanes Irma and María,” said researcher José Pérez-Ramos, Assistant Professor of Public Health Sciences at the University of Rochester. He notes that in the aftermath of 2017’s devastating hurricanes, participants in the study were worried about frequent dengue outbreaks. While the International Federation of the Red Cross (IFRC) and other relief organizations active in the Caribbean nations are in the early days of response and assessment, the confluence of the hurricane’s destruction and peak dengue season may spell out an increased case burden. “Hygiene kits, cleaning kits, tool kits, kitchen sets, tarpaulins, blankets and mosquito nets have already been dispatched to the hardest hit islands to meet the immediate needs of the affected population,” said Rhea Pierre, IFRC Disaster Manager for the English and Dutch-speaking Caribbean. “Still, rapid damage assessments show that the devastation is massive.” ‘A notable increase’ in cases, but low fatality rate Removing standing water sources is a key tactic in controlling for dengue. Despite this year’s record number of cases, the World Health Organisation’s (WHO) regional office in the Americas, the Pan-American Health Organization (PAHO), notes that the fatality rate for the Americas has not exceeded the regional benchmark of 0.05%. “While we are seeing a notable increase in the number of dengue cases in the region this year, it is important to highlight that the proportion of cases that progress to death remains low thanks to countries’ efforts and the support of PAHO,” said Jarbas Barbosa, PAHO Director, in a recent press release. “This situation highlights the importance of sustaining surveillance, strengthening prevention and control measures, and ensuring timely medical care,” he added. Standing water, seen here in the aftermath of Hurricane Otis, is needed for mosquitoes to breed. Few studies have assessed what causes some patients to progress to severe dengue. The WHO notes that ensuring access to sufficient medical care should remain at the forefront of countries’ priorities to treat severe dengue. PAHO’s Caribbean Mosquito Awareness Week, which took place in May, aimed to raise public awareness about the connection between mosquitoes and the diseases they transmit, such as dengue, chikungunya, and Zika, and to involve the community to prevent mosquito breeding. “The population and household members should be encouraged to eliminate sources of mosquito breeding, both household and peri-household. This is everyone’s task: the family, the community, the public and private sector,” said PAHO in a recent alert on increased cases in Central America, Mexico, and the Caribbean regions. Aedes aegypti, the main mosquito vector, typically breeds in sites such as water containers as well as in urban waste, including plastic wrapping that can accumulate rainwater. As the virus doesn’t have a cure and repeat infections can even be more severe, surveillance and control of mosquito breeding sites is critical to reduce dengue transmission and illness, particularly the most severe form of the disease, dengue hemorrhagic fever. Dengue cases expected to rise in Mexico, Central America and Caribbean Cases have yet to peak fully in the Caribbean, Central America and Mexico. Farther north of the equator, cases have yet to peak in the PAHO regions of the Caribbean, Central America Isthmus and Mexico. “Although there has been a decrease in dengue cases in the Southern Cone [Brazil, Argentina, Paraguay, and Uruguay] and Andean sub-regions in recent epidemiological weeks, the subregions of the Central American isthmus and Mexico, and the Caribbean subregion are entering the period of increased dengue circulation, which could significantly increase the number of cases reported in the Region during the second half of 2024,” said PAHO in their May epidemiological alert. Cases decreasing at tail-end of season Brazil, which accounts for more than 80% of the Americas’ dengue cases, is at the tail-end of its season. The number of dengue cases is finally tapering off for the South American countries hardest hit – Brazil in particular saw an explosive growth in cases earlier this year. PAHO attributes the country’s epidemic conditions to prolonged heat, higher rainfall levels, as well as decreased population immunity following COVID-19-related restrictions. In response, and to avoid losing vaccine stock to expiration, the Brazilian government recently expanded the population eligible for dengue vaccination. Now, children six to sixteen are eligible, rather than just ten to fourteen year-olds. Image Credits: Direct Relief/Felipe Luna, James Gathany/ PHIL, CDC, Public Domain, IFRC, PAHO , PAHO , PAHO. WHO Launches Platform for Standardised Medical Device Information 09/07/2024 Zuzanna Stawiska An online WHO platform gathers information about various medical devices: from simple syringes to complex hospital equipment. To help countries and organisations navigate a complex pool of over 10,000 different medical devices, the World Health Organization (WHO) launched an online platform on Monday that will collect and standardise the information about medical equipment. Medical Devices Information System, or MeDevIS, is inspired by the WHO Priority Medical Devices List (MDL) and the Essential Medicines List, the latter of which will soon have existed for 50 years, serving as an important support for health progress globally. MeDevIS includes 2,301 types of medical devices of varying levels of complexity: from single-use syringes, medical masks, and pulse oximeters, to imaging radiology technologies, implantable prostheses, or defibrillators. “The number of medical technologies used in health care is growing, as is their complexity, which can make it challenging for health care practitioners and patients to navigate,” said Dr Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products. The aim is for a “one-stop shop of international information” to help stakeholders to find appropriate equipment. The new platform references both major naming systems for medical devices, renowned internationally: the European Medical Device Nomenclature (EMDN) and the Global Medical Device Nomenclature (GMDN), used in some countries outside of the European region. Both systems facilitate handling specific types of equipment on the regulatory and logistics levels. MeDivIS also features information about the infrastructure required for the device, the healthcare facility level where it is typically used, and links to thematic WHO guidelines connected with the branch of care for which the equipment is made. “The MeDevIS platform can be useful for national policy-makers to develop or update their own national lists for the procurement of health technologies and devices and can contribute to the progress towards universal health coverage,” said Dr Deus Mubangizi, WHO Director for Health Products Policy and Standards. Image Credits: Unsplash. Russia’s Bombing of Ukraine Children Hospital is ‘Abominable’ 08/07/2024 Kerry Cullinan Children with cancer outside Okhmatdyt Hospital after the attack. Russia’s bombing of a children’s hospital and women’s health centre in Ukraine’s capital Kiev on Monday is “abominable”, said UN High Commissioner for Human Rights Volker Türk. “Civilians must be protected, and the laws of war strictly adhered to,” added Türk. “There must be prompt, thorough and independent investigations into these latest grave attacks on civilians and civilian infrastructure, and those responsible must be held to account.” “Shockingly, one of the strikes severely damaged the intensive care, surgical and oncology wards of Okhmatdyt, which is Ukraine’s largest children’s referral hospital, and destroyed its children’s toxicology department, where children receive dialysis,” said Türk. Okhmatdyt Hospital serves more than 20,000 children annually. Monday’s missile attack struck a medical building at the hospital where children were receiving dialysis, while also damaging the intensive care, operating, and oncology departments, according to the Minister of Health of Ukraine. The entire hospital is without electricity, preventing the use of ventilators and other urgent care. Dr Tedros Adhanom Ghebreyesus, Director General of the World Health Organisation (WHO), said that “several floors of the largest children’s hospital in Kyiv were severely impacted today, disrupting the hospital’s operations and affecting its ability to provide critical care to the young patients.” Several floors of the largest children’s hospital in Kyiv were severely impacted today, disruptng the hospital’s operations and affecting its ability to provide critical care to the young patients.@WHO has been working closely with the hospital before and since the war in… pic.twitter.com/9ReGcov71F — Tedros Adhanom Ghebreyesus (@DrTedros) July 8, 2024 Meanwhile, Türk said that OHCHR staff visiting the scene shortly after the attack had “observed children receiving treatment for cancer in hospital beds set up in parks and on streets, where medical workers had quickly established triage areas, amongst chaos, dust and debris.” Health officials said the entire hospital was now without electricity, preventing the use of ventilators and other urgent care. It was not immediately clear how many people were killed in the strike. The ISIDA Medical Centre, one of the largest women’s health and family planning centres in Ukraine, was also affected by the attack, with several casualties. The attack comes the day before a NATO summit in Washington DC. Russia has attacked Ukraine’s health care workers, facilities, and other medical infrastructure at least 1,442 times since its invasion of Ukraine in February 2022 and 13 April 2024,according to data from a partnership made up of the Ukrainian Health Center, Physicians for Human Rights (PHR) and others. Russian attacks on Ukraine health care since February 2022. “Russia’s strategy in Ukraine includes attacking babies and children. Domestic and international actors should intensify efforts to hold perpetrators accountable for these war crimes,” said Uliana Poltavets, PHR’s Ukraine emergency response coordinator in a statement. Researchers have documented 79 attacks that affected children’s health care, including 54 attacks that destroyed or damaged children’s hospitals. “Today’s devastating attack on the largest children’s hospital is emblematic of Russia’s onslaught against Ukraine’s health care system. Again and again, we have witnessed Russian forces attack vulnerable patients, health workers, and hospitals across the country,” said Poltavets. PHR called on “domestic and international prosecutors, including the International Criminal Court, to prioritise the investigation and prosecution of attacks on health care.” Image Credits: Twitter. Sierra Leone Outlaws Child Marriage 08/07/2024 Kerry Cullinan Sierra Leone First Lady Fatima Bio Sierra Leone’s President Julius Maada Bio signed into law the Prohibition of Child Marriage Act last week, introducing a penalty of at least 15 years and a fine of around $4,000 for any man who marries a girl under 18. The law also prohibits cohabiting with a child, and fines for anyone arranging, aiding or attending such marriage ceremonies. First Lady Fatima Bio’s “Hands Off Our Girls” campaign has been instrumental in advocating against child marriage in Sierra Leone. Sierra Leone has one of the highest rates of child marriages in Africa, alongside Niger and Nigeria. According to the 2019 Sierra Leone Demographic and Health Surveys, 30% of girls in Sierra Leone are married before their 18th birthday. In 2020, there were 800,000 child brides, half of whom were married before they turned 15, according to UNICEF. The country of slightly over eight million people also has a high rate of female genital mutilation. “Child marriages fuel the high adolescent pregnancy rate in Sierra Leone where, tragically, pregnancy complications are the leading cause of death for girls aged 15-19,” according to Human Rights Watch (HRW). In 2021, the country introduced a policy of “radical inclusion” in schools, targeting and marginalised groups including girls, particularly pregnant girls and parent learners. Last year, Sierra Leone passed an education law that guarantees children free education, including one year of pre-primary. “The legislation is a milestone in Sierra Leone’s journey towards gender equality and child protection. It also sets a pathway forward for other African nations, such as Tanzania and Zambia, to revoke laws that permit child marriage, and ensure girls can complete primary and secondary education,” said HRW. FDA Approves Eli Lilly’s Kisunla for Early-Stage Alzheimer’s Patients 08/07/2024 Maayan Hoffman Neurons with tau protein highlighted in red. Eli Lilly’s Alzheimer’s therapy, donanemab, has received FDA approval, offering new hope for patients with early symptomatic Alzheimer’s disease. The newly approved treatment, branded Kisunla, is set to challenge existing therapies from Eisai and Biogen. Clinical trials have shown Kisunla to be effective for individuals in the mild cognitive impairment or mild dementia stages of the disease, potentially marking a significant advancement in Alzheimer’s care. The drug is administered as an intravenous infusion every four weeks. Alzheimer’s disease is a degenerative condition of the brain that impacts over 6.5 million Americans and over 55 million people worldwide. It causes a gradual decline in memory, cognitive functions, and, eventually, the ability to perform daily activities. The disease is marked by structural changes in the brain, such as the buildup of amyloid beta plaques and neurofibrillary tangles made of tau protein, which is supposed to help stabilize the internal skeleton of neurons in the brain. The Alzheimer’s Association celebrated the FDA’s decision. “This is real progress,” said Joanne Pike, Alzheimer’s Association president and CEO, in a statement. “Today’s approval allows people more options and greater opportunity to have more time. Having multiple treatment options is the kind of advancement we’ve all been waiting for — all of us who have been touched, even blindsided, by this difficult and devastating disease.” Slows cognitive decline by at least 22% The approval was based on an extensive double-blind, placebo-controlled, parallel-group study evaluating the efficacy of Kisunla in slowing cognitive decline in participants with varying levels of tau protein in the brain. Tau is a protein that helps to stabilise the neurons in the brain. The study, conducted over 72 weeks with 1,736 patients averaging 73 years old, revealed that those receiving Kisunla experienced a 35% reduction in cognitive decline compared to those on placebo among individuals with low to medium tau levels. Even among participants with higher tau levels, the treatment demonstrated a meaningful but slightly reduced effect. Overall, including all tau levels, Kisunla slowed cognitive decline by 22% and reduced the likelihood of progressing to the next stage of the disease by 39% compared to placebo. Additionally, the study monitored amyloid plaque levels using positron emission tomography (PET) scans throughout the treatment period. Results showed substantial reductions in amyloid plaques over time among patients receiving Kisunla, with reductions of 61% at six months, 80% at 12 months, and 84% at 18 months compared to baseline levels. These findings suggest that Kisunla not only targets cognitive decline but also effectively reduces the hallmark amyloid pathology associated with Alzheimer’s disease progression. Potential side effects For some patients, there is a risk of amyloid-related imaging abnormalities (ARIA) developing, the FDA said. ARIA typically manifests as temporary brain swelling, sometimes accompanied by small areas of bleeding on or in the brain. While ARIA often resolves on its own and may not cause symptoms, rare instances of severe and potentially life-threatening events have been reported. ARIA is a recognized side effect of antibody therapies targeting amyloid. Infusion-related reactions are also a concern, including flu-like symptoms, nausea, vomiting, changes in blood pressure, and hypersensitivity reactions such as anaphylaxis (a severe allergic reaction) and angioedema (swelling). Kisunla joins Leqembi, on market since 2023 Kisunla is the third drug to receive FDA approval, although only the second is now available for use. Leqembi, a collaboration between Biogen of the United States and Eisai of Japan, gained approval in July 2023. In an 18-month Phase III trial, Leqembi demonstrated a 27% reduction in cognitive decline among early-stage Alzheimer’s patients compared to those receiving a placebo. Another drug, aducanumab, also developed by Biogen and Eisai, was granted accelerated approval by the FDA in June 2021. However, due to some side effects, the therapy was pulled from the market. The Alzheimer’s Association emphasized the importance of early detection and diagnosis now that multiple FDA-approved treatments for Alzheimer’s are available. The organization stressed that timely access to these treatments is crucial for maximizing their benefits, asserting that no stage or entity should hinder or delay such access. “Too many roadblocks have prevented individuals from getting equitable access to these beneficial treatments for far too long,” said Pike. “It is equally important that clinicians and health care systems are informed and prepared to help the individuals who could benefit. The Alzheimer’s Association is working with health systems and providers to ensure they have the tools and resources to meet the needs of their patients.” Image Credits: Gerry Shaw/ EnCor Biotechnology Inc. Earliest Ever Hurricane Tears Through Caribbean, Highlighting Need for Speedier Climate Action 05/07/2024 Kerry Cullinan Fishing vessels at the Bridgetown Fisheries Complex in Barbados damaged by Hurricane Beryl. Hurricane Beryl, which has destroyed homes and infrastructure in large parts of the eastern Caribbean, is the first first-ever Category 4 hurricane recorded in the region in June – and a portend of devastating changes in weather patterns. It also underscores the need for urgent international assistance to Small Island Developing States (SIDS) to strengthen early warning systems and the climate resilience of key infrastructure – notably water, sanitation and health services, according to experts. The hurricane reached peak speed of 265 km per hour at times as it whipped though Barbados, Grenada, St Vincent and the Grenadines, Haiti, northern Venezuela, the Dominician Republic, Cayman Islands, and Jamaica. “The storm first impacted Barbados, causing severe damage to the south coast and significantly affecting the fishing industry with over 200 fishing vessels damaged or destroyed,” according to the International Federation of Red Cross and Red Crescent Societies (IFRC). On Union Island, part of Saint Vincent and the Grenadines, 90% of infrastructure has been damaged, including houses, roads and the airport. Some 95% of homes in Grenada’s Carriacou and Petite Martinique islands, are damaged, and around 3,000 people are shelters, the IFRC added. Parts of Jamaica’s St Elizabeth region in the south east were also devastated, with around 1,000 people taking refuge in shelters. The Dominican Republic, Cayman Islands reported damage. Venezuela’s President Nicolas Maduro said that 8,000 houses had been destroyed, according to Reuters. More to still come? “Hurricane Beryl, the first hurricane of the 2024 Atlantic hurricane season, rapidly strengthened to a Category 5 storm unusually early in the year,” according to a report from the National Ocean and Atmospheric Administration (NOAA), which is part of the US Department of Commerce “This explosive strengthening was fuelled in part by exceptionally warm ocean temperatures. That heat was one of the factors behind NOAA’s prediction in May of an 85% chance that the 2024 Atlantic hurricane season would be above normal.” Sea surface temperatures were close to those usually found in mid-September, the peak of hurricane season, added NOAA. In late May, NOAA weather forecasters predicted an 85% chance of above-normal hurricane for the 2024 Atlantic hurricane season, which runs from 1 June 1 to 30 November. It also forecast eight to 13 hurricanes, with four to seven likely to be “major” hurricanes (winds of over 178km per hour) in coming months. Early warning systems “The unprecedented hurricane demonstrates the importance of effective multi-hazard early warning systems to save lives,” according to United Nations Disaster Risk Reduction (UNDRR). “Globally, the sustained investments in those systems are making progress in reducing the loss of life in disasters. But economic losses are escalating. Every year millions of households lose their livelihood and risk being pushed into poverty. Ensuring that infrastructure is resilient and that communities ‘build back better’ in the face of future hazards is essential,” added UNDRR. Damage sustained to the airport and surrounding areas on Union Island in the Grenadines during Hurricane Beryl. In late May, the Fourth International Conference on SIDS adopted the Antigua and Barbuda Agenda for SIDS, a 10-year development agenda that appeals for international assistance to address climate change. The Agenda notes that “SIDS are facing the unrelenting and compounding impacts of climate change, biodiversity loss, pollution, disasters and natural hazards, health and other social related challenges and economic vulnerabilities.” Key climate change challenges include “erratic precipitation, increasingly frequent and extreme weather phenomena, more frequent and severe tropical cyclones, floods and drought, diminishing fresh water resources, desertification, coastal erosion, land degradation and sea-level rise.” However, there has been a “progressive deterioration” in SIDS’ ability to “withstand external shocks and enhance their resilience” – largely as a result of the economic impact of COVID-19 and climate challenges. Financial reform to build resilience Protestors call on wealth countries to pay for climate-related loss and damage at COP27. “In the wake of Hurricane Beryl, it is clear that we must redouble our efforts to build resilience and preparedness in the face of growing disaster risk, especially for small island developing states, which have contributed the least to the climate crisis but suffer the greatest costs,” said UNDRR head Kamal Kishore. Kishore appealed for international support for the Antigua and Barbuda Agenda, which “integrates disaster risk reduction as central to climate change adaptation and sustainable development in SIDS with clear calls to action on enhancing multi-hazard early warning systems and resilient infrastructure.” There have also been numerous calls for reform of the international financial architecture to assist developing countries most affected by climate change who are being forced to borrow money to address climate crises largely caused by wealthy nations. The most significant of these is the 2022 Bridgetown Initiative, spearheaded by Prime Minister Mia Mottley of Barbados. This called for key actions including new loan mechanisms, reform of the world’s development banks, and a loss and damages fund to enable developing countries to access to resilient finance to address climate and development crises. The UN climate change conference, COP27, agreed to establish a loss and damage fund during the UN Climate Change Conference (COP27) in 2022. However, there is resistance from a number of wealthier countries to this as the world continues to experience record-breaking extreme weather events. Meanwhile, the International Cort of Justice (ICJ) is expected to hold public hearings and issue an advisory later this year on the international legal obligations countries have to safeguard people against climate change. This follows the adoption last year of a landmark UN resolution to seek such an advisory opinion from the ICJ. While not legally binding, the advisory opinion holds legal and moral weight and will spotlight the human rights impacts of climate policy. Image Credits: UNDP, AfricaNews. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
WHO Launches Platform for Standardised Medical Device Information 09/07/2024 Zuzanna Stawiska An online WHO platform gathers information about various medical devices: from simple syringes to complex hospital equipment. To help countries and organisations navigate a complex pool of over 10,000 different medical devices, the World Health Organization (WHO) launched an online platform on Monday that will collect and standardise the information about medical equipment. Medical Devices Information System, or MeDevIS, is inspired by the WHO Priority Medical Devices List (MDL) and the Essential Medicines List, the latter of which will soon have existed for 50 years, serving as an important support for health progress globally. MeDevIS includes 2,301 types of medical devices of varying levels of complexity: from single-use syringes, medical masks, and pulse oximeters, to imaging radiology technologies, implantable prostheses, or defibrillators. “The number of medical technologies used in health care is growing, as is their complexity, which can make it challenging for health care practitioners and patients to navigate,” said Dr Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products. The aim is for a “one-stop shop of international information” to help stakeholders to find appropriate equipment. The new platform references both major naming systems for medical devices, renowned internationally: the European Medical Device Nomenclature (EMDN) and the Global Medical Device Nomenclature (GMDN), used in some countries outside of the European region. Both systems facilitate handling specific types of equipment on the regulatory and logistics levels. MeDivIS also features information about the infrastructure required for the device, the healthcare facility level where it is typically used, and links to thematic WHO guidelines connected with the branch of care for which the equipment is made. “The MeDevIS platform can be useful for national policy-makers to develop or update their own national lists for the procurement of health technologies and devices and can contribute to the progress towards universal health coverage,” said Dr Deus Mubangizi, WHO Director for Health Products Policy and Standards. Image Credits: Unsplash. Russia’s Bombing of Ukraine Children Hospital is ‘Abominable’ 08/07/2024 Kerry Cullinan Children with cancer outside Okhmatdyt Hospital after the attack. Russia’s bombing of a children’s hospital and women’s health centre in Ukraine’s capital Kiev on Monday is “abominable”, said UN High Commissioner for Human Rights Volker Türk. “Civilians must be protected, and the laws of war strictly adhered to,” added Türk. “There must be prompt, thorough and independent investigations into these latest grave attacks on civilians and civilian infrastructure, and those responsible must be held to account.” “Shockingly, one of the strikes severely damaged the intensive care, surgical and oncology wards of Okhmatdyt, which is Ukraine’s largest children’s referral hospital, and destroyed its children’s toxicology department, where children receive dialysis,” said Türk. Okhmatdyt Hospital serves more than 20,000 children annually. Monday’s missile attack struck a medical building at the hospital where children were receiving dialysis, while also damaging the intensive care, operating, and oncology departments, according to the Minister of Health of Ukraine. The entire hospital is without electricity, preventing the use of ventilators and other urgent care. Dr Tedros Adhanom Ghebreyesus, Director General of the World Health Organisation (WHO), said that “several floors of the largest children’s hospital in Kyiv were severely impacted today, disrupting the hospital’s operations and affecting its ability to provide critical care to the young patients.” Several floors of the largest children’s hospital in Kyiv were severely impacted today, disruptng the hospital’s operations and affecting its ability to provide critical care to the young patients.@WHO has been working closely with the hospital before and since the war in… pic.twitter.com/9ReGcov71F — Tedros Adhanom Ghebreyesus (@DrTedros) July 8, 2024 Meanwhile, Türk said that OHCHR staff visiting the scene shortly after the attack had “observed children receiving treatment for cancer in hospital beds set up in parks and on streets, where medical workers had quickly established triage areas, amongst chaos, dust and debris.” Health officials said the entire hospital was now without electricity, preventing the use of ventilators and other urgent care. It was not immediately clear how many people were killed in the strike. The ISIDA Medical Centre, one of the largest women’s health and family planning centres in Ukraine, was also affected by the attack, with several casualties. The attack comes the day before a NATO summit in Washington DC. Russia has attacked Ukraine’s health care workers, facilities, and other medical infrastructure at least 1,442 times since its invasion of Ukraine in February 2022 and 13 April 2024,according to data from a partnership made up of the Ukrainian Health Center, Physicians for Human Rights (PHR) and others. Russian attacks on Ukraine health care since February 2022. “Russia’s strategy in Ukraine includes attacking babies and children. Domestic and international actors should intensify efforts to hold perpetrators accountable for these war crimes,” said Uliana Poltavets, PHR’s Ukraine emergency response coordinator in a statement. Researchers have documented 79 attacks that affected children’s health care, including 54 attacks that destroyed or damaged children’s hospitals. “Today’s devastating attack on the largest children’s hospital is emblematic of Russia’s onslaught against Ukraine’s health care system. Again and again, we have witnessed Russian forces attack vulnerable patients, health workers, and hospitals across the country,” said Poltavets. PHR called on “domestic and international prosecutors, including the International Criminal Court, to prioritise the investigation and prosecution of attacks on health care.” Image Credits: Twitter. Sierra Leone Outlaws Child Marriage 08/07/2024 Kerry Cullinan Sierra Leone First Lady Fatima Bio Sierra Leone’s President Julius Maada Bio signed into law the Prohibition of Child Marriage Act last week, introducing a penalty of at least 15 years and a fine of around $4,000 for any man who marries a girl under 18. The law also prohibits cohabiting with a child, and fines for anyone arranging, aiding or attending such marriage ceremonies. First Lady Fatima Bio’s “Hands Off Our Girls” campaign has been instrumental in advocating against child marriage in Sierra Leone. Sierra Leone has one of the highest rates of child marriages in Africa, alongside Niger and Nigeria. According to the 2019 Sierra Leone Demographic and Health Surveys, 30% of girls in Sierra Leone are married before their 18th birthday. In 2020, there were 800,000 child brides, half of whom were married before they turned 15, according to UNICEF. The country of slightly over eight million people also has a high rate of female genital mutilation. “Child marriages fuel the high adolescent pregnancy rate in Sierra Leone where, tragically, pregnancy complications are the leading cause of death for girls aged 15-19,” according to Human Rights Watch (HRW). In 2021, the country introduced a policy of “radical inclusion” in schools, targeting and marginalised groups including girls, particularly pregnant girls and parent learners. Last year, Sierra Leone passed an education law that guarantees children free education, including one year of pre-primary. “The legislation is a milestone in Sierra Leone’s journey towards gender equality and child protection. It also sets a pathway forward for other African nations, such as Tanzania and Zambia, to revoke laws that permit child marriage, and ensure girls can complete primary and secondary education,” said HRW. FDA Approves Eli Lilly’s Kisunla for Early-Stage Alzheimer’s Patients 08/07/2024 Maayan Hoffman Neurons with tau protein highlighted in red. Eli Lilly’s Alzheimer’s therapy, donanemab, has received FDA approval, offering new hope for patients with early symptomatic Alzheimer’s disease. The newly approved treatment, branded Kisunla, is set to challenge existing therapies from Eisai and Biogen. Clinical trials have shown Kisunla to be effective for individuals in the mild cognitive impairment or mild dementia stages of the disease, potentially marking a significant advancement in Alzheimer’s care. The drug is administered as an intravenous infusion every four weeks. Alzheimer’s disease is a degenerative condition of the brain that impacts over 6.5 million Americans and over 55 million people worldwide. It causes a gradual decline in memory, cognitive functions, and, eventually, the ability to perform daily activities. The disease is marked by structural changes in the brain, such as the buildup of amyloid beta plaques and neurofibrillary tangles made of tau protein, which is supposed to help stabilize the internal skeleton of neurons in the brain. The Alzheimer’s Association celebrated the FDA’s decision. “This is real progress,” said Joanne Pike, Alzheimer’s Association president and CEO, in a statement. “Today’s approval allows people more options and greater opportunity to have more time. Having multiple treatment options is the kind of advancement we’ve all been waiting for — all of us who have been touched, even blindsided, by this difficult and devastating disease.” Slows cognitive decline by at least 22% The approval was based on an extensive double-blind, placebo-controlled, parallel-group study evaluating the efficacy of Kisunla in slowing cognitive decline in participants with varying levels of tau protein in the brain. Tau is a protein that helps to stabilise the neurons in the brain. The study, conducted over 72 weeks with 1,736 patients averaging 73 years old, revealed that those receiving Kisunla experienced a 35% reduction in cognitive decline compared to those on placebo among individuals with low to medium tau levels. Even among participants with higher tau levels, the treatment demonstrated a meaningful but slightly reduced effect. Overall, including all tau levels, Kisunla slowed cognitive decline by 22% and reduced the likelihood of progressing to the next stage of the disease by 39% compared to placebo. Additionally, the study monitored amyloid plaque levels using positron emission tomography (PET) scans throughout the treatment period. Results showed substantial reductions in amyloid plaques over time among patients receiving Kisunla, with reductions of 61% at six months, 80% at 12 months, and 84% at 18 months compared to baseline levels. These findings suggest that Kisunla not only targets cognitive decline but also effectively reduces the hallmark amyloid pathology associated with Alzheimer’s disease progression. Potential side effects For some patients, there is a risk of amyloid-related imaging abnormalities (ARIA) developing, the FDA said. ARIA typically manifests as temporary brain swelling, sometimes accompanied by small areas of bleeding on or in the brain. While ARIA often resolves on its own and may not cause symptoms, rare instances of severe and potentially life-threatening events have been reported. ARIA is a recognized side effect of antibody therapies targeting amyloid. Infusion-related reactions are also a concern, including flu-like symptoms, nausea, vomiting, changes in blood pressure, and hypersensitivity reactions such as anaphylaxis (a severe allergic reaction) and angioedema (swelling). Kisunla joins Leqembi, on market since 2023 Kisunla is the third drug to receive FDA approval, although only the second is now available for use. Leqembi, a collaboration between Biogen of the United States and Eisai of Japan, gained approval in July 2023. In an 18-month Phase III trial, Leqembi demonstrated a 27% reduction in cognitive decline among early-stage Alzheimer’s patients compared to those receiving a placebo. Another drug, aducanumab, also developed by Biogen and Eisai, was granted accelerated approval by the FDA in June 2021. However, due to some side effects, the therapy was pulled from the market. The Alzheimer’s Association emphasized the importance of early detection and diagnosis now that multiple FDA-approved treatments for Alzheimer’s are available. The organization stressed that timely access to these treatments is crucial for maximizing their benefits, asserting that no stage or entity should hinder or delay such access. “Too many roadblocks have prevented individuals from getting equitable access to these beneficial treatments for far too long,” said Pike. “It is equally important that clinicians and health care systems are informed and prepared to help the individuals who could benefit. The Alzheimer’s Association is working with health systems and providers to ensure they have the tools and resources to meet the needs of their patients.” Image Credits: Gerry Shaw/ EnCor Biotechnology Inc. Earliest Ever Hurricane Tears Through Caribbean, Highlighting Need for Speedier Climate Action 05/07/2024 Kerry Cullinan Fishing vessels at the Bridgetown Fisheries Complex in Barbados damaged by Hurricane Beryl. Hurricane Beryl, which has destroyed homes and infrastructure in large parts of the eastern Caribbean, is the first first-ever Category 4 hurricane recorded in the region in June – and a portend of devastating changes in weather patterns. It also underscores the need for urgent international assistance to Small Island Developing States (SIDS) to strengthen early warning systems and the climate resilience of key infrastructure – notably water, sanitation and health services, according to experts. The hurricane reached peak speed of 265 km per hour at times as it whipped though Barbados, Grenada, St Vincent and the Grenadines, Haiti, northern Venezuela, the Dominician Republic, Cayman Islands, and Jamaica. “The storm first impacted Barbados, causing severe damage to the south coast and significantly affecting the fishing industry with over 200 fishing vessels damaged or destroyed,” according to the International Federation of Red Cross and Red Crescent Societies (IFRC). On Union Island, part of Saint Vincent and the Grenadines, 90% of infrastructure has been damaged, including houses, roads and the airport. Some 95% of homes in Grenada’s Carriacou and Petite Martinique islands, are damaged, and around 3,000 people are shelters, the IFRC added. Parts of Jamaica’s St Elizabeth region in the south east were also devastated, with around 1,000 people taking refuge in shelters. The Dominican Republic, Cayman Islands reported damage. Venezuela’s President Nicolas Maduro said that 8,000 houses had been destroyed, according to Reuters. More to still come? “Hurricane Beryl, the first hurricane of the 2024 Atlantic hurricane season, rapidly strengthened to a Category 5 storm unusually early in the year,” according to a report from the National Ocean and Atmospheric Administration (NOAA), which is part of the US Department of Commerce “This explosive strengthening was fuelled in part by exceptionally warm ocean temperatures. That heat was one of the factors behind NOAA’s prediction in May of an 85% chance that the 2024 Atlantic hurricane season would be above normal.” Sea surface temperatures were close to those usually found in mid-September, the peak of hurricane season, added NOAA. In late May, NOAA weather forecasters predicted an 85% chance of above-normal hurricane for the 2024 Atlantic hurricane season, which runs from 1 June 1 to 30 November. It also forecast eight to 13 hurricanes, with four to seven likely to be “major” hurricanes (winds of over 178km per hour) in coming months. Early warning systems “The unprecedented hurricane demonstrates the importance of effective multi-hazard early warning systems to save lives,” according to United Nations Disaster Risk Reduction (UNDRR). “Globally, the sustained investments in those systems are making progress in reducing the loss of life in disasters. But economic losses are escalating. Every year millions of households lose their livelihood and risk being pushed into poverty. Ensuring that infrastructure is resilient and that communities ‘build back better’ in the face of future hazards is essential,” added UNDRR. Damage sustained to the airport and surrounding areas on Union Island in the Grenadines during Hurricane Beryl. In late May, the Fourth International Conference on SIDS adopted the Antigua and Barbuda Agenda for SIDS, a 10-year development agenda that appeals for international assistance to address climate change. The Agenda notes that “SIDS are facing the unrelenting and compounding impacts of climate change, biodiversity loss, pollution, disasters and natural hazards, health and other social related challenges and economic vulnerabilities.” Key climate change challenges include “erratic precipitation, increasingly frequent and extreme weather phenomena, more frequent and severe tropical cyclones, floods and drought, diminishing fresh water resources, desertification, coastal erosion, land degradation and sea-level rise.” However, there has been a “progressive deterioration” in SIDS’ ability to “withstand external shocks and enhance their resilience” – largely as a result of the economic impact of COVID-19 and climate challenges. Financial reform to build resilience Protestors call on wealth countries to pay for climate-related loss and damage at COP27. “In the wake of Hurricane Beryl, it is clear that we must redouble our efforts to build resilience and preparedness in the face of growing disaster risk, especially for small island developing states, which have contributed the least to the climate crisis but suffer the greatest costs,” said UNDRR head Kamal Kishore. Kishore appealed for international support for the Antigua and Barbuda Agenda, which “integrates disaster risk reduction as central to climate change adaptation and sustainable development in SIDS with clear calls to action on enhancing multi-hazard early warning systems and resilient infrastructure.” There have also been numerous calls for reform of the international financial architecture to assist developing countries most affected by climate change who are being forced to borrow money to address climate crises largely caused by wealthy nations. The most significant of these is the 2022 Bridgetown Initiative, spearheaded by Prime Minister Mia Mottley of Barbados. This called for key actions including new loan mechanisms, reform of the world’s development banks, and a loss and damages fund to enable developing countries to access to resilient finance to address climate and development crises. The UN climate change conference, COP27, agreed to establish a loss and damage fund during the UN Climate Change Conference (COP27) in 2022. However, there is resistance from a number of wealthier countries to this as the world continues to experience record-breaking extreme weather events. Meanwhile, the International Cort of Justice (ICJ) is expected to hold public hearings and issue an advisory later this year on the international legal obligations countries have to safeguard people against climate change. This follows the adoption last year of a landmark UN resolution to seek such an advisory opinion from the ICJ. While not legally binding, the advisory opinion holds legal and moral weight and will spotlight the human rights impacts of climate policy. Image Credits: UNDP, AfricaNews. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Russia’s Bombing of Ukraine Children Hospital is ‘Abominable’ 08/07/2024 Kerry Cullinan Children with cancer outside Okhmatdyt Hospital after the attack. Russia’s bombing of a children’s hospital and women’s health centre in Ukraine’s capital Kiev on Monday is “abominable”, said UN High Commissioner for Human Rights Volker Türk. “Civilians must be protected, and the laws of war strictly adhered to,” added Türk. “There must be prompt, thorough and independent investigations into these latest grave attacks on civilians and civilian infrastructure, and those responsible must be held to account.” “Shockingly, one of the strikes severely damaged the intensive care, surgical and oncology wards of Okhmatdyt, which is Ukraine’s largest children’s referral hospital, and destroyed its children’s toxicology department, where children receive dialysis,” said Türk. Okhmatdyt Hospital serves more than 20,000 children annually. Monday’s missile attack struck a medical building at the hospital where children were receiving dialysis, while also damaging the intensive care, operating, and oncology departments, according to the Minister of Health of Ukraine. The entire hospital is without electricity, preventing the use of ventilators and other urgent care. Dr Tedros Adhanom Ghebreyesus, Director General of the World Health Organisation (WHO), said that “several floors of the largest children’s hospital in Kyiv were severely impacted today, disrupting the hospital’s operations and affecting its ability to provide critical care to the young patients.” Several floors of the largest children’s hospital in Kyiv were severely impacted today, disruptng the hospital’s operations and affecting its ability to provide critical care to the young patients.@WHO has been working closely with the hospital before and since the war in… pic.twitter.com/9ReGcov71F — Tedros Adhanom Ghebreyesus (@DrTedros) July 8, 2024 Meanwhile, Türk said that OHCHR staff visiting the scene shortly after the attack had “observed children receiving treatment for cancer in hospital beds set up in parks and on streets, where medical workers had quickly established triage areas, amongst chaos, dust and debris.” Health officials said the entire hospital was now without electricity, preventing the use of ventilators and other urgent care. It was not immediately clear how many people were killed in the strike. The ISIDA Medical Centre, one of the largest women’s health and family planning centres in Ukraine, was also affected by the attack, with several casualties. The attack comes the day before a NATO summit in Washington DC. Russia has attacked Ukraine’s health care workers, facilities, and other medical infrastructure at least 1,442 times since its invasion of Ukraine in February 2022 and 13 April 2024,according to data from a partnership made up of the Ukrainian Health Center, Physicians for Human Rights (PHR) and others. Russian attacks on Ukraine health care since February 2022. “Russia’s strategy in Ukraine includes attacking babies and children. Domestic and international actors should intensify efforts to hold perpetrators accountable for these war crimes,” said Uliana Poltavets, PHR’s Ukraine emergency response coordinator in a statement. Researchers have documented 79 attacks that affected children’s health care, including 54 attacks that destroyed or damaged children’s hospitals. “Today’s devastating attack on the largest children’s hospital is emblematic of Russia’s onslaught against Ukraine’s health care system. Again and again, we have witnessed Russian forces attack vulnerable patients, health workers, and hospitals across the country,” said Poltavets. PHR called on “domestic and international prosecutors, including the International Criminal Court, to prioritise the investigation and prosecution of attacks on health care.” Image Credits: Twitter. Sierra Leone Outlaws Child Marriage 08/07/2024 Kerry Cullinan Sierra Leone First Lady Fatima Bio Sierra Leone’s President Julius Maada Bio signed into law the Prohibition of Child Marriage Act last week, introducing a penalty of at least 15 years and a fine of around $4,000 for any man who marries a girl under 18. The law also prohibits cohabiting with a child, and fines for anyone arranging, aiding or attending such marriage ceremonies. First Lady Fatima Bio’s “Hands Off Our Girls” campaign has been instrumental in advocating against child marriage in Sierra Leone. Sierra Leone has one of the highest rates of child marriages in Africa, alongside Niger and Nigeria. According to the 2019 Sierra Leone Demographic and Health Surveys, 30% of girls in Sierra Leone are married before their 18th birthday. In 2020, there were 800,000 child brides, half of whom were married before they turned 15, according to UNICEF. The country of slightly over eight million people also has a high rate of female genital mutilation. “Child marriages fuel the high adolescent pregnancy rate in Sierra Leone where, tragically, pregnancy complications are the leading cause of death for girls aged 15-19,” according to Human Rights Watch (HRW). In 2021, the country introduced a policy of “radical inclusion” in schools, targeting and marginalised groups including girls, particularly pregnant girls and parent learners. Last year, Sierra Leone passed an education law that guarantees children free education, including one year of pre-primary. “The legislation is a milestone in Sierra Leone’s journey towards gender equality and child protection. It also sets a pathway forward for other African nations, such as Tanzania and Zambia, to revoke laws that permit child marriage, and ensure girls can complete primary and secondary education,” said HRW. FDA Approves Eli Lilly’s Kisunla for Early-Stage Alzheimer’s Patients 08/07/2024 Maayan Hoffman Neurons with tau protein highlighted in red. Eli Lilly’s Alzheimer’s therapy, donanemab, has received FDA approval, offering new hope for patients with early symptomatic Alzheimer’s disease. The newly approved treatment, branded Kisunla, is set to challenge existing therapies from Eisai and Biogen. Clinical trials have shown Kisunla to be effective for individuals in the mild cognitive impairment or mild dementia stages of the disease, potentially marking a significant advancement in Alzheimer’s care. The drug is administered as an intravenous infusion every four weeks. Alzheimer’s disease is a degenerative condition of the brain that impacts over 6.5 million Americans and over 55 million people worldwide. It causes a gradual decline in memory, cognitive functions, and, eventually, the ability to perform daily activities. The disease is marked by structural changes in the brain, such as the buildup of amyloid beta plaques and neurofibrillary tangles made of tau protein, which is supposed to help stabilize the internal skeleton of neurons in the brain. The Alzheimer’s Association celebrated the FDA’s decision. “This is real progress,” said Joanne Pike, Alzheimer’s Association president and CEO, in a statement. “Today’s approval allows people more options and greater opportunity to have more time. Having multiple treatment options is the kind of advancement we’ve all been waiting for — all of us who have been touched, even blindsided, by this difficult and devastating disease.” Slows cognitive decline by at least 22% The approval was based on an extensive double-blind, placebo-controlled, parallel-group study evaluating the efficacy of Kisunla in slowing cognitive decline in participants with varying levels of tau protein in the brain. Tau is a protein that helps to stabilise the neurons in the brain. The study, conducted over 72 weeks with 1,736 patients averaging 73 years old, revealed that those receiving Kisunla experienced a 35% reduction in cognitive decline compared to those on placebo among individuals with low to medium tau levels. Even among participants with higher tau levels, the treatment demonstrated a meaningful but slightly reduced effect. Overall, including all tau levels, Kisunla slowed cognitive decline by 22% and reduced the likelihood of progressing to the next stage of the disease by 39% compared to placebo. Additionally, the study monitored amyloid plaque levels using positron emission tomography (PET) scans throughout the treatment period. Results showed substantial reductions in amyloid plaques over time among patients receiving Kisunla, with reductions of 61% at six months, 80% at 12 months, and 84% at 18 months compared to baseline levels. These findings suggest that Kisunla not only targets cognitive decline but also effectively reduces the hallmark amyloid pathology associated with Alzheimer’s disease progression. Potential side effects For some patients, there is a risk of amyloid-related imaging abnormalities (ARIA) developing, the FDA said. ARIA typically manifests as temporary brain swelling, sometimes accompanied by small areas of bleeding on or in the brain. While ARIA often resolves on its own and may not cause symptoms, rare instances of severe and potentially life-threatening events have been reported. ARIA is a recognized side effect of antibody therapies targeting amyloid. Infusion-related reactions are also a concern, including flu-like symptoms, nausea, vomiting, changes in blood pressure, and hypersensitivity reactions such as anaphylaxis (a severe allergic reaction) and angioedema (swelling). Kisunla joins Leqembi, on market since 2023 Kisunla is the third drug to receive FDA approval, although only the second is now available for use. Leqembi, a collaboration between Biogen of the United States and Eisai of Japan, gained approval in July 2023. In an 18-month Phase III trial, Leqembi demonstrated a 27% reduction in cognitive decline among early-stage Alzheimer’s patients compared to those receiving a placebo. Another drug, aducanumab, also developed by Biogen and Eisai, was granted accelerated approval by the FDA in June 2021. However, due to some side effects, the therapy was pulled from the market. The Alzheimer’s Association emphasized the importance of early detection and diagnosis now that multiple FDA-approved treatments for Alzheimer’s are available. The organization stressed that timely access to these treatments is crucial for maximizing their benefits, asserting that no stage or entity should hinder or delay such access. “Too many roadblocks have prevented individuals from getting equitable access to these beneficial treatments for far too long,” said Pike. “It is equally important that clinicians and health care systems are informed and prepared to help the individuals who could benefit. The Alzheimer’s Association is working with health systems and providers to ensure they have the tools and resources to meet the needs of their patients.” Image Credits: Gerry Shaw/ EnCor Biotechnology Inc. Earliest Ever Hurricane Tears Through Caribbean, Highlighting Need for Speedier Climate Action 05/07/2024 Kerry Cullinan Fishing vessels at the Bridgetown Fisheries Complex in Barbados damaged by Hurricane Beryl. Hurricane Beryl, which has destroyed homes and infrastructure in large parts of the eastern Caribbean, is the first first-ever Category 4 hurricane recorded in the region in June – and a portend of devastating changes in weather patterns. It also underscores the need for urgent international assistance to Small Island Developing States (SIDS) to strengthen early warning systems and the climate resilience of key infrastructure – notably water, sanitation and health services, according to experts. The hurricane reached peak speed of 265 km per hour at times as it whipped though Barbados, Grenada, St Vincent and the Grenadines, Haiti, northern Venezuela, the Dominician Republic, Cayman Islands, and Jamaica. “The storm first impacted Barbados, causing severe damage to the south coast and significantly affecting the fishing industry with over 200 fishing vessels damaged or destroyed,” according to the International Federation of Red Cross and Red Crescent Societies (IFRC). On Union Island, part of Saint Vincent and the Grenadines, 90% of infrastructure has been damaged, including houses, roads and the airport. Some 95% of homes in Grenada’s Carriacou and Petite Martinique islands, are damaged, and around 3,000 people are shelters, the IFRC added. Parts of Jamaica’s St Elizabeth region in the south east were also devastated, with around 1,000 people taking refuge in shelters. The Dominican Republic, Cayman Islands reported damage. Venezuela’s President Nicolas Maduro said that 8,000 houses had been destroyed, according to Reuters. More to still come? “Hurricane Beryl, the first hurricane of the 2024 Atlantic hurricane season, rapidly strengthened to a Category 5 storm unusually early in the year,” according to a report from the National Ocean and Atmospheric Administration (NOAA), which is part of the US Department of Commerce “This explosive strengthening was fuelled in part by exceptionally warm ocean temperatures. That heat was one of the factors behind NOAA’s prediction in May of an 85% chance that the 2024 Atlantic hurricane season would be above normal.” Sea surface temperatures were close to those usually found in mid-September, the peak of hurricane season, added NOAA. In late May, NOAA weather forecasters predicted an 85% chance of above-normal hurricane for the 2024 Atlantic hurricane season, which runs from 1 June 1 to 30 November. It also forecast eight to 13 hurricanes, with four to seven likely to be “major” hurricanes (winds of over 178km per hour) in coming months. Early warning systems “The unprecedented hurricane demonstrates the importance of effective multi-hazard early warning systems to save lives,” according to United Nations Disaster Risk Reduction (UNDRR). “Globally, the sustained investments in those systems are making progress in reducing the loss of life in disasters. But economic losses are escalating. Every year millions of households lose their livelihood and risk being pushed into poverty. Ensuring that infrastructure is resilient and that communities ‘build back better’ in the face of future hazards is essential,” added UNDRR. Damage sustained to the airport and surrounding areas on Union Island in the Grenadines during Hurricane Beryl. In late May, the Fourth International Conference on SIDS adopted the Antigua and Barbuda Agenda for SIDS, a 10-year development agenda that appeals for international assistance to address climate change. The Agenda notes that “SIDS are facing the unrelenting and compounding impacts of climate change, biodiversity loss, pollution, disasters and natural hazards, health and other social related challenges and economic vulnerabilities.” Key climate change challenges include “erratic precipitation, increasingly frequent and extreme weather phenomena, more frequent and severe tropical cyclones, floods and drought, diminishing fresh water resources, desertification, coastal erosion, land degradation and sea-level rise.” However, there has been a “progressive deterioration” in SIDS’ ability to “withstand external shocks and enhance their resilience” – largely as a result of the economic impact of COVID-19 and climate challenges. Financial reform to build resilience Protestors call on wealth countries to pay for climate-related loss and damage at COP27. “In the wake of Hurricane Beryl, it is clear that we must redouble our efforts to build resilience and preparedness in the face of growing disaster risk, especially for small island developing states, which have contributed the least to the climate crisis but suffer the greatest costs,” said UNDRR head Kamal Kishore. Kishore appealed for international support for the Antigua and Barbuda Agenda, which “integrates disaster risk reduction as central to climate change adaptation and sustainable development in SIDS with clear calls to action on enhancing multi-hazard early warning systems and resilient infrastructure.” There have also been numerous calls for reform of the international financial architecture to assist developing countries most affected by climate change who are being forced to borrow money to address climate crises largely caused by wealthy nations. The most significant of these is the 2022 Bridgetown Initiative, spearheaded by Prime Minister Mia Mottley of Barbados. This called for key actions including new loan mechanisms, reform of the world’s development banks, and a loss and damages fund to enable developing countries to access to resilient finance to address climate and development crises. The UN climate change conference, COP27, agreed to establish a loss and damage fund during the UN Climate Change Conference (COP27) in 2022. However, there is resistance from a number of wealthier countries to this as the world continues to experience record-breaking extreme weather events. Meanwhile, the International Cort of Justice (ICJ) is expected to hold public hearings and issue an advisory later this year on the international legal obligations countries have to safeguard people against climate change. This follows the adoption last year of a landmark UN resolution to seek such an advisory opinion from the ICJ. While not legally binding, the advisory opinion holds legal and moral weight and will spotlight the human rights impacts of climate policy. Image Credits: UNDP, AfricaNews. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Sierra Leone Outlaws Child Marriage 08/07/2024 Kerry Cullinan Sierra Leone First Lady Fatima Bio Sierra Leone’s President Julius Maada Bio signed into law the Prohibition of Child Marriage Act last week, introducing a penalty of at least 15 years and a fine of around $4,000 for any man who marries a girl under 18. The law also prohibits cohabiting with a child, and fines for anyone arranging, aiding or attending such marriage ceremonies. First Lady Fatima Bio’s “Hands Off Our Girls” campaign has been instrumental in advocating against child marriage in Sierra Leone. Sierra Leone has one of the highest rates of child marriages in Africa, alongside Niger and Nigeria. According to the 2019 Sierra Leone Demographic and Health Surveys, 30% of girls in Sierra Leone are married before their 18th birthday. In 2020, there were 800,000 child brides, half of whom were married before they turned 15, according to UNICEF. The country of slightly over eight million people also has a high rate of female genital mutilation. “Child marriages fuel the high adolescent pregnancy rate in Sierra Leone where, tragically, pregnancy complications are the leading cause of death for girls aged 15-19,” according to Human Rights Watch (HRW). In 2021, the country introduced a policy of “radical inclusion” in schools, targeting and marginalised groups including girls, particularly pregnant girls and parent learners. Last year, Sierra Leone passed an education law that guarantees children free education, including one year of pre-primary. “The legislation is a milestone in Sierra Leone’s journey towards gender equality and child protection. It also sets a pathway forward for other African nations, such as Tanzania and Zambia, to revoke laws that permit child marriage, and ensure girls can complete primary and secondary education,” said HRW. FDA Approves Eli Lilly’s Kisunla for Early-Stage Alzheimer’s Patients 08/07/2024 Maayan Hoffman Neurons with tau protein highlighted in red. Eli Lilly’s Alzheimer’s therapy, donanemab, has received FDA approval, offering new hope for patients with early symptomatic Alzheimer’s disease. The newly approved treatment, branded Kisunla, is set to challenge existing therapies from Eisai and Biogen. Clinical trials have shown Kisunla to be effective for individuals in the mild cognitive impairment or mild dementia stages of the disease, potentially marking a significant advancement in Alzheimer’s care. The drug is administered as an intravenous infusion every four weeks. Alzheimer’s disease is a degenerative condition of the brain that impacts over 6.5 million Americans and over 55 million people worldwide. It causes a gradual decline in memory, cognitive functions, and, eventually, the ability to perform daily activities. The disease is marked by structural changes in the brain, such as the buildup of amyloid beta plaques and neurofibrillary tangles made of tau protein, which is supposed to help stabilize the internal skeleton of neurons in the brain. The Alzheimer’s Association celebrated the FDA’s decision. “This is real progress,” said Joanne Pike, Alzheimer’s Association president and CEO, in a statement. “Today’s approval allows people more options and greater opportunity to have more time. Having multiple treatment options is the kind of advancement we’ve all been waiting for — all of us who have been touched, even blindsided, by this difficult and devastating disease.” Slows cognitive decline by at least 22% The approval was based on an extensive double-blind, placebo-controlled, parallel-group study evaluating the efficacy of Kisunla in slowing cognitive decline in participants with varying levels of tau protein in the brain. Tau is a protein that helps to stabilise the neurons in the brain. The study, conducted over 72 weeks with 1,736 patients averaging 73 years old, revealed that those receiving Kisunla experienced a 35% reduction in cognitive decline compared to those on placebo among individuals with low to medium tau levels. Even among participants with higher tau levels, the treatment demonstrated a meaningful but slightly reduced effect. Overall, including all tau levels, Kisunla slowed cognitive decline by 22% and reduced the likelihood of progressing to the next stage of the disease by 39% compared to placebo. Additionally, the study monitored amyloid plaque levels using positron emission tomography (PET) scans throughout the treatment period. Results showed substantial reductions in amyloid plaques over time among patients receiving Kisunla, with reductions of 61% at six months, 80% at 12 months, and 84% at 18 months compared to baseline levels. These findings suggest that Kisunla not only targets cognitive decline but also effectively reduces the hallmark amyloid pathology associated with Alzheimer’s disease progression. Potential side effects For some patients, there is a risk of amyloid-related imaging abnormalities (ARIA) developing, the FDA said. ARIA typically manifests as temporary brain swelling, sometimes accompanied by small areas of bleeding on or in the brain. While ARIA often resolves on its own and may not cause symptoms, rare instances of severe and potentially life-threatening events have been reported. ARIA is a recognized side effect of antibody therapies targeting amyloid. Infusion-related reactions are also a concern, including flu-like symptoms, nausea, vomiting, changes in blood pressure, and hypersensitivity reactions such as anaphylaxis (a severe allergic reaction) and angioedema (swelling). Kisunla joins Leqembi, on market since 2023 Kisunla is the third drug to receive FDA approval, although only the second is now available for use. Leqembi, a collaboration between Biogen of the United States and Eisai of Japan, gained approval in July 2023. In an 18-month Phase III trial, Leqembi demonstrated a 27% reduction in cognitive decline among early-stage Alzheimer’s patients compared to those receiving a placebo. Another drug, aducanumab, also developed by Biogen and Eisai, was granted accelerated approval by the FDA in June 2021. However, due to some side effects, the therapy was pulled from the market. The Alzheimer’s Association emphasized the importance of early detection and diagnosis now that multiple FDA-approved treatments for Alzheimer’s are available. The organization stressed that timely access to these treatments is crucial for maximizing their benefits, asserting that no stage or entity should hinder or delay such access. “Too many roadblocks have prevented individuals from getting equitable access to these beneficial treatments for far too long,” said Pike. “It is equally important that clinicians and health care systems are informed and prepared to help the individuals who could benefit. The Alzheimer’s Association is working with health systems and providers to ensure they have the tools and resources to meet the needs of their patients.” Image Credits: Gerry Shaw/ EnCor Biotechnology Inc. Earliest Ever Hurricane Tears Through Caribbean, Highlighting Need for Speedier Climate Action 05/07/2024 Kerry Cullinan Fishing vessels at the Bridgetown Fisheries Complex in Barbados damaged by Hurricane Beryl. Hurricane Beryl, which has destroyed homes and infrastructure in large parts of the eastern Caribbean, is the first first-ever Category 4 hurricane recorded in the region in June – and a portend of devastating changes in weather patterns. It also underscores the need for urgent international assistance to Small Island Developing States (SIDS) to strengthen early warning systems and the climate resilience of key infrastructure – notably water, sanitation and health services, according to experts. The hurricane reached peak speed of 265 km per hour at times as it whipped though Barbados, Grenada, St Vincent and the Grenadines, Haiti, northern Venezuela, the Dominician Republic, Cayman Islands, and Jamaica. “The storm first impacted Barbados, causing severe damage to the south coast and significantly affecting the fishing industry with over 200 fishing vessels damaged or destroyed,” according to the International Federation of Red Cross and Red Crescent Societies (IFRC). On Union Island, part of Saint Vincent and the Grenadines, 90% of infrastructure has been damaged, including houses, roads and the airport. Some 95% of homes in Grenada’s Carriacou and Petite Martinique islands, are damaged, and around 3,000 people are shelters, the IFRC added. Parts of Jamaica’s St Elizabeth region in the south east were also devastated, with around 1,000 people taking refuge in shelters. The Dominican Republic, Cayman Islands reported damage. Venezuela’s President Nicolas Maduro said that 8,000 houses had been destroyed, according to Reuters. More to still come? “Hurricane Beryl, the first hurricane of the 2024 Atlantic hurricane season, rapidly strengthened to a Category 5 storm unusually early in the year,” according to a report from the National Ocean and Atmospheric Administration (NOAA), which is part of the US Department of Commerce “This explosive strengthening was fuelled in part by exceptionally warm ocean temperatures. That heat was one of the factors behind NOAA’s prediction in May of an 85% chance that the 2024 Atlantic hurricane season would be above normal.” Sea surface temperatures were close to those usually found in mid-September, the peak of hurricane season, added NOAA. In late May, NOAA weather forecasters predicted an 85% chance of above-normal hurricane for the 2024 Atlantic hurricane season, which runs from 1 June 1 to 30 November. It also forecast eight to 13 hurricanes, with four to seven likely to be “major” hurricanes (winds of over 178km per hour) in coming months. Early warning systems “The unprecedented hurricane demonstrates the importance of effective multi-hazard early warning systems to save lives,” according to United Nations Disaster Risk Reduction (UNDRR). “Globally, the sustained investments in those systems are making progress in reducing the loss of life in disasters. But economic losses are escalating. Every year millions of households lose their livelihood and risk being pushed into poverty. Ensuring that infrastructure is resilient and that communities ‘build back better’ in the face of future hazards is essential,” added UNDRR. Damage sustained to the airport and surrounding areas on Union Island in the Grenadines during Hurricane Beryl. In late May, the Fourth International Conference on SIDS adopted the Antigua and Barbuda Agenda for SIDS, a 10-year development agenda that appeals for international assistance to address climate change. The Agenda notes that “SIDS are facing the unrelenting and compounding impacts of climate change, biodiversity loss, pollution, disasters and natural hazards, health and other social related challenges and economic vulnerabilities.” Key climate change challenges include “erratic precipitation, increasingly frequent and extreme weather phenomena, more frequent and severe tropical cyclones, floods and drought, diminishing fresh water resources, desertification, coastal erosion, land degradation and sea-level rise.” However, there has been a “progressive deterioration” in SIDS’ ability to “withstand external shocks and enhance their resilience” – largely as a result of the economic impact of COVID-19 and climate challenges. Financial reform to build resilience Protestors call on wealth countries to pay for climate-related loss and damage at COP27. “In the wake of Hurricane Beryl, it is clear that we must redouble our efforts to build resilience and preparedness in the face of growing disaster risk, especially for small island developing states, which have contributed the least to the climate crisis but suffer the greatest costs,” said UNDRR head Kamal Kishore. Kishore appealed for international support for the Antigua and Barbuda Agenda, which “integrates disaster risk reduction as central to climate change adaptation and sustainable development in SIDS with clear calls to action on enhancing multi-hazard early warning systems and resilient infrastructure.” There have also been numerous calls for reform of the international financial architecture to assist developing countries most affected by climate change who are being forced to borrow money to address climate crises largely caused by wealthy nations. The most significant of these is the 2022 Bridgetown Initiative, spearheaded by Prime Minister Mia Mottley of Barbados. This called for key actions including new loan mechanisms, reform of the world’s development banks, and a loss and damages fund to enable developing countries to access to resilient finance to address climate and development crises. The UN climate change conference, COP27, agreed to establish a loss and damage fund during the UN Climate Change Conference (COP27) in 2022. However, there is resistance from a number of wealthier countries to this as the world continues to experience record-breaking extreme weather events. Meanwhile, the International Cort of Justice (ICJ) is expected to hold public hearings and issue an advisory later this year on the international legal obligations countries have to safeguard people against climate change. This follows the adoption last year of a landmark UN resolution to seek such an advisory opinion from the ICJ. While not legally binding, the advisory opinion holds legal and moral weight and will spotlight the human rights impacts of climate policy. Image Credits: UNDP, AfricaNews. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
FDA Approves Eli Lilly’s Kisunla for Early-Stage Alzheimer’s Patients 08/07/2024 Maayan Hoffman Neurons with tau protein highlighted in red. Eli Lilly’s Alzheimer’s therapy, donanemab, has received FDA approval, offering new hope for patients with early symptomatic Alzheimer’s disease. The newly approved treatment, branded Kisunla, is set to challenge existing therapies from Eisai and Biogen. Clinical trials have shown Kisunla to be effective for individuals in the mild cognitive impairment or mild dementia stages of the disease, potentially marking a significant advancement in Alzheimer’s care. The drug is administered as an intravenous infusion every four weeks. Alzheimer’s disease is a degenerative condition of the brain that impacts over 6.5 million Americans and over 55 million people worldwide. It causes a gradual decline in memory, cognitive functions, and, eventually, the ability to perform daily activities. The disease is marked by structural changes in the brain, such as the buildup of amyloid beta plaques and neurofibrillary tangles made of tau protein, which is supposed to help stabilize the internal skeleton of neurons in the brain. The Alzheimer’s Association celebrated the FDA’s decision. “This is real progress,” said Joanne Pike, Alzheimer’s Association president and CEO, in a statement. “Today’s approval allows people more options and greater opportunity to have more time. Having multiple treatment options is the kind of advancement we’ve all been waiting for — all of us who have been touched, even blindsided, by this difficult and devastating disease.” Slows cognitive decline by at least 22% The approval was based on an extensive double-blind, placebo-controlled, parallel-group study evaluating the efficacy of Kisunla in slowing cognitive decline in participants with varying levels of tau protein in the brain. Tau is a protein that helps to stabilise the neurons in the brain. The study, conducted over 72 weeks with 1,736 patients averaging 73 years old, revealed that those receiving Kisunla experienced a 35% reduction in cognitive decline compared to those on placebo among individuals with low to medium tau levels. Even among participants with higher tau levels, the treatment demonstrated a meaningful but slightly reduced effect. Overall, including all tau levels, Kisunla slowed cognitive decline by 22% and reduced the likelihood of progressing to the next stage of the disease by 39% compared to placebo. Additionally, the study monitored amyloid plaque levels using positron emission tomography (PET) scans throughout the treatment period. Results showed substantial reductions in amyloid plaques over time among patients receiving Kisunla, with reductions of 61% at six months, 80% at 12 months, and 84% at 18 months compared to baseline levels. These findings suggest that Kisunla not only targets cognitive decline but also effectively reduces the hallmark amyloid pathology associated with Alzheimer’s disease progression. Potential side effects For some patients, there is a risk of amyloid-related imaging abnormalities (ARIA) developing, the FDA said. ARIA typically manifests as temporary brain swelling, sometimes accompanied by small areas of bleeding on or in the brain. While ARIA often resolves on its own and may not cause symptoms, rare instances of severe and potentially life-threatening events have been reported. ARIA is a recognized side effect of antibody therapies targeting amyloid. Infusion-related reactions are also a concern, including flu-like symptoms, nausea, vomiting, changes in blood pressure, and hypersensitivity reactions such as anaphylaxis (a severe allergic reaction) and angioedema (swelling). Kisunla joins Leqembi, on market since 2023 Kisunla is the third drug to receive FDA approval, although only the second is now available for use. Leqembi, a collaboration between Biogen of the United States and Eisai of Japan, gained approval in July 2023. In an 18-month Phase III trial, Leqembi demonstrated a 27% reduction in cognitive decline among early-stage Alzheimer’s patients compared to those receiving a placebo. Another drug, aducanumab, also developed by Biogen and Eisai, was granted accelerated approval by the FDA in June 2021. However, due to some side effects, the therapy was pulled from the market. The Alzheimer’s Association emphasized the importance of early detection and diagnosis now that multiple FDA-approved treatments for Alzheimer’s are available. The organization stressed that timely access to these treatments is crucial for maximizing their benefits, asserting that no stage or entity should hinder or delay such access. “Too many roadblocks have prevented individuals from getting equitable access to these beneficial treatments for far too long,” said Pike. “It is equally important that clinicians and health care systems are informed and prepared to help the individuals who could benefit. The Alzheimer’s Association is working with health systems and providers to ensure they have the tools and resources to meet the needs of their patients.” Image Credits: Gerry Shaw/ EnCor Biotechnology Inc. Earliest Ever Hurricane Tears Through Caribbean, Highlighting Need for Speedier Climate Action 05/07/2024 Kerry Cullinan Fishing vessels at the Bridgetown Fisheries Complex in Barbados damaged by Hurricane Beryl. Hurricane Beryl, which has destroyed homes and infrastructure in large parts of the eastern Caribbean, is the first first-ever Category 4 hurricane recorded in the region in June – and a portend of devastating changes in weather patterns. It also underscores the need for urgent international assistance to Small Island Developing States (SIDS) to strengthen early warning systems and the climate resilience of key infrastructure – notably water, sanitation and health services, according to experts. The hurricane reached peak speed of 265 km per hour at times as it whipped though Barbados, Grenada, St Vincent and the Grenadines, Haiti, northern Venezuela, the Dominician Republic, Cayman Islands, and Jamaica. “The storm first impacted Barbados, causing severe damage to the south coast and significantly affecting the fishing industry with over 200 fishing vessels damaged or destroyed,” according to the International Federation of Red Cross and Red Crescent Societies (IFRC). On Union Island, part of Saint Vincent and the Grenadines, 90% of infrastructure has been damaged, including houses, roads and the airport. Some 95% of homes in Grenada’s Carriacou and Petite Martinique islands, are damaged, and around 3,000 people are shelters, the IFRC added. Parts of Jamaica’s St Elizabeth region in the south east were also devastated, with around 1,000 people taking refuge in shelters. The Dominican Republic, Cayman Islands reported damage. Venezuela’s President Nicolas Maduro said that 8,000 houses had been destroyed, according to Reuters. More to still come? “Hurricane Beryl, the first hurricane of the 2024 Atlantic hurricane season, rapidly strengthened to a Category 5 storm unusually early in the year,” according to a report from the National Ocean and Atmospheric Administration (NOAA), which is part of the US Department of Commerce “This explosive strengthening was fuelled in part by exceptionally warm ocean temperatures. That heat was one of the factors behind NOAA’s prediction in May of an 85% chance that the 2024 Atlantic hurricane season would be above normal.” Sea surface temperatures were close to those usually found in mid-September, the peak of hurricane season, added NOAA. In late May, NOAA weather forecasters predicted an 85% chance of above-normal hurricane for the 2024 Atlantic hurricane season, which runs from 1 June 1 to 30 November. It also forecast eight to 13 hurricanes, with four to seven likely to be “major” hurricanes (winds of over 178km per hour) in coming months. Early warning systems “The unprecedented hurricane demonstrates the importance of effective multi-hazard early warning systems to save lives,” according to United Nations Disaster Risk Reduction (UNDRR). “Globally, the sustained investments in those systems are making progress in reducing the loss of life in disasters. But economic losses are escalating. Every year millions of households lose their livelihood and risk being pushed into poverty. Ensuring that infrastructure is resilient and that communities ‘build back better’ in the face of future hazards is essential,” added UNDRR. Damage sustained to the airport and surrounding areas on Union Island in the Grenadines during Hurricane Beryl. In late May, the Fourth International Conference on SIDS adopted the Antigua and Barbuda Agenda for SIDS, a 10-year development agenda that appeals for international assistance to address climate change. The Agenda notes that “SIDS are facing the unrelenting and compounding impacts of climate change, biodiversity loss, pollution, disasters and natural hazards, health and other social related challenges and economic vulnerabilities.” Key climate change challenges include “erratic precipitation, increasingly frequent and extreme weather phenomena, more frequent and severe tropical cyclones, floods and drought, diminishing fresh water resources, desertification, coastal erosion, land degradation and sea-level rise.” However, there has been a “progressive deterioration” in SIDS’ ability to “withstand external shocks and enhance their resilience” – largely as a result of the economic impact of COVID-19 and climate challenges. Financial reform to build resilience Protestors call on wealth countries to pay for climate-related loss and damage at COP27. “In the wake of Hurricane Beryl, it is clear that we must redouble our efforts to build resilience and preparedness in the face of growing disaster risk, especially for small island developing states, which have contributed the least to the climate crisis but suffer the greatest costs,” said UNDRR head Kamal Kishore. Kishore appealed for international support for the Antigua and Barbuda Agenda, which “integrates disaster risk reduction as central to climate change adaptation and sustainable development in SIDS with clear calls to action on enhancing multi-hazard early warning systems and resilient infrastructure.” There have also been numerous calls for reform of the international financial architecture to assist developing countries most affected by climate change who are being forced to borrow money to address climate crises largely caused by wealthy nations. The most significant of these is the 2022 Bridgetown Initiative, spearheaded by Prime Minister Mia Mottley of Barbados. This called for key actions including new loan mechanisms, reform of the world’s development banks, and a loss and damages fund to enable developing countries to access to resilient finance to address climate and development crises. The UN climate change conference, COP27, agreed to establish a loss and damage fund during the UN Climate Change Conference (COP27) in 2022. However, there is resistance from a number of wealthier countries to this as the world continues to experience record-breaking extreme weather events. Meanwhile, the International Cort of Justice (ICJ) is expected to hold public hearings and issue an advisory later this year on the international legal obligations countries have to safeguard people against climate change. This follows the adoption last year of a landmark UN resolution to seek such an advisory opinion from the ICJ. While not legally binding, the advisory opinion holds legal and moral weight and will spotlight the human rights impacts of climate policy. Image Credits: UNDP, AfricaNews. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy
Earliest Ever Hurricane Tears Through Caribbean, Highlighting Need for Speedier Climate Action 05/07/2024 Kerry Cullinan Fishing vessels at the Bridgetown Fisheries Complex in Barbados damaged by Hurricane Beryl. Hurricane Beryl, which has destroyed homes and infrastructure in large parts of the eastern Caribbean, is the first first-ever Category 4 hurricane recorded in the region in June – and a portend of devastating changes in weather patterns. It also underscores the need for urgent international assistance to Small Island Developing States (SIDS) to strengthen early warning systems and the climate resilience of key infrastructure – notably water, sanitation and health services, according to experts. The hurricane reached peak speed of 265 km per hour at times as it whipped though Barbados, Grenada, St Vincent and the Grenadines, Haiti, northern Venezuela, the Dominician Republic, Cayman Islands, and Jamaica. “The storm first impacted Barbados, causing severe damage to the south coast and significantly affecting the fishing industry with over 200 fishing vessels damaged or destroyed,” according to the International Federation of Red Cross and Red Crescent Societies (IFRC). On Union Island, part of Saint Vincent and the Grenadines, 90% of infrastructure has been damaged, including houses, roads and the airport. Some 95% of homes in Grenada’s Carriacou and Petite Martinique islands, are damaged, and around 3,000 people are shelters, the IFRC added. Parts of Jamaica’s St Elizabeth region in the south east were also devastated, with around 1,000 people taking refuge in shelters. The Dominican Republic, Cayman Islands reported damage. Venezuela’s President Nicolas Maduro said that 8,000 houses had been destroyed, according to Reuters. More to still come? “Hurricane Beryl, the first hurricane of the 2024 Atlantic hurricane season, rapidly strengthened to a Category 5 storm unusually early in the year,” according to a report from the National Ocean and Atmospheric Administration (NOAA), which is part of the US Department of Commerce “This explosive strengthening was fuelled in part by exceptionally warm ocean temperatures. That heat was one of the factors behind NOAA’s prediction in May of an 85% chance that the 2024 Atlantic hurricane season would be above normal.” Sea surface temperatures were close to those usually found in mid-September, the peak of hurricane season, added NOAA. In late May, NOAA weather forecasters predicted an 85% chance of above-normal hurricane for the 2024 Atlantic hurricane season, which runs from 1 June 1 to 30 November. It also forecast eight to 13 hurricanes, with four to seven likely to be “major” hurricanes (winds of over 178km per hour) in coming months. Early warning systems “The unprecedented hurricane demonstrates the importance of effective multi-hazard early warning systems to save lives,” according to United Nations Disaster Risk Reduction (UNDRR). “Globally, the sustained investments in those systems are making progress in reducing the loss of life in disasters. But economic losses are escalating. Every year millions of households lose their livelihood and risk being pushed into poverty. Ensuring that infrastructure is resilient and that communities ‘build back better’ in the face of future hazards is essential,” added UNDRR. Damage sustained to the airport and surrounding areas on Union Island in the Grenadines during Hurricane Beryl. In late May, the Fourth International Conference on SIDS adopted the Antigua and Barbuda Agenda for SIDS, a 10-year development agenda that appeals for international assistance to address climate change. The Agenda notes that “SIDS are facing the unrelenting and compounding impacts of climate change, biodiversity loss, pollution, disasters and natural hazards, health and other social related challenges and economic vulnerabilities.” Key climate change challenges include “erratic precipitation, increasingly frequent and extreme weather phenomena, more frequent and severe tropical cyclones, floods and drought, diminishing fresh water resources, desertification, coastal erosion, land degradation and sea-level rise.” However, there has been a “progressive deterioration” in SIDS’ ability to “withstand external shocks and enhance their resilience” – largely as a result of the economic impact of COVID-19 and climate challenges. Financial reform to build resilience Protestors call on wealth countries to pay for climate-related loss and damage at COP27. “In the wake of Hurricane Beryl, it is clear that we must redouble our efforts to build resilience and preparedness in the face of growing disaster risk, especially for small island developing states, which have contributed the least to the climate crisis but suffer the greatest costs,” said UNDRR head Kamal Kishore. Kishore appealed for international support for the Antigua and Barbuda Agenda, which “integrates disaster risk reduction as central to climate change adaptation and sustainable development in SIDS with clear calls to action on enhancing multi-hazard early warning systems and resilient infrastructure.” There have also been numerous calls for reform of the international financial architecture to assist developing countries most affected by climate change who are being forced to borrow money to address climate crises largely caused by wealthy nations. The most significant of these is the 2022 Bridgetown Initiative, spearheaded by Prime Minister Mia Mottley of Barbados. This called for key actions including new loan mechanisms, reform of the world’s development banks, and a loss and damages fund to enable developing countries to access to resilient finance to address climate and development crises. The UN climate change conference, COP27, agreed to establish a loss and damage fund during the UN Climate Change Conference (COP27) in 2022. However, there is resistance from a number of wealthier countries to this as the world continues to experience record-breaking extreme weather events. Meanwhile, the International Cort of Justice (ICJ) is expected to hold public hearings and issue an advisory later this year on the international legal obligations countries have to safeguard people against climate change. This follows the adoption last year of a landmark UN resolution to seek such an advisory opinion from the ICJ. While not legally binding, the advisory opinion holds legal and moral weight and will spotlight the human rights impacts of climate policy. Image Credits: UNDP, AfricaNews. Posts navigation Older postsNewer posts