Millions of lives each year rely on the expertise and care of midwives and yet a global shortage is squeezing the profession like never before, the UN sexual and reproductive health agency UNPFA said on Sunday, marking the International Day of the Midwife. 

Some of the poorest women in an underdeveloped region south of Madagascar are “too ashamed” to seek the maternal health services they need, according to a midwife working in a health centre supported by United Nations agencies, but that may be about to change.

96 Global Health NOW: H5N1: Uncharted Territory, Unanswered Questions; The Limitations of Egg Freezing; and Schrödinger’s Shipment View this email in your browser May 3, 2024 Forward Share Post Cows graze in a field at a dairy farm in Petaluma, California. April 26. Justin Sullivan/Getty H5N1: Uncharted Territory, Unanswered Questions
As concerns mount about H5N1’s spread among U.S. dairy cattle, federal health officials are acknowledging “serious gaps” in their ability to track the virus’s spread in its new host. 

Under-the-radar: Federal officials now say bird flu likely circulated in U.S. dairy cows for about four months before it was confirmed, reports Reuters.

Undetected: There has been only one documented case of H5N1 human spillover—but epidemiologists suspect the number is higher, as local and state health departments have tested only ~25 people for the virus, per NPR Shots. 

Uncharted: In a Q&A with STAT, Vivien Dugan, the director of CDC’s influenza division, said the pivot from tracking H5N1 from poultry to tracking it in cattle has been like “crossing into a new country”—as dairy farms have no experience with the disease.

Underdeveloped: In the case of human spread, federal officials say they currently have two vaccine candidates on deck made from older strains of the virus—but infectious disease experts are casting doubt on those shots’ effectiveness, reports NPR.

Related: Bird flu outbreak in dairy cows fails to deter US raw milk sellers – Reuters GLOBAL HEALTH VOICES The Latest One-Liners   10,000 people are feared buried under the rubble in Gaza seven months into the conflict that has seen entire neighborhoods leveled, UN authorities said yesterday; UN mine action experts also estimated that some 7,500 tons of unexploded ordnance could be “scattered” throughout Gaza. UN News

Non-white pedestrians were treated for traffic-related injuries in U.S. emergency rooms at higher rates between 2021 and 2023, new CDC data show—with multiracial people or people of another race treated 2.47X more than white people; Asian pedestrians treated 2.23X more; Black pedestrians 1.93X more; and Hispanic pedestrians 1.7X more. AP

Action steps for AMR were released by an international coalition of organizations yesterday—with stakeholders hoping the recommendations will shape negotiations at the upcoming UN High-Level Meeting on Antimicrobial Resistance in September. CIDRAP

Benefits of hormone replacement therapy for menopause symptoms outweigh the risks for women under age 60, new research published in JAMA concludes—a shift that takes into account two decades of follow-up data from the Women’s Health Initiative, flaws in the original study, and safer hormone formulations available now. NPR Shots GLOBAL HEALTH VOICES REPRODUCTIVE HEALTH The Limitations of Egg Freezing
About a decade after the practice of freezing eggs to prolong fertility took off, researchers and specialists are seeking a clearer picture of the benefits—and failed promises—of the procedure. 

Questions of efficacy: While the procedure rapidly gained popularity, its long-term, large-scale effectiveness has long been unclear since not enough people had tried to use their frozen eggs to allow for reliable data collection.

An emerging picture: A 2022 study conducted at NYU Langone Fertility Center found that the chance of a live birth from frozen eggs was 39%.

In other words: “There isn’t a guarantee of having a baby from egg freezing,” says Sarah Druckenmiller Cascante, one of the study’s authors.

Vox

Related: America’s IVF Failure – The Atlantic FRIDAY DIVERSION Schrödinger’s Shipment  
Peas and carrots. Wine and cheese. Cat and cardboard box. These are some of the iconic duos of our time … except when the cat doesn’t meow and the box is an Amazon return about to be taped up.
 
A week after Galena, a box-loving American shorthair from Utah, went missing, her distraught human Carrie Clark received “the text that changed my life,” AP reports. Galena had been found … at an Amazon warehouse in California, comfortably nestled alongside six pairs of steel-toed boots. She was unharmed thanks to mild weather and an accidental breathing hole in the box.
 
At first, Amazon staff weren’t quite sure what to do, but like most groupings of intelligent humans, they had identified the self-described “crazy cat lady” among them, The Guardian reports. With the help of Amazon worker/feline hero Brandy and a microchip reader, Galena was soon homeward bound with her people, who are now considering when to “reintroduce cardboard.”
 
A Prime example of lost and found. QUICK HITS The ‘100-day cough’ can be lethal in babies – so what is behind its global rise? – The Telegraph

Pregnant women in Missouri can't get divorced. Critics say it fuels domestic violence – NPR

Medscape severs ties with tobacco industry after backlash over $3M Philip Morris International deal – The Examination

High-risk patients with COVID symptoms should use PCR rather than rapid tests, study suggests – CIDRAP

‘Unethical’ junk food packaging manipulates children into craving sweets, report claims – The Guardian

What is cannabinoid hyperemesis syndrome? Here’s what to know, and why experts say it’s on the rise – PBS NewsHour

Cancer Supertests Are Here: But are they really such a good idea? – The Atlantic

'Orangutan, heal thyself': First wild animal seen using medicinal plant – Nature Issue No. 2530
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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96 Global Health NOW: Congo’s New Mpox Challenge; Tracking Wildlife—and SARS‐CoV‑2; and Wartime Medicine On The Fly View this email in your browser May 2, 2024 Forward Share Post Electron micrograph of two mature mpox virus particles (pink). NIAID/Flickr CC Congo’s New Mpox Challenge
Scientists at Congo’s National Institute of Biomedical Research have discovered a new form of mpox that is more easily transmitted among people, AP reports.

• Genetic mutations in the virus were discovered in hospital patients in the eastern Congo region of Kamituga between October and January.

New challenge: The new form of the virus causes milder lesions typically located on the genitals, making mpox more difficult to diagnose, per the institute’s lead researcher Placide Mbala-Kingebeni. Previously, lesions were mostly on the chest, hands, and feet.

The Quote: “This suggests the virus is adapting to spread efficiently in humans and could cause some pretty consequential outbreaks,” said Emory University's Boghuma Titanji.

Outbreak status: Congo is fighting its biggest mpox outbreak with 4,500+ suspected cases and almost 300 deaths so far this year—numbers ~3X higher than in the same period last year.

Global take: Mpox transmission persists at low levels globally, with the largest number of cases occurring in Africa, Europe, the Americas, the Western Pacific, and the Southeast Asia regions, per the WHO’s 32nd situation report on the multi-country outbreak published Tuesday.

• In March, 22 countries reported a total of 466 new lab-confirmed mpox cases and three deaths.

Related: 

DRC is seeing its worst mpox outbreak — but has no vaccines or treatments yet. Why? – NPR

Machine learning in epidemiology: Neural networks forecasting of monkeypox cases – PLOS ONE GLOBAL HEALTH VOICES The Latest One-Liners   Liverpool School of Tropical Medicine scientists have discovered that the drug varespladib prevents tissue damage caused by African spitting cobra venom—responsible for high rates of disability and amputation across Africa; the treatment has cleared human clinical trials and could soon be available for patients. Liverpool School of Tropical Medicine (news release)
 
An “outbreak” of opioid overdoses in Austin, Texas, Monday has been linked to eight deaths and over 50 emergency calls earlier this week; paramedics distributed over 267 Narcan doses, while police investigating the drugs’ source said they have detained two “persons of interest.” NBC 
 
The U.S. maternal mortality rate has improved significantly since a pandemic spike in 2021; a new CDC report shows that 817 women died of maternal causes in the U.S. in 2022, compared to 1,205 in 2021. NPR Shots
 
LGBTQ+ young people in the U.S. continue to report high rates of mental health challenges, bullying, discrimination, and increased suicide risk, per new Trevor Project survey results that also found a link between lower suicide rates and supportive environments and safe spaces. UPI Avian Flu News
Tracking bird flu virus changes in cows is stymied by missing data, scientists say – STAT

FDA finds no live H5N1 avian flu virus in sour cream or cottage cheese, will assess raw milk – CIDRAP

CDC and USDA answer questions about the bird flu outbreak in Texas, other states – Dallas Morning News (free registration required)

This Texas veterinarian helped crack the mystery of bird flu in cows – AP THE QUOTE COVID-19 Tracking Wildlife—and SARS‐CoV‑2
As COVID-19 surveillance programs go dormant in U.S. health systems, one group of American scientists is embarking on a quest to track the virus in the wild. 

The goal: Understand how SARS‐CoV‑2 is spreading in North American wildlife—especially in deer—and how it might be evolving in animal hosts.

• SARS‐CoV‑2 is known to have spilled over into more than 50 animal species since the start of the pandemic. 

• In the U.S., a 2021 study showed 36% of 360 white-tailed deer shot in a culling program in Ohio were infected with SARS‐CoV‑2. 

All hands on deck: To provide enough test samples, wildlife management officials, hunters, a pest control company, and animal rehabs have all agreed to collect samples and swabs from mammals ranging from mice to moose. 

Science GLOBAL HEALTH VOICES CONFLICT: SUDAN Wartime Medicine On The Fly
After civil war broke out in Sudan last year, many of the country’s doctors scrambled to treat gunshot wounds and infections, as patients filled hospital wards. 

In an effort to keep up with war-related injuries, hundreds of Sudanese health workers with little formal training in trauma care have been learning wartime medicine—skills like improvised IV drips, treating gunshot wounds, identifying shock and PTSD—via the Telegram app on smart phones.

• They are using an international platform called Project ECHO, which connects them with medical experts worldwide, who deliver training sessions and provide real-time medical advice.

For example: In one case, a doctor consulted the Telegram group to ask for advice about what to do when the hospital ran out of PPE while treating gunshot patients. The group advised using trash bags instead for makeshift infection control.

The Telegraph QUICK HITS Colombia’s Wayúu people live on land rich in resources. So why are their children dying of hunger? – The Guardian

Arizona’s Democrats get enough votes to repeal 19th century abortion ban – PBS NewsHour

Elimination of human African trypanosomiasis: The long last mile – PLOS Neglected Tropical Diseases

UnitedHealth CEO's testimony on cyberattack leaves Congress wanting – Axios

Identifying risks of human flea infestations in plague-endemic areas of Madagascar – Emory University via ScienceDaily

Does the American Diabetes Association work for patients or companies? A lawsuit dared to ask – The Guardian

India widens spices probe amid contamination concerns – Reuters

Power outages linked to heat and storms are rising, and low-income communities are most at risk, as a new NYC study shows – The Conversation (commentary)

Mary Shelley's Lessons for a Plague-Ridden World – The Atlantic Issue No. 2529
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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96 Global Health NOW: Getting Kenyan Cult Leaders to Embrace Medicine; Dangerous SUVs; and Police Sedative Use Eliud Wekesa has said he’s Jesus and that his followers should trust prayer not meds. View this email in your browser May 1, 2024 Forward Share Post Eliud Wekesa speaks to visitors outside his home and church compound in Tongaren, Kenya, on February 29. Dominic Kirui Getting Kenyan Cult Leaders to Embrace Modern Medicine
LUKHOKHWE, Kenya — Eliud Wekesa—who claims to be Jesus—has been accused of feeding his hundreds of followers a flawed gospel, telling them only prayers can heal.
 
Wekesa is just one of many religious and cult leaders—not only in Kenya but across the region—blamed for undermining health efforts and urging their followers to shun modern medicine. Their influence is one reason that many easily treatable health problems persist in Kenya and other parts of the world.
 
Signs of change: Health officials in Kenya (with police backing, at times) are working to dispel these messages.

• Health officials are involving religious leaders in government health strategies, accompanied by training on the truth about medicine’s importance to human health. 

• After being arrested several times for discouraging his followers from seeking medical care and preventing their children from going to school, Wekesa has taken steps to publicly model acceptance of medical care. In 2021, he participated in a mass drug administration campaign to tackle two of Kenya’s most prevalent neglected tropical diseases: bilharzia and intestinal parasitic worms.  

Dominic Kirui for Global Health NOW

Ed. Note: Dominic Kirui is a freelance journalist based in Nairobi, Kenya, who writes on gender, climate change, water, and other topics. This article is part of Global Health NOW’s Local Reporting Initiative, made possible through the generous support of loyal GHN readers.
  READ THE FULL STORY GLOBAL HEALTH VOICES The Latest One-Liners   Breast cancer screenings are now being advised for women age 40 and up, after the U.S. Preventive Services Task Force lowered its recommended screening age from 50; however, cancer advocacy groups say the agency should go further by advising annual exams. Axios

Efforts to infect people with “ancestral” SARS-CoV-2 for a challenge trial in the U.K. were unsuccessful due to participants’ immunity, per a new study published in The Lancet Microbe; the outcome raises “questions about the usefulness” of such challenge trials for testing COVID-19 vaccines and drugs. Nature
 
Snakebites are most prevalent among young men working in agricultural or livestock settings, according to a new BMJ Public Health study that looked at bite cases reported in Paraguay from 2015–2021. Medical Xpress

Anger has been linked to an increased risk of cardiovascular disease by limiting blood vessels’ ability to dilate, per a new study published in the Journal of the American Heart Association. The Washington Post (gift article) Avian Flu News USDA to test ground beef for traces of H5N1 avian flu virus as more poultry outbreaks reported – CIDRAP

UK ramps up response to H5N1 outbreak in US cattle – but refuses to test British cows – The Telegraph

Spikes of flu virus in wastewater raise questions about spread of bird flu – CNN

America’s Infectious-Disease Barometer Is Off – The Atlantic POLICING Sedative Use in Police Encounters Has Resulted in Avoidable Deaths
More than 1,000 people died after being subdued with force by police between 2012 and 2021. 

• At least 94 of them were injected with a sedative in the process, according to an investigation led by the AP. 

Why? Supporters of sedatives’ use say they are used to calm people so they can be safely transported for treatment, but medical experts see “a pattern of misuse of sedation during law enforcement encounters and a disproportionate impact on Black people.”

Dangers: The sedatives often impact breathing and heart rate—and their effects can be exacerbated by physical restraint or substances already present in a person’s system.

Bigger story: The use of sedatives is compounded by numerous big issues: racism, questionable science, biased decision-making, overdosing, and lack of scrutiny of sedatives’ use.

AP GLOBAL HEALTH VOICES TRAFFIC DEATHS A Bulky Problem 
Four of every five new cars sold in the U.S. are SUVs or pickup trucks, but larger vehicles come with a litany of road safety concerns.

• An SUV or pickup truck collision with a smaller car was 28% or 159% more likely to kill the other driver, respectively, per a 2019 Traffic Injury Prevention article. 


• Fatalities among pedestrians and cyclists have reached a 40-year high, with an increased risk for those in a crash with a bigger car. 


• Between 2008 and 2023, the average “vehicle footprint” increased 6%. 

Playing favorites: U.S. policymakers are partly to blame. Less strict federal policies, such as a more lenient fuel economy standard for pickups and SUVs (and higher profit margins) have encouraged automakers to make bigger cars. 

Vox OPPORTUNITY QUICK HITS Florida's 6-week abortion ban is now in effect, curbing access across the South – NPR Shots

British Columbia's drug decriminalization experiment is being rolled back after backlash – BBC

Malaria Carrying Mosquitoes Return to Italy's Coast – Precision Vaccinations

Fields of filth: factory farms committing thousands of environmental breaches – The Bureau of Investigative Journalism

EPA bans consumer use of a toxic chemical widely used as a paint stripper but known to cause cancer – AP

After private equity firms gobbled up wheelchair makers, users pay the price in long repair times – STAT

WHO Africa Advances African Science by Promoting Peer-Reviewed Research – IPS

Johns Hopkins breeds millions of mosquitoes — to stop them from killing you – The Baltimore Banner Issue No. 2528
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Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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The COVID-19 pandemic has led to increased obesity in school-aged children in Europe, the World Health Organization (WHO) office for the region said in a new report issued on Wednesday, sounding the alarm for action. 

96 Global Health NOW: Measles’ Growing Global Threat; Adding an Antibody to the Malaria Arsenal; and Seeking Peace for 'Comfort Women' Rise in measles cases is another legacy of COVID-19 disruptions. View this email in your browser April 30, 2024 Forward Share Post A young boy recovering from measles gets his arm measured at a clinic on November 29, 2023, in Rotriak, South Sudan. Luke Dray/Getty Measles’ Growing Global Threat  
Global reported measles cases leapt to 320,000 last year, up from 170,000 in 2022, according to new WHO data shared last weekend.
 
Accelerating pace: Nearly 100,000 cases have been reported already this year, NPR reports.
 
Worse still: Those numbers are just reported cases—the true number is much higher, with +9 million estimated in 2022.
 
Why the surge? It’s another legacy of COVID-19 disruptions, according to Hanna Nohynek, of the Finnish Institute for Health and Welfare, per Medical Xpress.

• ~61 million doses were missed or delayed in 2021, NPR reports.

• Catch-up vaccinations aren’t reaching children who missed measles and other jabs.

Location: Major outbreaks are occurring in Southeast Asia and sub-Saharan Africa, said Patrick O'Connor, the WHO’s medical officer for measles and rubella.

• Five sub-Saharan African countries have first-dose vaccination coverage that’s under 50%.

New Hope: A measles vaccine patch was found to be safe and effective in a recent trial involving 200 toddlers and babies, the BBC reports.

• The patch provoked an immune response that equaled the shot’s.

• Plus: Doctors, nurses, and a cold chain aren’t required by the patch, and minimal training is needed in how to apply it.

GLOBAL HEALTH VOICES The Latest One-Liners
The Chinese scientist who first published the sequence of the SARS-CoV-2 virus staged a sit-in protest after being locked out of his lab this weekend; Zhang Yongzhen has been demoted and suffered other career setbacks since publishing the sequence in January 2020. AP

Cats died soon after consuming unpasteurized milk and colostrum from cows infected with the H5N1 avian flu virus, according to a new study published in Emerging Infectious Diseases; the finding adds to concerns about the virus’s ability to spread among mammals.

Phones are ringing “off the hook” at Florida abortion clinics before a 6-week abortion ban takes effect tomorrow, barring the procedure before most women know they are pregnant; prior to the ban, the state had been a refuge for out-of-state abortion seekers from places like Georgia and Alabama. Reuters
 
Hajj pilgrims will be offered the polio vaccine as they undertake the Muslim rite of passage next month, as part of a broader eradication effort from Saudi Arabia and the Bill & Melinda Gates Foundation; prior pilgrimages have been linked to outbreaks of the disease. Al Arabiya HUMAN RIGHTS Seeking Peace for ‘Comfort Women’
Activists are pushing for reparations and recognition of the sexual enslavement endured by 1,000 Filipino women during Japan’s occupation in WWII.
 
Since 1997, a comfort women survivors’ group called Malaya Lolas has repeatedly called on the Filipino government to press their case for compensation with Japan, to no avail.
 
In March 2023, the women took their fight to the UN, where CEDAW suggested the creation of a state-sanctioned fund to compensate women who are victims of war crimes.
 
Yet there have been no signs from the government about creating such a fund. The state is reluctant to upset Japan—the largest lender of foreign aid in the Philippines—as it seeks to build military ties.

The Telegraph GLOBAL HEALTH VOICES MALARIA Adding an Antibody to the Malaria Arsenal 
A single dose of a new injectable monoclonal antibody offers children 77% protection from malaria for up to 6 months—meaning it could be a key “addition to the arsenal” of tools to fight the disease, reports Science. 

The specifics: The NIH-developed therapy, called L9LS, reduced infections and clinical disease in 6- to 10-year-olds in Mali, per a new clinical study published in The New England Journal of Medicine. 

• The therapy has already shown 80% protection in adults, reports CIDRAP.

The implications: While the therapy isn’t a “silver bullet” for preventing malaria, it could be a critical tool along with antimalarials, insecticide-treated bed nets, and childhood vaccination, according to an accompanying editorial published in NEJM.

• “Even if the monoclonals do not provide full protection, they are very likely to reduce childhood mortality against malaria,” said malaria researcher Elizabeth Winzeler. 

QUICK HITS The WHO overturned dogma on how airborne diseases spread. Will the CDC act on it? – NBC News

FDA brings lab tests under federal oversight in bid to improve accuracy and safety – ABC News

Age and sex impact antimicrobial resistance levels, research shows – News Medical

Talks on global pandemic agreement are in race against time – VOA

Quiz: Can you pass our 9 question test on the latest theories of COVID-19 transmission – NPR Goats and Soda Issue No. 2527
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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96 Global Health NOW: Sounding Alarm in Sudan; Young Europeans’ Rising Colorectal Cancers; and U.S. Hepatitis-C Failure ~800,000 people are trapped between opposing forces in Darfur’s El Fasher. View this email in your browser April 29, 2024 Forward Share Post A newly arrived refugee from Darfur, in Sudan, sits on a donkey as her group heads to a shelter in Adre, Chad, on April 24. Dan Kitwood/Getty Sounding Alarm in Sudan
Escalating tensions in Sudan’s North Darfur have led UN officials to warn of “devastating consequences for civilians”—including ethnically motivated killings and the collapse of aid in a region already on the brink of famine. 

View from the ground: Rapid Support Forces have surrounded El Fasher, home to ~800,000 people and the last major city in the Darfur region under Sudanese Armed Forces’ control.

• This means “civilians are trapped” and essential supplies have been cut off, per UN News.


• Displaced people there already face “critical” water, food, sanitation, and health care shortages, a local official told Sudan Tribune. 

Reports of sexual violence have been recorded nationwide, and “reveal the war's disproportionate impact on women and girls,” per ReliefWeb.

Crisis on crisis: Amidst this, Sudan has reported its first case of mpox, reports The Standard.

Global neglect: ~25 million people—half Sudan’s population—require humanitarian aid. But reports of mass atrocities have been met with “a deafening silence,” write Don Cheadle and John Prendergast in a commentary for USA Today:

• “The only living creatures that are thriving in this environment are the vultures, feeding on corpses left in the streets to rot,” the authors write.

GLOBAL HEALTH VOICES The Latest One-Liners   Attacks on Ukraine so far this year have killed 25 children—40% more children compared to 2023—and damaged or destroyed thousands of homes, 36 health facilities, and 140 educational facilities, per UNICEF. UN News 

TB has increased in the U.S. every year since 2020, after 27 years of steady declines; CDC data show 9,615 cases were recorded last year. The Washington Post (gift article)

Insulin shortages in the U.K. are causing significant “stress and anxiety” for the ~400,000 people in the country with type 1 diabetes—as the nation copes with ongoing medication shortages. The Guardian

A U.S. ban on menthol cigarettes has been indefinitely postponed by the Biden administration, after backlash from civil rights groups, small business owners, and law enforcement groups. AP Avian Flu News Bird flu: US tests show pasteurized milk is safe – Reuters

Cattle testing for H5N1 bird flu will be more limited than USDA initially announced – STAT

As bird flu spreads in cows, here are 4 big questions scientists are trying to answer – NPR Shots

There’s never a good time to drink raw milk. But now’s a really bad time as bird flu infects cows ​​– STAT CANCER In Europe, More Colorectal Tumors at Younger Ages
Researchers are racing to understand the troubling trend of rising colorectal cancer cases among young people in Spain and other European countries.

• The rate of colorectal cancer deaths in young people in Europe and in the U.K. could rise by up to 40% this year compared to the 2014-2019 period.

• And 25% of cancerous colorectal tumors are now found in people under 50.

Researchers are analyzing a range of potential factors—including rising obesity rates, diets with more processed foods, antibiotic abuse, and high alcohol consumption.

• In particular, Spain’s pivot away from the Mediterranean diet towards one of more processed foods has driven concern among researchers at the Vall d’Hebron Institute of Oncology in Barcelona. 

The Telegraph GLOBAL HEALTH VOICES INFECTIOUS DISEASES U.S. Struggles Against Hepatitis-C
15 countries—including Egypt, Canada and Australia—are on track to eliminate hepatitis C by 2030, thanks to national screening and treatment campaigns.
 
Not on the list: The U.S. 

• Just 34% of Americans diagnosed since 2013 have been cured. 

Behind the lag: Many Americans don’t know they are infected and need treatment—which is often out-of-reach for at-risk people, including the uninsured, incarcerated, or unhoused.
 
The policy part: A Biden administration initiative to provide drugs, raise awareness, and train clinicians could prevent 24,000 deaths in the next decade, but it’s stuck in Congressional limbo.
 
Standout state: New Mexico has provided hepatitis C treatment for 10,000+ patients—by connecting rural primary care doctors with specialist training, funding prisoner treatment, and supporting harm reduction approaches like needle exchange programs.
 
The New York Times OPPORTUNITY QUICK HITS Hajj pilgrims to get polio vaccine under Bill & Melina Gates Foundation health drive – Al Arabiya

The ‘man who repairs women’ on rape as a weapon and how the world forgot the DRC – The Guardian

Malaria on the rise in Madagascar as climate change leaves healthcare out of reach – MSF

Doctors seeing more syphilis patients with unusual and severe symptoms, study shows – CNN

The Public Good on the Docket — The Supreme Court’s Evolving Approach to Public Health – New England Journal of Medicine (commentary)

Respiratory syncytial virus seasonality, transmission zones, and implications for seasonal prevention strategy in China: a systematic analysis – The Lancet Global Health

‘People are going to die this summer’: Advocacy groups join Texas lawsuit over excessive heat in prisons – The 19th

Medical students lose in the research arms race for residency slots – STAT (commentary)

Elevator or stairs? Your choice could boost longevity, study finds ​​– NPR Shots Issue No. 2526
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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Le système de santé palestinien doit être un lieu pour maintenir en vie et en santé le «corps social».

96 Global Health NOW: H5N1 Outbreak Likely ‘Much Bigger’ Than Official Counts; The Aftermath in Flint, Michigan; and ‘Make Seagulls Sexy Again’ View this email in your browser April 26, 2024 Forward Share Post Holstein cows walk back to the barn after milking at Sheepscot Valley Farm. Whitefield, Maine, March 30. Derek Davis/Portland Press Herald via Getty H5N1 Outbreak Likely ‘Much Bigger’ Than Official Counts
As U.S. government officials gradually release more data about H5N1 being detected in the commercial milk supply, scientists say there are signs that the outbreak is “far more widespread” than the official count of 33 herds in eight states, reports STAT. 

Yesterday, the FDA revealed that it had detected milk positive for traces of avian flu in 20% of samples.

• Such traces are genetic remnants: So far, live virus has not been detected in pasteurized milk—making it safe to drink, officials say. 


• But that prevalence—plus genetic data that show the virus has been circulating since December—“suggests that the outbreak is probably much bigger than we know,” said virologist Angie Rasmussen.

The bigger worry: The more widely H5N1 spreads in cows, the more opportunities it has to adapt—and become “a pathogen of pandemic potential,” said Keith Poulsen, director of the Wisconsin Veterinary Diagnostic Laboratory. 

Reminders of early COVID: Researchers worry the U.S. government’s early response is too fractured, slow, and obtuse—reminiscent of missteps in the early days of the COVID-19 pandemic, reports The Washington Post. 

Meanwhile: Colombia has become the first country to limit the import of U.S. beef products, reports Reuters—a sign of avian flu’s “broadening economic impact.” GLOBAL HEALTH VOICES Thanks for the tip, Joanna Schofield! The Latest One-Liners   A heatwave in Gaza has made the tents where ~1.2 million are living in Rafah feel “like living in a greenhouse”—and conditions are set to worsen once summer comes with even higher temperatures. UN News

The first known HIV cases transmitted via cosmetic injection were reported by the CDC, after three women were likely infected while receiving so-called vampire facials—a process involving microneedling—at a New Mexico spa. NBC

A phase 3 trial of the world’s first personalized mRNA cancer vaccine for melanoma is underway in London after a phase 2 trial showed the vaccines dramatically reduced the risk of the cancer returning. The Guardian Thanks for the tip, Cecilia Meisner!

COVID-19 may have eroded doctors’ belief that they are obligated to treat infectious patients, concluded Duke University–led researchers who compared trends during various pandemics; COVID-19-related characteristics including vaccine refusal, PPE shortages, and abuse of staff by patients and their families may have contributed to the shift. CIDRAP CHILD & ADOLESCENT HEALTH The Aftermath in Flint, Michigan 
A decade after the water crisis in Flint, Michigan—in which more than 100,000 people were exposed to lead from aging pipes—residents continue battling the consequences.

This must-read feature focuses on the physical, mental, and emotional challenges caused by lead exposure and the delayed response to the crisis.

• 50% of children struggle with behavioral problems. 


• 15% of kids have been diagnosed with anxiety and 10% with depression.


• The number of K-12 students with special needs has increased by 8%.


• 70% of Flint kids grow up in poverty.

Beacons of hope: Community members, pastors, and doctors have advocated for those affected, and 95% of the work on replacing the pipes has been completed. 

Harvard Public Health 

Related: 10 years after Flint, the fight to replace lead pipes across U.S. continues – NPR GLOBAL HEALTH VOICES CHILD RIGHTS Riding Toward Danger 
Advocacy groups are calling for tighter regulations surrounding child jockeys in Mongolia.

Horse racing is a large part of Mongolia’s cultural heritage, but over the past two decades, at least 30 children have been killed. 

Weighing in: Riders are required to weigh no more than 35 kg (77 lbs), meaning competitors are young children.

• There were 13,519 child jockeys in 2023, per official figures, though experts say the true number is much higher.


• There have been nine deaths and 466 injuries since 2021. 

Human rights groups have criticized the dangerous conditions, lack of quality safety gear, and exploitation of children.

• While some improvements have been made, UNICEF is calling for tighter restrictions. 

Telegraph FRIDAY DIVERSION ‘Make Seagulls Sexy Again’
When Cooper Wallace first started honing his seagull impression, his family thought it was just “another annoying sound” from the 9-year-old. When the opportunity arose for gull glory, they soon changed their tune. 

The boy is now a “seaside sensation” after his nuanced squawk won him the top youth prize at the European Seagull Screeching Competition in Belgium, BBC reports. 

The contest is designed to highlight the plight of these so-called “rats of the sea,” who face off against bird flu and probably only steal your sandwiches because they can’t find enough wild food, The Brussels Times reports. 

Thus, Joke De Keyrel, who won bronze in the adult category, arrived determined to “make seagulls sexy again.” She leapt to the misunderstood species’ defense: "Stop calling them the rats of the coast or the sky. Every time I get to the sea, I associate their cries with happiness, tranquility, peace, in short, a blissful feeling." QUICK HITS ‘Guantanamo on an epic scale’: Life inside ISIS detention camps in Syria – The World

Why the fight against malaria is having a ‘Red Queen’ moment – The Telegraph

The Lasting Impact of Exposure to Gun Violence – Undark

WHO reports widespread overuse of antibiotics in patients hospitalized with COVID-19 – WHO

Safe sex negotiation and HIV risk reduction among women – PLOS Global Public Health

Coke, Pepsi, or organic blueberry? Eye-catching "better-for-you" sodas reignite the cola wars – Axios Issue No. 2525
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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Antibiotics saw “extensive overuse” globally among hospitalised COVID-19 patients during the pandemic without improving clinical outcomes, while also potentially increasing the already serious and growing threat of antimicrobial resistance from "superbugs", the UN World Health Organization (WHO) said on Friday.

96 Global Health NOW: Worrying Trends in Adolescent Substance Use; Docs to Women: Pain No Longer a Four-Letter Word; and Unlikely Bike Lane Paves the Way View this email in your browser April 25, 2024 Forward Share Post Two girls have their photograph taken while drinking outside in Manchester, England, on April 16, 2021. Charlotte Tattersall/Getty Worrying Trends in Adolescent Substance Use  
57% of 15-year-olds across Europe, Central Asia, and Canada have tried alcohol at least once by age 15, according to a wide-ranging WHO adolescent substance use report released today.
 
Takeaways:

• 20% of 15-year-olds surveyed said they had been drunk at least twice in their lives.


• 20% of 15-year-olds said they had used e-cigarettes in the last 30 days.


• Cannabis use trended slightly downward: 12% of 15-year-olds reported in 2022 having used the substance, falling from 14% in 2018.

The highest rate of child alcohol abuse worldwide? That would be in Great Britain, where more than half of children under 13 have drunk alcohol, The Guardian reports.

• Roughly a third of boys and girls there had tried alcohol by age 11.

Risk to young brains: “Considering that the brain continues to develop well into a person’s mid-20s, adolescents need to be protected from the effects of toxic and dangerous products,” said Hans Kluge, the WHO regional director for Europe. “Unfortunately, children today are constantly exposed to targeted online marketing of harmful products, while popular culture, like video games, normalises them.” GLOBAL HEALTH VOICES The Latest One-Liners
The Republic of the Congo has declared an epidemic of mpox after 19 cases were confirmed across five areas, including the capital Brazzaville, per a health ministry statement Tuesday; no deaths have yet been recorded. Reuters
 
Advocacy groups filed a petition with the UN human rights committee this month over Honduras’s total abortion ban, on behalf of a Honduran woman who underwent a forced pregnancy after being raped and denied an abortion. The Guardian
 
Médecins Sans Frontières shared the cost of its landmark clinical trial for a four-drug combo treatment for drug-resistant tuberculosis—€34 million—challenging the prevailing Big Pharma narrative that high prices are needed to recover high research and development costs. MSF (news release)
 
The heart failure mortality rate for people under 45 spiked 906% between 1999 and 2021, much more than for older people, according to a new study in JAMA Cardiology—reversing a decline in deaths that means more Americans are dying of the condition today than 25 years ago. STAT Avian Flu News Dairy cattle must be tested for bird flu before moving between states, agriculture officials say – AP

Can we make enough H5N1 bird flu vaccine if there's a pandemic? – STAT

How Bird Flu Is Shaping People’s Lives – The Atlantic

This May Be Our Last Chance to Halt Bird Flu in Humans and We Are Blowing It – The New York Times (commentary; gift article)

The dairy industry really, really doesn’t want you to say “bird flu in cows” – Vox PAIN Docs to Women: Pain No Longer a Four-Letter Word
Women describing their pain to a health care provider are often dismissed, called “dramatic,” or flat out ignored. It’s worse for women of color.
 
But efforts to correct this major blind spot are mounting:

• Earlier this month, the American Society of Anesthesiologists offered new guidance on C-section pain management; a recent study found 15% experience pain during the procedure.


• A move away from the 10-point pain measurement scale—which doesn't capture the complexity of pain—to involving patients more in decision making.


• Adopting more concise vocabulary when addressing symptoms; abandoning vague terms like “pressure.” 

The shift is fueled in part by the testimonies of women themselves, like the women in a study featured in The Washington Post who shared videos of their excruciatingly painful IUD insertions on TikTok.
 
Axios GLOBAL HEALTH VOICES ROAD SAFETY Unlikely Bike Lane Paves the Way
A decade-in-the-making, two-mile cycling lane has opened in Edinburgh, Scotland—despite geographical and logistical challenges. 

It’s a small but symbolic step toward the city’s 2030 deadline for net-zero emissions.

The wheels are turning: Edinburgh recently launched its Future Streets transit plan to improve air quality, street safety, and residents’ well-being.

• Overall, residents support the change: 22% cycle at least once a week; 66% walk as often. Nearly half of residents want to do so more often.

The takeaway: If Edinburgh can install bike lanes on hilly and narrow historic streets, other cities can do it too.

Bloomberg OPPORTUNITY QUICK HITS Accelerating the fight against malaria for a more equitable Climate change is bringing malaria to new areas. In Africa, it never left – AP

France warns of surge in imported dengue cases ahead of Olympics – Euronews

Teen vaccination cut COVID-19 cases by 37% in California, new data show – CIDRAP

Fauci agrees to testify in Congress on covid origins, pandemic policies – The Washington Post

Can AI make Northeast Ohio schools safer from gun violence? – Ideastream Public Media

Relationship skills can reduce the risk of HIV in young male couples – Aidsmap

Decolonising global health research: Shifting power for transformative change – PLOS (commentary)

NIH boosts pay for postdocs and graduate students – Science

How do you get siblings to be nice to each other? Latino families have an answer  – NPR Goats and Soda Issue No. 2524
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, Jackie Powder, Aliza Rosen, and Rin Swann. Write us: dkerecm1@jhu.edu, like us on Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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A top Human Rights Council-appointed expert has welcomed the decision by all health authorities in the United Kingdom to halt the routine use of puberty-blockers offered to children as part of gender transition services, amid a sharp increase more widely in the number of teenage girls seeking such treatment and concerns that it might disrupt brain development.

Smoking and drinking is on the rise among teenagers in Europe, Central Asia and Canada, and girls now match or even exceed boys when it comes to substance use, the World Health Organization (WHO) said in a new report on Thursday.

96 Global Health NOW: Bird Flu: Assessing Milk Safety; The Pandemic Trail ‘Gone Cold’; and Criminalizing Camping? H5N1 virus particles have been detected in the pasteurized U.S. commercial milk supply. View this email in your browser April 24, 2024 Forward Share Post A customer reaches for a gallon of milk at a Stewart's Shops on January 2, 2015, in Latham, NY. Lori Van Buren/Albany Times Union via Getty Assessing Milk Safety 
Particles of H5N1 virus have been detected in the pasteurized U.S. commercial milk supply amid the nation’s ongoing outbreak, new testing shows—but FDA officials say the milk is still safe, reports STAT. 

What testing does—and doesn’t—show: The PCR testing cannot distinguish between fragments of live virus and virus killed by pasteurization.

• The FDA said it is testing milk from infected animals, milk being processed, and milk from store shelves. 

• But the agency did not specify how many samples were taken or what percentage tested positive for the virus. 

Research gaps: There have been no published studies about the effectiveness of pasteurization on H5N1 in milk, though scientists believe the process is effective based on research of similar viruses.

Of greater concern: Test results indicate the outbreak is “more widespread in dairy herds than we thought,” a health official told The Washington Post. 

Zoom out: As of Monday, 33 H5N1 outbreaks in herds have been confirmed. While this strain of avian flu has circulated for 20+ years, its leap into cows is of “substantial concern.” 

Related: Scientists find clues in early analysis of newly shared US H5N1 avian flu sequences – CIDRAP GLOBAL HEALTH VOICES The Latest One-Liners
The EU is investigating China's medical device market in an effort to determine whether European suppliers of such devices have been denied fair access in China. Reuters

New antibiotics are underprescribed, with U.S. clinicians opting instead for older, less effective generic antibiotics, per a new study published in the Annals of Internal Medicine. CIDRAP

Chimps are resorting to eating bat guano amid deforestation in Uganda, leading scientists to fear that chimps could be infected with deadly viruses—and transmit them to humans. Science

The U.K.’s proposed asylum law that seeks to deport migrants to Rwanda could have “harmful impacts” on asylum seekers and on refugee protection worldwide, UN human rights leaders have warned. U.N. (news release)  COVID-19: ORIGINS The Pandemic Trail ‘Gone Cold’
Answers about COVID-19’s origins remain elusive—but new questions continue to surface. 

In a detailed investigation, the AP revisits the earliest days of COVID-19’s emergence in Wuhan and explores ways the Chinese government clamped down or redirected global inquiry much earlier than previously known—with some market inspections conducted as early as December 25, 2019. 

In short: “Crucial initial efforts” to trace the outbreak’s source were thwarted by “toxic” political infighting between Wuhan officials, central Chinese officials, Chinese scientists, and the WHO, newly reviewed emails and documents show. 

The Quote: “It’s disturbing how quickly the search for the origins of (COVID-19) escalated into politics. Now this question may never be definitively answered,” said Mark Woolhouse, an epidemiologist at the University of Edinburgh. 

AP GLOBAL HEALTH VOICES HOMELESSNESS Criminalizing Camping?
The U.S. Supreme Court heard arguments yesterday in Grants Pass v. Johnson, a case that could have sweeping implications for how U.S. cities handle homelessness, explains the Christian Science Monitor.

Background: In 2013, the city of Grants Pass, Oregon, enacted an ordinance that criminalized camping on public property. 

• In 2018, a group of homeless individuals sued, arguing that because the city had inadequate shelters, the ordinance violated the Eighth Amendment’s prohibition on “cruel and unusual punishment.”

• A federal court agreed, meaning that while U.S. cities can regulate camping in public spaces, they can’t criminalize it.

That means: Officials from cities across the U.S. say the ruling has made addressing homelessness and public safety increasingly difficult. 

What’s at stake: The case could be “the most consequential case in decades” concerning homelessness and whether sleeping on public property can be penalized, reports Vox. 

What’s next: A majority of justices appeared sympathetic to city officials, reports The New York Times. A decision is expected by the end of June. 

Related: The Supreme Court doesn’t seem eager to get involved with homelessness policy – Vox QUICK HITS UN expert warns of mental health risks for Gaza citizens from war – Reuters

Survey: Already-isolated older adults fared better than socially connected peers early in COVID pandemic – CIDRAP

Survey unveils India's rising tide of metabolic diseases – News Medical

U.K. visa changes imperil recruitment of scientific talent, policy experts warn – Science

Study sheds new light on cross-species virus spillovers that can cause pandemics – Phys.org

3.6 million Medicare enrollees may now be eligible for Wegovy coverage – CNN

Joel Breman, Who Helped Stop an Ebola Outbreak in Africa, Dies at 87 – The New York Times

Garden gnomes and porch swings: Lively front yards linked to more connected residents – NPR Shots Issue No. 2523
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, and Jackie Powder. Write us: dkerecm1@jhu.edu, like us on Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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Two UN agencies alongside the Bill and Melinda Gates Foundation and the global vaccine alliance Gavi launched on Wednesday a campaign to scale up programmes to save lives, marking the start of World Immunisation Week, celebrated annually during the last week of April.

Dangerous levels of acute hunger affected a staggering 281.6 million people last year – the fifth year in a row that food insecurity has worsened – heightening growing fears of famine and “widespread death” from Gaza to Sudan and beyond, UN agencies warned on Wednesday.

96 Global Health NOW: New Rule Strengthens U.S. Abortion Privacy Protections; Inside a South African Soup Kitchen; & #1 in Pandemic Potential: Influenza View this email in your browser April 23, 2024 Forward Share Post Demonstrators protest outside the U.S. Supreme Court, on March 26. Michael Nigro/Pacific Press/LightRocket via Getty New Rule Strengthens U.S. Abortion Privacy Protections
The Biden administration rolled out a final rule banning the release of reproductive health information in an effort to bolster privacy protections for women seeking abortions.
 
Why is this important?

• The administration is seeking to protect women living in states where abortion is illegal who travel to get a legal abortion in another state, per Reuters.


• ~92,000 women traveled out of state to get an abortion in the first six months of 2023, according to the Guttmacher Institute.


• Alabama, Texas, and other states have criminalized helping or paying for such travel.

Protection: Biden said a person’s medical records shouldn’t be “used against them, their doctor, or their loved one just because they sought or received lawful reproductive health care.”
 
Meanwhile at the Supreme Court: The Biden administration will argue tomorrow that it has the right to penalize hospitals that don’t provide abortions in emergency situations, The Washington Post reports.

• The administration says a four-decade-old emergency-care law gives it the authority to enforce rights to emergency abortions in states that have banned the procedure after the Supreme Court overturned Roe v. Wade in June 2022.


• Opponents argue that the law the administration is relying on doesn’t mention abortion.

GLOBAL HEALTH VOICES The Latest One-Liners  
Alcohol deaths in the U.K. increased by 33% to 10,048 in 2022, up from 7,565 in 2019; research shows that people already consuming a lot of alcohol were most likely to have increased their drinking during the pandemic. The Guardian

A new oral medication to treat visceral leishmaniasis, developed by Drugs for Neglected Diseases initiative (DNDi) and its partners, has moved into a Phase II clinical trial in Ethiopia; the current treatment includes 17 painful daily shots at a hospital. The National Tribune

Taking race out of a metric that determines placement on the U.S. kidney transplant waitlist has meant that some Black people will get transplants sooner; the previous version of the “eGFR” calculation included a race-based score that assumed “Black patients had differences in kidney function compared with other groups.” ABC

The new HeatRisk warning system developed by the CDC and the National Oceanic and Atmospheric Administration will be used to provide warnings a week in advance of dangerous heat in the U.S.; the National Weather Service will launch the color-coded scale from zero (green) to five (magenta). NPR GHN EXCLUSIVE Children from Alexandra township, South Africa line up to collect their meals from the Foundation for Special Needs Children & Youth Development soup kitchen. Marcia Zali A South African Soup Kitchen Brings Relief to Caregivers
  ALEXANDRA, South Africa—In a white shipping container that has been converted into a kitchen, Vusi Msomi, a retired nurse, provides meals for children in need.
  Initially, he started a project for children with special needs, but upon realizing that other children from the community would also line up for meals, he expanded—providing meals at least 2X a week to children ages 2 and older and bringing relief to struggling parents and caregivers.
 
While this helps, it’s not enough to address community hunger—which worsened after the pandemic started.

• Up to 19% of children in the country went hungry during the pandemic’s first wave.


• Now, over half of South Africa’s ~20 million children under age 18 receive the Child Support Grant (CSG), a government relief program.

The CSG isn’t enough to lift a family above the food poverty line—resulting in high rates of child malnutrition and causing caregivers to struggle emotionally as a result.
 
“I don’t usually eat supper because I have to save the food for my daughter,” said one mother.
 
What could help: NGOs are calling on the government to increase the CSG, and to introduce a maternity support grant as well.
 
Marcia Zali for Global Health NOW
 
Ed. Note: The research for this article was supported by the Early Childhood Global Reporting fellowship from the Dart Center for Journalism and Trauma, a project of Columbia University. READ THE FULL STORY GLOBAL HEALTH VOICES INFECTIOUS DISEASES Number One in Pandemic Potential: Influenza
An influenza virus will cause the next deadly pandemic, if 57% of senior disease experts polled in a soon-to-be-published international survey are right.
 
Why influenza?

• “Constantly evolving and mutating” flu viruses are more or less controlled for now, but “that will not necessarily be the case for ever,” says study lead Cologne University’s Jon Salmanton-García.

Other top concerns, rated by the 187 experts:

• 21% of the scientists cited a still-unknown virus dubbed Disease X as the most likely cause of the next pandemic.

• SARS-CoV-2 still tops the list of concerns for 15%.

• Just 1–2% rated Lassa, Nipah, Ebola, and Zika viruses as serious global threats.

Wait for it: Complete survey results will be revealed next weekend at the European Society of Clinical Microbiology and Infectious Diseases congress in Barcelona.    
 
The Guardian QUICK HITS Dengue surges in war-torn Sudan as healthcare system nears collapse – The Telegraph

At Spring Meetings, alarm bells sound over global health finance – Devex

Infected blood scandal: Children were used as 'guinea pigs' in clinical trials – BBC

‘Where can you hide from pollution?’: cancer rises 30% in Beirut as diesel generators poison city – The Guardian

Amid Water Crisis, Mexico City’s Metro System Is Sinking Unevenly – Undark

Epistemic disobedience–Undoing coloniality in global health research – PLOS Global Public Health (commentary)

Rural jails turn to community health workers to help the newly released succeed – KFF Health News

Why is TB called the ‘disease of paper’ in Eastern Cape villages? – Bhekisisa

Children of Flint water crisis make change as young environmental and health activists – Los Angeles Times Issue No. 2522
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, and Jackie Powder. Write us: dkerecm1@jhu.edu, like us on Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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96 Global Health NOW: Earth Day Edition: Baking Europe; Arsenic in U.S. Water; and China’s Sinking Cities Heat-related deaths in Europe have increased about 30% in 20 years. View this email in your browser April 22, 2024 Forward Share Post A large wildfire at the border of Miren, Slovenia and Rupa, Italy on July 20, 2022. Luka Dakskobler/SOPA Images/LightRocket via Getty Heat-Stressed Europe’s ‘New Normal’
Record-breaking temperatures led to “extreme heat stress” across Europe last year, the World Meteorological Organization reported today.

• Greenhouse gas emissions fueled heat waves, wildfires, and flooding that countries must accept as “a new normal,” per UN News. 


• 2023 was confirmed as the warmest or second-warmest year on record for the continent, depending on the dataset. 

What this looked like:

• Land temperatures in Europe were above average for 11 months of 2023.

• The continent endured an “extended summer” from June to September—leading to wildfires in Greece, floods in Slovenia, and a 10% loss of Alpine glaciers’ volume. 

The bigger picture: The findings are significant because Europe is the fastest-warming continent, reports Reuters.

• Heat-related deaths on the continent have gone up ~30% in the past 20 years. 

The Quote: "Some of the events of 2023 took the scientific community by surprise because of their intensity, their speed of onset, extent and duration," said Carlo Buontempo, director of the EU’s Copernicus climate monitoring service. GLOBAL HEALTH VOICES The Latest One-Liners   The U.S. Department of Agriculture released genetic sequences late last night of the H5N1 bird flu virus behind multiple outbreaks among dairy cows; the agency has been criticized for being slow to release the sequence data. STAT
 
At least 435 attacks by Israeli forces have targeted health care in Gaza in the past six months; the average of 73 attacks per month is the highest in any war-torn country since 2018. Save the Children International

Pepsico, maker of Cheetos and Gatorade, has used suppliers that have sourced palm oil from deforested lands claimed by the Shipibo-Konibo people in eastern Peru; palm oil plantations have spurred deforestation in the Amazon since 2012. The Bureau of Investigative Journalism
 
Synthetic opioids responsible for dozens of deaths in the U.K. in the last six months are being openly advertised on social media; a Guardian investigation found nearly 3,000 SoundCloud and 700 X posts hawking nitazenes, “an illegal group of drugs several times more powerful than heroin.” The Guardian ENVIRONMENTAL HEALTH Watered Down Safety
For the last 16 years, drinking water in Sunland Park, New Mexico, has contained levels of arsenic that are up to 5X the legal limit.

• But nothing is being done, leading to growing frustration and fear that the arsenic is contributing to health problems including cancer, heart disease, and diabetes. 

Zoom out: 50 years after the Safe Drinking Water Act set legal limits for toxins in drinking water, communities across the U.S. repeatedly exceed those levels.

• 7,400+ public utilities reported a violation every quarter for the last three years, per EPA data. 

Most impacted: Low-income areas and communities of color like Sunland Park, which is 94% Latino.

• Latinos are exposed to arsenic in their drinking water at higher rates than any other racial or ethnic group, per a 2023 study in Nature. 

The Washington Post (gift article) Thanks for the tip, Chiara Jaffe! GLOBAL HEALTH VOICES CLIMATE CRISIS China’s Sinking Cities   
Nearly half of China’s major cities, including Beijing, are sinking—and one in 10 residents of some coastal cities could be living below sea level within a century, according to a new study in Science.
 
Why it’s happening: Groundwater depletion, the weight of buildings and transport systems, underground mining, and natural factors like the depth of a city’s bedrock. 

• Meanwhile, climate change fuels sea-level rise.

What can be done: Long-term, sustained control of groundwater extraction, Nature reports.
 
Success story: Tokyo slowed its sinking from a rapid 240 mm to 10 mm a year between the 1960s and 2000s, thanks to laws limiting groundwater pumping.
 
Other countries facing similar threats include the Netherlands, the U.S., and Indonesia—which is replacing Jakarta, the world’s most rapidly subsiding capital, with a new capital city, Nusantara.

• By 2040, almost one-fifth of the world’s population is projected to be living on sinking land.

OPPORTUNITY QUICK HITS Why Nations Need to Prepare for Climate-Fueled Dengue – Think Global Health (commentary)

Humans and elephants are struggling to coexist. Both are dying at alarming rates – CNN

Hospital emissions reporting proposal is a "game changer" – Axios

How Western food imports are fuelling obesity in Pacific nations – The Telegraph

He thinks his wife died in an understaffed hospital. Now he’s trying to change the industry – KFF Health News

Scotland pauses prescriptions of puberty blockers for transgender minors – NBC 

Former CDC Director Rochelle Walensky speaks on career and critical juncture in public health – Student Life (Washington University in St. Louis)

Lasers, Inflatable Dancers and the Fight to Fend Off Avian Flu – The New York Times (gift article) Issue No. 2521
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

Contributors include Brian W. Simpson, MPH, Dayna Kerecman Myers, Annalies Winny, Morgan Coulson, Kate Belz, Melissa Hartman, and Jackie Powder. Write us: dkerecm1@jhu.edu, like us on Facebook and follow us on Instagram @globalhealth.now and X @GHN_News.

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Climate change shocks caused record levels of disruption and misery for millions in Europe in 2023 with widespread flooding and severe heatwaves – a new normal which countries must adapt to as a priority, the UN weather agency said on Monday.