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96 Global Health NOW: Health Worker Exodus Exacerbates Inequality; On the Agenda for COSP17; and Eye-Related Syphilis on the Rise June 11, 2024 Health Worker Exodus Exacerbates Inequality
Low pay is driving more health care workers to leave sub-Saharan Africa for wealthier countries鈥攚orsening already dire staffing shortages and hampering basic efforts to fight infectious diseases and improve health outcomes like infant mortality. 

• 75% of African nations still face medical staff shortages and high rates of health workers leaving to work abroad, per a 2023 report from the WHO, which updated its last year. 

One pipeline: Cameroon to Canada. About a third of last year's medical graduates from Cameroon have already left the country for higher-paying jobs in North America and Europe. 

• On average, nurses in Cameroon earn less than $100 a month.


• Cameroon has one of the lowest ratios of health workers per capita鈥攚ith the country hiring only 100 doctors annually for 28 million people, and fewer than seven nurses per 10,000 people. 

The Quote: 鈥淲e want to work in Cameroon but there is no pay, so we have to look for other options,鈥� said nurse Nevielle Leinyuy, who migrated from Cameroon to Canada. 



Related: Africa Must Stop Putting Healthcare Abroad Over Its Own Peoples' Needs 鈥� GLOBAL HEALTH VOICES The Latest One-Liners   The Alzheimer鈥檚 drug donanemab has received strong support from a U.S. FDA advisory committee, which voted 11-0 to recommend that donanemab is effective at slowing down the early stages of Alzheimer鈥檚 and that its benefits outweigh risks.

Forecasts for dengue show that the mosquito-borne viral infection will affect nearly all of Brazil and Mexico by 2039, per a new in Nature Communications鈥攑osing 鈥渦nprecedented public health challenges.鈥�

A new endometriosis biorepository launching in Connecticut marks the first government-mandated spending on endometriosis research in the country鈥攁 鈥済roundbreaking鈥� initiative to better understand the condition.

The illegal e-cigarette market is getting renewed focus from U.S. officials, with the Justice Department partnering with the FDA to create a new task force to target black market sales of unauthorized products. DISABILITIES On the Agenda for COSP17
Today marks the start of the 17th Conference of State Parties to the Convention on the Rights of Persons with Disabilities, or COSP17鈥攃onvening hundreds of people with disabilities, NGOs, and other advocates at UN headquarters in New York to promote disability rights. 

Three roundtable discussions are slated for the week:

Leveraging AI and other tech: AI and other areas of digital innovation are shifting paradigms for inclusivity鈥攚ith new tools that can assist in communication and others that can quickly identify and help remedy accessibility gaps. 

Making job markets more inclusive: Representatives will present a range of for making various jobs more accessible.

Innovations in emergency response: The conference will also spotlight in conflict- or climate-related emergency responses focused on people with disabilities. 



Related: Convention on the Rights of Persons with Disabilities: 5 fast facts 鈥� GLOBAL HEALTH VOICES SEXUALLY TRANSMITTED INFECTIONS Eye-Related Syphilis on the Rise
With syphilis cases in the U.S. at alarming numbers, health officials are concerned about recent cases of ocular syphilis, which if left untreated, can  progress to blindness. 

Severe eye symptoms have appeared in patients who reported no other initial symptoms:

• Last year, doctors reported 17 new cases of eye syphilis to the Chicago Department of Public Health. 

• In Michigan, five women were diagnosed in 2022 with ocular syphilis back to the same male partner. 

The 鈥榮implest explanation鈥�: In the U.S., syphilis cases are increasing across the board, with 200,000+ Americans infected in 2022.

• Experts fear that the rise in ocular cases means that the disease has been allowed to spread so widely that 鈥渨hat used to be considered a fringe event might not be so rare anymore.鈥� 

OPPORTUNITY QUICK HITS 鈥楳y whole skull was throbbing鈥�: How it feels to survive bird flu 鈥�

With 100M birds dead, poultry industry could serve as example as dairy farmers confront bird flu 鈥�

It's Not Even Dengue Season Yet and Cases in Puerto Vallarta Are Already Smashing Records 鈥�

Wildfire smoke prematurely killed over 50,000 Californians in a decade 鈥� study 鈥�

Olympic athletes turn to diabetes tech in pursuit of medals 鈥�

ECDC report highlights rising drug-resistance in gonorrhea 鈥�

In Baltimore, nurses go door-to-door to bring primary care to the whole neighborhood 鈥�

US Expands Bilateral Pandemic Preparedness Measures And Establishes Global Health Security Coordinator Post 鈥�

This diet will likely keep you alive longer 鈥� and help the planet 鈥� Issue No. 2553
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

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

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96 Global Health NOW: 鈥榃orld鈥檚 Largest Humanitarian Crisis鈥� Looms in Sudan; Dispelling Dementia Myths in Nigeria; and Latin America鈥檚 Abortion Backlash June 10, 2024 Newly arrived Sudanese refugees arrive to set up makeshift shelters at twilight close to a relocation camp on April 24, near Adre, Chad. Dan Kitwood/Getty 鈥榃orld鈥檚 Largest Humanitarian Crisis鈥� Looms in Sudan
Fighting in Sudan has reached a 鈥渃ritical tipping point鈥� as battles for control of North Darfur escalate鈥攁nd as famine and genocide loom, . 

From the ground: The paramilitary group Rapid Support Forces has launched a series of assaults to gain control of Al-Fasher鈥攖he capital of North Darfur and a last 鈥渟afe haven鈥� for 2 million civilians.

Attacks on medical facilities: Yesterday, the RSF attacked South Hospital in Al-Fasher, 鈥攐pening fire on medical staff and patients.

• The M茅decins Sans Fronti猫res-supported hospital has endured repeated attacks since May, . 

Ethnic cleansing and violence: If Al-Fasher falls, analysts warn that genocide could threaten millions, .

• A gun and artillery assault by RSF on a village in Sudan鈥檚 main farming region killed ~104 people, 鈥� including ~35 children. 


• Sexual violence has been widespread, with girls and women sold at slave markets in RSF-controlled territories,

Famine looms: As aid falters, 鈥渢ime is running out鈥� for millions of Sudanese people facing famine, .

• Sudan may soon become the 鈥渨orld鈥檚 largest humanitarian crisis,鈥� World Food Programme executive director Cindy McCain warned yesterday, . 

GLOBAL HEALTH VOICES The Latest One-Liners   The U.N. is adding Israel, Hamas, and Islamic Jihad to its List of Countries and Groups That Harm Children in War Zones, citing the killing, maiming, and starvation of minors during the conflict in Gaza; the list, part of an annual report on children and armed conflict, will be shared publicly on June 18.

The Texas bird flu strain that infected a dairy worker in March was found to be lethal to ferrets in U.S. CDC-led experiments that were designed to mimic the disease in humans.

Whooping cough in South Korea has surged, with 1,365 cases logged as of June 1; children ages 9鈥�13 have accounted for ~50% of cases.

Two RSV-related breakthroughs add potential tools to the anti-virus arsenal: in one , researchers found that the monoclonal antibody nirsevimab was 80% effective against hospitalization in French pediatric ICUs, ; meanwhile, the U.S. FDA has approved the first RSV vaccine for use in at-risk adults aged 50+, . DEMENTIA Dispelling Myths in Nigeria
In parts of Nigeria, people suffering from dementia are frequently accused of being possessed by spirits or of witchcraft鈥攁ccusations that can lead to deadly attacks like stonings and beatings.

• The true scale of such attacks is unknown due to underreporting, but the U.N. estimates there were ~ of 鈥渉armful practices鈥� across 60 countries between 2009 and 2019. 

Despite government-led efforts to tamp down on such practices, ignorance about dementia persists throughout Nigeria, leading families to isolate or abandon loved ones with the disease. 

Grassroots groups are now leading the charge in educating the public about dementia, and run support groups for caregivers. 

The Quote: 鈥淚t is ignorance that is the problem,鈥� said Josephine Anenih, founder of the Alzheimer鈥檚 Disease Foundation in Nigeria. 

GLOBAL HEALTH VOICES REPRODUCTIVE HEALTH RIGHTS Latin America鈥檚 Abortion Backlash
Some of the world鈥檚 strictest abortion laws have historically been found across Latin America鈥攚ith 97% of women facing 鈥渟evere limitations鈥� until 2018, per the Guttmacher Institute. 

But even as a 鈥淕reen Wave鈥� of pro-abortion activism and legislation brings women new rights in Mexico, Argentina, and Colombia, a political backlash is leading to tightened restrictions for women in much of the region: 

In Peru, lawmakers have approved a 鈥渇etal personhood鈥� bill, which stipulates that health professionals are obliged to provide special protections for the 鈥渦nborn child.鈥�

In Honduras, lawmakers increased the number of votes needed to repeal its abortion ban.

In Argentina, which legalized abortion in 2020, antiabortion candidate Javier Milei was elected last year. 

QUICK HITS Covid-flu combination vaccine shows positive results in late-stage trial, Moderna says 鈥�

H5N1: international failures and uncomfortable truths 鈥�

Addressing acute watery diarrhoea in Yemen 鈥�

OB/GYNs routinely experience sexual harassment, study suggests 鈥�

Doxycycline shows promise in reducing deaths and seizures from nodding syndrome 鈥�

Overlooked and underfunded: Why the neglected tropical diseases need attention 鈥�

Association between women's empowerment and fertility preferences in Ghana  鈥�  

My embarrassing condition needs a simple operation 鈥� but in Nigeria few can afford it 鈥� 鈥嬧��

Bad math: NIH researchers didn鈥檛 pocket $710 million in royalties during pandemic 鈥�

Why the giant, inflatable IUD that set DC abuzz could visit your town this year 鈥� Issue No. 2552
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

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

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96 Global Health NOW: Simmering Surprises in Avian Flu; Why Global Health Should Prioritize Women鈥檚 Land Ownership; and The Magnet Fishing Attraction June 6, 2024 An employee walks in front of chickens in cages in a farm under quarantine, following a bird flu outbreak in Tepatitlan, Jalisco State, Mexico, on July 4, 2012. Hector Guerrero/AFP via Getty Simmering Surprises in Avian Flu  
H5N2 death in Mexico: WHO confirmed yesterday the first-ever, documented H5N2 avian flu infection in a human, .

• The 59-year-old Mexican man with underlying conditions had shortness of breath, fever, and diarrhea, was hospitalized on April 24, and died that day, .


• Contact tracing hasn鈥檛 identified any cases related to the man.


• Three H5N2 outbreaks among poultry had been reported in Mexico, but officials did not find a connection to the man.

Mice vectors? 11 house mice in New Mexico are the newest mammal to be found infected with H5N1, raising concerns that the pests could transmit the virus to humans, .

• Scientists think the mice, which lived on a farm, may have sipped unpasteurized milk from infected cattle.


• 鈥淗ouse mice living near infected farms can spread H5N1 virus into residential areas, making containment of the outbreak significantly more challenging,鈥� said Rick Bright, a U.S. biomedical expert. 鈥淭his is out of control.鈥�

The Finns are on it: Finland is sourcing avian flu vaccines to protect poultry farmers, veterinarians, scientists, fur farm workers, and others at risk because they work with farmed and wild animals, .

• The government is awaiting 20,000 vaccines and will start the jab campaign as soon as they arrive.

Related:

The Bird Flu Virus Adapted to Sea Mammals. It May Not Be Done Yet. 鈥�

Bird flu reported in Iowa dairy herd, expanding US outbreak in cows 鈥� GLOBAL HEALTH VOICES The Latest One-Liners  
FDA advisers voted yesterday to update the COVID-19 vaccine recipe for the fall, saying it should target the JN.1 variant 鈥渓ineage鈥� or family; the CDC will advise on who should receive updated shots and when.
 
A 10-minute brain scan could help detect dementia before the onset of noticeable symptoms, if findings from a 鈥攚hich predicted cases with ~80% accuracy up to nine years before pre-diagnosis鈥攃an be replicated in a larger cohort.

Two-thirds of Americans see climate change as a threat to human health and most expect to face summer weather extremes as bad as or worse than last year, ; 5% named climate change as the top public health threat鈥攁head of COVID-19 and alcohol, but behind the drug crisis (24%), obesity (18%), and mental health (16%).
 
A study of Nicaraguan children found that previous infection with the Zika virus upped their risk of some types of dengue virus infections; the sequencing findings in a offer clues to inform the development of vaccine campaigns for the flaviviruses. GHN EXCLUSIVE COMMENTARY Women farm workers in Palacode, Tamil Nadu, India, on September 15, 2020. Deepak Kumar/unsplash Why Global Health Should Prioritize Women鈥檚 Land Ownership   Something鈥檚 wrong here: Fewer than one in five landholders in the world are women, .
 
Discriminatory laws and social norms prevent millions of women in LMICs from owning land, creating barriers for women to grow sufficient food for their families or make health-related decisions, writes Anila Jacob in an exclusive commentary for GHN.
  When women own land:

• In , women made household decisions associated with reduced child stunting.


• In , women were more likely to have the final say in decisions related to their own health care.


• In , children were less likely to be ill and more likely to have health insurance. 

shows: When their land rights are secure, women 鈥渁re better able to determine where income for household investments go including for nutrition, health, and education,鈥� said Beth Roberts, who directs the Center for Women鈥檚 Land Rights at the nonprofit .  
Call to action: A growing body of evidence should persuade global health researchers and practitioners to consider women鈥檚 land ownership in the context of their own work and proactively engage with the land-rights sector.
 
GLOBAL HEALTH VOICES AGING For Healthy Aging, Stay Connected
Spending too much time alone can take a toll on both mind and body: The increased risk of mortality from social isolation to smoking 15 cigarettes a day.

鈥攁nd in the U.S., roughly .

According to , socially isolated people ages 65+ face elevated health risks:

• 25% increased risk of cancer-related mortality.


• 50% increased likelihood of developing dementia.


• 32% increased risk of stroke.

Physical decline can make it difficult to engage: Hearing loss, for example, is associated with a 28% greater risk of social isolation over time, per . 
 
Potential interventions:

• Designing more accommodating environments鈥攍ike restaurants with walls that dampen noise.


• Clinicians writing 鈥渟ocial prescriptions,鈥� to match patients with group activities or coordinate opportunities for interaction with others.

THURSDAY DIVERSION The Attraction of Magnet Fishing  
If you鈥檝e never been magnet fishing, you may wonder, 鈥淚s it worth the effort?鈥� If you鈥檙e James Kane, you may respond, 鈥淵ou don鈥檛 know what you鈥檙e missing.鈥�
 
For example: Last week in Queens, Kane鈥檚 powerful magnet attracted a slimy safe full of 鈥渨aterlogged, gunk-covered Benjamins,鈥� .
 
鈥淥h, that鈥檚 money,鈥� he declared. Possibly as much as $100,000鈥攁nd he gets to keep it.
 
And even when they don鈥檛 make him rich, Kane鈥檚 spoils, (enthusiastically documented in haul videos), are always an adventure鈥攍ike the time he found a grenade, called the cops, and was descended upon by a bomb squad.
 
Worth it? Definitely. QUICK HITS Republicans block bill to protect contraception access as Democrats make election-year push 鈥�

鈥楿nusual鈥� cancers emerged after the pandemic. Doctors ask if covid is to blame. 鈥�

Ukrainian Soldiers Freeze Their Sperm As A Demographic Crisis Looms 鈥�

Federal officials and physician groups express outrage over revelations of recent coercive sterilizations 鈥�

World Health Assembly special edition: A historic loss and a handful of wins 鈥�

France should create an NIH 脿 la fran莽aise to boost biomedical research, report urges 鈥�

Big Milk has taken over American schools 鈥�

New study sheds light on the effects of humor in medical practices 鈥� Issue No. 2551
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

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

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96 Global Health NOW: MDMA Fails to Pass Muster; Fentanyl Harm Reduction Faces a Backlash; and Young Women Fight for Menstrual Health Education A U.S. FDA panel rejected the psychedelic drug MDMA as a PTSD treatment June 5, 2024 A dose of MDMA in the office of Michael Mithoefer, a psychiatrist who has studied the use of the drug as a PTSD treatment in Mount Pleasant, SC. Aug. 2017. Travis Dove/ Washington Post/Getty Images MDMA Fails to Pass Muster 
A U.S. FDA panel has roundly rejected the psychedelic drug MDMA as a treatment for post-traumatic stress disorder鈥攁 setback for advocates who hope to bring the drug into mainstream mental health treatment, .

Background: The review marked the first time that FDA advisers have considered a Schedule I psychedelic for medical use. 

• If approved, MDMA would have been the first new treatment for PTSD in 20+ years, . 

• In trials, researchers found a 鈥渟ignificant reduction鈥� in the severity of participants鈥� PTSD symptoms after being given the drug, also known as ecstasy or molly. 

Sticking points: The panel of advisers voted 10-1 against the drug鈥檚 treatment benefits versus risks, citing flawed data submitted by the drugmaker, Lykos Pharmaceuticals, that included: 

• Potentially 鈥渋nflated鈥� results due to difficulties in double-blinding.

• Significant risks such as potential for heart problems.

• Allegations of research misconduct.

What鈥檚 next? The FDA is not required to follow the group鈥檚 advice, but it typically does. It is expected to make its final decision by August. 

Bigger picture: MDMA is the first in a series of psychedelics鈥攊ncluding LSD and psilocybin鈥攅xpected to soon come before FDA review. But the overwhelmingly negative panel ruling could derail financial investments in the industry. GLOBAL HEALTH VOICES The Latest One-Liners
To prevent bacterial STIs, the CDC now recommends doxycycline post-exposure prophylaxis (doxy PEP) for men who have sex with men and transgender women who have had at least one bacterial STI, per issued by the agency.

Excess COVID-19 death rates persisted in 47 Western countries for three consecutive pandemic years, per a new published in BMJ Public Health.  

Internet addiction alters brain chemistry in young people, potentially leading to more addictive behaviors, finds a of brain imaging studies published in PLOS Mental Health.  

61% of U.S. adults will have cardiovascular disease by 2050, new from the American Heart Association projects鈥攚ith the increase being driven by the growing number of people with high blood pressure. OPIOID CRISIS Fentanyl Harm Reduction Faces a Backlash
For years in West Virginia, fentanyl users could access supplies to smoke the drug via public health clinics that were using a harm reduction approach based on the belief that smoking the drug resulted in fewer overdoses than injecting it. 

But next month, a new law will ban the distribution of such paraphernalia鈥攑art of 鈥渂roader resistance鈥� to similar harm reduction measures, including: 

• In Oregon: Portland鈥檚 county health department ended a pilot program to hand out smoking supplies last summer amid criticism. 

• In Idaho: Police raided a Boise harm reduction organization on suspicion that it distributed drug paraphernalia.

• In Maryland: The Anne Arundel County health department halted giveaways of smoking supplies in 2021 after Black leaders protested, citing pipes鈥� connection to the crack cocaine epidemic decades ago. 

  GLOBAL HEALTH VOICES REPRODUCTIVE HEALTH Young Women Fight for Menstrual Health Education 
In Cameroon, eight young women have created the National Movement of Adolescent Girls and Young Women to promote female reproductive health options in rural areas and to remove taxes on sanitary pads. 

• The monthly wage in Cameroon is 41,875 CFA franc ($69), and most live below the poverty line ($2.15 per day). 

• A sanitary pad costs 600鈥�800 CFA franc ($0.99鈥�$1.31).

Period poverty: The high cost of menstrual products forces many women and girls to use unsanitary products such as toilet paper鈥攊ncreasing risk of UTIs and other infections. 

AGING Health Care鈥檚 Hidden Workforce: Caregivers
The , and caregivers are becoming an increasingly vital part of the aging discussion.
 
In the U.S. there are already:

• ~26 million unpaid caregivers of older adults.

• ~4.8 million paid direct care workers like home and residential aides.

 
By 2060, 94.7 million Americans鈥攏early a quarter of the U.S. population鈥攚ill be 65+, according to the U.S. Census Bureau. Many will need caregiving.
 
Why it matters: Caregiving can be mentally and physically challenging.

• 55% of family caregivers also work full- or part-time.

• 14.5% of caregivers reported experiencing 14 or more mentally unhealthy days in the past month.

There is hope: In May 2023, President Biden signed an executive order to improve access to care and support for caregivers, including better compensation and benefits, insurance, and mental health care.
 
QUICK HITS Gaza war impact ripples through neighbours' health systems, says WHO 鈥�

Why it's so challenging to develop vaccines for parasitic diseases 鈥�

Highly pathogenic H7 bird flu found on fourth poultry farm in Australia 鈥�

Health care needs more spirituality, experts say 鈥�

Don't just blame rat fleas. Lice may have helped spread 'black death' plague 鈥� Issue No. 2551
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

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

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96 Global Health NOW: Norway Succeeds, U.S. Fails in Preventing Maternal Mortality; A Senior Overdose Crisis; and Vaccine Hesitancy Puts Ugandans at Risk June 4, 2024 Norway Succeeds, U.S. Fails in Preventing Maternal Mortality  
Norway had a maternal mortality ratio of zero in 2022鈥攖he lowest recorded by far among 14 high-income countries鈥攚hile the U.S. remains the most dangerous wealthy country for pregnancy, .

• The U.S.鈥檚 22 maternal deaths for every 100,000 live births doubled and even tripled rates in most other high-income countries in 2022, .


• The maternal mortality ratio was much worse for Black women in the U.S., reaching nearly 50 deaths per 100,000 live births.

U.S. fails in comparison: The report found that half of the high-income nations had fewer than 5 maternal deaths per 100,000 live births.
 
What鈥檚 going wrong in the U.S.? Reasons for its dismal record include 鈥渁 shortage of maternity care providers, limited access to after-birth home visits and lack of guaranteed paid parental leave,鈥� .

• Two-thirds of maternal deaths happen up to 42 days after birth, making clear the need for postpartum care.


• +80% of pregnancy-related deaths in the U.S. are preventable.

Norway鈥檚 mystery: The country鈥檚 success mystified experts who couldn鈥檛 identify any specific maternal health or other policy changes made after 2020.  GLOBAL HEALTH VOICES The Latest One-Liners   An experimental mRNA Moderna/Merck vaccine taken with the therapy pembrolizumab (Keytruda) in a small study of 175 melanoma patients improved survival and showed durable efficacy; ~75% of patients on the combo survived with no signs of relapse at the 2.5-year mark, compared to 56% on pembrolizumab alone.
 
Teenage abortions in Finland fell by 66% between 2000 and 2023, per its public health institute, which attributes the reduction to offers of free contraception to adolescents and compulsory sex education in schools.
 
24% of U.S. adults do not know that claims that the MMR vaccine causes autism are false, a of 1,500 reveals鈥攁mid falling MMR (measles, mumps, rubella) vaccination rates and rising measles cases in the country.
 
Tafenoquine, an antimalarial drug, shows promise as a treatment against the tick-borne infection babesiosis for vulnerable patients who relapse after standard treatment, according to new . DATA POINT OPIOID CRISIS A Senior Overdose Crisis
Amid Baltimore鈥檚 ongoing overdose crisis, one group has suffered the brunt of the epidemic: Black men in their mid-50s to early-70s. 

In a must-read analysis, The New York Times and The Baltimore Banner shine a light on the troubling trend among Black men born from 1951 to 1970:

• Though this group makes up 7% of the city鈥檚 population, it accounts for ~30% of drug fatalities鈥攁 death rate 20X that of the rest of the U.S.

• The deaths among this population 鈥渉ave elevated Baltimore鈥檚 fatal overdose rate far above other cities,鈥� the analysis finds.

Tragic trajectory: The men in this group have had 鈥渢heir lives shaped by forces that have animated the city鈥檚 drug crisis for decades鈥濃�攚ith 4,000+ lives lost among this generation since 1993 to various drug epidemics. 

GLOBAL HEALTH VOICES VACCINES Vaccine Hesitancy Leaves Ugandans at Risk for Yellow Fever 
In April, Uganda began a second mass vaccination effort for yellow fever, but vaccine hesitancy has left 鈥渉undreds of unused doses鈥� in hospitals across the country. 

Yellow fever鈥檚 impact in Africa:

• 90% of reported cases occur in the continent. 


• 84,000鈥�170,000 severe annual cases, with up to half resulting in death.


• 27 African countries are categorized as high-risk.

Immunization reticence: Yellow fever鈥攁 mosquito-borne illness鈥攈as no specific treatment, but the vaccine can offer lifetime protection. 

Yet Uganda鈥檚 goal to vaccinate 27 million people during its 2023 and 2024 campaigns only resulted in 12 million people getting the shot.

HIV/AIDS Reimagining Meningitis Care
A simple intervention model could prevent ~100,000 meningitis deaths across Africa if adopted, a new research trial shows. 

Background: Meningitis remains a major threat to people already suffering from HIV/AIDS, and leads to ~200,000 deaths a year. 

But simple shifts in clinical practice cut meningitis mortality rates from 50% to 24% over five years, a trial conducted in Malawi, Tanzania, and Cameroon found. 

Key interventions:

• Updating basic clinical testing in public hospitals. 

• A training and mentorship program to give staff the tools to recognize meningitis.

The Quote: 鈥淲hat we鈥檙e showing is a huge reduction in mortality using existing diagnostic tests and medicines,鈥� said Angela Loyse, who designed the project. 

QUICK HITS Fauci pushes back partisan attacks in fiery House hearing over COVID origins and controversies 鈥�

Hope for global pandemic treaty rises 鈥� despite missed deadline 鈥�

Despite the spread of bird flu, lawmakers in some states are pushing to legalize raw milk 鈥�

鈥楽o Much Death鈥�: Lawmakers Weigh Stricter Speed Limits, Safer Roads for Pedestrians 鈥�

Tattoos May Be Risk Factors for Malignant Lymphoma 鈥� Thanks for the tip, Cecilia Meisner!

Software that detects 鈥榯ortured acronyms鈥� in research papers could help root out misconduct 鈥� Issue No. 2550
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

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

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96 Global Health NOW: A Silent Killer in Coastal Bangladesh and May鈥檚 Must-Reads 鈥淭hat water destroys us. That water is our salvation.鈥� June 3, 2024 Teenager Hasina Begum and her neighbors risk skin infections by fishing for hours every day in the salty Kholpetua River in southwestern Bangladesh. Rafiqul Islam Montu Silent Killer: Saltwater Threatens Women鈥檚 Health in Coastal Bangladesh  
SHYAMNAGAR, Bangladesh鈥� 鈥淭hat water destroys us. That water is our salvation,鈥� says Jamena Begum, who lives in Burigoalini village and catches baby shrimp with a blue net in the Kholpetua River.
 
Like other women across coastal Bangladesh, she stands in the salty water for nine to 10 hours per day. They catch shrimp to survive, but increasing salinity in the water caused by rising sea levels threatens their health, writes journalist Rafiqul Montu.

• An estimated 20 million people in coastal Bangladesh are affected by increased salinity in drinking water, .


• Women in the region are at special risk of skin infections and reproductive disorders because they stand for long days in the saltwater.


• Salinity in rivers has increased up to 200 kilometers (124 miles) inland. 

The Quote: 鈥淚t is no longer a secret that global warming and climate change are causing oceans to warm and sea levels to rise,鈥� says Atiq Rahman, executive director of the Bangladesh Center for Advanced Studies. 鈥淎s a direct consequence of rising sea levels and inundation of coastal villages, water sources and soil salinity in Bangladesh鈥檚 coastal areas have increased alarmingly.鈥�
 

 
Ed. Note: This article is part of , made possible through the generous support of loyal GHN readers. GLOBAL HEALTH VOICES The Latest One-Liners   A third case of H5N1 avian flu has been diagnosed in a U.S. dairy worker; it is the first case recorded that鈥檚 included respiratory symptoms鈥攁 development that suggests the virus could transmit more easily among people.

Gunmen fatally shot a police officer protecting polio workers in Pakistan鈥檚 northwest Wargari area today; it was the 11th murder of a police officer on security duty for a vaccination campaign so far this year.

Heart failure patients with a minority ethnic background are 36% 鈥渕ore likely to die鈥� than their white counterparts in the U.K., according to University of Birmingham that examined data from 16,700+ people from 12 existing clinical trials.

A blood cancer drug from GSK nearly halved the risk of disease progression or death, compared to standard-of-care treatments for multiple myeloma, according to new data from a late stage trial presented yesterday at the American Society of Clinical Oncology. MAY RECAP: MUST-READS Sterilizing Sickle Cell Patients?
Women with sickle cell disease who say doctors pressured them to have their fallopian tubes tied or undergo other forms of sterilization are raising alarm among advocacy groups.

In an investigation, STAT鈥檚 Eric Boodman found that of 50 women interviewed, seven reported 鈥渂eing sterilized with questionable consent.鈥� 

And: Advocates worry the distressing pattern could be more widespread. 


  Erasing Scabies
About 20% of people in the Solomon Islands live with scabies鈥攐ne of the world鈥檚 highest rates of the parasitic condition. Children are disproportionately affected.

But: There is growing hope that the disease could be eliminated through a new program to deliver the antiparasitic drug ivermectin to the entire population. The second round of mass doses is currently underway. 


Uganda鈥檚 LGBTQ+ Clinics Face Clampdown
Advocates of LGBTQ+ health in Uganda face a gantlet of social and new legal obstacles as they try to deliver care, including:

• Newly instated prison penalties for consensual same-sex relations and for 鈥減romoting homosexuality.鈥�

Limiting care: The law has forced LGBTQ+ clinics to reduce the scope of their care and advocacy鈥攊ncluding awareness campaigns around sexual health and safety.


South Africa鈥檚 Ambulances Ambushed
Armed thieves are robbing paramedics in Cape Town of medical equipment, drugs, wallets, and cellphones鈥攆orcing medic teams to require a police escort in many neighborhoods. 

Fatal tradeoffs: While paramedics say such escorts have reduced the number of attacks, the policy harms their ability to respond quickly to emergencies鈥攚ith sometimes hours-long delays that result in patients鈥� deterioration or death. 

MAY鈥橲 LOCAL REPORTING INITIATIVE HIGHLIGHTS Amsterdam鈥檚 Struggle to Improve Sex Worker Health
  AMSTERDAM鈥擨n a small clinic retrofitted in one of Amsterdam鈥檚 iconic rowhouses, a government-funded clinic offers free or low-cost testing for sexually transmitted infections and pregnancy, pre-exposure prophylaxis (PrEP), hepatitis A/B vaccinations, and mental health counseling to the region鈥檚 5,000 to 7,000 sex workers.

But the Dutch approach is far from seamless:

• Some sex workers who lack the right work permit can鈥檛 access health care because of immigration and labor policies, logistical hurdles, social stigma, and language issues.

  Getting Kenyan Cult Leaders to Embrace Modern Medicine
LUKHOKHWE, Kenya 鈥� Eliud Wekesa鈥攚ho claims to be Jesus鈥攊s just one of many religious and cult leaders across the region blamed for encouraging followers to shun medicine, undermining health efforts.

• But health officials in Kenya (with police backing, at times) are working to dispel these messages鈥攂y training and involving religious leaders in government health strategies.
   
• Positive step: Wekesa has publicly modeled acceptance of medical care, participating in a mass drug administration campaign to combat bilharzia and intestinal parasitic worms.  

GLOBAL HEALTH VOICES MAY鈥橲 BEST NEWS Kickstarting a Sickle Cell Cure
A 12-year-old U.S. boy is the world鈥檚 first person to begin a commercially approved gene therapy that may cure sickle cell disease.

Overview: The expensive, time-consuming process involves gathering stem cells from the patient鈥檚 bone marrow鈥攖hen introducing a healthy hemoglobin gene to the cells to correct the genetic mutation before returning the cells to the patient.



Other hopeful news from May: 

Amid Haiti鈥檚 escalating chaos, a 鈥榟eroic network鈥� keeps medical research running 鈥�

The Native-Led Forensics Lab Dedicated to Solving Missing and Murdered Indigenous People Cases 鈥�

Inside the Factory Supplying Half of Africa鈥檚 Syringes 鈥� OPPORTUNITY QUICK HITS 'The World Has Won': New Regulations To Protect Against Pandemics Finally Passed 鈥�

Uproar over Women in Global Health leadership changes 鈥�

As COVID precautions vanish, people with disabilities struggle with safety and isolation 鈥�

FDA approves Moderna鈥檚 RSV vaccine for seniors, the company鈥檚 second-ever product 鈥�

Study: Truthful yet misleading Facebook posts drove COVID vaccine reluctance much more than outright lies did 鈥�

A Breakthrough in Preventing Stillbirths 鈥�

Japan鈥檚 push to make all research open access is taking shape 鈥� Issue No. 2549
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

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

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

Want to change how you receive these emails? You can or . -->



 
  Copyright 2024 Johns Hopkins Bloomberg School of Public Health. All Rights Reserved. Views and opinions expressed in Global Health NOW do not necessarily reflect those of the Bloomberg School.


Want to change how you receive these emails?
You can or .

96 Global Health NOW: A Silent Killer in Coastal Bangladesh; and May鈥檚 Must-Reads 鈥淭hat water destroys us. That water is our salvation.鈥� June 3, 2024 Teenager Hasina Begum and her neighbors risk skin infections by fishing for hours every day in the salty Kholpetua River in southwestern Bangladesh. Rafiqul Islam Montu Silent Killer: Saltwater Threatens Women鈥檚 Health in Coastal Bangladesh  
SHYAMNAGAR, Bangladesh鈥� 鈥淭hat water destroys us. That water is our salvation,鈥� says Jamena Begum, who lives in Burigoalini village and catches baby shrimp with a blue net in the Kholpetua River.
 
Like other women across coastal Bangladesh, she stands in the salty water for nine to 10 hours per day. They catch shrimp to survive, but increasing salinity in the water caused by rising sea levels threatens their health, writes journalist Rafiqul Montu.

• An estimated 20 million people in coastal Bangladesh are affected by increased salinity in drinking water, .


• Women in the region are at special risk of skin infections and reproductive disorders because they stand for long days in the saltwater.


• Salinity in rivers has increased up to 200 kilometers (124 miles) inland. 

The Quote: 鈥淚t is no longer a secret that global warming and climate change are causing oceans to warm and sea levels to rise,鈥� says Atiq Rahman, executive director of the Bangladesh Center for Advanced Studies. 鈥淎s a direct consequence of rising sea levels and inundation of coastal villages, water sources and soil salinity in Bangladesh鈥檚 coastal areas have increased alarmingly.鈥�
 

 
Ed. Note: This article is part of , made possible through the generous support of loyal GHN readers. GLOBAL HEALTH VOICES The Latest One-Liners   A third case of H5N1 avian flu has been diagnosed in a U.S. dairy worker; it is the first case recorded that鈥檚 included respiratory symptoms鈥攁 development that suggests the virus could transmit more easily among people.

Gunmen fatally shot a police officer protecting polio workers in Pakistan鈥檚 northwest Wargari area today; it was the 11th murder of a police officer on security duty for a vaccination campaign so far this year.

Heart failure patients with a minority ethnic background are 36% 鈥渕ore likely to die鈥� than their white counterparts in the U.K., according to University of Birmingham that examined data from 16,700+ people from 12 existing clinical trials.

A blood cancer drug from GSK nearly halved the risk of disease progression or death, compared to standard-of-care treatments for multiple myeloma, according to new data from a late stage trial presented yesterday at the American Society of Clinical Oncology. MAY RECAP: MUST-READS Sterilizing Sickle Cell Patients?
Women with sickle cell disease who say doctors pressured them to have their fallopian tubes tied or undergo other forms of sterilization are raising alarm among advocacy groups.

In an investigation, STAT鈥檚 Eric Boodman found that of 50 women interviewed, seven reported 鈥渂eing sterilized with questionable consent.鈥� 

And: Advocates worry the distressing pattern could be more widespread. 


  Erasing Scabies
About 20% of people in the Solomon Islands live with scabies鈥攐ne of the world鈥檚 highest rates of the parasitic condition. Children are disproportionately affected.

But: There is growing hope that the disease could be eliminated through a new program to deliver the antiparasitic drug ivermectin to the entire population. The second round of mass doses is currently underway. 


Uganda鈥檚 LGBTQ+ Clinics Face Clampdown
Advocates of LGBTQ+ health in Uganda face a gantlet of social and new legal obstacles as they try to deliver care, including:

• Newly instated prison penalties for consensual same-sex relations and for 鈥減romoting homosexuality.鈥�

Limiting care: The law has forced LGBTQ+ clinics to reduce the scope of their care and advocacy鈥攊ncluding awareness campaigns around sexual health and safety.


South Africa鈥檚 Ambulances Ambushed
Armed thieves are robbing paramedics in Cape Town of medical equipment, drugs, wallets, and cellphones鈥攆orcing medic teams to require a police escort in many neighborhoods. 

Fatal tradeoffs: While paramedics say such escorts have reduced the number of attacks, the policy harms their ability to respond quickly to emergencies鈥攚ith sometimes hours-long delays that result in patients鈥� deterioration or death. 

MAY鈥橲 LOCAL REPORTING INITIATIVE HIGHLIGHTS Amsterdam鈥檚 Struggle to Improve Sex Worker Health
  AMSTERDAM鈥擨n a small clinic retrofitted in one of Amsterdam鈥檚 iconic rowhouses, a government-funded clinic offers free or low-cost testing for sexually transmitted infections and pregnancy, pre-exposure prophylaxis (PrEP), hepatitis A/B vaccinations, and mental health counseling to the region鈥檚 5,000 to 7,000 sex workers.

But the Dutch approach is far from seamless:

• Some sex workers who lack the right work permit can鈥檛 access health care because of immigration and labor policies, logistical hurdles, social stigma, and language issues.

  Getting Kenyan Cult Leaders to Embrace Modern Medicine
LUKHOKHWE, Kenya 鈥� Eliud Wekesa鈥攚ho claims to be Jesus鈥攊s just one of many religious and cult leaders across the region blamed for encouraging followers to shun medicine, undermining health efforts.

• But health officials in Kenya (with police backing, at times) are working to dispel these messages鈥攂y training and involving religious leaders in government health strategies.
   
• Positive step: Wekesa has publicly modeled acceptance of medical care, participating in a mass drug administration campaign to combat bilharzia and intestinal parasitic worms.  

GLOBAL HEALTH VOICES MAY鈥橲 BEST NEWS Kickstarting a Sickle Cell Cure
A 12-year-old U.S. boy is the world鈥檚 first person to begin a commercially approved gene therapy that may cure sickle cell disease.

Overview: The expensive, time-consuming process involves gathering stem cells from the patient鈥檚 bone marrow鈥攖hen introducing a healthy hemoglobin gene to the cells to correct the genetic mutation before returning the cells to the patient.



Other hopeful news from May: 

Amid Haiti鈥檚 escalating chaos, a 鈥榟eroic network鈥� keeps medical research running 鈥�

The Native-Led Forensics Lab Dedicated to Solving Missing and Murdered Indigenous People Cases 鈥�

Inside the Factory Supplying Half of Africa鈥檚 Syringes 鈥� OPPORTUNITY QUICK HITS 'The World Has Won': New Regulations To Protect Against Pandemics Finally Passed 鈥�

Uproar over Women in Global Health leadership changes 鈥�

As COVID precautions vanish, people with disabilities struggle with safety and isolation 鈥�

FDA approves Moderna鈥檚 RSV vaccine for seniors, the company鈥檚 second-ever product 鈥�

Study: Truthful yet misleading Facebook posts drove COVID vaccine reluctance much more than outright lies did 鈥�

A Breakthrough in Preventing Stillbirths 鈥�

Japan鈥檚 push to make all research open access is taking shape 鈥� Issue No. 2549
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

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

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

Want to change how you receive these emails? You can or . -->



 
  Copyright 2024 Johns Hopkins Bloomberg School of Public Health. All Rights Reserved. Views and opinions expressed in Global Health NOW do not necessarily reflect those of the Bloomberg School.


Want to change how you receive these emails?
You can or .

Countries on Saturday agreed to a set of key actions to better guide and coordinate international efforts in preventing, detecting, and responding to public health risks, while also committing to finalize negotiations on a global pandemic agreement within a year at the latest.

96 Global Health NOW: The Kenyan Factory Producing Self-Reliance; A Forgotten, Yet Life-Threatening Infection; and 鈥楢 National Crime Scene鈥� May 30, 2024 The Kenyan Factory Producing Self-Reliance 
The 300 million syringes produced each year by Revital Healthcare in Kenya are more than medical supplies: They are a measure of Africa鈥檚 growing medical independence. 

In a behind-the-scenes look at the company, the New York Times鈥� Apoorva Mandavilli explores how the factory has become a linchpin in Africa鈥檚 medical manufacturing industry since its founding in 2008. 

One highlight: Revital makes enough syringes to meet more than half of Africa鈥檚 routine immunization needs鈥攁 critical resource when most syringes are produced in Asia.

Next steps: Revital aims to become Africa鈥檚 largest manufacturer of rapid diagnostic test kits for HIV, malaria, hepatitis, dengue, and other diseases. It is also planning to produce health care kits for outbreaks.

EDITOR鈥橲 NOTE Summer Fridays off   Starting this week, we鈥檙e moving to a summer schedule to give the GHN team Fridays off to rest and recharge鈥攕o we won鈥檛 be publishing tomorrow, but we鈥檒l be back on Monday with more news (and your May recap).
 
And, as always, we love hearing from you. Please email me any tips, comments, or concerns.
 
We hope you all have a happy summer鈥攗nless you live in the Southern Hemisphere; for our friends Down Under and south of the equator, we wish you a wondrous winter! 鈥�Dayna GLOBAL HEALTH VOICES The Latest One-Liners   Nicotine alternatives used in vapes鈥攕uch as 6-methyl nicotine鈥攎ay be more addictive than nicotine itself and are not subject to U.S. tobacco and vaping regulations, the FDA and independent researchers warn.  
 
People with autism are 3X likelier to develop Parkinson鈥檚-like symptoms鈥�5.98% compared to a rate of .11%-1.85% in the general population, according to a for 247,539 people in the U.S.; the results have not yet been peer-reviewed.

Cuban officials confirmed Oropouche virus cases in two cities in the southeast this week鈥攂ringing the total number of countries in the Americas with cases to five, along with Brazil, Bolivia, Colombia, and Peru.

NIH-funded clinical trials often miss racial and gender diversity enrollment goals for participants, a sampled by the HHS Office of Inspector General determined. GHN EXCLUSIVE COMMENTARY Tikur Anbessa Specialized Hospital, Addis Ababa University medical campus. October 2023. Julianna Deutscher A Forgotten, Yet Life-Threatening Infection  
As Julianna Deutscher puzzled over the symptoms of a feverish man gasping for air on a stretcher, several potential illnesses came to mind: Pneumonia, tuberculosis, typhoid, meningitis.
 
The ultimate diagnosis? Louse-borne relapsing fever鈥攁n ancient yet neglected infection caused by the Borrelia recurrentis bacteria and spread by body lice, featuring a telltale recurring fever. 
 
鈥淚 traveled to Addis Ababa in 2022 to teach medicine, but this is one of the many times that I became the student,鈥� writes Deutscher, a Canadian emergency physician, who notes that LBRF is a completely preventable, treatable disease that disproportionately affects displaced populations.

• If caught early enough, a single dose of procaine penicillin can wipe out the infection鈥攂ut left untreated, LBRF can be fatal.


• The disease dates back to the age of Hippocrates, but Ethiopia and neighboring countries continue to face outbreaks鈥攁nd in refugees arriving from North Africa, a reminder that LBRF can show up anywhere.

What鈥檚 needed:

• More research and medicine-public health collaboration.


• Public education to reduce the spread of body lice and recognize infections earlier.


• Inclusion of LBRF on the WHO鈥檚 list of Neglected Tropical Diseases.

GLOBAL HEALTH VOICES HUMAN RIGHTS 鈥楢 National Crime Scene鈥�  
A devastating, meticulously reported Washington Post article reveals new details of the extent of the sexual abuse in Catholic-run Native American schools in the U.S.

• 120+ priests, sisters, and brothers who worked at 22 boarding schools dating back to the 1890s were later accused of sexually abusing Native American children,


• Most of the assaults happened in the 1950s and 1960s and 鈥渋nvolved more than 1,000 children.鈥�


• Deborah Parker, chief executive of the National Native American Boarding School Healing Coalition, called the church-run boarding schools 鈥渁 national crime scene.鈥�

History: The U.S. government forced tens of thousands of Native American children to 500+ boarding schools across the country from 1819 to 1969.

• The boarding school system fostered 鈥渞ampant physical, sexual, and emotional abuse鈥� of the children, . 

Future: Advocates are calling on the U.S. Congress to follow Canada鈥檚 lead and create a truth and healing commission.
 
The Quote: 鈥淭he church wounded my spirit, took away my soul and robbed me of my childhood,鈥� said Clarita Vargas, of the Confederated Tribes of the Colville Reservation in Washington. A MINI DIVERSION Counting Crows? Make That Crows Counting QUICK HITS UNICEF reports surge in violence against children in Africa鈥檚 central Sahel 鈥�

Indian capital of Delhi breaks all-time heat record, as authorities impose water rationing 鈥�

Gangs mix another potent sedative into U.S. street drugs causing 'mass overdoses' 鈥�

Children of Vietnam war鈥檚 rape survivors unjustly bear the burden of others鈥� crimes 鈥�

Widespread disrespect, abuse in maternity care leave mothers with lasting trauma 鈥�

Having 2 or more underlying conditions increase the risk of severe COVID-19 almost 10-fold in kids, data show 鈥�  

Africa CDC and CEPI deepen partnership to fortify African preparedness against disease outbreaks 鈥�

Day care, baby supplies, counseling: Inside a school for pregnant and parenting teens 鈥�

What Singapore could teach the world about disease control 鈥� Issue No. 2548
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

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

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

Want to change how you receive these emails? You can or . -->



 
  Copyright 2024 Johns Hopkins Bloomberg School of Public Health. All Rights Reserved. Views and opinions expressed in Global Health NOW do not necessarily reflect those of the Bloomberg School.


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You can or .

96 Global Health NOW: How H5N1 is Shapeshifting; Election Opportunity: Stop Xenophobia; Protecting Preschoolers Against Parasitic Worm May 29, 2024 Suri alpacas are seen at the Reed Family farm in Bethel, Pennsylvania, on September 16, 2019. Susan L. Angstadt/MediaNews Group/Reading Eagle via Getty How H5N1 is Shapeshifting
The most recent human case of H5N1 carries a new mutation, CDC officials have found鈥攈eightening concerns that the virus is quickly evolving, .

The basics: CDC officials reported the 鈥渘otable鈥� mutation in the case of a Michigan dairy worker鈥攖he second human infection linked to U.S. cattle. revealed new markers associated with 鈥渁daptation to mammalian hosts.鈥�

Other avian flu updates:  

Alpacas in Idaho have been infected with 鈥渉ighly pathogenic鈥� H5N1 at a farm where poultry was infected, the . It鈥檚 the first positive finding in alpacas, but 鈥渋sn't unexpected鈥� due to the high amount of virus in the environment, . 

Eyes on eggs: 4 million+ chickens will have to be killed after bird flu was detected at a large Iowa egg farm, .

• Scientists are also worried about bird flu infecting the egg supply devoted to vaccine production, .  

On the vaccine front, an experimental mRNA vaccine against H5N1 is 鈥渉ighly effective鈥� in preventing severe illness and death in lab animals, per . 

Related: China reports fatal H5N6 avian flu case 鈥� GLOBAL HEALTH VOICES The Latest One-Liners   Waterborne leptospirosis has killed four people in Brazil as the zoonotic disease spreads through floodwaters contaminated with infected animals鈥� urine; 50 human cases have been identified, and officials worry more will emerge.

Toxic 鈥渇orever chemical鈥� PFAS have been detected in rivers, lakes, and tap water near garment factories in Bangladesh, shows.

COVID-19 vaccine manufacturers pressured LMICs into accepting high prices and 鈥渦nusually harsh terms鈥� during negotiations around vaccine access, according to South Africa contracts released by public health activists.

Heat waves increase rates of premature and early-term births slightly鈥攁nd the risk grows as extreme temperatures persist, finds a new published in JAMA Network Open that looked at 25 years of birth data. HUMAN RIGHTS WATCH Election Opportunity: Stop Xenophobia
As South Africans head to the polls today for a general election, the nation鈥檚 scientists are calling for the next government to stamp out xenophobia, which they say is rising on university campuses.
 
Continued harmful rhetoric has led to of international researchers鈥攖hreatening vital international collaboration.
 
There are only about 34,000 researchers in South Africa鈥檚 shrinking research community. To remain competitive, the country鈥檚 scientists are working with peers in richer countries, and universities often look abroad to fill posts. One out of 10 researchers in South Africa is from another country.
 
Another concern: The scientists also say they hope the new government will stoke South Africa鈥檚 faltering economy and reverse its declining trend in research funding.

GHN EXCLUSIVE EXPLAINER The World Health Assembly: What It Does, Why It Matters NEGLECTED DISEASES Protecting Preschoolers Against Parasitic Worm
Schistosomiasis鈥攁 disease caused by a parasitic worm that can cause blood in urine鈥攊s so common in parts of Africa that it is thought of as male menstruation: 鈥渁 sign of maturity,鈥� said Zimbabwe physician Isaac Chikwanha. 

While there is a highly effective medication for schistosomiasis called praziquantel, the pills have only been designed for adults and older children鈥攍eaving preschool-age children largely unprotected.

• An estimated lack a reliable treatment option.

That鈥檚 about to change, with a version of praziquantel designed for the preschool population recently approved by the WHO. 

But challenges remain, including the questions of how the medication will be paid for and how it will be delivered when so many children of the target age are not yet in school.

QUICK HITS Global pandemic treaty could be more than a year away after deadline missed 鈥�

At long last, lead poisoning of kids is emerging as a priority on the world scene 鈥�

Wastewater from Tyson meat processing plants is polluting U.S. waterways, report says 鈥�

Warnings grow about unlicensed cosmetic treatment providers 鈥�

How 鈥榢angaroo鈥� care is saving the lives of thousands of babies every year 鈥�

After a deadly heat wave last summer, metro Phoenix is changing tactics 鈥�

How seven women heat chiefs are helping to offset effects of 鈥榞lobal boiling鈥� 鈥�

Striving for More Equitable Birth Control 鈥� Issue No. 2547
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

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

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

Want to change how you receive these emails? You can or . -->



 
  Copyright 2024 Johns Hopkins Bloomberg School of Public Health. All Rights Reserved. Views and opinions expressed in Global Health NOW do not necessarily reflect those of the Bloomberg School.


Want to change how you receive these emails?
You can or .

96 Global Health NOW: New Option for Pandemic Preparedness; Align Agencies = Increase Impact; and Salt Water Spreads in Bangladesh WHA: Pandemic agreement talks yielded frustration but no consensus May 28, 2024 New Option for Pandemic Preparedness  
Two and a half years of negotiations on a pandemic agreement yielded frustration but no consensus by the process鈥檚 deadline, as the World Health Assembly opened yesterday in Geneva.
 
But: WHO Director-General Tedros Adhanom Ghebreyesus remains optimistic that a pandemic accord will eventually be reached, .

• 鈥淚 know that there remains among you a common will to get this done," Tedros said during his opening address at the WHA. 

Timeframe: The agreement could be years away. Health officials are now considering reforms to the negotiating process as well as a five- to 24-month extension.

What鈥檚 happening now? The best hope for action on pandemic preparedness now shifts to changes to the WHO鈥檚 International Health Regulations.

• Options being considered 鈥渨ould urge countries to boost alert, detection and containment capacities and cooperate internationally,鈥� .

• Sticking points for IHR amendments include technology transfer and a new WHO pandemic fund that would increase the organization鈥檚 response in LMICs.

The Quote: 鈥淚f nothing comes out of WHA (the assembly), it鈥檚 a huge missed opportunity,鈥� said Yuanqiong Hu, a senior legal and policy adviser at Doctors Without Borders. 鈥淚f they don鈥檛 come up with a clear road map, how are they going to finish this process?鈥�
 
Related:

Global Leaders Urge Progress on Pandemic Measures Despite Missed Deadline 鈥� 
 
WHO states decide not to invite Taiwan to annual assembly 鈥� GLOBAL HEALTH VOICES The Latest One-Liners   The COVID-19 pandemic erased a decade鈥檚 worth of gains in global life expectancy at birth; from 2019 to 2021, average life expectancy worldwide fell by 1.8 years to 71.4 years,.

Tens of thousands of doses of a new malaria vaccine have been delivered to the Central African Republic, which has one of the highest malaria incidences in the world; the R21/Matrix-M vaccine was recommended by WHO last October.

A new survey of over 6,000 adults found that white Americans are more likely than Black or Hispanic counterparts to have received mental health care in the past three years; Asian and Black adults were more likely to report struggling to find mental health professionals that understood their background and experiences.
 
Chinese researchers have tested a lab-grown virus that mimics Ebola infection in an effort to aid in research into the effects of the deadly virus; the genetically engineered virus killed a group of hamsters and caused eye ulcers. H5N1 News Study confirms infection in mice fed H5N1-contaminated raw milk 鈥�

US, European nations consider vaccinating workers exposed to bird flu 鈥�

Bird flu vaccines for laying hens prove effective in practice 鈥�

Bird flu in U.S. cows caught scientists by surprise. Canadian research has seen it coming since 1953 WHA Align Agencies = Increase Impact
As 2030 grows closer鈥攁nd with just 15% of the 50+ health-related sustainable development goals on track to reach their targets鈥攁 is spotlighting ways global agencies can better align themselves to boost their impact.

Background: In 2019, 13 major health, development, and humanitarian agencies signed onto the to 鈥渟trengthen their collaboration鈥� in achieving the SDGs. 

The 5th progress report of the action plan takes stock of lessons learned and achievements so far鈥攁nd it also seeks to amplify 鈥渃ountries鈥� voices,鈥� including how to improve collaboration between various national health services and development partners, .  KIDNEY DISEASE Salt Water Spreads in Bangladesh
Rising levels of salt infiltrating fresh water sources in Bangladesh have been linked to adverse health effects like hypertension, respiratory problems, and preeclampsia. Now, researchers fear it could be driving increased rates of chronic kidney disease. 

Sources of salinization: Weather events like frequent floods, cyclones, and tidal surges are creating saline intrusion into the country鈥檚 safe water sources, recent shows.

Impacts: A 2017 that looked at the effects of water salinity on kidney health in coastal areas of Bangladesh found that 20% of participants experienced elevated levels of protein in their urine at 鈥渕oderate or substantial鈥� rates. 

The Quote: 鈥淪alt water surrounds us. It鈥檚 in our rivers, in our tubewells and in our drinking cups鈥攖here鈥檚 no escaping it,鈥� said Sayed Ahmed, whose wife has chronic kidney disease. 

GLOBAL HEALTH VOICES QUICK HITS To Incinerate Or Not To Incinerate: Maryland Hospitals Grapple With Question With Big Public Health Implications 鈥�

Africa鈥檚 cholera crisis worsens amid extreme weather events 鈥�

Ex-military surgeons embrace new mission: stop Americans from bleeding to death 鈥�  Thanks for the tip, Chiara Jaffe!

In communities of color, long-covid patients are tired of being sick and neglected 鈥�

Hollywood movies rarely reflect climate change crisis. These researchers want to change that 鈥�

Pregnancy takes 50,000 more calories over 9 months, study shows. That's 164 Snickers bars 鈥� Issue No. 2546
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

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

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UN agencies on Tuesday reiterated their call for an urgent ceasefire and humanitarian access in Gaza following Israeli air strikes on Sunday that hit a camp for displaced Palestinians in Rafah, killing 45 people, according to the Hamas-run Ministry of Health.  

96 Global Health NOW: Big Tobacco鈥檚 Youth-Targeting Tactics; Transporting Livestock鈥攁nd Pathogens; and Iepers Creepers! Young people are being hooked on nicotine by an industry embracing flavors, design, and social media. May 24, 2024 Big Tobacco鈥檚 Youth-Targeting Tactics
The tobacco industry has adopted new tactics to hook young people on nicotine鈥攗sing enticing flavors, eye-popping product designs, and social media marketing, in a . 

Vapes the new gateway: As tobacco regulation tightens, the industry is investing in vapes, heated tobacco products, and nicotine pouches under the auspices of providing a smoking alternative to adults, .

• But the WHO says the new products鈥� technicolor packaging and buzzy marketing campaigns鈥攊ncluding sponsoring music festivals鈥攂etrays a 鈥渂latant attempt鈥� to target youth. 

Details of the report, released ahead of World No Tobacco Day May 31:

• Globally, ~37 million children ages 13鈥�15 use tobacco.


• In many countries, the rate of e-cigarette use among adolescents exceeds that of adults. 


• 20% of 15-year-olds surveyed in the WHO European Region reported using e-cigarettes in the past 30 days.

And: Growing evidence shows that vaping increases traditional cigarette use by ~3X, the WHO says. 

The Quote: "History is repeating itself, but in a different form. The same nicotine with a different packaging," said WHO's Director-General Tedros Adhanom Ghebreyesus. EDITOR'S NOTE No GHN Monday, May 27
The GHN team will be taking the day off on Monday in observance of Memorial Day in the U.S.

We'll be back with more news on Tuesday, May 28. Thanks for reading! 鈥�Dayna GLOBAL HEALTH VOICES The Latest One-Liners
Legislation to classify abortion pills as controlled substances has been approved by lawmakers in Louisiana鈥攕etting the state up to be the first to criminalize possession of misoprostol and mifepristone.

Genetically modified mosquitoes have been released in Djibouti by the tens of thousands in an effort to combat malaria-spreading mosquito species.

HPV vaccines prevent cancer in men as well as in women鈥攂ut fewer boys than girls are getting the shots in the U.S., according to that looked specifically at cases of cancers of the mouth and throat.

Daily marijuana use has eclipsed daily alcohol consumption among Americans for the first time, per a published in the journal Addiction. World Health Assembly News 77th World Health Assembly to address global health challenges under 'All for Health, Health for All' 鈥�

Explainer: How the World Health Organization could fight future pandemics 鈥�

The deadline is nearly here. Will the global pandemic treaty be finished in time? 鈥�

The West should be on a war footing for the next pandemic 鈥� DATA POINT ONE HEALTH Transporting Livestock鈥攁nd Their Pathogens
Avian influenza (H5N1) outbreaks in have put animal agriculture under a microscope.

• Tens of millions of cows, chickens, and pigs are transported around the U.S. every year, with few restrictions, little regulation enforcement, and no consistent tracking of their movement.

Dangerous transport: Cramped conditions, poor ventilation, contaminated vehicles, exposure to extreme temperatures, and deprivation of food, water, and care weaken animals鈥� immune systems.

• It鈥檚 鈥渁 perfect mix of factors that can facilitate disease transmission,鈥� says Ann Linder, a Harvard animal law and policy expert. 

FRIDAY DIVERSION Iepers Creepers!
Many people profess their love of cats, but how many can claim they鈥檝e made a giant parade float honoring the species鈥攐r flown halfway around the globe to watch said float make its way down a street in Iepers, Belgium?
 
The town鈥檚 ghastly medieval history of throwing cats to their deaths may seem unforgivable, but Iepers deserves credit for an impressive act of repentance: 

• Kattenstoet, the town鈥檚 triannual feline festival has, since 1937, offered an apology for the town鈥檚 cat-hating past and a celebration of felines present, .  

Sure, they still throw cats off a belfry tower like old times鈥攂ut these ones are plush, and launched into a festive crowd of some 50,000 waiting below, eager to catch one.
 
But for all the fanfare, floats, and feline fashions, one thing seemed glaringly missing from the event: actual cats. QUICK HITS Cows Have Almost Certainly Infected More Than Two People With Bird Flu 鈥�

Study confirms face masks' effectiveness in reducing disease transmission, calls for improved public understanding 鈥�

Report: Mpox infections after two doses of Jynneos rare 鈥�

Use of Wegovy and other weight-loss drugs soars among kids and young adults 鈥�

4 Ways Vaccine Skeptics Mislead You on Measles and More 鈥�

Neglected tropical diseases threaten to become the next pandemic. We must prepare for them now 鈥�

Most older Americans who need hearing aids don鈥檛 use them. Here鈥檚 how to change that 鈥�

A promising approach to develop a birth control pill for men 鈥� Issue No. 2545
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

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

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Data crunched by the UN World Health Organization (WHO) has revealed that the COVID-19 emergency reversed more than a decade of gains in life expectancy, reinforcing the need for countries to agree on a global pandemic treaty to protect future generations.

96 Global Health NOW: Loyce Pace on U.S. World Health Assembly Priorities; 鈥楺uestionable鈥� Sickle Cell Patient Sterilizations; and Stamping Out Scabies May 23, 2024 GHN EXCLUSIVE HHS Assistant Secretary Loyce Pace joins a WHO 鈥淲alk the Talk鈥� event on May 21, 2023, in Geneva. Courtesy: HHS Loyce Pace: U.S. Priorities at the 77th World Health Assembly  
Among the delegates from 194 nations at the 77th World Health Assembly, which begins May 27 in Geneva, will be Loyce Pace, the assistant secretary for Global Affairs in the U.S. Department of Health and Human Services.
 
In an interview with GHN, Pace discusses the U.S. positions on the pandemic agreement, WHO reform, and other priority issues.
 
Takeaways:
 
On preparedness for a new pandemic threat: 鈥淚deally, we have the opportunity to make the information we share collectively more timely, more transparent, more easy for donors like the U.S. or actors like WHO to act on.鈥�
 
On the difficulty of pandemic agreement negotiations: 鈥淭he reality is that two and a half years is not a ton of time, especially with an ongoing response, to get it all right.鈥�
 
On Article 12, which calls on manufacturers to share up to 20% of vaccines, therapeutics, diagnostics, etc., in a public health emergency: 鈥淲e absolutely support 鈥� what that article entails both in terms of sharing data samples, genetic material, and the like, as well as, obviously, sharing products and technologies.鈥�
 
On representing the U.S. in international forums: 鈥淚 hadn't fully appreciated how much heft I would carry walking into a room. And sometimes that burden is quite heavy. Actually often, it is. It means we have to get it right.鈥�
 


Related: The World Health Assembly: What It Does, Why It Matters 鈥� GLOBAL HEALTH VOICES The Latest One-Liners
Landmines laid in Yemen by Houthi forces and others continue to kill and seriously injure civilians even in areas that are not active conflict zones, in violation of Yemeni law and the 1997 Mine Ban Treaty.
  A Michigan dairy farmworker鈥攖he second person in the U.S. confirmed to have contracted H5N1 avian influenza from a cow鈥攈as made a full recovery; the case was detected by a public health symptom monitoring system set up by the Michigan Department of Health and Human Services.
 
U.S. health officials are advancing a plan to produce 4.8 million doses of H5N1 avian flu vaccine in case it is needed; federal agencies are discussing what factors would trigger deployment of the doses, which will take two months to prepare.

Chinese citizen journalist Zhang Zhan was released from prison after serving a 4-year sentence on charges of 鈥減icking quarrels and provoking trouble鈥� tied to her reporting on China鈥檚 COVID-19 outbreak鈥攂ut advocates say her freedom of movement is still limited post-release.
 
Human body lice are more efficient vectors of the plague-causing bacterium Yersinia pestis than previously understood, a new 鈥攔aising the possibility that rats and fleas were not solely to blame for past pandemics. PARASITIC INFECTIONS Stamping Out Scabies
The Solomon Islands has one of the world鈥檚 highest rates of scabies and has struggled with infestations for generations.

• ~20% of the population are infected, with children most affected; some schools report ~50% of kids battle the condition.

• 鈥淪cabies is so prevalent it鈥檚 endemic,鈥� said Oliver Sokana of the country鈥檚 Ministry of Health and Medical Services, who explained the skin infestation is aggravated by overcrowding and poor sanitation.

But: There is growing hope that the disease could be eliminated.

• In June 2022 the government, in partnership with the World Scabies Program, rolled out a program to deliver the antiparasitic drug ivermectin to the entire country of 700,000+ people. The second round of mass doses is currently underway. 

  GLOBAL HEALTH VOICES REPRODUCTIVE HEALTH RIGHTS Sickle Cell Patients and 鈥楺uestionable鈥� Sterilizations
For those with sickle cell disease, pregnancy can come with major risk鈥攂ut it is typically manageable.
Still, advocates say they continue to receive troubling reports of women with sickle cell who are pressured into having their fallopian tubes tied or undergo other forms of sterilization.

In an investigation, STAT鈥檚 Eric Boodman sought to shed more light on the pattern:

• Of 50 women interviewed, seven reported 鈥渂eing sterilized with questionable consent.鈥� 


• The Sickle Cell Reproductive Health Education Directive has logged similar reports from ~15 women. 鈥淭hey felt pressured into getting their tubes tied, because their doctors just felt they should never get pregnant,鈥� said the organization鈥檚 CEO Teonna Woolford.

QUICK HITS More than half of Pakistan鈥檚 school-age children will be out of school due to extreme heat 鈥�

New research flags the urgent need for research and evidence on the impact of climate change on neglected tropical diseases and malaria 鈥�

Miami Faces Surge in Dengue Fever That鈥檚 Roiling Latin America 鈥�

Extreme temperatures may increase risk of stroke mortality, especially in low-income countries 鈥�  

Cancer victims sue J&J over 'fraudulent' bankruptcies 鈥�

A scoping review of ethics review processes during public health emergencies in Africa 鈥�

ADHD diagnoses are rising. 1 in 9 U.S. kids have gotten one, new study finds 鈥�

Study Finds Mental Disorders Spread Between Teenagers 鈥�

Marshall Allen, a Tenacious Health Care Journalist, Dies at 52 鈥� Thanks for the tip, Cecilia Meisner! Issue No. 2544
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

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

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A report published on Thursday from the World Health Organization鈥檚 (WHO) European region has revealed alarming health disparities in young people, especially those from less affluent families, representing a 鈥渧icious cycle of disadvantage鈥�.

96 Global Health NOW: Attacks on Health Care Escalate 鈥榓t a Relentless Pace鈥�; Global Mental Health NOW; and Heat Spikes Increase Snake Bites May 22, 2024 Employees of the State Emergency Service of Ukraine and medical staff evacuate medical equipment from a maternity hospital destroyed by a Russian missile attack in Selydove, Donetsk, Ukraine, on February 16. Anatolii Stepanov/AFP via Getty Attacks on Health Care Escalate 鈥榓t a Relentless Pace鈥�
  Attacks on health workers and hospitals spiked 25% last year鈥攖he highest level ever recorded, . 

The surge was driven by new conflict in Gaza and Sudan, though such attacks continued 鈥渁t a relentless pace鈥� in 30 conflict zones including Ukraine and Burma (Myanmar), per a released by the Safeguarding Health in Conflict coalition.

By the numbers:

• 2,562 incidents of 鈥渧iolence against or obstruction of healthcare鈥� 


• 487 cases of health workers killed鈥攁lmost 2X the 2022 number


• 685 cases of health workers being detained or kidnapped


• 625 incidents of facilities damaged


• 24 attacks on providers working vaccination campaigns across 10 countries

What now? The coalition called for prosecutions of 鈥渨ar crimes and crimes against humanity鈥� for health care attacks.

The Quote: 鈥淭he lack of restraint we are seeing, from the beginning of conflicts, suggests to me that the law on protecting healthcare has had no meaning to combatants,鈥� said Leonard Rubenstein of the Johns Hopkins Center for Public Health and Human Rights and the Center for Humanitarian Health. 

Related: 

Mapping the damage to Gaza鈥檚 hospitals: Battered, abandoned and raided 鈥�

Ukraine: humanitarian, health needs soar as Kharkiv hostilities intensify 鈥� GLOBAL HEALTH VOICES The Latest One-Liners   Australia鈥檚 first human H5N1 case has been reported after a child traveling back from India developed a 鈥渟evere infection鈥�; no other cases have been detected in the country.

Type 2 diabetes diagnoses among UK residents under age 40 have jumped 39% over six years, per a new report from 鈥攚ith related NHS costs forecast to rise to 拢10 billion a year by 2050.

The WHO has expanded its of 鈥渢rusted national regulatory authorities鈥� from three to 36 agencies鈥攁nd now includes the U.S. FDA and the European Medicines Agency.

888,000 U.S. military veterans have made 1 million+ disability benefits claims related to toxic exposure from burn pits and other sources encountered during their service. GHN EXCLUSIVE Young man hiding his face. November 24, 2017. BSIP/Universal Images Group via Getty Global Mental Health NOW   Imagine explaining to a senior official that they could prevent and treat a whole category of diseases that cause a third of all global disability鈥攎ostly through local nonprofessional workers, and without medications and equipment. 
 
Now picture that person鈥檚 eyes glazing over with disinterest. That鈥檚 what it鈥檚 like being a mental health advocate, writes Paul Bolton, a senior scientist in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health.
 
In a blind spot: Mental health is always a low-priority issue鈥攕uperseded by other public health issues, and treatment is undercut by many myths, Bolton says, including that mental illness is due to an inherent weakness, uncommon in LMICs, or requires expensive treatment.

• Extensive data and experience exist to counter all of these myths鈥攅specially the belief that most people can鈥檛 be helped, Bolton says.  

One proven solution: Training local people to provide psychotherapy in their own communities鈥攁 small ask鈥斺�測et, even this small investment is rejected by governments, service organizations, and foreign assistance programs as 鈥榯oo much,鈥欌�� says Bolton.  
鈥淚 think it is time to recognize that our 20th-century priorities are outdated. 鈥� People with mental illness have been ignored and poorly served for too long,鈥� Bolton concludes.
 
PHARMACEUTICALS Fake Drugs, Real Dangers
In need of medications but faced with steep prices, more Americans than ever are purchasing discount drugs online鈥攅xposing them to the risk of receiving substandard and falsified medications.

Despite FDA safeguards, the U.S. has seen an 鈥渁larming鈥� growth in fake medications, like counterfeit Adderall pills laced with meth and a cancer drug with no active ingredient.

To increase awareness of fake meds among patients and health care providers, Johns Hopkins Bloomberg School of Public Health experts have partnered with Pfizer in a project called BESAFE.

In a survey of providers, the BESAFE team found that: 

• 91% don鈥檛 talk to patients about counterfeit drugs.  


• 74% said an inability to determine counterfeit products is a barrier to reporting incidents. 


• ~90% said cost savings are the main reason patients end up with counterfeit medications.

CLIMATE CHANGE Heat Spikes Increase Snake Bites 
Higher temperatures in Zimbabwe have sparked early fire seasons and increased human-wildlife conflict, including a record number of snake bites. 

The heat has shortened hibernation periods for snakes, causing them to emerge earlier than usual and, in some cases, move to human-populated areas. 

• 141 snake bites with seven deaths were recorded in a single week in February, .


• In comparison, there were 707 bites and three deaths during all of 2023.

Conservation conundrum: Killing wildlife and protected snake species are punishable offenses in Zimbabwe, even when humans feel their lives are in danger. 

OPPPORTUNITY QUICK HITS In the house of psychiatry, a jarring tale of violence 鈥�

Heat stress: how soaring temperatures are taking their toll on migrant workers in India鈥檚 garden city 鈥�

New tool may help identify infants at high risk for poor RSV outcomes 鈥�

Trump says he is open to restrictions on contraception before backing away from the statement 鈥嬧�嬧��

Black men are a hidden segment of caregivers. It's stressful but rewarding, too 鈥�

How Do You Make A Global Health Podcast? 鈥� Issue No. 2543
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

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

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Can a magic suitcase save lives?

A comprehensive review by the UN health agency has revealed critical gaps in understanding the full impact of climate change on malaria, dengue, trachoma and other tropical diseases.

96 Global Health NOW: H5N1 Vaccine and Surveillance Options; Race-Neutral Lung Tests; and New Native-Led Forensics Lab 鈥楢 Beacon of Hope鈥� As many as 10 companies are looking into making H5N1 vaccines for poultry and cattle May 21, 2024 A cow grazes in a field at a dairy farm on April 26, 2024, in Petaluma, California. Justin Sullivan/Getty H5N1 Vaccine and Surveillance Possibilities
As many as 10 companies are looking into making H5N1 vaccines for poultry and cattle in the U.S., but it鈥檚 not easy work, .

Vaccine makers have to consider:

• Strict regulations for dealing with type A avian influenza viruses.

• The risk of the market disappearing if the nation鈥檚 biosecurity efforts are successful.

• Challenge trials of the vaccine that determine the effective virus dose must take place in biosecurity level-3 (BSL-3) labs, but few are built to handle cattle.

H5N1 sequenced: Scientists at the University of Washington and the Fred Hutchinson Cancer Center have completed the genetic sequence of H5N1 virus from milk, .

Why is this important?

• Knowing the sequence makes it easier to monitor the virus鈥檚 spread via commercially purchased milk products鈥攚hich is necessary because cattle owners have been reluctant to allow testing.

• The sequence also creates a baseline from which to watch for changes in the virus that could make it easier to infect mammals.

Watch the pigs: While H5N1鈥檚 spread among cattle has drawn the media attention, similar outbreaks among pigs would be even more concerning, . Swine have been effective in hosting flu viruses that have moved on to humans, as in the 2009 H1N1 pandemic.
  
Related: 

The Disease Detectives Trying to Keep the World Safe From Bird Flu 鈥� 
 
How annual bird migration could spread avian flu 鈥� 
 
US FDA tested retail milk samples for bird flu in 17 states 鈥�  GLOBAL HEALTH VOICES The Latest One-Liners
Ex-smokers who vape were more likely to develop lung cancer than people who didn鈥檛 use e-cigarettes after quitting, according to a large, decade-long study in South Korea.
 
New data from the WHO warns that a global burden in HIV, hepatitis, and STIs like syphilis continues to pose a major public health challenge, causing 2.5 millions deaths per year; four curable STIs account for over a million infections daily.

Long COVID codes used in electronic health records may play a part in underestimating the prevalence of the condition, according to a report based on clinical data from over 19 million NHS users in England.
 
Microplastics were found in human testicles in that suggests the tiny plastic particles may be linked to the decades-long decline in sperm counts. HEALTH DISPARITIES Race-Neutral Lung Tests: 鈥楶rofound鈥� Implications
Updated race-neutral guidelines for U.S. lung health assessments will likely have far-reaching impacts on both health outcomes and disability payouts, a new published in The New England Journal of Medicine has found. 

Background: Equations for interpreting the results of pulmonary function tests have traditionally included a racial component, based on assumptions that Black people naturally have smaller lungs than white people.

• Experts now believe smaller lung capacities may be due to risk factors like pollution and poor nutrition; the new guidelines seek to correct for this disparity. 

Impacts of new guidelines: 

• Asian and Black patients will move forward on U.S. lung transplant waiting lists, with 4.3 fewer days of wait time.

• U.S. diagnoses of lung disorders will likely jump 141% for Black patients.

• Annual disability payments for Black military veterans will likely rise by more than $1 billion.

GLOBAL HEALTH VOICES TUBERCULOSIS TB Vaccine Inches Closer鈥擝ut Obstacles Remain
Tuberculosis remains the biggest infectious killer in the world鈥攍eading to 1.5 million deaths in 2022 alone鈥攁n average of 2.5 deaths per minute.

And yet there is only one, partially effective, TB vaccine鈥攄eveloped more than a century ago.

New hopes: Researchers in South Africa have begun field trials to test whether a promising new vaccine, known as M72, is effective. 

• The trial will take up to five years鈥攂ut its launch is a relief to researchers. 

Funding shortfalls: Despite the optimism, researchers remain frustrated with a persistent lack of funding for TB vaccine development. 

The Quote: 鈥淲e need a funding revolution, so we won鈥檛 be sitting here 50 or 100 years from now, lamenting the situation,鈥� says Mel Spigelman, president and chief executive of the TB Alliance. 

INDIGENOUS PEOPLE New Native-Led Forensics Lab 鈥楢 Beacon of Hope鈥�
Amid the crisis of missing and murdered Indigenous people in the U.S., Montana stands out as a state with one of the highest disappearance rates. 

• Native Americans make up just 6.2% of the state鈥檚 population鈥攂ut account for 30.6% of missing persons cases. 

Stepping into the gap: The grim figures鈥攁nd the people they represent鈥攁re what motivated Haley Omeasoo to start Ohkomi Forensics, the first Indigenous-owned forensics organization dedicated to addressing the crisis of missing and murdered people from Blackfeet Nation. 

• 鈥淭here鈥檚 this huge gap between what families need and what law enforcement is doing鈥攐r not doing,鈥� said Omeasoo. 

The mission: Ohkomi, which means 鈥渢o use one鈥檚 voice鈥� in Blackfeet, uses advocacy and field work to help families dealing with cold cases. The organization is also creating tribal-specific cultural protocols to be used along with traditional forensic protocols. 

QUICK HITS Brazil counts cost of worst-ever floods with little hope of waters receding soon 鈥�

Toxic bullying claims blow up Brussels鈥� biggest health NGO 鈥�

How American Women Could Lose the Right to Birth Control 鈥�

Why are girls suffering so much right now? The problem is bigger than you think 鈥�

Medicaid Unwinding Deals Blow to Tenuous System of Care for Native Americans 鈥�

The booming business of eternal youth 鈥� Issue No. 2542
Global Health NOW is an initiative of Johns Hopkins Bloomberg School of Public Health.

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

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