Month: February 2023

The head of a U.S. government program to fight AIDS, Dr. John Nkengasong, says that in its 20 years of existence the President’s Emergency Plan for AIDS Relief, or PEPFAR, has saved 25 million lives.

PEPFAR, set up in 2003 under the administration of former U.S. president George W. Bush, has transformed the trajectory of HIV/AIDS, Nkengasong told reporters Tuesday while visiting South Africa.

“Twenty-five million lives have been saved, 5.5 million children have been born free of HIV/AIDS, health systems have been strengthened in a remarkable way,” he said.

Nkengasong, who comes from Cameroon, said there was once a “sense of hopelessness” in Africa, the continent worst-hit by HIV/AIDS, but since then countries’ economies have increased and life expectancy has improved.

Some 95% of the total $110 billion spent through PEPFAR was spent on Africa as it bore the brunt of the disease, he said.

“Before PEPFAR only 50,000 people, 50,000 people on the continent of Africa who were infected, were on treatment, 50,000. Today over 20 million people are receiving life-saving anti-retroviral therapy.” he said.

Nkengasong said the infrastructure rolled out across Africa as part of the U.S. government program was also useful during the COVID-19 pandemic.

The AIDS official said he was also “very positive” about the tools in the pipeline to combat HIV, including the roll out of pre-exposure prophylactics for HIV negative people that can be injected every three months and will stop the spread of new infections.
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Two more people in Equatorial Guinea have died of Marburg hemorrhagic fever, a cousin of the Ebola virus, bringing the toll of fatalities to 11, the authorities say.

“Two days ago, the monitoring system recorded eight notifications, including the deaths of two people with symptoms of the disease,” Health Minister Mitoha Ondo’o Ayekaba said in a statement issued late Tuesday.

Work is underway “to strengthen assessment of the spread of the epidemic,” said the statement, read on national television.

“Forty-eight contact cases have been documented, four of whom have developed symptoms, and three who have been quarantined in hospital,” it added.

The Marburg virus is a rare but highly dangerous pathogen that causes severe fever, often accompanied by bleeding and organ failure.

It is part of the so-called filovirus family that also includes the Ebola virus, which has wreaked havoc in several previous outbreaks in Africa.

The central African state announced on February 13 that nine people had died from Marburg between January 7 and February 7.

The U.N.’s World Health Organization (WHO) held an emergency session the following day.

The national authorities have declared a health alert in the remote northeastern province of Kie-Ntem province and in the neighboring district of Mongomo, which are located on the border with Cameroon and Gabon.

Measures include a lockdown plan implemented in collaboration with the WHO.

In their statement of February 13, the authorities had reported only three cases of infection in addition to the fatalities — individuals who were being isolated with “mild symptoms” in hospital.

The natural host of the Marburg virus is the African fruit bat, which carries the virus but does not fall sick from it.

But the animals can pass the virus to primates in close proximity, including humans, and human-to-human transmission then occurs through contact with blood or other bodily fluids.

Fatality rates in confirmed cases have ranged from 24 percent to 88 percent in previous outbreaks, depending on the virus strain and case management, according to the WHO.

There are currently no approved vaccines or antiviral treatments.

Potential treatments, including blood products, immune therapies and drug therapies, as well as early candidate vaccines are being evaluated, the WHO says.
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The U.S. ambassador to China says Beijing needs to be more forthcoming about the origins of the COVID-19 pandemic, a day after reports that the U.S. Energy Department concluded the outbreak likely began because of a Chinese laboratory leak.

Nicholas Burns told a U.S. Chamber of Commerce event by video link Monday that China needs to “be more honest about what happened three years ago in Wuhan with the origin of the COVID-19 crisis.” Wuhan is the Chinese city where the first cases of the novel coronavirus were reported in December 2019.

His comments come a day after U.S. media reported that the Energy Department determined the pandemic likely arose from a laboratory leak in Wuhan.

The department made its judgment in a classified intelligence report provided to the White House and key members of Congress, according to The Wall Street Journal, which first reported the development, citing people who read the report.

The WSJ said the Energy Department intelligence agency was now the second U.S. intelligence agency after the FBI to conclude a Chinese lab leak was the probable cause of the pandemic, although U.S. spy agencies remain divided over the origins of the virus.

White House national security spokesman John Kirby echoed that sentiment.

“There has not been a definitive conclusion and consensus in the U.S. government on the origins of the COVID-19 pandemic,” Kirby told reporters Monday when asked about the WSJ report.

The Energy Department assessment was made with “low confidence,” while the FBI conclusion was determined with “moderate confidence,” according to the WSJ. Four other U.S. agencies have reportedly determined with “low confidence” that the virus was transmitted naturally through animals, while an additional two agencies remain undecided.

The reports again bring national attention to the question of what caused the COVID-19 outbreak.

The Energy Department’s conclusion marks a change from its earlier position that it was undecided on how the virus began. U.S. officials did not disclose what new intelligence brought about the change. The Energy Department’s analysis came from its network of national laboratories, giving it a perspective different from more traditional intelligence assessments.

On Sunday, White House national security adviser Jake Sullivan told CNN that “there is a variety of views in the intelligence community.”

“Some elements of the intelligence community have reached conclusions on one side, some on the other,” he said.

Scientists have also been divided on the issue, with some pointing to the live animal market in Wuhan as the most probable place the virus emerged, noting that animal-to-human transmission has been the pathway for many previously unknown pathogens. Other scientists, however, have given credence to the lab leak theory, noting that no animal source has been found and that Wuhan is a major site of coronavirus research.

The question of how the virus began has also exacerbated political divisions in the U.S., with Republicans more likely to back the lab leak hypothesis.

Republican Senator Tom Cotton was one of the first high-profile politicians to voice the theory that the virus originated in a lab setting, commenting in February 2020, when the predominant view was the virus had been transmitted from bats and spread at a food market in Wuhan.

After a growing number of scientists urged for both hypotheses to be seriously considered, U.S. President Joe Biden ordered an intelligence review into the origins of COVID-19 in May 2021.

A declassified intelligence assessment in October 2021 stated that both hypotheses were plausible but that intelligence agencies remained divided over which theory was correct. The report said there was consensus among intelligence agencies that the pandemic was not the result of a Chinese biological weapons program.

China has repeatedly denied that a lab leak occurred in Wuhan. It has placed limits on World Health Organization investigations to determine the origin of the virus.

Some information in this report came from Reuters.
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The Ghana Health Service says a shortage of routine vaccines for children blamed for a measles outbreak that infected 120 will be resolved within weeks. Health officials said the shortage of vaccines against polio, hepatitis B, and measles was caused by the depreciation of Ghana’s currency, the cedi. The Pediatric Society of Ghana warned childhood diseases could quickly spread if the vaccines were not soon made available. 

For months, nursing mothers have been complaining of shortage of vaccines meant for babies from birth to at least 18 months.

The situation became worse in February after major health facilities in 10 out of the 16 administrative regions of Ghana kept turning nursing mothers away due to erratic supply.

Vivian Helemi said her baby girl missed one of the key vaccinations last month and the situation has not changed after combing three health centers on Monday. Like other mothers, Helemi is worried the shortage of the essential vaccines for infants will pose a threat to her child.

“It has been frustrating moving from one hospital to another,” she told VOA. “I don’t know what could happen to my baby because she is yet to receive her second vaccination. I am confused because no one is telling me when the vaccines will be ready.”

Timely vaccination of children, according to UNICEF, is a proven method for saving lives from vaccine-preventable diseases. It can also help attain some targets like the U.N. Sustainable Development Goal 3, which aims to ensure healthy lives and promote well-being for all.

UNICEF’s Ghana office says on its website that the country has seen a significant fall in deaths from vaccine-preventable diseases. For example, since 2003, there has been no death caused by measles, while in 2011, Ghana was certified as having attained elimination status for maternal and neonatal tetanus.

Dr. Agyeiwaa Bonuedie, a member of the Pediatric Society of Ghana, said the government must act now in order not to erode the gains made so far.

“It’s the first time I am hearing of such widespread shortages. We do have shortages from time to time, however, those are in very limited circumstances. The problem this time is that it has gone over for several months. This should actually be a thing of the past. The government should be encouraged to do what we call ring-fenced funding such that budgetary allocations for vaccines are actually protected, no matter what other dire or pressing needs the country has, the children should be secured in that light,” said Bonuedie.

The director-general of the Ghana Health Service, Dr. Patrick Kuma-Aboagye, said the situation will change by the end of March.

“We have had some delays in procuring some of those vaccines for which polio, MR [Measles-Rubella], and BCG [bacille Calmette-Guerin] are in short supply. It was also because the ministry’s budget to procure them are in cedis, and at the time it was due for procurement, because of exchange differences it was very difficult to procure, so now we have done it… we hope that within the next three weeks we will address it,” he said.

Parliament has summoned the West African country’s health minister Kwaku Agyeman-Manu to discuss the vaccine shortage. The next few weeks are crucial for many children, especially those who live in inner cities and dense parts of urban areas and are exposed to vaccine-preventable diseases at an early age.
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The big beasts of the telecom industry kicked off their most important annual get-together in Barcelona on Monday, promising to lead a “tsunami of innovation”, as they try to shrug off a major slump across the technology sector.

Some 80,000 delegates are expected at the four-day Mobile World Congress (MWC), which is back to near full strength following years of pandemic-related disruption.

Industrial titans like Huawei, Nokia and Samsung are set to showcase their latest innovations, flanked by smartphone makers like Oppo and Xiaomi and network operators like Orange, Verizon and China Mobile.

“We are at the doors of a new change of era driven by the intersection of Telco, Computing, Artificial Intelligence and Web3,” said Jose Maria Alvarez-Pallete, boss of Spanish operator Telefonica and current chairman of industry body GSMA, which organizes the Barcelona event.

He promised the telecoms industry would be at the forefront of the “tsunami of innovation”, adding: “Without telcos there is no digital future.”

But many of the firms are more concerned with finding a path back to profit as the global economy stutters and the wider tech sector slashes thousands of jobs.

In the first clear sign that the ills of the wider tech sector are reaching telecoms, equipment maker Ericsson announced 8,500 layoffs last week.

Overall sales of smartphones last year slumped by 11.3 percent compared with 2021, according to the IDC consultancy.

Research firm Gartner reckons sales of smartphones, tablets and computers will fall again by four percent this year.

And network operators are still struggling to make 5G pay, years after they spent billions in government auctions for the right to use the bandwidth.

‘Unsustainable situation’ 

A hugely popular idea for many at the show is to get the owners of bandwidth-hungry platforms like YouTube, Netflix and Facebook to pay network operators a “fair share”.

Christel Heydemann, boss of French operator Orange, said the five largest users — which she did not name — account for 55% of daily traffic on European networks, costing telecoms firms 15 billion euros ($16 billion) a year.

She said it was an “unsustainable situation” and welcomed a public consultation launched by EU commissioner Thierry Breton last week.

But Breton told the MWC on Monday that it was not a “binary choice” or a battle between telecoms and big tech.

He said the idea was for everyone to make sure Europe had the best possible network by 2030 and warned that telecoms firms “will have to adapt to survive”.

Critics of the “fair share” narrative point out that customers already pay the operators for use of their networks.

Netflix boss Greg Peters, who is unlikely to be enthusiastic about the fair share proposal, is expected at the MWC on Tuesday.

Huawei center stage 

The organizers are trumpeting the return of Chinese delegates as a vital boon to the event.

Chinese firms heavily sponsor the MWC and Huawei is once again getting pride of place, this time hosting the biggest dedicated pavilion in the event’s decades-long history.

The Chinese tech giant was the second biggest smartphone maker in the world in 2020 but retreated after US regulators accused it of being controlled by Beijing.

The firm is now under pressure in Europe, where Breton and other commissioners are pushing for its equipment to be removed from 5G network infrastructure.

Huawei boss Eric Xu said before the event he would use the MWC to display products that would “help carriers meet evolving demand and unleash more opportunities for new growth”.

In total, GSMA said the four-day show would host almost 750 operators and manufacturers and 2,000 exhibitors.
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Two experts appointed by the World Health Organization to investigate allegations that some of its staffers sexually abused women during an Ebola outbreak in Congo have dismissed the U.N. agency’s own efforts to excuse its handling of such misconduct as “an absurdity.”

Some of the victimized women say — nearly four years later — they are still waiting for WHO to fire those responsible or be offered any financial compensation.

In October 2020, Aichatou Mindaoudou and Julienne Lusenge were named by WHO Director-General Tedros Adhanom Ghebreyesus to head a panel investigating reports that some WHO staffers sexually abused or exploited women in a conflict-ridden region of Congo during the 2018-2020 Ebola outbreak.

Their review found there were at least 83 perpetrators of abuse who worked for WHO and partners, including complaints of rape, forced abortions and the sexual assault of a 13-year-old girl, in the biggest known sex abuse scandal in the U.N. health agency’s history.

The panel also found that three WHO managers mismanaged a sexual misconduct case first reported by the Associated Press, involving a U.N. doctor signing a contract to buy land for a woman he allegedly impregnated.

A confidential U.N. report submitted to WHO last month concluded that the managers’ handling of that case didn’t violate WHO’s sexual exploitation policies, because the woman wasn’t considered a “beneficiary” of WHO aid, since she didn’t receive any humanitarian assistance.

“The restrictive approach favored by WHO is an absurdity,” Mindaoudou and Lusenge said in a statement, adding that beneficiaries of WHO “should only be interpreted in favor of potential victims of sexual exploitation and abuse, with the view of maintaining accountability.”

Anifa, a Congolese woman who worked at an Ebola clinic in northeastern Congo, said she was offered a job at double her salary in exchange for sex with a WHO doctor and was still traumatized by the experience.

“How many times do I have to speak before [the doctors] at WHO responsible for the sexual abuse are punished?” she asked. “If WHO does not take radical measures, we will conclude that the organization has been made rotten by rapists.”

Anifa, who didn’t share her last name for fear of reprisals, said she didn’t expect any financial compensation from WHO, explaining that “money will not erase the wounds I have in my heart.” She reported the alleged misconduct to WHO in 2019, but never received a response.

Mindaoudou, a former government minister in Niger and Lusenge, a human rights activist in Congo, also slammed WHO for its failure to punish any senior staffers linked to the abuse, saying there was a “culture of impunity” at the organization.

When allegations of sexual abuse and exploitation surfaced in the press in September 2020, Tedros said he was “outraged” and that anyone found to be involved would face serious consequences. WHO emergencies chief Dr. Michael Ryan claimed the agency had “absolutely no details” of the abuse.

But the internal U.N. report noted that Tedros was informed of sexual abuse allegations in 2019 and that some cases of alleged misconduct were discussed by senior WHO staff shortly after they occurred. Tedros himself travelled to Congo 14 times during the outbreak and said he was personally responsible for WHO’s Ebola response.

To date, no senior managers at WHO linked to the sexual misconduct have been fired; Tedros said last month that because the U.N. report found there was no evidence managers acted improperly, three suspended officials returned to work.

WHO has refused to comment on the internal U.N. report, but Tedros has said repeatedly that he has “zero tolerance” for sexual abuse and exploitation, pointing to the creation of a new department to prevent misconduct. Dr. Gaya Gamhewage, who heads that work, told U.N. investigators that prior to being appointed, “sexual exploitation and abuse were not familiar terms to her.”

Tedros said earlier this month that the agency has established a $2 million fund to help survivors of sexual abuse in Congo, but it’s unclear how many women have obtained assistance.

Jeanette, a woman who says she was impregnated by a WHO doctor while working at an Ebola center in Butembo, said she was pressured into having an abortion, which nearly killed her. She said she is waiting for WHO to punish the doctor responsible for her pregnancy and has had no offers of financial compensation.

“I don’t have the strength to work since the abortion,” she said. “WHO should know that their staffers are flatterers, freeloaders and liars.”
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Elon Musk’s rocket company SpaceX was set to launch early Monday the International Space Station’s next long-duration team into orbit, with an astronaut from the United Arab Emirates and a Russian cosmonaut joining two NASA crewmates for the flight.

The SpaceX launch vehicle, consisting of a Falcon 9 rocket topped with an autonomously operated Crew Dragon capsule called Endeavour, was set for liftoff at 1:45 a.m. EST (0645 GMT) from NASA’s Kennedy Space Center in Cape Canaveral, Florida.

The four-member crew should reach the International Space Station (ISS) about 25 hours later, Tuesday morning, to begin a six-month mission in microgravity aboard the orbiting laboratory some 250 miles (420 km) above Earth.

Designated Crew 6, the mission marks the sixth long-term ISS team that NASA has flown aboard SpaceX since the private rocket venture founded by Musk – billionaire CEO of electric car maker Tesla and social media platform Twitter – began sending American astronauts to orbit in May 2020.

NASA said the mission’s launch readiness review was completed Saturday, and that the flight was given a “go” to proceed to liftoff as planned.

“All systems and weather are looking good for launch,” Musk wrote on Twitter Sunday.

The latest ISS crew is led by mission commander Stephen Bowen, 59, a onetime U.S. Navy submarine officer who has logged more than 40 days in orbit as a veteran of three space shuttle flights and seven spacewalks.

Fellow NASA astronaut Warren “Woody” Hoburg, 37, an engineer and commercial aviator designated as the Crew 6 pilot, will be making his first spaceflight.

The Crew 6 mission also is notable for its inclusion of UAE astronaut Sultan Alneyadi, 41, only the second person from his country to fly to space and the first to launch from U.S. soil as part of a long-duration space station team. UAE’s first-ever astronaut launched to orbit in 2019 aboard a Russian spacecraft.

Rounding out the four-man Crew 6 is Russian cosmonaut Andrey Fedyaev, 41, who like Alneyadi is an engineer and spaceflight rookie designated as a mission specialist for the team.

Fedyaev is the latest cosmonaut to fly aboard an American spacecraft under a ride-sharing deal signed in July by NASA and the Russian space agency Roscosmos, despite heightened tensions between Washington and Moscow over Russia’s invasion of Ukraine.

The Crew 6 team will be welcomed aboard the space station by seven current ISS occupants – three U.S. NASA crew members, including commander Nicole Aunapu Mann, the first Native American woman to fly to space, along with three Russians and a Japanese astronaut.

The ISS, about the length of a football field and the largest artificial object in space, has been continuously operated by a U.S.-Russian-led consortium that includes Canada, Japan and 11 European countries.

The outpost was conceived in part as a venture to improve relations between Washington and Moscow following the Soviet Union’s collapse and the end of Cold War rivalries that gave rise to the original U.S.-Soviet space race in the 1950s and 1960s.

NASA-Roscosmos cooperation has been tested as never before since Russia invaded Ukraine a year ago, leading the United States to impose sweeping sanctions against Moscow while steadily increasing military aid to the Ukrainian government.

The Crew 6 mission also follows two recent mishaps in which Russian spacecraft docked to the orbiting laboratory sprang coolant leaks apparently caused micrometeoroids, tiny grains of space rock, streaking through space and striking the craft at high velocity.

One of the affected Russian vehicles was a Soyuz crew capsule that had carried two cosmonauts and an astronaut to the space station in September for a six-month mission now set to end in March. An empty replacement Soyuz to bring them home blasted off Friday and arrived at the space station Saturday.
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A man in Spain who was suspected of having the deadly Marburg disease tested negative Saturday and does not have the virus, the health ministry said.

Health authorities in Valencia earlier said they had detected the country’s first suspected case of the infectious disease that has led to the quarantining of more than 200 people in Equatorial Guinea.

The 34-year-old man, who had recently been in Equatorial Guinea, had been given the all-clear but would be tested again in the coming weeks, officials said.

He had been transferred from a private hospital to an isolation unit at the Hospital La Fe in Valencia while tests were being conducted, the Valencian regional health authorities said.

Three health staff who are treating the man were also isolated as a precautionary measure, authorities said.

Marburg virus can have a fatality rate of up to 88%, according to the World Health Organization. There are no vaccines or antiviral treatments approved to treat it.

Equatorial Guinea quarantined more than 200 people and restricted movement February 13 in its Kie-Ntem province, where the hemorrhagic fever was first detected.

The small central African country has so far reported nine deaths as well as 16 suspected cases of the disease, with symptoms including fever, fatigue, blood-stained vomit and diarrhea, according to the WHO.

Cameroonian authorities detected two suspected cases of Marburg disease February 13 in Olamze, a commune on the border with Equatorial Guinea, the public health delegate for the region, Robert Mathurin Bidjang, said February 14.

Cameroon had restricted movement along the border to try to avoid contagion.
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Spain has identified its first suspected case of Marburg disease. 

The Spanish patient is a 34-year-old man who had recently traveled to the Central African nation of Equatorial Guinea.  He was in a private hospital but has been transferred to an isolation unit at Hospital La Fe in Valencia for further tests, regional medical officials said.

Marburg virus disease, or MVD, according to the Centers for Disease Control and Prevention, “is a rare but severe hemorrhagic fever which affects both people and non-human primates … Primates [including people] can become infected with Marburg virus, and may develop serious disease with high mortality.” 

Spanish health officials said Saturday that more than 200 people in Equatorial Guinea have recently been quarantined because of Marburg disease.  

Earlier this month, two suspected cases of Marburg were detected in Cameroon near its border with Equatorial Guinea.  

The World Health Organization says that the “highly virulent disease” can have “a fatality ratio of up to 88%” and “is in the same family as the virus that causes Ebola virus disease.” 

There are no vaccines or antiviral treatments for Marburg.
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Uber Technologies Inc. said on Friday plans by the local government in India’s Delhi city to only allow electric vehicles to function as bike taxis would risk “finishing off the sector” and impact the mobility needs of millions.

Delhi’s plans, part of a new policy to regulate vehicles used by ride-hailing companies like Uber and rival Ola, are being finalized and will be rolled out soon, the Economic Times reported earlier this week.

Reuters could not immediately confirm those plans.

If implemented, this would mark an aggressive step towards the country’s ambitions to ramp up the transition to vehicles that run on clean energy to reduce oil imports and curb pollution.

Uber, in a blogpost, said any such move would put at risk the livelihood of over 100,000 drivers in the city.

“Steep and infeasible EV mandates risk finishing off the sector as we know it. The impact of such a decision on the livelihoods and mobility needs of millions of Delhiites is clear,” San Francisco-headquartered Uber said, urging the government to initiate industry dialog.

Uber has set a 2040 target for 100% of its rides to be in zero-emission vehicles, public transport or with micro-mobility, including in India.

Earlier this month, Uber announced plans to introduce 25,000 EVs over three years in India. Electric cars will however still be a fraction of Uber’s current overall active fleet of 300,000 vehicles in India.

On Sunday, the Delhi government in newspaper ads said digital platforms offering two-wheeler bike taxi rides should not do so as it violates certain existing transport rules.

Uber, which offers bike rides in Delhi and many other states in India, did not respond to a Reuters request for a comment on the advertisement.
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The Biden administration is preparing for a worst-case scenario if a conservative federal judge rules in favor of a lawsuit seeking to restrict access to one of the two drugs typically used to induce a medicated abortion.

Two drugs, mifepristone and misoprostol, can be taken by women at home and are used for just over half of U.S. abortions. But that could be quickly changed by a lawsuit filed by an anti-abortion group in Texas that claims the Food and Drug Administration wrongly approved mifepristone for use more than 23 years ago.

The case is before a federal judge appointed by former President Donald Trump. A ruling in favor of the abortion opponents could immediately shut down the sale of the drug, but women would still have access to medicated abortions with a regimen of misoprostol.

Vice President Kamala Harris promised on Friday that the White House would push back on efforts to ban the drug, as she gathered a group of nearly a dozen doctors and abortion rights advocates to discuss a plan for responding to the looming threat to access to medical abortions.

“There are now partisan and political attacks attempting to question the legitimacy of a group of scientists and doctors who have studied the significance of this drug,” Harris said. “There is now an attempt by politicians to remove it from the ability of doctors to prescribe and the ability of people to receive.”

The lawsuit against mifepristone was filed by the Alliance for Defending Freedom, which was also involved in the Mississippi case that led to Roe v. Wade being overturned. It’s the latest fallout in the struggle over reproductive care that the Democratic administration must grapple with since the Supreme Court overturned the constitutional right to an abortion last year.

Harris did not publicly lay out how the administration plans to respond if a ruling that halts the sale of the drug nationwide comes down on Friday.

‘Medication abortion is not going away’

Health and Human Services Secretary Xavier Becerra, meanwhile, was in California on Friday to meet leaders from Planned Parenthood to talk about access to the abortion drugs.

Dr. Kristyn Brandi said she told the vice president on Friday that the ruling could trigger widespread confusion over the accessibility of medicated abortion in the U.S. Brandi, who is chair of the Physicians for Reproductive Health, said she already fields calls at her New Jersey clinic from women asking if medicated abortion is legal in the state.

“It’s a really important thing to communicate with people: medication abortion is not going away,” Brandi said.

She added that Harris expressed support for immediately challenging the ruling if it shuts down access to mifepristone.

Clinics and telehealth providers have been preparing for a ruling that shuts down access to mifepristone, ordering more doses of misoprostol so they can offer medication abortions with just that one drug. They will have to change the way they counsel patients, telling them that misoprostol-only abortions are slightly less effective and sometimes more painful than abortions done with both drugs.

Abortions using both drugs “can be as effective as 98% or more,” while misoprostol-only abortions are up to about 95% effective, Melissa Grant, chief operating officer of the Carafem abortion clinic, told The Associated Press.

Mifepristone dilates the cervix and blocks the action of the hormone progesterone, which enables a pregnancy to continue. Misoprostol causes contractions that empty the uterus. Typically, mifepristone is taken by mouth first, followed by misoprostol a day or two later.

Studies show medication abortions are safe and effective, though with a slightly lower success rate than ones done by procedure in a clinic.

Another lawsuit filed

With the Texas decision pending, a dozen Democratic-controlled states filed their own lawsuit in federal court against the FDA on Thursday in Washington. The lawsuit seeks to make it easier for woman to access the drug and alleges that several FDA requirements for prescribing and dispensing it are “burdensome, harmful and unnecessary.”

When the FDA approved mifepristone in 2000 it placed several safety restrictions on its use, including limiting dispensing to specialty clinics and requiring women to pick up the drug in person. The Biden administration had sought to expand access to medicated abortions in light of the Supreme Court’s ruling, with an FDA announcement this year that broadened the pill’s access through retail and mail-order pharmacies.

But several limitations remain, such as one that doctors must be specially certified to prescribe the drug.

Several medical groups have long opposed those requirements, pointing to the low rate of side effects seen with mifepristone compared with other medications that don’t carry any certification requirements.
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The trickle-down effects of Russia’s war in Ukraine are still being felt on food prices in vulnerable places, nearly one year after Moscow invaded the neighboring country.
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Federal wildlife officials on Wednesday announced a proposal to classify one of two dwindling California spotted owl populations as endangered after a lawsuit by conservation groups required the government to reassess a Trump administration decision not to protect the brown and white birds.

The U.S. Fish and Wildlife Service proposed that California spotted owls that have their habitats in coastal and Southern California be protected under the Endangered Species Act.

That population “does not have a strong ability to withstand normal variations in environmental conditions, persist through catastrophic events, or adapt to new environmental conditions throughout its range,” which led the agency to propose listing it as endangered, wildlife officials said.

The other California spotted owl population, which lives in Sierra Nevada forests in California and western Nevada, would be classified as threatened, the agency said.

The habitat of the medium-sized brown owl with white spots on its head and chest and a barred tail is under serious threat from current logging practices and climate change, including increased drought, disease and more extreme wildfires.

Most California spotted owls live on land overseen by the Bureau of Land Management and the U.S. Forest Service.

How much the population has declined since conservation groups started their effort to protect it more than 20 years ago is unclear.

The only available demographic data on spotted owls living in coastal and Southern California was collected in San Bernardino National Forest and shows a decline of 9%, the federal wildlife service said.

The Sierra Nevada population shows declines ranging from 50% to 31% percent in some areas, the agency said.

The federal agency’s decision follows an agreement reached in November between the U.S. Fish and Wildlife Service and several conservation groups that sued the federal agency in 2020 over its decision not to protect the California spotted owl population.

Justin Augustine, a senior attorney at the Center for Biological Diversity, one of the groups that sued, applauded the agency’s decision and said he was happy to see the California spotted owls could finally get the safeguards they need.

Augustine said he planned to use the 60-day public comment period to push for more protections for the California spotted population in the Sierra Nevada.

“One of the things I’ll be addressing is the issue of how to make sure that (Sierra Nevada) spotted owls are actually protected under their threatened status rather than potentially allowing some logging to occur that would be harmful,” he said.

The California spotted owl is one of three spotted owl subspecies and the last to be protected under the Endangered Species Act, Augustine said.

The other two subspecies are the northern spotted owl and the Mexican spotted owl.

The northern spotted owl habitat is in Oregon, Washington state and Northern California. The tiny owl was listed as threatened under the Endangered Species Act in 1990, sparking an intense battle over logging in the region. In 2020, the Trump Administration refused to upgrade it to endangered status despite losing nearly 4% of its population annually.

The Mexican spotted owl was first listed as threatened in the U.S. in 1993. It is found in Arizona, New Mexico, Colorado, Utah, parts of West Texas and Mexico.

The species is in danger of extinction due to lose of habitat to logging, development, mining and wildfires.
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A new report by four leading United Nations agencies and the World Bank estimates every two minutes, one woman dies during pregnancy or childbirth, mostly from preventable causes.

The report, “Trends in maternal mortality 2000 to 2020,” was produced by WHO, UNICEF, and the UNFPA, along with the World Bank Group and UNDESA/Population Division.

Health officials say the data presented in the report should be a wakeup call for world leaders to take action to end maternal deaths by investing in health care systems and closing the widening social and economic inequities that contribute to these deaths.

“While pregnancy should be a time of immense hope and a positive experience for all women, it is tragically still a shockingly dangerous experience for millions around the world,” said Tedros Adhanom Ghebreyesus, the World Health Organization’s director-general.

“These new statistics reveal the urgent need to ensure every woman and girl has access to critical health services before, during and after childbirth,” he said, “And that they can fully exercise their reproductive rights.”

The report finds an estimated 287,000 women around the world died from a maternal cause in 2020.  That is equivalent to 800 deaths a day, or one death every two minutes.

“These numbers show persistent inequities between countries which are undermining women’s rights.,” said Anshu Banerjee, assistant director general for universal health coverage at WHO. 

“There is over a hundred-fold risk of dying depending on where a woman delivers her baby, particularly in low-income countries compared to high income countries,” he said.

The statistics bear this out. While some significant progress in reducing maternal deaths was made between 2000 and 2015, the report notes this progress has largely stalled, and in some cases been reversed.

For example, between 2016 and 2020, it says the maternal mortality rate increased in Europe, Northern America, Latin America and the Caribbean.

While the number of deaths has gone up, the report says the regions have among the lowest maternal mortality rates in the world.

During this same period, the report says two regions, Australia and New Zealand, and Central and Southern Asia, reduced maternal deaths significantly. The picture is quite different in sub-Saharan Africa, which has the highest rate of maternal mortality, accounting for 70 percent of maternal deaths worldwide.

Jenny Cresswell, an epidemiologist at WHO and author of the report, said the maternal mortality ratio per 100,000 live births in sub-Saharan Africa in 2020 is estimated to be 545 maternal deaths for every 100,000 live births.

“This number is 136 times bigger than MMR (maternal mortality ratio) in Australia and New Zealand, the lowest region,” Cresswell said.

She adds, “A 15-year-old girl in Chad in 2020 has a one in 15 chance of dying from a maternal cause during her lifetime, and that is 4,000 times greater than the probability in Belarus.”

In 2020, Belarus had one MMR per 100,000 live births compared to Chad, which had 1,063 MMRs per 100,000 live births.

Leading causes

The leading causes of maternal deaths include severe bleeding, high blood pressure, pregnancy-related infections, complications from unsafe abortions, and underlying conditions such as HIV/AIDS and malaria.

Banerjee said nearly all these maternal deaths are preventable.

“Nearly half of all pregnancies are unintended, which is highlighting the lack of access of some 270 million women globally to modern family planning methods —meaning they are unable to choose how and when to plan their families,” he says.” Many lack access to safe abortion, which increases risk of complications, including deaths associated with unsafe procedures,” said Banerjee.

Natalia Kanem, executive director of the U.N. Population Fund, said it is unacceptable that so many women continue to die needlessly during pregnancy and childbirth.

She said, “We can and must do better by urgently investing in family planning and filling the global shortage of 900,000 midwives so that every woman can get the lifesaving care she needs. 

“We have the tools, knowledge, and resources to end preventable maternal deaths,” she said. “What we need now is the political will.”
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