Author: Dmedia

The U.S. Food and Drug Administration on Wednesday approved selling the leading version of naloxone without a prescription, setting the overdose-reversing drug on course to become the first opioid treatment drug to be sold over the counter.

It’s a move that some advocates have long sought as a way to improve access to a life-saving drug, though the exact impact will not be clear immediately.

Here’s a look at the issues involved.

What is Narcan?

The approved nasal spray from Gaithersburg, Maryland-based Emergent BioSolutions is the best-known form of naloxone.

It can reverse overdoses of opioids, including street drugs such as heroin and fentanyl and prescription versions including oxycodone.

Making naloxone available more widely is seen as a key strategy to control the nationwide overdose crisis, which has been linked to more than 100,000 U.S. deaths a year. The majority of those deaths are tied to opioids, primarily potent synthetic versions such as fentanyl, which can take multiple doses of naloxone to reverse.

The drug has been distributed to police and other first responders nationwide.

Advocates believe it’s important to get naloxone to the people most likely to be around overdoses, including drug users and their relatives.

The decision “represents a decisive, practical and humane approach to help people and flatten the curve of overdose deaths,” said Chuck Ingoglia of the National Council for Mental Wellbeing in a statement.

What does the FDA approval mean?

Narcan will become available over the counter by late summer, the company said.

Other brands of naloxone and injectable forms will not yet be available over the counter, but they could be soon.

Several manufacturers of generic naloxone, which is made similarly to Narcan, will now be required to file applications to switch their drugs to over the counter as part of an FDA requirement.

The nonprofit Harm Reduction Therapeutics Inc., which has funding from OxyContin maker Purdue Pharma, already has an application before the FDA to distribute its version of spray naloxone without a prescription.

How is naloxone distributed now?

Even before the FDA’s action, pharmacies could sell naloxone without a prescription because officials in every state have allowed it.

But not every pharmacy carries it. And buyers have to pay for the medication — either with an insurance co-pay or for the full retail price. The cost varies, but two doses of Narcan often go for around $50.

The drug is also distributed by community organizations that serve people who use drugs, though it’s not easily accessible to everyone who needs it.

Emergent has not announced its price, and it’s not clear yet whether insurers will continue to cover it as a prescription drug if it’s available over the counter.

FDA Commissioner Robert Califf in a statement encouraged Emergent to make the drug available “at an affordable price.”

Does making naloxone over the counter improve access?

It clears the way for Narcan to be made available in places without pharmacies — convenience stores, supermarkets and online retailers, for instance.

Jose Benitez, the lead executive officer at Prevention Point Philadelphia, an organization that tries to reduce risk for drug users through services including handing out free naloxone, said it could greatly help people who don’t seek services — or who live in places where they are not available.

Now, he said, some people are concerned about getting naloxone at pharmacies because their insurers will know they are getting it.

“Putting it out on the shelves is going to allow people just to pick it up, not have stigma attached to it,” he said.

But it remains to be seen how many stores will carry it and what the prices will be. The U.S. Centers for Medicare and Medicaid Services, or CMS, which now covers prescription naloxone for people on the government insurance programs, says that coverage of over-the-counter naloxone would depend on the insurance program. CMS has not given any official guidance.

Maya Doe-Simkins, a co-director of Remedy Alliance/For The People, which launched last year to provide low-cost — and sometimes free — naloxone to community organizations, said her group will continue to distribute injectable naloxone.

How will people learn to use Narcan?

Emergent had to conduct a study examining whether untrained people could follow directions for using Narcan.

Last month, an FDA expert panel voted to make the drug available over the counter, despite the numerous errors in using the device reported in the company study. The FDA suggested Emergent make several changes to how the directions will be displayed on the packaging and said the device could be safely used “without the supervision” of a health care worker.

Keith Humphreys, a Stanford University addiction expert, said one benefit of currently having pharmacists involved in dispensing the drug is that they can show buyers how to use it. One key thing people need to remember: Always call an ambulance for the person who has received the naloxone.

He also said there are fears that if the drug isn’t profitable as an over-the-counter option, the drugmaker could stop producing it. 
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The U.N. General Assembly adopted a landmark resolution Wednesday that will ask the International Court of Justice to issue an advisory opinion on the obligations of states under international law to protect the rights of present and future generations from the impact of climate change.

“This resolution and the advisory opinion it seeks will have a powerful and positive impact on how we address climate change and ultimately protect the present and future generations,” said Vanuatu Prime Minister Ishmael Kalsakau, whose government spearheaded the drafting and negotiations of the resolution, with a core group of 18 countries representing most corners of the world. 

“Together we will send a loud and clear message, not only around the world but far into the future: On this very day, the peoples of the United Nations, acting through their governments, decided to leave aside differences and work together to tackle the defining challenge of our times: climate change,” Kalsakau said.

More than 130 countries joined in co-sponsoring the resolution, which was adopted by consensus. While most of the world’s top emitters of greenhouse gases, including China and the United States, were noticeably absent from the co-sponsors, they did not prevent the adoption by consensus. 

The United States, which noted the Biden administration’s ambitious climate action to meet commitments consistent with keeping global warming to within the 1.5 degrees Celsius goal, said it has “serious concerns” that an ICJ opinion could hurt rather than help collective efforts to reach climate targets.

“We believe that launching a judicial process, especially given the broad scope of the questions, will likely accentuate disagreements and not be conducive to advancing our ongoing diplomatic and other processes,” U.S. delegate Nicholas Hill told the assembly. “In light of this, the United States disagrees that this initiative is the best approach for achieving our shared goals and takes this opportunity to reaffirm our view that diplomatic efforts are the best means by which to address the climate crisis.”

Japan and Germany are among the world’s top greenhouse gas emitters, and they joined as co-sponsors. Germany was also among the 18 countries that shepherded the initiative.

“Germany hopes that this initiative will contribute to further strengthen international cooperation, which is key for achieving the Paris Agreement’s objectives,” Ambassador Antje Leendertse said of the 2015 climate accord. 

The Pacific Island nation of Vanuatu’s very existence is threatened by rising sea levels. It is currently recovering from the devastation earlier this month of two Category 4 tropical cyclones in less than five days.

Kalsakau was clear that the effort is not intended to be a contentious one, nor is it a lawsuit. The authors also do not expect the Hague-based court to create new obligations on states, only to uphold existing ones. While the ICJ is the United Nation’s principal judicial organ, its decisions are not binding but carry considerable weight and can become part of what’s known as customary law.

“We believe the clarity it will bring can greatly benefit our efforts to address the climate crisis and could further bolster global and multilateral cooperation and state conduct in addressing climate change,” the prime minister said. 

U.N. Secretary-General Antonio Guterres welcomed the action, warning time is running out for nations to act boldly to fight global warming.

“This is the critical decade for climate action,” he told the assembly. “It must happen on our watch.”

The resolution began in 2019 as the brainchild of students from Vanuatu, which is among several small island states that are suffering the effects of the climate crisis but has contributed little to causing it.

“I don’t want to show a picture to my child one day of my island. I want my child to be able to experience the same environment, the same culture I grew up in,” Cynthia Houniuhi, president of Pacific Islands Students Fighting Climate Change, told reporters in a briefing ahead of the vote.

Human Rights Watch welcomed the resolution, saying it is a powerful demonstration of effective multilateral diplomacy led by a state from the Global South on behalf of people at risk.

“The overwhelming support for Vanuatu’s resolution is a major step toward gaining clarity on the legal obligations of states most responsible for climate change,” said HRW’s Environment and Human Rights director Richard Pearshouse. “It’s also important to focus — through the lens of human rights — on the obligations to protect those communities suffering most acutely.” 
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A joint project between Sudanese and Israeli scientists to study the unique resilience of Red Sea coral reefs has stalled due to red tape [bureaucratic delays], according to those involved. The project has been hailed not only for protecting coral reefs but also for normalizing Israel-Sudan relations. Henry Wilkins reports from Port Sudan, Sudan.
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The French ship the Plastic Odyssey is on a world tour to show how billions of tons of plastic waste is affecting the ocean. Allison Fernandes has this story from the Port of Dakar in Senegal. Salem Solomon narrates.
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Electricity generated from renewables surpassed coal in the United States for the first time in 2022, the U.S. Energy Information Administration announced Monday.

Renewables also surpassed nuclear generation in 2022, after first doing so last year.

Growth in wind and solar significantly drove the increase in renewable energy and contributed 14% of the electricity produced domestically in 2022. Hydropower contributed 6%, and biomass and geothermal sources generated less than 1%.

“I’m happy to see we’ve crossed that threshold, but that is only a step in what has to be a very rapid and much cheaper journey,” said Stephen Porder, a professor of ecology and assistant provost for sustainability at Brown University.

California produced 26% of the national utility-scale solar electricity followed by Texas with 16% and North Carolina with 8%.

The most wind generation occurred in Texas, which accounted for 26% of the U.S. total followed by Iowa (10%) and Oklahoma (9%).

“This booming growth is driven largely by economics,” said Gregory Wetstone, president and CEO of the American Council on Renewable Energy. “Over the past decade, the levelized cost of wind energy declined by 70%, while the levelized cost of solar power has declined by an even more impressive 90%.

“Renewable energy is now the most affordable source of new electricity in much of the country,” he added.

The Energy Information Administration projected that the wind share of the U.S. electricity generation mix will increase from 11% to 12% from 2022 to 2023 and that solar will grow from 4% to 5% during the period. The natural gas share is expected to remain at 39% from 2022 to 2023, and coal is projected to decline from 20% last year to 17% this year.

“Wind and solar are going to be the backbone of the growth in renewables, but whether or not they can provide 100% of the U.S. electricity without backup is something that engineers are debating,” said Porder, of Brown University.

Many decisions lie ahead, he said, as the proportion of renewables that supply the energy grid increases.

This presents challenges for engineers and policymakers, Porder said, because existing energy grids were built to deliver power from a consistent source. Renewables such as solar and wind generate power intermittently. So battery storage, long-distance transmission and other steps will be needed to help address these challenges, he said.

The EIA report found the country remains heavily reliant on the burning of climate-changing fossil fuels. Coal-fired generation was 20% of the electric sector in 2022, a decline from 23% in 2021. Natural gas was the largest source of electricity in the U.S. in 2022, generating 39% last year compared to 37% in 2021.

“When you look at the data, natural gas has been a major driver for lowering greenhouse gas emissions from electricity because it’s been largely replacing coal-fired power plants,” said Melissa Lott, director of research for the Center on Global Energy Policy at Columbia University.

“Moving forward, you can’t have emissions continuing to go up, you need to bring them down quickly,” she added.

The Inflation Reduction Act (IRA) influenced the amount of renewable energy projects that went online in 2022, Lott said, and it’s expected to have a “tremendous” impact on accelerating clean energy projects.
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The World Health Organization says about 87% of Sudanese females between ages 15 and 49 have undergone female genital mutilation, one of the highest rates in the world. A project by the U.N. children’s agency, UNICEF, is targeting sports clubs to engage men and boys in the fight against the practice. Henry Wilkins reports from Khartoum, Sudan.
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The Webb Space Telescope has found no evidence of an atmosphere at one of the seven rocky, Earth-sized planets orbiting another star.

Scientists said Monday that doesn’t bode well for the rest of the planets in this solar system, some of which are in the sweet spot for harboring water and potentially life.

“This is not necessarily a bust” for the other planets, Massachusetts Institute of Technology astrophysicist Sara Seager, who wasn’t part of the study, said in an email. “But we will have to wait and see.”

The Trappist solar system — a rarity with seven planets about the size of our own — has enticed astronomers ever since they spotted it just 40 light-years away. That’s close by cosmic standards; a light-year is about 5.8 trillion miles. Three of the seven planets are in their star’s habitable zone, making this star system even more alluring.

The NASA-led team reported little if any atmosphere exists at the innermost planet. Results were published Monday in the journal Nature.

The lack of an atmosphere would mean no water and no protection from cosmic rays, said lead researcher Thomas Greene of NASA’s Ames Research Center.

As for the other planets orbiting the small, feeble Trappist star, “I would have been more optimistic about the others” having atmospheres if this one had, Greene said in an email.

If rocky planets orbiting ultracool red dwarf stars like this one “do turn out to be a bust, we will have to wait for Earths around sun-like stars, which could be a long wait,” said MIT’s Seager.

Because the Trappist system’s innermost planet is bombarded by solar radiation — four times as much as Earth gets from our sun — it’s possible that extra energy is why there’s no atmosphere, Greene noted. His team found temperatures there hitting 450 degrees Fahrenheit (230 degrees Celsius) on the side of the planet constantly facing its star.

By using Webb — the largest and most powerful telescope ever sent into space — the U.S. and French scientists were able to measure the change in brightness as the innermost planet moved behind its star and estimate how much infrared light was emitted from the planet.

The change in brightness was minuscule since the Trappist star is more than 1,000 times brighter than this planet, and so Webb’s detection of it “is itself a major milestone,” the European Space Agency said.

More observations are planned not only of this planet, but the others in the Trappist system. Looking at this particular planet in another wavelength could uncover an atmosphere much thinner than our own, although it seems unlikely it could survive, said Taylor Bell of the Bay Area Environmental Research Institute, who was part of the study.

Further research could still uncover an atmosphere of sorts, even if it’s not exactly like what’s seen on Earth, said Michael Gillon of the University of Liege in Belgium who was part of the team that discovered the first three Trappist planets in 2016. He did not take part in the latest study.

“With rocky exoplanets, we are in uncharted territory” since scientists’ understanding is based on the four rocky planets of our solar system, Gillon said in an email.

Launched in late 2021 to an observation post 1 million miles (1.6 million kilometers) away, Webb is considered the successor to the Hubble Space Telescope, orbiting Earth for more than three decades.

In the past, Hubble and the Spitzer Space Telescope scoured the Trappist system for atmospheres, but without definitive results.

“It is just the beginning, and what we can learn with the inner planets is going to be different from what we can learn from the other ones,” MIT’s Julien de Wit, who was not involved in the study, said in an email.
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Scientists have long known that wild seabirds ingest bits of plastic pollution as they feed, but a new study Monday shows the tiny particles don’t just clog or transit the stomach but can subvert its complex mix of good and bad bacteria, too.

Plastic-infested digestive tracts from two species of Atlantic seabirds, northern fulmars and Cory’s shearwaters, showed a decrease of mostly beneficial “indigenous” bacteria and more potentially harmful pathogens.

There was also an increase in antibiotic-resistant and plastic-degrading microbes, researchers reported in the journal Nature Ecology & Evolution.

The findings suggested that certain types of microplastic may be leeching chemicals that disrupt the birds’ so-called gut microbiome.

Microplastics — produced when plastic products break down in the environment — are directly and indirectly ingested across most animal food chains.

They can be found in every corner of the world, from the deepest trenches of oceans to the top of Mount Everest.

In humans, they have been detected in the blood, breast milk and placentas.

The new study supports previous findings that prolonged ingestion of microplastics causes an imbalance of healthy and unhealthy bacteria in the stomach, a condition known as gut dysbiosis.

The implications are far-reaching.

Like humans, birds have evolved with a vast network of microbes, including bacteria, that live in our bodies in communities called microbiomes.

Some microbes cause diseases, but most exist as “friendly” bacteria with a critical role in digestion, immune response and other critical functions.

“There’s a symbiosis that goes on — and that’s the case in the seabirds as well as in humans,” lead author Gloria Fackelmann of Ulm University in Germany told AFP.

Little is known about the effects of individual microbes on the body.

But overall, a growing body of research points to the harmful impacts of microplastics on animal health.

The tiny particles — less than 5 millimeters in diameter — can cause cell death and allergic reactions in humans.

Chemicals in microplastics have also been linked to increased risks of cancer, reproductive problems and DNA mutations.

The authors hope the findings in seabirds will spur related studies for humans.

“If this man-made substance could alter our microbiome, I think that should make people think,” said Fackelmann.
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Florida has captured more than 17,000 Burmese pythons since 2000, but tens of thousands more are likely roaming the Florida Everglades. That’s a concern because the reptiles, which are not native to the area, are gobbling up the competition.

“[Pythons] can take out one of our apex predators, which are alligators and crocodiles, and then it’ll take down some of the other native animals that are small mammals — some of the rats, the mice, the marsh bunnies — things that are supposed to be food for other things,” says Mike Hileman, park director of Gatorland, a theme park and wildlife preserve in Orlando. “So, they compete with our native animals, and because they’re a more dominant species, they win that battle.”

The Everglades is among the world’s most unique and delicate ecosystems. The python invasion is upsetting the fragile balance of the 6 million-square-kilometer wetlands preserve, which is home to rare and endangered species like manatees, the Florida panther and the American crocodile.

“Once a species starts reproducing in the wild, and they have a system that works for them, it’s almost next to impossible to eradicate them,” Hileman says.

Florida is grappling with the most severe invasive animal crisis in the continental United States. The invasives flourish in the state’s subtropical climate, characterized by hot, humid summers and wet, mild winters. There are more than 500 non-native plant and wildlife species in the state, some of which — like pythons — are taking over the habitat and threatening the environment.

“They form almost like a monoculture of the invasives, and when your biodiversity plummets, then the environment isn’t as able to withstand perturbations like climate change,” says Kurt Foote, a ranger with the National Park Service and natural resource management specialist at Fort Matanzas National Monument in St. Augustine. “Nature relies on variety, and when you don’t have variety, it’s just more susceptible to collapse.”

There is a flourishing reptile pet trade in Florida. In 1992, Hurricane Andrew destroyed a Burmese python breeding facility, releasing the animals into the wild. The Category 5 hurricane also leveled thousands of homes, setting numerous exotic pets free.

However, the very first Burmese python was found in the Everglades in 1979, more than a decade before Hurricane Andrew, and was probably a pet that escaped or was intentionally released by its owner. Florida residents are no longer allowed to keep Burmese pythons as pets.

“Animals can be a lot of work. The parrots are loud; they live almost 80 years. Tortoises can get really big and live 100 years. So, it’s a big commitment to have a lot of these animals,” says Kylie Reynolds, deputy director of Amazing Animals Inc., a nonprofit exotic animal preserve in St. Cloud that takes in non-native animals that were once people’s pets.

“People sometimes just go, ‘You know, it’s nice in Florida. We’ll just let it loose.’… Maybe they think their animal would be happier free. But again, they could compete for our natural resources with our native wildlife,” Reynolds says.

In addition to Burmese pythons, Florida’s most problematic invasive animals include lionfish, feral hogs, Argentine black and white tegu lizards, and Cuban tree frogs, which can be found in many parts of the state, including Fort Matanzas.

“They’re a bigger tree frog than what we have here by quite a bit, and they’re also fairly omnivorous, and they will eat the native tree frogs,” Foote says. “Like a lot of invasives, when they get here, they don’t have the things that predated them or competed with them in their homelands. They get here and without that pressure, they’re able to really breed and reproduce.”

Feral hogs, originally brought to Florida by Spanish explorers in the 1500s, cause millions of dollars’ worth of damage to crops each year. The animals, which are found statewide, disrupt the soil in areas such as Lake Apopka in Mount Dora that biologists are trying to restore.

“We’re planting native vegetation. … A lot of times, they’re rare or endemic species,” says Ben Gugliotti, land manager of Lake Apopka North Shore, a nature preserve. “The hogs will come in and root up those areas, basically destroying the planting areas that we’re trying to restore. And then also actually create a secondary opening for invasive plant species that move into those disturbed soil areas.”

Argentine black and white tegu lizards are on the mind of Cheryl Millett, manager of The Nature Conservancy’s Tiger Creek preserve in Babson Park, which sits on Florida’s oldest and highest land mass.

“It’s a biodiversity hotspot. And yeah, we have a lot of things that … don’t exist anywhere else,” Millett says. “And if we lost them here, we wouldn’t have them anymore on Earth.”

She’s most concerned about tegu lizards, which haven’t reached Tiger Creek yet but have been spotted nearby. They can grow up to 1.5 meters long.

“They found baby gopher tortoises in the guts of tegu lizards that have been found in South Florida,” Millett says. “They can eat baby gopher tortoises. I’m really worried about their potential impact here.”

Gopher tortoises are listed as federally endangered. They are a keystone species, which means they are critical to the surrounding ecosystem because they provide shelter for hundreds of other animals.

“[Tegu lizards] love gopher tortoise burrows, and they’ve been found using gopher tortoise burrows in South Florida,” Millett says. “Gopher tortoises create these burrows. They’re like 10 feet deep, and can be 30 feet long, and they harbor over 300 different species in them.”

Florida spends more than $500 million a year trying to contain invasive species and the damage they cause. Officials organize hunts, exotic pet amnesty programs, and utilize other methods to combat invasive species. But it might come down to educating the future.

“Our generation, we already have preconceived ideas. We’re lost. We’re not going to change anything,” says Hileman of Gatorland, who speaks to school groups about wildlife conservation. “We’ve got to get with the little guys, and we got to get them on the same team so they can spread that message to their kids as they get older.”
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Keep an eye to the sky this week for a chance to see a planetary hangout.

Five planets — Mercury, Jupiter, Venus, Uranus and Mars — will line up near the moon.

Where and when can you see them?

The best day to catch the whole group is Tuesday. You’ll want to look to the western horizon right after sunset, said NASA astronomer Bill Cooke.

The planets will stretch from the horizon line to around halfway up the night sky. But don’t be late: Mercury and Jupiter will quickly dip below the horizon around half an hour after sunset.

The five-planet spread can be seen from anywhere on Earth, as long as you have clear skies and a view of the west.

“That’s the beauty of these planetary alignments. It doesn’t take much,” Cooke said.

Do I need binoculars?

Maybe. Jupiter, Venus and Mars will all be pretty easy to see since they shine brightly, Cooke said. Venus will be one of the brightest things in the sky, and Mars will be hanging out near the moon with a reddish glow. Mercury and Uranus could be trickier to spot, since they will be dimmer. You’ll probably need to grab a pair of binoculars.

If you’re a “planet collector,” it’s a rare chance to spot Uranus, which usually isn’t visible, Cooke said. Look out for its green glow just above Venus.

Does this happen often?

Different numbers and groups of planets line up in the sky from time to time. There was a five-planet lineup last summer and there’s another one in June, with a slightly different makeup.

This kind of alignment happens when the planets’ orbits line them up on one side of the sun from Earth’s perspective, Cooke said.
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Hundreds of volunteers descended on the beaches of the North Sea coast this weekend to collect sea shells as a measure of the sea’s biological diversity.

While there is a serious scientific purpose to the exercise, it is also a fun day out on the coast for Belgian, French and Dutch families with kids.

On Saturday, Natascha Perales and her children marked a wide spiral pattern on the sand in Middelkerke, in Flanders, and filled their plastic buckets with shells.

The harvests were taken to a sorting center run by volunteers, to be counted and divided up by species.

“We found mussels, oysters, cockles, at least six different species,” 40-year-old Perales told AFP. “It’s a great activity, despite the weather.”

Braving stiff gusts of wind, the dozen participants kept the Middelkerke collection point busy.

Laurence Virolee, 41, came with her three children.

“We learned a lot of things,” she said. “Last year we took part in a clean-up day on the beach. It’s important for the kids to see the evolution in biodiversity and make them aware of the climate.”

The collections took place along 400 kilometers of coastline and around 800 people took part in three countries, with France joining the sixth annual event for the first time.

In total, around 38,000 shells were brought in, roughly as many as in last year’s event.

Invasive species

“Shells are a good indicator of the state of biodiversity in the North Sea, ” explained Jan Seys, who organizes the survey for the Flanders Marine Institute.

“Last year, 15% of the shells found belonged to exotic species,” he said, amid fears that foreign shellfish species might become an invasive danger to native organisms. “We have seen, for example the Atlantic Jackknife Clam appearing on our coasts.”

The volunteers were also on the lookout for shells with holes in them, trying to measure the spread of predatory sea snails preying on shellfish.

Near the beach, retired biologist Joris Hooze, 75, taught volunteers how to examine mollusks under his microscope and distinguish their differences.

“We’ve seen organisms that normally live in warm waters turning up more and more,” he said. “It’s a sign of climate change.”

The European Union wants to clean up the seas around its coasts and restore the natural ecosystem by 2030. To do that, it has assigned 800 million euros ($861,600,000) in funding to the task.

“If we’re going to hit that target, we’ll need the general public,” said Seys. As well as its scientific value, the shell hunt served to raise awareness, he added.
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When China suddenly scrapped onerous zero-COVID measures in December, the country wasn’t ready for a massive onslaught of cases, with hospitals turning away ambulances and crematoriums burning bodies around the clock.

Chinese state media claimed the decision to open up was based on “scientific analysis and shrewd calculation,” and was “by no means impulsive.” But in reality, China’s ruling Communist Party ignored repeated efforts by top medical experts to kickstart exit plans until it was too late, The Associated Press found.

Instead, the reopening came suddenly at the onset of winter, when the virus spreads most easily. Many older people weren’t vaccinated, pharmacies lacked antivirals, and hospitals didn’t have adequate supplies or staff — leading to as many as hundreds of thousands of deaths that may have been avoided, according to academic modeling, more than 20 interviews with current and former China Center for Disease Control and Prevention employees, experts and government advisers, and internal reports and directives obtained by the AP.

“If they had a real plan to exit earlier, so many things could have been avoided,” said Zhang Zuo-Feng, an epidemiologist at the University of California, Los Angeles. “Many deaths could have been prevented.”

Experts estimate that many hundreds of thousands of people, perhaps millions, may have died in China’s wave of COVID-19 — far higher than the official toll of fewer than 90,000, but still a much lower death rate than in Western countries. However, 200,000 to 300,000 deaths could have been prevented if the country was better vaccinated and stocked with antivirals, according to modeling by the University of Hong Kong. Some scientists estimate even more lives could have been saved.

“It wasn’t a sound public health decision at all,” said a China CDC official, declining to be named to speak candidly on a sensitive matter. “It’s absolutely bad timing … this was not a prepared opening.”

For two years, China stood out for its tough but successful controls against the virus, credited with saving millions of lives as other countries struggled with stop-and-start lockdowns. But with the emergence of the highly infectious omicron variant in late 2021, many of China’s top medical experts and officials worried zero-COVID was unsustainable.

In late 2021, China’s leaders began discussing how to lift restrictions. As early as March 2022, top medical experts submitted a detailed reopening strategy to the State Council, China’s cabinet. The existence of the document is being reported for the first time by the AP.

But discussions were silenced after an outbreak the same month in Shanghai, which prompted Chinese leader Xi Jinping to lock the city down. Chinese public health experts stopped speaking publicly about preparing for an exit, as they were wary of openly challenging a policy supported by Xi.

By the time the Shanghai outbreak was under control, China was months away from the 20th Party Congress, the country’s most important political meeting in a decade, making reopening politically difficult. So the country stuck to mass testing and quarantining millions of people.

“Everybody waits for the party congress,” said one medical expert, declining to be named to comment on a sensitive topic. “There’s inevitably a degree of everyone being very cautious.”

At the Congress in mid-October, top officials differing with Xi were sidelined. Instead, six loyalists followed Xi onstage in a new leadership lineup, signaling his total domination of the party.

With the congress over, some voices in the public health sector finally piped up. In an internal document published October 28, obtained by The Associated Press and reported here for the first time, Wu Zunyou, China’s CDC chief epidemiologist, criticized the Beijing city government for excessive COVID-19 controls, saying it had “no scientific basis.” He called it a distortion of the central government’s zero-COVID policy, which risked “intensifying public sentiment and causing social dissatisfaction.”

At the same time, he called the virus policies of the central government “absolutely correct.” One former CDC official said Wu felt helpless because he was ordered to advocate for zero-COVID in public, even as he disagreed at times with its excesses in private.

Wu did not respond to an email requesting comment. A person acquainted with Wu confirmed he wrote the internal report.

Another who spoke up was Zhong Nanshan, a doctor renowned for raising the alarm about the original COVID outbreak in Wuhan. He wrote to Xi personally, telling him that zero-COVID was not sustainable and urging a gradual reopening, said a person acquainted with Zhong.

In early November, then-Vice Premier Sun Chunlan, China’s COVID czar, summoned experts from sectors including health, travel and the economy to discuss adjusting Beijing’s virus policies, according to three people with direct knowledge of the meetings. On November 10, Xi ordered adjustments.

The next day, Beijing announced 20 new measures tweaking restrictions, such as reclassifying risk zones and reducing quarantine times. But at the same time, Xi made clear, China was sticking to zero-COVID.

The government wanted order. Instead, the measures caused chaos.

With conflicting signals from the top, local governments weren’t sure whether to lock down or open up. Policies changed by the day.

In late November, public frustration boiled over. A deadly apartment fire in China’s far west Xinjiang region sparked nationwide protests over locked doors and other virus control measures. Some called on Xi to resign, the most direct challenge to the Communist Party’s power since pro-democracy protests in 1989.

Riot police moved in, and the protests were swiftly quelled. But behind the scenes, the mood was shifting.

References to zero-COVID vanished from government statements. State newswire Xinhua said the pandemic was causing “fatigue, anxiety and tension,” and that the cost of controlling it was increasing day by day.

Days after the protests, Sun held meetings where she told medical experts the state planned to “walk briskly” out of zero-COVID. The final decision was made suddenly, and with little direct input from public health experts, several told the AP.

“None of us expected the 180-degree turn,” a government adviser said.

Many in the Chinese government believe the protests accelerated Xi’s decision to scrap virus controls entirely, according to three current and former state employees.

“It was the trigger,” said one, not identified because they weren’t authorized to speak to the media.

On December 6, Xi instructed officials to change COVID-19 controls, Xinhua reported.

The next day, Chinese health authorities announced 10 sweeping measures that effectively scrapped controls, canceling virus test requirements, mandatory centralized quarantine and location-tracking health QR codes. The decision to reopen so suddenly caught the country by surprise.

“Even three days’ notice would have been good,” said a former China CDC official. “The way this happened was just unbelievable.”
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The discovery of major lithium deposits is being seen as a mixed blessing in India’s troubled Kashmir region, where hopes for a major economic boost are tempered by fears of human displacement and damage to the territory’s fragile ecology.

The finding of the lithium, key to the manufacture of batteries used in electric cars and other electronic devices, is likely very good news for India as a whole, promising to save the country billions of dollars as it seeks to move its economy away from fossil fuels.

It also offers the hope of good-paying jobs in Kashmir, where investment has been in decline amid political uncertainty and frequent internet shutdowns since the Indian government revoked the region’s autonomous status in 2019.

But residents in the southwestern Reasi district of Jammu & Kashmir where the deposits are located say they are torn between those hopes and a fear of being driven off their land to make way for mining operations, as well as concern about the impact on local vegetation and wildlife.

The Geological Survey of India has estimated the area holds 5.9 million metric tons of lithium valued at around $410 billion, although further studies will be needed to determine the quality of the lithium and confirm it can be recovered.

If initial hopes are borne out, the deposit would represent a significant share of the world’s known lithium reserves, which were estimated last year by the U.S. Geological Survey at just 80.7 million tons. The Indian government plans to hold auctions for the reserves as early as June, with the caveat that refined lithium can only be processed within India.

“The scale of the reserves is significant and can — if proven to be commercially viable — reduce India’s reliance on imports of lithium-ion cells, which are a key component for EV batteries and other clean energy technologies,” said Siddharth Goel, a senior policy adviser at the Canada-based International Institute for Sustainable Development, in an interview with VOA.

“These reserves could potentially be a huge carrot to attract investment into domestic battery manufacturing and other clean energy technologies,” he said.

Having a domestic source of lithium would dramatically improve India’s prospects of meeting its goal of achieving 30% electric vehicle penetration for private cars, 70% for commercial vehicles, and 80% for two and three-wheelers by 2030.

India’s ministry of commerce data shows that India spent around $3.2 billion importing lithium between 2018 and 2021, money that would remain in the country if the lithium could be produced domestically. By speeding its transition to electric vehicles, India also hopes to reduce its dependency on imported oil.

“It will help India reduce import bill substantially and boost domestic production if the entire reserve can be extracted sustainably and is economically viable,” said Pradeep Karuturi, a researcher at the India-based OMI Foundation, a new-age policy research and social innovation think tank.

“However, it may take years for actual output so it’s important for India to create a cohesive multi-dimensional policy to strengthen energy security,” he said.

Effect on environment

Kashmiri environmentalists are more focused on the impact that lithium extraction will have on the ecology of the scenic Himalayan region. A report published by an environmental organization, the Nature Conservancy, notes that proven technologies for lithium extraction require vast amounts of land and can result in the removal of native vegetation.

Earlier this month, a group of NGOs including Climate Front Jammu, Environmental Awareness Forum and Nature Human Centric People’s Movement organized a climate strike at Press Club Jammu to express their concerns.

The founding director of Climate Front India, Anmol Ohri, told VOA the mining could cause irreversible harm to the ecosystem and adversely affect the indigenous and local communities near the mining area.

“If regulations are not stringent enough, this discovery could result in the communities surrounding the region abandoning their homes and relocating to urban areas, resulting in a loss of cultural heritage,” he said.

Kulwant Raj, a local resident and former candidate in area elections, said residents are pleased about the economic prospects that the deposits represent but simultaneously fear the government will confiscate their land.

While not opposed to mining in the area, Raj told VOA, the locals would like to be relocated to someplace nearby and compensated with government jobs.

Goel said it is important for the government of India to look to the experience of other countries as it seeks to balance the economic benefits of the lithium discovery with the environmental and social safeguards demanded by residents.

“Meaningful representation and participation of local communities in decision-making are essential to prevent community opposition to lithium mining,” he said. “As India is looking to export li-ion batteries, ensuring an environmentally friendly mining process is also essential to attract investment from large international companies given the growing global scrutiny of the battery value chain’s environmental footprint.”
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Florida’s warm weather attracts millions of visitors, including animals that outstay their welcome. Wildlife brought in from somewhere else has seriously damaged the ecosystem in Florida, home to the most severe invasive animal crisis in the continental United States. VOA’s Dora Mekouar has more from Orlando. Camera: Adam Greenbaum Produced by: Dora Mekouar, Adam Greenbaum
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In marking World TB Day, health officials warn the COVID-19 pandemic and multiple global crises are setting back years of progress in fighting tuberculosis and eventually ending the deadly disease.

Tuberculosis, an ancient disease that some say goes back to biblical times, kills more people than any other infectious disease. The World Health Organization says 1.6 million people globally died from TB in 2021 and an estimated 10.6 million people were newly infected.

Tuberculosis – a bacterial infection of the lungs – is a preventable, treatable and curable disease.

Significant inroads have been made in battling tuberculosis, with the WHO saying that TB deaths have dropped by nearly 40 percent globally since 2000. Additionally, the organization reports an estimated 74 million lives were saved through TB diagnosis and treatment.

While acknowledging the promising results, Tedros Adhanom Ghebreyesus, the WHO director-general, said progress in the fight against TB recently has stalled and even been reversed.

“The COVID-19 pandemic and conflicts in many countries have severely disrupted services to prevent, detect and treat TB.”

As a result, he said the “WHO last year reported an increase in TB deaths for the first time in more than a decade” as well as an increase in the number of people falling ill with TB and drug-resistant TB.

He deplored the enormous impact of the ongoing epidemic on families and communities.

“We cannot truly end TB unless we address its drivers.”

Those, he said, included conditions of “poverty, malnutrition, diabetes, HIV, tobacco and alcohol use, poor living and working conditions, stigma and discrimination.”

The WHO says the largest number of new TB cases – 46% – occurred in the Southeast Asian region (or Southeast Asia), followed by the African region with 23% and the Western Pacific with 18%.

While the numbers remain high, WHO Regional Director for Africa Matshidiso Moeti observed that the continent has made progress in recent years in combating TB. For example, she noted that deaths in the region have fallen by 26% between 2015 and 2021.

“We do still face some challenges, notably delayed diagnosis and testing, since 40 percent of people living with TB did not know their diagnosis or the disease was not reported in 2021.

“Moreover, an estimated 1 million people are living with TB in the region, yet to be detected,” she said.

WHO chief Tedros’ five-year flagship initiative on TB, which he launched in 2018, seeks to build on the progress achieved by improving delivery of quality care to people living with TB.

Under the program, the WHO has provided two new TB drugs and 12 new TB diagnostic tests to more than 100 countries.

Tereza Kasaeva, director of the WHO’s global tuberculosis program, said the WHO, for the first time, has recommended “a fully oral, two to three times shorter and more effective treatment, including for the most severe forms of multi-resistant TB.”

Jeff Acebo, a TB and HIV survivor from the Philippines and a member of the WHO’s civil society task force, welcomed the development.

He said for too long, people with multidrug resistant TB “have struggled with painful injections, longer regimens, side effects and catastrophic out-of-pocket costs.

“We strongly urge governments, especially one with [a] high burden of TB, to roll out and accelerate the implementation of the novel six-month all-oral regimen treatment,” which he said “would improve the quality of life” for those suffering from the disease.

Given its success, Tedros said, “we have decided to extend the initiative for a further five years, until 2027 and broaden its scope.”

In 2015, the United Nations set a target date of 2030 to end the global TB epidemic as part of its sustainable development goals. In September, world leaders will meet in New York for the second high-level meeting on TB to invigorate the flagging process.

Tedros said he believes the meeting should be a turning point in the fight against TB – if leaders make real and lasting commitments to invest the financial resources needed to end it.

Lucica Ditiu, executive director of the Stop TB Partnership, echoed those sentiments.

“We have new innovations now to help us save lives—new diagnostic tools, shorter, less toxic treatment regimens and new digital tools,” she said.

“When we add the political muscle that the UNHLM [U.N. high level meeting] will gather to the many dedicated health care professionals already in the front lines,” she said, “ending TB looks increasingly possible.”
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What would turn bird flu – the kind that’s killed millions of birds around the world and a few hundred people – into the next deadly pandemic?

Scientists want to know so they can get ahead of it. That’s why, in 2010, two groups of researchers were studying an avian influenza virus that killed about half of the people it infected but does not spread easily among them. They infected ferrets with it to see what it would take to make it more transmissible. Ferrets’ lungs and airways are a lot like ours.

“They would infect a ferret, wait a certain amount of time, take the virus that comes out of that ferret and infect the next ferret,” said University of Michigan microbiologist Michael Imperiale.

After 10 rounds, the virus had mutated into a much more dangerous form. “They didn’t have to transfer it from one ferret to the next,” he said. “If they put the ferrets in close proximity, those ferrets could transfer to each other.”

That virus has pandemic potential.

The scientists figured out what parts of the virus had mutated to make it spread more easily. That could help experts looking out for the next dangerous virus, they said, and it could help develop drugs and vaccines against it.

On the other hand, the researchers had just created a new, deadly, easy-to-spread disease threat. If it were to get out of the lab somehow, it could start a global pandemic.

Lab leaks are rare but they do happen. SARS escaped from labs in Singapore, Taiwan and China in the early 2000s. A lab accident in Britain led to an outbreak of foot and mouth disease in livestock.

“It just shows that even the best labs in the world are not totally protected from accidents,” said Harvard University epidemiologist Marc Lipsitch. “Humans are fallible.”

The bird flu experiments set off alarm bells when the researchers went to publish their results in 2011, according to Rutgers University microbiologist Richard Ebright.

“I think everyone hearing the result was surprised, first, that anyone would be so ethically challenged as to conduct such an experiment; and second, surprised that there were no mechanisms of oversight whatsoever that would prevent a researcher from conducting such an experiment,” he said.

Not everyone thought the experiments were fundamentally a bad idea. But they did kick off a push for more oversight.

That kind of research is worthwhile under two conditions, according to University of Michigan microbiologist Imperiale.

“Is it addressing a pressing biomedical issue, [for which] we have to have the answer? Is that really the only, or the best way to get it such that other approaches just will not get you to the answer you need? And if the answer to those two questions are yes, then let’s figure out a way to do it safely,” he said.

U.S. health authorities set up a framework to ask those questions and decide what research should get funding.

However, Ebright said, “that framework was sound on paper but it has not actually occurred in practice.”

He said that several research projects that should have gotten extra scrutiny did not, including U.S.-funded research in Wuhan, China on what would make coronaviruses more infectious to people. Ebright contends that research could have been the source of the COVID-19 virus.

Where COVID-19 came from is fiercely debated. But the coronavirus pandemic has drawn more scrutiny of research on germs with pandemic potential.

“It reminds us that this is no laughing matter. It does not have to be a 50 percent lethal virus to cause global societal disruption and a lot of damage and that we need to be really careful,” Lipsitch said.

“I think it has spurred some more cautious thought about oversight but the oversight really still is not in place,” he added.

A U.S. advisory board has recommended ways to tighten the guidelines. Experts say they are a step in the right direction but loopholes remain. Some say they should be law, not guidelines.

On the other hand, Lipsitch noted, “there’s a real risk that Congress will overreact and unduly restrict very valuable and completely safe research in an effort to restrict less valuable and more dangerous research.”

Plus, the rules would only apply to U.S.-funded research. Other countries need to do the same, Imperiale said.

“If this is not some sort of international consensus, we’re not accomplishing what we really want to accomplish here, which is keeping the world safe,” he said. “Because, as we all know, infectious agents don’t respect national borders.”
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Cameroon and Gabon have stepped up border security after neighboring Equatorial Guinea confirmed a spreading Marburg virus has killed at least nine people. Despite the controls, people are still traveling across the porous borders, raising fears the virus that causes hemorrhagic fever could spread. 

At the government primary school in Kye-Ossi, a town on Cameroon’s southern border with Gabon and Equatorial Guinea, children sing that regular hand washing protects people from diseases.

Mireille Evan, head teacher of the school, said more than 15 children from Equatorial Guinea attended classes in Kye-Ossi on Friday. She said those children were separated from their Cameroonian peers and obliged to wash their hands before attending classes.

Evan said Cameroon’s public health ministry officials informed her that movement across the border was restricted because of an outbreak of the Marburg virus in Equatorial Guinea. She said it is not her duty to stop children from attending classes.

Cameroon’s ministries of basic and secondary education said that several hundred children cross every day from Kie Ntem, an administrative unit in Equatorial Guinea, to study in Kye-Ossi alongside scores of children from Gabon. 

Also, several hundred merchants cross borders to Gabon, Equatorial Guinea and Cameroon each day to conduct business, according to CEMAC, a regional economic bloc.

Authorities in Equatorial Guinea said the Marburg outbreak has killed nine people, but the World Health Organization said the death toll may be as high as 20.

Cameroon’s public health ministry said Friday that it had held discussions with health officials in Gabon and Equatorial Guinea on ways to stop or reduce the spread of the disease.

Felix Nguele Ngule, governor of Cameroon’s South Region, where Kye-Ossi is located, said surveillance and travel restrictions have been reinforced along the borders. 

“What we can assure the population is that the surveillance system has been activated, health staff are mobilized and even the administrative authorities at the border are equally mobilized to monitor the disease,” he said. “We want to thank the World Health Organization and the Red Coss that have joined us to see into it that that disease should not cross the border and enter our country.”

However, Nguele said the porous borders make it difficult for Cameroon and Equatorial Guinea police to fully control the movement of people.

On February 14, Cameroon’s health ministry reported two suspected cases of Marburg virus in the country after a first deadly outbreak in neighboring Equatorial Guinea.

Gabon’s state broadcaster, RTG, on Friday reported that after the second Marburg outbreak in Equatorial Guinea in less than two months, the government of Gabon reinforced its contingency plan of zero contamination of Marburg virus disease.

RTG reported Libreville had also dispatched a team of technicians to identify an isolation area for possible suspected cases in border areas.

Cameroon and Gabon said civilians should avoid contact with animals and people who have traveled to Equatorial Guinea and make sure people with fever, fatigue, and blood-stained vomit and diarrhea are isolated.

The WHO said Marburg is transmitted to people from fruit bats, spreads among people through bodily fluids, and has a fatality rate of up to 88%. 
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Several African and Latin American countries on Thursday launched a major initiative to restore 300,000 kilometers of rivers by 2030, as well as lakes and wetlands degraded by human activity. 

The “Freshwater Challenge,” led by a coalition of governments that includes Colombia, the Democratic Republic of the Congo, Mexico and Gabon, is the largest river and wetland restoration project in history. 

It aims to restore degraded rivers as long as seven times the Earth’s circumference and an area of wetlands larger than India by 2030, according to a statement from the U.N. Water Conference, which ends Friday in New York City. 

The initiative calls on all governments to set national river restoration targets to restore healthy freshwater ecosystems critical to humanity’s water needs and biodiversity. 

No details were given on how the effort will be funded. 

As water shortages become more widespread globally, driven by overconsumption, pollution and climate change, freshwater ecosystems are among the most threatened on the planet. 

“The clearest sign of the damage we have done — and are still doing — to our rivers, lakes and wetlands is the staggering 83 percent collapse in freshwater species populations since 1970,” Stuart Orr of the World Wildlife Fund said in a statement, adding that the initiative may “turn this around.” 

Inger Andersen, executive director of the U.N. Environment Program, said: “Healthy rivers, lakes and wetlands underpin our societies and economies, yet they are routinely undervalued and overlooked.” 

“While countries have pledged to restore 1 billion hectares of land, the Freshwater Challenge is a critical first step in bringing a much-needed focus on freshwater ecosystems,” Anderson added. 

Martha Delgado Peralta, Mexico’s undersecretary for multilateral affairs, voiced a similar view. 

“Healthy freshwater ecosystems are central to water and food security, while tackling the climate and nature crises, and driving sustainable development,” she said. 
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