science

New study probes why chronic pain lasts longer in women

BY MAGGY DONALDSON AND CHARLOTTE CAUSIT IN WASHINGTON

  • For decades women were excluded from clinical trials, and most pain studies analyzing animals only used males, Midavaine noted -- a medical bias that operated on the notion that female hormones created "too much variability."
  • To all the women who've heard the frustrating "it's all in your head" in response to medical maladies, a new study out Friday feels your pain.
  • For decades women were excluded from clinical trials, and most pain studies analyzing animals only used males, Midavaine noted -- a medical bias that operated on the notion that female hormones created "too much variability."
To all the women who've heard the frustrating "it's all in your head" in response to medical maladies, a new study out Friday feels your pain.
Research published in the journal Science Immunology shows that women actually do experience exacerbated chronic pain compared to men -- a gap that can be explained by biological differences in the immune system.
"The pain of women has been overlooked in clinical practice," lead author Geoffroy Laumet told AFP, "with the idea that it's more in the mind, or that it's because women are softer and more emotional."
"But here, our study shows that the difference is real... it's not a social construct. It has a real biological mechanism that is behind it."
Pain occurs when neurons react to stimuli: stubbing your toe, or tripping and skinning your knee, for example. 
But chronic pain persists with mild to no stimulation -- and women constitute 60 to 70 percent of the patients experiencing it, Laumet said.
The scientist at Michigan State University said his team set out to explore how hormone-regulated immune cells, known as monocytes, impacted pain resolution.
Researchers learned those monocytes play a key role in communicating with the neurons that sense pain -- and then working to shut down those pain-sensing neurons by producing the anti-inflammatory interleukin 10, or IL-10.
Their studies weren't originally aimed at exploring potential differences related to sex, but the data was clear: it took longer for pain to resolve in female mice, and the monocytes producing IL-10 were less active in them.
Those cells are more active in males, according to the study, which cited higher levels of sex hormones like testosterone as an explanation why.
Laumet is hopeful the new research could open new doors to improved pain treatment.
In the long-term, he said research can probe how to stimulate the monocytes and boost IL-10 production to "enhance the body's ability to resolve pain."
And in the short-term, he sees the potential for topical testosterone to prove a viable option to alleviate localized suffering.

'More equitable care'

Elora Midavaine -- a researcher at the University of California, San Francisco who also studies chronic pain -- told AFP the new study adds "important nuance" to how we understand the interactions of hormones and the immune system, and their influence on pain.
Midavaine, who was not involved in the study, said it fits into a broader movement focused on intersections of neuroscience with both immunology and endocrinology -- an approach she said "has potential to advance our understanding of chronic pain in women."
Laumet said he hopes that improved understanding and potential new treatment avenues could reduce prescriptions of opioid painkillers, which have high risks of side effects and addiction.
And more broadly, both researchers voiced optimism that as our knowledge of women's health improves, they will receive better treatment.
"I hope that we can contribute to erase this common idea that women's pain is exaggerated," Laumet said. "The standard of care should be adapted to the sex."
But why has it taken so long to begin understanding the bodies of half the population?
For decades women were excluded from clinical trials, and most pain studies analyzing animals only used males, Midavaine noted -- a medical bias that operated on the notion that female hormones created "too much variability."
Diagnosis of pain relies almost wholly on reporting from patients -- and the symptoms of women are "often interpreted as emotional or mood-driven rather than rooted in biology," Midavaine said.
But "the landscape is changing," Midavaine said. "As the science advances, I believe it will help shift outdated cultural beliefs and lead to more equitable care for women."
mdo/msp

media

Zuckerberg grilled over underage users at social media trial

BY BENJAMIN LEGENDRE

  • - 'Right place now' - Zuckerberg was confronted with an internal document that said Instagram had four million users under 13 in 2015, at the time the plaintiff adopted the app, and that 30 percent of all children age 10 to 12, or "tweens," in the United States were users.
  • CEO Mark Zuckerberg said Wednesday he regretted Meta's slow progress in identifying underage users on Instagram, as he faced stinging criticism at a landmark social media trial over accusations that his company deliberately hooked children.
  • - 'Right place now' - Zuckerberg was confronted with an internal document that said Instagram had four million users under 13 in 2015, at the time the plaintiff adopted the app, and that 30 percent of all children age 10 to 12, or "tweens," in the United States were users.
CEO Mark Zuckerberg said Wednesday he regretted Meta's slow progress in identifying underage users on Instagram, as he faced stinging criticism at a landmark social media trial over accusations that his company deliberately hooked children.
Asked to comment on complaints from inside the company that not enough was being done to verify whether children under 13 were using the platform, the 41-year-old head of Meta, which also owns Facebook and WhatsApp, said improvements had been made.
But "I always wish that we could have gotten there sooner," he added.
Zuckerberg was the most hotly anticipated witness in the California trial, the first in a series of lawsuits filed by American families against social media platforms.
The trial marked the first time the multibillionaire addressed the safety of his world-dominating platforms directly before a jury and under oath.
Zuckerberg was very reserved at first, an AFP journalist in the courtroom reported. But he grew animated, showing signs of annoyance, shaking his head and waving his hands as he turned toward the jury.
The 12 jurors in Los Angeles heard the increasingly testy testimony as plaintiff lawyer Mark Lanier pressed Zuckerberg on age verification and the tycoon's guiding philosophy for making decisions at the vast social media company he controls.
During questioning by his own lawyers, a more relaxed Zuckerberg described time spent on the app as a "side effect" of a quality experience and often addressed the jurors directly to emphasize his points.
He also stressed his belief that Apple and Google, the companies behind operating systems powering most of the world's smartphones, should arrange for age verification at the handset level instead of leaving it to each app.
"Doing it at the level of the phone is just a lot clearer than having every single app out there have to do this separately," Zuckerberg said.
"It would be pretty easy for them."
Zuckerberg faced a barrage of internal emails, including warnings from colleagues that age verification was not fit for purpose and others that seemed to plainly display that encouraging more time spent on Instagram was long a central goal of the company.
The trial is set to last until late March, when the jury will decide whether Meta, as well as Google-owned YouTube, bear responsibility for the mental health problems suffered by Kaley G.M., a 20-year-old California resident who has been a heavy social media user since childhood.
Kaley G.M. started using YouTube at age six, Instagram at nine, then TikTok and Snapchat.
Under-13s are not allowed on Instagram, and Lanier pressed Zuckerberg on the fact that Kaley had easily signed up for the platform.

'Right place now'

Zuckerberg was confronted with an internal document that said Instagram had four million users under 13 in 2015, at the time the plaintiff adopted the app, and that 30 percent of all children age 10 to 12, or "tweens," in the United States were users.
Zuckerberg said that "we're in the right place now" when it comes to age verification.
Lanier went on to argue that young people like Kaley were subject to Meta's efforts to increase time spent on its wildly popular apps, despite Zuckerberg having told the US Congress under oath that this was not the case.
Faced with emails displaying internal targets for usage, Zuckerberg admitted that "we used to have goals around time," but that the company's aim was always to "build useful services" that connected people.
Zuckerberg was also read an old email from former head of public policy Nick Clegg that said "the fact that we say we don't allow under-13s on our platform, yet have no way of enforcing it, is just indefensible."
The trial is set to determine whether Google and Meta deliberately designed their platforms to encourage compulsive use among young people, damaging their mental health in the process.
The case is expected to establish a standard for resolving thousands of lawsuits that blame social media for fueling an epidemic of depression, anxiety, eating disorders and suicide among young people.
TikTok and Snapchat, also named in the complaint, reached settlements with the plaintiff before the trial began.
bl-arp-gc/msp

vaccines

In reversal, US agrees to review new Moderna flu shot

  • In the large trial Moderna had compared its new vaccine with Fluarix, an approved flu shot from the company GSK. Moderna said the rejection was "inconsistent with previous written communications" with the FDA. In a statement Wednesday Moderna's CEO, Stephane Bancel, said "we appreciate the FDA's engagement" in a "constructive" meeting the company had requested following the rejection.
  • Vaccine manufacturer Moderna said Wednesday the US Food and Drug Administration walked back its previous position and agreed to review the company's new mRNA-based flu shot.
  • In the large trial Moderna had compared its new vaccine with Fluarix, an approved flu shot from the company GSK. Moderna said the rejection was "inconsistent with previous written communications" with the FDA. In a statement Wednesday Moderna's CEO, Stephane Bancel, said "we appreciate the FDA's engagement" in a "constructive" meeting the company had requested following the rejection.
Vaccine manufacturer Moderna said Wednesday the US Food and Drug Administration walked back its previous position and agreed to review the company's new mRNA-based flu shot.
Last week the US firm said the federal vaccine regulator rejected the application for review of the new shot, calling its clinical trial inadequate.
But Moderna said that after a "constructive" meeting the FDA had accepted the application for review based on a regulatory pathway focused on older adults.
The company's application now seeks full approval for adults 50 to 64 and accelerated approval for adults 65 and older, Moderna said in a statement. It also agreed to conduct an additional study after the shot hits the market.
The FDA's rejection had come as the body has called for a reconsideration of approval procedures for certain vaccines, including for influenza -- proposed federal policy changes under President Donald Trump that have triggered widespread alarm among public health and medical professionals.
The new shot uses mRNA technology, which health chief Robert F. Kennedy Jr, a vocal vaccine skeptic, has criticized. He notably cut off federal research grants that funded mRNA development.
That contradicts Trump's position during his first presidential term, when he called mRNA technology a "modern-day miracle." 
It was used during the Covid-19 pandemic to swiftly develop an immunization that global health authorities deemed safe and effective against the fast-spreading illness. It was credited with saving millions of lives.
Moderna's new shot had already been accepted for review in the European Union, Canada and Australia.
Vinay Prasad, the top US vaccine official, had signed the letter rejecting Moderna's bid for approval, saying the company's clinical trial was not "adequate and well-controlled," and had not tested its experimental shot against the best product on the market.
In the large trial Moderna had compared its new vaccine with Fluarix, an approved flu shot from the company GSK.
Moderna said the rejection was "inconsistent with previous written communications" with the FDA.
In a statement Wednesday Moderna's CEO, Stephane Bancel, said "we appreciate the FDA's engagement" in a "constructive" meeting the company had requested following the rejection.
"Pending FDA approval, we look forward to making our flu vaccine available later this year so that America's seniors have access to a new option to protect themselves against flu."
Since Trump retook the White House, both he and health chief Kennedy have come under broad criticism from public health and medical experts for sowing doubt about the safety and efficacy of vaccines widely known to be safe, and upending the pediatric immunization schedule.
mdo/sms

chemicals

Bayer proposes class settlement for weedkiller cancer claims

BY LOUIS VAN BOXEL-WOOLF

  • Bayer has spent more than $10 billion settling thousands of cases linked to Roundup since it acquired its producer, the US agrichemical group Monsanto, in 2018.
  • German agrichemical giant Bayer said Tuesday its subsidiary Monsanto had proposed a class settlement of up to $7.25 billion to settle claims that the Roundup weedkiller causes blood cancer, potentially drawing a line under years of costly litigation.
  • Bayer has spent more than $10 billion settling thousands of cases linked to Roundup since it acquired its producer, the US agrichemical group Monsanto, in 2018.
German agrichemical giant Bayer said Tuesday its subsidiary Monsanto had proposed a class settlement of up to $7.25 billion to settle claims that the Roundup weedkiller causes blood cancer, potentially drawing a line under years of costly litigation.
Under the proposed agreement, Monsanto would make a series of declining annual payments for up to 21 years, Bayer said, adding that the deal still required court approval.
Bayer has spent more than $10 billion settling thousands of cases linked to Roundup since it acquired its producer, the US agrichemical group Monsanto, in 2018.
The International Agency for Research on Cancer considers glyphosate, one of Roundup's ingredients, a probable human carcinogen, but Bayer says scientific studies and regulatory approvals show the weedkiller is safe.
The US Supreme Court in January agreed to hear Bayer's appeal against an award of $1.25 million to a Missouri man who claimed Roundup was responsible for his blood cancer.
The company argues that it should be shielded from state lawsuits since the federal Environmental Protection Agency (EPA) approved the sale of Roundup to US consumers and farmers without any warnings.
Speaking at a press conference, Bayer CEO Bill Anderson said the class settlement was needed despite the possibility of a favourable Supreme Court judgement.
"A decision in our favour would address cases not covered by the settlement, including significant adverse pending judgments," he said.
"Plus, a favourable decision from the Supreme Court would both disincentivise and cover potential opt-outs," he added in a reference to those claimants who might reject the proposed settlement.
Bayer shares surged after the announcement and were the best performer on Germany's bluechip DAX index, up 7.35 percent.

'Broken' legal system

Getting the settlement through would mark a milestone for Bayer, which otherwise faces a potentially still long and expensive legal road.
About 67,000 Roundup cases are still outstanding and Anderson told the Wall Street Journal last year that Bayer might give up on Roundup, the world's most popular weedkiller, citing the cost of prolonged court battles.
Announcing that it had reached separate settlements for some Roundup cases as well as other disputes, Bayer said it was now setting aside 11.8 billion euros to pay for litigation in its business year to end September 2025, up from 7.8 billion previously.
Bayer expected litigation payouts of about five billion euros for 2026 "on a first estimate", it said, adding that it would delay announcing its financial results and 2026 guidance from February 25 to March 4.
The settlements did not contain or imply any admission of liability or wrongdoing, Anderson said, charging that the US legal system was "broken".
"Today's announcement does not take away from the truth, a truth that scientists and regulators around the planet continue to uphold, that glyphosate is safe and essential," he said.
"So while this settlement is necessary for the company today, we maintain our significant objections to the broken tort system that makes it necessary."
vbw/yad

conflict

Ukrainian wife battles blackouts to keep terminally ill husband alive

BY MAGDALENA PACIOREK

  • Upbeat and cheerful, she said she takes her energy from her bedridden husband, and manages to leave the flat about twice a week -- to "get a haircut, a manicure.
  • Olena Grygorenko has barely left her Chernigiv flat in the past weeks.
  • Upbeat and cheerful, she said she takes her energy from her bedridden husband, and manages to leave the flat about twice a week -- to "get a haircut, a manicure.
Olena Grygorenko has barely left her Chernigiv flat in the past weeks. Every time a blackout hits the city in northern Ukraine, she rushes to her husband's bedside to plug his life support machine into its back-up batteries.
Bedridden, completely paralysed and connected 24/7 to a yellow-and-blue life support machine, her husband Anatoli Kuchynsky suffers amyotrophic lateral sclerosis (ALS) -- an incurable degenerative nerve disease that kills most people within five years of diagnosis.
Russia's incessant strikes on Ukraine's energy grid over the last month have made their fight against the condition even more perilous.
The missile and drone barrages have knocked heating and power to millions as temperatures hit minus 20C. 
Ukraine has been forced to ration electricity through rolling nationwide blackouts.
Next to his medication, nutrition for a feeding tube and inflatable sink to wash her husband's head, Grygorenko kept a daily schedule of the planned outages in Chernigiv, north of Kyiv.
They can drag on for up to nine hours a day.
During precious time when the mains are online, "the batteries don't have time to charge," Grygorenko, 57, told AFP.
Lying under a crisp, rose-pattern duvet, Kuchynsky can only move his eyes.
After a career in Ukraine's SBU security service, the 62-year-old now gasps for every breath, is unable to move, swallow or talk and requires round-the-clock care.
His cheeks sunken and sallow, he barely resembled the man in a medal-festooned military uniform glancing from a framed picture on a nearby shelf.

'War teaches you everything'

Amid the frequent blackouts, Grygorenko is planning for the worst.
"There's a house nearby where they don't turn off the power. So I've already made arrangements with them that if, God forbid, something happens, I'll run there to charge the battery."
As she spoke, the ventilator was humming steadily in a corner of the room. 
Against the wall, parallel to Kuchynsky's bed, was the click-clack sofa bed where Grygorenko keeps watch.
"We sleep top and tail. I look at him, he looks at me."
She sets three alarms every night -- 1:00, 4:00 and 6:00 -- and wakes every time the power clicks on or off to plug in the machine or re-charge the batteries.
"War teaches you everything."
She has stocked up on nutrition, disinfectants to clean the tubes keeping Kuchynsky alive, medication, and keeps a 100-litre barrel of water on the balcony.
The intricate planning is a lesson from when Russia invaded in February 2022.
Moscow's troops encircled Chernigiv and the power was cut -- leaving Kuchynsky with only two hours of battery for his life support machine.
Grygorenko "begged" a military ambulance to take him to the nearest hospital.
"At that time I didn't even know what a power bank was," she added with a sheepish smile.
"Some people say: 'send him to a specialised facility where there are professionals to care for him'. No professional will give this kind of love, this kind of care."

'A little cognac'

In their cosy second-floor apartment in a Soviet-era building, photos of a younger Kuchynsky show him fishing and crouching in the middle of a bright yellow rapeseed field.
The 2015 diagnosis of ALS -- the same disease that afflicted Stephen Hawking -- hit Kuchynsky hard.
"He didn't want to live," Grygorenko said, recalling how she got rid of his hunting rifle, fearing he would use it on himself.
"He really loved fishing, hunting. And we never had a weekend without guests. Right, Tolya?" she said, looking over at her husband, who she had married only a few years earlier.
Unable to even nod his head, he communicates through an alphabet board.
Grygorenko runs her finger along letters on a laminated sheet of paper, waiting for his eyes to flicker at the right one. 
Upbeat and cheerful, she said she takes her energy from her bedridden husband, and manages to leave the flat about twice a week -- to "get a haircut, a manicure. I'm a woman, after all".
Her main desire now is to get through the winter and for them both to outlast the Russian invasion, now about to drag into its fifth year.
"We live. I don't want to say we're surviving. We live. I want to wait it out. I tell all his friends that we'll live to see victory, the end of the war," she said.
"So everyone can come to us. We'll set a big table. The doctor allowed it. Says he can have a little cognac."
mmp/jc/gv

research

Why are more under-50s getting colorectal cancer? 'We don't know'

BY DANIEL LAWLER

  • - Before his death, a gaunt-looking Van Der Beek urged people with any symptoms to consider getting tested.
  • The death of US actor James Van Der Beek was just the latest reminder that colorectal cancer has been surging among people under 50 in recent years -- and no one knows why.
  • - Before his death, a gaunt-looking Van Der Beek urged people with any symptoms to consider getting tested.
The death of US actor James Van Der Beek was just the latest reminder that colorectal cancer has been surging among people under 50 in recent years -- and no one knows why.
The "Dawson's Creek" star died last week aged 48 after being diagnosed with colorectal cancer, also known as bowel cancer.
Fellow US actor Chadwick Boseman of "Black Panther" fame died from the same disease in 2020 at the age of 43.
The rate of people under 50 being diagnosed with this cancer has risen by roughly a third since the 1990s, Helen Coleman, a cancer epidemiology professor at Queen's University Belfast, told AFP.
It is now the leading cause of death from cancer among under-50s in the United States, according to research published in the JAMA journal last month. 
This "sounds really scary," but the increase has come from a low starting point, Coleman emphasised.
The vast majority of cases are still among older people -- only six percent of all colorectal cancers are diagnosed in people under 50, according to her research in Northern Ireland.
And rates are stabilising or even going down among older people in some areas because of better screening, she added.
However, young people are less likely to think they could be susceptible to this cancer, which was long considered to only be suffered by the elderly.
Once younger people finally get diagnosed, it is often too late -- as was the case with Van Der Beek.
- What is driving this increase? - 
Similar to other cancers among young people, colorectal cancer has been linked with being overweight, having a bad diet, not exercising enough, drinking and smoking.
But these lifestyle factors are not enough to "account for the massive change that we have seen in a relatively short time frame," Coleman said.
And many of the younger patients appear to have been in good health, including Van Der Beek, who was in great shape before being diagnosed in 2023.
"I was biohacking, I was doing the saunas and the cold plunges and all of it -- and I had stage three cancer, and had no idea," the father of six told a US TV interview in December.
So what could be behind this relatively sudden increase?
"We don't know," Jenny Seligmann, a researcher specialising in colorectal cancer at the University of Leeds in the UK, told AFP.
This mystery has led researchers to look for other potential causes, including inside the microbiome, a vast ecosystem of microbes in our guts that remains little understood.
A study in the journal Nature last year discovered a "really important first clue" in this area, Coleman said.
It found that DNA mutations of a toxin called colibactin, which is caused by the common bacteria E.Coli, were much more common in younger people with colorectal cancer than in older patients.
But significantly more research is needed in this area.
For one, it is not known if young people simply tend to have more of this toxin than older people, Coleman pointed out.
There has also been research suggesting that repeatedly using antibiotics could be associated with early colorectal cancer.
Seligmann said she was also seeing many different subtypes of colorectal cancer in her clinic, which suggests there is not a single cause behind the rise.
"It's going to be very difficult to pinpoint it to one cause," she said.

When should screening start?

Before his death, a gaunt-looking Van Der Beek urged people with any symptoms to consider getting tested.
"I want to shout from the rooftops -- if you are 45 or older, talk to your doctor," the father of six said.
The most noticeable symptom of colorectal cancer is changes in bowel movements -- such as diarrhoea or constipation.
Other symptoms include blood in faeces, unexplained weight loss and fatigue. 
Because of the increasing number of younger cases, in 2021 the United States lowered the age it starts colorectal cancer screening from 50 to 45.
There have been calls for other countries to do the same. The UK and France start screening from age 50.
dl/gv/lb

air

China has slashed air pollution, but the 'war' isn't over

BY PETER CATTERALL WITH REBECCA BAILEY IN SHANGHAI

  • "Back then when there was smog, I wouldn't come out," she told AFP, declining to give her full name.
  • Fifteen years ago, Beijing's Liangma riverbanks would have been smog-choked and deserted in winter, but these days they are dotted with families and exercising pensioners most mornings.
  • "Back then when there was smog, I wouldn't come out," she told AFP, declining to give her full name.
Fifteen years ago, Beijing's Liangma riverbanks would have been smog-choked and deserted in winter, but these days they are dotted with families and exercising pensioners most mornings.
The turnaround is the result of a years-long campaign that threw China's state power behind policies like moving factories and electrifying vehicles, to improve some of the world's worst air quality.
Pollution levels in many Chinese cities still top the World Health Organization's (WHO) limits, but they have fallen dramatically since the "airpocalypse" days of the past.
"It used to be really bad," said Zhao, 83, soaking up the sun by the river with friends. 
"Back then when there was smog, I wouldn't come out," she told AFP, declining to give her full name.
These days though, the air is "very fresh". 
Since 2013, levels of PM2.5 -- small particulate that can enter the lungs and bloodstream -- have fallen 69.8 percent, Beijing municipality said in January.
Particulate pollution fell 41 percent nationwide in the decade from 2014, and average life expectancy has increased 1.8 years, according to the University of Chicago's Air Quality Life Index (AQLI).
China's rapid development and heavy coal use saw air quality decline dramatically by the 2000s, especially when cold winter weather trapped pollutants close to the ground.
There were early attempts to tackle the issue, including installing desulphurisation technology at coal power plants, while factory shutdowns and traffic control improved the air quality for events like the 2008 Olympics.
But the impact was short-lived, and the problem worsened.

Action plan

Public awareness grew, heightened by factors like the US embassy in Beijing making monitoring data public.
By 2013, several international schools had installed giant inflatable domes around sport facilities to protect students. 
That year, multiple episodes of prolonged haze shrouded Chinese cities, with one in October bringing northeastern Harbin to a standstill for days as PM2.5 levels hit 40 times the WHO's then-recommended standard.
The phrase "I'm holding your hand, but I can't see your face" took off online.
Later that year, an eight-year-old became the country's youngest lung cancer patient, with doctors directly blaming pollution.
As concerns mounted, China's ruling Communist Party released a ten-point action plan, declaring "a war against pollution". 
It led to expanded monitoring, improved factory technology and the closure or relocation of coal plants and mines. 
In big cities, vehicles were restricted and the groundwork was laid for widespread electrification.
For the first time, "quantitative air quality improvement goals for key regions within a clear time limit" were set, a 2016 study noted.
These targets were "the most important measure", said Bluetech Clean Air Alliance director Tonny Xie, whose non-profit worked with the government on the plan.  
"At that time, there were a lot of debates about whether we can achieve it, because (they were) very ambitious," he told AFP.
The policy targeted several key regions, where PM2.5 levels fell rapidly between 2013 and 2017, and the approach was expanded nationwide afterwards.
"Everybody, I think, would agree that this is a miracle that was achieved in China," Xie said.
China's success is "entirely" responsible for a decline in global pollution since 2014, AQLI said last summer.

'Low-hanging fruits' gone

Still, in much of China the air remains dangerous to breathe by WHO standards.
This winter, Chinese cities, including financial hub Shanghai, were regularly among the world's twenty most polluted on monitoring site IQAir.
Linda Li, a running coach who has lived in both Beijing and Shanghai, said air quality has improved but she still loses up to seven running days to pollution in a good month.
A top environment official last year said China aimed to "basically eliminate severe air pollution by 2025", but the government did not respond when AFP asked if that goal had been met.
Official 2025 data found nationwide average PM2.5 concentrations decreased 4.4 percent on-year. 
Eighty-eight percent of days featured "good" air quality.
However, China's current definition of "good" is PM2.5 levels of under 35 micrograms per cubic metre, significantly higher than the WHO's recommended five micrograms.
China wants to tighten the standard to 25 by 2035.
The last five years have also seen pollution reduction slow.
The "low-hanging fruits" are gone, said Chengcheng Qiu from the Centre for Research on Energy and Clean Air (CREA). 
Qiu's research suggests pollution is shifting west as heavy industry relocates to regions like Xinjiang, and that some cities in China have seen double-digit percentage increases in PM2.5 in the last five years.
"They can't just stop all industrial production. They need to find cleaner ways to produce the output," Qiu said. 
There is hope for that, given China's status as a renewable energy powerhouse, with coal generation falling in 2025.
"Cleaner air ultimately rests on one clear direction," said Qiu. 
"Move beyond fossil fuels and let clean energy power the next stage of development."
pfc-reb/sah/ceg

trade

Bitter pill: Taliban govt shakes up Afghan medicine market

BY AYSHA SAFI

  • And domestic production of 600 medicines has "solved the problems" of many patients, he said.
  • Afghanistan's decision to overhaul its medicine market was meant to improve quality and boost domestic production, but industry specialists say the swift changes have led to a litany of problems.
  • And domestic production of 600 medicines has "solved the problems" of many patients, he said.
Afghanistan's decision to overhaul its medicine market was meant to improve quality and boost domestic production, but industry specialists say the swift changes have led to a litany of problems.
The Taliban authorities announced in November that the decades-long dependency on medicine imports from Pakistan would soon end, a step taken after deadly border clashes with their neighbour.
After the ban came into effect this month, finance ministry spokesman Abdul Qayoom Naseer told AFP that the government urged all importers to find "alternative and legal" sources to replace Pakistani supplies.
Despite a three-month grace period to end existing contracts and clear customs, the shift presents a huge challenge for a country which had imported more than half its medicine from Pakistan.
"Some of the prices have increased, some of them are short (unavailable), it has created a lot of problems for people," said Mujeebullah Afzali, a pharmacist in the capital, Kabul.
Drugs now have to come from elsewhere, increasing transit time and transport costs, and adding logistical complexities.
The pharmacist said he had begun importing medicine through the Islam Qala crossing on the Iranian border, "which increased the transportation fee 10 to 15 percent".
Transport costs used to account for six to seven percent of total spending on medicine, but this has now risen to 25 to 30 percent, said a person directly involved in the pharmaceutical industry, speaking to AFP on condition of anonymity due to security concerns.
He estimated that the overall losses to business owners had already reached millions of dollars.
"If a medicine was short in the market before, a call was made to Pakistan, and the medicine was delivered in two to three days," he said.
Whether legally or not, it was "delivered quickly", he added.

'Fill the gap'

The illicit trade in pharmaceuticals was a key driver for the overhaul, according to the health ministry.
"The biggest problem with Pakistani medicine was that we used to receive counterfeit and fake medicines," ministry spokesman Sharafat Zaman told AFP.
He acknowledged it will take some time to shift the market, saying that officials were working with Iran, India, Bangladesh, Uzbekistan, Turkey, China and Belarus to source medicine.
"India was second in the market, which means that now, through Indian medicines, we can cover the percentage needed," Zaman said.
And domestic production of 600 medicines has "solved the problems" of many patients, he said.
Afghanistan already produces a variety of serums including antibiotics, according to manufacturer Milli Shifa Pharmaceutical.
The company makes 100,000 bottles daily and "can double the capability" if demand merits, CEO Nasar Ahmad Taraki told AFP.
While Afghanistan has significantly expanded its pharmaceutical sector, domestic output still only meets a small fraction of the overall demand.
The industry source told AFP that the need to import raw materials, the high energy costs and limited infrastructure mean the country cannot be entirely self-sufficient in medicine production.
"If we are provided with the facilities, then we would be able to fill the gap created by Pakistan's situation," he said.
- Shortages and higher costs - 
But reshaping an industry nationwide takes more than three months.
Some drugs made in Afghanistan have proven more expensive than those imported from Pakistan, which over the years have gained consumers' trust.
Some people believe that "if they use Pakistani medicine, they will be cured" -- but not if it came from India "or any other country", the industry source said.
Physicians, meanwhile, are also struggling, a healthcare provider in Kabul told AFP.
Doctors "must change prescriptions, find suitable alternatives, and spend additional time adjusting treatment plans", he said, requesting anonymity for security reasons.
The shake-up, which ultimately is meant to end reliance on Pakistan, is complicating care in the short term and could delay treatment, he warned.
"Patients face medicine shortages, frequent switches to alternative products, and sometimes higher costs."
ash/rsc/ami

health

'Make America Healthy' movement takes on Big Ag, in break with Republicans

BY ISSAM AHMED

  • Researcher and influencer Kelly Ryerson said she felt "so good" after MAHA activists helped stall -- and likely kill -- Florida legislation that would give companies freer rein to sue critics of controversial agricultural practices such as pesticide use for defamation.
  • From Wyoming to Florida and the capital Washington, "Make America Healthy Again" activists have notched wins across the United States against agricultural and chemical giants long protected by the conservative politicians they generally support.
  • Researcher and influencer Kelly Ryerson said she felt "so good" after MAHA activists helped stall -- and likely kill -- Florida legislation that would give companies freer rein to sue critics of controversial agricultural practices such as pesticide use for defamation.
From Wyoming to Florida and the capital Washington, "Make America Healthy Again" activists have notched wins across the United States against agricultural and chemical giants long protected by the conservative politicians they generally support.
The MAHA movement is best known for championing Health Secretary Robert F. Kennedy Jr's policies on rolling back vaccine recommendations, overturning the traditional food pyramid, and pushing for the reduced use of synthetic food dyes.
But in its battles against pesticides and food industry interests, the network of mostly female activists has worked at times with conservation groups and even free-speech advocates -- not Republican lawmakers.
Researcher and influencer Kelly Ryerson said she felt "so good" after MAHA activists helped stall -- and likely kill -- Florida legislation that would give companies freer rein to sue critics of controversial agricultural practices such as pesticide use for defamation.
Those same activists also helped defeat a bill in Wyoming that would have made it harder to sue pesticide makers, and worked to hold up similar efforts in Tennessee, Kansas and in Congress, though the federal measure returned in draft form Friday.
But tensions are still simmering between Team MAHA and President Donald Trump's administration.
"It's frustrating seeing the chemical lobbyists getting what they asked for," against the wishes of "all of the people that actually put this administration into office," Ryerson told AFP, referring to voters.

Getting the message out

Last year, Ryerson launched an online petition, co-signed by fellow MAHA movement leaders and thousands of supporters, calling for the resignation of Environmental Protection Agency Administrator Lee Zeldin for allegedly prioritizing chemical industry interests over public safety.
Though they later held meetings to smooth over their differences, the network is again livid following the reauthorization of German agrochemical giant Bayer's dicamba herbicide for sprayed use on genetically modified soybean and cotton.
"I'm very concerned about the situation at the EPA and the fact that it appears to be run by chemical lobbyists rather than people that are committed to protecting people's health," toxicologist Alexandra Munoz, who works with MAHA and has given expert testimony in several state legislatures, told AFP.
Ryerson said it was "very undervalued how important the pesticide and EPA component is to the voting population."
The movement is energized.
Ryerson -- who uses the handle Glyphosate Girl online, in a reference to the herbicide -- says Instagram is her primary outreach tool, where she alerts followers to pending legislation and urges them to call and email lawmakers.
Her messages are amplified by other MAHA figures including nutritionist Courtney Swan, "Food Babe" Vani Hari and conservative podcaster Alex Clark.

Looming battles

The Florida proposal would have expanded the state's existing "veggie libel" law, making it easier for food producers to sue critics -- including activists, researchers and journalists -- and was seen by opponents as benefiting the sugar industry, which has faced accusations of polluting waterways.
MAHA was joined by conservation groups including Florida's Captains for Clean Water and Florida First Amendment Foundation, a free speech advocacy organization.
The pesticide bills seek to bar states from issuing guidance or requiring warning labels on the potential harms if those warnings are not consistent with the EPA's assessment -- even though many researchers warn federal rules are often out-of-step with scientific realities.
Decried by critics as "immunity shields," the measures are a priority for industry groups including the Modern Ag Alliance, founded by Bayer.
Bayer also has a related case before the US Supreme Court, on which it has gained the Trump administration's support. 
The company disputes the characterization of such laws as shielding corporate interests. 
"We agree that no company should have blanket immunity," it said in a statement to AFP, adding the legislation "simply seeks to reaffirm that EPA is the primary federal authority" for pesticide labeling.
Ryerson, who worked on Kennedy's independent presidential campaign, said she was tired of successive Democratic and Republican administrations going too soft on the chemical industry.
Despite setbacks -- and the looming rematch in Congress over pesticide labeling -- she still pins her hopes on Trump to set the EPA straight on chemicals, just as he empowered Kennedy to make radical changes in health.
But she warns that continued battles could hurt Republicans at the ballot box, going so far as to say she "can't imagine a situation in which the midterms go the way of the Republicans" in November if MAHA concerns go unaddressed. 
ia/sst

conflict

Exiled Kremlin critic on fighting Putin -- and cancer -- from abroad

BY ROMAIN COLAS

  • In September 2020, she and three other opposition activists won city council seats in the Siberian city of Novosibirsk, helping overturn the ruling party's majority on the council.
  • Russian opposition activist Khelga Pirogova defied the odds by winning election to a local council on behalf of late Kremlin foe Alexei Navalny's political movement in 2020.
  • In September 2020, she and three other opposition activists won city council seats in the Siberian city of Novosibirsk, helping overturn the ruling party's majority on the council.
Russian opposition activist Khelga Pirogova defied the odds by winning election to a local council on behalf of late Kremlin foe Alexei Navalny's political movement in 2020.
Forced to flee when Russia ramped up its persecution of opposition figures after invading Ukraine, she now faces her toughest battle yet: stage three cancer.
The disease has left her exhausted, but no less committed to fighting Russian President Vladimir Putin's government -- even if she has to do both from outside her homeland.
Pirogova's fate is just one part of the story of how Russia's opposition is battling to survive, stay relevant and challenge Putin amid the war in Ukraine.
Monday marks two years since Navalny's death in an Arctic prison colony. This weekend, several European countries announced -- after testing his body samples -- that Navalny was poisoned with a rare toxin.
In his absence, the Russian opposition has been plagued by factional infighting and scandal, while Putin has intensified a decades-long crackdown on dissent.
But Pirogova is determined.

'Be strong'

"I've always had this mentality that 'You need to be strong, you have to cope with everything,'" the 37-year-old told AFP from Lithuania, where she now lives.
Then the diagnosis gave her a "reason that I don't have to be strong".
In September 2020, she and three other opposition activists won city council seats in the Siberian city of Novosibirsk, helping overturn the ruling party's majority on the council.
It was an exceptional feat, even before Navalny's opposition movement was banned in 2021.
In March 2022, weeks after Russia invaded Ukraine, Pirogova attended a meeting wearing a blue shirt and a crown made of sunflowers in a show of support for the Ukrainian people.
In July that year, she fled Russia with her husband while pregnant.
The authorities had threatened to imprison her over a scathing social media post in which she said she wanted to give slain Russian soldiers a "good slap on the face and send them back to their graves".
She later deleted the post, saying it was "overly emotional" and misunderstood.

'Just one person'

Having taken refuge in Vilnius, she gave birth to a daughter and now works for the Anti-Corruption Foundation, an organisation founded by Navalny that investigates alleged wrongdoing among Russia's elites.
In January 2025, a doctor told Pirogova she had stage four terminal cervical cancer.
"She just casually said, 'Well, what would you like us to do? You have stage four'. They can't do anything for you anymore."
But the doctors were mistaken.
Three weeks later, she learnt she actually had stage three cancer with limited metastases.
Then came intensive treatment: chemotherapy, radiotherapy.
Pirogova documents her treatment on Instagram, posting videos that she once jokingly called "the diary of a vampire".
"Everything hurts and you have no strength," she says in one.
"Nuts are the best. I'm like a squirrel, basically gnawing on lots of nuts," she says in another.
Her first round of chemo and radiotherapy is over, although she is still living with the disease.
She is now undergoing targeted immunotherapy that directly attacks cancer cells, a rare treatment funded by 65,000 euros ($77,000) in donations from supporters.
"At some point, you realise that you are just one person. And you don't deal with cancer alone, you need outside support," she said.
Fighting cancer -- like fighting Putin -- requires help, she added.

'Afraid and curious'

Her work helps her get through the illness.
On the day AFP spoke with her, she made it to her office, despite bitterly cold weather outside.
She was an amateur dancer before her diagnosis, and said she hoped to get back to it afterwards.
She has also kept up her activism.
Declared a "foreign agent" by Moscow -- a label Russian authorities often levy against Putin critics -- she is effectively banned from activism and public office in Russia.
But she says a "new generation" who are willing to speak out on local issues gives her hope.
Her team's mission now, she says, is to sever as many of the Kremlin's "tentacles" as possible.
One of her personal goals? Living longer than 73-year-old Putin.
"A monstrous amount of corruption has permeated all authorities that currently exist," she said.
"I am both afraid and curious about how to combat this once Putin is gone."
rco-cad/jc/jhb/gv