Thailand

Six million children in SE Asia affected by Yagi disaster: UNICEF

  • Thailand reported three more deaths on Wednesday, taking the toll in the kingdom to 18, with a total of 537 fatalities now confirmed across the region.
  • Deadly floods and landslides triggered by Typhoon Yagi have affected nearly six million children across Southeast Asia, the UN said Wednesday, as the death toll from the disaster rose.
  • Thailand reported three more deaths on Wednesday, taking the toll in the kingdom to 18, with a total of 537 fatalities now confirmed across the region.
Deadly floods and landslides triggered by Typhoon Yagi have affected nearly six million children across Southeast Asia, the UN said Wednesday, as the death toll from the disaster rose.
Typhoon Yagi brought powerful winds and torrential rainfall to Vietnam, Thailand, Laos and Myanmar when it swept across the region almost two weeks ago.
Thailand reported three more deaths on Wednesday, taking the toll in the kingdom to 18, with a total of 537 fatalities now confirmed across the region.
Six million children have been affected by Yagi, United Nations children's agency UNICEF said in a statement, with access to clean water, education, healthcare, food and shelter all compromised. 
"The most vulnerable children and families are facing the most devastating consequences of the destruction left behind by Typhoon Yagi," said June Kunugi, UNICEF regional director for East Asia and Pacific.
In Vietnam, about three million people are facing the risk of disease due to a lack of safe drinking water and sanitation, UNICEF said. 
Almost 400,000 people have been forced from their homes by floods in Myanmar, piling misery on a population already struggling with more than three years of war between the military and armed groups opposed to its rule.
Yagi worsened an "already dire humanitarian situation" in Myanmar, said UNICEF, and "pushed... already marginalised communities into deeper crisis".
More than 100 flood victims near the capital Naypyidaw needed hospital treatment for food poisoning after eating donated meals on Tuesday, the junta said.
The UN's World Food Programme said Wednesday it would launch an emergency response in Myanmar this week, distributing a one-month ration of emergency food to up to half a million people.
Climate change and warming oceans, driven by human activities, are making extreme weather events like Typhoon Yagi more frequent and severe.
Overlapping climate and humanitarian hazards disproportionately affect children in East Asia and the Pacific, where they are six times more likely than their grandparents to be affected, according to UNICEF.
burs-pdw/sco

family

Chile birth rate plummets as women say no to motherhood

BY PAULINA ABRAMOVICH

  • I just disappear," said Ramirez, who is balancing her job with a master's degree.
  • Chilean lawyer Camila Ramirez, 29, does not want to give up her freedom and well-being to become a mother, and she is not alone.
  • I just disappear," said Ramirez, who is balancing her job with a master's degree.
Chilean lawyer Camila Ramirez, 29, does not want to give up her freedom and well-being to become a mother, and she is not alone.
In the past decade, births have fallen by 29 percent in Chile, now the country with the lowest birth rate in the Americas.
With 1.17 children being born per woman, the Latin American nation is far from the 2.1 needed to maintain its population, according to the National Statistics Institute (INE).
"Being a mother is an absolutely selfless task. I love to travel and when I go on a trip, I do it alone. I don't ask anyone. I just disappear," said Ramirez, who is balancing her job with a master's degree.
"I can't see myself being in charge of feeding and entertaining a child, always prioritizing the wellbeing and care of a child over my own wellbeing," she added.
Declining birth rates are sparking alarm across the globe, especially in developed economies. Even Pope Francis has weighed in, suggesting couples who have pets instead of children are selfish and a threat to humanity.
Chile's birthrate is below that of developed economies such as Italy, Japan, and Spain, according to the UN Population Division.
"The changes around reproduction in Chilean society have been very fast and abrupt. What took decades in Europe has happened in 10 or 20 years in Chile," said Catholic University sociologist Martina Yopo.
Chilean women have gained greater access to education -- especially since universities became free in 2008 -- and entered the workforce in higher numbers.
And with greater reproductive autonomy, "today being a woman does not necessarily mean being a mother, and having a family does not necessarily require children," added Yopo.

'An emergency'

The INE predicts Chile's birthrate will continue to fall in coming years, and not even an increase in immigration is managing to reverse the situation.
"It is an emergency, a health crisis. I can think of few things more important than this from an economic, social and ethical point of view," said Anibal Scarella, president of the Chilean Society of Reproductive Medicine.
Economist Jorge Berrios said the drop in birth rate means "there will be many older people and that they will most likely have to continue working."
"There is no generational renewal in people, in the economy."
As in many countries, gender inequality means that many working women know that if they become mothers, they will bear the main load of parenting. 
There is also little support from the state in areas such as childcare, said Yopo.
And women are choosing to have children later, with a third of all births in Chile last year to women aged between 30 and 34. The trend has led to a rise in infertility.
"We are not helping people to be able to reconcile the development of their careers and the desire to fall pregnant," said Scarella, who wants to improve access to assisted fertility and egg preservation.
Physiotherapist Tamara Guzman never dreamed of being a mother, and kept postponing the decision. Now 41, and married, she feels she can't afford the lifestyle she enjoys and raise a child.
"Everything is very expensive. I see it in my friends who are mothers and are super tired, with dark circles under their eyes, and stressed because they have to pay the nanny or the kindergarten, diapers and milk. If I had more income, yes, I would think about it," she said.

Dire state of the world

Angered by violence against women and the state of the world, banking executive Isidora Rugeronni decided to get sterilized four years ago, aged just 21.
"I felt that there was a lot of evil in the world, a lot of injustice and I came to 'Antinatalism', which is a philosophy that states that it is not ethical to have biological children with the world as it is," she said.
"I can do much stronger activism and impact society as a woman without biological children," she said.
Rugeronni said she would like to be a foster mother, and also "adopt all the animals I want."
Chile has seen an 80 percent drop in teen pregnancies over the past two decades, according to the INE.
And it is not only women balking at parenthood: the number of vasectomies performed in Chile has risen almost ten-fold in the past decade, from 768 in 2013 to 7,580 in 2023, said the agency. 
Meanwhile, female sterilization in public hospitals increased by 54 percent in the same period.
pa/vel/mar/fb/mlr/st

chemicals

More than 3,600 food packaging chemicals found in human bodies

BY DANIEL LAWLER

  • Around 100 of these chemicals are considered to be of "high concern" to human health, said lead study author Birgit Geueke from the Food Packaging Forum Foundation, a Zurich-based NGO. Some of these chemicals are relatively well-studied and have already been found in human bodies, such as PFAS and bisphenol A -- both of which are the target of bans.
  • More than 3,600 chemicals used in food packaging or preparation have been detected in human bodies, some of which are hazardous to health, while little is known about others, a study published on Tuesday said.
  • Around 100 of these chemicals are considered to be of "high concern" to human health, said lead study author Birgit Geueke from the Food Packaging Forum Foundation, a Zurich-based NGO. Some of these chemicals are relatively well-studied and have already been found in human bodies, such as PFAS and bisphenol A -- both of which are the target of bans.
More than 3,600 chemicals used in food packaging or preparation have been detected in human bodies, some of which are hazardous to health, while little is known about others, a study published on Tuesday said.
Around 100 of these chemicals are considered to be of "high concern" to human health, said lead study author Birgit Geueke from the Food Packaging Forum Foundation, a Zurich-based NGO.
Some of these chemicals are relatively well-studied and have already been found in human bodies, such as PFAS and bisphenol A -- both of which are the target of bans.
But little is known about the health effects of others, Geueke told AFP, calling for more research into how chemicals used in packaging end up being swallowed along with food.
The researchers had previously catalogued around 14,000 food contact chemicals (FCCs), which are capable of "migrating" into food from packaging made of plastic, paper, glass, metal or other materials. 
They can also come from other parts of the food-making process, such as from conveyer belts or kitchen utensils.
The researchers then searched for these chemicals in existing biomonitoring databases, which track chemicals in human samples.
The team was expecting to find a few hundred FCCs, Geueke said. Instead, they were surprised to find 3,601 -- a quarter of all the known FCCs.
Geueke emphasised that this study could not show that all these chemicals necessarily ended up in bodies from food packaging, as "other exposure sources are possible". 
Among the "high concern" chemicals were numerous PFAS, also known as forever chemicals, which have been detected in many parts of the human body in recent years and linked to a range of health problems.
Also detected was bisphenol A, a hormone-disrupting chemical used to make plastics that has already been banned from baby bottles in many countries.
Another hormone-disrupting chemical was phthalates, which has been linked to infertility.
Less is known about oligomers, which are also byproducts of plastic production. 
"There is almost no evidence on the health effects of these chemicals," Geueke said.

Reduce contact with packaging

When it comes to toxicology, an old saying is that "the dose makes the poison".
A limitation of the study was that it could not say whether there were particularly high concentrations of any of the chemicals, Geueke acknowledged.
But she warned that these chemicals can interact with each other, pointing to a single sample that had up to 30 different PFAS. 
Geueke recommended that people reduce their contact time with packaging -- and to avoid heating up food in the packaging it came in.
Duane Mellor, an expert in evidence-based medicine at the UK's Aston University and not involved in the research, praised the "very thorough piece of work".
"However, it does not cover how much of these chemicals we are exposed to and hints at other sources of these chemicals in our environment," he told AFP.
Rather than being "unduly alarmed", Mellor suggested that people "demand better data and minimise unnecessary exposure to chemicals which may ultimately impact our health".
Some of the chemicals are also already facing bans.
The European Union is in the final stages of banning the use of PFAS in food packaging. The EU has also proposed a similar ban for bisphenol A from the end of this year.
The study was published in the Journal of Exposure Science and Environmental Epidemiology.
dl/rlp/bc

abortion

Harris slams death of woman after abortion ban delayed medical care

  • Georgia had just passed a law that made performing dilation and curettage (D&C) a felony offense with medical exceptions that doctors had warned were vague and difficult to interpret.
  • Democratic presidential candidate Kamala Harris condemned anti-abortion laws in Georgia on Tuesday after a report in ProPublica revealed that a woman there died from delayed medical care caused by the US state's restrictive regulations.
  • Georgia had just passed a law that made performing dilation and curettage (D&C) a felony offense with medical exceptions that doctors had warned were vague and difficult to interpret.
Democratic presidential candidate Kamala Harris condemned anti-abortion laws in Georgia on Tuesday after a report in ProPublica revealed that a woman there died from delayed medical care caused by the US state's restrictive regulations.
Amber Nicole Thurman, 28, developed a rare complication from abortion pills and died during emergency surgery in August 2022, with an official state committee blaming the fatal outcome on a "preventable" lag in performing a critical procedure.
Georgia had just passed a law that made performing dilation and curettage (D&C) a felony offense with medical exceptions that doctors had warned were vague and difficult to interpret.
The US Supreme Court's 2022 decision to overturn national abortion rights unleashed a wave of bans and restrictions in 22 states, thrusting reproductive rights to the forefront of the upcoming presidential election.
"Women are bleeding out in parking lots, turned away from emergency rooms, losing their ability to ever have children again," Harris said in a statement following the report's release.
"This is exactly what we feared when Roe was struck down," she said, referring to the Supreme Court decision that had protected the national right to abortion.
ProPublica said the case marked the first abortion-related death officially deemed "preventable" and plans to publish details of a second case soon.
These official reviews are not made public, but ProPublica obtained copies of the reports.
"This young mother should be alive, raising her son, and pursuing her dream of attending nursing school," Harris said.

'Blood on their hands'

Thurman, an otherwise healthy medical assistant and mother of a six-year-old boy, made the decision to terminate a twin pregnancy to preserve her newfound stability, her best friend Ricaria Baker told ProPublica.
She and her son had recently moved to a new apartment complex and she planned to enroll in nursing school. She wanted a surgical abortion, but Georgia's six-week abortion ban forced her to seek care at a clinic in North Carolina.
On the day of the procedure, the hours-long drive was hampered by traffic, and Thurman missed her 15-minute appointment window. 
The clinic offered a medication abortion with mifepristone and misoprostol. While overwhelmingly safe, rare complications can occur.
Thurman's condition worsened over several days, turning into heavy bleeding and vomiting blood. She was taken to Piedmont Henry Hospital in Stockbridge.
Doctors found she had not expelled all the fetal tissue from her body and she was diagnosed with "acute severe sepsis."
But despite her rapidly deteriorating health, the hospital delayed Thurman's dilation and curettage procedure for 17 hours.
By the time they operated, the situation was so dire it required open abdominal surgery. The doctor performed the operation and found a hysterectomy was also required -- but during the procedure, Thurman's heart stopped.
Her mother recalled her last words: "Promise me you'll take care of my son."
The state committee found there was a "good chance" that an earlier procedure could have saved Thurman's life.
"Life of the mother" exceptions have widely proven inadequate, forcing women to cross state lines in desperate bids for lifesaving care.
Reproductive rights groups erupted in outrage following the report.
"Amber would be alive right now if it wasn't for Donald Trump and Brian Kemp's abortion ban," said Mini Timmara, president of Reproductive Freedom for All, referring to the former president and the governor of Georgia. "They have blood on their hands."
The Supreme Court ended federal protections for abortion access in June 2022 with the help of a super-conservative majority built under Trump's presidency.
"Survivors of rape and incest are being told they cannot make decisions about what happens next to their bodies. And now women are dying," Harris said. "These are the consequences of Donald Trump's actions."
ia/bfm/dhw

research

From new treatments to AI: advances in the fight against cancer

BY ISABELLE TOURNÉ

  • - AI for personalised medicine?
  • From combining treatments in unprecedented ways to deploying artificial intelligence for personalised medicine, a raft of new advances in the fight against cancer have been presented at the European Society for Medical Oncology (ESMO), which ends on Tuesday.
  • - AI for personalised medicine?
From combining treatments in unprecedented ways to deploying artificial intelligence for personalised medicine, a raft of new advances in the fight against cancer have been presented at the European Society for Medical Oncology (ESMO), which ends on Tuesday.
Here are some of the big announcements made at the five-day conference held in the Spanish city of Barcelona, which brought together 30,000 specialist doctors and researchers from around the world.

Breastfeeding after cancer

Women who breastfeed after receiving treatment for breast cancer do not have a higher risk of their cancer returning or of getting new tumours, according to two international studies presented at the conference.
This was also true for women carrying a genetic mutation called BRCA, which significantly increases the chance of developing breast cancer, the research found.
There had previously been concerns about pregnancy and breastfeeding after women had been diagnosed with breast cancer, because both can affect hormone levels.
"These results are key for women who wish to become pregnant and breastfeed their baby after breast cancer," said Fedro Alessandro Peccatori, a researcher and doctor at the European Institute of Oncology in Milan.

New combination for lung cancer

Immunotherapy, which stimulates the body's immune system to fight tumours, has already been shown to be an effective weapon against lung cancer.
On Saturday, the results of a phase two trial revealed promising signs against metastatic non-small cell lung cancer, which is when the most common form of lung cancer spreads to other parts of the body. 
The trial tested a new combination of two different immunotherapies along with chemotherapy.
"By aiming at a second target of the immune system and combining these treatments, it seems that we are improving response rates -- that is, the number of patients who have their tumours shrink," Nicolas Girard, an oncologist at France's Curie Institute, told AFP.

 Rare pregnancy-linked cancer

Another combination of immunotherapy and chemotherapy produced excellent results against a very rare form of pregnancy-related cancer which develops in the placenta. The cancer only occurs in around one out of every 10,000 pregnancies.
The combination of treatments led to 96 percent of the cancer in patients being eradicated.
"This is an exceptional result," said Benoit You, a France-based oncologist who presented the research.

AI for personalised medicine?

A huge artificial intelligence (AI) algorithm trained on a database of more than a billion images of tumours from around 30,000 patients in the United States also showed promise for future cancer treatment, researchers said Monday.
The model is capable of "detecting a certain number of molecular anomalies and mutations that the human eye is not always able to see," Fabrice Andre, research head at France's Gustave Roussy cancer centre, told AFP.
In the long term, the doctors hope this kind of AI will be able to help them offer personalised treatments for each patient.

Hope for saving affected organs

One of the main messages to come out of the ESMO conference was that combining immunotherapy with radiation therapy before surgery improves the overall survival rates for a growing number of cancers, including for the breast, bladder and cervix.
But receiving these kinds of treatments ahead of surgery seems to also allow for the affected organs themselves to be saved, Andre said.
"Organ preservation is absolutely essential to have a quality of life that is as close as possible to normal," he said.
Research presented on Monday showed encouraging results for preserving rectums in patients with cancer affecting this important part of the digestive tract. This only occurs after the treatments have caused the tumour to completely vanish.
"Until now the standard was surgery, but it seems we are entering a new era where surgery could be avoided," said David Sebag- Montefiore, an oncologist and researcher at the UK's University of Leeds.
There are hopes that this treatment combination could also have the potential to work for other cancers, such as those of the ear, nose and throat -- or lungs.
ito/dl/fg

superbugs

Drug-resistant superbugs projected to kill 39 million by 2050

  • The analysis has been billed as the first research to track the global impact of superbugs over time and to estimate what could happen next. 
  • Infections of drug-resistant superbugs are projected to kill nearly 40 million people over the next 25 years, a global analysis predicted on Monday, with the researchers urging action to avoid this grim scenario. 
  • The analysis has been billed as the first research to track the global impact of superbugs over time and to estimate what could happen next. 
Infections of drug-resistant superbugs are projected to kill nearly 40 million people over the next 25 years, a global analysis predicted on Monday, with the researchers urging action to avoid this grim scenario. 
Superbugs -- strains of bacteria or pathogens that have become resistant to antibiotics, making them much harder to treat -- have been recognised as a rising threat to global health. 
The analysis has been billed as the first research to track the global impact of superbugs over time and to estimate what could happen next. 
More than a million people died from the superbugs -- also called antimicrobial resistance (AMR) -- per year across the world between 1990 and 2021, according to the GRAM study in The Lancet journal. 
Deaths among children under five from superbugs actually fell by more than 50 percent over the last three decades, the study said, due to improving measures to prevent and control infections for infants. 
However, when children now catch superbugs, the infections are much harder to treat. 
And deaths of over-70s have surged by more than 80 percent over the same period, as an ageing population became more vulnerable to infection.
Deaths from infections of MRSA, a type of staph bacteria that has become resistant to many antibiotics, doubled to 130,000 in 2021 from three decades earlier, the study said.
The researchers used modelling to estimate that, based on current trends, the number of direct deaths from AMR would rise by 67 percent to reach nearly two million a year by 2050. 
It would also play a role in a further 8.2 million annual deaths, a jump of nearly 75 percent, according to the modelling. 

Threat to modern medicine

Under this scenario, AMR will have directly killed 39 million people over the next quarter century and contributed to a total of 169 million deaths, it added. 
But less dire scenarios are also possible. 
If the world works to improve care for severe infections and access to antimicrobial drugs, it could save the lives of 92 million people by 2050, the modelling suggested. 
The researchers looked at 22 pathogens, 84 combinations of drugs and pathogens, and 11 infectious syndromes such as meningitis. 
The study involved data from 520 million individual records across 204 countries and territories.
"These findings highlight that AMR has been a significant global health threat for decades and that this threat is growing," said study co-author Mohsen Naghavi of the US-based Institute of Health Metrics.
Jeremy Knox, infectious disease policy head at the UK-based health charity the Wellcome Trust, warned that the effects of rising AMR rates would be felt across the world.
"An increasing AMR burden at the scale described in the GRAM report would represent a steady undermining of modern medicine as we know it, as the antibiotics we rely upon to keep common medical interventions safe and routine could lose their effectiveness," Knox told AFP.
While there has been a steady increase in political attention on the subject over the last decade, "we have yet to see governments around the world go far enough, fast enough in tackling the threat of AMR", he added.
He described a high-level AMR meeting at the United Nations scheduled for September 26 as a "vital moment" for the fight against superbugs. 
Antimicrobial resistance is a natural phenomenon but the overuse and misuse of antibiotics in humans, animals and plants has made the problem worse. 
dl/gil

Global Edition

More than 95,000 Japanese aged over 100, most of them women

  • On Sunday separate government data showed that the number of over-65s has hit a record high of 36.25 million, accounting for 29.3 percent of Japan's population.
  • The number of people in Japan aged 100 or older has hit a record high of more than 95,000 -- almost 90 percent of them women -- government data showed Tuesday.
  • On Sunday separate government data showed that the number of over-65s has hit a record high of 36.25 million, accounting for 29.3 percent of Japan's population.
The number of people in Japan aged 100 or older has hit a record high of more than 95,000 -- almost 90 percent of them women -- government data showed Tuesday.
The figures further highlight the slow-burning demographic crisis gripping the world's fourth-biggest economy as its population ages and shrinks.
As of September 1, Japan had 95,119 centenarians, up 2,980 year-on-year, with 83,958 of them women and 11,161 men, the health ministry said in a statement.
On Sunday separate government data showed that the number of over-65s has hit a record high of 36.25 million, accounting for 29.3 percent of Japan's population.
The proportion puts Japan at the top of a list of 200 countries and regions with a population of over 100,000 people, the Ministry of Internal Affairs and Communications said.
Japan is currently home to the world's oldest living person Tomiko Itooka, who was born on May 23, 1908 and is 116 years old, according to the US-based Gerontology Research Group.
The previous record-holder, Maria Branyas Morera, died last month in Spain at the age of 117.
Itooka lives in a nursing home in Ashiya, Hyogo prefecture in western Japan, the ministry said.
She often says "thank you" to the nursing home staff and expresses nostalgia about her hometown, the ministry said.
"I have no idea at all about what's the secret of my long life," Japan's oldest man, Kiyotaka Mizuno, who is 110, told local media.
Mizuno, who lives in Iwata, Shizuoka prefecture in central Japan with his family, gets up at 6:30 am every morning and eats three meals a day -- without being picky about his food.
His hobby is listening to live sports, including sumo wrestling, the ministry said.
Japan is facing a steadily worsening population crisis, as its expanding elderly population leads to soaring medical and welfare costs, with a shrinking labour force to pay for it.
The country's overall population is 124 million, after declining by 595,000 in the previous,  according to previous government data.
The government has attempted to slow the decline and ageing of its population without meaningful success, while gradually extending the retirement age -- with 65 becoming the rule for all employers from fiscal 2025.
kh/stu/fox

environment

'Virus hunters' track threats to head off next pandemic

BY SARA HUSSEIN

  • And there is a growing need to track these threats as climate change expands the range of infectious disease globally.
  • A global network of doctors and laboratories is working to pinpoint emerging viral threats, including many driven by climate change, in a bid to head off the world's next pandemic.
  • And there is a growing need to track these threats as climate change expands the range of infectious disease globally.
A global network of doctors and laboratories is working to pinpoint emerging viral threats, including many driven by climate change, in a bid to head off the world's next pandemic.
The coalition of self-described "virus hunters" has uncovered everything from an unusual tick-borne disease in Thailand to a surprise outbreak in Colombia of an infection spread by midges.
"The roster of things that we have to worry about, as we saw with Covid-19, is not static," said Gavin Cloherty, an infectious disease expert who heads the Abbott Pandemic Defense Coalition.
"We have to be very vigilant about how the bad guys that we know about are changing... But also if there's new kids on the block," he told AFP.
The coalition brings together doctors and scientists at universities and health institutions across the world, with funding from healthcare and medical devices giant Abbott.
By uncovering new threats, the coalition gives Abbott a potential headstart in designing the kinds of testing kits that were central to the Covid-19 response.
And its involvement gives the coalition deep pockets and the ability to detect and sequence but also respond to new viruses.
"When we find something, we're able to very quickly make diagnostic tests at industry level," Cloherty said.
"The idea is to ringfence an outbreak, so that we would be able to hopefully prevent a pandemic."
The coalition has sequenced approximately 13,000 samples since it began operating in 2021.
In Colombia, it found an outbreak of Oropouche, a virus spread by midges and mosquitoes, that had rarely been seen there before.
Phylogenetic work to trace the strain's family tree revealed it came from Peru or Ecuador, rather than Brazil, another hotspot.
"You can see where things are moving from. It's important from a public health perspective," said Cloherty.

Difficult and costly

More recently, the coalition worked with doctors in Thailand to reveal that a tick-bourne virus was behind a mysterious cluster of patient cases.
"At the time, we didn't know what virus caused this syndrome," explained Pakpoom Phoompoung, associate professor of infectious disease at Siriraj Hospital.
Testing and sequencing of samples that dated back as far as 2014 found many were positive for severe fever with thrombocytopenia syndrome (SFTSV).
"Less than 10 patients had (previously) been diagnosed with SFTSV in Thailand... we don't have PCR diagnosis, we don't have serology for this viral infection diagnosis," Pakpoom told AFP.
Diagnosing it "is difficult, labour intensive and also is costly".
And there is a growing need to track these threats as climate change expands the range of infectious disease globally.
The link between climate change and infectious disease is well-established and multi-faceted.
Warmer conditions allow vectors like mosquitoes to live in new locations, more rain creates more breeding pools, and extreme weather forces people into the open where they are more vulnerable to bites.
Human impact on the planet is also driving the spread and evolution of infectious disease in other ways: biodiversity loss forces viruses to evolve into new hosts, and can push animals into closer contact with humans.

'You have to be vigilant'

Phylogenetic analysis of the SFTSV strain in Thailand gives a snapshot of the complex interplay.
It showed the virus had evolved from one tick with a smaller geographic range into the hardier Asian longhorned tick.
The analysis suggested its evolution was driven largely by pesticide use that reduced the numbers of the original tick host.
Once the virus evolved, it could spread further in part because Asian longhorned ticks can live on birds, which are travelling further and faster because of changing climate conditions.
"It's almost like they're an airline," said Cloherty.
Climate change's fingerprints are in everything from record outbreaks of dengue in Latin America and the Caribbean to the spread of West Nile Virus in the United States.
While the coalition grew from work that preceded the pandemic, the global spread of Covid-19 offered a potent reminder of the risks of infectious disease.
But Cloherty fears people are already forgetting those lessons.
"You have to be vigilant," he said.
"Something that happens in Bangkok could be happening in Boston tomorrow."
sah/sw

plastics

Plastics: navigating the maze of dizzying acronyms

BY ISABEL MALSANG

  • Expanded, it is used to package fish or for insulation in construction. 
  • Plastics are all around us -- from food packaging and drinking bottles to the insulation in our homes.
  • Expanded, it is used to package fish or for insulation in construction. 
Plastics are all around us -- from food packaging and drinking bottles to the insulation in our homes.
They are mostly all derived from fossil fuels like oil and natural gas, but what are the key differences between each type of plastic?
Here is a brief guide to the most commonly used plastics and their acronyms, as classified by the Organisation for Economic Cooperation and Development (OECD).

Three main families

Thermoplastics are the most common plastics, because they are so malleable when heated, and can be remelted.
Elastomers, meanwhile, can be stretched to a great extent and then regain their original form.
And thermosets are resins that become irreversibly hard when heated. 
Within each family, an infinite number of polymers are mixed with a wide range of additives that are sometimes harmful to the environment or health.
These additives can change the colour of plastics, prevent ageing, make them flexible, increase impact resistance, or reduce flammability. 

PP

Polypropylene, or PP, is the most widespread plastic in the world (16 percent), developed in the mid-1950s and used for automobile parts and food packaging as well as disposable trays. 

HDPE and LDPE

High and low density polyethylenes each represent 12 percent of global plastic use, according to the OECD. 
HDPE, invented in 1933 by British engineers, is used for toys, shampoo bottles, pipes, engine oil cans and a variety of household objects.
LDPE, developed later in the 1950s, is widely used to manufacture flexible products such as reusable bags and food packaging film.

PVC

Polyvinyl chloride (PVC) is mainly used in construction for window frames, floor covering, pipes or cable insulation. It represents 11 percent of global plastic. 

PS

Polystyrene (PS), invented in 1931 by IG Farben, represents five percent of the world's plastic and is mainly used for food packaging. 
In its unexpanded form, it is used for yoghurt packaging or in construction. 
Expanded, it is used to package fish or for insulation in construction. 

PET

Also representing five percent of plastic worldwide, polyethylene terephthalate (PET) is the most widely used plastic for drink bottles in their transparent form (water, sodas) and sometimes opaque versions for products such as long-life milk.

PUR

Polyurethane (PUR), developed in 1937 by Otto Bayer, is used in insulation and mattresses and represents four percent of the world's plastic. 
It is mainly used in refrigerator insulation, as padding foam in buildings, for adhesives, various coatings, shoe soles and in composite wood panels or surfboards.

Other types

In all, these represent 22 percent of all plastic and include ABS (acrylonitrile, butadiene, styrene) used for tires, PBT (polybutylene terephthalate), PC (polycarbonate), PTFE (polytetrafluoroethylene) and PMMA, another name for plexiglass.

Bio-based plastics

This group is made from biomass such as corn, sugar cane, wheat or other residues, and not from petroleum products. 
Their production generates fewer greenhouse gas emissions than fossil-based plastics but while their volume is increasing, it isn't keeping pace with other types of plastic.

Fibres

Fibres made of different polymers are used in the textile industry and represent 13 percent of all plastics globally.
im/eab/np/giv/sw

Global Edition

Environment takes centre stage as global summits loom

BY JULIEN MIVIELLE

  • The summit, known as COP29, is expected to land a new agreement on "climate finance": money from rich nations most responsible for global warming to developing countries vulnerable to climate change.
  • Global warming.
  • The summit, known as COP29, is expected to land a new agreement on "climate finance": money from rich nations most responsible for global warming to developing countries vulnerable to climate change.
Global warming. Disappearing plant and animal species. Fertile land turning to desert. Plastic in the oceans, on land, and the air we breathe.
These urgent environmental challenges will be in the spotlight over the next few months as the United Nations hosts four major sessions to address key threats to the planet.

Biodiversity

First up is a "Conference of the Parties" -- a COP -- dedicated to biodiversity being held in Cali, Colombia, from October 21 to November 1.
These are called every two years to debate how the world can cooperate to better protect the rich variety of plant and animal life in the natural world.
The COP16 isn't expected to break new ground but is more a stocktake of progress since the last summit secured historic assurances for biodiversity.
In 2022 in Montreal, nations agreed to place 30 percent of the planet under environmental protection by 2030 in a landmark pact aimed at arresting biodiversity loss and restoring ecosystems to health.
In Cali, countries will put forward national strategies to meet this global objective, and observers hope Colombia as host will provide a model for others to follow.
WWF has commended the leadership shown so far by Colombia, which hosts close to 10 percent of Earth's biodiversity, including countless bird, butterfly, and orchid species.

Climate

The world's most important conference on climate change is this year being hosted by Azerbaijan, a former Soviet republic heavily dependent on oil and gas exports, from November 11 to 22.
While the last summit in Dubai in 2023 delivered a historic commitment to transition the world away from fossil fuels, supporting poorer countries with climate change will top this year's agenda.
The summit, known as COP29, is expected to land a new agreement on "climate finance": money from rich nations most responsible for global warming to developing countries vulnerable to climate change.
There isn't an agreed figure yet, or even consensus on where the money should come from, who should receive it, and what form it could take.
But developing countries are pushing for much more than the $100 billion pledged in 2009. This was only reached for the first time in full in 2022.
"COP29 offers an opportunity to unlock more climate investments from a wider range of public and private sources and to improve the quality of this finance," said the World Resources Institute, a US think tank. 
The result of the US election, just six days before COP29 begins, could throw a last-minute curveball into the final negotiations, which have proved divisive so far.
It also remains to be seen how many world leaders travel to Baku, the capital on the Caspian Sea, with some expected to focus their energy on COP30 in Brazil next year.

Desertification

The least high profile of the three COPs, this session in Saudi Arabia addressing the loss of fertile land to desert is nonetheless critical.
Climate variation like droughts and human activities like overgrazing can result in desertification, a process mainly in dry areas where land degrades and becomes unproductive.
Experts hope the COP16 on desertification, scheduled to take place in Riyadh from December 2 to 13, can act as a turning point in addressing this problem.   
"Discussions will focus on ways to restore 1.5 billion hectares of land by 2030, as well as putting in place agreements to manage the droughts that are already affecting many regions of the globe," said Arona Diedhiou from the French National Research Institute for Sustainable Development.

Plastic

In 2022, some 175 nations agreed to fast-track negotiations toward a world-first treaty on plastic pollution, and the final session gets underway on November 25 in South Korea.
The treaty aims to marshal an international response to the plastic trash choking the environment, from oceans and rivers to mountains and sea ice.  
Some nations want the treaty to restrict how much plastic can be made while others -- particularly oil and gas producing countries that provide the raw materials to make plastic -- want a focus on recycling. 
Hellen Kahaso Dena, head of Greenpeace's Pan-African Plastics Project, hopes that countries "will agree on a treaty that prioritises reducing plastic production". 
"There is no time to waste with approaches that will not solve the problem," the activist told AFP.
jmi-eab/np/giv

deepfake

Beware 'deepfakes' of famous doctors promoting scams: experts

BY JULIE PACOREL

  • "People do seem to trust these videos," British doctor John Cormack told AFP.  "A lot of these media doctors have spent a great deal of time creating an image of trustworthiness, so they are believed even when they make incredible claims," said Cormack, who has worked with the British Medical Journal (BMJ) on the subject. 
  • Social media is being flooded by digitally created "deepfake" videos using the trusted identities of famous doctors to promote dangerous miracle cures for serious health problems, experts warn. 
  • "People do seem to trust these videos," British doctor John Cormack told AFP.  "A lot of these media doctors have spent a great deal of time creating an image of trustworthiness, so they are believed even when they make incredible claims," said Cormack, who has worked with the British Medical Journal (BMJ) on the subject. 
Social media is being flooded by digitally created "deepfake" videos using the trusted identities of famous doctors to promote dangerous miracle cures for serious health problems, experts warn. 
Videos on Facebook and Instagram have taken advantage of the credibility of star TV doctors to advertise untested "natural" syrups for diabetes, even claiming that the proven, first-line drug metformin "could kill" patients.
These scams risk endangering lives, experts said, particularly because they deploy the likenesses of popular health experts such as British TV presenter Michael Mosley, who died earlier this year. 
"People do seem to trust these videos," British doctor John Cormack told AFP. 
"A lot of these media doctors have spent a great deal of time creating an image of trustworthiness, so they are believed even when they make incredible claims," said Cormack, who has worked with the British Medical Journal (BMJ) on the subject. 
Artificial intelligence (AI) expert Henry Ajder said that doctor deepfakes "really took off this year".  
The AI videos typically target older audiences by faking the identity of doctors who appear regularly on daytime television, Ajder said. 
French doctor Michel Cymes, who often appears on TV in France, told AFP in May that he was taking legal action against Facebook owner Meta about "scams" using his image. 
British doctor Hilary Jones even hired an investigator to track deepfakes that featured his likeness.
One video depicted Jones selling a false cure for high blood pressure -- as well as weed gummies -- on a UK TV show on which he regularly appears.
"Even if they're taken down, they just pop up the next day under a different name," Jones lamented in the BMJ.

'Game of cat and mouse'

Recent advances in AI have made the quality of deepfake images, audio and video far more convincing, explained French academic and AI expert Frederic Jurie.
"Today we have access to tens of billions of images, and we are able to build algorithms that can model everything that appears in the images and regenerate them. This is what we call generative AI," he said.
It is not just the likenesses of widely respected doctors being misused.
The appearance of controversial French researcher Didier Raoult -- who has been accused of spreading misleading information about Covid drugs -- has also been used in several deepfake videos. 
Australian naturopath Barbara O'Neill, who has been roundly condemned for claiming that baking soda can cure cancer, has been falsely depicted selling pills that "clean blood vessels" in TikTok videos.
Contacted by AFP, her husband Michael O'Neill deplored that "a lot of unethical people" were using his wife's name "to sell products that she does not recommend, and in some cases they are just outright scams".
Some fake videos spiral even further down the rabbit hole, falsely claiming that O'Neill died from a miracle oil sold on Amazon.
AI expert Adjer was not surprised that such controversial health figures were also falling victim to deepfakes. 
"They are highly trusted by people in circles that, let's say, are unorthodox or conspiratorial," he said.
The experts were not optimistic that newly developed AI detection tools were capable of fighting back against the onslaught of deepfakes.
"It's a game of cat and mouse," Jurie said. 
Rather than trying to find all the fake videos out there, he pointed to technology that can "guarantee that content has not been altered, such as for messaging, thanks to software that produces digital signatures like a certificate", he said.
bur-jp/dl/rox/smw

health

US clears way for hearing aid feature in new Apple AirPods Pro

  • Apple touted the AirPods Pro 2 hearing aid feature as the first of its kind.
  • Apple on Thursday got a green light from US regulators to add a feature that would let upcoming AirPods Pro ear pieces be used as hearing aids, potentially disrupting that market.
  • Apple touted the AirPods Pro 2 hearing aid feature as the first of its kind.
Apple on Thursday got a green light from US regulators to add a feature that would let upcoming AirPods Pro ear pieces be used as hearing aids, potentially disrupting that market.
Early this week the company added AirPods Pro 2 to its lineup, touting a pending software upgrade that will let people test their hearing and then get personally-tuned assistance listening to what is around them or stream online.
The US Food and Drug Administration (FDA) on Thursday authorized the hearing aid feature for the new Apple devices, noting that a study showed users found them as beneficial as professionally fitted ones.
"Hearing loss is a significant public health issue impacting millions of Americans," said FDA acting director Michelle Tarver.
Tarver contended that authorization of AirPods Pro 2 hearing aid software "advances the availability, accessibility and acceptability of hearing support for adults with perceived mild to moderate hearing loss."
AirPods Pro 2 are priced at $249, considerably lower than the average price of clinical-grade hearing aids.
The hearing aid feature is designed to work with iPhones or iPads, though, meaning those interested will need to invest in Apple mobile devices.
Along with the new feature, Apple introduced the ability to use AirPods Pro 2, along with iPhones or iPads, to test their hearing and create a hearing profile stored privately in an Apple Health app.
"Hearing health is an essential part of our overall wellbeing, yet it can often be overlooked," Apple vice president of health doctor Sumbul Desai said in a release.
"We're thrilled to provide breakthrough software features with AirPods Pro that put users' hearing health front and center, bringing new ways to help test for and receive assistance for hearing loss."
More than 30 million US adults report some degree of hearing loss, causes of which include aging and being exposed to loud noises, according to the FDA.
Using results of the hearing test, the software turns AirPods Pro 2 into a clinical-grade hearing aid, according to Apple.
The user's personalized hearing profile is then "automatically applied to music, movies, games, and phone calls across their devices without needing to adjust any settings," Apple said.
Typical hearing aids don't adapt specifically for streamed content or phone calls.
Apple touted the AirPods Pro 2 hearing aid feature as the first of its kind.
The iPhone maker plans to make the hearing testing and aid features available in more than 100 countries in the coming months, pending authorization from relevent health authorities.
la-gc/mlm

health

US says new Apple AirPods can be hearing aids

BY GLENN CHAPMAN

  • Along with the new feature, the AirPods Pro 2, used with iPhones or iPads, will be able to test hearing and create a user's hearing profile stored privately in an Apple Health app.
  • Apple on Thursday got a green light from US regulators to add a feature that would let upcoming AirPods Pro ear pieces be used as hearing aids, potentially disrupting that market.
  • Along with the new feature, the AirPods Pro 2, used with iPhones or iPads, will be able to test hearing and create a user's hearing profile stored privately in an Apple Health app.
Apple on Thursday got a green light from US regulators to add a feature that would let upcoming AirPods Pro ear pieces be used as hearing aids, potentially disrupting that market.
Earlier this week the company added AirPods Pro 2 to its lineup, touting a pending software upgrade that will let people test their hearing and then get assisted listening for everyday life as well as streaming online.
The US Food and Drug Administration (FDA) on Thursday authorized the hearing aid feature for the devices, noting that a study showed users found them as beneficial as professionally fitted ones.
"Hearing loss is a significant public health issue impacting millions of Americans," said FDA acting director Michelle Tarver.
Apple's software "advances the availability, accessibility and acceptability of hearing support for adults with perceived mild to moderate hearing loss," Tarver added.
AirPods Pro 2 are priced at $249, considerably lower than the average price of clinical-grade hearing aids, but those interested will need to adopt Apple's devices.
Along with the new feature, the AirPods Pro 2, used with iPhones or iPads, will be able to test hearing and create a user's hearing profile stored privately in an Apple Health app.
The test takes about five minutes, with users tapping an iPhone or iPad screen when they hear tones at various volumes and frequencies.
The results are then used to calibrate the hearing aid.
That profile is also "automatically applied to music, movies, games, and phone calls across their devices without needing to adjust any settings," Apple said.
Typical hearing aids don't adapt specifically for streamed content or phone calls.
"Hearing health is an essential part of our overall wellbeing, yet it can often be overlooked," Apple vice president of health doctor Sumbul Desai said in a release.
Apple said that research indicates more than a billion people worldwide live with mild to moderate hearing loss.
"We are very excited about the new announcement by Apple," Hearing Loss Association of America executive director Barbara Kelley told AFP.
"The fact that a product that millions of people already own will offer hearing help and protection is a big step forward."
The iPhone maker plans to make the features available in more than 100 countries in the coming months, pending authorization from relevent health authorities.

Hearts and minds

Apple has steadily been integrating health and fitness features into its products.
Apple Watch can remind people when to take medicine; warn of harmful noise levels, or detect an irregular heart rhythm that should be checked.
It can also let women know when they are likely ovulating.
A new version of Apple Watch announced this week adds the ability to detect sleep apnea, a dangerous condition in which breathing stops intermittently while sleeping.
An Apple Health App collects data then uses machine learning to mine it for insights, keeping information on devices, according to the tech titan.
Health metrics offered by Apple include heart and respiration rates; blood glucose, and how well one sleeps.
la-gc/arp

health

State judge strikes down North Dakota abortion ban

  • The judge said the law passed by the Republican-majority North Dakota legislature was "confusing and vague."
  • A North Dakota judge on Thursday struck down a law banning most abortions in the conservative US state, ruling that it was vague and unconstitutional.
  • The judge said the law passed by the Republican-majority North Dakota legislature was "confusing and vague."
A North Dakota judge on Thursday struck down a law banning most abortions in the conservative US state, ruling that it was vague and unconstitutional.
North Dakota's legislature passed a ban on abortion last year except in cases of rape or incest and if a pregnancy poses serious health risks to the mother.
Even in cases of rape or incest an abortion may only be performed on women who have been pregnant for less than six weeks.
State District Judge Bruce Romanick issued his ruling in a lawsuit filed by the sole abortion clinic in North Dakota, which has since moved to the neighboring state of Minnesota, where the procedure is legal.
The judge said the law passed by the Republican-majority North Dakota legislature was "confusing and vague."
"As written, it can have a profound chilling effect on the willingness of physicians to perform abortions, even where the North Dakota Supreme Court has already said there is a fundamental right to do so to preserve a women's life or health," Romanick said.
He said the law also fails on constitutional grounds.
"The North Dakota Constitution guarantees each individual, including women, the fundamental right to make medical judgments affecting his or her bodily integrity, health, and autonomy, in consultation with a chosen health care provider free from government interference," Romanick said.
Meetra Mehdizadeh, an attorney at the Center for Reproductive Rights, welcomed the ruling as a "win for reproductive freedom."
"However, the damage that North Dakota's extreme abortion bans have done cannot be repaired overnight," Mehdizadeh said. "There are no abortion clinics left in North Dakota."
Abortion rights have become a key issue in the November presidential election between Republican Donald Trump and Democrat Kamala Harris.
Abortion has become a rallying cry for Democrats since the nationwide right to the procedure was struck down by the conservative-dominated Supreme Court in 2022.
Many Republican-led states quickly moved to restrict or outright ban the procedure after the ruling by the top court, which includes three justices nominated by Trump. 
Several states have added abortion access ballot measures in the November election.
cl/mlm

ADHD

High doses of Adderall linked with heightened risk of psychosis and mania

BY ISSAM AHMED

  • When the Food and Drug Administration became aware of such cases in the 2000s, it added a warning to the drug's label -- but relatively little research had been done to quantify the rates of side effects or how they related to the dosage level. 
  • Adderall is an effective treatment for attention deficit hyperactivity disorder (ADHD), but a sharp rise in US prescriptions over the past two decades has sparked concerns among researchers about rare but serious side effects. 
  • When the Food and Drug Administration became aware of such cases in the 2000s, it added a warning to the drug's label -- but relatively little research had been done to quantify the rates of side effects or how they related to the dosage level. 
Adderall is an effective treatment for attention deficit hyperactivity disorder (ADHD), but a sharp rise in US prescriptions over the past two decades has sparked concerns among researchers about rare but serious side effects. 
In a striking new study published in the American Journal of Psychiatry on Thursday, a team led by psychiatrist Lauren Moran of Mass General Brigham in Boston found that individuals taking high doses of the stimulant face more than a fivefold increased risk of developing psychosis or mania. 
Key factors include the lack of upper dosing guidelines and the notable increase in young adults using the medicine since the Covid-19 pandemic, driven in large part by the rise of telemedicine providers.
Moran told AFP her interest grew from her time at a hospital inpatient unit treating college students in the greater Boston area.  
"We were just seeing a lot of people coming in without much of a psychiatric history, developing the first episode of psychosis or mania in the context of using prescription stimulants," she said.
When the Food and Drug Administration became aware of such cases in the 2000s, it added a warning to the drug's label -- but relatively little research had been done to quantify the rates of side effects or how they related to the dosage level. 
For their investigation, Moran and colleagues reviewed the electronic health records of people aged 16 to 35 admitted at Mass General Brigham hospitals between 2005 and 2019. That is the typical onset age range for psychosis, or losing touch with reality.
The researchers identified 1,374 individuals experiencing their first episode of psychosis or mania -- a disruptive state characterized by high energy, erratic behavior -- and compared them to 2,748 control patients who were hospitalized for other psychiatric conditions.
By analyzing Adderall use during the previous month and adjusting for other variables like substance use, they were able to specifically determine the impact of stimulants.
They found those who had taken Adderall were 2.68 times more likely to have been hospitalized with psychosis or mania compared to those who were not -- and this increased to 5.28 times more likely at higher doses of 40 milligrams and above. 
Put another way, 81 percent of psychosis or mania cases may have been prevented if they were not on the high dose, the paper said.
A separate analysis found no increased risk with Ritalin, another stimulant prescribed for ADHD. Moran suggested this could be due to key differences in how the two drugs work.

Telemedicine companies

Both medications raise dopamine levels, a chemical messenger involved in the brain's reward system, motivation and learning. However, while Adderall, an amphetamine, increases dopamine release, Ritalin works by blocking its reabsorption.
For Moran, a critical takeaway was the need for clear upper dose limits on labels. The current label recommends treating patients with 20 milligrams, but in practice, doctors vary widely in their prescriptions.
This variability partly stems from severe impairment from ADHD symptoms that require higher doses, but Moran has occasionally observed "carelessness in dose prescribing," while at other times, patients may "shop" for a doctor willing to prescribe what they want.
"People, including clinicians, might think they can eliminate all ADHD symptoms, but that's not a realistic expectation," she added.
Telemedicine companies, in particular, have come under scrutiny for allegedly overprescribing Adderall, contributing to shortages for those who genuinely need the medication.
The Drug Enforcement Administration, which had proposed revoking telehealth prescriptions for Adderall, extended them through the end of 2024 in response to significant public feedback.
ia/st/sco

strike

Pakistan police strike after attacks on polio vaccination teams

  • Since the launch of the latest vaccination drive on Monday, at least two police officers and one polio worker have been shot dead in separate attacks in rural districts near the border with Afghanistan, including one officer escorting a team on Thursday. 
  • More than 100 Pakistan police who provide security for polio vaccination teams in restive border areas went on strike Thursday after a string of deadly militant attacks this week. 
  • Since the launch of the latest vaccination drive on Monday, at least two police officers and one polio worker have been shot dead in separate attacks in rural districts near the border with Afghanistan, including one officer escorting a team on Thursday. 
More than 100 Pakistan police who provide security for polio vaccination teams in restive border areas went on strike Thursday after a string of deadly militant attacks this week. 
Police officers who are routinely deployed to protect polio workers going door-to-door frequently come under attack by militants waging a war against security forces.
Hundreds of police and polio workers have been killed over the past decade.
"Any constable who learns of the protest is leaving their polio duty to join the demonstration," said a police officer at the sit-in who asked not to be named.
He told AFP that negotiations have failed between the protesting police and senior officials in Bannu district, in the northwestern border province of Khyber Pakhtunkhwa.
Since the launch of the latest vaccination drive on Monday, at least two police officers and one polio worker have been shot dead in separate attacks in rural districts near the border with Afghanistan, including one officer escorting a team on Thursday. 
Nine people were also wounded on Monday in a bomb attack on a polio vaccination team claimed by the Islamic State group.
Most attacks are claimed by the Pakistani Taliban, a separate group from the Afghan Taliban but with a similar ideology. 
In the latest attack, two motorcyclists opened fire on the police officer.
"The polio team was in a nearby street at the time, so they remained unharmed," Ziauddin Ahmed, the district police officer, told AFP. 

Polio and militancy surge

Pakistan has seen a surge in polio cases this year, recording 17 cases so far in 2024, compared to six in 2023. 
Pakistan and Afghanistan are the only countries in the world where polio remains endemic despite an effective vaccine.
Health officials had aimed to vaccinate 30 million children in a week-long campaign.
"A partial polio campaign is underway here, but many police officials have abandoned their duties to join the sit-in," another protesting police officer told AFP on condition of anonymity. 
According to the United Nations children's agency (UNICEF), the number of polio cases in Pakistan has fallen dramatically from around 20,000 annually in the early 1990s.
Pockets of Pakistan's mountainous border regions however remain resistant to inoculation as a result of misinformation, conspiracy theories, and some firebrand clerics declaring it un-Islamic.
Pakistan has witnessed a surge in militant attacks since the Taliban government returned to power in neighbouring Afghanistan in 2021, mostly in Khyber Pakhtunkhwa, but also in southwestern Balochistan, which abuts Afghanistan and Iran.
Islamabad accuses Kabul's rulers of failing to root out militants sheltering on Afghan soil as they prepare to stage assaults on Pakistan -- a charge the Taliban government denies. 
la-kf-ecl/rsc

politics

Starmer to say UK's national health service needs 'major surgery'

BY PETER HUTCHISON

  • "We know working people can't afford to pay more, so it's reform or die," Starmer was expected to say.
  • Prime Minister Keir Starmer will warn Thursday that Britain's state-run National Health Service must "reform or die" after an independent report said the venerated institution was in a "critical condition".
  • "We know working people can't afford to pay more, so it's reform or die," Starmer was expected to say.
Prime Minister Keir Starmer will warn Thursday that Britain's state-run National Health Service must "reform or die" after an independent report said the venerated institution was in a "critical condition".
Starmer, whose Labour party was elected by a landslide in July, will promise "the biggest reimagining" of the NHS since it was founded 76 years ago.
His speech in central London follows the publication of a 142-page investigation which found that the health of Britons had deteriorated over the past 15 years.
The report's author, Ara Darzi, an unaffiliated Lord in parliament's upper chamber, said the NHS had fallen into "disrepair" due to a lack of investment, top-down reorganisation and the coronavirus pandemic.
"What we need is the courage to deliver long-term reform -- major surgery not sticking plaster solutions," Starmer was due to say, according to excerpts of his speech released to reporters.
"The NHS is at a fork in the road, and we have a choice about how it should meet these rising demands.
"Raise taxes on working people to meet the ever-higher costs of ageing population -- or reform to secure its future.
"We know working people can't afford to pay more, so it's reform or die," Starmer was expected to say.
Health minister Wes Streeting told Sky News there would be "three big shifts" -- moving certain services from hospitals to the community, fully switching from analog to digital and "giving staff the tools to do the job, so that we tackle that productivity challenge."
He said the government would not "do as the Conservatives did, which is just pour more money into a broken model, and fail to reform."
- 'Reimagining' - 
Labour dumped the Conservatives out of power on July 4 in part on a pledge to "fix" the NHS, accusing the Tories of having "broken" it during their 14 years in power.
Darzi's report notes that the NHS is seeing a surge in patients suffering multiple long-term illnesses such as diabetes and high blood pressure.
It says the UK has higher cancer rates than other countries and is lagging behind in its treatment of major conditions.
It also notes that waiting lists have swelled to 7.6 million and that a tenth of patients at accident and emergency wards now wait 12 hours or more before being seen.
Darzi said that he was "shocked" by what he discovered but added that the NHS's vital signs "remain strong".
Starmer was expected to outline the three areas of reform for a 10-year plan to "turn around the NHS", whose universal model is a source of British pride, despite its shortcomings in meeting demand.
Just over a year ago, his Tory predecessor Rishi Sunak announced a 15-year drive to recruit more than 300,000 staff to deal with a chronic shortage of doctors and nurses.
At the time, it was estimated that the NHS would have a staff shortfall of 360,000 by 2037 because of an ageing population, a lack of domestically trained health workers and difficulties recruiting and retaining staff, in part because of new visa rules.
"The challenge is clear before us; the change could amount to the biggest reimagining of our NHS since its birth," the prime minister was set to say.
Starmer, whose mother was an NHS nurse, has spent much of his first two months in power blaming the Tories for leaving Labour a dire inheritance in sectors ranging from health to the economy and prisons.
The Conservatives, whose leader Sunak is the son of an NHS doctor and a pharmacist, accuse him of exaggerating the country's problems as a way of laying the groundwork for future tax increases.  
pdh/jwp/ach