disease

Rare bone-eroding disease ruining lives in Kenya's poorest county

BY ROSE TROUP BUCHANAN

  • - Neglected - In Kenya's poorest county, Turkana, around 70 percent of the population lives beneath the poverty line, with healthcare limited and hard to reach.
  • Joyce Lokonyi sits on an upturned bucket, fingers weaving palm fronds as the wind pulls her dress to expose the stump of her amputated foot, lost to a little-known disease ravaging Kenya's poorest county.
  • - Neglected - In Kenya's poorest county, Turkana, around 70 percent of the population lives beneath the poverty line, with healthcare limited and hard to reach.
Joyce Lokonyi sits on an upturned bucket, fingers weaving palm fronds as the wind pulls her dress to expose the stump of her amputated foot, lost to a little-known disease ravaging Kenya's poorest county.
Mycetoma is a fungal or bacterial infection that enters the body through any open wound, often as tiny as a thorn prick.
Starting as tiny bumps under the skin, it gradually leads to the erosion of tissue, muscles and bone.
The fungal variety is endemic across the so-called "mycetoma belt" -- including Somalia, Sudan, Yemen and northern Kenya -- with funding and research desperately lacking.
Once the disease has reached the bone the only option is amputation.
"I was able to slightly walk, although the disease had eaten all my toes," Lokonyi, 28, told AFP.
She was shunned by the local community, she said.
"They used to say that when you go to someone's home, you will leave traces of the disease where you stand."
She was unable to afford medication despite her husband selling off his goats, and amputation became the only option.
"I accepted because I saw that it was going to kill me," she said, a pair of battered crutches lying on the sand beside her two-year-old daughter.
But she has struggled with the aftermath.
"I have become a good-for-nothing, I can't work, I can't burn charcoal, I can't do anything," she said.

Neglected

In Kenya's poorest county, Turkana, around 70 percent of the population lives beneath the poverty line, with healthcare limited and hard to reach.
Mycetoma disproportionately affects rural communities of farmers and herders, according to the Drugs for Neglected Diseases initiative (DNDi), a global NGO.
It was only recognised as a neglected disease by the World Health Organization in 2016. Ignorance and misdiagnosis remain widespread.
"Doctors are not aware of the disease," Borna Nyaoke-Anoke, DNDi's head of mycetoma research, told AFP.
"If you're used to donkeys, you don't start seeing zebras everywhere."
The scale of the problem is difficult to estimate, but Ekiru Kidalio, director of Lodwar Hospital in Turkana, said they "rarely go a week without finding a case". 
He added that the local population, 80 percent of which is illiterate, often turns to traditional medicine.
By the time they come to hospital "the condition is already advanced such that it's not easy to reverse".
Medication is also expensive -- treatment takes up to a year and costs as much as $2,000 -- and comes with dizzying side effects.
Diagnosis and treatment are not free under Kenya's overwhelmed health system, leaving patients at the mercy of foreign donors or seeking sums that are unimaginable for subsistence farmers.

'Think about the worst'

In Lodwar Hospital, lab technician John Ekai bends over his microscope and examines a suspected mycetoma sample. 
"Mycetoma is a very neglected disease, no-one is giving it attention," he told AFP.
He has become the go-to man for suspected patients, handling his charges with a mischievous sense of humour that puts them at ease.
Ekai has treated more than 100 mycetoma patients in the past year, but has seen only five recoveries, with many simply vanishing back into Turkana's arid plains.
He worries for those who have disappeared: "The mycetoma will grow and grow and maybe... lead to amputation."
During AFP's visit, he examined young mother Jennifer Ekal, 19, who had lived with the disease since she was 11.
"I was in school but I decided to leave because of my foot," she said, showing her swollen and painful extremity, hidden beneath a red-and-white dishcloth.
Four doses of medication a day appeared to be helping, she said. 
But as she gathered up her daughter, three-year-old Bianca, she admitted she was worried about the future.
"I do not want to think about the worst."
rbu/er/phz/jhb

AI

AI tool uses selfies to predict biological age and cancer survival

BY ISSAM AHMED

  • It was then tested on 6,196 cancer patients treated in the United States and the Netherlands, using photos snapped just before radiotherapy.
  • Doctors often start exams with the so-called "eyeball test" -- a snap judgment about whether the patient appears older or younger than their age, which can influence key medical decisions. 
  • It was then tested on 6,196 cancer patients treated in the United States and the Netherlands, using photos snapped just before radiotherapy.
Doctors often start exams with the so-called "eyeball test" -- a snap judgment about whether the patient appears older or younger than their age, which can influence key medical decisions. 
That intuitive assessment may soon get an AI upgrade.
FaceAge, a deep learning algorithm described Thursday in The  Lancet Digital Health, converts a simple headshot into a number that more accurately reflects a person's biological age rather than the birthday on their chart.
Trained on tens of thousands of photographs, it pegged cancer patients on average as biologically five years older than healthy peers. The study's authors say it could help doctors decide who can safely tolerate punishing treatments, and who might fare better with a gentler approach.
"We hypothesize that FaceAge could be used as a biomarker in cancer care to quantify a patient's biological age and help a doctor make these tough decisions," said co-senior author Raymond Mak, an oncologist at Mass Brigham Health, a Harvard-affiliated health system in Boston.
Consider two hypothetical patients: a spry 75‑year‑old whose biological age clocks in at 65, and a frail 60‑year‑old whose biology reads 70. Aggressive radiation might be appropriate for the former but risky for the latter. 
The same logic could help guide decisions about heart surgery, hip replacements or end-of-life care.  

Sharper lens on frailty

Growing evidence shows humans age at different rates, shaped by genes, stress, exercise, and habits like smoking or drinking. While pricey genetic tests can reveal how DNA wears over time, FaceAge promises insight using only a selfie.
The model was trained on 58,851 portraits of presumed-healthy adults over 60, culled from public datasets. 
It was then tested on 6,196 cancer patients treated in the United States and the Netherlands, using photos snapped just before radiotherapy. Patients with malignancies looked on average 4.79 years older biologically than their chronological age.
Among cancer patients, a higher FaceAge score strongly predicted worse survival -- even after accounting for actual age, sex, and tumor type -- and the hazard rose steeply for anyone whose biological reading tipped past 85.
Intriguingly, FaceAge appears to weigh the signs of aging differently than humans do. For example, being gray-haired or balding matters less than subtle changes in facial muscle tone. 
FaceAge boosted doctors' accuracy, too. Eight physicians were asked to examine headshots of terminal cancer patients and guess who would die within six months. Their success rate barely beat chance; with FaceAge data in hand, predictions improved sharply.
The model even affirmed a favorite internet meme, estimating actor Paul Rudd's biological age as 43 in a photo taken when he was 50.

Bias and ethics guardrails

AI tools have faced scrutiny for under‑serving non-white people. Mak said preliminary checks revealed no significant racial bias in FaceAge's predictions, but the group is training a second‑generation model on 20,000 patients.
They're also probing how factors like makeup, cosmetic surgery or room lighting variations could fool the system.
Ethics debates loom large. An AI that can read biological age from a selfie could prove a boon for clinicians, but also tempting for life insurers or employers seeking to gauge risk. 
"It is for sure something that needs attention, to assure that these technologies are used only in the benefit for the patient," said Hugo Aerts, the study's co-lead who directs MGB's AI in medicine program. 
Another dilemma: What happens when the mirror talks back? Learning that your body is biologically older than you thought may spur healthy changes -- or sow anxiety.
The researchers are planning to open a public-facing FaceAge portal where people can upload their own pictures to enroll in a research study to further validate the algorithm. Commercial versions aimed at clinicians may follow, but only after more validation.
ia/arp

Gates

Bill Gates speeds up giving away fortune, blasts Musk

BY JOHN BIERS

  • The organization, which had more than $71 billion in assets at the end of 2023, has been credited with helping to reshape the world of global public health.
  • Microsoft co-founder Bill Gates announced Thursday an accelerated timeframe for giving away his fortune as he touted artificial intelligence as a game-changer to boost public health and save lives globally.
  • The organization, which had more than $71 billion in assets at the end of 2023, has been credited with helping to reshape the world of global public health.
Microsoft co-founder Bill Gates announced Thursday an accelerated timeframe for giving away his fortune as he touted artificial intelligence as a game-changer to boost public health and save lives globally.
Under a new timetable, the Gates Foundation will spend more than $200 billion over the next 20 years, shutting down in 2045. The organization had originally planned to close 20 years after Gates' death.
The announcement came as Gates took aim at another billionaire tech titan, Elon Musk.
The Tesla CEO pushed through draconian cuts to the US Agency for International Development because Musk "didn't go to a party that weekend," Gates told the New York Times in an apparent dig at Musk's lifestyle.
Gates is listed as the 13th on the Forbes "real-time" billionaire list, with a net worth of $112.6 billion. Musk is first with $383.2 billion.
Gates, 69, published a chart showing his net worth plummeting 99 percent over the next 20 years in a blog post announcing the shift, describing a doubling of the pace of giving.
"People will say a lot of things about me when I die, but I am determined that 'he died rich' will not be one of them," Gates wrote.
The Bill and Melinda Gates Foundation launched in 2000, the same year Bill Gates stepped down as CEO of Microsoft. In 2024, Melinda French Gates exited the foundation three years after the couple's divorce.
The organization, which had more than $71 billion in assets at the end of 2023, has been credited with helping to reshape the world of global public health.
It lists five offices throughout Africa, in addition to locations in the United States, Europe, China, India and the Middle East.
Gates cited progress in health efforts including campaigns to eradicate polio and the creation of a new vaccine for rotavirus that has helped reduce the number of children who die from diarrhea each year by 75 percent.
Separate from the Gates Foundation, the Microsoft founder said he plans to continue to provide funding for initiatives to expand access to affordable energy and for breakthrough research into Alzheimer’s disease.

Not a 'forever' foundation

In the blog post, Gates credited the writings of 19th-century US steel magnate Andrew Carnegie, whose foundation is still around.
But Gates told the New York Times he had no designs on creating a "forever" foundation out of "some weird legacy thing," preferring to pump out billions more to take advantage of emerging technologies.
"The tools are so phenomenal," he said of the potential for AI in global health.
"All the intelligence will be in the AI, and so you will have a personal doctor that's as good as somebody who has a full-time dedicated doctor -- that’s actually better than even what rich countries have," Gates told the New York Times.
While private foundations can do a lot, Gates described the government role as essential, ruing deep budget cuts by the United States, Britain, France and other countries.
"It's unclear whether the world’s richest countries will continue to stand up for its poorest people. But the one thing we can guarantee is that, in all of our work, the Gates Foundation will support efforts to help people and countries pull themselves out of poverty," he wrote. 
The moves have included the assault on USAID by Musk's "Department of Government Efficiency" in Donald Trump's presidential administration. 
Gates called the cuts "stunning," far more severe than expected.
Musk is "the one who cut the USAID budget," Gates told the New York Times. "He put it in the wood chipper."
In an interview with the Financial Times, Gates ridiculed Musk's apparent confusion of Gaza Province in Mozambique with Gaza in the Middle East as the Trump administration targeted programs.
"The picture of the world's richest man killing the world's poorest children is not a pretty one," Gates said of Musk in an interview with the Financial Times.
jmb/bgs

agriculture

Tobacco town thrives as China struggles to kick the habit

BY AGATHA CANTRILL AND MATTHEW WALSH

  • Named for a centuries-old pagoda painted scarlet after the country's communist takeover, it is owned by state-run monopoly the China National Tobacco Corporation and offers visitors factory tours, a museum and a tobacco-themed cultural park.
  • Visitors mill around a bright red hilltop pagoda in southwestern China, gazing down at a sprawling cigarette factory whose deadly output has put an otherwise unremarkable city on the map.
  • Named for a centuries-old pagoda painted scarlet after the country's communist takeover, it is owned by state-run monopoly the China National Tobacco Corporation and offers visitors factory tours, a museum and a tobacco-themed cultural park.
Visitors mill around a bright red hilltop pagoda in southwestern China, gazing down at a sprawling cigarette factory whose deadly output has put an otherwise unremarkable city on the map.
China is home to a third of the world's smokers and tobacco-related diseases are a major cause of death in the country -- a trend likely to worsen as its population rapidly ages.
Beijing hopes to dramatically reduce that by the end of the decade, but even the government machine is struggling to achieve that as it clashes with a powerful state tobacco monopoly and local economies reliant on the crop.
That contradiction smoulders in Yuxi, Yunnan province, whose nascent tourism businesses and local farmers thrive on its history of cigarette production.
A mostly agricultural area where incomes lag behind the national average, the city has firmly hitched its fortunes to tobacco, which accounted for almost a third of its gross domestic product in the first quarter of last year, according to official figures.
That income helps "pay for our children's schooling or to build a house", farmer Li told AFP as her husband ploughed furrows into a hilltop field.
She said her family can earn up to 60,000 yuan ($8,300) annually from the tobacco harvest, far exceeding other crops with more variable prices.
Tobacco also brings tourists to Yuxi -- local firm Hongta, or "red tower", is one of China's most prominent cigarette brands.
Named for a centuries-old pagoda painted scarlet after the country's communist takeover, it is owned by state-run monopoly the China National Tobacco Corporation and offers visitors factory tours, a museum and a tobacco-themed cultural park.

Up in smoke

"Yuxi's cigarettes are quite famous, so we've always wanted to come and have a look," said a tourist surnamed Dong from the northeastern city of Dalian.
Foreign cigarettes, he claimed, "don't put the same demand on quality".
China is the world's largest producer and consumer of tobacco and has more than 300 million smokers, according to the World Health Organization.
As trains pull into stations across China, passengers frequently jump off for a quick cigarette on the platform before continuing their journey.
Indoor smoking bans are loosely enforced and the stench of tobacco smoke is commonplace, from public toilets to taxis and late-night eateries.
Beijing says it aims to reduce the number of smokers from around a quarter of the population to a fifth by 2030.
Progress has been slow. The number of smokers fell just 14 percent between 2010 and 2022, well below the average for richer nations, a study by a Chinese think tank found last year.
Policymakers must also navigate the interests of China Tobacco, which controls virtually all of the domestic production, processing and distribution.
The company has a chokehold on a domestic tobacco sector that last year generated a record 1.6 trillion yuan ($220 billion) in taxes and profits.
The State Tobacco Monopoly Administration, responsible for industry oversight, has been criticised by researchers for being essentially the same organisation under a different name.
This means the country's largest cigarette manufacturer is its own regulator, in what has been decried by public health advocates as a clear conflict of interest and an impediment to effective tobacco controls.
The firm touts its contribution to the economy, but researchers into China's tobacco market argue that the revenue does not outweigh the health costs.

Changing times

A recent study found that the annual economic cost of cigarette smoking in China -- estimated at 2.43 trillion yuan in 2020 -- was approximately 1.6 times greater than the gains from the industry.
"Stronger tobacco control policies can reduce smoking prevalence without severely harming government revenue," Qinghua Nian at the Institute for Global Tobacco Control at Johns Hopkins Bloomberg School of Public Health told AFP.
Efforts to curb cigarette consumption at home have coincided with an overseas push from Hongta and other tobacco brands.
The country exported more than $9 billion in tobacco and tobacco products in 2023, up from less than $1.5 billion five years prior, according to the United Nations.
Beneath Yuxi's looming red pagoda, tourist Dong said smoking was slowly losing its appeal among younger generations.
"As society develops, some things are progressing and it's better to smoke less," he said.
"My children and grandchildren don't smoke at all."
But nearby, a worker surnamed Long watching over tobacco seedlings in a greenhouse at a plant nursery said the crop was still a good way to earn a living.
"Tobacco used to be a couple of yuan per pound, but now it's a couple of dozen yuan," the 54-year-old said.
"This critical industry is still a good source of income for farmers."
ac-mjw/oho/je/dan/pst

drug

Ozempic slimming craze sweeps Kosovo despite side effects

BY ISMET HAJDARI

  • - Ozempic 'every day' - While Kosovo has lower levels of obesity than the European average, more than 57 percent of the population is overweight and 20 percent is clinically obese, according to a 2019 World Health Organization report. 
  • Kosovo influencer Tringa Kadriu sees the slimming drug Ozempic as a chance to shed excess pounds -- and she is not the only one in her Balkan nation, where more than half the population is overweight.
  • - Ozempic 'every day' - While Kosovo has lower levels of obesity than the European average, more than 57 percent of the population is overweight and 20 percent is clinically obese, according to a 2019 World Health Organization report. 
Kosovo influencer Tringa Kadriu sees the slimming drug Ozempic as a chance to shed excess pounds -- and she is not the only one in her Balkan nation, where more than half the population is overweight.
"I want to lose 15-16 kilos (33-35 pounds) in two months," Kadriu, 29, told AFP, "and then I'll continue with fitness".
Ozempic, approved in the United States to treat diabetes in 2017, has found an international market for people trying to lose weight.
Despite its cost, the drug has soared in popularity in Kosovo, a country of 1.7 million.
While Kosovo authorities have not sanctioned the drug's use for weight loss, they have noted their limited means to confront use of a drug widely available in the country.
Merita Emini-Sadiku, who heads the Kosovo university hospital's endocrinology clinic, said the cost of the drug had soared.
"The monthly dose used to be 75-80 euros ($85-91), while now it is 130-140 euros ($147-159), probably due to high demand," she said.
But she warned that "Ozempic has side effects that people are not aware of".
Ozempic use can potentially cause issues including thyroid cancer, pancreatitis, gastroparesis and bowel obstruction, according to the latest studies.

'Constant demand'

Meant to treat Type 2 diabetes -- of which the WHO says Kosovo has lower than average levels -- the drug regulates blood sugar levels but also helps suppress hunger, leading to a lower calorie intake.
As a result, its potentially cancerous complications have done little to stem the drug's popularity or availability.
"I checked a lot of pharmacies in Kosovo and I noticed that Ozempic is very easy to get," said Kadriu, adding that pharmacists even suggested she gradually increase her dosage.
A worker at a pharmacy in the capital Pristina's downtown, who asked to remain anonymous, said she had trouble recalling when someone last came into her pharmacy to buy Ozempic with a diabetes prescription.
"But we have a constant demand for Ozempic without a prescription. You can guess why," she said.
Given its availability, Emini-Sadiku said authorities should exercise greater control over Ozempic's distribution.
But Bujar Vitija, a journalist specialising in health, said that would be tricky to achieve given Kosovo's poor health record-keeping.
"Unfortunately there is no data," Vitija said.
With 1,500 to 1,600 private pharmacies in Kosovo, the country's 20 pharmaceutical inspectors have their work cut out for them, he added.

Ozempic 'every day'

While Kosovo has lower levels of obesity than the European average, more than 57 percent of the population is overweight and 20 percent is clinically obese, according to a 2019 World Health Organization report. 
And women, who are more likely to face societal pressure to be thin, were 66 percent more likely to be obese than men, the WHO report found.
But not every Kosovar who has used Ozempic had the best experience with the drug.
"I took Ozempic on the advice of a doctor for two years but it had no effect," said 48-year-old merchant Lulzim Rrahmani, adding that three of his relatives even experienced "a negative effect of the drug".
"It was just a waste of money and time."
Given the risk of side effects, Emini-Sadiku said Ozempic was "by no means to be taken without a doctor's prescription".
Yet Kadriu said she would not be deterred, adding that she saw colleagues taking the drug "every day at work".
"I don't see any symptom that would deter me."
ih/sbk/jm/js

health

US aid cuts push Bangladesh's health sector to the edge

BY SHEIKH SABIHA ALAM

  • Instead, it is reeling from a $48 million snap aid cut by US President Donald Trump's government, which health workers say could rapidly unravel years of hard work and cause huge numbers of preventable deaths.
  • Bangladesh hoped to celebrate progress towards eradicating tuberculosis this year, having already slashed the numbers dying from the preventable and curable disease by tens of thousands each year.
  • Instead, it is reeling from a $48 million snap aid cut by US President Donald Trump's government, which health workers say could rapidly unravel years of hard work and cause huge numbers of preventable deaths.
Bangladesh hoped to celebrate progress towards eradicating tuberculosis this year, having already slashed the numbers dying from the preventable and curable disease by tens of thousands each year.
Instead, it is reeling from a $48 million snap aid cut by US President Donald Trump's government, which health workers say could rapidly unravel years of hard work and cause huge numbers of preventable deaths.
"Doctors told me I was infected with a serious kind of tuberculosis," labourer Mohammed Parvej, 35, told AFP from his hospital bed after he received life-saving treatment from medics funded by the US aid who identified his persistent hacking cough.
But full treatment for his multidrug-resistant tuberculosis requires more than a year of hospital care and a laborious treatment protocol -- and that faces a deeply uncertain future.
"Bangladesh is among the seven most TB-prevalent countries globally, and we aim to eradicate it by 2035," said Ayesha Akhter, deputy director of the formerly US-funded specialised TB Hospital treating Parvej in the capital Dhaka.
Bangladesh had made significant progress against the infectious bacteria, spread by spitting and sneezing, leaving people exhausted and sometimes coughing blood.
TB deaths dropped from more than 81,000 a year in 2010, down to 44,000 in 2023, according to the World Health Organization, in the country of some 170 million people.
Akhter said the South Asian nation had "been implementing a robust programme", supported by the US Agency for International Development (USAID).
"Then, one fine morning, USAID pulled out their assistance," she said.

Starving children

More than 80 percent of humanitarian programmes funded by USAID worldwide have been scrapped.
Tariful Islam Khan said the International Centre for Diarrhoeal Disease Research Bangladesh (ICDDR,B) had, with US funding, carried out mass screening "improving TB case detection, particularly among children" from 2020 to 2024.
"Thanks to the support of the American people... the project has screened 52 million individuals and diagnosed over 148,000 TB cases, including 18,000 children," he said.
Funding cuts threatened to stall the work.
"This work is critical not only for the health of millions of Bangladeshis, but also for global TB control efforts," he said.
Growing rates of infectious diseases in one nation have a knock-on impact in the region.
Cuts hit further than TB alone.
"USAID was everywhere in the health sector," said Nurjahan Begum, health adviser to the interim government -- which is facing a host of challenges after a mass uprising toppled the former regime last year.
US aid was key to funding vaccines combatting a host of other diseases, protecting 2.3 million children against diphtheria, measles, polio and tetanus.
"I am particularly worried about the immunisation programme," Begum said.
"If there is a disruption, the success we have achieved in immunisation will be jeapordised."
Bangladeshi scientists have also developed a special feeding formula for starving children. That too has been stalled.
"We had just launched the programme," Begum said. "Many such initiatives have now halted". 

Pivot to China

US State Department official Audrey M. Happ said that Washington was "committed" to ensuring aid was "aligned with the interests of the United States, and that resources are used as effectively and efficiently as possible".
Bangladesh, whose economy and key garment industry are eyeing fearfully the end of the 90-day suspension of Trump's punishing 37 percent tariffs, is looking for other supporters.
Some Arab nations had expressed interest in helping fill the gap in Muslim-majority Bangladesh.
China, as well as Turkey, may also step into Washington's shoes, Begum said.
Jobs are gone too, with Dhaka's Daily Star newspaper estimating that between 30,000 and 40,000 people were laid off after the United States halted funding.
Zinat Ara Afroze, fired along with 54 colleagues from Save the Children, said she worried for those she had dedicated her career to helping.
"I have seen how these projects have worked improving the life and livelihoods of underprivileged communities," she said, citing programmes ranging from food to health, environmental protection to democracy.
"A huge number of this population will be in immediate crisis."

Babies dying  

Those with the least have been hit the hardest.
Less dollars for aid means more sick and dead among the Rohingya refugees who fled civil war in their home in neighbouring Myanmar into Bangladesh since 2017.
Much of the US aid was delivered through the UN's WHO and UNICEF children's agency.
WHO official Salma Sultana said aid cuts ramped up risks of "uncontrolled outbreaks" of diseases including cholera in the squalid refugee camps.
Faria Selim, from UNICEF, said reduced health services would impact the youngest Rohingya the hardest, especially some 160,000 children under five.
Hepatitis C, with a prevalence rate of nearly a fifth,"is likely to increase in 2025", Selim said.
Masaki Watabe, who runs the UN Population Fund (UNFPA) in Bangladesh working to improve reproductive and maternal health, said it was "trying its best to continue".
Closed clinics and no pay for midwives meant the risk of babies and mothers dying had shot up.
"Reduced donor funding has led to... increasing the risk of preventable maternal and newborn deaths," he said.
sa/pjm/stu/cms

plant

Brazilian ritual root gets second life as potential anti-depressant

BY JUAN SEBASTIAN SERRANO

  • Jurema's roots are combined with other plants in a wine-like beverage that is consumed at rituals that include dancing and drums, part of Indigenous tradition in northeast Brazil where the plant grows.
  • Long used in Indigenous Brazilian rituals, the jurema preta plant, which contains a potent psychedelic, is gaining ground as a potential treatment for depression.
  • Jurema's roots are combined with other plants in a wine-like beverage that is consumed at rituals that include dancing and drums, part of Indigenous tradition in northeast Brazil where the plant grows.
Long used in Indigenous Brazilian rituals, the jurema preta plant, which contains a potent psychedelic, is gaining ground as a potential treatment for depression.
At street stalls where medicinal herbs are sold, customers can buy the plant's root which contains dimethyltryptamine (DMT), a hallucinogenic substance that researchers say could be used to alleviate symptoms.
Following instructions he found on the internet, Guaracy Carvajal extracted DMT at home in 2016 from roots he bought on the street.
The 31-year-old software programmer, who had tried various treatment for chronic depression he has suffered since adolescence, said the drug makes it "feel like you've solved something in your life."
Physicist Draulio Araujo, who has conducted extensive research on the drug, said "the response is rapid. One day after treatment, (patients) already showed a significant improvement in their depression symptoms."
Yet he also warned that it "is not a magic cure" and that psychedelics "are not for everyone."
As a researcher at the Brain Institute of the Federal University of Rio Grande do Norte, Araujo and his team treated 14 people with the drug for six months.
The patients inhaled vaporized DMT, under medical supervision.
"It's common for our patients to say that something changed, that a key opened something," he said.
His patients also received psychological therapy, and some continued with conventional pharmaceutical drugs.
Neuroscientist Fernanda Palhano-Fontes, also of the Brain Institute, said "we have patients who improve significantly, others who don't improve at all."
Araujo's findings were published in the scientific journal Nature in April. In 2024, he published another study with promising results in the journal Psychedelic Medicine.
As for Carvajal, who stopped using jurema preta some time ago, he said the drug really allows a person to "start to have a lighter life."
It helped him get through a time when he was in "a state of questioning myself" about "work, day-to-day life," he said. 

Spiritual channels

Brazil occupies a fairly prominent place in DMT research due to the substance's prominence in society, Araujo said.
While there is no ban on the cultivation or possession of jurema, which is also known as Mimosa tenuiflora, consumption of DMT is prohibited, except for religious and scientific use.
Jurema's roots are combined with other plants in a wine-like beverage that is consumed at rituals that include dancing and drums, part of Indigenous tradition in northeast Brazil where the plant grows.
"It's not hallucination," said Joyce Souza, a young woman attending a jurema ceremony in Planaltina, on the outskirts of Brasília.
"My spiritual channels become more accessible, I can communicate better with myself," Souza said.
Gathered in a house courtyard and dressed in white, the group of mostly novices waited for more seasoned practitioners to enter a trance and bring messages from ancient spirits.
Meanwhile, back in the lab, Araujo is hoping to expand his DMT research to a study of 100 patents.
"Let's say that in five years we'll have... a clear picture on when it will reach a real clinical setting," he said.
jss/bfm/bjt

pope

Francis's popemobile converted into clinic for Gazan children

  • The health ministry in Hamas-run Gaza said Sunday that at least 2,436 people had been killed since Israel resumed its campaign on March 18, bringing the overall death toll from the war to 52,535.
  • Before his death, Pope Francis donated one of his popemobiles to be converted into a children's clinic in war-torn Gaza, Catholic charity Caritas said on Monday.
  • The health ministry in Hamas-run Gaza said Sunday that at least 2,436 people had been killed since Israel resumed its campaign on March 18, bringing the overall death toll from the war to 52,535.
Before his death, Pope Francis donated one of his popemobiles to be converted into a children's clinic in war-torn Gaza, Catholic charity Caritas said on Monday.
The iconic open-sided vehicle, designed to allow the pontiff to greet crowds of well-wishers, has been transferred to Caritas Jerusalem and will head to Gaza if and when Israel opens a humanitarian corridor.
The car, a converted Mitsubishi, was used by the pope during a 2014 visit to Bethlehem and had since been on display, gathering dust and rust. It has now been repaired and refurbished as a mobile clinic.  
"With the vehicle, we will be able to reach children who today have no access to healthcare -- children who are injured and malnourished," said Peter Brune, secretary general of Caritas Sweden.
Brune told AFP that Sweden's Cardinal Anders Arborelius had asked the late pope, who died on April 21 aged 88, that the spare vehicle be put to use providing essential frontline healthcare to Palestinian children.
It will be fitted with medical equipment and a fridge for medicines and be assigned a driver and a team of doctors.
"This vehicle represents the love, care and closeness shown by His Holiness for the most vulnerable, which he expressed throughout the crisis," said Anton Asfar, secretary general of Caritas Jerusalem.
It was not clear, however, if or when the aid agency's hoped-for humanitarian corridor would open.
Israel resumed major operations across Gaza on March 18 amid political deadlock over how to build on a two-month ceasefire in its war against Hamas, which was sparked by the militants' October 2023 attack.
On Monday, Israel's security cabinet approved an expansion of military operations that would lead to what an official described as the "conquest" of the Palestinian territory. 
The health ministry in Hamas-run Gaza said Sunday that at least 2,436 people had been killed since Israel resumed its campaign on March 18, bringing the overall death toll from the war to 52,535.
Hamas's attack on October 7, 2023 resulted in the deaths of 1,218 people on the Israeli side, mostly civilians, according to an AFP tally based on official figures.
bur-dc/ar/sbk

Bolsonaro

Bolsonaro leaves hospital three weeks after abdominal surgery

  • His "next challenge," he said on X, would be to attend a rally Wednesday in Brasilia.
  • Former Brazilian president Jair Bolsonaro was discharged from hospital Sunday in Brasilia, according to an AFP reporter, three weeks after undergoing complex abdominal surgery.
  • His "next challenge," he said on X, would be to attend a rally Wednesday in Brasilia.
Former Brazilian president Jair Bolsonaro was discharged from hospital Sunday in Brasilia, according to an AFP reporter, three weeks after undergoing complex abdominal surgery.
Brazil's far-right leader, who has been ordered to stand trial on charges he directed a 2023 coup plot to hold on to power, underwent surgery on April 13 to fix an intestinal obstruction stemming from a stabbing attack suffered during a 2018 rally.
"Thank you, my God, for this miracle," 70-year-old Bolsonaro wrote on X hours before his release. He thanked his doctors and said he was returning home "refreshed."
Members of his medical team said they were impressed by Bolsonaro's recovery from the 12-hour operation -- the latest of several surgeries since the attack.
"He is in very good health" and should return "gradually to a normal life," cardiologist Leandro Echenique told reporters. But he cautioned that the risk of a relapse "is never zero."
Bolsonaro smiled as he walked out of the DF Star clinic to be greeted by cheering supporters.
His "next challenge," he said on X, would be to attend a rally Wednesday in Brasilia.
But his doctors said they have urged him not to take part in person.
"We have advised against it," said Claudio Birolini, the clinic's chief of surgery, according to local media.
The politician had spent 17 days in the clinic's intensive-care ward, undergoing physical therapy and receiving most of his food through a feeding tube. He was transferred Wednesday to the inpatient ward.
Brazil's Supreme Court decided in late March to prosecute Bolsonaro for his role in the alleged coup attempt at the end of his 2019-2022 term.  
He is accused of having led a plot to prevent the inauguration of Luiz Inacio Lula da Silva after the left-leaning Lula won the 2022 presidential elections.
The rally Bolsonaro wanted to attend on Wednesday was organized to support a call for an amnesty for the former leader's supporters who on January 8, 2023 vandalized key government buildings as they urged the military to block Lula from taking office.
rsr/mr/bbk/mlm/jbr

health

US researchers seek to legitimize AI mental health care

BY THOMAS URBAIN

  • The Dartmouth team is prioritizing understanding how their digital therapist works and establishing trust. 
  • Researchers at Dartmouth College believe artificial intelligence can deliver reliable psychotherapy, distinguishing their work from the unproven and sometimes dubious mental health apps flooding today's market.
  • The Dartmouth team is prioritizing understanding how their digital therapist works and establishing trust. 
Researchers at Dartmouth College believe artificial intelligence can deliver reliable psychotherapy, distinguishing their work from the unproven and sometimes dubious mental health apps flooding today's market.
Their application, Therabot, addresses the critical shortage of mental health professionals. 
According to Nick Jacobson, an assistant professor of data science and psychiatry at Dartmouth, even multiplying the current number of therapists tenfold would leave too few to meet demand.
"We need something different to meet this large need," Jacobson told AFP.
The Dartmouth team recently published a clinical study demonstrating Therabot's effectiveness in helping people with anxiety, depression and eating disorders. 
A new trial is planned to compare Therabot's results with conventional therapies.
The medical establishment appears receptive to such innovation. 
Vaile Wright, senior director of health care innovation at the American Psychological Association (APA), described "a future where you will have an AI-generated chatbot rooted in science that is co-created by experts and developed for the purpose of addressing mental health."
Wright noted these applications "have a lot of promise, particularly if they are done responsibly and ethically," though she expressed concerns about potential harm to younger users.
Jacobson's team has so far dedicated close to six years to developing Therabot, with safety and effectiveness as primary goals. 
Michael Heinz, psychiatrist and project co-leader, believes rushing for profit would compromise safety.
The Dartmouth team is prioritizing understanding how their digital therapist works and establishing trust. 
They are also contemplating the creation of a nonprofit entity linked to Therabot to make digital therapy accessible to those who cannot afford conventional in-person help.

Care or cash?

With the cautious approach of its developers, Therabot could potentially be a standout in a marketplace of untested apps that claim to address loneliness, sadness and other issues. 
According to Wright, many apps appear designed more to capture attention and generate revenue than improve mental health.
Such models keep people engaged by telling them what they want to hear, but young users often lack the savvy to realize they are being manipulated.
Darlene King, chair of the American Psychiatric Association's committee on mental health technology, acknowledged AI's potential for addressing mental health challenges but emphasizes the need for more information before determining true benefits and risks. 
"There are still a lot of questions," King noted.
To minimize unexpected outcomes, the Therabot team went beyond mining therapy transcripts and training videos to fuel its AI app by manually creating simulated patient-caregiver conversations.
While the US Food and Drug Administration theoretically is responsible for regulating online mental health treatment, it does not certify medical devices or AI apps. 
Instead, "the FDA may authorize their marketing after reviewing the appropriate pre-market submission," according to an agency spokesperson.
The FDA acknowledged that "digital mental health therapies have the potential to improve patient access to behavioral therapies."

Therapist always in

Herbert Bay, CEO of Earkick, defends his startup's AI therapist Panda as "super safe." 
Bay says Earkick is conducting a clinical study of its digital therapist, which detects emotional crisis signs or suicidal ideation and sends help alerts.
"What happened with Character.AI couldn't happen with us," said Bay, referring to a Florida case in which a mother claims a chatbot relationship contributed to her 14-year-old son's death by suicide.
AI, for now, is suited more for day-to-day mental health support than life-shaking breakdowns, according to Bay.
"Calling your therapist at two in the morning is just not possible," but a therapy chatbot remains always available, Bay noted.
One user named Darren, who declined to provide his last name, found ChatGPT helpful in managing his traumatic stress disorder, despite the OpenAI assistant not being designed specifically for mental health.
"I feel like it's working for me," he said.
"I would recommend it to people who suffer from anxiety and are in distress."
tu-gc/arp/sst