demographics

Young Chinese parents tighten belts as childcare costs rise

BY MARY YANG

  • The government has also promoted the image of "the ideal Chinese family that is centred around heterosexual marriages" as it tries to boost birth rates, said Zhou, an assistant professor at the University of Michigan.
  • New mother Zhang Xiaofei wanted to be financially secure before having a baby, wary of high childcare costs that have been softened only a little by Chinese government cash incentives to boost record-low births.
  • The government has also promoted the image of "the ideal Chinese family that is centred around heterosexual marriages" as it tries to boost birth rates, said Zhou, an assistant professor at the University of Michigan.
New mother Zhang Xiaofei wanted to be financially secure before having a baby, wary of high childcare costs that have been softened only a little by Chinese government cash incentives to boost record-low births.
The world's second-most populous country is threatened with a demographic crisis after its birth rate halved over the past decade -- all while people rapidly age out of the workforce.
Beijing has made "building a childbirth-friendly society" a priority over the next five years, China's Premier Li Qiang said on Thursday as lawmakers gathered in the Great Hall of the People for their annual political conclave.
The government introduced a raft of financial incentives last year,including free pre-school education and annual subsidies of 3,600 yuan ($500) for each child born.
However, young Chinese say the measures do little to alleviate financial stress.
Zhang, 32, and her husband Zhu Yunfei, both manicurists, decided to save before having a child.
"We discussed it before. The two of us were aligned in wanting to (focus on) work first because our families' (financial) conditions aren't that good," she told AFP while on maternity leave in Hebei province.
"If we were to have a child, we would want to give them the very best life," she said, cradling her three-week-old daughter.

'Doesn't mean anything'

The new childcare subsidies have cost the government more than 100 billion yuan ($14.5 billion), China's national health director told reporters on Saturday.
They were announced shortly after Zhang and Zhu learned they would be parents.
"We thought our kid was too lucky," Zhu, 36, said.
However, the handout -- roughly 1.5 percent of their pooled annual income -- doesn't come close to covering a year's worth of baby formula.
"People joke that it's like giving you a five-yuan voucher towards a Rolls-Royce," he told AFP. 
Zhu scours second-hand platforms for deals on diapers, while Zhang plans to return to work after her daughter turns one month old.
In Henan, soon-to-be father Li plans to take up a second job once his daughter is born.
To save money, he and his wife made a five-hour round trip to neighbouring Hubei province, where he said hospitals offer free prenatal genetic screening.
Li, using a pseudonym for fear of repercussions, was reluctant to have children and said he was indifferent to the incentives.
"This bit of cash doesn't mean anything," the 35-year-old told AFP.

Incompatible with careers

Social demographer Yun Zhou warned that subsidies "often do not lead to any meaningful rebound in fertility".
The government has also promoted the image of "the ideal Chinese family that is centred around heterosexual marriages" as it tries to boost birth rates, said Zhou, an assistant professor at the University of Michigan.
"For young Chinese women, especially young highly educated Chinese women, there is also this inherent concern about the pervasive gender-based discriminations in the labour market that is front and centre on their mind."
In 2023, the government banned employers from withholding advancement based on marriage, pregnancy, or parental status, as well as the practice of including pregnancy tests as part of pre-employment physical exams.
However, some women still "feel like childbearing and having successful careers and having a life as a whole is fundamentally incompatible", Zhou said.
Lawmakers this week proposed measures such as extra cash for families with three children and lowering the legal marriage age from 22 for men and 20 for women to encourage earlier childbearing.
Chinese social media users slammed such proposals as "nonsense".
Being a parent in China is "very difficult", Yuan Limei, a 30-year-old mother of two, told AFP.
"There are all kinds of expenses. Everything requires money," she said, pushing her six-year-old on a swing in Beijing.
"And with kids, there's no way for you to work."
Yuan's oldest child is 10 but she does not plan on having a third.
"A kid is much harder to raise than a dog or cat," she laughed.
New father Zhu noted that, while subsidies have little impact in big cities like Beijing, they can make a dent in smaller villages.
"In the city, 3,600 yuan is hardly anything and can't even buy a baby pram, but in some rural areas it's not a small sum," he said.
mya/dhw/pbt

health

Japan approves stem-cell treatment for Parkinson's in world first

  • Pharmaceutical company Sumitomo Pharma said it received the green light for the manufacture and sale of Amchepry, its Parkinson's disease treatment that transplants stem cells into a patient's brain.
  • Japan has approved ground-breaking stem-cell treatments for Parkinson's and severe heart failure, one of the manufacturers and media reports said Friday, with the therapies expected to reach patients within months.
  • Pharmaceutical company Sumitomo Pharma said it received the green light for the manufacture and sale of Amchepry, its Parkinson's disease treatment that transplants stem cells into a patient's brain.
Japan has approved ground-breaking stem-cell treatments for Parkinson's and severe heart failure, one of the manufacturers and media reports said Friday, with the therapies expected to reach patients within months.
Pharmaceutical company Sumitomo Pharma said it received the green light for the manufacture and sale of Amchepry, its Parkinson's disease treatment that transplants stem cells into a patient's brain.
Japan's health ministry also gave the go-ahead to ReHeart, heart muscle sheets developed by medical startup Cuorips that can help form new blood vessels and restore heart function, media reports said.
The treatments could be on the market and rolled out to patients as early as this summer, reports said, citing the health ministry, becoming the world's first commercially available medical products using (iPS) cells.
Japanese scientist Shinya Yamanaka won the Nobel Prize in 2012 for his research into iPS, which have the potential to develop into any cell in the body.
"I hope this will bring relief to patients not only in Japan but around the world," health minister Kenichiro Ueno told a press conference. 
"We will promptly carry out all necessary procedures to ensure it reaches all patients without fail."
In a statement, Sumitomo Pharma said it had obtained "conditional and time-limited approval" for the manufacture and marketing of Amchepry under a system which is reportedly designed to get these products to patients as quickly as possible.
The approval is a kind of "provisional license", the Asahi newspaper said, after the safety and efficacy of the treatment was judged based on data from fewer patients than in ordinary clinical trials for drugs.
A trial led by Kyoto University researchers indicated that the company's treatment was safe and successful in improving symptoms.
The study involved seven Parkinson's patients aged between 50 and 69, with each receiving a total of either five million or 10 million cells implanted on both sides of the brain. 
The iPS cells from healthy donors were developed into the precursors of dopamine-producing brain cells, which are no longer present in people with Parkinson's disease.
The patients were monitored for two years and no major adverse effects were found, the study said. Four patients showed improvements in symptoms.
Parkinson's disease is a chronic, degenerative neurological disorder that affects the body's motor system, often causing shaking and other difficulties in movement.
Worldwide, about 10 million people have the illness, according to the Parkinson's Foundation.
Currently available therapies "improve symptoms without slowing or halting the disease progression," the foundation says.
iPS cells are created by stimulating mature, already specialised, cells back into a juvenile state -- basically cloning without the need for an embryo.
The cells can be transformed into a range of different types of cells, and their use is a key sector of medical research.
kh-aph/tc

US

Middle East war halts work at WHO's Dubai emergency hub

BY NINA LARSON

  • "Operations at WHO's logistics hub for global health emergencies in Dubai are currently on hold due to insecurity," he told a press conference.
  • The Middle East war has forced the World Health Organization to suspend operations at its global emergency logistics hub in Dubai, the UN agency's chief said Thursday.
  • "Operations at WHO's logistics hub for global health emergencies in Dubai are currently on hold due to insecurity," he told a press conference.
The Middle East war has forced the World Health Organization to suspend operations at its global emergency logistics hub in Dubai, the UN agency's chief said Thursday.
Tedros Adhanom Ghebreyesus warned that the impact of the conflict, sparked by the US-Israeli attacks on Iran on Saturday, "goes beyond the immediately affected countries".
"Operations at WHO's logistics hub for global health emergencies in Dubai are currently on hold due to insecurity," he told a press conference.
Last year, the Dubai logistics hub processed more than 500 emergency orders for 75 countries around the world, Hanan Balkhy, the WHO's Eastern Mediterranean regional director, told reporters.
"Humanitarian health supply chains are now being jeopardised," she warned.
Balkhy explained that "the hub's operations are temporarily on hold due to insecurity, airspace closures and restrictions affecting access to the Strait of Hormuz".
The disruption, she said, was "preventing access to $18 million in humanitarian health supplies while another $8 million in shipments cannot reach the hub".
It was affecting more than 50 emergency supply requests from 25 countries, as well as some $6 million in medicines destined for the war-torn Gaza Strip.

'Extremely important lifeline'

On top of that, $1.6 million in polio laboratory supplies were being held up, which could have dire impacts for Afghanistan and Pakistan, where the disease is endemic, she cautioned.
Balkhy said the WHO was discussing and coordinating with authorities in the United Arab Emirates on how to continue using the hub.
It was also in discussions with other countries and humanitarian partners on using other hubs in Nairobi, Dakar and Brindisi to establish other routes.
If the conflict draws out, Balkhy acknowledged there could be a need to discuss "all types of potential road routes or ground routes, potentially through the Kingdom of Saudi Arabia", but said the WHO hoped it would not need to do so.
"The Dubai hub is an extremely important lifeline for the humanitarian response," she said.

'Nuclear risks'

As for the direct impact of war, Balkhy said the UN health agency was coordinating the health response across 16 affected countries, and was supporting health ministries and partners "to sustain essential services".
The WHO was also "strengthening disease surveillance and preparing for potential mass casualties and displacement", she said.
Iran meanwhile had not made any "formal request for any specific supplies" from WHO, "as their system is withholding and withstanding the current situation", Balkhy said.
But she said the WHO was "scaling readiness for chemical, biological, radiological and nuclear risks".
Tedros also pointed to the threats to nuclear facilities posed by the conflict. 
"Any compromise to nuclear safety could have serious public health consequences," he warned.
The WHO also sounded the alarm over the more than a dozen attacks on healthcare registered by Thursday in the not even one-week-old conflict.
The organisation said it had so far verified 13 attacks on healthcare in Iran, killing four people and injuring 25, while an attack in Lebanon killed three paramedics and injured six others.
"Under international humanitarian law, health care must be protected and not attacked," Tedros said.
nl/rjm/sbk

death

Canadians are choosing when to die, often with a smile

BY MARION THIBAUT

  • "I don't want my daughters to have to answer the question: 'Do we pull the plug?'"
  • Jacques Poissant's suffering stopped the day he asked his daughter if it would be "cowardly to ask to be helped to die".
  • "I don't want my daughters to have to answer the question: 'Do we pull the plug?'"
Jacques Poissant's suffering stopped the day he asked his daughter if it would be "cowardly to ask to be helped to die".
The retired Canadian insurance adviser was 93, and "was wasting away" after a long battle with prostate cancer.
"He no longer had any zest for life," Josee Poissant told AFP.
Last year her mother made the same choice at 96 when she realised she would not be getting out of hospital.
She died surrounded by her children and their partners listening to the music she loved. "She was at peace. She sang until she went to sleep."
Josee Poissant remembers it as a beautiful and moving moment. "There isn't a good way to die, but for me this was the best" and it was "a privilege to have the time to say goodbye".
- One Canadian in 20 - 
One in 20 Canadians who died in 2023 chose themselves when they would go.
Assisted dying has been legal since 2016 for people at the end of life. The right was extended to those suffering from serious and incurable illness in 2021, even if death was not "reasonably foreseeable."
While Britain and France are considering similar measures, Canada is preparing to go even further.
A parliamentary committee is set to start work next month on whether assisted dying should be extended to those suffering exclusively from mental illness.
Claire Brosseau hopes this will be her final battle. She took her right-to-die case to the courts after struggling for decades with bipolar disorder.
"I've been treated by psychiatrists, psychologists, counsellors and 12-steps rehab in Montreal, New York City, Toronto and Los Angeles," she said.
"I've tried antidepressants, antipsychotics, mood stabilizers, benzos, sleeping pills and stimulants, cognitive behavioral therapy, dialectical behavioral therapy... tai chi, reiki, meditation, veganism, art therapy and music therapy," the former stand-up comedian said.
"There's nothing really that I haven't tried. It's just been too much for too long," she told AFP.
Every day is a trial for the 49-year-old who lives alone with her dog Olive in a little apartment in Toronto.
"I have about 10 to 30 minutes a day where I'm OK. But the rest of it is just terrible," Brosseau said.
She only goes out to walk Olive when the streets are deserted, has very limited contact with her family, no longer sees her friends, and has her groceries delivered. Even her appointments with her psychiatrists are done by video from her neat, minimalist home.
A change in the law would allow her to "go in peace and safety, surrounded by love. It won't be violent. I won't be alone," she said.
- Trivialised 'as therapy' - 
Canada was to allow assisted dying regardless of illness by 2024. But this was pushed back by three years, with the government saying it wanted to make sure that the already overwhelmed mental health system was ready.
Eight out of 10 Canadians support assisted dying, but some worry about widening it further.
The issue has been trivialized to the point of being "presented as a form of therapy", argued Trudo Lemmens, a health law professor at the University of Toronto.
"We have already seen a sharper rise in cases than in other countries" like Belgium and the Netherlands, which pioneered the practice.
"The desire to commit suicide is often an integral part of a psychiatric disorder," and it is extremely difficult to predict how a mental illness will develop, he said.
But Mona Gupta, a psychiatrist who chaired an expert panel that advised the government, insisted "there is no clinical reason to draw a line separating people with mental disorders from those with chronic physical illnesses.
"We are talking about a very small number of people" who have chronic, severe, treatment‑resistant mental disorders, Dr Gupta said.
"We have to acknowledge that there are people who have been ill for decades and have undergone all kinds of treatments, and that the suffering caused by certain mental illnesses is sometimes just as unrelievable as physical pain," she argued.

'Keeping control' to the end

Quebecker Rachel Fournier, who has brain cancer, has just learned that her request to die has been approved.
"When you're suffering, you feel like it's never going to end," the 71-year-old told AFP.
"Knowing that there will be an end, and that I can choose the moment, is an immense relief.
"I'm keeping control over my life even though I can't control what's happening to my body," said the mother of two and grandmother of four as she admired the winter sun on the snow outside her room in a palliative care centre.
Two doctors examined her request, making sure all the criteria required by law were met.
The applicant must be an adult, "have decision-making capacity", suffer from a serious or incurable illness, and "experience constant, unbearable physical or psychological suffering that cannot be relieved under conditions deemed tolerable".
Only then is a doctor authorized to administer the lethal drugs on the date and time the patient has chosen. 
Fournier said she is proud to live in a country that allows patients to decide for themselves. She watched her mother sink into dementia without being able to ask to leave "with dignity", as she had wished, because the law was not yet in force.
"I don't want my daughters to have to answer the question: 'Do we pull the plug?'"

'Celebrate my life'

For weeks now, the former gallerist has been spending part of her days "revisiting my life" through old photo albums, smiling about everything she "had the chance to experience".
She said it's a pity "that society wants to hide aging and death". 
Yet in Canada, more and more families are choosing to turn their loved one's last day into a moment of celebration with music, singing, speeches and a buffet.
"Come celebrate my life," read the invitations one man sent out for his last day on Earth.
Doctors who have accompanied these patients talk of beautiful and moving ceremonies in gardens, a family's vacation cabin by a lake and even on a boat.
Now undertakers are offering dedicated spaces to families.
"We noticed that people were going to hotels or renting Airbnbs," said Mathieu Baker, whose Quebec funeral complex rents out a room overflowing with plants and paintings.
Baker remembered one woman who asked to watch a horror movie one last time before she passed and another who opted for a few final beers and cigarettes. "These are very beautiful moments, very powerful ones," he said.

Don't 'deny my humanity'

"It is often a celebration," confirmed Georges L'Esperance, a doctor who has been providing assisted dying since the early days.
"Thanks to medicine, we have added years to people's lives, but not always life to those years," he said.
"The decision to end life must rest with the patient," he argued, adding that medical paternalism long ago took a back seat in Canada.
Claire Brosseau rails against the idea that people with mental illness are incapable of making informed decisions. "We're allowed to get married, write a will, make decisions that affect our entire lives. But not this one?"
She wants to be recognized as a whole person, capable of deciding, worthy of compassion and respect. "To deny me this right is to deny my humanity," she said.
tib/dp/fg/phz

climate

Warming El Nino may return later this year: UN

  • La Nina is a naturally occurring climate phenomenon that cools surface temperatures in the central and eastern equatorial Pacific Ocean.
  • The warming El Nino weather phenomenon could return later this year as its cooling opposite La Nina fades away, the United Nations said Tuesday.
  • La Nina is a naturally occurring climate phenomenon that cools surface temperatures in the central and eastern equatorial Pacific Ocean.
The warming El Nino weather phenomenon could return later this year as its cooling opposite La Nina fades away, the United Nations said Tuesday.
The UN's World Meteorological Organization (WMO) said the recent, weak La Nina was expected to give way to neutral conditions, which could then swing into El Nino before the end of 2026.
La Nina is a naturally occurring climate phenomenon that cools surface temperatures in the central and eastern equatorial Pacific Ocean. It brings changes in winds, pressure and rainfall patterns.
The WMO said there was a 60-percent chance of neutral conditions during the three-month window from March to May, with a 30-percent chance of La Nina conditions, and El Nino at a 10-percent probability.
There is a 70-percent chance of neutral conditions during April-June.
In May-July, the chance of neutral conditions drops back to 60 percent, with the chances of El Nino at 40 percent.
"The WMO community will be carefully monitoring conditions in the coming months to inform decision-making," said Celeste Saulo, who heads the UN's weather and climate agency.
"The most recent El Nino, in 2023-24, was one of the five strongest on record and it played a role in the record global temperatures we saw in 2024," the WMO secretary-general said.
El Nino contributed to making 2023 the second-hottest year on record and 2024 the all-time high.

Above-average temperatures

The WMO underlined that naturally occurring climate events such as La Nina and El Nino take place against the backdrop of human-induced climate change, which is "increasing global temperatures in the long-term, exacerbating extreme weather and climate events, and impacting seasonal rainfall and temperature patterns".
The US National Oceanic and Atmospheric Administration says there is a 50- to 60-percent chance of El Nino developing during the July-September period and beyond.
"Seasonal forecasts for El Nino and La Nina help us avert millions of dollars in economic losses and are essential planning tools for climate-sensitive sectors like agriculture, health, energy and water management," said Saulo.
"They are also a key part of the climate intelligence provided by WMO to support humanitarian operations and disaster risk management, and thus save lives," she said.
The WMO's latest Global Seasonal Climate update says there is a widespread global signal for above-average land surface temperatures for March to May.
Rainfall predictions in the equatorial Pacific show a lingering La Nina-like pattern, but in other parts of the world the signal is more mixed, it says.
rjm/apo/jhb

politics

China's overstretched healthcare looks to AI boom

BY REBECCA BAILEY

  • While the app can't replace doctors, "it can reduce the number of questions we need to ask doctors directly", Wang told AFP as her baby dozed in her Shanghai apartment.
  • Throughout her first pregnancy, Wang Yifan had lots of questions, which she usually put to renowned obstetrician Duan Tao -- or rather, an AI clone of the top Shanghai-based doctor.
  • While the app can't replace doctors, "it can reduce the number of questions we need to ask doctors directly", Wang told AFP as her baby dozed in her Shanghai apartment.
Throughout her first pregnancy, Wang Yifan had lots of questions, which she usually put to renowned obstetrician Duan Tao -- or rather, an AI clone of the top Shanghai-based doctor.
Duan has created a digital double for healthcare app AQ, which now boasts more than 100 million users in a display of how high-tech parts of China's medical sector have become.
A state-driven digitisation, aiming to inject efficiency into the overstretched healthcare system, has been underway for over a decade.
But with rapid developments in AI and robotics, the government, companies and practitioners see an opportunity to turbocharge that transition.
"Three to five years at most, and our entire medical model will be radically transformed," the soft-spoken Duan told AFP.
To train his avatar, Duan selected
material, including textbooks, clinical case studies and content from his social platforms -- followed by more than 10 million -- to capture his tone.
The chatbot cannot prescribe medication, and AQ's maker, tech giant Ant Group, says it is not a substitute for treatment.
"At the beginning, I did have concerns," Duan said. "I value my personal reputation."
But he believes in "actively embracing" technology to help improve it.

'Democratising access'

Beijing is soon expected to release its 15th Five-Year Plan, a blueprint for the world's second-largest economy until 2030 with technological transformation at its heart.
An October framework called for scientific breakthroughs to "enter practical application quickly", and referenced intelligent healthcare solutions.
AQ, or Afu in Chinese, now has more than 1,000 expert digital doubles. 
The app "gives any ordinary user -- no matter where they are -- the opportunity to get good answers to their questions," Duan said. 
"What we're doing is democratising access to medical knowledge."
That's especially appealing in China, where "waiting all morning for a three-minute appointment" is common, he said.
Within half a year, Duan's AI bot had 160,000 patients. 
During Wang's pregnancy, digital Duan was a trusted mediator when she and her husband disagreed, for example on using cooking wine in food.
Since giving birth, she has used AQ even more, asking paediatrician avatars about rashes or for general care advice.
While the app can't replace doctors, "it can reduce the number of questions we need to ask doctors directly", Wang told AFP as her baby dozed in her Shanghai apartment.
"If I take my baby to hospital, I worry about cross-infection."

 'Urgency drives change'

China's vast population and territory have always posed challenges to consistent, evenly distributed healthcare –- and as its citizens age, stress on the system is increasing.
The challenges are similar to other countries', but are happening "at a greater scale and a greater pace", said Ruby Wang, a writer and director of LINTRIS Health consultancy.
"China's health technology landscape is maturing so quickly, partly because... urgency drives change," she said.
And "state-industry alignment allows many pilots to occur quickly", Wang added.
Chatbot DeepSeek is already used in hundreds of Chinese hospitals, according to one study, and Beijing's prestigious Tsinghua University runs a hospital it says is designed to use AI in almost all its processes.
Nationwide, there are more than 100 AI medical projects, an official said recently.
In a top Shanghai hospital, a specialised AI model called CardioMind supports cardiology diagnoses, while a tool called PANDA is being deployed, including in remote towns, to flag early stage pancreatic cancer.
Robotics companies tout their healthcare potential, with firms like Fourier already supplying rural rehab centres with devices like mechanical arms for physiotherapy.
Enthusiasm for AI in healthcare is signalled culturally too.
This year's televised Spring Festival Gala, a state broadcaster-run New Year ritual, featured a sketch that referenced AQ, and one starring humanoid robots caring for a neglected grandmother.
- Human decisions - 
At a busy health centre in Shanghai, Yan Sulian, an energetic 65-year-old volunteer, helped older patients with electronic registration.
"Many elderly people just can't keep up with the smartphone era, so we volunteer to teach them how to adapt," she told AFP.
Yan said she and her friends all used AQ, after initially crosschecking its answers with doctors. 
Life is already highly digitised in China, which explains the broad uptake of high-tech healthcare, said LINTRIS' Wang, with data and privacy not often cited as a concern. 
Globally, its accuracy has come under scrutiny though.
Studies suggest while AI chatbots can match human doctors in exam conditions, they are less effective in messier, real-life conversations.
"We must always remember (AI) can hallucinate," obstetrician Duan said.
"Humans must retain the ultimate decision-making and choice."
But infectious disease expert Zhang Wenhong, a top doctor in China's Covid-19 fight, has voiced concerns that if AI becomes default, "without systematic training, doctors will lose the ability to judge whether AI's conclusions are correct".
Others emphasised that the adoption of AI in healthcare will be cautious.
"Doctors as a group are very conservative," Duan said.
"We insist on safety... because the nature of the profession puts us in that mindset."
reb/kaf/cms/lb