Qamar Ali Haji has been using skin-lightening products for four years. Initially she liked the change in her appearance but now the exposure to the chemicals in the products is taking a toll. She says she regrets it.

“I can’t sit too long in the school, I cannot bear the heat, my cheeks turn red, and I cannot go into the kitchen,” Haji said. “I cannot bear the slightest heat, I become boiled, there are ulcers on my legs, redness all over.”

The 19-year-old student is one of a growing number of women in Somalia who use the skin-lightening products.

Locally known as “qasqas” or “mixture,” the term reflects the combination of various skin-whitening products. Health advocates say using these products can cause dangerous side effects and lead to physical and mental health problems.

Somali officials and activists said the country’s political upheavals and the war on the al-Shabab militant group are overshadowing socially driven health dangers like skin-whitening. Due to a lack of awareness, some people don’t realize how dangerous these products can be.

The issue has attracted the attention of Amira Adawe, a leading activist with a master’s degree in public health from Minnesota. Adawe has traveled to the Horn of Africa region multiple times in recent years as part of her research into the practice of skin-whitening.

She is the founder of Beautywell, an organization that has been addressing this issue in the United States.

Adawe said the skin-lightening products from Kenya and Somalia that she tested contained high levels of toxic chemicals like mercury, hydroquinone and lead.

Mercury, hydroquinone, steroids and lead are the four main chemicals found in skin-whitening products, according to Adawe. Mercury is a toxic heavy metal. Women who use skin-lightning products that contain mercury, can suffer neurological side effects, and develop depression and anxiety, Adawe added.

“We had a Somali woman in the state of Minnesota who actually lost her vision because of (the) neurological impact that came from the use of skin-lighting products containing mercury,” she told Women’s Square, a new VOA Somali program.

“Some people also develop diabetics because medically, skin-lightning products impact hormones … which impacts the insulin in our body,” she said.

Other health risks include hypertension, kidney problems, skin sensitivity and skin cancer as product users cannot tolerate any sunlight, Adawe said.

“Steroids can give them a lot of skin tenderness,” she added.

There’s also the possibility of a mother passing the toxicity to her baby if she is breastfeeding.

Skin-whitening is multibillion-dollar industry that targets women around the globe. Adawe says the practice is especially high in countries where regulations on toxic products are weak or nonexistent, like Somalia.

According to Adawe many people in Somalia are using skin-whitening products.

“I have done several focus group sessions, key informant interviews and surveyed two universities,” she said. “In all these more than 140 women, girls and some men participated, and all of the women and girls were using. Some of the men were using.”

The focus groups and interviews took place in Mogadishu and Hargeisa.

“Women that I interviewed … in Somalia had kidney problems and other health issues like very (a) bad smell of fish odor, skin redness, skin ulcers, blue skin pigmentation, headache, severe wound healing problems and endocrinological problems,” she said.

“All of these (health issues) are associated with the use of mercury, hydroquinone and steroids in skin-lightening products.”

Adawe shared her work with Somali officials and explained the health issues associated with exposure to the toxic ingredients in skin-lightening products.

In Mogadishu she met female parliamentarians who promised to support legislation to regulate skin-lightening products with toxic chemicals. She also has been communicating with the Somali ministry of health to increase awareness of the problem and find strategies for regulating the toxic products.

Interim manager of the National Medicine Regulatory Authority at the Ministry of Health, Dr. Farah Mohamed Sharawe was one of the officials who met Adawe last month. He admits the government has not researched skin-whitening products.

“The first action of my office is to register the importation of these medications, find out who is bringing [them] in, and give them license. The other action is widespread awareness about the harmful impacts of these medications. [To] prevent expanding of skin-whitening problems,” he said.

Sharawe said the ministry agreed with Adawe on the need for research about the cosmetics coming into Somali and the amount of toxicity, if any, the products may contain.

“Conduct research into the compounds, check the level of mercury and other harmful elements, and then share … [the] data with the public,” he said. “This needs legislation, the Medicine and Food Safety Bill, which the Cabinet has passed. That legislation is important.”

While the Medicine and Food Safety Bill has Cabinet approval, it won’t become law until Parliament approves it.

Dr. Mamunur Rahman Malik, the World Health Organization representative for Somalia, also met Adawe.

“These are poisons which should never be allowed to come in. She is using science to understand the scope of this problem and address these problems which are harmful to public health. She is doing it without any fear,” he said.

Malik said WHO is planning to set up a laboratory for the Ministry of Climate Change and Environment to test and identify contaminated products.

“Within (the) next few months we will help them to have the ability to test these cosmetic products, food and any other imported products which pose (a) risk to (the) health of the population,” he said.

Personal mission

The practice of whitening skin is personal to Adawe. She has faced discrimination because of her own dark skin color.

“At a very young age I had a little experience of colorism; as you know colorism, it’s a cultural thing that happens all over the world because of skin color discrimination especially in countries that went through colonization and slavery,” Adawe said.

“So at very young age I remember people always commenting on my skin color and so that stayed with me but also I have seen when I was growing up in Somalia and also growing up in the United States especially in Minnesota, many individuals that are using these products, whether it’s relatives or friends or people that I came to know using these products and externally I could see how it was impacting their skin color.”

She said she hopes to see the Somali government ban the toxic ingredients like mercury, lead and other chemicals found in some skin-lightening products and establish a regulatory system for the drugs and cosmetics.

Harun Maruf contributed to this report.
…

During the coronavirus pandemic, telemedicine became a virtual phenomenon. As people remained in their homes during the pandemic, they began chatting with their doctors over the phone or video platforms on subjects such as chronic disease management, ongoing medical support, mental health issues and specialty care.

To reach their patients, many health professionals had to figure out quickly how to set up their first online systems for telemedicine, also known as telehealth.

“Doctors hadn’t provided it as an option previously because the infrastructure and technology wasn’t widely available,” said Dr. Shira Fischer, a physician policy researcher at the RAND Corp., which has conducted surveys asking Americans whether they use telehealth.

Fisher noted that in a February 2019 survey, less than 4% of the respondents said they used video telehealth. But two years later during the pandemic, that number had skyrocketed to 45%.

“I think telehealth is great,” said Michael Wu, a restaurant manager who lives in Alexandria, Virginia. “When I have a cold or the flu, I don’t have to take time off work to go to the doctor’s office for an exam, and maybe to get medication. It’s easier for me to have a video appointment with my doctor using my cellphone.”

Here to stay

Many health professionals think telemedicine is here to stay.

“Telehealth can be really useful,” Dr. Jack Resneck Jr., president of the American Medical Association, told VOA. “If you’re talking to a patient with diabetes, for instance, and you ask them about their diet, they can point their camera phone at the food in their refrigerator and show you what they eat.”

According to a 2021 AMA survey of doctors, a majority of physicians enthusiastically embraced telehealth and expected to use it more often. Some 85% of them said they were using telehealth to care for their patients.

Over the last two years, “we have seen telemedicine has seamlessly integrated into health care,” said Resneck.

This also includes private health insurance companies and Medicare (a U.S. government national insurance program) “suddenly covering the cost of telehealth,” which hadn’t been the case before, he said.

Patients, providers save time

Nevertheless, some patients remain reluctant to give up the person-to-person contact that comes with a traditional visit to a doctor’s office.

“I’m not opposed to it, but I’m wary about using it for my child,” said Erin Thompson, a stay-at-home mom who lives in Gaithersburg, Maryland.

“When my daughter is sick, I feel more comfortable bringing her to see the doctor in person, instead of her talking to him on a video screen.”

Despite such reservations, telehealth offers a host of benefits, such as increasing patients’ access to health care and helping health care providers determine whether a patient needs additional treatment in person. Telehealth can also help reduce expensive and unnecessary trips to the emergency room.

“Telehealth is definitely gaining traction in Lubbock, Texas,” said Dr. Ariel Santos, director of the telemedicine program at Texas Tech University Health Sciences Center. “Because of the coronavirus pandemic, there has been a more than a 200% increase in telemedicine within our organization.”

Santos, who is also the vice chair of the department of surgery at the Texas Tech University Health Sciences Center, thinks telehealth is a win-win for doctors and their patients.

“Many follow-up appointments with patients after surgery could be done through a video conference rather than an office visit,” he told VOA, adding that “telemedicine also reduces unnecessary travel for both the health provider and patient and improves access to health care, especially in rural areas.”

Dr. Karen Rheuban, a pediatric cardiologist and pioneer in the telehealth field, agrees. She is the director of the Karen S. Rheuban Center for Telehealth at the University of Virginia, which was named after her in 2016 for her significant contributions to the field of telemedicine. They include telehealth services in rural and underserved areas of Virginia and lifesaving care for stroke victims.

“Patients love telemedicine,” she said, “and it’s convenient for them to receive care in their homes.”

Rheuban said whether it’s enabling physicians to provide an emergency service, such as prescribing clot-busting medication for a stroke, or helping patients manage a chronic condition such as heart disease, telemedicine has grown and can save lives around the world.

Telemedicine has also revolutionized behavioral health.

“It is an incredibly useful tool,” said Terry Rabinowitz, medical director of the psychiatric consultation service at the University of Vermont Medical Center.

“Some patients have a lot easier time showing up for telemedicine encounters,” said Rabinowitz, who has been doing telepsychiatry for 20 years. “It’s very useful for patients with psychiatric illnesses like depression, schizophrenia and autism spectrum disorders because they may be averse to seeing someone face-to-face or even putting on their clothes to come for a visit.”

Accessibility, privacy concerns

Telehealth can have its challenges, however.

“Some people don’t have good internet access or don’t know how to use it. And some people are worried about their privacy,” said Fischer at the RAND Corp. Rabinowitz said broadband internet needs to be increased in underserved and rural areas.

Santos at Texas Tech said while some doctors and patients may be hesitant to use telehealth, it can “make it quicker and easier for patients to be seen by a physician.”

Telehealth won’t completely take over in-office visits, Santos said.

“Obviously, some health issues require the patient to be seen in person by a doctor,” he said. “And sometimes it may be difficult for me to express my empathy and concern through an online connection.”

Still, he said, telehealth will become more prominent in the future, and “there could even be public libraries with telemedicine kiosks.”
…

With the whir of a mower under a clear blue sky, Senegalese researchers have begun harvesting a crop of experimental homegrown wheat, the latest step in a yearslong effort to reduce reliance on imports.

The second-most consumed cereal after rice, wheat is an important staple in the bread-loving West African nation.

But Senegal, like many of its neighbors, depends entirely on foreign supplies.

It imports 800,000 metric tons of the grain per year.

Its tropical climate is not naturally suited to wheat, but domestic trials have been underway for years.

Supply chain problems, rising grain prices and inflation caused by the war in Ukraine have added urgency to the country’s efforts to achieve self-sufficiency.

Four varieties

Since late last week, researchers from the Senegalese Institute for Agricultural Research, a public research institute, have been harvesting four varieties of wheat on a demonstration plot in Sangalkam, 35 kilometers from the capital Dakar.

Three of the varieties are Egyptian and the fourth was developed by the institute.

It operates five demonstration plots in total, two near Dakar and three in the Senegal River Valley, and has tested hundreds of wheat varieties, Amadou Tidiane Sall, one of the researchers, told AFP.

Not all thrive

Many have proved unsuitable.

The Sangalkam crop, one of several successful experiments by the institute, was sown in early January and matured in three months during Senegal’s cold season.

Agriculture Minister Aly Ngouille Ndiaye visited the plot earlier this month.

He said he had requested Egyptian seeds on a visit to the North African country for the United Nations’ COP27 climate conference in November.

“We have significant potential,” the minister said during his visit, promising the government would work with the private sector to expand trial plots.

He acknowledged that a lack of adequate water for irrigation posed a significant challenge.

Not everyone is convinced that wheat can be grown at scale in Senegal.

Amadou Gaye, the president of the National Federation of Bakers of Senegal, who represents about 2,500 bakeries across the country, told AFP he would prefer to see resources dedicated to producing local cereals such as millet, maize and sorghum.
…

A growing number of state legislatures are considering bans on cosmetics and other consumer products that contain a group of synthetic, potentially harmful chemicals known as PFAS.

In Vermont, the state Senate gave final approval this week to legislation that would prohibit manufacturers and suppliers from selling or distributing any cosmetics or menstrual products in the state that have perfluoroalkyl and polyfluoroalkyl substances, as well as a number of other chemicals.

The products include shampoo, makeup, deodorant, sunscreen, hair dyes and more, said state Sen. Terry Williams, a Republican, and member of the Senate Committee on Health and Welfare.

“Many known toxic chemicals are used in or found as contaminants in personal care products, including PFAS, lead and formaldehyde,” Williams said in reporting the bill to Senate colleagues.

California, Colorado and Maryland passed similar restrictions on cosmetics that go into effect in 2025. Other proposals are under consideration in Washington and Oregon while bills have also been introduced in Illinois, Rhode Island and Georgia.

According to the U.S. Environmental Protection Agency, studies have linked PFAS exposure to increased cancer risk, developmental delays in children, damage to organs such as the liver and thyroid, increased cholesterol levels and reduced immune functions, especially among young children.

Like in Colorado and California, the proposed Vermont crackdown on PFAS — known as “forever chemicals” for their persistence in the environment — goes beyond cosmetics. The bill, which now must be considered by the Vermont House, would extend the ban to apparel, including outdoor apparel for severe wet conditions, athletic turf, clothing, ski wax and textiles, including upholstery, draperies, towels and bedding that intentionally contain PFAS. The bill has been referred to a House committee and the chairwoman said Friday that she’s not sure if the panel will get to it this session. The legislation gives various timelines for the phaseouts.

“We must stop importing dangerous chemicals like PFAS into our state so we can prevent the harms they are causing up and down the supply chain — from their production and use to their disposal,” Lauren Hierl, executive director of Vermont Conservation Voters, said in a statement.

In March, the Environmental Protection Agency proposed the first federal limits on the chemicals in drinking water, saying the protection will save thousands of lives and prevent serious illnesses, including cancer. The chemicals had been used since the 1940s in consumer products and industry, including in nonstick pans, food packaging and firefighting foam. Their use is now mostly phased out in the U.S., but some still remain. Pressure is also growing to remove PFAS from food packaging.

A study by University of Notre Dame researchers released in 2021 found that more than half the cosmetics sold in the United States and Canada were awash with a toxic industrial compound associated with serious health conditions.

Researchers tested more than 230 commonly used cosmetics and found that 56% of foundations and eye products, 48% of lip products and 47% of mascaras contained fluorine — an indicator of PFAS.

The U.S. Food and Drug Administration says on its website that there have been few studies of the presence of PFAS in cosmetics, and the ones published found the concentration is at very low levels.

The Personal Care Products Council, which represents the cosmetics industry, says in 2020 it supported California legislation to phase out certain ingredients, including 13 PFAS in cosmetics, and identical legislative language in Maryland the following year. The group called for states to pass uniform laws to avoid confusion.

As for bans on apparel containing the chemicals, the American Apparel & Footwear Association supports the bill passed unanimously in the Vermont Senate and appreciates that amendments were made to align with phase-out timelines in existing PFAS restrictions in California and New York, said Chelsea Murtha, AAFA’s director of sustainability, in a statement.

The Outdoor Industry Association, based on Colorado, said overall it supports the Vermont bill, also noted the current version more closely matches the timeline for compliance with California’s.

“We are also appreciative of the exemption for outdoor apparel severe wet conditions until 2028, as our industry is diligently working to move toward non-regrettable alternatives that will not compromise consumer safety or the quality of the product,” said association President Kent Ebersole in a statement.
…

Dust off your eclipse glasses: It’s only a year until a total solar eclipse sweeps across North America. 

On April 8, 2024, the moon will cast its shadow across a stretch of the U.S., Mexico and Canada, plunging millions of people into midday darkness. 

It’s been less than six years since a total solar eclipse cut across the U.S., from coast to coast. That was on August 21, 2017. 

If you miss next year’s spectacle, you’ll have to wait 20 years until the next one hits the U.S. But that total eclipse will be visible only in Montana and the Dakotas. 

Here’s what to know to get ready for the 2024 show: 

Where can I see it? 

Next year’s eclipse will slice a diagonal line across North America on April 8, which falls on a Monday. 

It will start in the Pacific and first reach land over Mexico around 11:07 a.m. local time, NASA predicts. Then, it’ll cross over into Texas and move across parts of the Midwest and Northeast in the afternoon. 

All in all, it will hit parts of 13 U.S. states: Texas, Oklahoma, Arkansas, Missouri, Illinois, Kentucky, Indiana, Ohio, Pennsylvania, New York, Vermont, New Hampshire and Maine. Cities in its path include Dallas; Little Rock, Arkansas; Indianapolis; Cleveland and Buffalo, New York. 

Parts of Canada, including Quebec and Newfoundland, will also get a glimpse before the eclipse heads out to sea in the early evening. 

A total eclipse will be visible within a 115-mile-wide swath — the path of totality. Outside that path, you can still see a partial solar eclipse, where the moon takes a bite out of the sun and turns it into a crescent shape. 

Total eclipses happen about every 18 months, but a lot of times they cross over remote areas where few people see them. 

What happens during an eclipse? 

Solar eclipses occur when the moon passes between the Earth and the sun, blocking the sun’s light from reaching us. 

Even though the moon is about 400 times smaller than the sun, it’s also about 400 times closer to Earth, said University of Colorado astronomer Doug Duncan. So when the orbits line up just right, the little moon can block out the whole sun. Those who are standing in the right spots will experience totality: when the moon casts its shadow over the landscape. 

“In just seconds, you go from bright, bright daylight to like the middle of the night,” said Debby Brown, who saw her first total eclipse in 2017 with Duncan in Grand Teton National Park in Wyoming. 

“The stars are out. All of a sudden, all the animals are quiet,” said Brown, of Arlington, Virginia. 

During the 2024 eclipse, totality will stretch to around four and a half minutes — almost twice as long as in 2017.

What’s the best spot? 

To catch the full eclipse experience, planning ahead is key, Duncan said. Weather could be a big factor since the eclipse is coming in the spring, when conditions are unpredictable. That’s why Duncan selected Texas for his eclipse tour next year, where the odds of clear skies are better. 

Your choice also depends on what kind of experience you’re looking for, said Bob Baer, who’s coordinating eclipse plans at Southern Illinois University in Carbondale. 

Carbondale — in the crossroads of both the 2017 and 2024 eclipse paths — will hold a viewing event at the school’s stadium again. It’s a big group experience, Baer said: “The last 20 minutes before totality, the stadium gets as loud as a football game.” 

But you can find events of all different flavors planned along the eclipse path: luxury cruises in Mexico, music festivals in Texas, farm camping in Arkansas, planetarium visits in upstate New York. 

“The goal, at the end of the day, is to get as many people outside as possible, looking up during totality,” said Dan Schneiderman, who is helping the Rochester Museum and Science Center plan events.  

You’ll want to grab eclipse glasses to see the partial phases before and after totality, Schneiderman added. Looking at the partially covered sun without protection can cause serious eye damage. 

Brown and her husband are planning to join Duncan’s eclipse tour in Austin. Her first eclipse experience flew by. 

“I’m looking forward to being able to enjoy this even longer,” Brown said. “To be able to just lean into the moment.” 

What other eclipses are coming up?

The U.S. will get some eclipse action ahead of the big event in 2024. There will be an annular eclipse — when the sun isn’t completely covered but appears like a ring of fire in the sky — later this year, on October 14. 

The path of that eclipse will cross from Oregon down through California, Nevada, Utah, Arizona, New Mexico and Texas. 

Later this month, there will be a rare hybrid eclipse, which switches between a total and an annular eclipse at different points along its path. But few people will see it. The April 20 eclipse is mostly over the Indian Ocean and crosses over only a few slivers of Australia and Southeast Asia. 

With a 20-year gap until the next total solar eclipse in the U.S., Duncan says it will be worth it to be in the path of totality next year. He’s witnessed 12 total eclipses so far. 

Seeing a partial eclipse — even if it’s 90% covered — means “you missed all the good stuff,” he said.
…

Changes in air patterns as the world warms will likely push more and nastier hurricanes up against the United States’ East and Gulf coasts, especially in Florida, a new study said.

While other studies have projected how human-caused climate change will probably alter the frequency, strength and moisture of tropical storms, the study in Friday’s journal Science Advances focuses on where hurricanes are going.

It’s all about projected changes in steering currents, said study lead author Karthik Balaguru, a Pacific Northwest National Laboratory climate scientist.

“Along every coast they’re kind of pushing the storms closer to the U.S.,” Balaguru said. The steering currents move from south to north along the Gulf of Mexico; on the East Coast, the normal west-to-east steering is lessened considerably and can be more east-to-west, he said.

Overall, in a worst-case warming scenario, the number of times a storm hits parts of the U.S. coast in general will probably increase by one-third by the end of the century, the study said, based on sophisticated climate and hurricane simulations, including a system researchers developed.

The central and southern Florida Peninsula, which juts into the Atlantic, is projected to get even more of an increase in hurricanes hitting the coast, the study said.

Climate scientists disagree on how useful it is to focus on the worst-case scenario as the new study does, because many calculations show the world has slowed its increase in carbon pollution. Balaguru said because his study looks more at steering changes than strength, the levels of warming aren’t as big a factor.

The study projects changes in air currents traced to warming in the equatorial eastern Pacific Ocean, just off the coast of South America. Climate change is warming different parts of the world at different rates, and models show the eastern Pacific area warming more quickly, Balaguru said.

According to the study, that extra warming sets things in motion through Rossby waves — atmospheric waves that move west to east and are connected to changes in temperature or pressure, like the jet stream or polar vortex events.

“I like to explain it to my students like a rock being dropped in a smooth pond,” said University of Albany atmospheric scientist Kristen Corbosiero, who wasn’t part of the study. “The heating is the rock and Rossby waves are the waves radiating away from the heating which disturbs the atmosphere’s balance.”

The wave ripples trigger a counterclockwise circulation in the Gulf of Mexico, which bring winds blowing from east to west in the eastern Atlantic and south to north in the Gulf of Mexico, Corbosiero and Balaguru said.

It also reduces wind shear — which is the difference in speed and direction of winds at high and low altitudes — the study said. Wind shear often decapitates hurricanes and makes it harder for nascent storms to develop.

Less wind shear means stronger storms, Balaguru said.

Overall, the steering current and wind shear changes increase the risk to the United States, Corbosiero said in an email.
…

India’s federal government asked states to identify emergency hotspots and ramp up testing for COVID-19 after the country recorded its highest daily case count since September, a Reuters tally showed on Friday.

There were 6,050 new cases of COVID-19 in the past 24 hours, the federal Health Ministry said on Friday, continuing a sharp upward trend since a lull last year.

At a meeting to review the degree to which the states are prepared, Health Minister Mansukh Mandaviya asked them to ramp up genome testing and conduct mock drills in hospitals, a government statement said.

Daily new cases have nearly tripled from around 2,000 at the end of March.

The prevalence of XBB.1.16, classified as a variant of interest by the World Health Organization, increased from 21.6% in February to 35.8% in March, the Health Ministry said, adding there that was no evidence of an increase in hospitalizations or deaths.

Active cases totaled more than 28,300 with 14 deaths during the last 24 hours, taking the country’s official death toll from the disease to 530,943.

India has recorded more than 44.7 million confirmed cases of COVID-19 since the start of the pandemic three years ago, the third-highest tally after the United States and China.
…

Health care workers in Zimbabwe have condemned the government’s plan to criminalize their recruitment to work in other countries as part of efforts to reduce a medical brain drain.  Zimbabwe’s vice president and health minister, Constantino Chiwenga, said the country will introduce a law to make it illegal for foreign nations to hire their health care workers. 

Zimbabwe’s Association of Doctors for Human Rights says any attempt to prevent health care workers from leaving the country for better jobs would be illegal.

The head of the association, Dr. Norman Matara, told VOA Friday the government’s plan to criminalize foreign recruitment of health care workers was shocking. 

“Also in our constitution, the Zimbabwe constitution, it guarantees citizens have the right to move freely within the country or leave the country,” Matara said. “We don’t know why those comments were made by the honorable minister of health. The government continue to use scare tactics and command approach to solving health care problems.” 

Matara was responding to comments Wednesday by Zimbabwe’s vice president, Constantino Chiwenga.

Chiwenga, who doubles as health minister, said the government would introduce a law against foreign recruiting of its health care workers to address a medical brain drain. 

“If one deliberately recruits and make the country suffer because it lacks the required professionals, that’s a crime against humanity,” Chiwenga said. “If people die in hospitals because there are no nurses and doctors and somebody who has been so irresponsible of not training their nationals but wanting poor countries to train for them it’s a crime. That must be taken seriously.” 

Matara stressed that Zimbabwe’s health care workers are choosing to leave.

“The government should note that health workers are not being pulled away from the country but pushed away from the country by the meager salaries they are getting,” Matara said. “They are being pushed by the worsening economic crisis in the country. They are being pushed by poor working conditions: lack of equipment, lack of sundries, lack of medicines in the hospitals that they work in. We urge the government to improve working conditions, pay a living wage, you will find that people will not leave the country.”     

Eustina Shava, a nurse who is leaving Zimbabwe in May for better work in Canada, said leaving her home country is not her preference.   

“If we were being given enough money, I don’t think anybody would love to leave their families, their relatives and work abroad,” Shava said. “But at the end of the day, we all want to achieve good things in life. We all want to buy houses, we all want to buy cars and we all want to send our children to good schools.

“That’s the reason we are reaching to recruiters. They have done nothing wrong. They are actually helping us to achieve certain things in life.” 

Zimbabwe’s Health Services Board said in November more than 4,000 nurses have left the country since 2021.

The Zimbabwe Medical Association says the country has only 3,500 doctors for a population of almost 16 million people.

Health care workers regularly go on strike over poor pay and working conditions.

Zimbabwe’s government said it doesn’t have enough funds for raises or better equipment and in January made it illegal for health care workers to strike for more than three days.

Reuters contributed to this report.
…

Celebrations marking World Health Day are taking place in the shadow of the coronavirus that has sickened more than 762 million people around the world and killed more than 6.8 million. 

“For the past three years, [the World Health Organization] has coordinated the global response to the COVID-19 pandemic, the most severe health crisis in a century,” said Tedros Adhanom Ghebreyesus, WHO director-general. “And as COVID-19 has exposed so brutally, there remain serious gaps in the world’s defenses against epidemics and pandemics. 

“For all these reasons and more, the world needs WHO now more than ever,” he said. 

This year’s World Health Day coincides with the 75th anniversary of the founding of the WHO, which emerged from the ashes of World War II to create a healthier world in the aftermath of what is recognized as the deadliest and most destructive war in human history. 

The vision of attaining a higher standard of health and protecting people from diseases, in many ways, has been achieved. 

Tedros notes that “life expectancy globally, for both sexes, has increased from 46 to 73 years, with the biggest gains in the poorest countries.” 

“Smallpox has been eradicated and polio is on the brink,” he said. 

However, many challenges remain, especially with the emergence of new diseases and deadly pathogens, including Ebola, Marburg, SARS and COVID-19. 

“The world is at increasing risk of new pandemics emerging,” said Bruce Aylward, senior adviser to the director-general and assistant director-general ad interim for external relations and governance. 

Last month, the WHO’s 194 member states began negotiations on a global accord to prevent and prepare for future pandemic emergencies. Aylward said it was important to reach an agreement as rapidly as possible.

“We hope not just for future generations but today’s generation,” he said. “There is quite a high risk of another pandemic and we want to make sure that we are much, much better prepared for that than we were for this,” he said. 

“And we can be with an accord like the one under negotiation,” Aylward added. 

Maria Van Kerkhove, technical lead on COVID-19, stressed the need to find the origins of the coronavirus. She said a study published by China this week offers some clues as to how infected wild animals at the wet market in Wuhan, China, may have infected humans with the deadly virus, triggering the pandemic. 

“But it does not give us concrete answers,” she said. “There is more information that is out there and we need scientists, public health professionals, governments, to share this information.

“We need answers to understand how this pandemic began because we will get better at preventing the next one,” Van Kerkhove said. 

WHO chief Tedros said he has been pressing China to share information about the origins of COVID-19 because “without full access to the information that China has, you cannot say this or that.” 

“All hypotheses are on the table,” he said. “That is WHO’s position and that is why we have been asking China to be cooperative on this.”

Tedros noted that countries will continue to negotiate the pandemic accord over the next year in preparation for the World Health Assembly in 2024, where it will be presented for adoption.

“No nation can protect itself against future epidemics and pandemics without the engagement and cooperation of all nations,” he added. 
…

The World Health Organization said Thursday that it was sure China had far more data that could shed light on the origins of COVID-19, demanding that Beijing immediately share all relevant information.

“Without full access to the information that China has … all hypotheses are on the table,” WHO chief Tedros Adhanom Ghebreyesus said in Geneva.

“That’s why we have been asking China to be cooperative on this,” he said, insisting that if Beijing does provide the missing data, “we will know what happened or how it started.”

More than three years after COVID-19 surfaced, heated debate still rages around the origins of the pandemic.

The issue has proved divisive for the scientific community and even different U.S. government agencies, which are split between one theory that the virus jumped naturally from animals to humans and another that the virus likely leaked from a Wuhan laboratory — a claim China has angrily denied.

Late last month, new evidence emerged that raccoon dogs, known to be able to carry and transmit viruses similar to the SARS-CoV-2 virus that causes COVID-19, were at a market in Wuhan when the disease was first detected in humans.

The researchers who unexpectedly stumbled over the genetic data say that those data support but cannot prove the theory that the virus originated in animals, possibly first jumping over to humans at the market.

‘Clues,’ not clarity

Maria Van Kerkhove, WHO’s technical lead on COVID-19, told journalists Thursday that the new information provided “clues” but no clear answers, insisting that the data “collected in January and February 2020, more than three years ago,” should have been shared long ago.

“Without information, without data to make a proper assessment, it’s very difficult for us to give a concrete answer,” she said. “And in the present time, we don’t have a concrete answer of how the pandemic began.”

But she voiced certainty that China’s “incredible scientists” had conducted far more studies and collected much more data that could be relevant in the search.

“We know there is more information that’s out there,” she said. “We need scientists, public health professionals and governments to share this information. This is not a game.”

‘A moral imperative’

In an editorial in Science magazine published Thursday, Van Kerkhove said she believed China had data that it had not shared, including on the wild and farmed animal trade at the Wuhan market, the testing of humans and animals in Wuhan and across China, and operations of labs in Wuhan working on coronaviruses.

“Lab audit data exist and have not been shared, for example,” she wrote, demanding that China share all data on the virus that causes COVID-19 “immediately.”

WHO chief Tedros stressed the vital importance of getting to the bottom of the mystery, pointing out that determining COVID-19’s origins could help avert future pandemics.

And with nearly 7 million deaths officially registered in the pandemic — with the real toll believed to be several times higher — he said there was a “moral imperative.”

“We need to know the answer, beyond reasonable doubt.”
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A federal judge in Texas could soon order the U.S. Food and Drug Administration to withdraw its approval of abortion pill mifepristone, a move that if allowed to stand could severely undermine the agency, health policy and legal experts said.   

The closely followed case could potentially lead to a nationwide ban on mifepristone — part of a two-drug regimen that accounts for more than half of U.S. abortions — and call into question the FDA’s power to regulate all drugs nationwide, they said.   

It also risks leading to self-censure by the pharmaceutical industry as drugmakers embrace treatments perceived as safe investments and shy away from those that might get caught up in politically charged legal entanglements, some experts cautioned.   

“This case potentially has very significant consequences for both products that are already on the market, as well as new products,” said Susan Lee, a partner in Goodwin’s Life Sciences group and FDA practice. “The potential implications are so much broader than just what could happen to mifepristone.”   

A ruling against the agency’s approval of a drug over 20 years earlier would be unprecedented and could ripple through drug research and development for years, with implications for public health and access to new treatments.   

Any impact on the FDA will depend on details of the judge’s ruling in the case known as Alliance for Hippocratic Medicine v. U.S. Food and Drug Administration. The challenge was brought by a coalition of anti-abortion groups and doctors seeking withdrawal of the FDA’s mifepristone approval before U.S. District Judge Matthew Kacsmaryk of the Northern District of Texas, a conservative former Christian activist. 

  The court could order mifepristone pulled from the market while it considers a final ruling. When the case is resolved, that could become a permanent ban, though it is not clear how long that might take and any ruling is expected to be appealed.   

If it finds the FDA did not follow proper procedures, that would undermine confidence in the agency and likely lead it to adopt more stringent regulations, some experts suggested.   

Should the court ban mifepristone sales based on a finding that it’s not safe, that would effectively end the FDA’s status as the ultimate arbiter on drug safety, experts said.   

It would call into question the entire drug approval process, said Laurie Sobel, associate director for Women’s Health Policy at the Kaiser Family Foundation.   

“That would have much bigger implications for other drugs and probably would shake up pharma’s ability to rely on the FDA and feel secure when they submit something, if a court can overrule the FDA’s findings on safety,” Sobel said.   

Plaintiffs are arguing that the FDA in its 2000 approval did not adequately consider the drug’s safety when used by girls under age 18 to terminate a pregnancy.   

‘So much uncertainty’  

The possibility of its approvals being overruled would likely see the FDA become more cautious, Lee said.   

The increased scrutiny would make it more difficult and time-consuming to get products approved, and possibly more expensive to develop.   

“There’s going to be so much uncertainty about what would happen even if you were to achieve approval in the first place,” said Lee. “There could be a downstream impact on pricing.”   

A ruling against the FDA is likely to spur increased activism and lobbying from organizations opposed to other drugs or medical treatments, such as COVID-19 vaccines, contraceptives, hormones for artificial reproductive technology or gender affirming procedures, and HIV prevention drugs.   

Similar challenges in front of hand-picked sympathetic judges could lead to other reversed approvals, Lee warned.   

“If you can have somebody come in successfully challenging an approval that was more than 20 years ago,” she said, “there’s very little comfort that any manufacturer could take in their approval.” 
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