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Sydney — Bird flu continues to spread in the Australian state of Victoria, where more than 500,000 chickens have been euthanized.  Strict quarantine zones restricting the movement of birds and equipment have also been put in place.  Australian health authorities say bird flu spreads mainly among wild water birds.

The highly pathogenic H7N3 strain of avian influenza has been found on four farms, while another virus, H7N9, has been detected at a fifth property over the past seven weeks in Victoria state.  The Australian farms have been put into lockdown.  At least 580,000 birds have been destroyed as part of sweeping biosecurity controls.

Japan and the United States have temporarily banned imports of poultry from Victoria as a precaution.

In Australia, some supermarkets are restricting the number of eggs that consumers can buy because of disruptions to the supply chain.

Avian influenza is a viral disease found across the world. It spreads between birds or when contaminated animal feed and equipment is moved between areas.

Danyel Cucinotta is the vice president of the Victorian Farmers Federation, an industry group.  She told the Australian Broadcasting Corp.  Tuesday that the virus can spread quickly.

“There is very little we can do and no matter how good your biosecurity is you cannot stop wild fowl coming in. This is a particular flight path for migratory birds.  There is housing orders at the moment, which means all birds get locked up.  This is about protecting our birds and protecting the food supply chain,” she said.

The strains of bird flu identified in the states of Victoria and Western Australia can infect people, but experts insist that cases are rare.

The virus can also infect cows.  The United States’ Department of Agriculture has said that avian flu has infected dairy cows in more than 80 herds across several states since late March.

At least three U.S. dairy workers have tested positive for bird flu after exposure to infected cattle.  All three patients are recovering.  

The U.S. Centers for Disease Control and Prevention said the infections do not change its assessment that bird flu is a low risk to the general community and that it has not seen evidence of human-to-human transmission.

Last month, health authorities in Mexico confirmed a fatal case of human infection with an avian flu virus that had been reported in poultry.
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WASHINGTON — A closely watched Alzheimer’s drug from Eli Lilly won the backing of federal health advisers Monday, setting the stage for the treatment’s expected approval for people with mild dementia caused by the brain-robbing disease. 

Food and Drug Administration advisers voted unanimously that the drug’s ability to slow the disease outweighs its risks, including side effects like brain swelling and bleeding that will have to be monitored. 

“I thought the evidence was very strong in the trial showing the effectiveness of the drug,” said panel member Dean Follmann, a National Institutes of Health statistician. 

The FDA will make the final decision on approval later this year. If the agency agrees with the panel’s recommendation, the drug, donanemab, would only be the second Alzheimer’s drug cleared in the U.S. that’s been shown to convincingly slow cognitive decline and memory problems due to Alzheimer’s. The FDA approved a similar infused drug, Leqembi, from Japanese drugmaker Eisai last year. 

The slowdown seen with both drugs amounts to several months and experts disagree on whether patients or their loved ones will be able to detect the difference. 

But Lilly’s approach to studying its once-a-month treatment prompted questions from FDA reviewers. 

Patients in the company’s study were grouped based on their levels of a brain protein,  

called tau, that predicts severity of cognitive problems. That led the FDA to question whether patients might need to be screened via brain scans for tau before getting the drug. But most panelists thought there was enough evidence of the drug’s benefit to prescribe it broadly, without screening for the protein. 

“Imposing a requirement for tau imaging is not necessary and would raise serious practical and access concerns to the treatment,” said Dr. Thomas Montine of Stanford University, who chaired the panel and summarized its opinion. 

At a high level, Lilly’s results mirrored those of Leqembi, with both medications showing a modest slowing of cognitive problems in patients with early-stage Alzheimer’s. The Indianapolis-based company conducted a 1,700-patient study showing patients who received monthly IV infusions of its drug declined about 35% more slowly than those who got a placebo treatment. 

The FDA had been widely expected to approve the drug in March. But instead, the agency said it would ask its panel of neurology experts to publicly review the company’s data, an unexpected delay that surprised analysts and investors. 

Several unusual approaches in how Lilly tested its drug led to the meeting. 

One change was measuring patients’ tau — and excluding patients with very low or no levels of the protein. But panelists said there was enough data from other measures to feel confident that nearly all patients could benefit from the drug, regardless of their levels. 

In another key difference, Lilly studied taking patients off its drug when they reached very low levels of amyloid, a sticky brain plaque that’s a contributor to Alzheimer’s. 

Lilly scientists suggested stopping treatment is a key advantage for its drug, which could reduce side effects and costs. But FDA staff said Lilly provided little data supporting the optimal time to stop or how quickly patients might need to restart treatment. 

Despite those questions, many panelists thought the possibility of stopping doses held promise. 

“It’s a huge cost savings for the society, we’re talking about expensive treatment, expensive surveillance,” said Dr. Tanya Simuni of Northwestern University. She and other experts said patients would need to be tracked and tested to see how they fare and whether they need to resume treatment. 

The main safety issue with donanemab was brain swelling and bleeding, a problem common to all amyloid-targeting drugs. Most cases identified in Lilly’s trial were mild. 

Three deaths in the donanemab study were linked to the drug, according to the FDA, all involving brain swelling or bleeding. One of the deaths was caused by a stroke, a life-threatening complication that occurs more frequently among Alzheimer’s patients. 

The FDA’s panel agreed those risks could be addressed by warning labels and education for doctors and medical scans to identify patients at greater risk of stroke.
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After Russia invaded Ukraine, the West responded, sending military weaponry and aid to the embattled nation. But as the war drags on, there is also a need for doctors. One nonprofit is sending American surgeons to Ukraine, and Ukrainian surgeons to train in the United States. Iryna Solomko has the story, narrated by Anna Rice. VOA footage by Pavlo Terekhov.
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KAMPALA, Uganda — Early last year, Caroline Ikendi was in distress after undergoing an emergency Caesarean section to remove one stillborn baby and save two others. Doctors said one of the preterm babies had a 2% chance of living.

If the babies didn’t get breast milk — which she didn’t have — Ikendi could lose them as well.

Thus began a desperate search for breast milk donors. She was lucky with a neighbor, a woman with a newborn baby to feed who was willing to donate a few milliliters at a time.

“You go and plead for milk. You are like, ‘Please help me, help my child,'” Ikendi told The Associated Press.

The neighbor helped until Ikendi heard about a Ugandan group that collects breast milk and donates it to mothers like her. Soon the ATTA Breastmilk Community was giving the breast milk she needed, free of charge, until her babies were strong enough to be discharged from the hospital.

ATTA Breastmilk Community was launched in 2021 in the Ugandan capital, Kampala, by a woman who had struggled like Ikendi without getting support. The registered nonprofit, backed by grants from organizations and individuals, is the only group outside a hospital setting in Uganda that conserves breast milk in substantial amounts.

ATTA, as the group is known, receives calls for support from hospitals and homes with babies born too soon or too sick to latch onto their mothers’ breasts.

More than 200 mothers have donated breast milk to support more than 450 babies since July 2021, with over 600 liters of milk delivered for babies in that period, according to ATTA’s records.

In a measure of efforts to build a reliable community, many donors have given multiple times while others help to find new ones, said ATTA administrator Racheal Akugizibwe.

“We are an emergency fix,” Akugizibwe said. “As the mother is working on their own production, we are giving (her) milk. But we do it under the directive and under the support of a lactation specialist and the medical people.”

She added: “Every mother who has given us milk, they are kind of attached to us. They are we; we are them. That’s what makes it a community.”

ATTA makes calls for donors via social media apps like Instagram. Women who want to donate must provide samples for testing, including for HIV and hepatitis B and C, and there are formal conversations during which ATTA tries to learn more about potential donors and motivations. Those who pass the screening are given storage bags and instructed in safe handling.

Akugizibwe spoke of ATTA’s humble beginnings in the home of its founder, Tracy Ahumuza, who would store the milk in her freezer. Ahumuza started the group amid personal grief: She hadn’t been able to produce breast milk for her newborn who battled life-threatening complications. Days later, after the baby died, she started lactating.

She asked health workers, “Where do I put the milk that I have now?'” Akugizibwe said. “They told her, ‘All we can do for you is give you tablets to dry it out.’ She’s like, ‘No, but if I needed it and I didn’t get it, someone could need it.'”

In the beginning, ATTA would match a donor to a recipient, but it proved unsustainable because of the pressure it put on donors. ATTA then started collecting and storing breast milk, and donors and recipients don’t know each other.

Akugizibwe said the group gets more requests for support than it can meet. Challenges include procuring storage bags in large quantities as well as the costs of testing. And donors are required to own freezers, a financial obstacle for some.

“The demand is extremely, extremely high,” Akugizibwe said, “but the supply is low.”

Lelah Wamala, a chef and mother of three in Kampala who twice has donated milk, said she was spurred to act when, while having a baby in 2022, she saw mothers whose premature babies were dying because they didn’t have milk.

Being a donor is a time-consuming responsibility, “but this is the right thing to do,” she said.

Via motorcycle courier on Kampala’s busy streets, breast milk from donors is taken to ATTA’s storage and delivered to parents in need.

ATTA’s goal is to set up a full-fledged breast milk bank with the ability to pasteurize. The service is necessary in a country where an unknown number of women suffer for lack of lactation support, said Dr. Doreen Mazakpwe, a lactation specialist who collaborates with ATTA.

Mazakpwe cited a range of lactation issues mothers can face, from sore nipples to babies born too sick or too weak to suckle and stimulate milk production.

If both mother and baby are healthy, “this mother should be able to produce as much milk as the baby needs because we work on the principle of supply and demand,” said Mazakpwe, a consultant with a private hospital outside Kampala. “So, in situations where there’s a delay in putting the baby on the breast, or the baby is not fed frequently enough … you can eventually have an issue where you have low supply.”

Mazakpwe said she advises mothers on how to establish their own supply within about a month of receiving donated breast milk, and sometimes all that’s needed is to hold the baby the right way. When mothers start lactating, it frees up supply for new ones who need ATTA’s help, she said.

Akugizibwe said their work is challenging in a socially conservative society where such a pioneering service raises eyebrows. Questions, even from recipients, include fears that babies who drink donated breast milk might inherit the bad habits of their benefactors.

In addition, “If you don’t breastfeed there is a lot of negativity,” said Ikendi, whose premature babies survived on donated milk. “Society looks at you as though you’ve just literally refused to breastfeed.”

She spoke of struggling even when she knew she had no choice after seeing her babies in the intensive care unit for the first time. Through the glass she saw they were so tiny, on oxygen therapy and bleeding from their noses. The babies, a boy and a girl, had been removed at seven months.

Ikendi’s babies received donated breast milk for two months.

One recent morning, an emotional Ikendi held her children as she described how the donated milk “contributed 100% to our babies’ growth.”
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GENEVA — Scientific evidence documented in a series of articles presented by the World Health Organization this week highlights the harmful impact of climate change at key stages of the human life cycle.

“These provide important scientific evidence on how the health of pregnant women, newborns, children, adolescents and older people is affected by air pollution and different climate hazards, including wildfires, flooding and extreme heat,” Anayda Portela, director of the WHO’s department of maternal, newborn, child and adolescent health and aging, said at a briefing Friday for journalists in Geneva.

“This evidence is critically important, because it shows the leading health risks for each of these groups for these different climate events,” Portela said.

She noted that the collection of articles published in the Journal of Global Health shows that climate-related health risks “have been crucially underestimated” for younger and older people and during pregnancy, “with serious, often life-threatening implications.”

The studies find that climate-related natural hazards have some “serious mental and physical health impacts” in pregnancy, and for younger and older people.

For example, the authors note that preterm births, which now are the leading cause of childhood deaths, “increase during heatwaves, while older people are more likely to suffer heart attacks or respiratory distress.”

They report that heatwaves also “affect cognitive function and therefore learning for children and adolescents.”

The World Meteorological Organization’s State of Global Climate report confirms 2023 as the hottest year on record and predicts that global temperatures over “the entire five-year 2024-2028 period will exceed 1.5 degrees centigrade above the pre-industrial era,” which scientists warn could lead to rapid and irreversible changes in the climate.

According to the World Health Organization, between 2030 and 2050, climate change is projected to cause approximately “250,000 additional deaths per year from malnutrition, malaria, diarrhea and heat stress alone.”

Portela also warned that air pollution increases the likelihood of high blood pressure during pregnancy, low birth weight, preterm birth and negative impacts on fetal brain and lung development.

“It raises risk of respiratory illness among children and older people,” she said, adding that they also face greater risks of “cancer, cardiovascular disease and pneumonia.”

The studies detail the many noxious effects on mental and physical well-being from climate-related natural disasters, including flooding and drought, as well as wildfires, which have been shown to increase respiratory disorders and cardiovascular mortality rates for older people.

“There is an urgent need to mitigate climate change by reducing greenhouse gas emissions and to build climate resilience, to take specific actions that protect health at these various life stages,” Portela said.

Authors of the reports note that “few climate adaptation measures are tailored for the specific needs of women, infants, children and adolescents,” as well as older people who may have mobility and cognitive constraints.

Nevertheless, the WHO urges governments to prioritize climate change as a health issue, pointing out several specific actions they can take to promote and protect health at different life stages.

For example, this could include flexibility around work hours, preparing childcare and educational systems for extreme weather events and rising temperatures, and informing people and communities about various measures that can protect vulnerable people during heatwaves and periods of worsening air pollution.
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MONTGOMERY, Alabama — Parts of the north side of Montgomery are defined by what it has lost: restaurants, grocery stores and a convenient pharmacy, the latter of which closed five years ago.

People who still live in the historically Black neighborhood of Newtown, like Sharon Harris, are frustrated. She goes to a different location of the same pharmacy chain, which is four miles from her home.

“You have to come back sometimes,” she said, “and then they wait so long to fill the prescription.”

In cities across the U.S., major retail pharmacies have closed hundreds of stores over the past few years and independents can’t always afford to stay open. That can leave residents of color without easy access to a business that provides not only prescriptions but also fundamental public health services like vaccinations, over-the-counter medicines and even food.

Closures create “a situation where there’s not just (a lack of) investment in terms of pharmacy development and expansion, but there’s no incentive to stay in those neighborhoods,” said Dima Qato, a professor of clinical pharmacy at the University of Southern California who has studied pharmacy access.

And an Associated Press analysis of licensing data from 44 states, data from the National Council for Prescription Drug Programs and the American Community Survey shows residents of neighborhoods that are majority Black and Hispanic have fewer pharmacies per capita than people who live in mostly white neighborhoods.

MAC Pharmacy is the only one serving about 20,000 people in a majority Black ZIP code in Cleveland. George Tadross, the part-owner and pharmacy manager, said he is adamant about making things as as easy as possible for his mostly older customers — sometimes by organizing their medications by day for them.

“You have to have a pharmacist to talk to,” he said. “My philosophy in the pharmacy business is you know your doctor, he knows everything about you. You need to know your pharmacist as well (because) the pharmacist is the only one that sees the whole medical treatment plan you have.”

Pharmacists play a role in managing chronic diseases like diabetes and heart-related issues, which Black and Hispanic people are more likely to be diagnosed with.

And when pharmacists or pharmacy technicians reflect their customer base — by speaking the same language or understanding the community — it can be easier to build a strong rapport and trust, said Jasmine Gonzalvo, who teaches at Purdue University’s College of Pharmacy and has researched the needs of Spanish-speaking patients at pharmacies.

She noted that if people don’t feel comfortable asking questions about the medication, then it might mean they don’t take it or don’t take it correctly.

“You don’t get a refill,” Gonzalvo said, “simply because there were barriers in the way of your communicating and feeling safe in that relationship with your pharmacist.”

That’s why Bert’s Pharmacy in Elizabeth, New Jersey, has “Spanish- and English-speaking staff all the time,” said owner and pharmacist Prakash Patel said. His business is located in an ZIP code where nearly 70% of the residents are Hispanic.

“We want to make sure, too, they understood everything,” Patel said. “We have Spanish-language labels for them, we print all the instructions in Spanish for them.”

In Montgomery, where Harris lives, the city is working on a development plan for the north side. A retail analysis in the plan shows a small pharmacy could generate $1.5 million in sales a year.

“There’s an opportunity there because you have what I call a captive market,” said Bob Gibbs, the director of Gibbs Planning Group, which did the analysis. “People that live in a lot of these neighborhoods have limited access to transportation … and they’re very loyal to local businesses that will treat them with respect.

“They will go out of their way just to go there. And they just don’t like having to drive … two miles to go to a drugstore. That’s unfair.”

Harris, though, doesn’t have much hope a new pharmacy will open.

“I don’t see it,” she said. “As long as they have (that CVS) they think it’s OK. … Everybody is waiting for them to do something on this side.”
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seattle, washington — Retired Major General William Anders, the former Apollo 8 astronaut who took the iconic “Earthrise” photo showing the planet as a shadowed blue marble from space in 1968, was killed Friday when the plane he was piloting alone plummeted into the waters off the San Juan Islands in Washington state. He was 90. His son, Greg Anders, confirmed the death to The Associated Press.

“The family is devastated,” Greg Anders said. “He was a great pilot, and we will miss him terribly.”

Anders said the photo was his most significant contribution to the space program, given the ecological and philosophical impact it had, along with making sure the Apollo 8 command module and service module worked.

A report came in around 11:40 a.m. local time that an older-model plane had crashed into the water and had sunk near the north end of Jones Island, San Juan County Sheriff Eric Peter said.

Only the pilot was on board the Beech A45 airplane at the time, according to the Federal Aviation Association.

William Anders said in a 1997 NASA oral history interview that he didn’t think the Apollo 8 mission was risk-free but there were important national, patriotic and exploration reasons for going ahead.

He estimated there was about a one-in-three chance that the crew wouldn’t make it back and the same chance the mission would be a success and the same chance that the mission wouldn’t start to begin with. He said he suspected Christopher Columbus sailed with worse odds.

He recounted how the Earth looked fragile and seemingly physically insignificant yet was home.

“We’d been going backwards and upside down, didn’t really see the Earth or the sun, and when we rolled around and came around and saw the first Earthrise,” he said. “That certainly was, by far, the most impressive thing. To see this very delicate, colorful orb which to me looked like a Christmas tree ornament coming up over this very stark, ugly lunar landscape really contrasted.”

The National Transportation Safety Board and FAA are investigating the crash.
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