Tech innovations offer hope for overburdened Africa health care system

Nairobi, Kenya — Overcrowding in African hospitals is blamed on the scarcity of health facilities and doctors, especially in rural areas.

According to the United Nations, there is only one doctor for every 5,000 people in Africa, a continent that bears 25% of the global disease burden. But with the number of mobile phone users on the rise, some technological innovations are helping to bridge the doctor-patient gap and expand health care coverage. 

Yaw Asamoah is head of MedPharma Care in Ghana. The company has developed an app that allows patients to connect face-to-face with doctors and pharmacies online so they can get medicine in their homes.

He says the system improves patients’ experiences when they seek health care services.

“That’s where MedPharma care comes in to see how we can digitize the whole idea of health care bringing telemedicine — making it possible for people either [to] have e-consultation, e-prescription, get their medicine delivered to them wherever they are, either at the office or at home… do their diagnostic remotely,” Asamoah said.

The World Health Organization says 57 countries are suffering from a critical shortage of health personnel, 36 of them in Africa.

The 2001 Abuja Declaration requires that African Union countries allocate 15% of their annual budgets to health, a requirement most governments have yet to fulfill.

Funding and infrastructure issues have blocked millions of Africans’ access to quality health care, but experts say digital tools could improve access to services in hard-to-reach areas that lack doctors.

Mountaga Keita is a Guinean-born businessman who invented three portable diagnostic terminals which can monitor a patient’s temperature, blood pressure, heart function and conduct ultrasounds.

“The benefit of that is the ease it brings to doctors and patients instead of clogging hospitals,” Keita said. “Now the doctors or nurses can get to the patient collected data and send the data in a very secure manner to the hospitals, and people can analyze and bring it back to the patient.”

Keita has so far deployed 40 kits to different hospitals in Guinea.

According Keita, the diagnostic terminals have attracted the attention of other countries like Gabon, which has requested six machines. He is in talks with the governments of Burkina Faso, Ivory Coast, and Senegal to supply the kits there.

Keita said his technology can help solve the doctor-to-patient ratio problem and save patients money.   

“With this kind of technology, all the vital signs of a patient, forward it in a very secure manner, encrypted to a specialist who is in Tunisia, who is in Kenya, who is in Tokyo, Paris to interpret and bring the result,” he said. “Then we know if we are supposed to spend that 45,000 euros to evacuate … or if we can locally cure the person.”

Since the COVID-19 pandemic, telemedicine has grown expansively and gained attention in Africa.

Asamoah said telemedicine provides access to many doctors who specialize in different diseases, easing the burden on health care facilities. 

“In a normal circumstance, if you went to a clinic in Ghana, you wanted to talk to a specialized consultant, you might probably not get either because they don’t have, they haven’t booked you, or they are not available,” he said. “But telemedicine can make it possible for you to make your appointment and talk to any doctor.”

McKinsey & Company, a global management consulting firm, analyzed the impact of digital health tools in Kenya, Nigeria, and South Africa and found that the tools could reduce the continent’s total health care costs by 15% by 2030.

India port workers to go on strike to demand better wages, benefits 

CHENNAI — A group of Indian port workers’ unions has called for a strike from Aug. 28 to demand immediate settlement of pay revisions and pension benefits, according to a note signed by its members. 

A strike by India’s port workers could exacerbate the existing congestion issues at Asian and European ports, leading to further delayed shipments, which have a global impact on trade and commerce. 

The country’s shipping ministry formed a bipartite wage negotiation committee in March 2021, and the workers submitted their demands six months later, ahead of the expiration of the previous agreement in December of that year, according to the note. 

Although the wage negotiation committee met seven times, it failed to meet the port workers’ demands, the note said. 

The workers’ group agreed to call for a strike after a meeting this month in Thoothukudi, a port city in the southern state of Tamil Nadu.  

The government and port management should consider demands such as pay scale revisions, payment of arrears and protection of exiting benefits to help avoid the strike, the workers’ group said in the note. 

India’s federal shipping ministry did not immediately respond to a Reuters request for comment. 

The annual cargo handling capacity of major Indian ports such as Chennai, Cochin and Mumbai totaled 1.62 billion metric tons, according to the shipping ministry. 

In the fiscal year to March 31, 2024, India exported goods worth $437 billion, with imports estimated at $677 billion. 

 

Fed’s pandemic-era vow to prioritize employment may soon be tested

Washington — Four years after Federal Reserve Chair Jerome Powell made fighting unemployment a bigger priority during the COVID-19 pandemic, he faces a pivotal test of that commitment amid rising joblessness, mounting evidence inflation is under control, and a benchmark interest rate that is still the highest in a quarter of a century.   

High interest rates may be on the way out, with the U.S. central bank expected to deliver a first cut at its Sept. 17-18 meeting and Powell potentially providing more information about the approach to the policy easing in a speech on Friday at the Kansas City Fed’s annual conference in Jackson Hole, Wyoming.   

But with the Fed’s policy rate in the 5.25%-5.50% range for more than a year, the impact of relatively high borrowing costs on the economy may still be building and could take time to unwind even if the central bank starts cutting — a dynamic that could put hopes for a “soft landing” of controlled inflation alongside continued low unemployment at risk.   

“Powell says the labor market is normalizing,” with wage growth easing, job openings still healthy, and unemployment around what policymakers see as consistent with inflation at the central bank’s 2% target, former Chicago Fed President Charles Evans said. “That would be great if that is all there is. The history is not good.”   

Indeed, increases in the unemployment rate like those seen in recent months are typically followed by more.   

“That does not seem the situation now. But you may only be one or two poor employment reports away” from needing aggressive rate cuts to counter rising joblessness, Evans said. “The longer you wait, the actual adjustment becomes harder to make.” 

Inflation versus employment  

Evans was a key voice in reframing the Fed’s policy approach, unveiled by Powell at Jackson Hole in August 2020 as the pandemic was raging, policymakers were gathering via video feed, and the unemployment rate was 8.4%, down from 14.8% that April.   

In that context the Fed’s shift seemed logical, changing a long-standing bias towards heading off inflation at the expense of what policymakers came to view as an unnecessary cost to the job market.   

Standard monetary policymaking saw inflation and unemployment inextricably and inversely linked: Unemployment below a certain point stoked wages and prices; weak inflation signaled a moribund job market. Officials began to rethink that connection after the 2007-2009 recession, concluding they needn’t treat low unemployment as an inflation risk in itself.   

As a matter of equity for those at the job market’s margins, and to achieve the best outcomes overall, the new strategy said Fed policy would “be informed by assessments of the shortfalls of employment from its maximum level.”   

“This change may appear subtle,” Powell said in his 2020 speech to the conference. “But it reflects our view that a robust job market can be sustained without causing an outbreak of inflation.”   

A pandemic-driven inflation surge and dramatic employment recovery made that change seem irrelevant: The Fed had to raise rates to tame inflation, and until recently the pace of price increases had slowed without much apparent damage to the job market. The unemployment rate through April had been below 4% for more than two years, an unparalleled streak not seen since the 1960s. The unemployment rate since 1948 has averaged 5.7%.   

But the events of the last two years, and a coming Fed strategy review, have also triggered a wave of research into exactly what happened: why inflation fell, what role policy played in that, and how things might be done differently if inflation risks rise again.   

While the agenda for this year’s conference remains under wraps, the broad theme focuses on how monetary policy influences the economy. That bears on how officials may evaluate future choices and tradeoffs and the wisdom of tactics like preempting inflation before it starts.   

Some of that work is already emerging from Fed researchers, including top economist Michael Kiley. He has authored a paper questioning whether policy “asymmetry” — treating employment shortfalls differently than a tight labor market, for example — really helps. Another recent paper suggested policymakers who believe public inflation expectations are formed in the short-run and are volatile should react sooner and raise rates higher in response.   

The role public expectations play in driving inflation — and the policy response – was on full display in 2022. When it appeared expectations risked moving higher, the Fed pushed its tightening cycle into overdrive with 75-basis-point hikes at four consecutive meetings. Powell then used a truncated Jackson Hole speech to emphasize his commitment to fight inflation —a stark shift from his jobs-first commentary two years earlier.   

It was a key moment that put the U.S. central bank’s seriousness on display, underpinned its credibility with the public and markets, and rebuilt some of the standing that preemptive policies had lost.   

‘Too tight’ 

Powell now faces a test in the other direction. Inflation is progressing back to 2%, but the unemployment rate has risen to 4.3%, up eight-tenths of a percentage point from July 2023.   

There’s debate over what that really says about the labor market versus rising labor supply, a positive thing if new job seekers find employment.   

But it did breach a rule-of-thumb recession indicator, and while that has been downplayed given other indicators of a growing economy, it also is slightly above the 4.2% that Fed officials regard as representing full employment.   

It’s also higher than at any point in Powell’s pre-pandemic months as Fed chief: It was 4.1% and falling when he took over in February 2018.   

The “shortfall” in employment that he promised to respond to four years ago, in other words, may already be taking shape.   

While Powell will be reluctant to ever declare victory over inflation for fear of touching off exuberant overreaction, Ed Al-Hussainy, senior global rates strategist at Columbia Threadneedle Investments, said it was past time for the Fed to get in front of the risk to unemployment – preemption of a different sort.   

Al-Hussainy said the Fed had proved its ability to keep public expectations about inflation in check, an important asset, but that “also has put in motion some downside risk to employment.”   

“The policy stance today is offside — it is too tight — and that warrants acting on.” 

Cholera outbreak in Sudan has killed 22 people, health minister says

Cairo — Sudan has been stricken by a cholera outbreak that has killed nearly two dozen people and sickened hundreds more in recent weeks, health authorities said Sunday. The African nation has been roiled by a 16-month conflict and devastating floods.

 

Health Minister Haitham Mohamed Ibrahim said in a statement that at least 22 people have died from the disease, and that at least 354 confirmed cases of cholera have been detected across the county in recent weeks.

 

Ibrahim didn’t give a time frame for the deaths or the tally since the start of the year. The World Health Organization, however, said that 78 deaths were recorded from cholera this year in Sudan as of July 28. The disease also sickened more than 2,400 others between Jan. 1 and July 28, it said.

 

Cholera is a fast-developing, highly contagious infection that causes diarrhea, leading to severe dehydration and possible death within hours when not treated, according to WHO. It is transmitted through the ingestion of contaminated food or water.

 

The cholera outbreak is the latest calamity for Sudan, which was plunged into chaos in April last year when simmering tensions between the military and a powerful paramilitary group exploded into open warfare across the country.

 

The conflict has turned the capital, Khartoum and other urban areas into battlefields, wrecking civilian infrastructure and an already battered health care system. Without the basics, many hospitals and medical facilities have closed their doors.

It has killed thousands of people and pushed many into starvation, with famine already confirmed in a sprawling camp for displaced people in the wrecked northern region of Darfur.

 

Sudan’s conflict has created the world’s largest displacement crisis. More than 10.7 million people have been forced to flee their homes since fighting began, according to the International Organization for Migration. Over 2 million of those fled to neighboring countries.

 

The fighting has been marked by atrocities including mass rape and ethnically motivated killings that amount to war crimes and crimes against humanity, according to the U.N. and international rights groups.

 

Devastating seasonal floods in recent weeks have compounded the misery. Dozens of people have been killed and critical infrastructure has been washed away in 12 of Sudan’s 18 provinces, according to local authorities. About 118,000 people have been displaced due to the floods, according to the U.N. migration agency.

 

Cholera is not uncommon in Sudan. A previous major outbreak left at least 700 dead and sickened about 22,000 in less than two months in 2017.

 

Tarik Jasarevic, a spokesperson for WHO, said the outbreak began in the eastern province of Kassala before spreading to nine localities in five provinces.

 

He said in comments to The Associated Press that data showed that most of the detected cases were not vaccinated. He said the WHO is now working with the Sudanese health authorities and partners to implement a vaccination campaign.

 

Sudan’s military-controlled sovereign council, meanwhile, said Sunday it will send a government delegation to meet with American officials in Cairo amid mounting U.S. pressure on the military to join ongoing peace talks in Switzerland that aim at finding a way out of the conflict.

 

The council said in a statement the Cairo meeting will focus on the implementation of a deal between the military and the Rapid Support Forces, which required the paramilitary group to pull out from people’s homes in Khartoum and elsewhere in the country.

 

The talks began Aug. 14 in Switzerland with diplomats from the U.S., Saudi Arabia, Egypt, the United Arab Emirates, the African Union and the United Nations attending. A delegation from the RSF was in Geneva but didn’t join the meetings.

Wall Street week ahead — ‘Soft landing’ hopes are back to lift US stocks after recession scare 

NEW YORK — Hopes for an economic soft landing are once again powering U.S. stocks higher, as encouraging data relieve recession worries following a brutal sell-off earlier this month.

The S&P 500 .SPX has rebounded more than 6% since Aug. 5, when a steep drop pushed the benchmark U.S. index to its biggest three-day slide in over two years. A rapid return to calm was also evident in the Cboe Volatility Index .VIX, or Wall Street’s “fear gauge,” which has retreated from last week’s four-year highs at a record pace.

Driving the turnaround are last week’s reports on retail sales, inflation and producer prices, which helped allay worries over an economic slowdown sparked by weaker-than-expected employment data at the start of the month. The favorable data has bolstered the case for investors looking to hop back aboard many of the trades that have worked this year, from buying Big Tech stocks to a more recent bet on small and mid-cap names that accelerated in July.

“There was a real growth scare that had emerged,” said Mona Mahajan, senior investment strategist at Edward Jones. “Since then, what we’ve seen is the economic data has actually come out in a much more positive light.”

Some of 2024’s biggest winners have staged strong rebounds since Aug. 5. Chipmaker Nvidia NVDA.O has bounced more than 20%, while the Philadelphia SE Semiconductor index .SOX has gained more than 14%. Small-cap shares, which had been strong performers in July, have also recovered from recent lows, with the Russell 2000 .RUT up nearly 5%.

Meanwhile, traders are unwinding bets that the Federal Reserve will need to deliver jumbo-sized rate cuts in September to stave off a recession.

As of late Thursday, futures tied to the Fed funds rate showed traders pricing a 25% chance that the central bank will lower rates by 50 basis points in September, down from around 85% on Aug. 5, CME FedWatch data showed. The probability of a 25 basis point cut stood at 75%, in line with expectations that the Fed will kick off an easing cycle in September.

“You can’t necessarily rule out the hard landing scenario outright, but there’s a lot of reason to believe that at this point that economic momentum is being sufficiently sustained,” said Jim Baird, chief investment officer with Plante Moran Financial Advisors.

The Fed’s plans could become clearer when Chair Jerome Powell speaks at the central bank’s annual economic policy symposium in Jackson Hole, Wyoming.

“We think a key highlight of Powell’s speech will be the acknowledgement that progress on inflation has been sufficient to allow the start of rate cuts,” economists at BNP Paribas said in a note on Thursday.

For the year, the S&P 500 is up more than 16% and is within about 2% from its July all-time closing high.

Mahajan, of Edward Jones, expects the soft-landing scenario, combined with lower interest rates, to help pave the way for more stocks to participate in the market’s rally, instead of the small number of megacaps that have led indexes higher for much of this year.

Analysts at Capital Economics believe that a U.S. economic soft landing will support the artificial intelligence fervor that helped drive markets higher.

“Our end-2024 forecast for the S&P 500 remains at 6,000, driven by a view that the AI narrative which dominated in the first half of the year will reassert itself,” they wrote. That target would be some 8% from the S&P 500’s closing level on Thursday.

The recent economic data, while reassuring, is far from an all-clear for markets heading into September, which has historically been one of the year’s more volatile periods. Investors will be closely watching Nvidia’s earnings at the end of the month, and another employment report on Sept. 6.

“There’s been a sigh of relief in the market, clearly,” said Quincy Krosby, chief global strategist at LPL Financial. “The question now is, will the next payroll report underpin what the market expects at this point in terms of the soft landing.”

Magnitude 7 earthquake strikes off coast of Russia’s Kamchatka region

moscow — A magnitude 7.0 earthquake struck off the coast of Russia’s far-eastern Kamchatka Peninsula early Sunday morning local time, according to the regional earthquake monitoring service.

The local emergencies ministry said tremors were felt along the coast including in the region’s capital Petropavlovsk-Kamchatsky.

“Operational teams of rescuers and firefighters are inspecting buildings,” the regional branch of Russia’s emergencies ministry in the Kamchatka region said on Telegram.

The earthquake struck at a depth of nearly 50 kilometers just after 7 a.m. local time, some 90 kilometers east of Petropavlovsk-Kamchatsky, the United States Geological Survey reported.

The U.S. National Tsunami Warning Center had initially issued a tsunami threat, but later said the threat had passed. Local authorities never issued a tsunami alert.

Several aftershocks were recorded after the initial quake, but of lower intensity, the Kamchatka branch of Russia’s Unified Geophysical Service reported on its website.

“Most of the aftershocks are imperceptible,” the regional emergency authority said on Telegram.

The peninsula lies on a seismically active belt surrounding most of the Pacific Ocean known as the “Ring of Fire,” and is home to more than two dozen active volcanoes. 

Rare deep-sea oarfish found in California, scientists want to know why

SAN DIEGO — A rarely seen deep-sea fish resembling a serpent was found floating dead on the ocean surface off the San Diego coast and was brought ashore for study, marine experts said. 

The silvery, 12-foot-long (3.6-meter) oarfish was found last weekend by a group of snorkelers and kayakers in La Jolla Cove, north of downtown San Diego, in the U.S. state of California, the Scripps Institution of Oceanography said in a statement. 

It’s only the 20th time an oarfish is known to have washed up in California since 1901, according to institution fish expert Ben Frable. 

Scripps noted that oarfish have a mythical reputation as predictors of natural disasters or earthquakes, although no correlation has been proven. 

Oarfish can grow longer than 20 feet (6 meters) and normally live in a deep part of the ocean called the mesopelagic zone, where light cannot reach, according to the National Oceanic and Atmospheric Administration. 

Swimmers brought the La Jolla Cove oarfish to shore atop a paddleboard. It was then transferred to the bed of a pickup truck. 

Scientists from NOAA Southwest Fisheries Science Center and Scripps planned a necropsy Friday to try to determine the cause of death. 

India’s doctors strike in protest of rape, murder of colleague

KOLKATA/BHUBANESWAR, India — Hospitals and clinics across India turned away patients except for emergency cases on Saturday as medical professionals staged a 24-hour shutdown in protest over the rape and murder of a doctor this month in the eastern city of Kolkata.

More than 1 million doctors were expected to join the strike, paralyzing medical services across the world’s most-populous nation. Hospitals said faculty from medical colleges had been pressed into service for emergency cases.

The government, in a statement issued on Saturday after a meeting with representatives of medical associations, urged doctors to return to duties in the public interest. The government would set up a committee to suggest measures to improve protection for health care professionals, it said.

In response, the Indian Medical Association said it was studying the government offer, but it did not call off the strike, which was due to end at 6 a.m. Sunday.

The walk-out was the latest action in response to the killing of a 31-year-old trainee doctor last week inside the medical college in Kolkata where she worked.

The crime has triggered nationwide protests among medical workers and a public outpouring of anger over violence against women reminiscent of what followed the notorious gang rape and murder of a 23-year-old student on a bus in New Delhi in 2012.

No elective procedures

The strike halted access to elective medical procedures and out-patient consultations, according to the Indian Medical Association, or IMA.

There was a heavy police presence outside Kolkata’s RG Kar Medical College, where the woman was killed, while the hospital premises were deserted, according to the ANI news agency.

Mamata Banerjee, the chief minister of West Bengal, which includes Kolkata, has backed the protests across the state. Her government announced on Saturday evening measures to improve security for women working night shifts, including designated rest rooms and safe zones monitored by cameras.

It also asked private institutions to consider measures such as night patrols to make the working environment more secure for women.

India’s Central Bureau of Investigation has so far detained one suspect in the case.

The CBI summoned some medical students from the college as part of its investigation, according to a police source in Kolkata, who said the agency also questioned the principal of the hospital on Friday.

There were protests throughout the day in Kolkata, led by doctors, civil society members and political leaders. Many private clinics and diagnostic centers were closed.

Dr. Sandip Saha, a private pediatrician in the city, told Reuters he would not attend to patients except in emergencies.

Hospitals and clinics in Lucknow in Uttar Pradesh, Ahmedabad in Gujarat, Guwahati in Assam and Chennai in Tamil Nadu and other cities joined the strike, set to be one of the largest shutdowns of hospital services in recent memory.

Patients queue at hospitals

Patients queued at hospitals, some unaware that they would not get medical attention.

“I have spent 500 rupees [$6] on travel to come here. I have paralysis and a burning sensation in my feet, head and other parts of my body,” an unidentified patient at SCB Medical College Hospital in the city of Cuttack in Odisha told local television.

“We were not aware of the strike. What can we do? We have to return home.”

Raghunath Sahu, 45, who had lined up at SCB Medical College and Hospital in Cuttack, told Reuters a daily quota set by the doctors to see patients had ended before noon.

“I have brought my ailing grandmother. They did not see her today. I will have to wait for another day and try again,” Sahu said.

India’s government introduced sweeping changes to the criminal justice system, including tougher sentences, after the 2012 Delhi gang-rape, but campaigners say little has changed and not enough has been done to deter violence against women.

“Women form the majority of our profession in this country.

Time and again, we have asked for safety for them,” IMA President R.V. Asokan told Reuters on Friday.

The IMA has called for further legal measures to better protect health care workers from violence.

Nigeria records mpox cases amid global health emergency

ABUJA, NIGERIA — Barely 48 hours after the World Health Organization declared mpox a global health emergency, Nigeria went on high alert Friday, announcing new mpox cases and raising concerns about the country’s ability to contain the outbreak.

The Nigeria Center for Disease Control and Prevention, or NCDC, said it has recorded 39 cases of mpox so far this year amid a surge in infections across Africa. No deaths have been recorded in Nigeria.

Bayelsa, Cross River, Ogun and Lagos states are the most affected by the outbreak.

Speaking at a news conference, NCDC lead Dr. Olajide Idris said that the nation is ramping up its response to manage the spread of the virus and prevent the disease from being imported.

Mpox is a rare viral zoonotic disease, meaning it is primarily an animal disease that can be transmitted to humans. It is endemic in several African countries, with over 2,800 cases reported across 13 countries this year, claiming more than 500 lives.

Symptoms include fever, body aches, weakness, headaches and rashes.

With a more lethal strain emerging, Idris said that vaccination plans are being considered for high-risk populations.

“The Nigerian government is making effort to make vaccines available to the public, especially for the hotspot areas,” he said. “These vaccines have been shown to have a favorable safety profile. They are not yet in the country, but they are on their way.”

Olayinka Badmus, deputy project director for Global Health Security, Breakthrough Action Nigeria, said the new strain poses a higher risk.

“This particular strain is new, and anything new requires new learning. The things that we have seen related to this particular strain is the fact that it is spreading quite fast, the presenting symptoms — especially the rash — are widespread,” she said, meaning that the rash is all over the body.

“We are also seeing more children affected with mpox compared to the other strains,” Badmus said.

Another cause for concern, she said, is that this strain has “a higher human-to-human transmission at an accelerated rate.”

Idris stressed the need for public awareness in containing the spread and urged people to seek medical attention if they experience symptoms.

“We encourage everybody feeling feverish, muscle pain, sore throat to please visit the nearest health care facility,” he said.

Public health experts are also urging people to adhere to preventive measures such as avoiding contact with potentially infected animals and practicing good hygiene.

DR Congo’s humanitarian crisis helped mpox spiral into a global health emergency

GOMA, Democratic Republic of Congo — Sarah Bagheni had a headache, fever, and itchy and unusual skin lesions for days, but she had no inkling that her symptoms might have been caused by mpox and that she might be another case in a growing global health emergency. 

She also has no idea where to go to get medical help. 

She and her husband live in the Bulengo displacement camp in eastern Congo, a region that is effectively ground zero for a series of mpox outbreaks in Africa.

This year’s alarming rise in cases, including a new form of the virus identified by scientists in eastern Congo, led the World Health Organization to declare it a global health emergency on Wednesday. It said the new variant could spread beyond the five African countries where it had already been detected — a timely warning that came a day before Sweden reported its first case of the new strain.

In the vast central African nation of Congo, which has had more than 96% of the world’s roughly 17,000 recorded cases of mpox this year — and some 500 deaths from the disease — many of the most vulnerable seem unaware of its existence or the threat that it poses.

“We know nothing about this,” Bagheni’s husband, Habumuremyiza Hire, said Thursday about mpox. “I watch her condition helplessly because I don’t know what to do. We continue to share the same room.”

Millions are thought to be out of reach of medical help or advice in the conflict-torn east, where dozens of rebel groups have been fighting Congolese army forces for years over mineral-rich areas, causing a huge displacement crisis. Hundreds of thousands of people like Bagheni and her husband have been forced into overcrowded refugee camps around Goma, while more have taken refuge in the city.

Conditions in the camps are dire and medical facilities are almost nonexistent.

Mahoro Faustin, who runs the Bulengo camp, said that about three months ago, administrators first started noticing people in the camp exhibiting fever, body aches and chills — symptoms that could signal malaria, measles or mpox.

There is no way of knowing how many mpox cases there might be in Bulengo because of a lack of testing, he said. There haven’t been any recent health campaigns to educate the tens of thousands of people in the camp about mpox, and Faustin said he’s worried about how many people might be undiagnosed.

“Just look at the overcrowding here,” he said, pointing to a sea of ramshackle tents. “If nothing is done, we will all be infected here, or maybe we are already all infected.”

Around 70% of the new mpox cases in the Goma area in the last two months that were registered at a treatment center run by Medair were from displacement camps, said Dr. Pierre Olivier Ngadjole, the international aid group’s health advisor in Congo. The youngest of those cases was a month-old baby and the oldest a 90-year-old, he said.

In severe cases of mpox, people can develop lesions on the face, hands, arms, chest and genitals. While the disease originated in animals, the virus has in recent years been spreading between people via close physical contact, including sex.

Bagheni’s best hope of getting a diagnosis for her lesions is a government hospital that’s a two-hour drive away. That’s likely out of the question, given that she already struggles with mobility having previously had both her legs amputated.

Seven million people are internally displaced in Congo, with more than 5.5 million of them in the country’s east, according to the U.N. refugee agency. Congo has the largest displacement camp population in Africa, and one of the largest in the world.

The humanitarian crisis in eastern Congo has almost every possible complication when it comes to stopping an mpox outbreak, said Dr. Chris Beyrer, director of Duke University’s Global Health Institute.

That includes war, illicit mining industries that attract sex workers, transient populations near border regions, and entrenched poverty. He also said the global community missed multiple warning signs.

“We’re paying attention to it now, but mpox has been spreading since 2017 in Congo and Nigeria,” Beyrer said, adding that experts have long been calling for vaccines to be shared with Africa, but to little effect. He said the WHO’s emergency declaration was “late in coming,” with more than a dozen countries already affected.

Beyrer said that unlike COVID-19 or HIV, there’s a good vaccine and good treatments and diagnostics for mpox, but “the access issues are worse than ever” in places like eastern Congo.

In 2022, there were outbreaks in more than 70 countries around the world, including the United States, which led the WHO to also declare an emergency that lasted until mid-2023. It was largely shut down in wealthy countries within months through the use of vaccines and treatments, but few doses have been made available in Africa.

The new and possibly more infectious strain of mpox was first detected this year in a mining town in eastern Congo, about 450 kilometers south of Goma. It’s unclear how much the new strain is to blame, but Congo is now enduring its worst outbreak yet and at least 13 African countries have recorded cases, four of them for the first time.

The outbreaks in those four countries — Burundi, Kenya, Rwanda and Uganda — have been linked to Congo’s, and Doctors Without Borders said Friday that Congo’s surge “threatens a major spread of the disease” to other countries.

Salim Abdool Karim, an infectious disease expert who chairs the Africa Centers for Disease Control and Prevention’s emergency committee, said the Congo outbreak has a particularly concerning change, in that it’s disproportionately affecting young people. Children under 15 account for 70% of cases and 85% of all deaths in the country, the Africa CDC reported.

Unlike the 2022 global outbreak, which predominantly affected gay and bisexual men, mpox now appears to be spreading in heterosexual populations.

All of Congo’s 26 provinces have recorded mpox cases, according to the state-run news agency. But Health Minister Samuel-Roger Kamba said Thursday that the country doesn’t have a single vaccine dose yet and he pleaded for “vigilance in all directions from all Congolese.”

Dr. Rachel Maguru, who heads the multi-epidemic center at Goma’s North Kivu provincial hospital, said they also don’t have drugs or any established treatments for mpox and are relying on other experts such as dermatologists to help where they can. A larger outbreak around the city and its numerous displacement camps already overburdened with an influx of people would be “terrible,” she said.

She also noted a pivotal problem: poor and displaced people have other priorities, like earning enough money to eat and survive. Aid agencies and stretched local authorities are already wrestling with providing food, shelter and basic health care to the millions displaced, while also dealing with outbreaks of other diseases like cholera.

Europe warned to prepare for mpox as Pakistan reports first case

Stockholm — Health authorities warned Friday that Europe must be ready for more cases of a deadly strain of mpox that has killed hundreds of people in the Democratic Republic of Congo.

The World Health Organization urged pharmaceutical firms to ramp up vaccine production and China said it would screen travelers for the disease after the first cases of the more deadly strain to be recorded outside Africa were announced in Sweden and Pakistan.

France’s Prime Minister Gabriel Attal said his country was on the “highest alert” and would implement “new recommendations” for travelers to risk areas.

Mpox is caused by a virus transmitted to humans by animals but can also spread human-to-human through close physical contact.

It causes fever, muscular aches and large boil-like skin lesions.

The WHO on Wednesday declared the rapid spread of the new Clade 1b strain an international public health emergency — the agency’s highest alert.

This follows the spread of the more deadly mpox from Democratic Republic of Congo (DRC) to other African countries.

“We do need the manufacturers to really scale up so that we’ve got access to many, many more vaccines,” WHO spokesperson Margaret Harris told reporters.

The WHO is asking countries with vaccine stockpiles to donate them to countries with outbreaks.

Harris said mpox was “particularly dangerous for those with a weak immune system, so people who maybe have HIV or are malnourished,” and was also dangerous for small children.

The United States has said it will donate 50,000 doses of an mpox vaccine to DRC and Attal said France would also send vaccines to risk countries.

Danish drugmaker Bavarian Nordic said Thursday it would be ready to make up to 10 million doses of its mpox vaccine by 2025 but that it needed contracts to start production.

The Stockholm-based European Center for Disease Prevention and Control (ECDC) said the overall risk in Europe was “low.” But it warned that “effective surveillance, laboratory testing, epidemiological investigation and contact tracing capacities will be vital to detecting cases.”

“Due to the close links between Europe and Africa, we must be prepared for more imported clade I cases,” ECDC director Pamela Rendi-Wagner said in a statement.

Hundreds killed in DRC

The virus has swept across DRC, killing 548 people so far this year, the government said Thursday.

Nigeria has recorded 39 mpox cases this year, but no deaths, according to its health authorities. Previously unaffected countries such as Burundi, Kenya, Rwanda and Uganda have reported outbreaks, according to the Africa Centers for Disease Control and Prevention.

Sweden’s Public Health Agency announced Thursday it had registered a case of Clade 1b.

The patient was infected during a visit to “the part of Africa where there is a major outbreak of mpox Clade 1,” epidemiologist Magnus Gisslen said in a statement.

The mpox strain in the Pakistan case was not immediately known, the country’s health ministry said in a statement.

It said the patient, a 34-year-old man, had “come from a Gulf country.”

China announced it would begin screening people and goods entering the country for mpox over the next six months.

People arriving from countries where outbreaks have occurred, who have been in contact with mpox cases or display symptoms should “declare to customs when entering the country,” China’s customs administration said.

Vehicles, containers and items from areas with mpox cases should be sanitized, it added in a statement.

Vaccination drive

Mpox has two subtypes: the more virulent and deadlier Clade 1, endemic in the Congo Basin in central Africa; and Clade 2, endemic in West Africa.

A worldwide outbreak beginning in 2022 involving the Clade 2b subclade caused some 140 deaths out of about 90,000 cases, mostly affecting gay and bisexual men.

France reported 107 cases of the milder mpox variant between January 1 and June 30 this year.

The WHO’s European regional office in Copenhagen said the Sweden case was “a clear reflection of the interconnectedness of our world.”

But it added: “Travel restrictions and border closures don’t work and should be avoided.”

What is mpox, where are the outbreaks and will the virus spread?

london — The World Health Organization declared Wednesday that the increasing spread of mpox in Africa is a global health emergency, warning the virus might ultimately spill across international borders. 

The announcement by WHO director-general Tedros Adhanom Ghebreyesus came after a meeting of the United Nation health agency’s emergency committee. The Africa Centers for Disease Control and Prevention declared mpox a public health emergency on the continent on Tuesday. 

The WHO said there have been more than 14,000 cases and 524 deaths in Africa this year, which already exceeds last year’s figures. 

So far, more than 96% of all cases and deaths are in a single country — Congo. Scientists are concerned by the spread of a new version of the disease there that might be more easily transmitted among people. 

Here’s a look at what we know about mpox, and what might be done to contain it: 

What is mpox? 

Mpox, also known as monkeypox, was first identified by scientists in 1958 when there were outbreaks of a “pox-like” disease in monkeys. Until recently, most human cases were seen in people in central and West Africa who had close contact with infected animals. 

In 2022, the virus was confirmed to spread via sex for the first time and triggered outbreaks in more than 70 countries across the world that had not previously reported mpox. 

Mpox belongs to the same family of viruses as smallpox but causes milder symptoms such as fever, chills and body aches. People with more serious cases can develop lesions on the face, hands, chest and genitals. 

What’s happening in Africa that’s causing all this concern? 

The number of cases has jumped dramatically. Last week, the Africa CDC reported that mpox has now been detected in at least 13 African countries. Compared with the same period last year, the agency said cases are up 160% and deaths have increased by 19%. 

Earlier this year, scientists reported the emergence in a Congolese mining town of a new form of mpox that can kill up to 10% of people and may spread more easily. 

Unlike in previous mpox outbreaks, where lesions were mostly seen on the chest, hands and feet, the new form of mpox causes milder symptoms and lesions on the genitals. 

That makes it harder to spot, meaning people might also sicken others without knowing they’re infected, said Dr. Placide Mbala-Kingebeni, a Congolese researcher who led the research into the new form of mpox. 

WHO said mpox was recently identified for the first time in four East African countries: Burundi, Kenya, Rwanda and Uganda. All of those outbreaks were linked to the epidemic in Congo. Tedros said there was concern for the further spread of the disease within Africa and beyond. 

In the Ivory Coast and South Africa, health authorities have reported outbreaks of a different and less dangerous version of mpox that spread worldwide in 2022 and infected nearly 100,000 people. 

What’s the threat to the rest of the world? 

Like any infectious disease, the new form of mpox seen in Congo could cross borders — cases have already been detected in four other East African countries. 

On Thursday, Sweden’s public health agency said it identified the first case of the new mpox variant in someone who had recently been in Africa, and who sought health care in Stockholm. 

Officials said the risk to the general public was considered “very low” and that they expect sporadic imported cases to continue. 

Kamituga, the region in Congo where the new form of mpox was first spotted, is home to a significant transient population traveling through Africa and beyond. 

Still, given the resources in rich countries to stop mpox, scientists suspect that if new outbreaks linked to Congo were to be identified, transmission could be stopped relatively quickly. 

Unlike COVID-19 or measles, mpox is not airborne and typically requires close, skin-to-skin contact to spread. 

What does an emergency declaration mean? 

WHO’s emergency declaration is meant to spur donor agencies and countries into action. But the global response to previous declarations has been mixed. 

Africa CDC Director General Dr. Jean Kaseya said the agency’s declaration of a public health emergency was meant “to mobilize our institutions, our collective will and our resources to act swiftly and decisively.” He appealed to Africa’s international partners for help, saying that the escalating caseload in Africa had largely been ignored. 

Dr. Boghuma Titanji, an infectious diseases expert at Emory University, said the last WHO emergency declaration for mpox “did very little to move the needle” on getting things like diagnostic tests, medicines and vaccines to Africa. 

How does the current outbreak in Africa compare to the 2022 epidemic? 

During the global outbreak of mpox in 2022, gay and bisexual men made up the vast majority of cases and the virus was mostly spread through close contact, including sex. 

Although some similar patterns have been seen in Africa, children under 15 now account for more than 70% of the mpox cases and 85% of deaths in Congo. 

Greg Ramm, Save the Children’s Congo director, said the organization was particularly worried about the spread of mpox in the crowded camps for refugees in the east, noting there were 345,000 children “crammed into tents in unsanitary conditions.” He said the country’s health system was already “collapsing” under the strain of malnutrition, measles and cholera. 

Emory’s Titanji said it was unclear why children were so disproportionately hit by mpox in Congo. She said it might be because kids are more susceptible to the virus or that social factors, like overcrowding and exposure to parents who caught the disease, might explain it. 

How might mpox be stopped? 

The 2022 outbreak of mpox in dozens of countries was largely shut down with the use of vaccines and treatments in rich countries, in addition to convincing people to avoid risky behavior. But barely any vaccines or treatments have been available in Africa. 

Marks, of the London School of Hygiene and Tropical Medicine, said that immunization would likely help — including inoculating people against smallpox, a related virus. 

“We need a large supply of vaccine so that we can vaccinate populations most at risk,” he said, adding that would mean sex workers, children and adults living in outbreak regions. 

Congolese authorities have asked for 4 million doses mostly for young children, but no doses have yet been received, said Cris Kacita Osako, coordinator of Congo’s Monkeypox Response Committee. 

Survey shows disaster-prone Southeast Asia is also best prepared

BANGKOK — Southeast Asia is among the regions most prone to natural disasters, but a new analysis released Thursday shows its people also feel the best equipped to deal with them.

It seems logical that the countries in and around the Pacific Ring of Fire, vulnerable to earthquakes, typhoons, storm surges and other dangers, are also the best prepared, but the survey by Gallup for the Lloyd’s Register Foundation shows that’s not always the case in other regions.

“Frequent exposure to hazard isn’t the only factor that determines how prepared people feel,” Benedict Vigers, a research consultant with Gallup, told The Associated Press.

The report found the Association of Southeast Asian Nations has played a key role in disaster risk reduction, and Vigers said the region’s wider approach includes widespread and effective early warning systems, scaled-up community approaches and regional cooperation, and good access to disaster finance.

“Southeast Asia’s success in feelings of disaster preparedness can be linked to its high exposure to disasters, its relatively high levels of resilience – from individual people to overall society, and the region’s approach to — and investment into — disaster risk management more broadly,” he said.

Forty percent of people surveyed in Southeast Asia said they had experienced a natural disaster in the past five years, while a similar number — 36% — in Southern Asia said the same. But 67% of Southeast Asians felt among the best prepared to protect their families and 62% had emergency plans, while Southern Asians felt less ready, with 49% and 29% respectively.

Respondents from North America, which is significantly less disaster-prone than Southeast Asia, said they only felt slightly less prepared, while those in Northern and Western Europe were in the middle of the pack.

The results from Southeast Asia, primarily made up of lower-middle-income countries, suggest wealth is not a deciding factor in disaster response and preparation, said Ed Morrow, senior campaigns manager for Lloyd’s Register Foundation, a British-based global safety charity.

Southeast Asia is “a region that clearly has much to teach the world in terms of preparing for disasters,” he said.

Globally, no country ranked higher than the Philippines for having experienced a natural disaster in the past five years, with 87% of respondents saying they had.

It was also among the top four countries where the highest proportion of households have a disaster plan. All were in Southeast Asia: the Philippines (84%), Vietnam (83%), Cambodia (82%) and Thailand (67%), followed by the United States (62%).

Those with the lowest proportion were Egypt, Kosovo and Tunisia, all with 7%.

The data were drawn from the World Risk Poll, conducted every two years, with the main results from the 2023 survey published in June. Questions on disasters focused on natural hazards instead of conflicts or financial disasters, and they excluded the coronavirus pandemic.

Surveys were conducted of people aged 15 and above in 142 countries and based on telephone or face-to-face conversations with approximately 1,000 or more respondents in each country with the exception of China, where some 2,200 people were contacted online.

Margin of error ranged from plus or minus 2.2 to 4.9 percentage points, for an overall 95% confidence level.

“It is our intention that this freely available data should be used by governments, regulators, businesses, NGOs and international bodies to inform and target policies and interventions that make people safer,” Morrow said.

Nigeria on ‘high alert’ amid surging cases of mpox in Africa

Abuja, Nigeria — Nigerian authorities on Thursday placed key entry points into the country on high alert following the outbreak of the mpox virus in Africa. Authorities have also put nine Nigerian states, including the commercial hub, Lagos, and the capital, Abuja, under serious surveillance.

The Nigerian Center for Disease Control and Prevention told journalists that the action is in response to surging cases of the mpox virus in Africa and to intensify coordination to limit importation and spread of the virus.

This week, the Africa Centers for Disease Control and Prevention said it had recorded 2,863 confirmed cases of mpox, with 517 deaths, across 13 countries this year. It said there are about 17,000 suspected cases of mpox, formerly known as monkeypox, in total.

So far this year, Nigeria has recorded 39 cases of mpox, with no deaths.

Jide Idris, head of the Nigerian CDC, said it’s best to be prepared.

“We’re intensifying surveillance activities by tracking cases across Nigeria to swiftly detect and respond to any new cases,” he said. “Along this line, five designated international airports, some key seaports … land and foot crossing borders have been placed in high alert. Declaration forms have been distributed to airlines where there’s an ongoing outbreak of mpox in the last 90 days.”

The Nigerian CDC said authorities are distributing diagnostic tools to states. They also have issued a public advisory on ways to prevent the spread of the mpox virus, including limiting contact with animals such as rodents and monkeys.

“We’re also considering vaccination efforts for high-risk groups, as Nigeria expects to receive about 10,000 doses of the new vaccines that have just recently been approved for emergency use,” Idris said. “We’re also meeting with collaborative agencies like Ministry of Environment and Agriculture for support and coordination efforts.”

Authorities say a new strain of the virus, which is more deadly and more easily transmitted, is responsible for the recent spread. The strain was first discovered in the Democratic Republic of Congo and later reported in Kenya, Rwanda and Uganda, all previously unaffected nations.

On Tuesday, the Africa CDC declared mpox a public health emergency of international-continental concern.

Jean Kaseya, head of the Africa CDC, said, “This declaration is not merely a formality. It’s a clarion call to action. It’s a recognition that we can no longer afford to be reactive; we must be proactive and aggressive in our effort to contain and eliminate this threat.”

Mpox is a viral disease that causes pus-filled lesions resembling rashes to appear on the skin.

In 2022, the World Health Organization declared it an international health emergency after cases were found in more than 70 countries.

Health analysts say the new strain is worrisome and will need a coordinated international response to control it and save lives.

Mpox virus now in Pakistan, health authorities say

PESHAWAR, Pakistan — Pakistan’s health ministry has confirmed at least one case of the mpox virus in a patient who had returned from a Gulf country, it said on Friday, as provincial health authorities reported they had detected three cases.

A health ministry spokesperson said the sequencing of the confirmed case was under way, and that it would not be clear which variant of mpox the patient had until the process was complete.

A new form of the virus has triggered global concern because it seems to spread more easily though routine close contact.

Earlier on Friday, the health department in northern Khyber Pakhtunkhwa province said three cases had been detected in patients on arrival from the United Arab Emirates. It was not clear whether the patient confirmed by the central health ministry was among the three.

The World Health Organization has declared the recent outbreak of the disease as a public health emergency of international concern after the new variant of the virus was identified.

Health ministry spokesperson Sajid Shah said so far they had no confirmation of the new variant, but the sequencing of the sample of the confirmed patient was under way.

“Once that’s done, we will be able to say what strain is this,” said Shah.

Salim Khan, the director general of health services for Khyber Pakhtunkhwa, said three patients were in quarantine.

Global health officials on Thursday confirmed an infection with a new strain of the mpox virus in Sweden and linked it to a growing outbreak in Africa, the first sign of its spread outside the continent.

The WHO on Wednesday sounded its highest level of alert over the outbreak in Africa after cases in the Democratic Republic of Congo spread to nearby countries.

There have been 27,000 cases and more than 1,100 deaths, mainly among children, in Congo since the current outbreak began in January 2023.

The disease, caused by the monkeypox virus, leads to flu-like symptoms and pus-filled lesions. It is usually mild but can kill, with children, pregnant women and people with weakened immune systems, such as those with HIV, all at higher risk of complications.