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Report: Highly potent opioids now show up in drug users in Africa

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ABUJA, Nigeria — Traces of highly potent opioids known as nitazenes have for the first time been found to be consumed by people who use drugs in Africa, according to a report released Wednesday by the Global Initiative Against Transnational Organized Crime, a nonprofit organization.

Nitazenes, powerful synthetic opioids, have long been in use in Western countries as well as in Asia where they have been associated with overdose deaths. Some of them can be up to 100 times more potent than heroin and up to 10 times more potent than fentanyl, meaning that users can get an effect from a much smaller amount, putting them at increased risk of overdose and death.

The report focused on Sierra Leone and Guinea-Bissau and is based on chemical testing of kush, a derivative of cannabis mixed with synthetic drugs like fentanyl and tramadol and chemicals like formaldehyde. Researchers found that in Sierra Leone, 83% of the samples were found to contain nitazenes, while in Guinea-Bissau it was identified in 55%.

“The GI-TOC ( Global Initiative Against Transnational Organized Crime) believes that these results are the first indication that nitazenes have penetrated retail drug markets in Africa,” the report said.

Many young people in West and Central Africa have become addicted to drugs with between 5.2% and 13.5% using cannabis, the most widely used illicit substance on the continent, according to the World Health Organization.

In Sierra Leone where kush is one of the most widely consumed drugs, President Julius Maada Bio this year declared war on the substance, calling it an epidemic and a national threat.

Nitazenes have been detected repeatedly in substances sold to young people in the region such that users are most likely ingesting them “without knowing the risks they face,” Wednesday’s report said.

The authors said their findings suggest that nitazenes are being imported into Sierra Leone from elsewhere and that the substance being sold as kush in Guinea-Bissau was of similar chemical composition to that found in Freetown.

Officials in the two countries must deploy chemical testing equipment as a first step in tackling drug abuse, the report said. “Without this, it is impossible for the government of Sierra Leone, Guinea-Bissau and the wider subregion to accurately monitor the countries’ illicit drug markets and develop evidence-based responses,” it said.
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Disease, extreme weather push up orange juice prices

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MOGI GUACU, Brazil — Orange juice prices have always been volatile, falling when bumper harvests create an oversupply of oranges and rising when frost or a hurricane knocks out fruit trees.

But the record-high prices the world is seeing for OJ right now may be on the table for a while, since the diseases and extreme weather ravaging orange groves in some top-producing countries aren’t easily resolved problems.

This year’s harvest in Brazil, the world’s largest exporter of orange juice, is likely to be the worst in 36 years due to flooding and drought, according to a forecast by Fundecitrus, a citrus growers’ organization in Sao Paulo state.

“The concern isn’t just that the price of juice is going up. The concern is not having the juice,” Oscar Simonetti, an orange farmer in Mogi Guacu, Brazil, said.

In the U.S., Florida’s already diminished orange production fell 62% in the 2022-23 season after Hurricane Ian further battered a crop that was struggling due to an invasive pest. Drought also cut Spain’s orange production last year.

Scarce supplies have sent prices soaring. In the U.S., a 12-ounce can of frozen orange juice concentrate cost an average of $4.27 in April, 42% more than during the same month a year earlier, according to government figures.

In the United Kingdom, where the British Fruit Juice Association says supplies are at 50-year lows, the price of fresh orange juice rose 25% over the past year, according to consumer research company Nielsen.

Those price increases are turning off inflation-weary consumers. Orange juice consumption has fallen 15% to 25% in major global markets — including the U.S. and the European Union — over the last year, according to Rabobank, a Dutch bank that focuses on food and agriculture.

Jonna Parker, a principal for fresh food client insights at market research company Circana, said consumers are increasingly getting their morning fruit intake from energy drinks, smoothies and other beverages besides orange juice.

“The price gets high and people consider other alternatives,” she said.

Global orange juice consumption was already declining before the current price hikes due to competition from other drinks and public concern about the amount of sugar in fruit juices. If that trend continues, it should help balance supply with demand and keep prices from rising much further, Rabobank said. But it expects limited supplies will keep prices elevated for some time.

In some markets, orange juice is disappearing from shelves altogether.

Late last year, McDonald’s in Australia removed orange juice from its menu in favor of an “orange fruit drink” that contains 35% orange juice. The company cited short supplies.

Tokyo-based Morinaga Milk Industry Co. expects to stop shipping its Sunkist brand orange juice – which uses juice from Brazil – by the end of June because of low juice supplies from Brazil, a company spokeswoman said. In April 2023, Megmilk Snow Brand Co., based in the northern Japanese city of Sapporo, stopped shipments of 1-liter and 450-milliliter packs of orange juice, which it sells under an agreement with Dole. Sales haven’t yet resumed.

Some companies are considering using alternatives to oranges in their products. Coldpress, a British juice company, introduced a mandarin juice product in February, citing the high price of regular juicing oranges.

But others are tight-lipped about their plans. Several major orange juice makers – including Dole, Tropicana, Florida’s Natural, Uncle Matt’s and Coca-Cola, which makes the Simply and Minute Maid brands – declined to comment or failed to respond to inquires from The Associated Press.

The roots of the current supply troubles stretch back decades. In 2005, an invasive bug called the Asian citrus psyllid arrived in Florida, injecting bacteria from its saliva into the state’s orange trees. The bacteria slowly kills the tree by destroying its root systems. There’s no known cure once a tree is infected.

The impact has been devastating. In 2004, before the disease – called citrus greening – hit Florida, the state produced 200 million boxes of oranges. This year, it will produce less than 20 million.

Michael Rogers, a professor of entomology and the director of the University of Florida’s Citrus Research and Education Center, said no type of orange tree is totally resistant to greening, but scientists have been trying to breed trees that are more tolerant of it.

Citrus greening arrived in Brazil around the same time as Florida, but it has progressed more slowly there because Brazil has much larger orange groves. Bugs spread the disease by flying from tree to tree, Rogers said.

Still, the disease is spreading. Fundecitrus estimates that 38% of Brazil’s orange trees had citrus greening in 2023. Simonetti, the orange farmer, estimates that 20% of his production is affected by greening. Oranges on affected trees don’t ripen properly and fall off early, affecting the quality of their juice, he said.

Shifting production to other locations isn’t necessarily an option. California grows oranges, for example, and the citrus psyllid doesn’t fare as well in the state’s climate. But California also doesn’t get the rainfall needed for juicing oranges; its oranges are usually sold for eating, Rogers said.

Another issue impacting orange harvests is extreme weather, which is becoming more common as the world warms due to climate change.

Last year, nine heat waves swept across Brazil, resulting in lower output and poorer fruit quality. This year, the impacts of El Niño have been particularly dramatic, with a historic drought in the Amazon and devastating floods in the southern state of Rio Grande do Sul.

“The temperatures are high during the day. At night the temperature drops. The plant can’t stand this temperature difference,” Simonetti said.

Brazil’s 2024-25 harvest is expected to yield 232 million boxes of oranges, down 24% from the prior year.

“We have never seen a harvest like this,” Vinícius Trombin, the coordinator of Fundecitrus’ crop estimates survey, said.

To make up for the anticipated smaller yield, some producers are considering blending oranges with tangerines to make juice, Trombin said. But he’s skeptical.

“The consumer wants an orange juice made up 100% out of oranges,” he said.

Parker, of Circana, isn’t so sure. She thinks blends with other fruits might help hold down costs and revive consumer interest in orange juice.

“The idea of multiple flavors is very popular and is a way to stand out,” she said. “You’ve got to keep people engaged. Once you lose that interest, it’s really hard to get people back.”
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Contraception, in-vitro fertilization become key campaign issue

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The debate over the right to an abortion has divided U.S. politics for decades. But two years after the Supreme Court overturned Roe v. Wade, sending that decision back to the states, a new front has opened — the debate over birth control. VOA Congressional Correspondent Katherine Gypson reports on the election-year battle over contraception and in-vitro fertilization.
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Astronaut health and a VIP tour of Boeing’s Starliner capsule

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New studies examine the effects of spaceflight on amateur astronauts. Plus, a VIP tour of Boeing’s Starliner capsule, and we remember a spaceflight pioneer. VOA’s Arash Arabasadi brings us The Week in Space.
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US Federal Reserve sees inflation progress but envisions only one rate cut this year

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washington — Federal Reserve officials said Wednesday that inflation has fallen further toward their target level in recent months but signaled they expect to cut their benchmark interest rate just once this year. 

The policymakers’ forecast for one rate cut was down from a previous forecast of three, because inflation, despite having cooled in the past two months, remains persistently elevated. 

In a statement issued after its two-day meeting, the Fed said the economy is growing at a solid pace, while hiring has “remained strong.” The officials also noted that in recent months there has been “modest” further progress toward their 2% inflation target. That is a more positive assessment than after the Fed’s previous meeting May 1, when the officials had noted a lack of progress. 

Still, the central bank made clear Wednesday that further improvement is needed. 

“We’ll need to see more good data to bolster our confidence that inflation is moving sustainably toward 2%,” Chair Jerome Powell said at a news conference after the Fed meeting ended. 

As expected, the policymakers kept their key rate unchanged at roughly 5.3%. The benchmark rate has remained at that level since July of last year, after the Fed raised it 11 times to try to slow borrowing and spending and cool inflation. Fed rate cuts would, over time, lighten loan costs for consumers, who have faced punishingly high rates for mortgages, auto loans, credit cards and other forms of borrowing. 

The officials’ rate-cut forecast reflects the individual estimates of 19 policymakers. The Fed said eight of the officials projected two rate cuts. Seven projected one cut. Four of the policymakers envisioned no cuts at all this year. 

“What everyone agrees on,” Powell said at his news conference, is that the Fed’s timetable for rate cuts is “going to be data dependent.” 

The Fed’s latest projections are by no means fixed. The policymakers frequently revise their plans for rate cuts — or hikes — depending on how economic growth and inflation evolve over time. 

On Wednesday morning, the government reported that inflation eased in May for a second straight month, a hopeful sign that an acceleration of prices that occurred early this year may have passed. Consumer prices excluding volatile food and energy costs — the closely watched “core” index — rose just 0.2% from April, the smallest rise since October. Measured from a year earlier, core prices climbed 3.4%, the mildest pace in three years. 

“We welcome today’s reading and hope for more like that,” Powell said. 

Though inflation has tumbled from a peak of 9.1% two years ago, it remains too high for the Fed’s liking. The policymakers now face the delicate task of keeping rates high enough to slow spending and defeat high inflation without derailing the economy. 
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World Bank: Inflation, poverty keep climbing in war-torn Myanmar

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Bangkok — Myanmar’s economy shows no signs of recovering from the 2021 military coup, as civil war drives more workers abroad, pushes inflation into triple digits in some parts of the country and pulls it deeper into poverty, a new World Bank report says.

“Livelihoods Under Threat,” launched Wednesday in Myanmar, says the economy shuffled along over the past year with gross domestic product growing at a meager 1%. The same is expected for next year.

While staving off recession, slow growth still leaves Myanmar’s once-booming economy 10% smaller than it was before the country’s military ousted the democratically elected government more than three years ago.

Resistance groups have made major battlefield gains against the junta since late last year and are believed to control more than half the country, including some key border trade routes.

“The overall storyline is that the economy remains weak and fragile overall. Operating conditions for businesses of all sizes and all sectors remain very difficult,” World Bank senior economist Kim Edwards said at the report’s launch.

The bank says overall inflation rose some 30% in the year leading up to September 2023, and even more in areas where fighting has been fiercest.

“You can see in the conflict-affected states and regions — Kayin, Kachin, Sagaing, northern Shan, Kayah — price rises of 40 to 50%,” Edwards said.

“And then in Rakhine, where … there’s been particular problems and increasing conflict recently, we’ve seen price rises of 200% over the year. So, very substantial. And obviously, it has very significant effects for food insecurity,” he said.

The United Nations’ World Food Program says food insecurity now plagues a quarter of Myanmar’s 55 million people, especially the more than 3 million displaced by the fighting.

In Wednesday’s report, the World Bank also estimates that nearly one-third of the population now lives in poverty.

“And we see the depth and severity of poverty. So, this is really a measure of how poor people in poverty actually are — worsening also in 2023, meaning that poverty is more entrenched than at any time in the last six years,” Edwards said.

The bank says much of the inflation is being driven by the steady depreciation of the currency, the kyat. While the official exchange rate remains stuck at 2,100 to the U.S. dollar, trading of the kyat on the black market soared past 4,500 to the dollar in May.

The junta has imposed several controls to conserve its dwindling foreign currency reserves. Last month, it urged companies doing business abroad to barter with their trade partners and settle bills with their wares instead of cash.

At the same time, the bank says border trade — a major source of tax revenue for the regime — is being hit hard by the gains the resistance has been making along Myanmar’s frontiers with China, India and Thailand. It says imports and exports by land fell 50% and 44% respectively, in the past six months.

The junta has leaned heavily on oil and gas revenue, but with little investment for exploration of new reserves, those exports are likely to start falling in the coming years, as well, Edwards said.

More of what the junta does earn is going to the military at the expense of other basic services. According to the report, defense spending hit 17% of the national budget in the fiscal year that ended in March, nearly twice what was spent on health and education combined.

Encouraging news

The World Bank says manufacturing and agriculture output in Myanmar have started to pick up, and a combination of cheaper fertilizer and higher crop prices could keep the farming sector growing.

Traders stymied by blocked border gates also seem to be shifting some of their traffic to new routes on land and sea.

“There are some signs of life,” Edwards said. “And these really speak to the adaptability of many of Myanmar’s businesses and their ability to cope with what, under any objective circumstances, are very difficult business constraints and conditions.”

Even so, Edwards said, “The near-term outlook remains quite weak, with the economy failing to recover from its recent, very sharp contraction.”

Htwe Htwe Thein, an associate professor at Australia’s Curtin University who has been studying Myanmar’s business and economic development for two decades, said she could not recall a worse time for Myanmar’s economy.

“The state of the economy has never been this low in terms of prospects, in terms of … the trajectory,” she told VOA.

“The only people who are doing well … is a very, very small percentage at the top who are working with the junta,” she said. “Everybody else is suffering severely.”

Amid the fierce inflation, falling wages and dwindling job prospects, Thein said, the young are losing hope and grasping at any opportunity to work or study abroad.

She added that the junta’s efforts to shore up the economy have been ad hoc and short-sighted, and that rebuilding will take years and can only be achieved if and when the junta is out of power.
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Kenyan group uses old ATMs to dispense free sanitary pads to students

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A public-private partnership in Kenya provides female students with free sanitary napkins dispensed from converted ATMs at school. The goal is to provide pads to young women from poor families so they don’t miss school because they are menstruating. Victoria Amunga reports from Nairobi, Kenya.
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US inflation cooled in May in sign that price pressures may be easing 

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WASHINGTON — Inflation in the United States eased in May for a second straight month, a hopeful sign that a pickup in prices that occurred early this year may have passed. The trend, if it holds, could move the Federal Reserve closer to cutting its benchmark interest rate from its 23-year peak.

Consumer prices excluding volatile food and energy costs — the closely watched “core” index — rose 0.2% from April to May, the government said Wednesday. That was down from 0.3% the previous month and was the smallest increase since October. Measured from a year earlier, core prices rose 3.4%, below last month’s 3.6% increase.

Fed officials are scrutinizing each month’s inflation data to assess their progress in their fight against rising prices. Even as overall inflation moderates, such necessities as groceries, rent and health care are much pricier than they were three years ago — a continuing source of public discontent and a political threat to President Joe Biden’s re-election bid. Most other measures suggest that the economy is healthy: Unemployment remains low, hiring is robust and consumers are traveling, eating out and spending on entertainment.

Overall inflation also slowed last month, with consumer prices unchanged from April to May, in part because of sharp falls in the cost of gasoline, air fares and new cars. Measured from a year earlier, consumer prices rose 3.3%, less than the 3.6% increase a month earlier.

The cost of auto insurance, which has soared in recent months, actually dipped from April to May, though it’s still up more than 20% from a year earlier. Grocery prices were unchanged last month, after declining slightly in April. They’re now up just 1% on a year-over-year basis.

The Fed has kept its key rate unchanged for nearly a year after having rapidly raised it in 2022 and 2023 to fight the worst bout of inflation in four decades. Those higher rates have led, in turn, to more expensive mortgages, auto loans, credit cards and other forms of consumer and business borrowing. Though inflation is now far below its peak of 9.1% in mid-2022, it remains above the Fed’s target level.

Persistently elevated inflation has posed a vexing challenge for the Fed, which raises interest rates — or keeps them high — to try to slow borrowing and spending, cool the economy and ease the pace of price increases.

The longer the Fed keeps borrowing costs high, the more it risks weakening the economy too much and causing a recession. Yet if it cuts rates too soon, it risks reigniting inflation. Most of the policymakers have said they think their rate policies are slowing growth and should curb inflation over time.

Inflation had fallen steadily in the second half of last year, raising hopes that the Fed could pull off a “soft landing,” whereby it manages to conquer inflation through higher interest rates without causing a recession. Such an outcome is difficult and rare.

But inflation came in unexpectedly high in the first three months of this year, delaying hoped-for Fed rate cuts and possibly imperiling a soft landing.

In early May, Chair Jerome Powell said the central bank needed more confidence that inflation was returning to its target before it would reduce its benchmark rate. Several Fed officials have said in recent weeks that they needed to see several consecutive months of lower inflation.

Some signs suggest that inflation will continue to cool in the coming months. Americans, particularly lower-income households, are pulling back on their spending. In response, several major retail and restaurant chains, including Walmart, Target, Walgreen’s, McDonald’s and Burger King, have responded by announcing price cuts or deals.
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Despite war, surrogacy in Ukraine keeps flourishing

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Before Russia’s invasion, Ukraine was an international surrogacy hub. Relatively low cost and a favorable legal framework led to thousands of babies born every year thanks to Ukrainian surrogate mothers, many of them for overseas parents. Despite the war and the risks, hopeful foreigners keep coming to Ukraine. Mariia Prus has the story.
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EU moves to hike tariffs on Chinese electric car imports, escalating trade spat 

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BRUSSELS — The European Union moved Wednesday to hike tariffs on Chinese electric vehicles, escalating a trade dispute over Beijing’s subsidies for the exports that Brussels worries is hurting domestic automakers.

The European Commission, the EU’s executive arm, said it would impose provisional tariffs that would result in Chinese automakers facing additional duties of as much as 38%, up from the current level of 10%.

The commission said it reached out to Chinese authorities to discuss the findings of its investigation into the subsidies and “explore possible ways to resolve the issues.”

“Should discussions with Chinese authorities not lead to an effective solution,” the new rates would take effect on a provisional basis by July 4, the commission said in a press release.

Electric cars are the latest flash point in a broader trade dispute over what Brussels says is China’s unfair state support for green tech exports that also include solar panels, batteries and wind turbines.

Imports of Chinese-made EVs to the European Union have skyrocketed in recent years. They include vehicles from Western brands that have auto plants in China, including Tesla and BMW.

But EU officials complain that Chinese automakers like BYD and SAIC are increasing market share and undercutting European car brands on price thanks to Beijing’s massive subsidies.

The commission said an investigation it opened last year into China’s EV subsidies found that China’s battery electric vehicle value chain “benefits from unfair subsidization, which is causing a threat of economic injury to EU BEV producers.”

The extra tariffs would vary by company. BYD would face an additional 17.4% charge. Geely, which owns Sweden’s Volvo, would be hit with a further 20%. For SAIC, it would be 38.1% extra.

Chinese Foreign Ministry spokesperson Lin Jian, speaking at a daily briefing, blasted the EU’s investigation as “typical protectionism” and said Beijing would “take all measures necessary to protect our legitimate rights and interests.”

U.S. President Joe Biden slapped major new tariffs on Chinese electric vehicles, advanced batteries, solar cells, steel, aluminum and medical equipment last month. Biden said that Chinese government subsidies ensure the nation’s companies don’t have to turn a profit, giving them an unfair advantage in global trade.
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Australian-led study issues food security warning over plant breeding skills shortage

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Sydney — Australia’s national science agency warns a lack of scientists specialized in plant breeding could lead to ‘dire’ food security implications around the world. Researchers say plant breeding is a critical science that underpins the global production of food, animal feed and fuel. The finding is among the conclusions of a recently published paper by researchers from Australia, New Zealand and Canada.      

A joint paper published earlier this month by the Commonwealth Scientific and Industrial Research Organization, in collaboration with Lincoln University in New Zealand and McGill University in Canada, warns that highly-skilled plant breeding experts, who are reaching the end of their careers, are not being replaced by sufficient numbers of university graduates, many of whom are choosing other areas of plant science including molecular biology.

Lucy Egan is the study’s lead author and a CSIRO research scientist.  She told VOA Wednesday that new recruits are needed.

“It is really based on developing new plant varieties for future climates.  So, plant breeding is a slow game.  It takes a long time to develop a new crop variety, so you’re looking at least ten years on average to develop a new variety.  When you have a lack of plant breeders coming through to replace the generation that are retiring, it does generate a bit of concern around the succession plan,” she said.

The report said that the implications of a skills shortage “could be dire” and that global food security could be affected. It recommends establishing “dedicated training facilities in different countries”.  

Egan said that plant breeding can help countries adapt to a warming climate.

“I think instead of focusing on, you know, certain countries and the implications, I think if you look at it on a global level plant breeding is really the backbone of the agricultural sector.  Without the development of new varieties with changing climates and all these things that are sort of happening across the world, we need to really build strength and resilience within the agricultural sector and plant breeding is really key to do that,” she said.

The research is published in the journal, Crop Science.  It reports that since the 1960s, global crop production has increased by more than 250%, which is due in large part to plant breeding science.
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Australia locks down farms as avian influenza spreads

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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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Alzheimer’s drug that slows disease gets backing from FDA advisers

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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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US reconstructive surgeons step up to help Ukrainian counterparts

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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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G7 to warn small Chinese banks over Russia ties, sources say

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Washington — U.S. officials expect the Group of Seven (G7) wealthy democracies to send a tough new warning next week to smaller Chinese banks to stop assisting Russia in evading Western sanctions, according to two people familiar with the matter.

Leaders gathering at the June 13-15 summit in Italy hosted by Prime Minister Giorgia Meloni are expected to focus heavily during their private meetings on the threat posed by burgeoning Chinese-Russian trade to the fight in Ukraine, and what to do about it.

Those conversations are likely to result in public statements on the issue involving Chinese banks, according to a U.S. official involved in planning the event and another person briefed on the issue.

The United States and its G7 partners — Britain, Canada France, Germany, Italy and Japan — are not expected to take any immediate punitive action against any banks during the summit, such as restricting their access to the SWIFT messaging system or cutting off access to the dollar. Their focus is said to be on smaller institutions, not the largest Chinese banks, one of the people said.

Negotiations were still ongoing about the exact format and content of the warning, according to the people, who declined to be named discussing ongoing diplomatic engagements. The plans to address the topic at the G7 were not previously reported.

The White House did not respond to a request for comment. The U.S. Treasury Department had no immediate comment, but Treasury officials have repeatedly warned financial institutions in Europe and China and elsewhere that they face sanctions for helping Russia skirt Western sanctions.

Daleep Singh, deputy national security adviser for international economics, told the Center for a New American Security this week that he expected G7 leaders to target China’s support for a Russian economy now reoriented around the war.

“Our concern is that China is increasingly the factory of the Russian war machine. You can call it the arsenal of autocracy when you consider Russia’s military ambitions threaten obviously the existence of Ukraine, but increasingly European security, NATO and transatlantic security,” he said.

Singh and other top Biden administration officials say Washington and its partners are prepared to use sanctions and tighter export controls to reduce Russia’s ability to circumvent Western sanctions, including with secondary sanctions that could be used against banks and other financial institutions.

Washington is poised to announce significant new sanctions next week on financial and nonfinancial targets, a source familiar with the plans said.

This year’s G7 summit is also expected to focus on leveraging profits generated by Russian assets frozen in the West for Ukraine’s benefit.

Russia business moves to China’s small banks

Washington has so far been reluctant to implement sanctions on major Chinese banks – long deemed by analysts as a “nuclear” option – because of the huge ripple effects it could inflict on the global economy and U.S.-China relations.

Concern over the possibility of sanctions has already caused China’s big banks to throttle payments for cross-border transactions involving Russians, or pull back from any involvement altogether, Reuters has reported.

That has pushed Chinese companies to small banks on the border and stoked the use of underground financing channels or banned cryptocurrency. Western officials are concerned that some Chinese financial institutions are still facilitating trade in goods with dual civilian and military applications.

Beijing has accused Washington of making baseless claims about what it says are normal trade exchanges with Moscow.

The Biden administration this year began probing which sanctions tools might be available to it to thwart Chinese banks, a U.S. official previously told Reuters, but had no imminent plans to take such steps. In December, President Joe Biden signed an executive order threatening sanctions on financial institutions that help Moscow skirt Western sanctions.

The U.S. has sanctioned smaller Chinese banks in the past, such as the Bank of Kunlun, over various issues, including working with Iranian institutions.

China and Russia have fostered more trade in yuan instead of the dollar in the wake of the Ukraine war, potentially shielding their economies from possible U.S. sanctions.
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