Tuberculosis remains a critical public health issue in many countries and is a leading cause of death in South Africa. Over the past six years, the BEAT Tuberculosis study, conducted in South Africa and focused on children and pregnant women, has revealed a promising new oral treatment that could mark a significant breakthrough in the fight against drug-resistant TB. Zaheer Cassim reports.
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new york — Get ready for a partial lunar eclipse and supermoon, all rolled into one. 

The spectacle will be visible in clear skies across North America and South America Tuesday night and in Africa and Europe Wednesday morning. 

A partial lunar eclipse happens when the Earth passes between the sun and moon, casting a shadow that darkens a sliver of the moon and appears to take a bite out of it. 

Since the moon will inch closer to Earth than usual, it’ll appear a bit larger in the sky. The supermoon is one of three remaining this year. 

“A little bit of the sun’s light is being blocked so the moon will be slightly dimmer,” said Valerie Rapson, an astronomer at the State University of New York at Oneonta. 

The Earth, moon and sun line up to produce a solar or lunar eclipse anywhere from four to seven times a year, according to NASA. This lunar eclipse is the second and final of the year after a slight darkening in March. 

In April, a total solar eclipse plunged select cities into darkness across North America. 

No special eye protection is needed to view a lunar eclipse. Viewers can stare at the moon with the naked eye or opt for binoculars and telescopes to get a closer look. 

To spot the moon’s subtle shrinkage over time, hang outside for a few hours or take multiple peeks over the course of the evening, said KaChun Yu, curator at the Denver Museum of Nature and Science. 

“From one minute to the next, you might not see much happening,” said Yu. 

For a more striking lunar sight, skywatchers can set their calendars for March 13. The moon will be totally eclipsed by the Earth’s shadow and will be painted red by stray bits of sunlight filtering through Earth’s atmosphere. 
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Chinhoyi, Zimbabwe — Zimbabwe’s government has given in to pressure from rights groups and is now providing free treatment to women with obstetric fistula, a condition that makes it hard for mothers who went through difficult labor to control their bowels. For a closer look, VOA visited Chinhoyi, a farming and mining area about 150 kilometers west of Harare, where early marriages are common, and where the treatment is being offered.

Among the first beneficiaries of the treatment were young women at Chinhoyi Provincial Hospital after government gynecologists had performed surgery to address their cases of obstetric fistula. Twenty-three-year old Chiedza, not her real name as she requested that VOA protect her identity, was visibly happy as she had not been able to control her bowels since giving birth to her son seven years ago.

“When I gave birth I tore my private parts, so I couldn’t hold my feces,” she said. “It would just come out on its own. I would just feel something on my body flowing. I stayed like that because I did not have money to seek services of gynecologists to correct my condition. So, when I heard about this free service on a WhatsApp group for women, I called a toll-free number which was there and I came here. So I am now going to live a comfortable life. I can now perform even house chores comfortably.”

Another woman who asked to be called Tendai ruptured her bladder after protracted labor at home while giving birth at the age of 16.

“I would share nappies with my baby so as to block my smell from others,” she said. “At one time I almost committed suicide because people kept on laughing at my condition. I thought I had been bewitched till I came here and saw that there are some people in my condition. I am grateful for this procedure for it has given me hope.”

The World Health Organization estimates that between 50,000 and 100,000 women experience obstetric fistula every year and that about 2 million women in sub-Saharan Africa are living with the condition.  

Dr. Stanley Ngwaru, a senior gynecologist in Zimbabwe’s ministry of health, says the condition is an abnormal communication between the woman’s genital tract and the urinary tract or the rectum.

“They suffer shame and they suffer social segregation,” he said. “It’s very common in young women, because the genital tract is not well developed and when they go into labor, they are more likely to suffer from obstruction and this can lead to these communications are developing between the genital tract and the unit tract and the rectum.”

Lucia Masuka, head of Amnesty International in Zimbabwe, says she commends the government for offering the free service. However, she believes authorities needs to develop a strategy to help prevent this condition from afflicting young women in the first place.

“If we therefore facilitate access to sexual reproductive health services for this group, it will reduce instances of early pregnancies, and in turn, reduce cases of obstetrics fistula,” she said. “Whilst treatment is a positive development, it’s akin to trying to mop water from an open tap; you will never really be able to mop that water as long as the tap is open.”

Amnesty International in Zimbabwe last year pleaded with parliament to push the government to make obstetric fistula treatment a national issue after its research had revealed that the condition was rampant among young women in Zimbabwe and was not getting enough attention.
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LONDON — Less than two months ahead of the COP29 United Nations Climate Summit, the Azerbaijani leadership laid out its plans on Tuesday for what it hoped to achieve, as countries continue to wrestle with how to raise ambitions for a new financing target.

The main task for the November summit is for countries to agree on a new annual target for funding that wealthy countries will pay to help poorer nations cope with climate change. Many developing countries say they cannot upgrade their targets to cut emissions faster without first receiving more financial support to invest in doing this.

With countries remaining far from agreement on the financing goal, the COP29 presidency this week outlined more than a dozen side initiatives that could raise ambitions, but do not require party negotiation and building consensus which can hamper progress. These take the form of new funds, pledges, and declarations that national governments can adopt.

Notably, this includes a fund with voluntary contributions from fossil fuel producing countries and companies for the public and private sectors working on climate issues, as well as grants that can be doled out to assist with climate-fueled natural disasters in developing countries.

Such side agendas use “the convening power of COP and the hosts’ respective national capabilities to form coalitions and drive progress,” said Mukhtar Babayev, who holds the rotating COP presidency, in a letter to all parties and stakeholders.

Over 120 countries pledged at last year’s COP28 summit in Dubai, for example, to triple renewable energy capacity by 2030.

The COP29 presidency also hopes to build support around a pledge to increase global energy storage capacity six times above 2022 levels, reaching 1,500 gigawatts by 2030. This would include a commitment to scale up investments in energy grids, adding or refurbishing more than 80 million km by 2040.

Babayev, who is Azerbaijan’s minister of ecology and natural resources, said the agenda would “help to enhance ambition by bringing stakeholders together around common principles and goals.”

“We hope to address some of the most pressing issues while also highlighting remaining priorities,” he said.

Another declaration would see countries and companies create a global market for clean hydrogen, addressing regulatory, technological, financing and standardization barriers.

COP29 leaders have also appealed for a “COP Truce” that would highlight the importance of peace and climate action.

Despite countries’ existing climate commitments, carbon dioxide emissions from burning fossil fuels hit a record high last year, and the world just registered its hottest summer on record as temperatures climb.
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LONDON — Malnutrition is the world’s worst child health crisis and climate change will only make things more severe, according to Microsoft-co-founder turned philanthropist Bill Gates.

Between now and 2050, 40 million more children will have stunted growth and 28 million more will suffer from wasting, the most extreme and irreversible forms of malnutrition, as a result of climate change, the Bill & Melinda Gates Foundation said in a report on Tuesday.

“Unless you get the right food, broadly, both in utero and in your early years, you can never catch up,” Gates told Reuters in an online interview last week, referring to a child’s physical and mental capacity, both of which are held back by a lack of good nutrition. Children without enough of the right food are also more vulnerable to diseases like measles and malaria, and early death.

“Around 90% of the negative effect of climate change works through the food system. Where you have years where your crops basically fail because of drought or too much rain,” he said.

Gates was speaking ahead of the publication of the Bill and Melinda Gates Foundation’s annual Goalkeepers report, which tracks progress on the United Nations Sustainable Development Goals (SDGs), around reducing poverty and improving health. The report includes the projections above.

In 2023, the World Health Organization estimated that 148 million children experienced stunting and 45 million experienced wasting.

Gates called for more funding for nutrition, particularly through a new platform led by UNICEF aiming to co-ordinate donor financing, the Child Nutrition Fund, as well as more research. But he said the money should not be taken away from other proven initiatives, like routine childhood vaccinations, for this purpose.

“(Nutrition) was under-researched … it’s eye-opening how important this is,” he added, saying initiatives like food fortification or improving access to prenatal multi-vitamins could be as effective as some vaccines in improving child health in the world’s poorest countries.

The Gates Foundation said in January it plans to spend more on global health this year than ever before – $6.8 billion – as wider funding efforts stall.
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Authorities in Nairobi are trying to tackle the Kenyan capital’s chronic and worsening air pollution. With help from the U.S. Agency for International Development, authorities are placing sensors that can monitor air quality around the densely populated city. Victoria Amunga reports from Nairobi. Camera: Jimmy Makhulo
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CAPE CANAVERAL, Florida — A billionaire spacewalker returned to Earth with his crew on Sunday, ending a five-day trip that lifted them higher than anyone has traveled since NASA’s moonwalkers.

SpaceX’s capsule splashed down in the Gulf of Mexico near Florida’s Dry Tortugas in the predawn darkness, carrying tech entrepreneur Jared Isaacman, two SpaceX engineers and a former Air Force Thunderbird pilot.

They pulled off the first private spacewalk while orbiting nearly 740 kilometers above Earth, higher than the International Space Station and Hubble Space Telescope. Their spacecraft hit a peak altitude of 1,408 kilometers following Tuesday’s liftoff.

Isaacman became only the 264th person to perform a spacewalk since the former Soviet Union scored the first in 1965, and SpaceX’s Sarah Gillis the 265th. Until now, all spacewalks were done by professional astronauts.

“We are mission complete,” Isaacman radioed as the capsule bobbed in the water, awaiting the recovery team. Within an hour, all four were out of their spacecraft, pumping their fists with joy as they emerged onto the ship’s deck.

It was the first time SpaceX aimed for a splashdown near the Dry Tortugas, a cluster of islands 113 kilometers west of Key West. To celebrate the new location, SpaceX employees brought a big, green turtle balloon to Mission Control at company headquarters in Hawthorne, California. The company usually targets closer to the Florida coast, but two weeks of poor weather forecasts prompted SpaceX to look elsewhere.

During Thursday’s commercial spacewalk, the Dragon capsule’s hatch was open barely a half-hour. Isaacman emerged only up to his waist to briefly test SpaceX’s brand-new spacesuit followed by Gillis, who was knee-high as she flexed her arms and legs for several minutes. Gillis, a classically trained violinist, also held a performance in orbit earlier in the week.

The spacewalk lasted less than two hours, considerably shorter than those at the International Space Station. Most of that time was needed to depressurize the entire capsule and then restore the cabin air. Even SpaceX’s Anna Menon and Scott “Kidd” Poteet, who remained strapped in, wore spacesuits.

SpaceX considers the brief exercise a starting point to test spacesuit technology for future, longer missions to Mars.

This was Isaacman’s second chartered flight with SpaceX, with two more still ahead under his personally financed space exploration program named Polaris after the North Star. He paid an undisclosed sum for his first spaceflight in 2021, taking along contest winners and a pediatric cancer survivor while raising more than $250 million for St. Jude Children’s Research Hospital.

For the just completed so-called Polaris Dawn mission, the founder and CEO of the Shift4 credit card-processing company shared the cost with SpaceX. Isaacman won’t divulge how much he spent. 
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JOHANNESBURG — Thethiwe Mahlangu woke early on a chilly morning and walked through her busy South African township, where minibuses hooted to pick up commuters and smoke from sidewalk breakfast stalls hung in the air.

Her eyes had been troubling her. But instead of going to her nearby health clinic, Mahlangu was headed to the train station for an unusual form of care.

A passenger train known as Phelophepa — or “good, clean, health” in the Sesotho language — had been transformed into a mobile health facility. It circulates throughout South Africa for much of the year, providing medical attention to the sick, young and old who often struggle to receive the care they need at crowded local clinics.

For the past 30 years — ever since South Africa’s break with the former racist system of apartheid — the train has carried doctors, nurses and optometrists on an annual journey that touches even the most rural villages, delivering primary health care to about 375,000 people a year.

The free care it delivers is in contrast to South Africa’s overstretched public health care system on which about 84% of people rely.

Health care reflects the deep inequality of the country at large. Just 16% of South Africans are covered by health insurance plans that are beyond the financial reach of many in a nation with unemployment of over 32%.

Earlier this year, the government began to address that gap. President Cyril Ramaphosa in May signed into law the National Health Insurance Act, which aims to provide funding so that millions of South Africans without health insurance can receive care from the better-provisioned private sector.

But the law has been divisive. The government has not said how much it will cost and where the money will come from. Economists say the government will have to raise taxes. Critics say the country can’t afford it and warn that the system — yet to be implemented — will be open to abuse by corrupt officials and businessmen. They say the government should fix the public health care system instead.

For Mahlangu and others who look to the train for a rare source of free treatment, the situation at local health clinics is one of despair.

Long lines, shortages of medicines and rude nurses are some of the challenges at the clinics that cater for thousands of patients a day in Tembisa, east of Johannesburg.

“There we are not treated well,” Mahlangu said. “We are made to sit in the sun for long periods. You can sit there from 7 a.m. until around 4 p.m. when the clinic closes. When you ask, they say we must go ask the president to build us a bigger hospital.”

The health train has grown from a single three-carriage operation over the years to two 16-carriage trains. They are run by the Transnet Foundation, a social responsibility arm of Transnet, the state-owned railway company.

When the train began in 1994, many Black people in South Africa still lived in rural villages with little access to health facilities. It was a period of change in the country. The train began as an eye clinic, but it soon became clear that needs were greater than that.

Now both trains address the booming population of South Africa’s capital of Pretoria and nearby Johannesburg, the country’s economic hub. One would spend two weeks in Tembisa alone.

“The major metros are really struggling,” said Shemona Kendiah, the train’s manager.

But the traveling clinic is far from the solution to South Africa’s health care problems.

Public health expert Alex van den Heever said there have been substantial increases in the health care budget and the public sector employment of nurses and doctors since the country’s first democratic government in 1994. The health department’s budget in Gauteng province, which includes Pretoria and Johannesburg, has grown from 6 billion rand ($336 million) in 2000 to 65 billion ($3.6 billion) rand now.

But van den Heever accused the African National Congress, the ruling party since the end of apartheid, of allowing widespread corruption to undermine the public sector, including the health care system.

“This has led to a rapid deterioration of performance,” he said.

For South Africans who have witnessed the decline firsthand, it can be a relief when the health train pulls into town.

Mahlangu — with her new pair of glasses — was among hundreds who walked away satisfied with its services and already longing for the train’s return next year.

Another patient, Jane Mabuza, got a full health checkup along with dental services. She said she hoped the train would reach many other people.

“Here on the train, you never hear that anything has been finished,” she said.
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Geneva, Switzerland — Limited capacity is keeping mpox testing coverage low in the DR Congo — the epicenter of the international emergency — the World Health Organization said Saturday in its latest situation report. 

“Testing coverage in the Democratic Republic of the Congo remains low, due to limited testing capacity,” the United Nations health agency said in its update. 

It said the mpox case fatality ratio in the DRC in 2024 was 0.5% among confirmed cases — or 25 deaths from 5,160 cases — and 3.3% among suspected cases, both tested and untested — or 717 deaths among 21,835 cases. 

“Due to limited access to laboratory testing in remote areas, only about 40% of all suspected cases have been tested in 2024 (up from 9% in 2023), and among these, around 55% tested positive,” the WHO said. 

It said the three countries reporting the most suspected cases in the year up to September 8 were the DRC, followed by Burundi (1,489 suspected cases, no deaths), and Nigeria (935 suspected cases, no deaths). 

There are two clades of mpox, each with a and b subclades. 

The WHO said the clades and their subclades were circulating in different geographic areas and were affecting different populations — and therefore needed “tailored and locally adapted outbreak responses.” 

The WHO declared an international emergency over mpox on August 14, concerned by the surge in cases of the new Clade 1b strain in the DRC that spread to nearby countries. 

In the DRC, Clade 1b has been detected chiefly in the eastern South Kivu and North Kivu provinces, with additional cases in the Kinshasa capital province. 

Current sequencing capacity in the DRC “is limited, and clade distribution might be broader than what is currently known” the WHO said. 

Clade 1b has also been detected in the DRC’s eastern neighbors Burundi, Rwanda and Uganda, plus Kenya. Additionally, a single case has been detected in Sweden and another in Thailand. 

Looking at global vaccine availability, the WHO said more than 3.6 million doses had been pledged for the global response, including more than 620,000 doses of the MVA-BN vaccine by European countries, the United States and manufacturer Bavarian Nordic. 

Meanwhile Japan has pledged 3 million doses of the LC16 vaccine. 

To date, 265,000 MVA-BN doses have been delivered to Kinshasa, while 10,000 have gone to Nigeria. 
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brasilia — In a visit to see the damage caused by drought and fire in the Amazon, President Luiz Inacio Lula da Silva pledged to pave a road that environmentalists and some in his own government say threatens to vastly increase destruction of the world’s largest tropical forest — and contribute to climate change. 

The BR-319 roadway is a mostly dirt road through the rainforest that connects the states of Amazonas and Roraima to the rest of the country. It ends in Manaus, the Amazon’s largest city with over 2 million people, and runs parallel to the Madeira River, a major tributary of the Amazon River. The Madeira is at its lowest recorded level, disrupting cargo navigation, with most of its riverbed now endless sand dunes under a sky thick with smoke. 

“We are aware that, while the river was navigable and full, the highway didn’t have the importance it has now, while the Madeira River was alive. We can’t leave two capitals isolated. But we will do it with the utmost responsibility,” Lula said Tuesday during a visit to an Indigenous community in Manaquiri, in Amazonas state. He didn’t specify what steps the government would take to try to prevent deforestation from increasing after paving. 

Hours later, he oversaw the signing of a contract to pave 52 kilometers (32 miles) of the road, and promised to begin work before his term ends in 2026 on the most controversial section of the road — a 400-kilometer (249-mile) stretch through old-growth forest. 

A permit for the longer stretch was issued under Lula’s far-right predecessor, Jair Bolsonaro, who favored development in the Amazon and weakened environmental protections. In July, a federal court suspended the permit in a lawsuit brought by the Climate Observatory, a network of 119 environmental, civil society and academic groups. 

Lula’s government had appealed the suspension, but it wasn’t until his visit on Tuesday that Lula made clear his plan to move ahead with paving. The Climate Observatory lamented the move. 

“Without the forest, there is no water, it’s interconnected,” said Suely Araujo, a public policy coordinator with the group. “The paving of the middle section of BR-319, without ensuring environmental governance and the presence of the government in the region, will lead to historic deforestation, as pointed out by many specialists and by Brazil’s federal environmental agency in the licensing process.” 

Lula has sought to portray himself as an environmental protector, and deforestation has slowed significantly since he took over for Bolsonaro. But he has also struck out at times against pressure from richer nations on preserving the Amazon, an invaluable resource for the planet in storing the carbon driving atmospheric warming, and did so again on Tuesday. 

“The world that buys our food is demanding that we preserve the Amazon,” he said. “And why? Because they want us to take care of the air they breathe. They didn’t preserve their own lands in the last century during the Industrial Revolution.” 

Brazil is enduring its worst drought ever recorded, with 59% of the country under stress — an area about half the size of the U.S. In the Amazon, rivers’ low levels have stranded hundreds of riverine communities, with shortage of potable water and food. Lula announced a wide distribution of water filters and other measures during his visit to the region. 

Meanwhile, most of Brazil has been under a thick layer of smoke from wildfires in the Amazon, affecting millions of people in faraway cities such as Sao Paulo, Brasilia and Curitiba and reaching as far south as Argentina and Paraguay. At Lula’s event, Environment Minister Marina Silva blamed the extreme drought brought by climate change for the widespread fires in a rainforest usually resistant to fire, calling it “a phenomenon we don’t even know how to handle.” 

Silva has been more cautious than Lula about paving the roadway. At a congressional hearing earlier, she called the Bolsonaro era’s permit a “sham” and praised the judicial ruling that suspended it. 

Brazil is the world’s fifth-largest emitter of greenhouse gases, contributing nearly 3% of global emissions, according to Climate Watch, an online platform managed by the World Resources Institute. Almost half these emissions stem from destruction of trees in the Amazon rainforest. 
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