KAVUMU, Congo — Health authorities have struggled to contain outbreaks of mpox in Congo, a huge central African country where a myriad of existing problems makes stemming the spread particularly hard.

Last month, the World Health Organization declared the outbreaks in Congo and about a dozen other African countries a global health emergency. And in Congo, scientists have identified a new strain of mpox that may spread more easily. It has reached areas where conflict and the displacement of a large number of people have already put health services under pressure.

Overall, Congo has more than 21,000 of the 25,093 confirmed and suspected mpox cases in Africa this year, according to WHO’s most recent count.

Has Congo seen cases of mpox before?

Yes, Congo is one of the African countries where mpox has been endemic for decades.

Mpox, once known as monkeypox, comes from the same family of viruses as smallpox but causes milder symptoms such as fever. People with more serious cases can develop skin lesions. More than 720 people in Africa have died in the latest outbreaks, mostly in Congo.

Mpox is a zoonotic disease, meaning it can spread to humans from infected animals. In the global mpox outbreak of 2022, the virus spread between people primarily through sex and close physical contact.

What changed in Congo?

In September 2023, mpox spread to Congo’s eastern province of South Kivu; it had previously been seen in the center and far west. Scientists then identified a new form of mpox in South Kivu that may be more infectious.

The WHO said that from the outbreak in South Kivu, the virus spread among people elsewhere in the country, arriving in neighboring province North Kivu. Those two provinces — some 2,000 kilometers from the capital, Kinshasa — face escalating violence, a humanitarian crisis and other issues.

What are the problems in eastern Congo?

More than 120 armed groups have been fighting each other and the Congolese army for years in the eastern part of the country over the control of minerals. That has forced millions of people fleeing violence into refugee camps or nearby towns.

That means mpox is hitting already-stretched health facilities. Dr. Musole Mulambamunva Robert, medical director of the Kavumu hospital in eastern Congo, said it is “truly a challenge” — sometimes treating as many as four times the facility’s capacity for patients.

With more than 6 million displaced people in the east, authorities and aid agencies were already struggling to provide food and healthcare, while fighting other diseases such as cholera. Many people have no access to soap, clean water or other basics.

Some eastern Congo communities are out of reach of health clinics — roads are unreliable, and hourslong risky boat trips are sometimes the only means of transport, said Mercy Muthee Lake of the International Federation of Red Cross and Red Crescent.

People can be more susceptible to severe mpox cases because of malnutrition and undiagnosed HIV, she said.

She also said health workers in eastern Congo have requested more mpox training as medications to treat fever and ease pain run out.

Health authorities “are up against it because it’s such a complex area,” said Chris Beyrer, of Duke University’s Global Health Institute.

What about vaccines?

Africa has no capacity to produce mpox vaccines. Around 250,000 doses have arrived in Congo from the European Union and the United States, and more are expected. Congolese authorities say they need around 3 million vaccines. It will likely be weeks before any vaccines reach people in eastern Congo.

For now, the vaccine is approved only for adults. There’s limited evidence of how it works in children.

Vaccines are desperately needed, but they’re just “an additional tool,” said Emmanuel Lampaert, the Congo representative for Doctors Without Borders. The key, Lampaert said, is still identifying cases, isolating patients, and executing grassroots health and education campaigns.

Local conditions make that trying — Lampaert noted it’s almost impossible to isolate cases among poor, displaced people.

“Families with six to eight children are living in a hut, which is maybe the space of the bed we are sleeping in,” he said. “So, this is the reality.”

Why are critics blasting the mpox response?

Unlike the millions of dollars that poured into Congo for Ebola and COVID aid, the response to mpox has been sluggish, many critics say.

Health experts say the sharp contrast is due to a lack of both funds and international interest.

“Ebola is the most dangerous virus in the world, and COVID wiped out the world economy,” said professor Ali Bulabula, who works on infectious diseases in the medical department at Congo’s University of Kindu. “While mpox is a public health emergency of international concern, there is a lack of in-depth research and interest in the virus, as it’s still seen as a tropical disease, localized to Africa with no major impact on Western economies.” 
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Harare, Zimbabwe — A new report released by the main United Nations agency for action on AIDS and HIV says growing public debt is choking sub-Saharan African countries, leaving them with little fiscal room to finance critical HIV services.

In the report, launched ahead of the 79th session of the U.N. General Assembly in New York, Winnie Byanyima, the executive director of UNAIDS, asks the international community for more funding to ensure Africa eliminates AIDS by 2030.

She said Africa, which accounts for the largest number of people living with HIV — some 26 million out of 40 million globally — is overwhelmed by public debt.

Robert Shivambu, UNAIDS communication officer, told VOA: “The region’s success in having reduced new HIV infections by 56% since 2010 will not be sustained if fiscal space is constrained.”

Shivambu said the U.N. believes that when debt payments hinder countries’ ability to effectively look after health care needs of their people, global health security is put at risk.

Zimbabwe is one of the countries fighting to reduce the rate of HIV infection while dealing with high debt.

On Friday, parliament Speaker Jacob Mudenda told colleagues that the country had made strides in fighting HIV/AIDS, starting in 1999 as a pioneer of the AIDS levy — a 3% income tax for individuals and 3% tax on profits of employers.

He said that the budget of $387 million for HIV programs — largely foreign sponsored — was no longer enough and that there was need to expand the tax base.

“Let’s create wealth, when that wealth is created from our wealth, including mineral resources, we are going to be able to expand the tax base,” he said.

“From that expanded tax base we will be able as parliament to come with a very stout budget. These donations are going to dwindle, slowly but surely. This current funding level still falls far short of the estimated $500 million needed annually to achieve [the] ambitious goal of the Zimbabwe national AIDS strategic plan, especially with over 1 million people living with HIV now on anti-retroviral therapy.”

Mudenda declined to say if servicing Zimbabwe’s debt — which stands at $17.5 billion, according to the African Development Bank — was one reason funding for HIV programs is falling short.

Zimbabwe is battling to service its debt so that it can resume receiving loans from multilateral development banks such as the IMF and World Bank.

Shivambu said, “Public debt needs to be urgently reduced and domestic resource mobilization strengthened to enable the fiscal space to fully fund the HIV response and end AIDS. World leaders cannot let a resource crunch derail global progress to end AIDS as a public health threat by 2030.”

That’s the message UNAIDS officials will take to the high-level summit of the U.N. General Assembly beginning next week.
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GENEVA — The United Nations Children’s Fund, or UNICEF, warned Friday that children in Burundi are bearing the brunt of the mpox outbreak, with cases of this deadly, infectious disease spreading at an alarming rate among a young population.

“Of the nearly 600 reported cases, two-thirds are in children under 19. The situation has escalated rapidly, with a more-than-40% increase in cases over the past three weeks,” Dr. Paul Ngwakum, UNICEF’s regional health adviser for Eastern and Southern Africa, told journalists in Geneva via video link Friday.

Ngwakum, who currently is on a visit to Burundi, said, “The fear expressed by the parents and the resilience of communities in the face of this public health crisis” and the rapid escalation of the disease “were striking.”

Speaking from the capital, Bujumbura, he said the rise of mpox among children under the age of 5 is of particular concern as they represent 30% of the reported cases. This, he said, underscores the urgent need for targeted interventions to protect children from becoming infected as schools have reopened this week.

“UNICEF is supporting the Ministry of Education to implement health measures in schools, train staff to recognize early symptoms of mpox and reinforce hand hygiene. We aim to ensure that all children can safely return to school and minimize educational disruptions,” he said, noting that this was “a rapidly evolving situation.”

Even amid the grim situation, he observed that Burundi has had no deaths from mpox, formerly known as monkeypox. He said this provides “an opportunity to end this outbreak in a very short time period.”

“The geographical area is still limited, and with concerted effort from all partners, we can limit the spread, contain the virus, and potentially end the outbreak with no lives lost,” said Ngwakum.

He added that “it was difficult to make firm statements regarding when the outbreak could be brought under control,” both in Burundi and the wider African region, a sentiment echoed by the World Health Organization.

WHO spokesperson Dr. Margaret Harris told journalists, “The response to the outbreak is made more difficult by the context, with insecurity in the affected areas, and concurrent outbreaks of other diseases including measles and chickenpox. WHO is on the ground, working to stop these outbreaks.”

So far this year, the WHO reports there have been more than 25,000 suspected mpox cases and 723 deaths among suspected cases in Africa. The most heavily infected country is the Democratic Republic of Congo, with 21,835 suspected cases and 717 deaths, followed by Burundi with 1,489 suspected cases and no deaths and Nigeria with 935 suspected cases and no deaths.

“Vaccination is going to be a very useful tool, particularly for trying to break the chains of transmission,” Harris said. “But the virus primarily spreads through close personal contact within families. And when people are living in difficult conditions, if they do not have access to the materials, to the soap, to the clean bedding, to the clean clothing, it is very, very difficult for them to not transmit.

“Many of the children who we have seen who have sadly died in the Democratic Republic of the Congo were severely malnourished, had suffered the effects of conflict, and perhaps also had other diseases at the same time. … It may indeed be that this population cannot respond immunologically to yet another threat,” she warned.

While affirming the importance of vaccines in the fight against mpox, UNICEF representative Ngwakum observed that “unfortunately,” the vaccines that are available now “cannot be used for children.”

“I do not want to bank all our interventions on vaccines,” he said. “Vaccines are only one tool that can be used to protect children and communities against mpox. And we are, in addition to vaccines, deploying other different tools” to keep children safe, he said.

UNICEF says it is possible to halt the rapid spread of mpox if agencies act swiftly and have the means in which to do it. The U.N. children’s agency is urgently appealing for $58.8 million to scale up its humanitarian response across six African countries, including Burundi.

“These funds are essential to stop the transmission of mpox, protect children and maintain critical services like education and health care,” said Ngwakum.
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LONDON — Scientists searching for the origins of COVID-19 have zeroed in on a short list of animals that possibly helped spread it to people, an effort they hope could allow them to trace the outbreak back to its source.

Researchers analyzed genetic material gathered from the Chinese market where the first outbreak was detected and found that the most likely animals were raccoon dogs, civet cats and bamboo rats. The scientists suspect infected animals were first brought to the Wuhan market in late November 2019, which then triggered the pandemic.

Michael Worobey, one of the new study’s authors, said they found which sub-populations of animals might have transmitted the coronavirus to humans. That may help researchers pinpoint where the virus commonly circulates in animals, known as its natural reservoir.

“For example, with the raccoon dogs, we can show that the raccoon dogs that were [at the market] … were from a sub-species that circulates more in southern parts of China,” said Worobey, an evolutionary biologist at the University of Arizona. Knowing that might help researchers understand where those animals came from and where they were sold. Scientists might then start sampling bats in the area, which are known to be the natural reservoirs of related coronaviruses like SARS.

While the research bolsters the case that COVID-19 emerged from animals, it does not resolve the polarized and political debate over whether the virus instead emerged from a research lab in China.

Mark Woolhouse, a professor of infectious diseases at the University of Edinburgh, said the new genetic analysis suggested that the pandemic “had its evolutionary roots in the market” and that it was very unlikely COVID-19 was infecting people before it was identified at the Huanan market.

“It’s a significant finding and this does shift the dial more in favor of an animal origin,” said Woolhouse, who was not connected to the research. “But it is not conclusive.”

An expert group led by the World Health Organization concluded in 2021 that the virus probably spread to humans from animals and that a lab leak was “extremely unlikely.” WHO chief Tedros Adhanom Ghebreyesus later said it was premature to rule out a lab leak.

An AP investigation in April found the search for the COVID origins in China has gone dark after political infighting and missed opportunities by local and global health officials to narrow the possibilities.

Scientists say they may never know for sure where exactly the virus came from.

In the new study, published Thursday in the journal Cell, scientists from Europe, the U.S. and Australia analyzed data previously released by experts at the Chinese Center for Disease Control and Prevention. It included 800 samples of genetic material Chinese workers collected on Jan. 1, 2020, from the Huanan seafood market, the day after Wuhan municipal authorities first raised the alarm about an unknown respiratory virus.

Chinese scientists published the genetic sequences they found last year, but did not identify any of the animals possibly infected with the coronavirus. In the new analysis, researchers used a technique that can identify specific organisms from any mixture of genetic material collected in the environment.

Worobey said the information provides “a snapshot of what was [at the market] before the pandemic began” and that genetic analyses like theirs “helps to fill in the blanks of how the virus might have first started spreading.”

Woolhouse said the new study, while significant, left some critical issues unanswered.

“There is no question COVID was circulating at that market, which was full of animals,” he said. “The question that still remains is how it got there in the first place.”
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People from across the globe are convening on the sidelines of the U.N. General Assembly in New York City for Climate Week. On the agenda: the environmental impact of seabed mining. The discussion comes as tech companies seek ways to fuel the green revolution while minimizing environmental impacts. VOA’s Jessica Stone has more.]
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CHONBURI, Thailand — Only a month after Thailand’s adorable baby hippo Moo Deng was unveiled on Facebook, her fame became unstoppable both domestically and internationally.

Zookeeper Atthapon Nundee has been posting cute moments of the animals in his care for about five years. He never imagined Khao Kheow Open Zoo’s newborn pygmy hippo would become an internet megastar within weeks.

Cars started lining up outside the zoo well before it opened Thursday. Visitors traveled from near and far for a chance to see the pudgy, expressive 2-month-old in person at the zoo about 100 kilometers southeast of Bangkok. The pit where Moo Deng lives with her mom, Jona, was packed almost immediately, with people cooing and cheering every time the pink-cheeked baby animal made skittish movements.

“It was beyond expectation,” Atthapon told The Associated Press. “I wanted people to know her. I wanted a lot of people to visit her, or watch her online, or leave fun comments. I never would’ve thought (of this).”

Moo Deng, which literally means “bouncy pork” in Thai, is a type of meatball. The name was chosen by fans via a poll on social media, and it matches her other siblings: Moo Toon (stewed pork) and Moo Waan (sweet pork). There is also a common hippo at the zoo named Kha Moo (stewed pork leg).

“She’s such a little lump. I want to ball her up and swallow her whole!” said Moo Deng fan Areeya Sripanya while visiting the zoo Thursday.

Already, Moo Deng has been made into memes. Artists are drawing cartoons based on her. Social media platform X even featured her in its official account’s post.

With all that fame, zoo director Narongwit Chodchoi said they have begun patenting and trademarking “Moo Deng the hippo” to prevent the animal from being commercialized by anyone else. “After we do this, we will have more income to support activities that will make the animals’ lives better,” he said.

“The benefits we get will return to the zoo to improve the life of all animals here.”

The zoo sits on 800 hectares of land and is home to more than 2,000 animals. It runs breeder programs for many endangered species like Moo Deng’s. The pygmy hippopotamus that’s native to West Africa is threatened by poaching and loss of habitat. There are only 2,000-3,000 of them left in the wild.

To help fund the initiative, the zoo is making Moo Deng shirts and pants that will be ready for sale at the end of the month, with more merchandise to come.

Narongwit believes a factor of Moo Deng’s fame is her name, which compliments her energetic and chaotic personality captured in Atthapon’s creative captions and video clips.

Appropriately, Moo Deng likes to “deng,” or bounce, and Atthapon got a lot of cute and funny moments of her giddy bouncing on social media. Even when she’s not bouncing, the hippo is endlessly cute — squirming as Atthapon tries to wash her, biting him while he was trying to play with her, calmly closing her eyes as he rubs her pinkish cheeks or her chubby belly.

Atthapon, who has worked at the zoo for eight years taking care of hippos, sloths, capybaras and binturongs, said baby hippos are usually more playful and energetic, and they become calmer as they get older.

The zoo saw a spike in visitors since Moo Deng’s fame — so much that the zoo now has to limit public access to the baby’s enclosure to five-minute windows throughout the day during weekends.

Narongwit said the zoo has been receiving over 4,000 visitors during a weekday, up from around just 800 people, and more than 10,000 during a weekend, up from around 3,000 people.

But the fame has also brought some hostile visitors to Moo Deng, who only wakes up ready to play about two hours a day. Some videos showed visitors splashing water or throwing things at the sleeping Moo Deng to try to wake her up. The hippo pit now has a warning sign against throwing things at Moo Deng — posted prominently at the front in Thai, English and Chinese.

Narongwit said the zoo would take action under the animal protection law if people mistreat the animal. But clips emerged of people treating Moo Deng poorly, and the backlash was fierce. The zoo director said that since then, they haven’t seen anyone doing it again.

For fans who can’t make the journey or are discouraged after seeing the crowds for Moo Deng, the Khao Kheow Open Zoo set up cameras and plan to start a 24-hour live feed of the baby hippo in the coming week. 
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Addis Ababa, Ethiopia — One of the hurdles to improving health care systems for African countries is the shortage of scientists and lack of meaningful medical research on the continent, experts say.

An organization hopes to change that by enabling researchers and policymakers in three large African countries to develop more extensive and relevant research.

According to a 2017 report by the World Economic Forum, Africa is home to 15% of the world’s population and 25% of the world’s disease burden — but produces just 2% of the world’s medical research.

The report said of the medical research that does occur, much of it fails to prioritize diseases or health problems most pressing for Africans.

A group of African health researchers and institutions are now pushing for the continent’s medical research to be more focused on the continent’s own medical problems.

The African Population and Health Research Center is bringing together scientists, academics, policymakers and government officials from Ethiopia, Kenya and Nigeria.

Their goal is to strengthen African leadership in research and development, ensuring that the findings from these researchers are relevant and accessible to decision-makers, leading to better health care systems across the continent.

Catherine Kyobutungi, head of the organization, said African-led research can help solve health problems on the continent much more easily and quickly.

“If we want the research to be done by Africans in Africa on African issues, that is [how] the priorities for what research should be done are defined, not just by academics, but by the people who are going to use that research for decision-making,” she said.

“What we are trying to achieve is to shift what research is and what it is for and to create an army of African scientists that do research to solve African problems in real time, not after 50 years,” Kyobutungi said.

Dr. Hadiza Galadanci, a professor of obstetrics and gynecology at Bayero University in Nigeria, said her country accounts for about 28% of maternal deaths worldwide each year.

She and researchers from four African countries, Birmingham University in the United Kingdom and the World Health Organization published research on the best way to save women who were dying from postpartum hemorrhage, or excessive bleeding after childbirth. Their innovation — a calibrated obstetric drape, which is placed beneath a birthing mother — allows physicians to collect and precisely measure blood and fluid loss.

“The drape is just put under … the woman when she’s going to deliver. And then, as soon as she delivers, any blood that comes out goes to the drape. So, we have an objective assessment,” Galadanci explained, saying that the process allows for more specific treatment.

“When we did this, we found out that we could reduce the rate of severe [postpartum hemorrhage] leading to maternal death by 60%.”

African researchers face challenges ranging from a lack of reliable data and funding to poor infrastructure to cultural and religious issues.

With the support of the Bill and Melinda Gates Foundation, Africa Research Connect was developed to connect and enhance the visibility of scientists, institutions, policymakers and donors.

Jude Igumbor, an associate professor at Wits School of Public Health in South Africa, wants to improve the visibility of African scientists and their work.

“What we give African scientists is they are able to find each other for collaboration,” he said.

The African Population and Health Research Center is calling on donors to fund African institutions and researchers directly instead of going through other organizations, saying that doing so helps the money create opportunities and hone the skills of researchers on the continent.
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Washington — When activists, policymakers and representatives from across the globe gather next week in New York to participate in climate week, one pressing issue on the agenda that is less frequently discussed and known will be the environmental impact of seabed mining.

As countries look for ways to lower emissions, critical minerals are playing a key role in that transition. Critical minerals are used in all kinds of green technologies, from solar panels and wind turbines to batteries in electric vehicles. And one place where those mineral resources are abundant is deep under the sea.

The debate over accessing seabed resources is heated. Supporters say the technology exists to safely access these critical minerals undersea, but environmentalists and activists say the potential of undiscovered biodiversity on the seafloor is too important to endanger.

During climate week, which will take place on the sidelines of U.N. General Assembly meetings, organizers are expected to host a roundtable on the environmental impact of seabed mining and other discussions about critical minerals.

The World Economic Forum says that if the globe wants to reach net-zero emissions by 2050, two-thirds of vehicles must be powered by electric batteries. And the International Energy Agency says that to reach that goal, the world needs six times more mineral resources by 2040 than it has today.

Some of the largest mineral deposits are found on the ocean floor in the form of polymetallic nodules, or rocks.

Ocean of resources

According to the International Seabed Authority, or ISA, there are 21 billion tons of polymetallic nodules strewn across the seabed of the Clarion-Clipperton Zone, or CCZ. Each nodule contains a combination of electric vehicle battery components such as nickel, manganese, copper and cobalt. The ISA plans to release regulations for mining in the international waters of the CCZ by 2025.

The ISA has already awarded 17 exploration contracts for polymetallic nodules in the Clarion-Clipperton Zone – a large swath of the Pacific Ocean the size of the continental United States which sits between Hawaii and Mexico. Three of those exploration contracts went to The Metals Company, a Canadian deep-sea mining company.

The Pacific Island Nations of Nauru, Kiribati and Tonga have sponsored The Metals Company’s efforts to develop a portion of the seabed. In an interview with VOA, CEO Gerard Barron said the company is ready to begin as soon as the ISA allows mining.

“Our collector methodology is to put a robot on the seafloor which crawls around the ocean floor and fires a jet of water at the nodule and it creates an inverse pressure and lifts the nodule up, and so we don’t go down and scour the seafloor,” said Barron via Zoom, adding that TMC has spent the past decade focused on testing this equipment and collecting data on its environmental impact as part of its permit application to the ISA.

Moratorium needed

Critics worry scooping up these mineral-rich rocks will disrupt important biodiversity – much of it still unnamed and some of it undiscovered. Researchers have found that 90% of the more than 5,000 species in the zone are new to science. Eddie Palu, president of the Tonga Fishery Association, wants a pause for more research.

“We demand a moratorium on the seabed mining until the environmental, economic and social risk are comprehensively understood,” he said during a panel discussion at the recent Pacific Islands Forum in Tonga.

Shiva Gounden from Greenpeace Australia Pacific, who also sat on the panel, agreed.

“We know only very little of the deep sea, and the race for the final frontier could cause irreversible damages to the people and to the communities of our Pacific,” Gounden said.

But scientists say no light and very little oxygen reaches the deep sea – limiting the life there to mostly bacteria and small invertebrates.

The Metals Company’s Barron said combating climate change is a bigger threat to the planet than undersea mining, adding that the company’s environmental impact studies show that “we can safely collect these nodules” and turn them into battery metals without having “a negative impact on the ocean.”

“The notion that we can do any extraction with zero impact is a dream,” added Barron. “The oceans are impacted by every single thing we do today, especially global warming. So, we need to address the main driver for climate change and reduce emissions.”

Fueling innovation

Still, the quest to do just that – access minerals on the seabed with minimal impact to the environment – has created competition between technology companies.

U.S. tech startup Impossible Metals is testing a robot which can avoid nodules where it detects life and harvests those where it does not.

“The vehicle hovers above the seabed, uses the camera and it actually picks up the nodules one by one. So this really minimizes all of the negative concerns around big sediment plumes,” CEO Oliver Gunasekra told VOA in an interview.

Gunaskera’s company spun off Viridian Biometals. Its technology bypasses energy-intensive processes such as smelting with bacteria which can separate metal ore from the rock around it. The process creates no emissions or waste.

“The bacteria need oxygen just like we do to breathe. And when there’s not enough oxygen in the water around them, the bacteria have learned that there’s oxygen in the rocks, and they have adapted to breathe that oxygen,” said Viridian CEO Eric Macris.

Impossible Metals and Viridian Biometals say they are two to three years out from commercializing their technology, depending on funding. TMC says it could be ready to begin its collection operations as soon as international regulations are released next year.
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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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