A large team of international researchers has found 30 percent of HIV positive individuals in nearly a dozen countries delay starting life-saving drugs.

A study spearheaded by the U.S. Centers for Disease Control and Prevention looked at the prevalence of HIV in Haiti, Vietnam, Nigeria, Namibia, Swaziland, Zimbabwe, Mozambique, Tanzania, Uganda and Zambia.

Investigators reviewed more than 694,000 treatment records from 2004 to 2015, from nearly 800 clinical facilities, focusing on patients age 15 and older.

HIV expert Andrew Auld, Malawi Country Director at the CDC, is lead author of the study.  He said in eight of the countries, the percentage of people receiving early treatment increased, in Haiti, Mozambique and Namibia by 40 percent or more during the time period.

But Auld said treatment is still not reaching a significant portion of HIV positive people.

“So some of the key things that still need to be done in these countries to further reduce the prevalence of advanced disease and HIV treatment initiation are to scale up testing strategies and facilitate HIV diagnosis at earlier disease stages, and also treatment policies that mean that patients once they are diagnosed are eligible to start HIV treatment the same day,” he said.

HIV infects and destroys the immune system’s CD-4 T-cells, so the body gradually loses its ability to fight off infections, eventually with lethal consequences in untreated individuals.

Ambitious target

UNAIDS has set a 90-90-90 target in dealing with the HIV epidemic.

By 2020, it’s hoped that 90 percent of all people with HIV will know their status, 90 percent will receive antiretroviral therapy and 90 percent of those receiving treatment will have viral suppression.

Not only does immediate antiretroviral treatment mean avoiding life-threatening complications, Auld said it reduces the risk of transmission.  

Another study, published in the New England Journal of Medicine in 2016, found treatment reduces the risk of spreading HIV to a sexual partner by up to 96 percent.  The risk of vertical transmission, from pregnant women to their newborn babies, is also reduced if the mother is treated with antiretroviral drugs.

Despite advances in treatment and care of people infected with the AIDS virus, the NEJM article noted that there were more than two million HIV infections reported worldwide in 2014.

Auld said the main reason people wait until they are very sick to go for treatment is they are unaware that quick action increases their chances of survival.

Men with more advanced cases, according to Auld, point to work demands that keep them from seeking treatment earlier in the course of the disease.  For women, childcare and family obligations are often cited.  Among infected children, Auld said the problem is access to testing and treatment.

“HIV diagnosis is not a death sentence,” he stressed.  “Excellent HIV treatment is available and people can live long, healthy, productive lives if they adhere to the HIV treatment.  And it will increase demand for both testing and treatment services.”

The study by Auld and colleagues is published in the journal Morbidity and Mortality Weekly. 
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The tiny nation of Lesotho is one of the few countries in the world, including the United States, and one of just two in Africa, without mandated paid leave for new mothers. International watchdogs and activists say maternity leave is often poorly enforced, especially since so many African women work in the informal sector.

When Makhopotsohad Letsie had her youngest child, she took a three-month break from her job as a riveter to care for her baby boy.

Her employer, a large factory in Lesotho’s capital, paid her during that time. She got a grand total of just more than $23.

It was not enough to meet her needs, she says, but she had no choice.

That amount was not even a quarter of her monthly salary. But she was grateful, she says, because she lives in one of the few countries that does not mandate maternity benefits.

Parliament Member and All Basotho Congress spokesman Moeketsi Majoro says paid leave is not a kindness, it is a necessity. He says his party wants to implement a three-month maternity leave policy.

“We want everybody to participate, and participate fully in the economy and without the insecurity or the difficult choices of having to raise the future of Lesotho and having to go to work for a minimum wage,” said Majoro. “It is, in fact, an empowerment process that we need to put in place, as a policy.”

The International Labor Organization recommends maternity leave of at least 18 weeks. But in a survey, the organization found no African government offers that to all mothers, South Africa leads with its law mandating 17 weeks.

Other African nations are trying to expand their policies. Rwanda last year expanded benefits to 12 weeks. Nigeria’s government recently expanded leave for civil servants to six paid months, but the private sector is only required to give three months.

In Kenya, employers have strongly objected to a recent proposal to offer at least six months leave, the last three unpaid and voluntary. They say they can not afford such a plan.

The ILO estimates a universal maternity cash benefit would cost low- and lower-middle income countries less than 0.5 percent of their economy. But the organization acknowledges, cash-strapped countries, like Lesotho, struggle in the face of more urgent needs.

Professor Anita Bosch, who researches gender and workplace issues at the University of Stellenbosch Business School, says societies cannot afford to deny newborns the bonding and formative experiences that will set them up for life.

But she says few women in Africa benefit from maternity leave, because these laws only apply to the formal sector. The ILO estimates worldwide less than a third of women hold formal employment.

“In the informal sector, people are so desperate for work, remember our unemployment levels are at extreme levels. People are just desperate to have a job and to hang on to a job. And so for that, they will do whatever, and that makes them highly exploitable,” said Bosch.

In most African nations, the law puts the burden on employers to pay maternity benefits. For mothers without jobs, there is often little help from the state.

Letsie says that worries her. Her 18-year-old daughter just married and like a quarter of Lesotho’s population can not find a job. Letsie is the breadwinner for her extended family and says she desperately needs help. She wonders what they will do when her first grandchild comes along?

 
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Most Americans believe the United States should take “aggressive action” to fight climate change, but few see it as a priority issue when compared with the economy or security, according to a Reuters/Ipsos poll released on Tuesday.

The June 2-4 opinion poll suggests American voters may not penalize President Donald Trump too harshly for walking away from the 2015 Paris Climate Agreement, even if they would have preferred he keep the country in the deal.

The poll found 68 percent of Americans want the United States to lead global efforts to slow climate change, and 72 percent agree “that given the amount of greenhouse gases that it produces, the United States should take aggressive action to slow global warming.”

Even so, Americans rank the environment near the bottom of their list of priorities for the country. Only about 4 percent of Americans believe that the “environment” is a bigger issue than health care, the economy, terrorism, immigration, education, crime and morality, Reuters/Ipsos polling shows.

“I just kind of feel helpless about it,” Dana Anderson, 54, of Mesa, Arizona, said about climate change. “If something happens to the environment, it is what it is, right?”

Anderson, who has multiple sclerosis, said that whatever Trump says about health care will matter to her much more than his thoughts on global temperatures.

The poll was conducted after Trump announced on Thursday that the United States would abandon the landmark agreement with 195 countries to slash carbon emissions and curb global warming.

The Republican president, who had previously called climate change a “hoax” despite overwhelming evidence to the contrary, said he thought the pact would harm the U.S. economy without providing a tangible benefit.

The decision drew anger and condemnation from world leaders and business chiefs, many of them worried a U.S. exit would put the planet at risk and leave the United States behind in a global shift away from fossil fuels.

The poll found the U.S. public split along party lines over the move to withdraw from the global climate pact, with most Republicans supporting it and most Democrats opposing it.

Overall, 38 percent agreed with Trump’s decision, 49 percent disagreed and 13 percent were undecided.

The poll also showed 50 percent of Americans believe global temperatures will rise faster as a result of the U.S. withdrawal from the climate deal, and 64 percent think U.S. relations with other countries will suffer.

The public was split over the decision’s economic impact, too, with 41 percent saying it will strengthen the economy and 44 percent saying it will not.

The Reuters/Ipsos poll was conducted online in English throughout the United States. It gathered responses from 1,398 Americans, including 459 Republicans and 635 Democrats. The poll has a credibility interval, a measure of accuracy, of 3 percentage points for the entire group and 5 percentage points for the Republicans and Democrats.
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A massive and deep circular pit on Mars has NASA officials stumped.

The image of the hole on the Martian surface was taken by the agency’s Mars Reconnaissance Orbiter (MRO) as it scanned the planet’s south pole region.

The hole, which is surrounded by a “Swiss cheese terrain” of frozen carbon dioxide, is likely hundreds of meters across and quite deep.

The image also captures a glimmer of light coming from the bottom of the hole, likely a reflection of the Sun off the ice.

According to Science Alert, there are several possible ways the hole formed, including a meteorite impact, collapsing lava tubes, floods or some kind of volcanic activity.

The “Swiss cheese terrain” is believed to be caused by the sublimation, going directly from solid to gas, of the frozen carbon dioxide.

The image was snapped with the MRO’s “High Resolution Imaging Science Experiment,” which allows NASA to see objects on the Martian surface that are larger than one meter from between 200 and 400 kilometers above the Red Planet.

MRO has been circling Mars since 2006 and has captured many interesting images, including dust devils and moving sand dunes.
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To celebrate the June 5 World Environment Day, diplomats from more than a dozen foreign embassies and international organizations Monday joined the U.S. State Department to plant underwater seagrass in the Potomac River, a tributary of the Chesapeake Bay.

Diplomats told VOA their participation in “green diplomacy” is to help raise awareness of the challenges of clean water here and at home.

Underwater grasses growing in shallow waters of the Chesapeake Bay add oxygen to the water, provide wildlife with food and habitat, absorb nutrient pollution, trap sediment and reduce erosion, according to the Chesapeake Bay Foundation.

Representatives from China, Costa Rica, Finland, Germany, Indonesia, Iraq, Malta, Pakistan, Portugal, Slovenia, Spain, Switzerland and the United Arab Emirates, as well as the European Union and the World Bank, have been growing seagrasses in their chanceries or ambassadors’ residences since January 2017.

After six months of grow-out, diplomats gathered at the Mason Neck State Park in Lorton, VA to plant their grasses to bolster grass populations and help restore the Chesapeake Bay.

Nursing the grasses is a challenge.

“My gosh, it is very difficult,” Anggarini Sesotyoningtyas from Embassy of Indonesia’s Economic Affairs office told VOA.

“It’s not just like regular plant ‘cause I think it really needs a careful maintenance and care,” said Sesotyoningtyas, adding that the first few days were making sure grass-growing kits were set up correctly, then checking constantly that the seeds were growing. 

By working with the CBF’s “Grasses for the Masses” program, diplomats are demonstrating the commitment to environmental protection.  

“Underwater grasses are great to protect the natural ecosystem. They offer a lot of benefits for the water. One of the neat things about grasses is they provide shade for some of the river critters or the bay critters. They also provide oxygen to the water, bring in more oxygen, they help trap pollution,“ said Rebecca LePrell, Chesapeake Bay Foundation’s Virginia executive director.

Addressing the challenge of clean water is part of the State Department’s green diplomacy initiative.  

“It’s certainly something that many other countries, most other countries, struggle with as well. And so it’s something that we share in common and can work around a simple product that can be taken to other countries to use. Just simple six months of growing grasses makes a huge benefit to waterways,“ the State Department’s Office of Foreign Missions director Cliff Seagroves told VOA.

Some diplomats say the U.S. decision to leave the Paris agreement will affect their partnerships. Instead of country-to-country relationships, they will instead focus on cooperation with local governments and communities. 

“My job here at the embassy is environmental cooperation with the United States.That might take a different form going forward. We might focus more on state local actors, on the business community who have been very loud in their opposition to the pulling out with the Paris agreement and want to continue to fight climate change,” said Anton Hufnagl from the Germany Embassy.

By helping restore seagrass in the Chesapeake Bay, the State Department said it aims to raise awareness of the challenge of clean water, both in the Washington, DC metropolitan area and around the world.  

It also is an opportunity for the U.S. to work with the foreign diplomatic community to address an environmental challenge that people face globally.
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Former New York City Mayor Michael Bloomberg submitted a statement to the United Nations on Monday that over 1,000 U.S. governors, mayors, businesses, universities and others will continue to meet the goals of the Paris climate agreement abandoned by President Donald Trump last week.

Bloomberg, who is the U.N. Secretary-General’s special envoy for Cities and Climate Change, submitted the “We Are Still In” declaration to U.N. Secretary General Antonio Guterres and the U.N. Framework Convention on Climate Change (UNFCCC) Executive Secretary Patricia Espinosa.

He also launched a process to work with local governments and non-state entities to formally quantify the combined – and overlapping – emissions reduction pledges, which will be known as “America’s Pledge,” and submit the report to the United Nations.

“Today, on behalf of an unprecedented collection of U.S. cities, states, businesses and other organizations, I am communicating to the United Nations and the global community that American society remains committed to achieving the emission reductions we pledged to make in Paris in 2015,” Bloomberg said in a statement.

Signatories to the new initiative include 13 Democratic and Republican governors, 19 state attorneys general, over 200 mayors, and CEOs of Fortune 500 companies and small businesses.

Trump on Thursday pulled the United States from the landmark 2015 agreement designed to fight climate change, fulfilling a major campaign pledge despite entreaties from U.S. allies and corporate leaders.

Although the formal process to withdraw from the Paris agreement takes four years, Trump said the United States will not honor the pledge the Obama administration submitted, known as the nationally determined contribution to reduce greenhouse gas emissions 26-28 percent below 2005 levels by the year 2025.

To fill the void, “America’s Pledge” will be submitted to the UNFCCC as a “Societal NDC.”

“The UNFCCC welcomes the determination and commitment from such a wealth and array of cities, states, businesses and other groups in the United States to fast forward climate action and emissions reductions in support of the Paris Climate Change Agreement,” said Espinosa.

The coalition will align a number of different efforts to how U.S. support for the Paris agreement, including a commitment of over 260 corporations including Kellogg, Pepsi Co. and Walmart to reduce their greenhouse gas emissions in line with the latest science.

Thirteen governors have also pledged to continue to honor the Paris pledges.

“It will be up to the American people to step forward-and in Virginia we are doing just that,” said Virginia Governor Terry McAuliffe.
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The remote South Pacific island of Henderson hit the headlines recently not for its pristine natural beauty, but for the 38 million tons of accumulated plastic and other debris that ocean currents had landed on its shores.

The uninhabited island is a UNESCO heritage site and one of the world’s biggest marine reserves. It is also a victim of the pollution that is slowly killing our oceans.

“Conserving our oceans and using them sustainably is preserving life itself,” declared U.N. Secretary-General António Guterres at the opening Monday of a week-long Ocean Conference at the United Nations.

That is not an understatement. The ocean provides nearly half of the oxygen produced on Earth and its marine bounty feeds billions.

Some 4,000 leaders from the worlds of politics, science, academia, business and civil society have gathered for the conference, which kicked off on World Environment Day.

They hope to draw attention to the effects of pollution, plastics, climate change, over-fishing and other factors that are affecting all marine life, with potentially disastrous consequences.

WATCH: Pollution, plastics damaging the earth’s oceans

Plastics: A Top Offender

“Marine plastic debris is a slow motion catastrophe waiting to happen,” warned Indonesia’s Maritime minister Luhut Binsar Pandjaitan.

Plastics and microplastics  plastic particles under 5mm in diameter  are among the biggest threats to the ocean and marine life. A World Economic Forum study warns that by 2050 the oceans could contain more plastics than fish.

The ocean is overflowing with manmade items, including water bottles, plastic shopping bags, cigarette butts, and larger items from fishing nets to sunken vessels. It all presents a danger to marine life through entanglement, ingestion or leakage of harmful chemicals.

“The ultimate way to keep marine debris from becoming a threat is by preventing it from entering the ocean in the first place,” said Nancy Wallace, Director of the Marine Debris Program at the National Oceanic and Atmospheric Administration (NOAA) for the United States. “Changing behaviors is a particularly important aspect of prevention,” she added.

That includes getting the public to cut back or eliminate its use of plastic shopping bags, cutlery and bottled beverages.

In the Pacific, where the ocean covers 90 percent of the region and land is only two percent, leaders are striving for cleaner seas by 2025.

Kosi Latu of the Secretariat of the Pacific Regional Environment Program said his group did a recent study that examined 215 species of marine life. They found 136 types had ingested plastic, and in fish, the figure was 97 percent.

“That gives you a sense of how big this problem is,” Latu said. He noted that in the Pacific the rate is about 30 percent higher than the global average of about 67 percent.

“The challenge is implementing, enforcing policies; it is enforcing legislation,” Latu said.

He said his region is also looking at innovative policies, not just banning plastics. “But looking at policies that will put the onus on those who produce the plastics, so making sure there is some way they contribute to the solution.”

Call to Action

This week, conference attendees will discuss a range of other problems confronting the oceans. On Friday, they will formally adopt a Call to Action. So far, they have more than 700 voluntary commitments to improve the health of the ocean, and they are growing.

The commitments include agreeing to implement long-term strategies to reduce the use of plastics and microplastics, as well as to develop and implement mitigation measures to help the ocean recover from other harmful impacts, such as climate change.
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A smartphone app lets citizen scientists help professional scientists track changes in the natural world as urbanization, habitat loss, invasive species and climate change shake up ecosystems worldwide.

More than 100,000 users on all seven continents are snapping pictures of plants and animals they find and uploading the images using an app called iNaturalist. Those geotagged photos are giving researchers an unprecedented amount of information about what lives where, and how that’s changing with humanity’s expanding footprint.

On a spring afternoon in Arlington, Virginia’s Barcroft Park, a half-dozen eager onlookers huddle around a plywood board on the forest floor, waiting for the big reveal. Spray-painted on the board are the words, “wildlife study.”

As one volunteer lifts the plywood board, Arlington natural resources manager Alonso Abugattas spots a pair of snakes coiled underneath.

“Northern brown, northern brown,” he calls.

Another volunteer leans in with smartphone clicking. He uploads the photos to iNaturalist, where crowdsourcing soon confirms Abugattas’ identification.

WATCH: App lets citizen scientists help professional scientists

That observation, tagged by date, time and location, is now part of a growing database of nearly 5 million species finds all over the world.

“Everyone knows that if you want to protect something, you’ve got to know what you have,” Abugattas said.

Visitors to the iNaturalist website can search an annotated Google map for what lives in their neighborhood. Or search for where others have found a particular species.

As he works to protect Arlington County’s natural spaces, Abugattas will be looking for how iNaturalist data gathered on this day-long photo safari compare with earlier surveys.

“Are some things that we had then no longer here? Are some things that we never knew we had now popping back up?” he asks. “That will give us a gauge of how good or how poorly we’re doing as far as being stewards.”

Data + excitement

The app came about as a collaboration between biologist and software developer Ken-ichi Ueda and environmental scientist Scott Loarie.

Loarie was studying methods to gather more data for wildlife conservation, while Ueda “was looking for a way to connect people to nature and find ways to use technology to get people excited about the outdoors,” Loarie said.

“That’s one of the great things about citizen science. It achieves both those goals,” he said.

And it comes at an important time.

“Species are going extinct at an unprecedented rate,” he said. “We’ve only begun to understand exactly how those ecosystems contribute to our food system, or human health, all these things that we depend on.”

There’s a popular analogy in the field: it’s like pulling rivets off the wing of an airplane while it’s in flight.  

“We don’t know exactly which rivet is going to cause the wing to fall off, but it’s probably not a good idea to go around popping rivets off the plane,” Loarie said.

Butterflies, snails and mushrooms

So far, iNaturalist data has been a part of studies on monarch butterflies, bats that may carry Ebola, and more.

An iNaturalist user snapped a picture of a rare snail on an island off the coast of Vietnam.

“It’s never been collected. It’s never been photographed. It’s only been drawn. And it was drawn on one of Captain Cook’s voyages,” when the 18th-century explorer sailed around the world, Loarie said.

Back in Arlington, the group logged more than 450 species, including some rare plants and the biggest puffball mushroom anyone had seen, as big as a mid-sized dog.

“If you just open up your eyes to the natural world, you’d be amazed at what’s out there,” Abugattas said.
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