The World Health Organization says Malawi has become the first country to begin immunizing children against malaria, using the only licensed vaccine to protect against the mosquito-spread disease.

Although the vaccine only protects about one-third of children who are immunized, those who get the shots are likely to have less severe cases of malaria. The parasitic disease kills about 435,000 people every year, the majority of them children under 5 in Africa.

“It’s an imperfect vaccine but it still has the potential to save tens of thousands of lives,” said Alister Craig, dean of biological sciences at the Liverpool School of Tropical Medicine, who was not linked to WHO or to the vaccine. Craig said immunizing the most vulnerable children during peak malaria seasons could spare many thousands of children from falling ill with malaria or even dying.

The vaccine, known as Mosquirix, was developed by GlaxoSmithKline and was approved by the European Medicines Agency in 2015. A previous trial showed the vaccine was about 30% effective in children who got four doses, but that protection waned over time. Reported side effects include pain, fever and convulsions.

WHO’s Director-General Tedros Adhanom Ghebreyesus welcomed the new program, noting progress has “stalled and even reversed” in the ongoing fight against malaria. In the coming weeks, WHO said similar vaccination programs would begin in Kenya and Ghana together with other partners and that they aimed to reach about 360,000 children across the three countries. GSK is donating up to 10 million vaccine doses.

Other experts warned the vaccination programs should not divert limited public health funds from inexpensive and proven tools to curb malaria, like bednets and insecticides.

“This is a bold thing to do, but it’s not a silver bullet,” said Thomas Churcher, a malaria expert at Imperial College London. “As long as using the vaccine doesn’t interfere with other efforts, like the urgent new for new insecticides, it is a good thing to do.”

Craig noted one of health officials’ biggest challenges could be convincing parents to bring their children for repeated doses of a vaccine that only protects about a third of children for a limited amount of time.

More commonly used vaccines, like those for polio and measles, work more than 90 percent of the time.

“This malaria vaccine is going to save many lives, even if it is not as good as we would like,” Craig said. “But I hope this will kick-start other research efforts so that the story doesn’t end here.”
…

Communist Vietnam is moving to privatize some parts of its health care system, raising questions about the state’s duty to guarantee care for all as a basic right, and about its budget to do so. 

A publicly funded medical school in Ho Chi Minh City said this month it is looking for a private investor to help it build a new training and outpatient center on its campus. The Pham Ngoc Thach University of Medicine said the idea is for it to handle the clinical operations and training, while a private company would handle the actual construction.

Tapping private funding

“Ho Chi Minh City’s health care needs are critical due to rapid urbanization and a growing population,” said Dr. Ngo Minh Xuan, who is the rector of the Pham Ngoc Thach University of Medicine. “However, we cannot cater to these needs effectively and timely by relying solely on public budget.”

The shift to partially privatize these health services is an ongoing trend as the country of 100 million people turns ever closer to capitalism. More and more international hospitals are popping up and expanding, like Hanh Phuc and the Vietnam Germany Hospital, as the government increasingly opens up the sector to private parties, such as through a trade deal with the European Union that permits higher foreign investment.

A record of health care for all

Since its establishment as a communist nation at the end of the Vietnam War in 1975, the country has provided universal health care, with most citizens having access to subsidized insurance but also paying out of pocket for some expenses. As public opinion generally supports the idea that all people are entitled to health care, doctors treat their roles as a public service, doing regular rotations from their home base to hospitals in rural areas and other underserved communities. The government also works to improve access in the countryside, through a network of commune health centers that are the first point of contact for patients when they can’t make it to bigger city hospitals. 

Vietnam’s record on health services is part of the reason it ranks relatively well on the Sustainable Economic Development Assessment (SEDA), which takes a look at not just how rich a country is, but also how well it translates its riches into creating a good quality of life for the public. Vietnam outperforms the Southeast Asian average on health care in the SEDA index. Between 2009 and 2018, its life expectancy rose from 74.8 years to 75.9 years, while rates of infant mortality, tuberculosis, and undernourishment fell and measles immunization rose.

There are financial strains on the current system 

“Over the last decade, Vietnam made significant improvements, placing it in the first quartile of SEDA score change,” the Boston Consulting Group, which created the index, said in a statement. “In 2018, Vietnam’s wealth to well-being coefficient of 1.28 highlights the country’s well above average ability of converting wealth to well-being.”

Still there are shortcomings in the health care system that are prompting calls for more private sector involvement. It is not uncommon for a patient to pay a bribe to a doctor to request better care, nor for patients to share hospital beds or wait outside buildings on bamboo mats.

There are concerns about affordability for a state that has gotten close to its public debt ceiling of 65 percent of gross domestic product. Amid the strained public budget, Vietnam has undergone a drop in the rate of physicians per 1,000 people and in the relative number of hospital beds available in the past decade, according to the BCG. That is a particular burden for Ho Chi Minh City, the southern business center of as many as 13 million residents, accounting for about a quarter of Vietnam’s overall demand for health care. There are more than 100 hospitals in the city, according to the Vietnam Chamber of Commerce and Industry.

At the same time the country is expected to transition from a lower middle income nation to an upper middle income nation in the next decade or so. 

“This [transition] will make Vietnam a fast-growing market for a wide range of goods and services” — including health care — said Asia Pacific chief economist Rajiv Biswas and principal economist Bernard Aw in a joint report for investment research firm IHS Markit in February.

With medical needs on the rise, Vietnam’s debate about public versus private health care will only deepen in the coming years.
…

An animal orphanage in Zimbabwe is one of the organizations leading efforts to ensure poaching and development do not wipe out the wildlife of the southern African nation. 

About half an hour drive southeast of Bulawayo is a special orphanage caring for abandoned and injured animals.

The Chipangali Wildlife Orphanage is home to 25 animal species, some endangered, some rescued from poachers.

Vivian and Paddy Wilson established the orphanage in 1973 and a second generation now runs it. 

Chipangali’s co-director Nicky Wilson explains what motivated her in-laws to begin rescuing wildlife.

​“(When) Chipangali was formed there was only CROW (Centre for Rehabilitation of Wildlife), which was in Durban (South Africa) and Daphne Sheldrick Orphanage in Kenya. There was no other places where you would put animals that wouldn’t survive in the wild,” Wilson said.

Animals are brought to Chipangali after being injured, seized, or orphaned, says Wilson. Some are later released into the wild, and some are not.

“Some birds might have flown into power lines and are missing part of their wings, they won’t be able to be released. We also have baby animals, sometimes if they are reared, they become too tame and assume that every human is friendly, unfortunately that is not the case in our world. So, they will stay here permanently and utilize them for our education,” Wilson said.

​The oldest resident of the orphanage is a crocodile rescued four decades ago from a community angry it was eating their goats and cattle. 

The locals wanted to kill the crocodile, believed to be in its 90s, but at Chipangali it was made part of the education program for visitors.

Wilson shows visiting journalists a display of animal fetuses, removed from mothers that died in poacher’s snares. 

“We are obviously trying to educate mainly locals and anyone who comes visit us here at Chipangali into the importance of Zimbabwe wildlife heritage. Tourists would not come and visit Zimbabwe if it weren’t for the big five: elephant, lion, buffalo, leopard and then rhino. Because without our wildlife, they wouldn’t come to Zimbabwe. So we are trying to tell people to look after our animals,” Wilson said.

Since its creation, Chipangali Wildlife Orphanage has rescued and released numerous animals into the nearby Matobo National Park. 

They include several troops of vervet monkeys and baboons, more than 30 pangolins, five leopards, 20 cheetahs, and various antelopes, small carnivores, and birds of prey.
…

The world’s recyclable plastic is being shipped to Asia where it is illegally dumped, buried or burned in the country with the lightest regulations, environmentalists warned on Tuesday calling for greater transparency in the global waste trade.

A report by Global Alliance for Incinerator Alternatives (GAIA) and Greenpeace East Asia analyzed the top 21 exporters and importers of plastic recyclable waste from 2016 until 2018 – before and after China stopped taking such waste last year.

It found that plastic waste imports into Thailand, Malaysia and Vietnam jumped from mid-2017 to early 2018, leading to illegal operations dumping and open-burning, contaminating water supplies, killing crops and causing respiratory illnesses.

“For the first world, it makes them feel good about their waste supposedly being recycled but in reality it ends up in countries that cannot deal with the waste,” said Beau Baconguis, a plastics campaigner at GAIA in Manila.

“So the pollution is heading south to countries that do not have that capacity,” she told the Thomson Reuters Foundation.

As pollution and environmental damage linked to the rise in plastic waste became known in countries like Malaysia and Thailand during 2018, protests led to tighter waste regulations and import restrictions by authorities, the study found.

Large volumes of plastic waste then diverted to other countries in the region, like Indonesia and India, where regulations on the waste trade are more lenient, the study said.

“Once one country regulates plastic waste imports, it floods into the next un-regulated destination,” said Kate Lin, a Hong Kong based campaigner with Greenpeace East Asia.

“It’s a predatory system, but it’s also increasingly inefficient,” she said. “Each new iteration shows more and more plastic going off grid – where we can’t see what’s done with it – and that’s unacceptable.”

​​China was the leading importer of plastic waste until it banned imports at the start of 2018 after a string of scandals.

This disrupted the flow of more than 7 million tons of plastic scrap a year, valued at about $3.7 billion.

The top exporters of plastic waste analyzed for the report included the United States, Britain, Germany and Japan.

Members of the Basel Convention, the main global pact regulating the trans-boundary movement of hazardous waste, will meet in Geneva from April 29 and decide on a proposal from Norway to create greater transparency in plastic waste trade.

If adopted, any plastic waste exporters would be required to obtain prior approval from an importing country, and give more detailed information on the volume and type of waste.

Greenpeace’s Lin welcomed the proposal but urged consumer goods companies to reduce the single-use plastics they produce.

“It is a good step but definitely not a final solution,” Lin said.
…

The world’s recyclable plastic is being shipped to Asia where it is illegally dumped, buried or burned in the country with the lightest regulations, environmentalists warned on Tuesday calling for greater transparency in the global waste trade.

A report by Global Alliance for Incinerator Alternatives (GAIA) and Greenpeace East Asia analyzed the top 21 exporters and importers of plastic recyclable waste from 2016 until 2018 – before and after China stopped taking such waste last year.

It found that plastic waste imports into Thailand, Malaysia and Vietnam jumped from mid-2017 to early 2018, leading to illegal operations dumping and open-burning, contaminating water supplies, killing crops and causing respiratory illnesses.

“For the first world, it makes them feel good about their waste supposedly being recycled but in reality it ends up in countries that cannot deal with the waste,” said Beau Baconguis, a plastics campaigner at GAIA in Manila.

“So the pollution is heading south to countries that do not have that capacity,” she told the Thomson Reuters Foundation.

As pollution and environmental damage linked to the rise in plastic waste became known in countries like Malaysia and Thailand during 2018, protests led to tighter waste regulations and import restrictions by authorities, the study found.

Large volumes of plastic waste then diverted to other countries in the region, like Indonesia and India, where regulations on the waste trade are more lenient, the study said.

“Once one country regulates plastic waste imports, it floods into the next un-regulated destination,” said Kate Lin, a Hong Kong based campaigner with Greenpeace East Asia.

“It’s a predatory system, but it’s also increasingly inefficient,” she said. “Each new iteration shows more and more plastic going off grid – where we can’t see what’s done with it – and that’s unacceptable.”

​​China was the leading importer of plastic waste until it banned imports at the start of 2018 after a string of scandals.

This disrupted the flow of more than 7 million tons of plastic scrap a year, valued at about $3.7 billion.

The top exporters of plastic waste analyzed for the report included the United States, Britain, Germany and Japan.

Members of the Basel Convention, the main global pact regulating the trans-boundary movement of hazardous waste, will meet in Geneva from April 29 and decide on a proposal from Norway to create greater transparency in plastic waste trade.

If adopted, any plastic waste exporters would be required to obtain prior approval from an importing country, and give more detailed information on the volume and type of waste.

Greenpeace’s Lin welcomed the proposal but urged consumer goods companies to reduce the single-use plastics they produce.

“It is a good step but definitely not a final solution,” Lin said.
…

A new study shows that many teenagers who use e-cigarettes do not understand the amount of addictive nicotine they are inhaling. 

The study, published in the American Academy of Pediatrics, found that 40 percent of adolescents who believed they were only using nicotine-free products were actually vaping significant amounts of the substance. 

The research involved 517 adolescents, aged 12 to 21, who were questioned about their use of e-cigarettes, traditional cigarettes and marijuana. 

Researchers from Stony Brook University in New York state compared adolescents’ responses about their use of such substances against urine samples taken from the teenagers. They found that almost all of the respondents were honest about their substance use, however, they discovered the biggest discrepancy in the study came from teens who thought they were using nicotine-free e-cigarettes. 

“Many of our participants were unaware of the nicotine content of the e-cigarette products they were using,” the researchers concluded. 

Pros and cons

The study comes at a time when the popularity of e-cigarettes is on the rise and their use has become a divisive topic in the public health community. 

Advocates for e-cigarettes say the products have the potential to shift lifelong smokers of traditional cigarettes onto less-harmful nicotine products, including e-cigarettes, while critics say that vaping risks bringing a new generation into nicotine addiction. Critics also point out that the health effects from the chemicals in e-cigarettes are not fully known.

E-cigarettes contain nicotine, which is addictive, but they do not contain tar or many of the other substances in traditional cigarettes, which make them deadly. Battery-powered e-cigarettes turn liquid nicotine into an inhalable vapor.

Use among teens

Last year, the U.S. Food and Drug Administration announced a plan to restrict sales of most flavored e-cigarettes at drug stores and gasoline stations in an attempt to keep them out of the hands of young people.

U.S. federal law bans the sale of e-cigarettes to anyone under 18 years of age. But a study published last year found that 1 in 5 high school students report using the devices — an activity known as vaping. 
…

A new study shows that many teenagers who use e-cigarettes do not understand the amount of addictive nicotine they are inhaling. 

The study, published in the American Academy of Pediatrics, found that 40 percent of adolescents who believed they were only using nicotine-free products were actually vaping significant amounts of the substance. 

The research involved 517 adolescents, aged 12 to 21, who were questioned about their use of e-cigarettes, traditional cigarettes and marijuana. 

Researchers from Stony Brook University in New York state compared adolescents’ responses about their use of such substances against urine samples taken from the teenagers. They found that almost all of the respondents were honest about their substance use, however, they discovered the biggest discrepancy in the study came from teens who thought they were using nicotine-free e-cigarettes. 

“Many of our participants were unaware of the nicotine content of the e-cigarette products they were using,” the researchers concluded. 

Pros and cons

The study comes at a time when the popularity of e-cigarettes is on the rise and their use has become a divisive topic in the public health community. 

Advocates for e-cigarettes say the products have the potential to shift lifelong smokers of traditional cigarettes onto less-harmful nicotine products, including e-cigarettes, while critics say that vaping risks bringing a new generation into nicotine addiction. Critics also point out that the health effects from the chemicals in e-cigarettes are not fully known.

E-cigarettes contain nicotine, which is addictive, but they do not contain tar or many of the other substances in traditional cigarettes, which make them deadly. Battery-powered e-cigarettes turn liquid nicotine into an inhalable vapor.

Use among teens

Last year, the U.S. Food and Drug Administration announced a plan to restrict sales of most flavored e-cigarettes at drug stores and gasoline stations in an attempt to keep them out of the hands of young people.

U.S. federal law bans the sale of e-cigarettes to anyone under 18 years of age. But a study published last year found that 1 in 5 high school students report using the devices — an activity known as vaping. 
…

The endangered killer whales of the Pacific Northwest live very different lives from orcas in captivity.

They swim up to 100 miles (161 kilometers) a day in pursuit of salmon, instead of being fed a steady diet of baitfish and multivitamins. Their playful splashing awes and entertains kayakers and passengers on Washington state ferries instead of paying theme park customers.

But the captive whales are nevertheless providing a boon to researchers urgently trying to save wild whales in the Northwest.

SeaWorld, which displays orcas at its parks in California, Texas and Florida, has recently published data from thousands of routine blood tests of its killer whales over two decades, revealing the most comprehensive picture yet of what a healthy whale looks like. The information could guide how and whether scientists intervene to help sick or stranded whales in the wild.

“For us, collecting blood from free-ranging killer whales is exceedingly difficult, so it’s something we would rarely ever do,” said Deborah Fauquier, a veterinary medical officer at the National Marine Fisheries Service. “Having partners that are in the managed-care community that can provide us with blood values from those animals is very useful. It’s giving us a very robust baseline data set that we haven’t had previously for these whales.”

The round-up of killer whales for theme-park display in the 1960s and ’70s was devastating for the Pacific Northwest’s resident orcas: At least 13 were killed and 45 kept to awe and entertain paying crowds around the world, according to the Center for Whale Research on Washington’s San Juan Island. Only one of those orcas survives: Lolita, at the Miami Seaquarium.

​Protecting orcas

Washington state eventually sued SeaWorld to stop the hunts. Today, 17 of SeaWorld’s 20 whales were born in captivity, including some descended from orcas captured near Iceland; the company hasn’t collected a wild orca in more than 40 years. Under public pressure, it ended its captive breeding program and is replacing trained orca shows with what it describes as “more educational experiences where guests can still enjoy and marvel at the majesty and power of the whales.”

It took decades for the so-called southern resident killer whales, which spend several months every summer and fall in the marine waters between Washington state and Canada, to recover from the hunts. By the mid-1990s, their population reached 98. 

Half a century later, the orcas are struggling against different threats: pollution, vessel noise and, most seriously, starvation from a dearth of Chinook salmon, their preferred prey. There are just 75 left, and researchers say they’re on the verge of extinction.

Gov. Jay Inslee has proposed $1.1 billion in spending to help the whales, with much of the money going toward protecting and restoring salmon habitat. The National Marine Fisheries Service, also known as NOAA Fisheries, is planning to propose expanded habitat protections this year for the whales’ foraging areas off the Washington, Oregon and California coasts.

SeaWorld has also boosted its efforts to help the southern resident orcas, pledging $10 million to the National Fish and Wildlife Foundation’s Killer Whale Research and Conservation Program.

​SeaWorld research

“Our stance is to do research with our animals to try to help this population now, and that’s what we’re doing,” said Todd Robeck, SeaWorld’s vice president of conservation research. “That’s why I got into what I do — to try to help animals in the wild.”

Robeck is one of the lead authors on the review of SeaWorld’s data, which included results of more than 2,800 blood tests on 32 whales from 1993 to 2013. Data from sick and pregnant whales were excluded to obtain a standard range for blood values, including cholesterol, platelet count, triglycerides and many other metrics. The whales were trained to present the underside of their tails for the blood draws, which were taken once or twice a month.

The results show that most of the values don’t differ much between male and female whales, but they do differ considerably with age and season, Robeck said. The study suggests that orcas lose some immune function as they age.

While there will be some difference between the values for captive and wild whales due to differences in climate, diet and other factors, the research provides a template for understanding the whales, Robeck said. Further, the values may be compared to data from blow samples or fecal samples to provide even greater insight, he said. Among the ongoing research projects at SeaWorld is studying the extent to which toxins that build up in the whales due to pollution are transferred to calves from their mothers.

“It’s something that could only be done with our animals,” Robeck said. “It’s an example of how we are dedicated to participating in the well-being of killer whales in the Pacific Northwest and around the world, and how research with our animals is vital in answering some of these questions about how to address the needs of the animals in the wild.” 
…

The endangered killer whales of the Pacific Northwest live very different lives from orcas in captivity.

They swim up to 100 miles (161 kilometers) a day in pursuit of salmon, instead of being fed a steady diet of baitfish and multivitamins. Their playful splashing awes and entertains kayakers and passengers on Washington state ferries instead of paying theme park customers.

But the captive whales are nevertheless providing a boon to researchers urgently trying to save wild whales in the Northwest.

SeaWorld, which displays orcas at its parks in California, Texas and Florida, has recently published data from thousands of routine blood tests of its killer whales over two decades, revealing the most comprehensive picture yet of what a healthy whale looks like. The information could guide how and whether scientists intervene to help sick or stranded whales in the wild.

“For us, collecting blood from free-ranging killer whales is exceedingly difficult, so it’s something we would rarely ever do,” said Deborah Fauquier, a veterinary medical officer at the National Marine Fisheries Service. “Having partners that are in the managed-care community that can provide us with blood values from those animals is very useful. It’s giving us a very robust baseline data set that we haven’t had previously for these whales.”

The round-up of killer whales for theme-park display in the 1960s and ’70s was devastating for the Pacific Northwest’s resident orcas: At least 13 were killed and 45 kept to awe and entertain paying crowds around the world, according to the Center for Whale Research on Washington’s San Juan Island. Only one of those orcas survives: Lolita, at the Miami Seaquarium.

​Protecting orcas

Washington state eventually sued SeaWorld to stop the hunts. Today, 17 of SeaWorld’s 20 whales were born in captivity, including some descended from orcas captured near Iceland; the company hasn’t collected a wild orca in more than 40 years. Under public pressure, it ended its captive breeding program and is replacing trained orca shows with what it describes as “more educational experiences where guests can still enjoy and marvel at the majesty and power of the whales.”

It took decades for the so-called southern resident killer whales, which spend several months every summer and fall in the marine waters between Washington state and Canada, to recover from the hunts. By the mid-1990s, their population reached 98. 

Half a century later, the orcas are struggling against different threats: pollution, vessel noise and, most seriously, starvation from a dearth of Chinook salmon, their preferred prey. There are just 75 left, and researchers say they’re on the verge of extinction.

Gov. Jay Inslee has proposed $1.1 billion in spending to help the whales, with much of the money going toward protecting and restoring salmon habitat. The National Marine Fisheries Service, also known as NOAA Fisheries, is planning to propose expanded habitat protections this year for the whales’ foraging areas off the Washington, Oregon and California coasts.

SeaWorld has also boosted its efforts to help the southern resident orcas, pledging $10 million to the National Fish and Wildlife Foundation’s Killer Whale Research and Conservation Program.

​SeaWorld research

“Our stance is to do research with our animals to try to help this population now, and that’s what we’re doing,” said Todd Robeck, SeaWorld’s vice president of conservation research. “That’s why I got into what I do — to try to help animals in the wild.”

Robeck is one of the lead authors on the review of SeaWorld’s data, which included results of more than 2,800 blood tests on 32 whales from 1993 to 2013. Data from sick and pregnant whales were excluded to obtain a standard range for blood values, including cholesterol, platelet count, triglycerides and many other metrics. The whales were trained to present the underside of their tails for the blood draws, which were taken once or twice a month.

The results show that most of the values don’t differ much between male and female whales, but they do differ considerably with age and season, Robeck said. The study suggests that orcas lose some immune function as they age.

While there will be some difference between the values for captive and wild whales due to differences in climate, diet and other factors, the research provides a template for understanding the whales, Robeck said. Further, the values may be compared to data from blow samples or fecal samples to provide even greater insight, he said. Among the ongoing research projects at SeaWorld is studying the extent to which toxins that build up in the whales due to pollution are transferred to calves from their mothers.

“It’s something that could only be done with our animals,” Robeck said. “It’s an example of how we are dedicated to participating in the well-being of killer whales in the Pacific Northwest and around the world, and how research with our animals is vital in answering some of these questions about how to address the needs of the animals in the wild.” 
…