A plan to legalize irrigation around the Donana wildlife reserve in southern Spain, one of Europe’s largest wetlands and a wintering location for migratory birds, has sparked an outcry during a prolonged drought.

Andalusia’s conservative regional government wants to allow agricultural irrigation in five municipalities around Donana, saying the move poses no risk to the national park.

The regional assembly, where the conservatives have a majority, on Wednesday voted in favor of proceeding with detailed studies of the proposal.

During the debate, a lawmaker for the left-wing Adelante Andalucia party emptied a glass full of sand on regional leader Juanma Moreno’s vacant seat after accusing him of wanting to “dry up” Donana.

‘No water at all’

Scientists and the national government warn the park is in critical condition with lagoons drying out and biodiversity disappearing, and want a reduction in water extracted.

“There is no water at all. It makes no sense to promise something that is not there,” Environment Minister Teresa Ribera said on Tuesday, vowing to take all possible legal measures to protect Donana from the move “that directly attacks one of the country’s most precious ecosystems.”

While some irrigation is already allowed, many farmers use illegal wells that drain underwater reserves. The central government closed this week 220 illegal wells and plans to close hundreds more in the near future.

The European Commision, which has already taken Spain to court for failure to protect the wetlands, warned last month the plan could lead to sanctions.

Home to eagles, lynx, more

Donana boasts lagoons, marshlands, scrub woodland, beaches and sand dunes and is home to fallow deer, badgers and endangered species including the Spanish imperial eagle and the Iberian lynx.

Spain is in the grip of a long-term drought after 36 months of poor rainfall. The Guadalquivir basin, where Donana is located, and Catalonia in the northeast are two of the most affected areas.

Exacerbating the drought, scientists say, is illegal use of underground waters by local red fruit producers in greenhouses and by tourism ventures that have mushroomed around Donana.

A study by the Spanish National Research Council said this week 19% of Donana’s 267 lagoons have disappeared over the past decade, and the number of wintering migratory birds dropped to below 90,000 from some 500,000.

Campaign group Greenpeace said in a statement the proposed regulation “threatens the survival of Donana, one of Europe’s most emblematic natural areas, and punishes (legal) irrigators who have been complying with the law.”
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Electronic cigarette-maker Juul Labs will pay $462 million to six states and the District of Columbia, marking the largest settlement the company has reached so far for its role in the youth vaping surge, New York Attorney General Letitia James said Wednesday.

The agreement with New York, California, Colorado, Illinois, Massachusetts, New Mexico and Washington, D.C., marks the latest in a string of recent legal settlements Juul has reached across the country with cities and states.

The vaping company, which has laid off hundreds of employees, will pay $7.9 million to settle a lawsuit alleging the company violated West Virginia’s Consumer Credit and Protection Act by marketing its products to underage users, the state’s Attorney General Patrick Morrisey announced Monday. Last month, the company paid Chicago $23.8 million to settle a lawsuit.

Minnesota’s case against Juul went to trial last month with the state’s Attorney General Keith Ellison asserting that the company “baited, deceived and addicted a whole new generation of kids after Minnesotans slashed youth smoking rates down to the lowest level in a generation.”

Like some other settlements reached by Juul, this latest agreement includes various restrictions on the marketing, sale and distribution of the company’s vaping products. For example, it is barred from any direct or indirect marketing that targets young people, which includes anyone younger than 35. Juul is also required to limit the purchases customers can make in retail stores and online.

“Juul lit a nationwide public health crisis by putting addictive products in the hands of minors and convincing them that it’s harmless,” James said in a statement. “Today they are paying the price for the harm they caused.”

James said the $112.7 million due to New York will pay for underage smoking abatement programs across the state.

District of Columbia Attorney General Brian Schwalb said in a statement that Juul “knew how addictive and dangerous its products were and actively tried to cover up that medical truth.”

A spokesperson for the Washington, D.C.-based Juul said that with Wednesday’s settlement, “we are nearing total resolution of the company’s historical legal challenges and securing certainty for our future.”

The spokesperson added that underage use of Juul products has declined by 95% since 2019 based on the National Youth Tobacco Survey. According to the CDC, since surveys were administered online instead of on school campuses during the pandemic, the results cannot be compared to prior years.

In September, Juul agreed to pay nearly $440 million over a period of six to 10 years to settle a two-year investigation by 33 states into the marketing of its high-nicotine vaping products to young people. That settlement amounted to about 25% of Juul’s U.S. sales of $1.9 billion in 2021.

Three months later, the company said it had secured an equity investment to settle thousands of lawsuits over its e-cigarettes brought by individuals and families of Juul users, school districts, city governments and Native American tribes.

Juul rocketed to the top of the U.S. vaping market about five years ago with the popularity of flavors like mango and mint. But the startup’s rise was fueled by use among teenagers, some of whom became hooked on Juul’s high-nicotine pods.

Parents, school administrators and politicians have largely blamed the company for a surge in underage vaping.
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Hospitals in Cameroon are reporting an increase in cases of river blindness, a parasitic disease caused by bites from infected blackflies. Hundreds of aid workers have been dispatched to remote, riverside villages to encourage those infected to seek treatment. 

In Sa’a district, 74 kilometers north of Cameroon’s capital of Yaounde, 45-year-old Jean Christophe Onana says he has not been able to recover his sight after receiving treatment from an African traditional healer for two months. He says he strongly believes that he has been bewitched by his enemies who are envious of last year’s abundant yield from his cocoa farm.

Aid workers say Onana suffers from river blindness, a parasitic disease particularly prevalent in Africa, where 99% of all cases occur.

Cameroon’s ministry of public health says that hospitals in Lekie, the administrative unit where Sa’a is located, have reported several hundred fresh cases of river blindness within the past three months. 

The central African state’s government says the increase is in areas where there have been floods and where new farmland was opened near rivers, attracting settlers.

Ophthalmologist Raoul Edgard Cheuteu, one of the aid workers in Sa’a, says humanitarian agencies and the government of Cameroon have decided to jointly equip the Sa’a district hospital and scores of other hospitals in areas where there is an increase in river blindness cases with standard tests for the diagnosis of the disease. Cheuteu says Onchocerciasis is increasing in Sa’a because of its many rivers that are breeding sites for blackflies that transmit river blindness.

Aid workers are educating civilians in Cameroon riverside villages that river blindness is not a spell or divine punishment for wrongdoing but an infection that can be controlled and treated at hospitals.

Cameroon reports that youths are deserting remote villages where the number of people suffering from the parasitic disease of the skin and eyes transmitted by the blackfly is increasing. 

The Cameroon government says besides Sa’a, several hundred hospitals in Cameroon’s Centre, East and South regions have reported at least 6,000 new infections within three months.

The figures may be higher since 70% of Cameroonians go for African traditional medicine where it is difficult to collect data, the government says.

The Global Institute for Disease Elimination, GLIDE, works with the Cameroon ministry of Public Health to help accelerate treatment for river blindness, a neglected tropical disease.

GLIDE’s top official, Dr. Aissatou Diawara, says river blindness is a public health concern in Cameroon because about 6 million of the country’s 26 million inhabitants are already infected.

“Despite two decades of annual treatment or community-directed treatment with ivermectin or CDTI, confirmed cases of Onchocerciasis are still present in 113 health districts previously classified as hyperendemic,” Diawara said via a messaging app. “So the use of test and treat strategy and addressing communities to get used to treatment are essential steps towards eliminating Onchocerciasis in Cameroon.”

Diawara says blackflies that transmit river blindness breed along fast-flowing rivers and streams, close to remote villages located near fertile land where people rely on agriculture. She said river blindness is transmitted to humans through exposure to repeated bites of infected blackflies and symptoms include severe itching, disfiguring skin conditions and visual impairment, including permanent blindness.

The United Nations says Onchocerciasis occurs mainly in tropical areas, with more than 99% of infected people living in 31 countries in sub-Saharan Africa.  
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The U.S. Environmental Protection Agency (EPA) on Wednesday proposed sweeping emissions cuts for new cars and trucks through 2032, a move it says could mean two out of every three new vehicles automakers sell will be electric within a decade.

The proposal, if finalized, represents the most aggressive U.S. vehicle emissions reduction plan to date, requiring 13% annual average pollution cuts and a 56% reduction in projected fleet average emissions over 2026 requirements. The EPA is also proposing new stricter emissions standards for medium-duty and heavy-duty trucks through 2032.

The EPA projects the 2027-2032 model year rules would cut more than 9 billion tons of CO2 emissions through 2055 – equivalent to more than twice total U.S. CO2 emissions last year.

Automakers and environmentalists say the administration is moving quickly in order to finalize new rules by early 2024 to make it much harder for a future Congress or president to reverse them. Then President Donald Trump rolled back tough emissions limits through 2025 set under Barack Obama but the Biden administration reversed the rollback.

The agency estimates net benefits through 2055 from the proposal range from $850 billion to $1.6 trillion. By 2032 the proposal would cost about $1,200 per vehicle per manufacturer, but save an owner more than $9,000 on average on fuel, maintenance, and repair costs over an eight-year period.  

“A lot has to go right for this massive – and unprecedented – change in our automotive market and industrial base to succeed,” said John Bozzella, CEO of the Alliance for Automotive Innovation representing General Motors GM.N, Volkswagen VOWG_p.DE, Toyota 7203.T and others.

“Factors outside the vehicle, like charging infrastructure, supply chains, grid resiliency, the availability of low carbon fuels and critical minerals will determine whether EPA standards at these levels are achievable.”

The proposal is more ambitious than President Joe Biden’s 2021 goal, backed by automakers, seeking 50% of new vehicles by 2030 to be electric vehicles (EVs) or plug-in hybrids. Stellantis STLAM.MI said it was “surprised that none of the alternatives align with the President’s previously announced target of 50% EVs by 2030.”

The Biden administration is not proposing banning gasoline-powered vehicles, but wants comments on whether it should extend emissions rules through 2035 and on other alternatives. Some environmental groups want the EPA to set tougher rules, especially on heavy trucks.

“These standards are very ambitious and they track with the sense of urgency that the president and this administration have as we tackle the climate crisis,” EPA Administrator Michael Regan said in a Reuters interview, declining to endorse setting a date to end the sale of new gasoline-powered vehicles. He emphasized the proposal is a “performance-based standard” and not an EV mandate.

Under the EPA proposal, automakers are forecast to produce 60% EVs by 2030 and 67% by 2032 to meet requirements – compared with just 5.8% of U.S. vehicles sold in 2022 that were EVs. The National Highway Traffic Safety Administration plans to propose parallel economy standards in the coming weeks.

California in August moved to require all new vehicles sold in the state by 2035 be electric or plug-in electric hybrids, but must still seek an EPA waiver to proceed. Regan would not to say how the EPA would react to a California request. “We’ll be on the lookout for that if it were to ever come,” he said.

Dan Becker, director of the Safe Climate Transport Campaign, said the EPA proposal should have been tougher.

“Automakers talk out of both sides of their tailpipes, promising electric vehicles while delivering mostly the same old gas-guzzlers and lobbying for weak, loophole-riddled rules,” Becker said.

Under the proposal, the EPA estimates 50% of new vocational vehicles like buses and garbage trucks could be EVs by 2032, along with 35% of new short-haul freight tractors and 25% of new long-haul freight tractors. Medium-duty vehicle rules are projected to cut emissions by 44% over 2026.
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The U.S. has named a veterinary tranquilizer as an “emerging threat” when it’s mixed with the powerful opioid fentanyl, clearing the way for more efforts to stop the spread of xylazine.

The Office of National Drug Control Policy announced the designation Wednesday, the first time the office has used it since the category for fast-growing drug dangers was created in 2019.

Dr. Rahul Gupta, director of the drug policy office, said xylazine has become increasingly common in all regions of the country.

It was detected in about 800 drug deaths in the U.S. in 2020 — most of them in the Northeast. By 2021, it was present in more than 3,000 fatalities —with the most in the South — according to a report last year from the Drug Enforcement Administration.

“We cannot ignore what we’re seeing,” Gupta said. “We must act and act now.”

Xylazine was approved for veterinary use in 1971. Sometimes known as “tranq,” it’s been showing up in supplies of illicit drugs used by humans in major quantities in only the last several years.

It’s believed to be added to other drugs to increase profits. Officials are trying to understand how much of it is diverted from veterinary uses and how much is made illicitly.

The drug causes breathing and heart rates to slow down, sometimes to deadly levels, and causes skin abscesses and ulcers that can require amputation. Withdrawal is also painful.

While it’s often used in conjunction with opioids, including fentanyl and related illicit lab-made drugs, it’s not an opioid. And there are no known antidotes.

Gupta said his office is requesting $11 million as part of its budget to develop a strategy to tackle the drug’s spread. Plans include developing an antidote, learning more about how it is introduced into illicit drug supplies so that can be disrupted, and looking into whether Congress should classify it as a controlled substance.

Gupta said it needs to be available for veterinary uses even amid crackdowns on the supply used by people. He also said systems to detect the drug and data about where it’s being used need to be improved.

The drug is part of a deepening overdose crisis in the U.S.

The U.S. Centers for Disease Control and Prevention estimates that more than 107,000 people died from overdoses in the 12 months that ended Oct. 31, 2022. Before 2020, the number of overdose deaths had never topped 100,000.

Most of the deaths were linked to fentanyl and other synthetic opioids. Like xylazine, they’re often added to other drugs — and users don’t always know they’re getting them.
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U.S. health officials released data Tuesday showing how chlamydia, gonorrhea and syphilis cases have been accelerating, but doctors are hoping an old drug will help fight the sexually transmitted infections.

Experts believe STDs have been rising because of declining condom use, inadequate sex education, and reduced testing during the COVID-19 pandemic.

Millions of Americans are infected each year. Rates are highest in men who have sex with men, and among Black and Hispanic Americans and Native Americans.

“Sexually transmitted infections are an enormous, low-priority public health problem. And they’ve been a low-priority problem for decades, in spite of the fact that they are the most commonly reported kind of infectious disease,” said Dr. John M. Douglas Jr., a retired health official who lectures at the Colorado School of Public Health.

To try to turn the tide, many doctors see promise in doxycycline, a cheap antibiotic that has been sold for more than 50 years.

The Centers for Disease Control and Prevention is drafting recommendations for using it as a kind of morning-after pill for preventing STDs, said Dr. Leandro Mena, director of the agency’s STD prevention division.

The drug is already used to treat a range of infections. A study published last week in The New England Journal of Medicine showed its potential to prevent sexually transmitted infections.

In the study, about 500 gay men, bisexual men and transgender women in Seattle and San Francisco with previous STD infections took one doxycycline pill within 72 hours of unprotected sex. Those who took the pills were about 90% less likely to get chlamydia, about 80% less likely to get syphilis, and more than 50% less likely to get gonorrhea compared with people who did not take the pills after sex, the researchers found.

The study was led by researchers at the University of California, San Francisco and built on a similar French study that saw promise in the idea.

“We do need new approaches, new innovations” to help bring sexually transmitted infections under control, said Dr. Philip Andrew Chan, who is consulting with the CDC on the doxycycline recommendations.

Mena, of the CDC, said there is no sign the STD trend is slowing.

Mississippi had the highest rate of gonorrhea cases, according to 2021 CDC data released Tuesday. Alaska saw a sharp increase in its chlamydia case rate that allowed it to overtake Mississippi at the top of that list. South Dakota had the highest rate of early-stage syphilis.

Arizona had the highest rate of cases in which infected mothers pass syphilis on to their babies, potentially leading to death of the child or health problems like deafness and blindness.

Using an antibiotic to prevent these kinds of infections won’t “be a magic bullet. but it will be another tool,” said Chan, who teaches at Brown University and is chief medical officer at Open Door Health, a health center for gay, lesbian and transgender patients in Providence, Rhode Island.

Experts noted the CDC will have many factors to weigh as it develops the recommendations.

Among them: The drug can cause side effects such as stomach problems and rashes after sun exposure. Some research has found it ineffective in heterosexual women. And widespread use of doxycycline as a preventive measure could contribute to mutations that make bacteria impervious to the drug, as has happened with antibiotics before.

Nevertheless, the San Francisco Department of Public Health in October became the first U.S. health department to issue guidance about doxycycline as an infection-prevention measure. And some other clinics have been recommending the antibiotic to patients who may be at higher risk.

Derrick Woods-Morrow, a 33-year-old artist and an assistant professor at the Rhode Island School of Design, is an early adopter. Woods-Morrow said he isn’t a fan of condoms — they can break, and sometimes people slip them off during sex. But he wants to stay healthy.

About a decade ago, he started taking an anti-viral medication before sex to protect himself from HIV infection. Five years ago, a doctor told him about research into whether doxycycline might protect people from other diseases.

“I thought it was probably in my best interest to protect myself and my partners, as well,” he said. He said it’s been a positive experience, and that he hasn’t tested positive for chlamydia, gonorrhea or syphilis while using it.

“I feel like it’s a tool to sort of take back the sexual freedoms that someone may have lost and to really enjoy sex and interactions with people with a peace of mind,” he said.
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Even before he has dipped his toes into the murky waters of Paris ‘ famous but forbidden River Seine, French triathlete Thibaut Rigaudeau is already fielding questions from disbelieving friends.

“Are you scared of swimming in the Seine?” he says they ask him. “It looks disgusting.'”

For decades, it was. Though immortalized in art, literature and song, and cherished by lovers who whisper sweet nothings or tearfully part on the privacy of its banks, the river was ecologically dying. It was too toxic for most fish and for swimmers, largely useful only as a waterway for goods and people or as a watery grave for discarded bicycles and other trash. Swimming in the Seine has, with some exceptions, been off-limits since 1923.

Now, however, its admittedly unappetizing green-brown waters hide a tale of rebirth.

A costly and complex cleanup is resuscitating the Seine just in time for it to play a starring role in the 2024 Paris Olympics and, after that, for it to genuinely live up to its billing as the world’s most romantic river, one that’s actually fit again for people. And in a warming world, a renewed ability to take cooling dips in the river should help France’s capital remain livable during increasingly frequent heat waves. It possibly might also inspire other cities to invest in reclaiming their waterways.

“It will create waves, so to speak, across the world because a lot of cities are watching Paris,” says Dan Angelescu, a scientist who is tracking the Seine’s water quality for City Hall, with regular sampling.

“It’s the beginning of a movement,” he says. “We hope so, at least.”

The Olympic deadline has supercharged a cleanup that has been decades in the making. Without the imperative of having to be ready for 10,500 Olympians in July and August next year, followed by 4,400 Paralympians, City Hall officials say it would have taken many more years to fund the multi-pronged, 1.4 billion-euro ($1.5 billion) effort. Because as well as hosting outdoor swim races, the Seine is going to be the centerpiece of Paris’ unprecedented Olympic opening ceremony. For the first time, it will take place not in a stadium setting but along the river and its banks.

So it needs to be ready. Officials have been going after homes upstream of Paris and houseboats on the Seine that were emptying their sewage and wastewater directly into the river. An Olympic law adopted in 2018 gave moored boats two years to hook up to Paris’ sewage network. Sewage treatment plants on the Seine and its tributary, the Marne, are also being improved.

And more than half a billion euros (dollars) is going into huge storage basins and other public works that will reduce the need to spill bacteria-laden wastewater into the Seine untreated when it rains. One storage facility is being dug next to Paris’ Austerlitz train station. The giant hole will hold the equivalent of 20 Olympic swimming pools of dirty water that will now be treated rather than being spat raw through storm drains in the river.

City Hall says the water quality is already improving and that there are many more types of fish than the two or three species that were the only ones hardy enough to survive in the filth a few decades ago. It says samples taken daily last July and August in the stretch of river where Olympians and Paralympians will compete showed the water quality was overwhelmingly “good.” By their sports’ standards, that means acceptable.

Setting off from the Seine’s ornate Alexandre III bridge, triathletes will race first in 2024, with men on July 30, followed by women the next day. Then come marathon swimmers, on Aug. 8 and 9, and para-triathletes on Sept. 1 and 2.

Rigaudeau, who competed in para-triathlon at the 2021 Tokyo games, is thrilled by the prospect. He’s hoping for an early taste of the experience when Paris hosts warm-up swims in the Seine this summer to hone its readiness for 2024. It will be Rigaudeau’s first-ever dip in his home river.

“We will be the ‘testers,'” he says. “I hope we don’t get sick.”

After the games, the river should then reopen to everyone — in the summer of 2025. City Hall says five potential bathing spots are being studied within Paris itself, with others a bit further afield.

Officials hope that after so many years where swimming in the Seine was unthinkable, Parisians will start to feel that it’s safe to go back in the water when they see Olympians and Paralympians leading the way.

“It’s going to change our lives,” Rigaudeau says. “But it’s also true that because everyone thinks that it’s really very dirty, I’m not sure if people will go of their own accord, at least at first.”
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The U.S. national emergency to respond to the COVID-19 pandemic ended Monday as President Joe Biden signed a bipartisan congressional resolution to bring it to a close after three years — weeks before it was set to expire alongside a separate public health emergency. 

The national emergency allowed the government to take sweeping steps to respond to the virus and support the country’s economic, health and welfare systems. Some of the emergency measures have already been successfully wound down, while others are still being phased out. The public health emergency — it underpins tough immigration restrictions at the U.S.-Mexico border — is set to expire on May 11. 

The White House issued a one-line statement Monday saying Biden had signed the measure behind closed doors, after having publicly opposed the resolution though not to the point of issuing a veto. More than 197 Democrats in the House voted against it when the GOP-controlled chamber passed it in February. Last month, as the measure passed the Senate by a 68-23 vote, Biden let lawmakers know he would sign it. 

The administration said once it became clear that Congress was moving to speed up the end of the national emergency it worked to expedite agency preparations for a return to normal procedures. Among the changes: The Department of Housing and Urban Development’s COVID-19 mortgage forbearance program is set to end at the end of May, and the Department of Veterans Affairs is now returning to a requirement for in-home visits to determine eligibility for caregiver assistance. 

Legislators last year extended for another two years telehealth flexibilities that were introduced as COVID-19 hit, leading health care systems around the country to regularly deliver care by smartphone or computer. 

More than 1.13 million people in the U.S. have died from COVID-19 over the past three years, according to the Centers for Disease Control and Prevention, including 1,773 people in the week ending April 5. 

Then-President Donald Trump’s Health and Human Services Secretary Alex Azar first declared a public health emergency on January 31, 2020, and Trump declared the COVID-19 pandemic a national emergency that March. The emergencies have been repeatedly extended by Biden since he took office in January 2021, and he broadened the use of emergency powers after entering the White House. 
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An international team of scientists is rushing to save West Africa’s Atlantic humpback dolphin, which environmental groups say has been pushed to the brink of extinction. In 1987, Senegal banned nylon monofilament fishing nets that threaten dolphins and other marine life, but critics say the government has failed to enforce the law. Annika Hammerschlag reports from Senegal’s Sine Saloum Delta.
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The Iowa Attorney General’s Office has paused its practice of paying for emergency contraception — and in rare cases, abortions — for victims of sexual assault, a move that drew criticism from some victim advocates.

Federal regulations and state law require Iowa to pay many of the expenses for sexual assault victims who seek medical help, such as the costs of forensic exams and treatment for sexually transmitted infections. Under the previous attorney general, Democrat Tom Miller, Iowa’s victim compensation fund also paid for Plan B, the so-called morning after pill, as well as other treatments to prevent pregnancy.

A spokeswoman for Republican Attorney General Brenna Bird, who defeated Miller’s bid for an 11th term in November, told the Des Moines Register that those payments are now on hold as part of a review of victim services.

“As a part of her top-down, bottom-up audit of victim assistance, Attorney General Bird is carefully evaluating whether this is an appropriate use of public funds,” Bird Press Secretary Alyssa Brouillet said in a statement. “Until that review is complete, payment of these pending claims will be delayed.”

 

Victim advocates were caught off guard by the pause. Ruth Richardson, CEO of Planned Parenthood North Central States, said in a statement that the move was “deplorable and reprehensible.”

Bird’s decision comes as access to the most commonly used method of abortion in the U.S. plunged into uncertainty following conflicting court rulings on Friday over the legality of the abortion medication mifepristone. For now, the drug the Food and Drug Administration approved in 2000 appeared to remain at least immediately available in the wake of separate rulings issued in quick succession.

U.S. District Judge Matthew Kacsmaryk in Texas, an appointee of former President Donald Trump, ordered a hold on federal approval of mifepristone. But that decision came at nearly the same time that U.S. District Judge Thomas O. Rice in Washington state, an appointee of former President Barack Obama, essentially ordered the opposite.

The extraordinary timing of the competing orders revealed the high stakes surrounding the drug nearly a year after the U.S. Supreme Court overturned Roe v. Wade and curtailed access to abortion across the country. President Joe Biden said his administration would fight the Texas ruling.

In Iowa, money for the victim compensation fund comes from fines and penalties paid by convicted criminals. For sexual assault victims, state law requires that the fund pay “the cost of a medical examination of a victim for the purpose of gathering evidence and the cost of treatment of a victim for the purpose of preventing venereal disease,” but makes no mention of contraception or pregnancy risk.

Sandi Tibbetts Murphy, who served as director of the victim assistance division under Miller, said the longtime policy for Iowa has been to include the cost of emergency contraception in the expenses covered by the fund. She said that in rare cases, the fund paid for abortions for rape victims.

“My concern is for the victims of sexual assault, who, with no real notice, are now finding themselves either unable to access needed treatment and services, or are now being forced to pay out of their own pocket for those services, when this was done at no fault of their own,” she said.
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Climate change, deforestation, and urbanization are some of the major risk factors behind the increasing number of outbreaks of viruses such as dengue, Zika, and chikungunya around the world, warns a study by the World Health Organization. 

The study says the incidence of infections caused by these mosquito-borne illnesses, which thrive in tropical and subtropical climates, have grown dramatically in recent decades.  The report says cases of dengue have increased from just over half a million globally in 2000 to 5.2 million in 2019. 

And the trend continues.  The latest data show about half of the world’s population now is at risk of dengue, the most common viral infection that spreads from mosquitoes to people, with an estimated 100 to 400 million infections occurring every year. 

“Right now, around 129 countries are at risk of dengue, and it is endemic in over 100 countries,” said Raman Velayudhan, unit head of WHOs global program on control of neglected tropical diseases coordinating dengue and arbovirus initiative.  

He said dengue in South America alone is moving further south to countries such as Bolivia, Peru, and Paraguay. 

Climate change gives rise to increased precipitation, higher temperatures and higher humidity, conditions under which mosquitos thrive and multiply.  There is new research, which shows that even dry weather enables mosquitos to breed.  Scientists say dry weather makes mosquitos thirsty and when they become dehydrated, they want to feed on blood more often. 

“This is really worrying because this shows that climate change has played a key role in facilitating the spread of the vector mosquitoes down south.  And then when people travel, naturally the virus goes along with them,” he said.   “And this trend is likely to continue for the rest of the world. 

“We have already got reports from Sudan, which has recorded a quite high increase in dengue cases, over 8,000 cases and 45 deaths since July.”   

WHO officials note that cases of dengue in Asia have increased in Cambodia, Vietnam, Laos, the Philippines, Malaysia, and Singapore.   

Dengue is a mild disease, in most cases.  While most people will not have symptoms, some might experience high fever, headache, body aches, nausea, and rash.  Most people will recover in a couple of weeks, but dengue could be fatal for those who develop severe cases. 

“This is a big threat to the world because most of the countries now have all the four related dengue viruses in circulation,” Velayudhan said.  “Dengue unfortunately does not have a treatment and even vaccines are just emerging in the market right now,” he said.  

He noted that one vaccine, found to be effective in people who have had dengue once, is licensed in about 20 countries, two other vaccines are in the pipeline, and two drugs are under development. 

Chikungunya and Zika 

The Chikungunya virus is spread by Aedes mosquitoes and is found on nearly all continents.  To date, about 115 countries have reported cases. The disease can cause chronic disabilities in some people and severely impact their quality of life.   

Diana Rojas Alvarez, WHO technical lead for Zika and chikungunya and co-lead of the global arbovirus initiative said that cases of chikungunya in the Americas have increased from 50,000 in 2022 to 135,000 this year.   She said the virus was circulating out of the usual endemic areas inside South America and was spreading into other regions. 

Arboviruses are spread by arthropods – which include mosquitos, ticks, centipedes and millipedes and spiders. 

“Now we are seeing transmission where we did not see it before.  The countries where the mosquito has been introduced is increasing and where the mosquito is established is alarming,” she said. 

“We should be prepared to detect some cases during spring and summer in Europe and in the northern hemisphere, also in southeast Asia because the arbovirus season starts later there.  It is usually when the summer season starts,” Rojas Alvarez said.  

Like dengue and chikungunya, the Zika virus is spread by the Aedes mosquitoes, which mostly bite during the day.  However, unlike the other two viruses, Zika also can be transmitted sexually between people and from mother to child during pregnancy. 

Between October 2015 and January 2016, Brazil reported 1.5 million people were infected with the Zika virus and more than 3,500 babies were born with smaller heads than normal—a condition known as microcephaly.  

The epidemic spread to other parts of South and North America and several islands in the Pacific.  The WHO declared Zika a Public Health Emergency of International Concern in February 2016. 

“Zika is still circulating,” said Rojas Alvarez.   “Of course, we went from millions of cases in 2015 and 2016 and since 2017 the cases are going down, but we still have about 30 to 40,000 cases reported every year, mostly in the Americas.” 

She added that 89 countries and territories have reported cases of Zika virus transmission.  

Last year, WHO launched the Global Arbovirus Initiative to tackle emerging and re-emerging arboviruses with epidemic and pandemic potential.  The plan focuses on preparedness, early detection, and response to outbreaks, as well as the development of new drugs and vaccines.   

While these strategies take shape, health officials are urging communities to eliminate mosquito breeding sites in and around homes and use mosquito repellent to protect themselves against the potentially fatal diseases.
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