Malawi has launched a nationwide rollout of the newest typhoid vaccine for children under 15.

A two-year study of the vaccine, the first in Africa, found it safe to use and effective in more than 80% of recipients. Health authorities say the vaccine is expected to reduce the threat from a disease that kills close to 20,000 people in sub-Saharan Africa each year.

Typhoid fever is a contagious bacterial infection caused by consuming contaminated foods or drinks. Its symptoms include nausea, fever and abdominal pain, and if left untreated it can be fatal.

Malawi health authorities said the typhoid conjugate vaccine (TCV) rollout would be part of a nationwide program expected to start Monday when children will be vaccinated against three other diseases: measles, rubella and polio.

However, some fear the campaign will encounter hesitancy and resistance from people, as was the case with COVID-19 vaccines, which led to the burning of about 20,000 expired doses in Malawi in 2021.

George Jobe, chairperson of the Universal Health Coverage Coalition in Malawi, told VOA that efforts were made to educate people on the importance of the campaign.

“There was training for community health care workers as well as teachers, so that they take messages to community leaders, who would also take messages to their subjects,” Jobe said.

Terrible toll

Typhoid has long been a health threat in Malawi and across sub-Saharan Africa, with an estimated 1.2 million cases and 19,000 deaths each year.

In 2018, Malawi became the first country to use TCV to fight typhoid infections in children under clinical trials.

Over 20,000 children from 9 months to 12 years of age took part in a clinical trial in Malawi led by professor Melita Gordon of the University of Liverpool. The trial found the vaccine was safe and was more than 80% effective.

Priyanka Patel, an understudy doctor at the Malawi Liverpool Wellcome program, told VOA that this vaccine can offer protection for at least four years, making it a highly effective and efficient tool for preventing the spread of typhoid.

“Secondly,” Patel said, “the typhoid conjugate vaccine can be given to children as young as 6 months old, making it easier to reach vulnerable populations. This is in contrast to older vaccines, which were not approved for use in young children.”

In Malawi, TCV was expected to be rolled out in 2021, but the effort was postponed because of the COVID-19 pandemic.

Gianfranco Rotigliano, country representative for the U.N. children’s agency in Malawi, urged the government to prioritize its immunization campaign in hard-to-reach areas where most of the children are unvaccinated.

“Vaccination is a right, health is a right,” he said. “So we should definitely look for children who are not vaccinated, because in urban areas most of the children are vaccinated, but there are those who never got even one dose of vaccine.”

Government authorities hope the campaign will be a success, following the efforts they have put in place to educate people on the importance of vaccinating children.
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Astronomers have created a stunning mosaic of baby star clusters hiding in our galactic backyard.

The montage, published Thursday, reveals five vast stellar nurseries less than 1,500 light-years away. A light-year is nearly 9.7 trillion kilometers.

To come up with their atlas, scientists pieced together more than 1 million images taken over five years by the European Southern Observatory in Chile. The observatory’s infrared survey telescope was able to peer through clouds of dust and discern infant stars.

“We can detect even the faintest sources of light, like stars far less massive than the sun, revealing objects that no one has ever seen before,” University of Vienna’s Stefan Meingast, the lead author, said in a statement.

The observations, conducted from 2017 to 2022, will help researchers better understand how stars evolve from dust, Meingast said.

The findings, appearing in the journal Astronomy and Astrophysics, complement observations by the European Space Agency’s star-mapping Gaia spacecraft, orbiting nearly 1.5 million kilometers away.

Gaia focuses on optical light, missing most of the objects obscured by cosmic dust, the researchers said.
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The World Health Organization on Thursday declared mpox — formerly known as monkeypox — no longer poses a global public health emergency.

At a briefing at agency headquarters in Geneva, WHO Director-General Tedros Adhanom Ghebreyesus said the organization’s emergency committee on mpox met and recommended the multi-country outbreak no longer represents a public health emergency of international concern, and that he accepted that recommendation.

One major factor in the decision Tedros cited was a nearly 90% drop in cases of the disease during the last three months compared to the previous three months.

The WHO chief credited the sharp drop in cases to the work of community organizations and public health authorities around the world. The United Nations-linked health body noted that organizational efforts to inform the public of the risks of mpox, encouraging and supporting behavior change, and advocating for access to tests, vaccines and treatments, were critical.

But Tedros warned mpox continues to pose significant public health challenges that require “a robust, proactive and sustainable response.” In fact, Wednesday the U.S. Centers for Disease Control and Prevention announced a new cluster of cases were reported in Chicago.

Symptoms of mpox often include a rash that may be located on hands, feet, chest, face, or mouth or near the genitals, as well as fever, chills, and fatigue.

The WHO reported 98% of cases are among men who have sex with other men and can be spread from person to person through sexual contact, kissing, hugging and through contaminated clothing, towels and bed sheets.

In his briefing, Tedros said the misinformed stigma that mpox is a “gay disease” had been a driving concern in managing the epidemic, adding that it continues to hamper access to care for the disease. A feared much larger backlash against the most affected communities with mpox has largely not materialized.

As the outbreak expanded late last year, a trend of racist and stigmatizing language online and in some communities toward the term “monkeypox” was reported to the WHO. After consultations with international experts, the agency adopted mpox as a new, preferred term for the disease.

Some information in this report came from The Associated Press, Reuters and Agence France Presse.
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A new wing of the American Museum of Natural History in New York City officially opened to the public in in early May. The futuristic space features new galleries including an insectarium, butterfly vivarium, floor-to-ceiling collections displays and more. Evgeny Maslov has the story, narrated by Anna Rice. Camera: Vladimir Badikov 
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Health agencies warn that viral hepatitis could kill more people by 2040 than HIV, tuberculosis and malaria combined if it remains a neglected disease and efforts to fight it remain underfunded.  

 

The World Health Organization reports every year that viral hepatitis, a potentially life-threatening liver infection, affects more than 350 million people globally and kills more than a million. Ninety percent of these infections and deaths are in low- and middle-income countries. 

 

Despite a cure for hepatitis C and a vaccine for hepatitis B, campaigners for a world free of this dangerous and debilitating disease remain far off that mark. 

 

“Over the last 10 years, we have seen really remarkable progress in this journey to eliminate viral hepatitis,” said Oriel Fernandez, senior director of the Viral Hepatitis Global Program at the Clinton Health Access Initiative, or CHAI.

“We have the tools to prevent, diagnose and treat viral hepatitis,” she said. “Secondly, the price of hepatitis drugs and diagnostics has significantly fallen over the years.” 

 

For example, Fernandez noted that in 2018, CHAI supported the government of Rwanda to set the lowest price for WHO-approved hepatitis B treatment. 

“The total cost to cure a patient dropped by 96%, from over $2,500 per person to less than $80 per person cured. And this made the idea of elimination affordable for Rwanda and really established a benchmark price for all countries to aim for,” she said. 

Pledging conference

 

But funding to help poor countries pay for the treatments and vaccines to cure and eliminate this debilitating disease remains elusive. To address this issue, the Hepatitis Fund and CHAI will hold the first-ever pledging conference in Geneva next week.  

 

The conference hopes to raise $150 million to support countries that are committed to the elimination of viral hepatitis and have taken action to implement programs toward this end. Organizers cite Egypt, Rwanda, Georgia, India, Indonesia, Nigeria and Vietnam among other countries that have begun this process. 

 

Kenneth Kabagambe, who has been living in Uganda with hepatitis B since 2012, is the founding executive director of the National Organization for People Living with Hepatitis B. He said he started the organization to raise awareness of the disease and to shatter the myths that stigmatize people and discourage them from seeking help. 

 

“For example, there are issues to do with the myths and misconceptions, which actually are drawn from the lack of clear information about the transmission of hepatitis B and hepatitis C in the communities,” he said. “These actually have led to domestic violence in some families because people think that hepatitis B is just casually transmitted, which is not correct.”

Hepatitis B is spread through sexual transmission and through contact with the blood, open sores or body fluids from a person infected with the disease. The main mode of transmission, however, is from mother to child during birth and delivery.   

 

WHO reports that about 70% of hepatitis B infections worldwide occur in Africa, and 70% of those infected with the disease are children younger than 5.   

Birth doses

While vaccination is the best way to prevent hepatitis B, Fernandez noted that the first birth dose of this vaccine has very low coverage in Africa. 

 

“In 2021, only 17% of newborn babies in the WHO Africa region received a timely hepatitis B birth dose,” she said. “And only 14 of the countries in the region have policies for routine HB-dose vaccinations.”   

 

Fernandez said effective and affordable treatments are available for both hepatitis B and hepatitis C, which is largely spread through unsafe drug injections and is a particularly huge problem in countries in the Eastern Mediterranean and Central and Southeast Asian regions, as well as some countries in the Western Pacific. 

 

“I think the bottom line is we do have effective tools for prevention in the case of hepatitis C and B, and treatment in the case of a cure for hepatitis C,” she said. “They just have not been implemented effectively, and to do this, we need a surge in financing. It is not an insurmountable goal. Countries have shown that we can do this.” 

 

Conference organizers say that investing $6 billion annually to end hepatitis in 67 low- and middle-income countries would prevent the deaths of 4.5 million people by 2030.  

They add, “For every dollar spent on HBV [hepatitis B virus] elimination activities, there is a two to four times return on investment.”
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For two decades, scientists have been comparing every person’s full set of DNA they study to a template that relies mostly on genetic material from one man affectionately known as “the guy from Buffalo.”

But they’ve long known that this template for comparison, or “reference genome,” has serious limits because it doesn’t reflect the spectrum of human diversity.

“We need a really good understanding of the variations, the differences between human beings,” said genomics expert Benedict Paten of the University of California, Santa Cruz. “We’re missing out.”

Now, scientists are building a much more diverse reference that they call a “pangenome,” which so far includes the genetic material of 47 people from various places around the world. It’s the subject of four studies published Wednesday in the journals Nature and Nature Biotechnology. Scientists say it’s already teaching them new things about health and disease and should help patients down the road.

Paten said the new reference should help scientists understand more about what’s normal and what’s not. “It is only by understanding what common variation looks like that we’ll be able to say, ‘Oh, this big structural variation that affects this gene? Don’t worry about it,'” he said.

A human genome is the set of instructions to build and sustain a human being, and experts define a pangenome as a collection of whole genome sequences from many people that is designed to represent the genetic diversity of the human species. The pangenome is not a composite but a collection; scientists depict it as a rainbow of stacked genomes, compared with one line representing the older, single reference genome.

The Human Pangenome Project builds upon the first sequencing of a complete human genome, which was nearly completed more than two decades ago and finally finished last year. Paten, a pangenome study author and project leader, said 70% of that first reference genome came from an African American man with mixed African and European ancestry who answered an ad for volunteers in a Buffalo newspaper in 1997. About 30% came from a mix of around 20 people.

The pangenome contains material from 24 people of African ancestry, 16 from the Americas and the Caribbean, six from Asia and one from Europe.

Although any two people’s genomes are more than 99% identical, Paten said “it’s those differences that are the things that genetics and genomics is concerned with studying and understanding.”

It may take a while for patients to see concrete benefits from the research. But scientists said new insights should eventually make genetic testing more accurate, improve drug discovery and bolster personalized medicine, which uses someone’s unique genetic profile to guide decisions for preventing, diagnosing and treating disease.

“The Pangenome Project gives a more accurate representation of the genome of people from around the world,” and should help doctors better diagnose genetic conditions, said clinical genetics expert Dr. Wendy Chung at Columbia University, who was not involved in the research.

If someone has a variation in a certain gene, it could be compared to the rainbow of references.

Study author Evan Eichler of the University of Washington said researchers will also learn more about genes already linked to problems, such as one tied to cardiovascular disease in African Americans.

“Now that we can actually sequence that gene in its entirety and we can understand the variation in that gene, we can start to go back to unexplained cases of patients with coronary heart disease” and look at them in light of the new knowledge, he said.

University of Minnesota plant genetics expert Candice Hirsch, who wasn’t involved in the research but has closely followed the effort, said she expects many discoveries to flow from it. Until now, “we really have only been able to scratch the surface of understanding the genetics that underlies disease,” she said.

The consortium leading the research is part of the Human Genome Reference Program, which is funded by an arm of the U.S. National Institutes of Health.

The team is in the process of adding to the collection of reference genomes, with the goal of having sequences from 350 people by the middle of next year. Scientists are also hoping to work more with international partners, including those focusing on Indigenous populations.

“We’re in it for the long game,” Paten said.
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An unmarried Chinese woman on Tuesday began her final appeal of a hospital’s denial of access to freeze her eggs five years ago in a landmark case of female reproductive rights in the country. 

Teresa Xu’s case has drawn broad coverage in China, including by some state media outlets, since she first brought her case to court in 2019. She lost her legal challenge last year at another Beijing court, which ruled the hospital did not violate her rights in its decision. 

The upcoming judgment will have strong implications for the lives of many unmarried women in China and the country’s demographic changes, especially after the world’s second-largest economy recorded its first population decline in decades. 

In China, the law does not explicitly ban unmarried people from services such as fertility treatments and simply states that a “husband and wife” can have up to three children. But hospitals and other institutions, in practice, implement the regulations in a way that requires people to present a marriage license. 

Xu, who wanted to preserve her eggs so she could have the option to bear children later, is one of those facing difficulties in accessing fertility treatment. 

In 2018, Xu, then 30 years old, had gone to a public hospital in Beijing to ask about freezing her eggs. But after an initial check-up, she was told she could not proceed without a marriage certificate. 

According to the judgment she received last year, the hospital argued that egg freezing poses certain health risks. It said that egg-freezing services were only available to women who could not get pregnant in the natural way, and not for healthy patients. 

But it also stated that delaying pregnancy could bring risks to the mother during pregnancy and “psychological and societal problems” if there is a large age gap between parents and their child. 

After Tuesday’s hearing, Xu told reporters that the denial constituted a violation of her right to bodily autonomy, and she chose to fight on because this matter is very important to single women. 

“I also have grown up a lot as the case evolves, I don’t want to give up easily,” she said. 

It is unclear when the court will hand down the judgment, she said. 
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A report by leading United Nations agencies says global progress in reducing maternal and newborn deaths has stalled for nearly a decade largely due to underinvestment in providing the health care.

The report shows more than 4.5 million women and babies die every year in pregnancy, childbirth or the first weeks after birth — equivalent to one death every seven seconds — “mostly from preventable or treatable causes if proper care was available.”

Allisyn Moran, unit head for maternal health at the World Health Organization, said all the deaths have similar risk factors and causes.

While the trends pre-date the coronavirus pandemic, she said “COVID-19-related service disruptions and funding diversions, rising poverty and worsening humanitarian crises are intensifying pressures on already overstretched maternity and newborn health services.”

Since 2018, the report finds, more than three-quarters of all conflict-affected and sub-Saharan African countries report funding for maternal and newborn health has declined and that only one in 10 of more than 100 countries surveyed reported they had the money needed to implement their current plans.

Speaking in Cape Town, South Africa, the site of a major global conference on maternal health, Moran said that a lack of investment in primary health care risked lowering survival prospects.

“For instance, while prematurity is now the leading cause of all under-5 deaths globally, less than a third of countries report having sufficient newborn care units to treat small and sick babies,” she said. “Two-thirds of emergency childbirth facilities in sub-Saharan Africa lack essential resources like medicines and supplies, water, electricity or staffing for 24-hour care.”

Steven Lauwerier, UNICEF director of health, agreed with that assessment. Since the COVID-19 pandemic, he said “babies, children, and women who were already exposed to threats to their well-being, especially those living in fragile countries and emergencies, are facing the heaviest consequences of decreased spending and efforts on providing quality and accessible healthcare.”

The report, “Improving Maternal and Newborn Health and Survival and Reducing Stillbirth,” found that in sub-Saharan Africa and central and southern Asia, the regions with the greatest number of newborn and maternal deaths, fewer than 60 percent of women receive even four of the WHO’s recommended eight prenatal checks.

“The death of any woman or young girl during pregnancy or childbirth is a serious violation of their human rights,” said Julitta Onabanjo, director of the technical division at the U.N. Population Fund.  “It also reflects the urgent need to scale-up access to quality sexual and reproductive health services as part of universal health coverage and primary health care, especially in communities where maternal mortality rates have stagnated or even risen during recent years.”

The authors of the report agree that women and babies must have quality, affordable health care before, during and after childbirth, as well as access to family planning services to increase survival rates.

They add that “more skilled and motivated health workers, especially midwives, are needed, alongside essential medicine and supplies, safe water, and reliable electricity.”

The stated aim of health leaders from over 30 countries attending the week-long conference is to develop plans that accelerate progress where it is most needed.

Anshu Banerjee, the WHO director of maternal, newborn, child and adolescent health and aging, is in no doubt as to where that is. “Pregnant women and newborns continue to die at unacceptably high rates worldwide,” he said, “and the COVID-19 pandemic has created further setbacks to providing them with the healthcare they need.”

“If we wish to see different results, we must do things differently,” he said. “More and smarter investments in primary health care are needed now so that every woman and baby — no matter where they live — has the best chance of health and survival.”
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Providing simple and cheap healthcare measures to pregnant women — such as offering aspirin — could prevent more than a million babies from being stillborn or dying as newborns in developing countries every year, new research said on Tuesday.   

An international team of researchers also estimated that one quarter of the world’s babies are born either premature or underweight, adding that almost no progress is being made in this area.    

The researchers called for governments and organizations to ramp up the care women and babies receive during pregnancy and birth in 81 low- and middle-income countries.   

SEE ALSO: A related video by VOA’s Timothy Obiezu

Eight proven and easily implementable measures could prevent more than 565,000 stillbirths in these countries, according to a series of papers published in the Lancet journal.    

The measures included providing micronutrient, protein and energy supplements, low-dose aspirin, the hormone progesterone, education on the harms of smoking, and treatments for malaria, syphilis and bacteria in urine.   

If steroids were made available to pregnant women and doctors did not immediately clamp the umbilical cord, the deaths of more than 475,000 newborn babies could also be prevented, the research found.    

Implementing these changes would cost an estimated $1.1 billion, the researchers said.   

This is “a fraction of what other health programs receive”, said Per Ashorn, a lead study author and professor at Finland’s Tampere University.    

‘Shockingly’ common 

Another study author, Joy Lawn of the London School for Hygiene and Tropical Medicine, told AFP that the researchers used a new definition for babies born premature or underweight.   

She said the traditional way to determine a baby had a low birthweight — if it was born weighing under 2.5 kilograms — was “a bit randomly selected” by a Finnish doctor in 1919.   

 This “very blunt measure” has remained the benchmark for more than a century, despite plentiful evidence that “those babies are not all the same”, Lawn said.   

The researchers analyzed a database that included 160 million live births from 2000 to 2020 to work out how often babies are born “too soon and too small”, she said.   

“Quite shockingly, we found that this is much more common once you start to think about it in a more nuanced way.”   

The researchers estimated that 35.3 million — or one in four — of the babies born worldwide in 2020 were either premature or too small, classifying them under the new term “small vulnerable newborns.”   

While most of the babies were born in southern Asia and sub-Saharan Africa, Lawn emphasized that every country was affected.    

One reason progress has flatlined is that these problems tend “to be something that happens to families and women with less of a voice”, Lawn said.   

For example, pregnant African American women in the United States received a lower level of care than other groups, she added. 
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Mexican officials and the conservation group Sea Shepherd said Monday that experts would set out in two ships in a bid to locate the few remaining vaquita marina, the world’s most endangered marine mammal. 

Mexico’s environment secretary said experts from the United States, Canada and Mexico will use binoculars, sighting devices and acoustic monitors to try to pinpoint the location of the tiny elusive porpoises. The species cannot be captured, held or bred in captivity. 

The trip will start Wednesday and run to May 26 in the Gulf of California, also known as the Sea of Cortez, the only place the vaquita lives. The group will travel in a Sea Shepherd vessel and a Mexican boat and try to sight vaquitas. As few as eight of the creatures are believed to remain. 

SEE ALSO: A related video by VOA’s Annika Hammerschlag

Illegal gillnet fishing traps and kills the vaquita. Fishermen set the nets to catch totoaba, a fish whose swim bladder is considered a delicacy in China and can fetch thousands of dollars per pound (0.45 kilograms). 

Sea Shepherd has been working in the Gulf alongside the Mexican navy to discourage illegal fishing in the one area where vaquitas were last seen. The area is known as the “zero tolerance” zone, and fishing is supposedly not allowed there. However, illegal fishing boats are regularly seen there, and so Mexico has been unable to completely stop them. 

Pritam Singh, Sea Shepherd’s chairman, said that a combination of patrols and the Mexican navy’s sinking of concrete blocks with hooks to snare illegal nets has reduced the number of hours that fishing boats spend in the restricted zone by 79% in 2022, compared with the previous year. 

Singh said that “the last 18 months have been incredibly impactful and encouraging,” while noting that “the road ahead for saving this species is long.” 

SEE ALSO: A related video by VOA’s Henry Wilkins

The last such sighting expedition in 2021 yielded probable sightings of between five and 13 vaquitas, a decline from the previous survey in 2019. The porpoises are so small and so elusive, and are usually seen from so far away, that it is hard for observers to be certain that they saw a vaquita, count how many they saw or determine whether they saw the same animal twice. 

Illegal fishing itself has impeded population calculations in the past. 

According to a report published in 2022, both the 2019 and 2021 surveys “were hindered by the presence of many illegal fishing boats with gillnets in the water. Some areas could not be surveyed at all on some days due to the density of illegal fishing.” 

The government’s protection efforts have been uneven, at best, and often face violent opposition from local fishermen. 

President Andrés Manuel López Obrador’s administration has largely declined to spend money to compensate fishermen for staying out of the vaquita refuge and not using gillnets, or to monitor the fishing boats or the areas they launch from. 
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