United Nations agencies said Friday that millions of Sudanese cannot obtain treatment for emergency and chronic health conditions because fighting has brought the country’s fragile health system to near total collapse.   

The U.N. Office for the Coordination of Humanitarian Affairs said in a statement violence and “shortages of supplies, damage or occupation of facilities and assaults on medical staff” are having a devastating impact on people’s lives and on their ability to access health care. 

The World Health Organization has said that some 50 attacks on health care facilities have caused 10 deaths and 21 injuries since fighting began between the Sudanese armed forces and paramilitary Rapid Support Forces three months ago. 

“Ongoing violence, rampant insecurity, repeated attacks on health, and limited access to essential health supplies, are putting the people of Sudan in a life-or-death situation, with no immediate political solution in sight,” Rick Brennan, emergency director for the WHO’s regional office for the Eastern Mediterranean said.  

Speaking from Cairo, Brennan said the violence has had a huge impact on access to the most basic health care, including treatment of such common infections as pneumonia and diarrhea, trauma treatment, and obstetric care.   

He said the conflict is preventing people with chronic conditions, such as diabetes and hypertension from getting treatment.   

“Patients who have been receiving dialysis for kidney failure and treatment for cancer are facing a sudden cessation of their treatment, with life-threatening consequences,” he said. 

He said disrupted access to those services is risking the lives of 8,000 people, including 240 children who need regular dialysis sessions.  He said many of an estimated 49,000 Sudanese cancer patients could die “without restoration of access to their cancer care.” 

He said lack of access to health care is raising the risk of malaria, measles, dengue, and cholera outbreaks.  The dangers, he said, are particularly acute with the onset of the rainy season. 

“The delivery of health care across the entire country is limited by shortage of supplies, lack of health workers and functioning health facilities, and logistic constraints due to insecurity and roadblocks by militias,” he said. 

The World Health Organization estimates 11 million people in Sudan need urgent health assistance, but few health facilities still are functioning.   Brennan said that between two-thirds and 80% of hospitals are not functioning and “in West Darfur, only one hospital is operational, but only partially.” 

Despite the ongoing insecurity and bureaucratic impediments, he said the WHO was working with local health authorities and U.N. agencies, including UNICEF and the U.N. Population Fund, to provide health care. 

For example, he said more than 170 tons of medical supplies have been delivered to hospitals and therapeutic treatments have been provided for more than 100,000 severely malnourished children. 

He said the WHO and and the U.N. Population Fund were working to provide women and girls access to sexual, reproductive, and maternal health care.   

He added that survivors of sexual and gender-based violence, which reportedly “is widespread in this conflict, as it is in so many conflicts,” were receiving medical and psychosocial support. 

“But the reality is that there are large proportions of the population to whom we do not have access, especially in Khartoum, Darfur and Kordofan,” he said. 

“Therefore, together with our U.N. partners, we are exploring all options to expand our operations, including through cross-border assistance.” 
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Visitors to Las Vegas on Friday stepped out momentarily to snap photos and were hit by blast-furnace air. But most will spend their vacations in a vastly different climate — at casinos where the chilly air conditioning might require a light sweater.

Meanwhile, emergency room doctors were witnessing another world, as dehydrated construction workers, passed-out elderly residents and others suffered in an intense heat wave threatening to break the city’s all-time record high of 47.2 degrees Celsius this weekend.

Few places in the scorching Southwest demonstrate the surreal contrast between indoor and outdoor life like Las Vegas, a neon-lit city rich with resorts, casinos, swimming pools, indoor nightclubs and shopping. Tens of millions of others across California and the Southwest, were also scrambling for ways to stay cool and safe from the dangers of extreme heat.

“We’ve been talking about this building heat wave for a week now, and now the most intense period is beginning,” the National Weather Service wrote Friday.

Nearly a third of Americans were under extreme heat advisories, watches and warnings. The blistering heat wave was forecast to get worse this weekend for Nevada, Arizona and California, where desert temperatures were predicted to soar in parts past 48.8 degrees Celsius during the day and remain above 32.2 C overnight.

Sergio Cajamarca, his family and their dog, Max, were among those who lined up to pose for photos in front of the city’s iconic “Welcome to Fabulous Las Vegas” sign. The temperature before noon already topped 37.8 C.

“I like the city, especially at night. It’s just the heat,” said Cajamarca, 46, an electrician from Brooklyn Park, Minnesota.

His daughter, Kathy Zhagui, 20, offered her recipe for relief: “Probably just water, ice cream, staying inside.”

Meteorologists in Las Vegas warned people not to underestimate the danger. “This heatwave is NOT typical desert heat due to its long duration, extreme daytime temperatures, & warm nights. Everyone needs to take this heat seriously, including those who live in the desert,” the National Weather Service in Las Vegas said in a tweet.

Phoenix marked the city’s 15th consecutive day of 43.3 degrees Celsius or higher temperatures on Friday, hitting 46.6 degrees Celsius by late afternoon, and putting it on track to beat the longest measured stretch of such heat. The record is 18 days, recorded in 1974.

“This weekend there will be some of the most serious and hot conditions we’ve ever seen,” said David Hondula the city’s chief heat officer. “I think that it’s a time for maximum community vigilance.”

The heat was expected to continue well into next week as a high pressure dome moves west from Texas.

“We’re getting a lot of heat-related illness now, a lot of dehydration, heat exhaustion,” said Dr. Ashkan Morim, who works in the ER at Dignity Health Siena Hospital in suburban Henderson.

Morim said he has treated tourists this week who spent too long drinking by pools and became severely dehydrated; a stranded hiker who needed liters of fluids to regain his strength; and a man in his 70s who fell and was stuck for seven hours in his home until help arrived. The man kept his home thermostat at 26.7 C, concerned about his electric bill with air conditioning operating constantly to combat high nighttime temperatures.

Regional health officials in Las Vegas launched a new database Thursday to report “heat-caused” and “heat-related” deaths in the city and surrounding Clark County from April to October.

The Southern Nevada Health District said seven people have died since April 11, and a total of 152 deaths last year were determined to be heat-related.

Besides casinos, air-conditioned public libraries, police station lobbies and other places from Texas to California planned to be open to the public to offer relief at least for part of the day. In New Mexico’s largest city of Albuquerque, splash pads will be open for extended hours and many public pools were offering free admission. In Boise, Idaho, churches and other nonprofit groups were offering water, sunscreen and shelter.

Temperatures closer to the Pacific coast were less severe, but still made for a sweaty day on picket lines in the Los Angeles area where actors joined screenwriters in strikes against producers.

In Sacramento, the California State Fair kicked off with organizers canceling planned horseracing events due to concerns for animal safety.

Employers were reminded that outdoor workers must receive water, shade and regular breaks to cool off.

Pet owners were urged to keep their animals mostly inside. “Dogs are more susceptible to heat stroke and can literally die within minutes. Please leave them at home in the air conditioning,” David Szymanski, park superintendent for Santa Monica Mountains National Recreation Area, said in a statement.

Meanwhile, the wildfire season was ramping up amid the hot, dry conditions with a series of blazes erupting across California this week, Wade Crowfoot, secretary of the Natural Resources Agency, said at a media briefing.

Global climate change is “supercharging” heat waves, Crowfoot added.

Firefighters in Riverside County, southeast of Los Angeles, were battling multiple brush fires that started Friday afternoon.

Stefan Gligorevic, a software engineer from Lancaster, Pennsylvania visiting Las Vegas for the first time said he planned to stay hydrated and not let it ruin his vacation.

“Cold beer and probably a walk through the resorts. You take advantage of the shade when you can,” Gligorevic said. “Yeah, definitely.”
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Countries at this year’s U.N. climate summit must face up to how far behind they are on climate change targets and agree to a plan to get on track, the United Arab Emirates’ incoming president of the event said on Thursday. 

In a speech laying out the country’s plan for the COP28 summit, to be held in Dubai in November, Sultan al-Jaber said the event should also yield international goals to triple renewable energy as well as double energy savings and hydrogen production by 2030. 

“We must be brutally honest about the gaps that need to be filled, the root causes and how we got to this place here today,” Jaber told a meeting in Brussels of climate ministers and officials from countries including Brazil, China, the United States and European Union members. 

“Then we must apply a far-reaching, forward-looking, action-oriented and comprehensive response to address these gaps practically,” he said. 

The COP28 summit will be the first formal assessment of countries’ progress towards the Paris Agreement’s target to limit climate change to 1.5 Celsius (34.7 Fahrenheit) of warming. The current policies and pledges of countries would fail to meet that goal.  

“We can’t afford a meaningless stocktake. This is about accountability of our previous, present and future updates,” Canadian Climate Minister Steven Guilbeault told Thursday’s meeting. 

The assessment at COP28 — known as the Global Stocktake — will increase pressure on major emitters to update their actions to cut greenhouse gas emissions. 

Jaber said all governments should update their emissions-cutting targets by September, which the UAE did last month.  

Fund for poorer countries  

The UAE, a major OPEC oil exporter, has been under pressure to lay out its vision for the COP28 summit and guide preparations among the nearly 200 countries expected to attend. 

A round of preparatory United Nations climate negotiations in June yielded little progress. Countries spent days wrangling over issues including whether to even discuss urgent CO2-cutting action — known in U.N. jargon as the “mitigation work program.” 

Jaber, who is also the head of UAE state-owned oil company ADNOC, said the COP28 summit also aims to establish a promised fund to compensate poorer countries where climate change is inflicting irreparable damage.  

Countries finally agreed at last year’s U.N. climate talks to form the “loss and damage” fund, but left the toughest decisions for later, including which countries should pay into it. 

Finance has dominated recent climate negotiations, as poorer nations demand greater support to both invest in low-carbon energy and cope with spiraling costs from droughts, floods and rising sea levels. 

Jaber called for a “comprehensive transformation” of international financial institutions to unlock more capital to tackle climate change — echoing ideas put forward by climate-vulnerable nations including the Barbados-led “Bridgetown Initiative” to reform multilateral finance institutions.  
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Health care providers in Zimbabwe are leaving the country in droves for better work abroad. The government is scrambling to fill the gaps by better equipping hospitals, as Columbus Mavhunga reports from Harare, Zimbabwe.
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Leading global health agencies report consumers who limit their intake of aspartame and other artificial sweeteners are at little risk of getting cancer.

“The occasional level of exposure, which is far from the acceptable daily intake, is safe and is not producing appreciable health risk,” said Francesco Branca, World Health Organization director, department of nutrition and food safety.

“The problem is for high consumers and the problem is for situations where consumption is shifting towards high consumers,” he said. “But I think our results do not indicate that occasional consumption should pose a risk to most consumers.”

Aspartame, an artificial sweetener, has been widely used in a variety of foods and beverages, including diet soda, chewing gum, ice cream, and breakfast cereal, since the 1980s.

Recent media reports that the WHO’s cancer research arm, the International Agency for Research on Cancer, or IARC, was likely to declare aspartame carcinogenic for humans created an uproar among stalwart dieters hooked on these low-fat products.

Two scientific bodies conducted independent but complementary reviews to assess the potential carcinogenic hazard and other health risks associated with aspartame consumption.

Mary Schubauer-Berigan, head of the IARC monographs program, says her agency’s task was to identify the possible hazards, not the risks associated with aspartame.

“It is very important to note that this was a hazard identification and not a risk assessment,” she said. “A hazard identification aims to identify the specific properties of the agent and their potential to cause harm, that is the potential of an agent to cause cancer,” she said, noting it does not reflect the risk of developing cancer at a given exposure level. “So, the working group classified aspartame as possibly carcinogenic to humans.”

Schubauer-Berigan said the IARC Group 2C classification was made based on limited evidence from three studies for a type of liver cancer in humans, adding that there also was limited evidence for cancer in experimental animals.

“Despite consistent positive findings in the three studies, the working group concluded that chance, bias, and confounding could not be ruled out with reasonable confidence. And, thus, they concluded that the evidence was limited,” she said.

The WHO’s Branca said the JECFA, the Joint Expert Committee on Food Additives, reviewed the risks associated with aspartame and concluded that “there was no convincing evidence from experimental or human data that aspartame has adverse effects after ingestion within the previously established daily intake of 0-40 milligrams per kilo body weight.”

What this means, he said, is that a person who weighs 70 kilograms can consume 2,800 milligrams of aspartame a day. “If we look at, for example, the contents of aspartame in common sodas, which is between 200 and 300 milligrams per day, that means consuming between nine and 14 cans of these sodas. You can see this is quite a large amount.”

Since the long-range impact of artificial sweeteners is not known, Branca advises people to limit the consumption of sweetened products altogether.

“It is particularly important for young children who will be exposed early enough to a taste adjustment, and they will then basically be on a track to continually consume sweetened products.”

He said a child who weighs 20 kilograms could consume two to three cans of soda laced with artificial sweeteners, which would be within the prescribed acceptable daily intake. However, he warned many children are likely to consume much more.

“You may have families that instead of having water at the table, have a big can of sparkling drinks with sweeteners. That is not good practice,” he said. “So, children may be at a higher risk also because starting the consumption early in life, not only puts you on a track of being accustomed to that taste and levels, but also because we have a really long-term exposure, and I am not sure whether our studies have been able to tell us about the lifelong exposure.”

While companies could reconsider their products, Branca said WHO is not advising food and drink companies to consider replacing aspartame with alternative sweeteners.

“It is not about really looking at new alternatives for the moment. It is about changing the formulation of products and changing the choice of ingredients so that you can have still tasty products without the need to use sweeteners,” he said.

In the meantime, he suggests people consider consuming products that do not contain either free sugars or artificial sweeteners, such as water and fresh fruit that is naturally sweet.
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An Indian rocket hurtled into space Friday to land a robotic rover on an unexplored area of the moon – a challenging feat India was unable to accomplish on a mission four years ago.   

Only three countries, the U.S., China and Russia, have made what is called a “soft” or “controlled” landing on the lunar surface. If the Indian Space Research Organization, or ISRO, is successful this time, some observers say the mission will establish India’s position as one of the world’s leading space powers.   

Millions around the country watched a live telecast of the launch of the “Chandrayaan-3” spacecraft from Sriharikota in southern India and thousands packed a viewing gallery in the launch site’s vicinity.   

“Congratulations India. Chandrayaan-3 has started its journey toward the moon,” ISRO Chairman Sreedhara Panicker Somanath said, after the launch, as scientists at the mission control center clapped and shook hands.   

The mission’s real test will come some 40 days from now when the lander equipped with a robotic rover will separate from the main spacecraft to land on the lunar surface on August 23 or August 24.  

“This remarkable mission will carry the hopes and dreams of our nation,” Prime Minister Narendra Modi, who is visiting France, tweeted ahead of the launch.  

Friday’s launch by the ISRO is the country’s first major space mission since the failed attempt in 2019 when scientists lost contact with the lander minutes before it was scheduled to descend on the lunar surface. It was later established that it had crashed.   

Chandrayaan-3 also will deploy a rover near the lunar South Pole, where it is expected to run a series of experiments for 14 days focusing on the composition of lunar soil and rocks. Chandrayaan means “moon vehicle” in Sanskrit.  

India is hoping to become the first country to conduct studies of the South Pole, where no mission has ventured, and which scientists say has a different geology from the equatorial regions of the lunar surface.  

There is an expectation the South Pole has ice deposits in the depths of craters, as well as minerals.    

Scientists at the ISRO expressed optimism about Chandrayaan-3 achieving its goal of a “soft landing,” saying the mistakes that led to the failure of the previous mission have been rectified.  

The Chandrayaan-3 mission is crucial for India — even though its space program is much more modest than that of countries like the U.S. and China, the country wants to showcase its technological prowess amid its ambitions to be seen as an emerging global power.  

“It is indeed a moment of glory for India and a moment of destiny for all of us,” India’s minister for science and technology, Jitendra Prasad, said after the lift-off of the spacecraft.   

“Entering a small elite club, or becoming one of the pioneers of certain efforts, such as those in space, will continue to be a major indicator of skill, talent, capability and sound organization that decision-makers are able to utilize and leverage in politics,” Tomas Hrozensky of the European Space Policy Institute told VOA in emailed comments.    

India’s space program, built largely on its own proprietary technology, has long been a source of pride for the country. Its first mission to the moon helped establish the presence of water on the moon.

Although the second mission was unsuccessful in making a landing, it placed an orbiter around the moon that continues to relay data. An unmanned mission to Mars in 2013 marked the country’s first interplanetary mission. The ISRO is now developing a spacecraft to take astronauts into orbit, probably in 2025.    

India has also for decades launched its own satellites and those of other countries with its space program focusing heavily on low-cost access to space.  

Experts also say the price tag of India’s current mission, $75 million, also underlines India’s prowess in conducting space exploration at a modest cost.    

Exploring the moon has reemerged on the radar of many countries in recent years. The U.S. space agency NASA has announced that a four-member astronaut crew will carry out a planned test mission around the moon next year. In addition, India and the U.S. are collaborating to send an Indian astronaut to the International Space Station next year.  
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The World Health Organization’s cancer agency has deemed the sweetener aspartame — found in diet soda and countless other foods — as a possible cause of cancer, while a separate expert group looking at the same evidence said it still considers the sugar substitute safe in limited quantities.

The differing results of the coordinated reviews were released early Friday in Europe. One came from the International Agency for Research on Cancer, a special branch of the WHO. The other report was from an expert panel selected by WHO and another U.N. group, the Food and Agriculture Organization, based in Rome.

The Lyon, France-based cancer agency periodically reviews potential cancer hazards but doesn’t determine how likely they are to cause cancer in their evaluations, which range from possibly carcinogenic to probably to cancer-causing.

Aspartame joins a category with more than 300 other possible cancer-causing agents, including things like aloe vera extract, Asian-style pickled vegetables and carpentry work.

The guidance on use of the sweetener, though, isn’t changing.

“We’re not advising consumers to stop consuming [aspartame] altogether,” said WHO’s nutrition director, Dr. Francesco Branca. “We’re just advising a bit of moderation.”

Here’s a look at the announcement:

What is aspartame?

Aspartame is a low-calorie artificial sweetener that is about 200 times sweeter than sugar. It is a white, odorless powder and the world’s most widely used artificial sweetener.

Aspartame is authorized as a food additive in Europe and the U.S. and is used in numerous foods, drinks such as Diet Coke, desserts, chewing gum, medications including cough drops, and foods intended to help with weight loss. It’s in tabletop sweeteners sold as Equal, Sugar Twin and NutraSweet.

Aspartame was approved in 1974 by the U.S. Food and Drug Administration with an acceptable daily intake of 50 milligrams per kilogram of body weight. According to the FDA, a person weighing 60 kilograms (132 pounds) would need to consume about 75 aspartame packets to reach that level.

U.N. experts evaluated the safety of aspartame in 1981 and set the safe daily limit slightly lower, at 40 milligrams of aspartame per kilogram.

David Spiegelhalter, an emeritus statistics professor at Cambridge University, said the guidance means that “average people are safe to drink up to 14 cans of diet drink a day … and even this ‘acceptable daily limit’ has a large built-in safety factor.”

What did the two groups say?

WHO’s cancer agency, the IARC, convened its expert group in June to assess the potential of aspartame to cause cancer. It based its conclusion that aspartame is “possibly carcinogenic” on studies in humans and animals that found limited evidence that the compound may be linked to liver cancer.

In a separate evaluation, experts assembled by WHO and the food agency updated their risk assessment, including reviewing the acceptable daily intake. They concluded there was “no convincing evidence” at the currently consumed levels that aspartame is dangerous; their guidelines regarding acceptable levels of consumption were unchanged.

The announcements came weeks after the WHO said that non-sugar sweeteners don’t help with weight loss and could lead to increased risk of diabetes, heart disease and early death in adults.

Should I be concerned about getting too much?

No, as long as you don’t exceed the guidelines. The FDA said scientific evidence continues to support the agency’s conclusion that aspartame is “safe for the general population,” when used within limits.

Almost any substance can be dangerous in excessive amounts, said David Klurfeld, a nutrition expert at the Indiana University School of Public Health in Bloomington.

“The dose makes the poison,” said Klurfeld, who previously served on an IARC panel. “Even essential nutrients like vitamin A, iron and water will kill you within hours if too much is consumed.”

What should consumers do?

WHO’s Branca said it was acceptable for people to consume a “pretty large” amount of aspartame without suffering any ill effects. “High consumers” might want to cut back, he said.

Dr. Peter Lurie, executive director of the Center for Science in the Public Interest, which previously nominated aspartame for IARC review, said there’s an easy choice for consumers.

“At least when it comes to beverages, our message is your best choice is to drink water or an unsweetened beverage,” he said.

The IARC has previously classified processed meat like hot dogs and bacon as cancer-causing, noting in particular its link to colon cancer. That move surprised others in the scientific community — the U.K.’s biggest cancer charity reassured Britons that eating a bacon sandwich every so often wouldn’t do them much harm.

What does this mean for the food and beverage industry?

Food and beverage producers say there’s no reason to avoid products with aspartame.

“There is a broad consensus in the scientific and regulatory community that aspartame is safe,” the American Beverage Association said in a statement.

WHO’s Branca said the agency advises food manufacturers in general to “use ingredients that do not require the addition of too much sugar.” After the latest assessments of aspartame, Branca said that using sweeteners “is probably not the way forward.”
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HIV/AIDS can end as a public health threat by 2030 if nations can muster the political will and critical financial support to completely defeat it, a new report published Thursday says. The deadly disease has killed 40.4 million people since the start of the epidemic in 1981.

“The data in this report show that the path that ends AIDS is not a mystery, but it is a choice. It is a political and a financial choice,” said Winnie Byanyima, executive director of UNAIDS.

“The report shows that HIV responses can succeed when they are anchored in strong political leadership,” she said.

The report released by UNAIDS, the United Nations AIDS program, finds that in 2022, 39 million people worldwide were living with HIV, 1.3 million became newly infected and 630,000 died from AIDS-related illnesses. 

While new infections have been declining globally over the past 10 to 12 years, rates remain high in several regions. Data show that two-thirds of all people living with HIV are found in sub-Saharan Africa, the hardest-hit region in the world. Other heavily infected regions include Asia and the Pacific, Latin America and the Caribbean, as well as Eastern Europe and Central Asia.

The report says women and girls are still disproportionately affected, particularly in sub-Saharan Africa.

“Every single week, 4,000 adolescent girls and young women were newly infected with HIV globally; 3,100 of those are from sub-Saharan Africa. It is a sub-Saharan crisis,”  Byanyima said.

At the same time, she noted that eastern and southern Africa, the region with the highest burden of HIV, is also where resources have been well-deployed and have achieved positive results.

“We see that since 2010 to now, new infections have been reduced by 57 percent. It is the region with the sharpest decline in new infections,” she said.

She said that since 2000, millions of lives have been saved through antiretroviral therapy. The number of people receiving this life-saving treatment worldwide “has risen four times since 2010 from 7.7 million to 29.8 million last year,” Byanyima said.

Another notable success has been in nearly doubling the number of pregnant and breast-feeding women living with HIV who were accessing antiretroviral treatment in 2022. Byanyima said that number has risen from 46% in 2010 to 82% last year.

“This has led to a reduction of 58 percent in new infections among children over the past 12 years,” she said.

Still, Byanyima noted that significant issues remain to be resolved before the prospect of ending AIDS can be realized. She said it is critical for governments to reach out to society’s most vulnerable, marginalized groups, including men who have sex with men, sex workers, transgender women, drug users and prisoners.

“Tackling inequalities is key to making progress,” she said, noting that several countries, including Antigua and Barbuda, the Cook Islands, Barbados, Saint Kitts and Nevis and Singapore, have decriminalized same-sex relations.

“Unfortunately, Uganda, my country, took the opposite direction, and that is not positive,” she said, referring to the country’s new anti-LGBTQ law that includes the death penalty.  

She added that stigmatizing people serves to drive the infection underground where it can blossom and grow.

The report highlights several countries as diverse as Botswana and Cambodia, as well as Eswatini, Rwanda and Tanzania, that have made considerable progress toward ending HIV/AIDS.

Sheila Tiou, Botswana’s former health minister and co-chair of the Global HIV Prevention Coalition, said the countries have succeeded in doing this “by scaling up proven interventions, addressing inequalities, enabling communities, and investing in resources.” 

“We have already heard about countries that have succeeded, but countries like Cameroon, Nepal, Zimbabwe have achieved major reductions in new HIV infections thanks to focused and scaled-up comprehensive prevention programs,” she said.

But she underscored that inequalities and inequities are blocking quicker and wider access in protecting people against HIV.

“Doing the right things will drastically improve the health and well-being of societies, it will reduce HIV vulnerabilities, and indeed, it will avert new HIV infections,” she said.

Tiou said AIDS can be ended if world leaders are courageous, tackle stigma and discrimination, empower and work with communities, and invest in what is needed.

“The data is clear. The evidence is all there,” she said.

Byanyima echoed these sentiments, emphasizing the opportunity for successfully ending the epidemic is dependent upon action.

“The facts and figures shared in this report do not show that as a world, we are already on the path.”

However, she said they show that the world can get on the right path “to save millions of lives and protect the health of everyone by putting a stop to the world’s deadliest pandemic.”
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U.S. officials have approved the first over-the-counter birth control pill, which will let American women and girls buy contraceptive medication from the same aisle as aspirin and eyedrops.

The Food and Drug Administration said Thursday it cleared Perrigo’s once-a-day Opill to be sold without a prescription, making it the first such medication to be moved out from behind the pharmacy counter. The company won’t start shipping the pill until early next year, and there will be no age restrictions on sales.

Hormone-based pills have long been the most common form of birth control in the U.S., used by tens of millions of women since the 1960s. Until now, all of them required a prescription.

Medical societies and women’s health groups have pushed for wider access, noting that an estimated 45% of the 6 million annual pregnancies in the U.S. are unintended. Teens and girls, women of color and those with low incomes report greater hurdles in getting prescriptions and picking them up.

Some of the challenges can include paying for a doctor’s visit, getting time off from work and finding child care.

“This is really a transformation in access to contraceptive care,” said Kelly Blanchard, president of Ibis Reproductive Health, a non-profit group that supported the approval. “Hopefully this will help people overcome those barriers that exist now.”

Ireland-based Perrigo did not announce a price. Over-the-counter medicines are generally much cheaper than prescriptions, but they aren’t covered by insurance.

Many common medications have made the switch to non-prescription status in recent decades, including drugs for pain, heartburn and allergies.

Perrigo submitted years of research to FDA to show that women could understand and follow instructions for using the pill. Thursday’s approval came despite some concerns by FDA scientists about the company’s results, including whether women with certain underlying medical conditions would understand they shouldn’t take the drug.

FDA’s action only applies to Opill. It’s in an older class of contraceptives, sometimes called minipills, that contain a single synthetic hormone and generally carry fewer side effects than more popular combination hormone pills.

But women’s health advocates hope the decision will pave the way for more over-the-counter birth control options and, eventually, for abortion pills to do the same.

That said, FDA’s decision has no relation to the ongoing court battles over the abortion pill mifepristone. The studies in Perrigo’s FDA application began years before the Supreme Court’s reversal of Roe v. Wade, which has upended abortion access across the U.S.

With some states curtailing women’s reproductive rights, the FDA has faced pressure from Democratic politicians, health advocates and medical professionals to ease access to birth control. The American Medical Association and the leading professional society for obstetricians and gynecologists backed Opill’s application for over-the-counter status.

An outside panel of FDA advisers unanimously voted in favor of the switch at a hearing in May where dozens of public speakers called for Opill’s approval.

Dyvia Huitron was among those who presented, explaining how she has been unable to get prescription birth control more than three years after becoming sexually active. The 19-year-old University of Alabama student said she still isn’t comfortable getting a prescription because the school’s health system reports medical exams and medications to parents.

“My parents did not let me go on the pill,” Huitron said in a recent interview. “There was just a lot of cultural stigma around being sexually active before you’re married.”

While she uses other forms of contraception, “I would have much preferred to have birth control and use these additional methods to ensure that I was being as safe as possible.”

Huitron spoke on behalf of Advocates for Youth, one of the dozens of groups that have pushed to make prescription contraceptives more accessible.

The groups helped fund some of the studies submitted for Opill and they encouraged HRA Pharma, later acquired by Perrigo, to file its application with the FDA.

Advocates were particularly interested in Opill because it raised fewer safety concerns. The pill was first approved in the U.S. five decades ago but hasn’t been marketed here since 2005.

“It’s been around a long time and we have a large amount of data supporting that this pill is safe and effective for over-the-counter use,” said Blanchard, of Ibsis Reproductive Health.

Newer birth control pills typically combine two hormones, estrogen and progestin, which can help make periods lighter and more regular. But their use carries a heightened risk of blood clots and they shouldn’t be used by women at risk for heart problems, such as those who smoke and are over 35.

Opill has only progestin, which prevents pregnancy by blocking sperm from reaching the cervix. It must be taken around the same time daily to be most effective.

In its internal review published in May, the FDA noted that some women in Perrigo’s study had trouble understanding the drug’s labeling information. In particular, the instructions warn that women with a history of breast cancer should not take the pill because it could spur tumor growth. And women who have unusual vaginal bleeding are instructed to talk to a doctor first, because it could indicate a medical problem.

Perrigo executives said the company will spend the rest of the year manufacturing the pill and its packaging so it can be available in stores nationwide and online by early next year.
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It is possible to end AIDS by 2030 if countries demonstrate the political will to invest in prevention and treatment and adopt non-discriminatory laws, the United Nations said on Thursday.

In 2022, an estimated 39 million people around the world were living with HIV, according to UNAIDS, the United Nations AIDS program. HIV can progress to AIDS if left untreated.

“We have a solution if we follow the leadership of countries that have forged strong political commitment to put people first and invest in evidence-based HIV prevention and treatment programs,” UNAIDS said in a report published on Thursday.

It said an effective response to HIV also meant adopting non-discriminatory laws and empowering community networks, among other initiatives. People living with HIV or AIDS in many countries face stigma, discrimination and violence.

“Progress has been strongest in the countries and regions that have the most financial investments, such as in eastern and southern Africa, where new HIV infections have been reduced by 57% since 2010,” the report said.

It added, however, that there has been a steep increase in new infections in eastern Europe and central Asia, as well as in the Middle East and North Africa.

“These trends are due primarily to a lack of HIV prevention services for marginalized and key populations and the barriers posed by punitive laws and social discrimination,” it said.

Last year, 1.3 million people became newly infected with HIV and 630,000 died from AIDS-related illnesses, according to UNAIDS.
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Warmer, drier weather because of an earlier-than-usual El Nino is expected to hamper rice production across Asia, hitting global food security in a world still reeling from the impacts of the war in Ukraine. 

An El Nino is a natural, temporary and occasional warming of part of the Pacific that shifts global weather patterns, and climate change is making them stronger. The National Oceanic and Atmospheric Administration announced this one in June, a month or two earlier than it usually does. This gives it time to grow. Scientists say there’s a one in four chance it will expand to supersized levels. 

That’s bad news for rice farmers, particularly in Asia where 90% of the world’s rice is grown and eaten, since a strong El Nino typically means less rainfall for the thirsty crop. 

Past El Ninos have resulted in extreme weather, ranging from drought to floods. 

There are already “alarm bells,” said Abdullah Mamun, a research analyst at the International Food Policy Research Institute or IFPRI, pointing to rising rice prices due to shortfalls in production. The average price of 5% broken white rice in June in Thailand was about 16% higher than last year’s average. 

Global stocks have run low since last year, in part due to devastating floods in Pakistan, a major rice exporter. This year’s El Nino may amplify other woes for rice-producing countries, such as reduced availability of fertilizer due to the war and some countries’ export restrictions on rice. Myanmar, Cambodia and Nepal are particularly vulnerable, warned a recent report by research firm BMI. 

“There is uncertainty over the horizon,” Mamun said. 

Recently, global average temperatures have hit record highs. Monsoon rains over India were lighter than usual by the end of June. Indonesian President Joko Widodo on Monday asked his ministers to anticipate a long dry season. And in the Philippines, authorities are carefully managing water to protect vulnerable areas. 

Some countries are bracing for food shortages. Indonesia was among the worst hit by India’s decision to restrict rice exports last year after less rain fell than expected and a historic heat wave scorched wheat, raising worries that domestic food prices would surge. 

Last month, India said it would send more than 1 million metric tons (1.1 million U.S. tons) to Indonesia, Senegal and Gambia to help them meet “their food security needs.” 

Challenges finding fertilizer

Fertilizer is another crucial variable. Last year China, a major producer, restricted exports to keep domestic prices in check after fertilizers were among exports affected by sanctions on Russian ally Belarus for human rights violations. Sanctions on Russia for its invasion of Ukraine don’t target fertilizers but the war has disrupted shipments of the three main chemical fertilizers: potash, phosphorus, and nitrogen. 

Bangladesh found suppliers in Canada to make up for lost potash shipments from Belarus, but many countries are still scrambling to find new sources. 

Farmers such as Abu Bakar Siddique, who cultivates 1.2 hectares (3 acres) in northern Bangladesh, had enough fertilizer to keep his yields steady last year. But less rainfall meant he had to rely more on electric pumps for his winter harvest at a time of power shortages due to war-related shortfalls of diesel and coal. 

“This increased my costs,” he said. 

Attempting to adapt

Each El Nino is different, but historical trends suggest scarce rainfall in South and Southeast Asia will parch the soil, causing cascading effects in coming years, said Beau Damen, a natural resources officer with the Food and Agriculture Organization based in Bangkok, Thailand. Some countries, like Indonesia, may be more vulnerable in the early stages of the phenomenon, he said. 

Kusnan, a farmer in Indonesia’s East Java, said rice farmers there have tried to anticipate that by planting earlier so that when the El Nino hits, the rice might be ready for harvest and not need so much water. Kusnan, who like many Indonesians uses only one name, said he hoped high yields last year would help offset any losses this year. 

Widodo, the Indonesian leader, stressed the need to manage water in coming weeks, warning that various factors — including export restrictions and fertilizer shortages — could combine with the El Nino to “make this a particularly damaging event.” 

Baldev Singh, a 52-year-old farmer in northern India’s Punjab state, is already worried. He typically sows rice from late June until mid-July, then needs the monsoon rains to flood the paddies. Less than a tenth of the usual rainfall had come by early this month, and then floods ravaged northern India, battering young crops that had just been planted. 

The government has encouraged Punjab farmers to grow rice along with their traditional wheat crops since the 1960s to improve India’s food security, even though farmers like Singh don’t typically eat rice and irrigation of rice fields has drained the area’s aquifers. But he keeps growing it, counting on the certainty of government purchases at fixed prices. 

With rain scarce, Singh may need to dig wells. Last year, he dug down 200 feet (60 meters) to find water. 

“Rice has been our ruin … I don’t know what will happen in the future,” he said. 

 
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BEIJING — Employers across much of China were ordered Monday to limit outdoor work due to scorching temperatures, while the east and southwest were warned to prepare for torrential rain as the country struggled with heat, flooding and drought.

Temperatures as high as 40 C (104 F) were reported in cities including Shijiazhuang, southwest of Beijing, the capital. Highs of 35 C (95 F) to 38 C (100 F) were reported in Beijing, Guangzhou in the south, Chongqing in the southwest and Shenyang in the northeast.

The weather agency issued an orange alert, its second-highest warning, for heat across southern China and much of the north and northeast. That requires employers to limit outdoor work, though delivery workers for restaurants and online retailers were still working.

The agriculture ministry warned Sunday that persistent hot weather could damage rice harvests and told local authorities to ensure adequate water supplies to prevent the crop from ripening prematurely.

Meanwhile, the Ministry of Water Resources warned the provinces of Shandong on the east coast and Sichuan in the southwest to prepare for heavy rain from Tuesday to Friday, according to the official Xinhua News Agency. It said multiple rivers were likely to rise above safe levels.

In the central city of Yichang, in Hubei province, heavy rain triggered a landslide Saturday that buried a highway construction site and killed one person. Authorities were searching Monday for seven missing construction workers, Xinhua reported.

Business and schools in Heilongjiang province in the northeast were ordered Monday to close and shut down outdoor electrical equipment after 84 millimeters (3.3 inches) of rain fell in one hour, according to state TV. It said traffic police were ordered to close dangerous road sections.

Tens of thousands of people who were driven out of their homes by earlier flooding moved to shelters in northern, central and southeastern China.

Residents of some cities have moved into underground air raid shelters to escape the heat.

Earth’s average temperature set a new unofficial record high last Thursday, the third such milestone in the hottest week on record.
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