Three astronauts who were launched into space aboard a Russian Soyuz spacecraft Monday entered the International Space Station nearly eight hours later, a relief to relatives and scientists months after a rocket failure aborted another mission.

The hatch of the capsule carrying NASA astronaut Anne McClain, David Saint-Jacques of the Canadian Space Agency and Oleg Kononenko of Russian space agency Roscosmos was opened while the station was flying over the southern coast of Yemen.

The three were greeted upon arrival Monday by the station’s current crew members, who had waited outside the hatch after the astronauts’ capsule docked and underwent safety checks. 

Their Soyuz MS-11 spacecraft launched from the Russian-leased Baikonur Cosmodrome in Kazakhstan on Monday at 5:31 p.m. (1131 GMT; 6:31 a.m. EST) then entered a designated orbit just under nine minutes later. The spacecraft made four orbits over six hours as it chased down the space station for the docking.

The astronauts were the first sent to be sent to the space station since a crewed Soyuz launch was aborted in October after a booster rocket failed to separate properly, crippling the rocket. The families of the crew, other astronauts and space officials from several nations breathed a sigh of relief after observing the flawless launch.

NASA and Roscosmos said all onboard systems operated normally and the astronauts felt fine during the six-hour trip to the space station. After two hours of waiting in their capsule to confirm their ship was firmly docked to the station, they exited the capsule to join three astronauts already aboard the orbiting outpost at 1:37 a.m. (1940 GMT; 2:40 p.m. EST.) 

The station’s current crew of NASA’s Serena Aunon-Chancellor, Russian Sergei Prokopyev and German Alexander Gerst were waiting to greet the newcomers. They are scheduled to return to Earth on Dec. 20.

McClain, Saint-Jacques and Kononenko will spend more than six months at the space station doing research and experiments in biology, Earth science, physical sciences and technology.

A Soyuz-FG rocket carrying NASA astronaut Nick Hague and Roscosmos’ Alexei Ovchinin failed two minutes into its flight on Oct. 11, activating an automatic rescue system that sent their capsule into a steep ride back to Earth. They managed to emerge safely despite the harrowing ordeal.

A Russian investigation attributed the failure to a sensor that was damaged during the rocket’s final assembly.

NASA announced Monday that Hague and Ovchinin will now launch to the space station on Feb. 28, along with NASA astronaut Christina Hammock Koch.

The Soyuz accident in October was the first aborted crew launch for the Russian space program since 1983, when two Soviet cosmonauts safely jettisoned after a launch pad explosion.

Russian space officials took measures to prevent the repeat of such a rocket failure. Since the October mishap, four successful unmanned Soyuz satellite launches have been conducted to clear the path for the crew’s launch on Monday.

After Monday’s successful launch, NASA Administrator Jim Bridenstine tweeted his thanks to his Russian counterpart Dmitry Rogozin and to NASA and Roscosmos space teams “for their dedication to making this launch a success.”

The Soyuz spacecraft is currently the only vehicle that can ferry crews to the space station, but Russia stands to lose that monopoly in the coming years with the arrival of SpaceX’s Dragon and Boeing’s Starliner crew capsules.

 

 

 
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A SpaceX rocket carrying 64 small satellites lifted off from California on Monday, marking the first time the same Falcon 9 rocket has been used in three space missions.

The rocket blasted off from Vandenberg Air Force Base, arcing over the Pacific Ocean west of Los Angeles as it headed toward space.

Minutes later, the rocket’s first stage performed a so-called boost back maneuver and landed on an unmanned ship in the Pacific. The landing marked the first time SpaceX had flown a first stage three times.

The first stage was previously launched and recovered during missions in May and August as part of a program intended to make the equipment capable of being used 10 or more times without refurbishment.

SpaceX founder Elon Musk has made reusability a major goal.

The payload of the Spaceflight SSO-A SmallSat Express includes satellites from 34 organizations in 17 countries. Full deployment into low Earth orbit was expected to take six hours.

SpaceX was also attempting to use an enormous net atop a vessel to catch the Falcon’s aerodynamic shield over the payload that gets jettisoned at high altitude and falls back to Earth.

The shield is equipped with parachutes and would add another reusable element to the spacecraft.

The 64-satellite payload was a record for a U.S.-based launch vehicle, SpaceX said.
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Pollution in the world’s lakes, rivers and bays is creating conditions in which algae thrive, but other forms of life suffer. Scientists have found they can put those algae to work cleaning up that pollution, and help generate clean power in the process. VOA’s Steve Baragona visited the Port of Baltimore to see how it works.
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Pakistan is registering approximately 20,000 new HIV infections annually, the highest rate of increase among all countries in the region, warns the World Health Organization (WHO).

The international body says mortality among Pakistanis living with the virus, which causes the deadly AIDS disease, is also rising, in spite of the availability of lifesaving antiretroviral therapy.

The latest government figures show that only 16 percent of the estimated 150,000 people living with HIV had been tested and only 9 percent have access to lifesaving treatment.

“The remaining 135,000 people are walking around in the communities as carriers of (HIV) infection who are ready to transmit infections to those who are not infected, even to their unborn babies,” Dr. Saima Paracha of the National AIDS Control Program, told VOA.

Officials say the HIV epidemic in Pakistan remains largely concentrated among the key populations, including people who inject drugs, the transgender community, sex workers and their clients and men who have sex with men.

“The drivers of infection are now the sexual networks and they are ready to spill the infection into the general public,” Dr. Paracha cautioned.

Paracha says the Pakistani government offers free HIV testing and treatment, but she notes the marginalized key populations continue face widespread stigma and discrimination in the society.

The fear of maltreatment, and punitive actions by law enforcers impacts the willingness of these populations to pursue testing, which remains a major challenge facing national efforts to treat and prevent the spread of HIV, she lamented.

Official estimates show that Pakistan has seen a 45 percent increase in new HIV infections since 2010.

“The number of new HIV infections will continue to increase dramatically if implementation rates of intervention remain at current levels,” said Dr. Nima Saeed Abid, country head of WHO.

An official statement issued in connection with World AIDS Day quoted him as saying that Pakistan has the lowest rate of all regional countries in diagnosing people who are infected and linking them to care and treatment.

Naila Bashir, who heads the HIV treatment center at Islamabad’s Pakistan Institute of Medical Sciences (PIMS), told VOA the facility receives up to 40 new HIV patients every month, underscoring the alarming increase in the number of infections.

The center was established in 2005 and the number of patients has since increased from 22 to more than 3,000, including men, women and children of all ages, said Dr. Bashir.

HIV has never been a priority program in the national health system and the recent abolition of the federal health ministry and the devolution of its functions to the provinces, which lacked preparedness and capacity, have led to the increase in infections, say WHO experts in the country. However, they acknowledge the new government of Prime Minister Imran Khan is giving priority to tackling health emergencies in Pakistan, including HIV.

Federal Minister for National Health Services Regulation and Coordination, Aamir Mehmood Kiyani, says the government is working on a strategy to remove barriers and challenges in protecting people from HIV infections.

Kiyani told a seminar in Islamabad that since taking office three months ago, the government has moved to established 12 new HIV treatment centers while overall 33 such facilities have been working throughout Pakistan.

U.N. officials say the Pakistan government urgently needs to redouble efforts to “de-stigmatize HIV testing, advocate for confidential, non-discriminatory, community based care models and raise awareness about disease transmission, prevention treatment” to achieve reductions in new infections in affected populations.
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Negotiators from around the world began two weeks of talks on curbing climate change Sunday, three years after sealing a landmark deal in Paris that set a goal of keeping global warming well below 2 degrees Celsius (3.6 degrees Fahrenheit).

 

Envoys from almost 200 nations gathered in Poland’s southern city of Katowice, a day earlier than originally planned, for the U.N. meeting that’s scheduled to run until Dec. 14.

 

Ministers and some heads of government are joining in Monday, when host Poland will push for a joint declaration to ensure a “just transition” for fossil fuel industries like coal producers who are facing closures as part of efforts to reduce greenhouse gas emissions.

 

The meeting received a boost over the weekend, after 19 major economies at the G-20 summit affirmed their commitment to the 2015 Paris climate accord. The only holdout was the United States, which announced under President Donald Trump that it is withdrawing from the climate pact.

 

“Despite geopolitical instability, the climate consensus is proving highly resilient,” said Christiana Figueres, a former head of the U.N. climate office.

 

“It is sad that the federal administration of the United States, a country that is increasingly feeling the full force of climate impacts, continues to refuse to listen to the objective voice of science when it comes to climate change,” Figures said.

 

She cited a recent expert report warning of the consequences of letting average global temperatures rise beyond 1.5 degrees C (2.7 degrees F).

 

“The rest of the G-20 have not only understood the science, they are taking actions to both prevent the major impacts and strengthen their economies,” said Figueres, who now works with Mission 2020, a group that campaigns to reduce greenhouse gas emissions.

 

The meeting in Katowice is regarded as a key test of countries’ willingness to back their lofty but distant goals with concrete measures, some of which are already drawing fierce protests . At the top of the agenda is the so-called Paris rulebook , which will determine how governments record and report their greenhouse emissions and efforts to cut them.

 

Separately, negotiators will discuss ramping up countries’ national emissions targets after 2020, and financial support for poor nations that are struggling to adapt to climate change.

 

The shift away from fossil fuels, which scientists say has to happen by 2050, is expected to require a major overhaul of world economies.

 

“The good news is that we do know a lot of what we need to be able to do to get there,” said David Waskow of the World Resources Institute.

 

Waskow, who has followed climate talks for years, said despite the Trump administration’s refusal to back this global effort the momentum is going in the right direction.

 

“It’s not one or two players anymore in the international arena,” he said. “It’s what I think you could call a distributed leadership, where you have a number of countries — some of them small or medium-sized — really making headway and doing it in tandem with cities and states and businesses.”

 

Later Sunday, protests were planned by environmental activists calling for an end to coal mining in Poland, which gets some 80 percent of its energy from coal. Katowice is at the heart of Poland’s coal mining region of Silesia and there are still several active mines in and around the city.

 

On Saturday, thousands of people marched in Berlin and Cologne to demand that Germany speed up its exit from coal-fired power plants.
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The World Bank has announced it is doubling its funding to help poor nations adjust to global warming to $200 billion over five years.

“If we don’t reduce emissions and build adaption now, we’ll have 100 million more people living in poverty by 2030,” the bank’s climate change chief John Roome told the French News Agency.

“And we also know that the less we address this issue proactively in just three regions – Africa, South Asia, and Latin America – we’ll have 133 million climate migrants, Roone cautioned.”

Helping poorer nations adapt to a warmer environment and the weather extremes that come with it include building sturdier homes, finding new sources of fresh water, and what the bank calls “climate smart agriculture.”

The bank’s announcement comes as delegates from 200 countries started a two week-long climate change conference in Katowice, Poland.

The threat posed by global warming “has never been worse,” U.N. climate chief Patricia Espinosa said Sunday.

The threat posed by global warming “has never been worse,” U.N. climate chief Patricia Espinosa said at the start of climate talks in Poland.

“This year is likely to be one of the four hottest years on record. Climate change impacts have never been worse. This reality is telling us that we need to much more,” she said Sunday.

Negotiators from nearly 200 nations are in the southern Polish city of Katowice for two weeks of talks on implementing the landmark 2015 Paris Accord. Signatories to that agreement pledged to cut greenhouse gas emissions and limit the rise in global temperatures to less than two degrees Celsius by 2030.

“Looking from the outside perspective, it’s an impossible task,” Poland’s Deputy Environment Minister Michal Kurtyka told the Associated Press last week.

“The United Nations secretary-general is counting on all of us to deliver. There is no ‘Plan B'”

The climate change talks got a boost when 19 of 20 G-20 nations meeting in Buenos Aires reaffirmed their commitment to fighting climate change.

The United States was the only holdout. President Donald Trump has threatened to pull the U.S. out of the Paris agreement because of what he says is the economic damage the treaty’s provisions would cause.

Trump is a promoter of fossil fuels and nuclear power and has proposed renegotiating the Paris Accord – an idea many dismiss as impractical.

Host country Poland is expected to propose what it calls a “just transition” for the oil, gas, and coal industries to ease the financial blow from the move away from such polluting sources of energy.

Negotiators are also expected to put forth plans to help developing nations adapt to a warming climate.

 
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Teacher Rishi Rawat has one student who is not human, but a machine.

Lessons take place at a lab inside the University of Southern California’s (USC) Clinical Science Center in Los Angeles, where Rawat teaches artificial intelligence, or AI.

To help the machine learn, Rawat feeds the computer samples of cancer cells.

“They’re like a computer brain, and you can put the data into them and they will learn the patterns and the pattern recognition that’s important to making decisions,” he explained.

AI may soon be a useful tool in health care and allow doctors to understand biology and diagnose disease in ways that were never humanly possible.

​Doctors not going away

“Machines are not going to take the place of doctors. Computers will not treat patients, but they will help make certain decisions and look for things that the human brain can’t recognize these patterns by itself,” said David Agus, USC’s professor of medicine and biomedical engineering, director at the Lawrence J. Ellison Institute for Transformative Medicine, and director at the university’s Center for Applied Molecular Medicine.

Rawat is part of a team of interdisciplinary scientists at USC who are researching how AI and machine learning can identify complex patterns in cells and more accurately identify specific types of breast cancer tumors.

Once a confirmed cancerous tumor is removed, doctors still have to treat the patient to reduce the risk of recurrence. The type of treatment depends on the type of cancer and whether the tumor is driven by estrogen. Currently, pathologists would take a thin piece of tissue, put it on a slide, and stain with color to better see the cells.

“What the pathologist has to do is to count what percentage of the cells are brown and what percentage are not,” said Dan Ruderman, a physicist who is also assistant professor of research medicine at USC.

The process could take days or even longer. Scientists say artificial intelligence can do something better than just count cells. Through machine learning, it can recognize complicated patterns on how the cells are arranged, with the hope, in the near future of making a quick and more reliable diagnosis that is free of human error.

“Are they disordered? Are they in a regular spacing? What’s going on exactly with the arrangement of the cells in the tissue,” described Ruderman of the types of patterns a machine can detect.

“We could do this instantaneously for almost no cost in the developing world,” Agus said.

​Computing power improves

Scientists say the time is ripe for the marriage between computer science and cancer research.

“All of a sudden, we have the computing power to really do it in real time. We have the ability of scanning a slide to high enough resolution so that the computer can see every little feature of the cancer. So it’s a convergence of technology. We couldn’t have done this, we didn’t have the computing power to do this several years ago,” Agus said.

Data is key to having a machine effectively do its job in medicine.

“Once you start to pool together tens and hundreds of thousands of patients and that data, you can actually [have] remarkable new insight, and so AI and machine learning is allowing that. It’s enabling us to go to the next level in medicine and really take that art to new heights,” Agus said.

Back at the lab, Rawat is not only feeding the computer more cell samples, he also designs and writes code to ensure that the algorithm has the ability to learn features unique to cancer cells.

The research now is on breast cancer, but doctors predict artificial intelligence will eventually make a difference in all forms of cancer and beyond.
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With the help of artificial intelligence and machine learning, doctors may soon have new ways of diagnosing and treating patients in ways that were never humanly possible. Scientists at the University of Southern California in Los Angeles are developing a way of using machine learning to identify specific types of breast cancer tumors, and they say it’s just the beginning of what the computer can do. VOA’s Elizabeth Lee has the details from Los Angeles.
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There’s been a lot of progress in the fight against AIDS over the past 30 years, but as the 30th World AIDS Day is observed on Dec. 1 — people still die from the disease. And others are newly infected every day even though the tools are available to end the epidemic.

Fear, stigma and ignorance. The World Health Organization says these are the reasons the AIDS epidemic is not over because doctors can treat HIV, the virus that causes AIDS. 

With treatment, no one needs to die from AIDS, and those with the virus can’t give it to someone else. In addition, with prevention therapy, no one needs to get infected.  

Dr. Jared Baeten, an HIV specialist at the University of Washington, spoke to us via Skype and says even with these tools we’re not there yet.

“… because the ability to deliver those at the scale and with the coverage needed to be able to get HIV to go away is not nearly where it should be,” said Baeten. 

Nearly a million people still die every year from AIDS. Professor Steffani Strathdee at the University of California San Diego says one of the biggest challenges is that HIV often affects people on the fringes of some societies around the world.  

“There are populations all over the world that are underserved and these include injection drug users and sex workers, in particular,” Strathdee said.

It also includes men who have sex with men, transgender people, prisoners and the sexual partners of these people. Professor Strathdee says people who are hungry or need shelter are more concerned about their immediate needs than they are about HIV.

“My research and research in this field really shows you have to address the whole person and their needs in order to address HIV as one of their health concerns,” Strathdee said.

Strathdee says unless this happens, countries will have to bear the heavy social and economic costs of AIDS.

In addition, Baeten says testing and treatment have to be available to everyone.    

“The biggest thing that we’ve learned for preventing HIV in the last decades is that there is no magic bullet, but when you put a whole bunch of really good things together and it has exactly the kind of impact that a magic bullet can give you,” Beaten said 

Scientists say using these tools, educating people and getting more people into treatment will reduce stigma, and then, when a vaccine comes along, we can finally put an end to AIDS.
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Tremendous progress has been made in efforts to wipe out polio around the world. Before a global eradication program began 30 years ago, about 350,000 children became paralyzed from polio each year. The figure dropped to 28 in 2018. 

Nevertheless, Helen Rees, chair of the World Health Organization’s emergency committee, said Friday that polio remained an international threat. She said every available health strategy must be used to prevent the wild polio virus from spreading across borders. 

“The fear is that we might well see a resurgence, that we could see exportation again and a reversal of all of the work and all of the country global efforts that have gone into trying to eradicate polio,” Rees said. “And we certainly cannot allow that to happen.” 

Polio remains endemic in Afghanistan, Pakistan and Nigeria. Rees said that over the last few months, there has been a worrying exportation of the wild polio virus to and from Pakistan and Afghanistan. 

“We have got widespread, positive environmental sampling in Pakistan,” she said. “And in Afghanistan, because of the more difficult situation there in terms of security, we are unable to access probably as many as a million children for vaccination.”  

Separately, there is good news from the African region. The director of WHO’s polio eradication program, Michel Zaffran, noted that the wild polio virus has not been seen in Nigeria since it was last detected more than two years ago. 

If this keeps up, he said, the regional certification commission could be able to declare the wild polio virus eradicated from the African region at the end of 2019 or early 2020. He said $4.2 billion would be needed over the next five years to see the last of this disease. 

Polio, which has no cure, invades the nervous system and can cause irreversible paralysis within hours. The WHO says polio is transmitted from one person to another through the fecal-oral route, or less frequently by a common vehicle like contaminated food and water. Fever, fatigue, headache, vomiting, stiffness in the neck and limb pain are among polio’s symptoms. 
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Ahead of World AIDS Day, Uganda is recruiting women to participate in a trial of an injectable antiretroviral drug to replace Truvada, a daily pill that has low adherence by users. The trial will assess if the new drug – Cabotegravir – can further reduce the risk of acquiring HIV. Halima Athumani has more from Kampala.
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Former New York Mayor Michael Bloomberg’s charity has announced a $50 million donation to help fight the nation’s opioid epidemic.

Bloomberg Philanthropies said over the next three years it will help up to 10 states address the causes of opioid addiction and strengthen prevention and treatment programs. Its initiative involves a partnership with the Centers for Disease Control and Prevention, The Pew Charitable Trusts, Johns Hopkins University and Vital Strategies.

Bloomberg, who has been considering a 2020 Democratic presidential bid, was expected to discuss the funding Friday during his keynote address at The Bloomberg American Health Summit in Washington. A spokeswoman said there was “no stated link” between his political aspirations and the $50 million investment to fight opioids.

Bloomberg’s charity said CDC data shows there were more than 70,000 U.S. drug overdose deaths last year, including more than 47,000 from opioids, the highest numbers on record. It said those numbers are a leading factor in the decline of U.S. life expectancy over the past three years.

Bloomberg called the sobering numbers part of “a national crisis.”

“For the first time since World War I, life expectancy in the U.S. has declined over the past three years — and opioids are a big reason why,” he said. “We cannot sit by and allow this alarming trend to continue — not when so many Americans are being killed in what should be the prime of their lives.”

He said in a statement he hoped his charity’s work in Pennsylvania, one of the states hardest hit by the opioids crisis, would lay the groundwork “for more effective action across the country.”

The partnership focuses on identifying new approaches to tackle opioids and plugging gaps in current treatment and prevention programs. Staff members from partner organizations will support state and local programs to reduce opioid-related deaths, and successful initiatives and guidelines will be replicated elsewhere, with the goal of creating a model for the rest of the nation.

Pennsylvania Governor Tom Wolf said he was “deeply grateful” for the financial and technical resources his state will receive through the partnership with Bloomberg Philanthropies.

“From our first responders and health care professionals to teachers and social service providers, heroes across our commonwealth are saving lives and protecting residents in our communities every day from this awful scourge,” Wolf, a Democrat, said in a statement issued by the Bloomberg charity. “We are doing everything we can to help them, and I am confident that this partnership will mark a turning point in our efforts.”

The Drug Enforcement Administration said this month in its National Drug Threat Assessment that heroin, fentanyl and other opioids continue to be the highest drug threat in the nation.

Bloomberg, who has been an independent, a Republican and a Democrat, declared lifetime allegiance to the Democratic Party and outlined an aggressive timeline for deciding whether to run for president in an interview with The Associated Press this month. He has regularly criticized President Donald Trump and spent a fortune to help elect Democrats in the midterm elections.
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Top administration officials are debating whether to create a stand-alone Space Force to handle space defense or a Space Force that falls within the Air Force, officials tell VOA.

Either option requires congressional approval, which could prove difficult with a Democratic-led House and a Republican-led Senate.

An Oct. 26 memo obtained by VOA directs that the Department of Defense create the “optimal organizational construct to meet (the president’s) intent.” 

The memo, signed by Executive Secretary of the National Space Council Scott Pace and National Security Council official Earl Matthews, instructs the Pentagon to focus on whether the Space Force is most efficient as a new independent department or as “a separate service within the Department of the Air Force, along the lines of the U.S. Marine Corps within the Department of the Navy or the U.S. Coast Guard within the Department of Homeland Security.”

Support in the House

This latter organizational structure has bipartisan support in the House, but the former has often been seen by Democrats as an expensive solution. 

Vice President Mike Pence and Deputy Secretary of Defense Patrick Shanahan met Thursday to discuss how to build the first new military branch since 1947, as President Donald Trump has directed. 

A National Space Council official told VOA Thursday the October memo does not represent a shift in White House guidance. 

“The direction to create the U.S. Space Force remains exactly the same, and the Space Council is continuing to work with the departments and agencies responsible for implementing the president’s direction to develop the sixth branch of the Armed Forces,” the official said.

Space Command next?

Officials say the president also intends to establish a U.S. Space Command, a move already directed by Congress.

The U.S. military is organized into 10 combatant commands based on either geography, such as Indo-Pacific Command and European Command, or unified functions, such a Transportation Command and Cyber Command.

This new, 11th combatant command would oversee space defense much like U.S. Cyber Command oversees cyber defense. Space Command is expected to start in mid-2019 with initial operation capability.

Officials familiar with Space Force deliberations have raised concerns to VOA that a new military branch could duplicate the work of the new combatant command. They say a separate military service may not be needed once the combatant command is fully operational. 

“You don’t see a Cyber Force in addition to Cyber Command,” one official said on condition of anonymity.

Cost estimates for the Space Command have been modeled after the creation of U.S. Strategic Command, which was set up in the early 1990s. The biggest expense will be the creation of a new headquarters for the combatant command in order to make room for providing new capabilities, according to one official.
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Three tiny rocks brought back from the moon in 1970 by the unmanned Soviet Luna-16 mission sold for $855,000 on Thursday at a New York auction. 

They’re the only documented lunar rocks in private hands, Sotheby’s auction house said. The U.S. collector who bought the rocks was not named. 

The sellers, also from the U.S., bought the rocks for $442,500 at a Sotheby’s Russian space history sale in 1993. That was the first time that a piece of a celestial body had been offered for sale to the public.

The rocks originally had been given to the widow of Sergei Pavlovich Korolev, the former director of the Soviet Union’s space program, by the Soviet government in recognition of her husband’s work.

It is extremely rare for authentic lunar samples to come on the market. All samples collected by American astronauts are deemed the property of the U.S. government — except one.

Last year, a bag used by Apollo 11 astronaut Neil Armstrong to collect moon dust was sold by Sotheby’s for $1.8 million, netting a hefty profit for its owner. 

 

A Chicago-area woman, Nancy Carlson, bought the bag, which had been misidentified, at an online government auction for $995. After she sent it to NASA for identification, the space agency confirmed that it had been used by Armstrong and still contained moon dust. 

NASA fought to keep the bag but lost a court fight in 2016. 
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The number of uninsured children in the United States has increased for the first time in nearly a decade, placing it at 3.9 million in 2017, according to a report Thursday from Georgetown University’s Center for Children and Families. 

 

Nationally, the number of uninsured children increased by an estimated 276,000 in 2017, from a historic low of 4.7 percent in 2016 to 5 percent last year. Experts say about 75 percent of the newly uninsured children are clustered in states that did not expand Medicaid such as Florida, Texas and Georgia. 

 

Under President Obama’s Affordable Care Act, Florida and other states could take federal funding to help pay for health coverage for nearly 900,000 people, but the Republican-led Legislature in Florida voted against it. The vast majority of states have already expanded Medicaid and increased the number of residents eligible for its coverage. 

 

Joan Alker, executive director for Georgetown’s Center for Children and Families, has written the report for the last eight years and said she’s never seen the rates of uninsured children go up in all 50 states, which happened last year. 

Better economy, low unemployment

 

She said that what is perhaps most concerning is that the uninsured rate among children increased despite an improving economy and low unemployment rate that allowed more children to get private coverage through their parents. 

 

The study blamed the increases on the Trump administration’s repeated attempts to prompt an overhaul of publicly funded health care. There were major efforts to repeal Obama’s Affordable Care Act and cut Medicaid, and the children’s CHIP insurance funding also ran out and hung in the balance for months before Congress extended it. 

 

“There was a lot of confusion among families as to whether these public coverage sources were available,” Alker said.  

  

At the same time, the Trump administration slashed funding for advertising and enrollment counselors to help sign people up for these health insurance programs. The country’s enrollment decline was not just in Medicaid and CHIP, but also in Obamacare, or the federal marketplace where parents can purchase private health insurance and often receive a subsidy to help pay for it. 

 

The report noted that many of the children who do not have health insurance are eligible for coverage but just aren’t enrolled. 

‘More of a fluctuation’

 

Ed Haislmaier, a senior research fellow with the Heritage Foundation, a conservative think tank, said the figures were statistically insignificant. 

 

He did agree that there were dips in Medicaid enrollment and through the Obamacare marketplace, but noted there’s no enrollment cutoff for Medicaid, meaning families can sign up their children year-round. 

 

“It’s really more of a fluctuation. There’s no policy driver there,” he said, saying he didn’t think marketing cuts had any impact. 

 

In Florida, the uninsured rate went from 288,000 in 2016 to 325,000 in 2017.

Florida has one of the highest rates of uninsured residents in the country, and also has had the highest number of enrollees purchasing insurance through the Obamacare federal marketplace. However, Medicaid expansion in Florida is likely off the table for this upcoming legislative session. Incoming Gov.-elect Ron DeSantis, a Republican, is against it. His opponent, Democrat Andrew Gillum, campaigned heavily on his support to expand Medicaid coverage for more residents. 

The report also expressed concern that strict immigration policies and enforcement were making many immigrant families leery of enrolling, even if their children were eligible for health coverage. “We think it’s really this national unwelcome mat regarding public coverage,” Alker said. 
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The expansive court case seeking to hold drugmakers responsible for the nation’s opioid crisis has a new complication: How does it deal with claims covering the thousands of babies born addicted to the drugs?

Attorneys representing the children and their guardians want their claims separated from the federal case in Cleveland that involves hundreds of local governments and other entities such as hospitals. They told a skeptical panel of judges in New York on Thursday that they have different legal issues, a need for faster relief because the babies need services in the first years of their lives. They also told the judges that as it is, they lack the leverage to exact a settlement from drug companies.

Babies, unlike governments or businesses, have been directly harmed by the actions of drugmakers and are entitled to their own payments, said Scott Bickford, a lead lawyer for the children and their guardians.

Bickford said more than 150,000 babies were born in opioid withdrawal from 2012 through 2016, and that the number grows each year

Federal cases consolidated

He said initial hospital stays for babies born to an opioid-addicted mother can cost $200,000 to $250,000 more than other infants born without complications. 

“Then you have to address their developmental and learning problems,” Bickford said in a Tuesday interview. “A lot of them have organ problems. A lot of them have problems we don’t even know about.”

Drug manufacturers and distributors oppose creating a new structure for the lawsuits over the children and judges on the Judicial Panel on Multidistrict Litigation hearing the matter in New York on Thursday wondered what good it would do.

Opioids — including prescription painkillers, heroin and synthetic substances including fentanyl — killed nearly 48,000 Americans last year, according to the U.S Centers for Disease Control and Prevention. The cost of treatment, providing an overdose antidote, foster care, jail stays, ambulance runs and addressing a growing homeless crisis have added up for governments and taxpayers. Studies have found that opioid addiction also has depleted the workforce, harming the economy.

More than 1,400 plaintiffs have had their federal cases consolidated under a single judge. They include county and local governments, hospitals, unions, American Indian tribes and individuals. Hundreds of others have sued in state courts. Cleveland-based federal Judge Dan Polster has been pushing the parties to reach a settlement.

Children need a voice

The judicial panel’s chairwoman, Judge Sarah Vance, said it’s unlikely any settlement would be reached without considering the children.

“It’s hard for me to see how the defendants are going to settle if they’ve got 150,000 children unhappy because their needs are unmet,” Vance said.

Angela Vicari, a lawyer for the drug manufacturers, told the judge that she wasn’t aware of the lawyers for the babies seeking to negotiate.

But lawyers for the children said they don’t have a voice in the committee of plaintiffs’ lawyers leading the case, making it hard to request the information from the industry that they believe would help prove their case. Attorney Kevin Thompson said it’s essential to request information on any industry laboratory studies on the impact of drugs passed from mothers to children.

Lawyers also worry that any settlement reached by government agencies won’t go to help the people who have been hurt. “They end up paving a road with that,” Bickford said.

Other plaintiffs in the omnibus opioid litigation have not objected formally and did not speak in court Thursday, but some are cool to the idea of separating the cases involving the children. One of the lead lawyers for the local governments, Paul Farrell Jr., said he is trying to get help for children born with opioid dependency and have prenatal care funded by the drug industry.

He said in an interview that the plaintiffs share a goal: holding drug manufacturers liable for the crisis. Unless that happens, he said, no one will get the payouts they’re seeking.

“You’ve only got to shoot the pig once,” he said Tuesday.

Indian tribes allowed to go it alone

Lawyers representing the children and their guardians say there is precedent for their request to go it alone, after Polster granted the American Indian tribes a separate test trial for their claims. In August, the judge denied similar status for the cases brought on behalf of babies.

That decision prompted the lawyers to ask the panel of judges to put their cases under another judge in West Virginia or Illinois.

A ruling is expected in the next several weeks.
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After repeated food poisoning outbreaks linked to romaine lettuce, the produce industry is confronting the failure of its own safety measures in preventing contaminations.

The E. coli outbreak announced just before Thanksgiving follows one in the spring that sickened more than 200 people and killed five, and another last year that sickened 25 and killed one.

No deaths have been reported in the latest outbreak, but the dozens of illnesses highlight the challenge of eliminating risk for vegetables grown in open fields and eaten raw, the role of nearby cattle operations that produce huge volumes of manure and the delay of stricter federal food safety regulations.

A contested aspect of the regulation, for example, would require testing irrigation water for E. coli. The Food and Drug Administration put the measure on hold when the produce industry said such tests wouldn’t necessarily help prevent outbreaks. Additional regulations on sanitation for workers and equipment — other potential sources of contamination — only recently started being implemented.

FDA Commissioner Scott Gottlieb said he thinks the combination of rules, once fully in place, will make vegetables safer to eat.

“I don’t think any one element of this is going to be the magic bullet,” Gottlieb said.

Health officials say improved detection may make outbreaks seem more frequent. Still, that is intensifying pressure on growers and regulators to prevent, catch and contain contamination.

Prevention

It’s not yet known how romaine got contaminated in the latest outbreak.

The spring outbreak was traced to romaine from Yuma, Arizona. Irrigation water tainted with manure was identified as a likely culprit, and investigators noted the presence of a large animal feeding operation nearby.

Subsequently, growers in Arizona and California adjusted an industry agreement to expand buffer zones between vegetable fields and livestock. The industry says the change was in place for lettuce now being grown in Yuma, which hasn’t been implicated in the latest outbreak. But Trevor Suslow of the Produce Marketing Association said there isn’t consensus about the exact distances that might effectively prevent contamination.

He noted specific buffer zones aren’t required by the new federal rules on produce safety.

“They look to the industry to determine what is the appropriate distance,” Suslow said.

Growers in Yuma also started treating irrigation water that would touch plant leaves with chlorine to kill potential contaminants, Suslow said. But he said such treatment raises concerns about soil and human health.

Meanwhile, the proximity of produce fields to cattle operations is likely to continue posing a problem. Travis Forgues of the milk producer Organic Valley noted consolidation in the dairy industry is leading to bigger livestock operations that produce massive volumes of manure.

Testing

Already, the industry agreement in Arizona and California requires leafy green growers to test water for generic E. coli.

But James Rogers, director of food safety research at Consumer Reports, said it’s important to make water testing a federal requirement. Since romaine is often chopped up and bagged, a single contaminated batch from one farm that skips testing could make a lot of people sick, he said.

Teressa Lopez of the Arizona Leafy Greens Marketing Agreement also said federal regulation can ensure greater compliance, even though the industry agreement has stricter measures.

Despite industry measures implemented after a spinach outbreak more than a decade ago, health officials note d this month there have been 28 E. coli outbreaks linked to leafy greens since 2009.

The produce industry says the failure to prevent the Yuma outbreak could also reflect the limitations of testing water for generic E. coli.

Elizabeth Binh, a food science expert at Cornell University, said the tests look for the amount of fecal matter in water. The problem is, “some feces has pathogens in it, some feces doesn’t,” said Binh, who is part of a federal program helping farmers comply with the new produce regulations.

Testing for specific E. coli strains that are harmful is more difficult, and doesn’t rule out the possibility of other harmful bacteria, Binh said.

Containment

Whole-genome sequencing is making it easier to detect outbreaks, which is pressuring the produce industry.

The FDA warned against all romaine last week because it said it was able to identify it as a likely source early enough. The agency narrowed its warning to romaine from California’s Central Coast after the produce industry agreed to label romaine with harvest dates and regions, so people know what’s OK to eat.

The labeling is voluntary, and the industry said it will evaluate whether to extend it to other leafy greens. Gottlieb said improving traceability would allow targeted health alerts that don’t hurt the entire industry. The FDA recently hired a former Walmart executive who used blockchain technology to improve traceability in the retailer’s supply chain.

Stephen Basore, director of food safety at a Florida romaine grower, said he expects more regulations and self-imposed industry guidelines.

“Anytime there is an issue, the immediate response is saying our protocols aren’t enough,” he said.
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Suicides and drug overdoses helped lead a surge in U.S. deaths last year, and drove a continuing decline in how long Americans are expected to live.

Overall, there were more than 2.8 million U.S. deaths in 2017, or nearly 70,000 more than the previous year, the Centers for Disease Control and Prevention said Thursday. It was the most deaths in a single year since the government began counting more than a century ago.

The increase partly reflects the nation’s growing and aging population. But it’s deaths in younger age groups — particularly middle-aged people — that have had the largest impact on calculations of life expectancy, experts said.

The suicide death rate last year was the highest it’s been in at least 50 years, according to U.S. government records. There were more than 47,000 suicides, up from a little less than 45,000 the year before.

​A general decline

For decades, U.S. life expectancy was on the upswing, rising a few months nearly every year. Now it’s trending the other way: It fell in 2015, stayed level in 2016, and declined again last year, the CDC said.

The nation is in the longest period of a generally declining life expectancy since the late 1910s, when World War I and the worst flu pandemic in modern history combined to kill nearly 1 million Americans. Life expectancy in 1918 was 39.

Aside from that, “we’ve never really seen anything like this,’’ said Robert Anderson, who oversees CDC death statistics.

In the nation’s 10 leading causes of death, only the cancer death rate fell in 2017. Meanwhile, there were increases in seven others: suicide, stroke, diabetes, Alzheimer’s, flu/pneumonia, chronic lower respiratory diseases and unintentional injuries.

An underlying factor is that the death rate for heart disease, the nation’s No. 1 killer, has stopped falling. In years past, declines in heart disease deaths were enough to offset increases in some other kinds of death, but no longer, Anderson said.

The CDC’s numbers do sometimes change. This week, CDC officials said they had revised their life expectancy estimate for 2016 after some additional data came in.

What’s driving this?

CDC officials did not speculate about what’s behind declining life expectancy, but Dr. William Dietz, a disease prevention expert at George Washington University, sees a sense of hopelessness.

Financial struggles, a widening income gap and divisive politics are all casting a pall over many Americans, he suggested. 

“I really do believe that people are increasingly hopeless, and that that leads to drug use, it leads potentially to suicide,’’ he said.

Drug overdose deaths also continued to climb, surpassing 70,000 last year, in the midst of the deadliest drug overdose epidemic in U.S. history. The death rate rose 10 percent from the previous year, smaller than the 21 percent jump seen between 2016 and 2017.

That’s not quite a cause for celebration, said Dr. John Rowe, a professor of health policy and aging at Columbia University.

“Maybe it’s starting to slow down, but it hasn’t turned around yet,’’ Rowe said. “I think it will take several years.”

Accidental drug overdoses account for more than a third of the unintentional injury deaths, and intentional drug overdoses account for about a tenth of the suicides, said Dr. Holly Hedegaard, a CDC injury epidemiologist.

Other findings

The CDC figures are based mainly on a review of 2017 death certificates. The life expectancy figure is based on current death trends and other factors.

The agency also said:

A baby born last year in the U.S. is expected to live about 78 years and 7 months, on average. An American born in 2015 or 2016 was expected to live about a month longer, and one born in 2014 about two months longer than that.
The suicide rate was 14 deaths per 100,000 people. That’s the highest since at least 1975.
The percentage of suicides from drug overdose has been inching downward.
Deaths from flu and pneumonia rose by about 6 percent. The 2017-2018 flu season was one of the worst in more than a decade, and some of the deaths from early in that season appeared in the new death dates.
West Virginia was once again the state with the highest rate of drug overdose deaths. The CDC did not release state rates for suicides.
Death rates for heroin, methadone and prescription opioid painkillers were flat. But deaths from the powerful painkiller fentanyl and its close opioid cousins continued to soar in 2017.
The CDC did not discuss 2017 gun deaths in the reports released Thursday. But earlier CDC reports noted increase rates of suicide by gun and by suffocation or hanging.

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A Chinese researcher who claims to have helped make the world’s first genetically edited babies says a second pregnancy may be underway.

The researcher, He Jiankui of Shenzhen, revealed the pregnancy Wednesday while making his first public comments about his controversial work at an international conference in Hong Kong.

He claims to have altered the DNA of twin girls born earlier this month to try to make them resistant to infection with the AIDS virus. Mainstream scientists have condemned the experiment, and universities and government groups are investigating.

The second pregnancy is in a very early stage and needs more time to be monitored to see if it will last, He said.

Leading scientists said there are now even more reasons to worry, and more questions than answers, after He’s talk. The leader of the conference called the experiment “irresponsible” and evidence that the scientific community had failed to regulate itself to prevent premature efforts to alter DNA.

Altering DNA before or at the time of conception is highly controversial because the changes can be inherited and might harm other genes. It’s banned in some countries including the United States except for lab research.

He defended his choice of HIV, rather than a fatal inherited disease, as a test case for gene editing, and insisted the girls could benefit from it.

“They need this protection since a vaccine is not available,” He said.

Scientists weren’t buying it.

“This is a truly unacceptable development,” said Jennifer Doudna, a University of California-Berkeley scientist and one of the inventors of the CRISPR gene-editing tool that He said he used. “I’m grateful that he appeared today, but I don’t think that we heard answers. We still need to understand the motivation for this.”

“I feel more disturbed now,” said David Liu of Harvard and MIT’s Broad Institute, and inventor of a variation of the gene-editing tool. “It’s an appalling example of what not to do about a promising technology that has great potential to benefit society. I hope it never happens again.”

There is no independent confirmation of He’s claim and he has not yet published in any scientific journal where it would be vetted by experts. At the conference, He failed or refused to answer many questions including who paid for his work, how he ensured that participants understood potential risks and benefits, and why he kept his work secret until after it was done.

After He spoke, David Baltimore, a Nobel laureate from the California Institute of Technology and a leader of the conference, said He’s work “would still be considered irresponsible” because it did not meet criteria many scientists agreed on several years ago before gene editing could be considered.

“I personally don’t think that it was medically necessary. The choice of the diseases that we heard discussions about earlier today are much more pressing” than trying to prevent HIV infection this way, he said.

If gene editing is ever allowed, many scientists have said it should be reserved to treat and prevent serious inherited disorders with no good alternatives, such as sickle cell anemia and Huntington’s disease. HIV is not an appropriate candidate because there are already safe ways to prevent transmission, and if contracted it can be kept under control with medications, researchers said.

The case shows “there has been a failure of self-regulation by the scientific community” and said the conference committee would meet and issue a statement on Thursday about the future of the field, Baltimore said.

Before He’s talk, Dr. George Daley, Harvard Medical School’s dean and one of the conference organizers, warned against a backlash to gene editing because of He’s experiment. Just because the first case may have been a misstep “should in no way, I think, lead us to stick our heads in the sand and not consider the very, very positive aspects that could come forth by a more responsible pathway,” Daley said.

“Scientists who go rogue … it carries a deep, deep cost to the scientific community,” Daley said.

Regulators have been swift to condemn the experiment as unethical and unscientific.

The National Health Commission has ordered local officials in Guangdong province to investigate He’s actions, and his employer, Southern University of Science and Technology of China, is investigating as well.

On Tuesday, Qui Renzong of the Chinese Academy of Social Science criticized the decision to let He speak at the conference, saying the claim “should not be on our agenda” until it has been reviewed by independent experts. Whether He violated reproductive medicine laws in China has been unclear; Qui contends that it did, but said, “the problem is, there’s no penalty.”

He called on the United Nations to convene a meeting to discuss heritable gene editing to promote international agreement on when it might be OK.

Meanwhile, more American scientists said they had contact with He and were aware of or suspected what he was doing.

Dr. Matthew Porteus, a genetics researcher at Stanford University, where He did postdoctoral research, said He told him in February that he intended to try human gene editing. Porteus said he discouraged He and told him “that it was irresponsible, that he could risk the entire field of gene editing by doing this in a cavalier fashion.”

Dr. William Hurlbut, a Stanford ethicist, said he has “spent many hours” talking with He over the last two years about situations where gene editing might be appropriate.

“I knew his early work. I knew where he was heading,” Hurlbut said. When he saw He four or five weeks ago, He did not say he had tried or achieved pregnancy with edited embryos but “I strongly suspected” it, Hurlbut said.

“I disagree with the notion of stepping out of the general consensus of the scientific community,” Hurlbut said. If the science is not considered ready or safe enough, “it’s going to create misunderstanding, discordance and distrust.”

Jennifer Doudna and David Liu are paid by the Howard Hughes Medical Institute, which also supports AP’s Health & Science Department.
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A Chinese researcher has publicly defended his claim he has created the world’s first genetically-edited babies.

He Jiankui addressed a crowd of fellow scientists Wednesday at a biomedical conference in Hong Kong, two days after he posted a video online claiming to have used a gene-editing technology dubbed CRISPR to alter the DNA of twin girls born to an HIV-positive father to prevent them from contracting the virus that causes AIDS.

Dr. He said he conducted his research in secret. His work has not been independently verified, and Dr. He has not submitted his report to any scientific journals where it could be examined by experts. But he told his colleagues that he felt “proud…proudest” of his achievement.

His claims have set off a firestorm of skepticism and criticism. The Southern University of Science and Technology, the university in the southern Chinese city in Shenzhen that employs him, says he has been on unpaid leave since February. The school denounced his research for violating “academic ethics and codes of conduct,” and the Chinese government is urging local authorities to launch an investigation into He’s work.

Shortly after He’s speech before the Second International Summit on Human Genome Editing, American biologist David Baltimore, a Nobel laureate in physiology or medicine and a leader of the summit, called Dr. He’s work “irresponsible” and a “failure of self-regulation by the scientific community.”

Genetic editing has the potential to remove inherited diseases from the gene pool, but scientists and ethicists worry it could be used to create so-called “designer babies.” They also worry any genetic changes could lead to other genes being altered in unpredictable ways.
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Feeding a hungry planet is growing increasingly difficult as climate change and depletion of land and other resources undermine food systems, the U.N. Food and Agricultural Organization said Wednesday as it renewed appeals for better policies and technologies to reach “zero hunger.”

 

Population growth requires supplies of more nutritious food at affordable prices, but increasing farm output is hard given the “fragility of the natural resource base” since humans have outstripped Earth’s carrying capacity in terms of land, water and climate change, the report said.

 

About 820 million people are malnourished. The FAO and International Food Policy Research Institute released the report at the outset of a global conference aimed at speeding up efforts to achieve zero hunger around the world.

 

“The call for action is very clear. It is possible in our lifetime and it is also realistic to end hunger and malnutrition,” Inonge Wina, vice president of Zambia, told the gathering.

 

Food security remains tenuous for many millions of people who lack access to affordable, adequately nourishing diets for a variety of reasons, the most common being poverty.

 

But it’s also endangered by civil strife and other conflicts. In Yemen, where thousands of civilians have died in airstrikes by a Saudi-led coalition, the aid group Save the Children says 85,000 children under 5 may have died of hunger or disease in the civil war.

 

In Afghanistan, severe drought and conflict have displaced more than 250,000 people, according to UNHCR, the U.N. refugee agency.

 

FAO Director-General Jose Graziano da Silva noted that the number of hungry and malnourished people in the world has risen to levels last seen a decade ago.

 

“After decades of gains in fighting hunger, this is a serious setback and FAO and the U.N. sister agencies, together with member governments and other partners, are all very concerned,” Graziano da Silva said in a videotaped address to the conference.

 

Hunger is still most severe in Africa, but the largest number of undernourished people live in the Asia-Pacific region, the report said. It said good public policies and technology are the keys to improving the situation.

 

The FAO estimates that global demand for food will jump by half from 2013 to 2050. Farmers can expand land use to help make up some of the difference, but that option is constrained in places like Asia and the Pacific and urbanization is eating up still more land that once may have been used for agriculture.

 

Increasing farm output beyond sustainable levels can cause permanent damage to ecosystems, the report said, noting that it often causes soil erosion, pollution with plastic mulching, pesticides and fertilizers, and a loss of biodiversity.

 

China destroys 12 million tons of tainted grain each year, at a loss of nearly $2.6 billion, according to the report.

 

 

 

 
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