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seattle — The U.S. government said Thursday it plans to spend more than $1 billion over the next decade to help recover depleted populations of salmon in the Pacific Northwest, and that it will help figure out how to offset the hydropower, transportation and other benefits provided by four controversial dams on the Snake River, should Congress ever agree to breach them.

President Joe Biden’s administration stopped short of calling for the removal of the dams to save the fish, but Northwest tribes and conservationists who have long sought that called the agreement a road map for dismantling them. Filed in U.S. District Court in Oregon, it pauses long-running litigation over federal operation of the dams and represents the most significant step yet toward breaching them.

“Today’s historic agreement marks a new direction for the Pacific Northwest,” senior White House adviser John Podesta said in a written statement. “Today, the Biden-Harris administration and state and tribal governments are agreeing to work together to protect salmon and other native fish, honor our obligations to tribal nations, and recognize the important services the Columbia River system provides to the economy of the Pacific Northwest.”

The Columbia River Basin, an area roughly the size of Texas, was once the world’s greatest salmon-producing river system, with at least 16 stocks of salmon and steelhead.

Today, four are extinct and seven are listed under the Endangered Species Act. Another iconic but endangered Northwest species, a population of killer whales, also depends on the salmon.

Dams blamed for decline

Dams are a main culprit behind the salmon’s decline, and federal fisheries scientists have concluded that breaching the dams in eastern Washington on the Snake River, the largest tributary of the Columbia, would be the best hope for recovering them, providing the fish with access to hundreds of miles of pristine habitat and spawning grounds in Idaho.

Conservation groups sued the federal government more than two decades ago in an effort to save the fish. They have argued that the continued operation of the dams violates the Endangered Species Act as well as treaties dating to the mid-19th century ensuring the tribes’ right to harvest fish.

Republicans in Congress who oppose the breaching of the dams released a leaked copy of the draft agreement late last month.

“I have serious concerns about what this agreement means for the future of our region,” Representative Cathy McMorris Rodgers, a Republican from Washington, said in an emailed statement Thursday. “It jeopardizes the energy, irrigation and navigation benefits that support our entire way of life, and it makes commitments on behalf of Congress without engaging us.”

Details of agreement

Under the agreement, the U.S. government will build enough new clean energy projects in the Pacific Northwest to replace the hydropower generated by the dams — the Ice Harbor, Little Goose, Lower Monumental and Lower Granite.

The agreement includes a compromise regarding dam operations — providing for additional water to be spilled in the spring, fall and winter to help some salmon runs such as spring and summer Chinook, while reducing the spill required in late summer, when energy demand is high and production is especially profitable. That could harm fall Chinook, said the environmental law firm Earthjustice, which is representing environmental, fishing and renewable energy groups in the litigation.

The federal Bonneville Power Administration, which operates the dams, will spend $300 million over 10 years to restore native fish and their habitats throughout the Columbia River Basin, though it said the agreement would result in rate increases of only 0.7%. Two-thirds of that money will go toward hatchery improvements and operations, and the rest will go to what the agreement refers to as the “six sovereigns” — Oregon, Washington and the four tribes involved: the Yakama Nation, the Nez Perce Tribe, the Confederated Tribes of the Umatilla Indian Reservation and the Confederated Tribes of the Warm Springs.

Combined with other fish-restoration funding, the federal government will be spending more than $1 billion over the next decade, the White House said.

The U.S. also will conduct or pay for studies of how the transportation, irrigation and recreation provided by the dams could be replaced. The dams made the town of Lewiston, Idaho, the most inland seaport on the West Coast, and many farmers in the region rely on barges to ship their crops, though rail is also available.

The agreement “lays out a pathway to breaching,” said Shannon Wheeler, chairman of the Nez Perce Tribe. “When these things are replaced, and the Pacific Northwest is transforming into a stronger, more resilient, better place, then there’s a responsibility … to make the decisions that are necessary to make sure these treaty promises are kept.”

Utility and business groups Northwest RiverPartners, the Public Power Council and the Pacific Northwest Waterways Association have opposed the agreement.

“This settlement undermines the future of achieving clean energy goals and will raise the rates of electricity customers across the region while exacerbating the greatest threat to salmon that NOAA scientists have identified — the warming, acidifying ocean,” Northwest RiverPartners said in a news release Thursday.

There has been growing recognition that the harm some dams cause to fish outweighs their usefulness, but only a few lawmakers in the region have embraced the idea. Dams on the Elwha River in Washington state and the Klamath River along the Oregon-California border have been or are being removed.

In 2021, Republican Representative Mike Simpson of Idaho proposed removing the earthen berms on either side of the four Lower Snake River dams to let the river flow freely, and to spend $33 billion to replace the benefits of the dams.

Last year, Washington Governor Jay Inslee and Washington U.S. Senator Patty Murray, both Democrats, released a report saying carbon-free electricity produced by the dams must be replaced before they are breached. Inslee declined to endorse breaching the dams during a conference call with reporters on Thursday, but he said figuring out how to replace their benefits would enable Congress to make a better decision.

“I don’t think this agreement makes anything inevitable, but it does make it much more likely that we’ll have the information we need to make the decision,” he said.

In October, Biden directed federal agencies to use all available resources to restore abundant salmon runs in the Columbia River Basin, but that memo too stopped short of calling for the removal of the dams.

“The energy needs of the Pacific Northwest should not rest on the backs of salmon,” said Donella Miller, fisheries science manager with the Columbia River Inter-Tribal Fish Commission. “What’s good for the salmon is good for the environment, and what’s good for the environment is good for the people.”
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washington — The maiden liftoff of a new American rocket called Vulcan Centaur has been delayed from December 24 to January 8, the company that developed it said Thursday.

The postponement stems from last-minute technical snags, but United Launch Alliance CEO Tory Bruno said on X, formerly Twitter, that a recent dress rehearsal on the launch pad went well.

The rocket will carry a private lunar lander, developed by the startup Astrobotic, which could become the first such private craft to touch down on the moon and the first American robot to land on the surface since the Apollo program ended in 1972.

“This is sort of, in a way, the first giant step in the campaign for the U.S., and for all of our friends, to go back to the moon, eventually with people,” Bruno told AFP in an interview last week.

“It’s a pretty big deal to have a payload at all, let alone one that goes to the surface of the moon,” he added.

“We wanted to do something really important, and we have a lot of confidence, obviously, in the design of our rocket,” Bruno said.

Liftoff for this mission called Cert-1 will take place at the U.S. Space Force launch base at Cape Canaveral, Florida.

In dress rehearsals in recent days, some “routine” issues emerged in the ground system so a Christmas Eve flight is now out, and the new window opens January 8, Bruno wrote on X.

Besides the lunar lander, this rocket will carry the cremated remains of several people associated with the original “Star Trek” series, including creator Gene Roddenberry and cast member Nichelle Nichols, who played the character Uhura. Roddenberry’s ashes have been launched into orbit previously.

A sample of Bruno’s own DNA will also be taken into space. “Who wouldn’t want to go to space with five ‘Star Trek’ people?” he mused in the interview with AFP.

Vulcan Centaur is meant to replace ULA’s Atlas V and Delta IV rockets and is designed to carry a payload of up to 27.2 metric tons into low orbit, comparable to what the SpaceX Falcon 9 can do.
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London/Dubai — Nearly 200 countries signed a deal Wednesday at the COP28 climate summit in Dubai to transition away from fossil fuels. Proponents say it heralds the end of the age of oil — but not all nations are satisfied with the text of the deal. 

The deal calls for “transitioning away from fossil fuels in energy systems, in a just, orderly and equitable manner … so as to achieve net zero by 2050 in keeping with the science.”  

 

It also calls for a tripling of renewable energy capacity globally by 2030, speeding up efforts to reduce coal use, and accelerating technologies such as carbon capture and storage. 

Sultan al-Jaber, the COP28 president who also is head of the United Arab Emirates’ state-owned oil firm, said the deal could prevent global warming exceeding 1.5 degrees Celsius above pre-industrial levels, the target agreed to at the Paris climate summit in 2015. Scientists say that exceeding this level of warming will likely cause irreversible and increasingly catastrophic climate change. 

“It is a plan that is led by the science. It is a balanced plan that tackles emissions, bridges the gap on adaptation, reimagines global finance and delivers on loss and damage,” al-Jaber said of the COP28 agreement. 

He called the deal “historic” but added that its true success would be in its implementation. “We are what we do, not what we say. We must take the steps necessary to turn this agreement into tangible actions,” al-Jaber told delegates in Dubai. 

Many nations, including the United States and China – the world’s two largest emitters of greenhouse gases – welcomed the agreement after two weeks of hard-fought negotiations. 

“Everybody here should be pleased that in a world of Ukraine and the Middle East war and all the other challenges of a planet that is foundering, this is a moment where multilateralism has actually come together and people have taken individual interests and attempted to define the common good,” John Kerry, the U.S. climate envoy, told delegates Wednesday. 

However, more than 100 countries, including many European states, had lobbied for stronger language to fully phase out fossil fuels.  

They faced strong opposition from oil-producing members of the OPEC cartel, led by representatives from Saudi Arabia, who argued the world can slash emissions without shunning specific fuels.

That prompted criticism from some delegates, including small island states, that are most vulnerable to rising sea levels in a warming world.

“We have made an incremental advancement over business as usual, when what we really needed is an exponential step change in our actions and support,” said Anne Rasmussen, the chair of the Alliance of Small Island States, whose members include 39 island nations.  

Many climate change campaigners said the text of the deal is too weak. “On the one hand, this is a good sign and signal that the world is finally dealing with fossil fuels after almost three decades of refusing to deal with it. But on the other hand, the new text includes cavernous loopholes that will allow for the oil and gas industry to continue,” said Jean Su of the Arizona-based Center for Biological Diversity. 

Those loopholes include the use of so-called carbon capture technology, which removes some carbon dioxide emissions from the burning of greenhouse gases.  

“That technology exists in some places, but it’s never been proven to work at the kind of scale that you would need if you were to continue burning fossil fuels,” said Ruth Townend, a research fellow with the Environment and Society Program at Chatham House, a research institution. 

Scientists say we need to cut greenhouse gas emissions by 43 percent in just six years, in order to meet the target of limiting global warming to 1.5 degrees Celsius above pre-industrial levels.  

“The energy transition to renewables is far more feasible than trying to capture carbon from the atmosphere. We know what we need to do. And governments now need to find ways that work for them economically and politically to commit to that and deliver it. And that needs to happen very fast,” Townend told VOA. 

Along with the agreement to transition away from fossil fuels, the COP28 summit secured agreement on a loss and damage fund, with close to $800 million pledged during the conference. 

“The new fund helps the poorest countries of the world and the ones most vulnerable to climate change with money for the loss and damage that they are experiencing when they have a hurricane, flooding, fires or other damage to their economies,” said Professor Michael Jacobs, of the London-based ODI research group. 

“Some of the richer countries have put in money for this fund. They still need to make good on this money. It’s a pledge at this point but normally pledges are realized in time.  It’s something that the poorer countries have wanted for some time,” Jacobs told VOA.   

COP28 also saw the first ever ‘global stocktake’ – a new process whereby countries assess their progress toward achieving the goals of the Paris Climate Change Agreement, to be conducted every five years. The conclusion from COP28 is that the world remains well off target, said Teresa Anderson, who leads climate justice research at the global non-profit, ActionAid International. 

“The global stocktake report is quietly devastating in U.N. language. It says in no uncertain terms that we are not on track to save ourselves. The question is now, what do we do with that knowledge? Do we actually realize that we need to do something very different and very soon? Otherwise, we’ll be pushing the planet to the brink,” Anderson told VOA.

Dale Gavlak contributed to this report.
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DUBAI, UNITED ARAB EMIRATES — Undeterred by wars at home, delegations from Ukraine and the Palestinian territories are active at COP28, determined to call attention not only to the environmental threats facing their homelands but also to emphasize their places in the global community.

Ukraine, attending its second COP international conference, is using its pavilion in Dubai to highlight the extensive environmental damage caused by Russia’s invasion and propose preventive measures against ecocide on a global scale.

Ruslan Strilets, Ukraine’s minister of environmental protection and natural resources, told VOA that the delegation aims not only to showcase the environmental and climate consequences of the war, but also to unite and engage the international community in achieving justice and peace.

Ukraine is committed to fighting climate change, Strilets said.

“Despite the war, Ukraine is finalizing the development of its climate architecture and consistently fulfilling its climate commitments. At COP28, we plan to gather even more partners around our country for a greener future for Ukraine and the entire world,” he said.

The Ukraine pavilion’s exposition is organized into three key blocks. One block recounts a catastrophic explosion at the Kakhovka Hydroelectric Power Plant dam in June, which flooded dozens of towns and villages and killed more than 50 people.

A second block illustrates Ukrainians’ efforts to swiftly rebuild what the war has destroyed, and the third block details the impact the war is having on the environment.

During a visit this week to the Ukrainian Pavilion, Moldova Energy Minister Victor Parlicov expressed his country’s endorsement of the COP28 Environmental Declaration and reiterated that Russia should be held responsible for the environmental harm resulting from the war.

Other visitors to the pavilion have included Slovakian President Zuzana Caputova and Keit Kasemets, first deputy minister of climate for Estonia.

In the Palestinian pavilion, Ahmed Abuthaher, director general of the West Bank-based Environment Quality Authority, told VOA his delegation is in Dubai “to tell people to look at us as humanitarians, and this conference is for human beings.”

“For climate change, we need to have easy access to the financial resources. We have water shortage and in some areas we have desertification,” he said, expressing hope for help from a Loss and Damage Fund announced on the first day of the conference.

A June 2022 report prepared by the U.N. Office for the Coordination of Humanitarian Affairs said that 78% of piped water in Gaza is unfit for human consumption.

According to the COP28 official webpage of their pavilion, the Palestinian leadership recognizes that collective efforts across sectors are crucial to the fulfillment of the conference’s climate commitments and ensuring a sustainable and resilient future.

Abuthaher emphasized the Palestinian commitment to participating in COP28 while calling for the global community to take meaningful action to address the issues faced by the Palestinian people.

The environmental damage inflicted by Russia’s full-scale invasion of Ukraine has been documented in several studies, including an October 2022 report from the U.N. Environment Program finding that almost 1 million hectares (3,800 square miles) of land have experienced significant impact, with 812 specific sites facing threats.

VOA reported in January that the repercussions of the war extend as far as Indian-administered Kashmir, where ornithologists have cited its contribution to a scarcity of migratory birds.

COP28 delegate Ievgeniia Kopytsia, an associate of Oxford Net Zero at the University of Oxford in the U.K., said the war is also increasing carbon emissions that are widely blamed for rising temperatures worldwide.

“On top of the local pollution caused by the warfare,” she told VOA, a significant amount of greenhouse gas has been emitted into the atmosphere “caused by the consumption of fuel for military purposes, use of munitions, fires caused by shelling, bombing and mine-laying operations, and reconstruction of the civilian infrastructure.”

In July 2022, during a head-of-states conference in Lugano, Switzerland, the Ukrainian government unveiled the initial version of its 10-year national recovery plan, outlining proposed recovery pathways for major sectors at an estimated cost of $750 billion.

Kopytsia said participation in events such as COP28 can help turn that vision into a reality.

“Engaging with the global community in climate initiatives may foster diplomatic relations and provide opportunities for assistance in conflict resolution,” she said.

The impact of conflict on the environment must be addressed not only in Ukraine and Gaza but around the world, argued Simon Chambers, the director of ACT Alliance, a global alliance of more than 145 churches and other organizations from over 120 countries that provides humanitarian aid for poor and marginalized people.

“Climate justice is possible to be achieved, as is a just transition” to cleaner sources of energy, he said to VOA, but it will require all parts of society to come together — governments, nongovernmental organizations and businesses.

“We need to put the needs of the creation, of people and the planet ahead of profit and power,” he said. “If we all act in the face of the urgency of the climate emergency, it is possible to achieve the goals of the Paris Agreement and to do so in a way that is just.”
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Five countries in East and southern Africa are in the middle of outbreaks of the anthrax disease, with more than 1,100 suspected cases and 20 deaths this year, the World Health Organization said Monday. 

A total of 1,166 suspected cases had been reported in Kenya, Malawi, Uganda, Zambia and Zimbabwe. Thirty-seven cases had been confirmed by laboratory tests, according to the WHO, which also said the five countries have seasonal outbreaks every year, but Zambia was experiencing its worst since 2011 and Malawi reported its first human case this year. Uganda had reported 13 deaths. 

Anthrax usually affects livestock like cattle, sheep and goats, as well as wild herbivores. Humans can be infected if they are exposed to the animals or contaminated animal products. Anthrax isn’t generally considered to be contagious between humans, although there have been rare cases of person-to-person transmission, WHO says. 

Anthrax is caused by spore-forming bacteria and is sometimes associated with the weaponized version used in the 2001 attacks in the United States, when five people died and 17 others fell sick after being exposed to anthrax spores in letters sent through the mail. 

Anthrax bacteria also occurs naturally in soil. 

In a separate assessment of the Zambia outbreak, which was the most concerning, WHO said that 684 suspected cases had been reported in the southern African nation as of November 20, with four deaths. Human cases of anthrax had been reported in nine out of Zambia’s 10 provinces. In one instance, 26 people were suspected of contracting the disease from eating contaminated hippopotamus meat. 

WHO said there was a high risk that the Zambian outbreak would spread to neighboring countries. 

The outbreaks in all five countries were “likely being driven by multiple factors, including climatic shocks, food insecurity, low-risk perception and exposure to the disease through handling the meat of infected animals,” the WHO said. 
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The U.N.’s climate body has published a draft of what is set to be its final agreement from the COP28 climate summit, which ends Tuesday.

Activists have condemned the draft as moving away from previously expected language, and not containing measures that would tackle the global warming that scientists blame for sea rise, increasing droughts and other trends that threaten hundreds of millions across the world. 

Specifically, activists are upset that the draft, which was written by the COP28 presidency, run by an Emirati oil company CEO, does not call for a phasing out of all fossil fuels, something that was asked for by over 100 nations.

In referring to fossil fuels, the draft says that countries must engage in the “phasing out of inefficient fossil fuel subsidies that encourage wasteful consumption and do not address energy poverty or just transitions, as soon as possible.”

The COP28 presidency viewed the draft as a success, calling it a “huge step forward.”

“We have a text and we need to agree on the text,” COP28 President Sultan al-Jaber said. “The time for discussion is coming to an end and there’s no time for hesitation. The time to decide is now.”

Discussions are ongoing with the summit expected to end at 11 a.m. Tuesday. Fossil fuels are at the forefront of negotiations.

The presidency of the conference “recognizes that for this to be viewed as a success, we need to find some agreement on fossil fuels,” said Steven Guilbeault, Canadian environment minister and one of eight “super-negotiators.”

“I think if we can’t do that, people will see this as a failure, even though we’ve agreed on lots of other good things,” Guilbeault said.

U.N. Secretary-General Antonio Guterres called on delegates at COP28 to go into “overdrive,” to ensure that a deal gets done before the conclusion of the event.

“We can’t keep kicking the can down the road. We are out of road – and almost out of time,” Guterres said. 

Some information in this report came from The Associated Press and Reuters.
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Prime Minister Rishi Sunak defended Britain’s handling of the COVID-19 pandemic on Monday, telling an official inquiry he did not recognize testimony describing a dysfunctional government and saying his hospitality scheme was supported at the time.  

The inquiry is examining Britain’s response to the pandemic which killed more than 230,000 people in the country. It has heard that the government of then-prime minister Boris Johnson was gripped by infighting and incompetence, and unable to make a decision.  

Sunak was a relatively unknown politician when he was promoted to finance minister on the eve of the pandemic, appearing to be sure-footed as he set out hundreds of billions of pounds of support to keep companies and livelihoods afloat. 

He has come under fire during the inquiry from other witnesses over his “Eat out to help out” subsidized meal scheme, which encouraged people to visit restaurants and pubs in August 2020.  

Some scientists have questioned whether Sunak’s policy may have contributed to a wave of infections, but Sunak said scientists and other ministers did not raise any objections during meetings in the month leading up to the scheme. 

He said that “Eat out to help out” took place within guidelines for the safe reopening of hospitality which had happened in July and that was why the policy went ahead.  

“My primary concern was protecting millions of jobs of particularly vulnerable people who worked in this industry (hospitality),” Sunak told the inquiry.  

The inquiry has also heard testimony from scientists and officials who questioned whether Sunak prioritized the economy over public health, as economic output contracted by 10% in 2020.  

He told the inquiry on Monday that he wanted to say how “deeply sorry” he was to those who had lost loved ones, and that he was there in the spirit of wanting to learn how the government could do better in any future pandemic.  

But he echoed Johnson in saying the fact that “debates raged” was not necessarily a bad thing.  

“It’s right that there was vigorous debate because these were incredibly consequential decisions for tens of millions of people in all spheres, whether it was health, whether it’s education, whether it was economic, whether it was social, whether it was a long-term impact.  

“These were incredibly big decisions, the likes of which no prime minister has taken in decades, if ever,” he said.  

Sunak became prime minister in October 2022 after Johnson and his successor Liz Truss were forced out of office.  
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Renowned Chinese doctor and activist Gao Yaojie who exposed the AIDS virus epidemic in rural China in the 1990s, has died at the age of 95 at her home in the United States. Gao’s outspokenness about the virus outbreak embarrassed the Chinese government and drove her to live in self-exile for over a decade in Manhattan, New York.

Gao became China’s most well-known AIDS activist after speaking out against blood-selling schemes that infected thousands with HIV. Her contributions were ultimately acknowledged to a certain extent by the Chinese government, which was forced to grapple with the AIDS crisis well into the 2000s. She moved to the U.S. in 2009, where she began holding talks and writing books about her experiences.

Renowned Chinese doctor and activist Gao Yaojie who exposed the AIDS virus epidemic in rural China in the 1990s died Sunday at the age of 95 at her home in the United States.

Gao’s outspokenness about the virus outbreak — which some gauged to have infected tens of thousands — embarrassed the Chinese government and drove her to live in self-exile for over a decade in Manhattan, New York.

Columbia University professor Andrew J. Nathan, an expert in Chinese politics who had Gao’s legal power of attorney and managed some of her affairs, confirmed her death.

Gao became China’s most well-known AIDS activist after speaking out against blood-selling schemes that infected thousands with HIV, mainly in her home province of Henan in central China. Her contributions were ultimately acknowledged to a certain extent by the Chinese government, which was forced to grapple with the AIDS crisis well into the 2000s.

Gao’s work received recognition from international organizations and officials. She moved to the U.S. in 2009, where she began holding talks and writing books about her experiences.

She told the Associated Press in a previous interview that she withstood government pressure and persisted in her work because “everyone has the responsibility to help their own people. As a doctor, that’s my job. So it’s worth it.”

She said she expected Chinese officials to “face the reality and deal with the real issues — not cover it up.”

A roving gynecologist who used to spend days on the road treating patients in remote villages, Gao met her first HIV patient in 1996 — a woman who had been infected from a transfusion during an operation. Local blood bank operators would often use dirty needles, and after extracting valuable plasma from farmers, would pool the leftover blood for future transfusions — a disastrous method almost guaranteed to spread viruses such as HIV.

At the time, Gao investigated the crisis by traveling to people’s homes. She would sometimes encounter devastating situations where parents were dying from AIDS and children were being left behind. Some estimates put the number of HIV infections from that period at tens of thousands, though no national survey was undertaken as the government was trying to conceal the crisis.

Gao delivered food, clothes and medicine to ailing villagers. She spoke out about the AIDS epidemic, capturing the attention of local media and angering local governments, which often backed the reckless blood banks. Officials repeatedly tried to prevent her from traveling abroad, where she was being celebrated for her work.

In 2001, the government refused to issue her a passport to go to the U.S. to accept an award from a United Nations group. In 2007, Henan officials kept her under house arrest for about 20 days to prevent her from traveling to Beijing to get a U.S. visa to receive another award. They were eventually overruled by the central government, which allowed her to leave China. Once in Washington, D.C., Gao thanked then-President Hu Jintao for allowing her to travel.

Gao was born on Dec. 19, 1927, in the eastern Shandong province. She grew up during a tumultuous time in China’s history, which included a Japanese invasion and a civil war that brought the Communist Party to power under Mao Zedong.

Her family moved to Henan, where she studied medicine at a local university. During the Cultural Revolution, a turbulent decade beginning in 1966, she endured beatings from Maoist “red guards” due to her family’s previous “landlord” status. She remained critical of Mao into her later years.

After news of her death circulated on Monday, Chinese social media was flooded with messages of condolences, while some criticized her move to the U.S. and her stance against the Chinese government.

“We can say Dr Gao Yaojie has dedicated everything to AIDS patients,” wrote a commenter on the social media platform Weibo, “and people with a conscience will always remember her.”
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After seven weeks held hostage in the tunnels of Gaza, they are finally free to laugh and chat and play. But some of the children who have come back from captivity are still reluctant to raise their voices above a whisper.

In theory, they can eat what they want, sleep as much as they choose and set aside their fears. In practice, some have had to be convinced there’s no longer a need to save a cherished bit of food in case there is none later.

At last, the 86 Israelis released during a short-lived truce between their government and Hamas are home. But the October 7 terror attack by Hamas on roughly 20 towns and villages left many of the children among them without permanent homes to go back to. Some of their parents are dead and others are still held hostage, foreshadowing the difficulty of the days ahead.

And so, step by step, these children, the mothers and grandmothers who were held alongside them, and their families are testing the ground for a path to recovery. No one, including the physicians and psychologists who have been treating them, is sure how to get there or how long it might take.

“It’s not easy in any way. I mean, they’re back. They’re free. But you can definitely see what they went through,” said Yuval Haran, whose family is celebrating the reunion with his two nieces, their mother and grandmother, while yearning for the return of the girls’ father, who remains a captive.

“We’re trying to give them love, to give them hugs, to give them control back of their life,” said Haran, visibly exhausted by the stress of the past two months, but every bit as busy now as he rushes to fix bicycles and set up bank accounts for those who have returned. “I think that’s the most important thing, to give them the sense that they can decide now.”

It was clear as soon as the youngest were helped from helicopters that captivity had been brutal.

“They looked like shadows of children,” said Dr. Efrat Bron-Harlev of Schneider Children’s Medical Center in suburban Tel Aviv, who helped treat more than two dozen former captives, most of them youngsters.

Some had not been allowed to bathe during the entirety of their captivity. Many had lost up to 15% of their total weight, but they were reluctant to eat the food they were served.

Asked why, the answer came in whispers: “Because we have to keep it for later.”

One 13-year-old girl recounted how she’d spent the entirety of captivity believing that her family had abandoned her, a message reinforced by her kidnappers, Bron-Harlev said.

“They told me that nobody cares for you anymore. Nobody’s looking for you. Nobody wants you back. You can hear the bombs all around. All they want to do is kill you and us together,” the girl told her doctors.

After enduring such an experience, “I don’t think it’s something that will leave you,” said Dr. Yael Mozer-Glassberg, who treated 19 of the children released. “It’s part of your life story from now on.”

“Be very, very quiet”

In the days since the hostages were freed, nearly all have been released from hospitals and rejoined their families, including some welcomed back by thousands of well-wishers.

Doctors and others charged with treating the former hostages spent weeks preparing for their return. But the reality of caring for so many who endured such extremes has stunned physicians, starting with the reluctance of many children to speak.

“Most of them talk about needing to be very quiet. At all times. Not to stand up. Not to talk. Of course, not to cry. Not to laugh. Just to be very, very quiet,” said Bron-Harlev, the physician.

“What these children have gone through is simply unimaginable.”

Despite that, at times now some appear to be thriving.

Noam Avigdori, 12, who was released with her mother, has spent the past week trading jokes with her father and meeting with friends, and has even ventured out to a store.

“When I say, ‘Noam, do this, go do that,’ she says, ‘Dad, you know what happened to me.’ And she knows that she can squeeze that lemon and … she’s enjoying it,” her father, Hen Avigdori, said in an interview.

But there are also nights when his daughter wakes up screaming, Avigdori said this week at a separate news conference.

Nearly all those who have been freed have said little publicly about the conditions of their captivity. Their families say officials have told them not to disclose details of their individual treatment, for fear of putting those still being held in further jeopardy.

But interviews with their families, doctors and mental health professionals, as well as statements released by officials and others, make clear that while all the hostages suffered, their experiences in captivity varied significantly.

Different experiences

Some were isolated from their fellow hostages. Others, like Noam Avigdori and her mother, Sharon, were held together with relatives, making it possible for the 12-year-old to act as something like an older sibling to the young cousins who were held with her.

“Everyone who was with a family member or with friends was in much better condition” when they were released, said Dani Lotan, a clinical psychologist at Scheider who treated some of the former hostages.

That varies, though, even within families.

In the weeks they were imprisoned, Danielle Aloni and her 5-year-old daughter, Emilia, established a close friendship with one of the imprisoned Thai farm workers, Nutthawaree Munkan. Last week, after all were released, the girl sang to a delighted Munkan when they were reunited in a video call, reciting the numbers she learned in Thai during captivity.

But Emilia’s cousins, 3-year-old twins, are having a difficult time since their return.

In captivity, Sharon Aloni was held with her husband and one of the twin girls in a small room, together with eight or so others. The couple spent “10 agonizing days” believing their other daughter had been killed, when she was snatched away shortly after they were taken into Gaza, Aloni’s brother Moran Aloni told reporters.

That lasted until the day Sharon insisted to her husband that she could hear the cries of their missing daughter, Emma. Minutes later, a woman appeared without explanation to bring them the child, a joyous reunion that allowed mother and daughters to stay together throughout the remainder of their captivity. But a couple of days before they were released, the girls’ father was taken away and his whereabouts remain unknown.

Now free, the girls wake up crying in the middle of the night, Moran Aloni said. Emma won’t allow anyone to leave her side. They have gotten used to speaking up again, but their mother still whispers.

Varying amounts of food

Many former hostages have recounted being given meager amounts of food. But the rations seemed to vary from group to group with little explanation, said Mozer-Glassberg, a senior physician at Schneider.

One family told doctors they each were given a biscuit with tea at 10 every morning and, from time to time, a single dried date. At 5 p.m., they were served rice. It wasn’t enough, but day after day of worry left their appetites withered.

One 15-year-old girl recounted not eating for days so she could give her share of the food to her 8-year-old sister.

Some of the 23 Thai hostages released recently told caregivers they were each given roughly a half liter of water and then had to make it last for three days. Sometimes, they said, it was saltwater.

One group of former captives reported being allowed to bathe three times over seven weeks with buckets of cold water. But one child never bathed at all, doctors say.

“Many of them talk about feeling very hungry. Very, very hungry. Many of them talk about feeling very dirty, not being able to clean, not being able to go to the bathroom,” Bron-Harlev said.

Recuperation will be difficult

The process of recuperation from such prolonged trauma will be slow and piecemeal, doctors say. And while the adults may be better able to process what they have experienced, their recovery poses its own challenges.

Many, particularly the older and infirm, remain weak after losing 9 kilos (20 pounds) or more because of the meager rations provided by their captors. When they speak, their families hear notes of resilience, but also of fragility.

Margalit Moses, a 78-year-old cancer survivor who has long struggled with multiple health problems, is back on the medications she was deprived of as a captive. But she remains too weak to walk more than a few steps.

“I think two months was up to the very, very last limit of her body hanging in there,” her niece Efrat Machikawa said.

In the days since Moses returned, she has been savoring pleasures that once seemed trivial, such as peeling a fresh orange and lingering over crossword puzzles, her niece said.

Yaffa Adar, 85, a Holocaust survivor who was seized from her kibbutz and hustled into Gaza on golf cart, talks at length with her family about her time in captivity. But the days since have become more difficult as she grapples with what happened to her and the community she cherished, granddaughter Adva Adar said.

“She’s incredibly mentally strong, but you can see how the hell got into her soul,” the younger Adar said. “It’s in the way she looks at the world, the way she looks at people.”

In the hospitals, doctors, social workers and psychologists were careful about how they talked with the former hostages, not wanting to magnify their trauma. But as they settle in, both children and adults are confronting the toll of the October attack that captivity kept hidden from them.

Throughout the seven weeks she was held, Shoshan Haran, her daughters and grandchildren had to wonder what had happened to her husband.

“We had to tell them my father was murdered,” Yuval Haran said.

In the days ahead, he and others acknowledge, they will face questions about how to move forward without those who were killed or remain missing. But for most, it is far too soon.
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Majestic cedar trees towered over dozens of Lebanese Christians gathered outside a small mid-19th century chapel hidden in a mountain forest to celebrate the Feast of the Transfiguration, the miracle in which Jesus Christ, on a mountaintop, shined with light before his disciples.

The sunset’s yellow light coming through the cedar branches bathed the leader of Lebanon’s Maronite Church, Patriarch Beshara al-Rai, as he stood at a wooden podium and delivered a sermon. Then the gathering sang hymns in Arabic and the Aramaic language.

For Lebanon’s Christians, the cedars are sacred, these tough evergreen trees that survive the mountain’s harsh snowy winters. They point out with pride that Lebanon’s cedars are mentioned 103 times in the Bible. The trees are a symbol of Lebanon, pictured at the center of the national flag.

The iconic trees in the country’s north are far from the clashes between Hezbollah militants and Israeli troops along the Lebanon-Israel border in recent weeks against the backdrop of the Israel-Hamas war.

The long-term survival of the cedar forests is in doubt for another reason, as rising temperatures due to climate change threaten to wipe out biodiversity and scar one of the country’s most iconic heritage sites for its Christians.

The lush Cedars of God Forest, some 2,000 meters (6,560 feet) above sea level near the northern town of Bcharre, is part of a landscape cherished by Christians. The preserve overlooks the Kadisha Valley — Aramaic for “sacred” — where many Christians took refuge from persecution over Lebanon’s tumultuous history. One of the world’s largest collections of monasteries remains hidden among the thick trees, caves and rocky outcroppings along the deep, 35-kilometer (22-mile) valley.

The United Nations’ culture agency UNESCO in 1998 listed both the cedar forest and the valley as World Heritage Sites. They’ve become popular destinations for hikers and environmentalists from around the world. A growing number of Lebanese of all faiths visit as well, seeking fresh air away from the cities.

“People from all religions visit here, not just Christians … even Muslims and atheists,” said Hani Tawk, a Maronite Christian priest, as he showed a crowd of tourists around the Saint Elisha Monastery. “But we as Christians, this reminds us of all the saints who lived here, and we come to experience being in this sacred dimension.”

Climate change and mismanagement

Environmentalists and residents say the effects of climate change, exacerbated by government mismanagement, pose a threat to the ecosystem of the valley and the cedar forest.

“Thirty or 40 years from now, it’s quite possible to see the Kadisha Valley’s biodiversity, which is one of the richest worldwide, become much poorer,” said Charbel Tawk, an environmental engineer and activist in Bcharre — unrelated to Hani Tawk.

Lebanon for years has felt the heat of climate change, with farmers decrying lack of rain and forest fires wreaking havoc on pine forests north of the country, similar to blazes that scorched forests in neighboring Syria and nearby Greece. Residents across much of the country, struggling with rampant electricity cuts, could barely handle the summer’s soaring heat.

Temperatures have been above 30 degrees Celsius (86 Fahrenheit) in Bcharre, not uncommon along Lebanon’s coastal cities but unusual for the mountainous northern town.

Nuns in the medieval Qannoubin Monastery, perched on the side of a hill in the Kadisha Valley, fanned themselves and drank water in the shade of the monastery’s courtyard. They reminisced about when they could sleep comfortably on summer nights without needing much electricity.

Impact already seen

Already, there are worrying signs of the impact on the cedars and Kadisha.

Warmer temperatures have brought larger colonies of aphids, which feed on the bark of cedar trees and leave a secretion that can cause mold, Charbel Tawk said. Bees normally remove the secretion, but they have become less active. Aphids and other pests also last longer in the season and reach higher altitudes because of warmer weather.

Such pests threaten to stunt or damage cedar growth.

Tawk worries that if temperatures continue to change like this, cedars at lower altitudes might not be able to survive. Fires are becoming more of a potential danger.

Cedar trees usually grow at an altitude from 700 up to 1,800 meters (about 1 mile) above sea level. Tawk’s organization has planted some 200,000 cedars over the years at higher altitudes and in areas where they were not present. Some 180,000 survived.

“Is it climate change or whatever it is happening in nature that these cedars are able to survive at 2,100 to 2,400 meters?” Tawk asked, while checking on a grove of cedars on a remote hilltop.

Mitigating solutions

Local priests and environmental activists have urged Lebanon’s government to work with universities to do a wide-ranging study on temperature changes and the impact on biodiversity.

But Lebanon has been in the throes of a crippling economic crisis for years. State coffers are dried up, and many of the country’s top experts are rapidly seeking work opportunities abroad.

“There is nothing today called the state. … The relevant ministries, even with the best intentions, don’t have the financial capabilities anymore,” Bcharre Mayor Freddy Keyrouz said. He and the mayors of nearby towns have asked residents to help with conservation initiatives and Lebanese diaspora abroad to help with funding.

The Maronite Church has strict rules to protect the Cedars of God Forest, including keeping development out of it. Kiosks, tourist shops and a large parking lot have been set far away from the forest.

“We don’t allow anything that is combustible to be brought into the sacred forest,” said Charbel Makhlouf, a priest at Bcharre’s Saint Saba Cathedral.

The Friends of the Cedar Forest Committee, to which Tawk belongs, has been looking after the cedar trees for almost three decades, with the church’s support. It has installed sensors on cedar trees to measure temperature, wind and humidity, watching for worsening conditions that could risk forest fires.

Trouble beyond the forest

Below the forest, in the Kadisha Valley, Tawk points to other concerns.

In particular, the spread of cypress trees threatens to crowd out other species, “breaking this equilibrium that we had in the valley,” he said.

“We’ve seen them increase and tower over other species, whether it’s taking sunlight, wind or expanding their roots,” he said. “It will impact other plants, birds, insects and all the reptile species down there.”

Steps to protect the valley have actually hurt its biodiversity by removing human practices that had been beneficial, Tawk said.

In the past, herders grazing their goats and other livestock in the valley helped prevent the spread of invasive species. Their grazing also reduced fire hazards, as did local families collecting deadwood to burn in the winter.

But residents left the valley when it became a heritage site and the Lebanese government implemented strict regulations. Few live there now other than a handful of priests and nuns.

“Trees have overtaken places where people lived and farmed,” Tawk said. “Now a fire could move from one end of the valley to the other.”

Sitting in a cave near the Qannoubine Monastery, Father Hani Tawk listened to the variety of birds chirping in the valley. He said he believes in the community’s faith and awareness of nature, engrained since their ancestors took refuge here.

“When you violate that tree, you’re intruding on a long history, and possibly the future of your children,” he said.
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One of the biggest and brightest stars in the night sky will momentarily vanish as an asteroid passes in front of it to produce a one-of-a-kind eclipse.

The rare and fleeting spectacle, late Monday into early Tuesday, should be visible to millions of people along a narrow path stretching from central Asia’s Tajikistan and Armenia, across Turkey, Greece, Italy and Spain, to Miami and the Florida Keys and finally, to parts of Mexico.

The star is Betelgeuse, a red supergiant in the constellation Orion. The asteroid is Leona, a slowly rotating, oblong space rock in the main asteroid belt between Mars and Jupiter.

Astronomers hope to learn more about Betelgeuse and Leona through the eclipse, which is expected to last no more than 15 seconds. By observing an eclipse of a much dimmer star by Leona in September, a Spanish-led team recently estimated the asteroid to be about 55 kilometers wide and 80 kilometers long.

There are lingering uncertainties over those predictions as well as the size of the star and its expansive atmosphere. It’s unclear if the asteroid will obscure the entire star, producing a total eclipse. Rather, the result could be a “ring of fire” eclipse with a miniscule blazing border around the star. If it’s a total eclipse, astronomers aren’t sure how many seconds the star will disappear completely, perhaps up to 10 seconds.

“Which scenario we will see is uncertain, making the event even more intriguing,” said astronomer Gianluca Masa, founder of the Virtual Telescope Project, which will provide a live webcast from Italy.

An estimated 700 light-years away, Betelgeuse is visible with the naked eye. Binoculars and small telescopes will enhance the view. A light-year is 5.8 trillion miles.

Betelgeuse is thousands of times brighter than our sun and some 700 times bigger. It’s so huge that if it replaced our sun, it would stretch beyond Jupiter, according to NASA.

At just 10 million years old, Betelgeuse is considerably younger than the 4.6 billion-year-old sun. Scientists expect Betelgeuse to be short-lived, given its mass and the speed at which it’s burning through its material.

After countless centuries of varying brightness, Betelgeuse dimmed dramatically in 2019 when a huge bunch of surface material was ejected into space. The resulting dust cloud temporarily blocked the starlight, NASA said, and within a half year, Betelgeuse was as bright as before.

Scientists expect Betelgeuse to go supernova in a violent explosion within 100,000 years.
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European Union negotiators clinched a deal Friday on the world’s first comprehensive artificial intelligence rules, paving the way for legal oversight of technology used in popular generative AI services such as ChatGPT that have promised to transform everyday life and spurred warnings of existential dangers to humanity. 

Negotiators from the European Parliament and the bloc’s 27 member countries overcame big differences on controversial points, including generative AI and police use of facial recognition surveillance, to sign a tentative political agreement for the Artificial Intelligence Act. 

“Deal!” tweeted European Commissioner Thierry Breton, just before midnight. “The EU becomes the very first continent to set clear rules for the use of AI.” 

The result came after marathon closed-door talks this week, with the initial session lasting 22 hours before a second round kicked off Friday morning. 

Officials were under the gun to secure a political victory for the flagship legislation but were expected to leave the door open to further talks to work out the fine print, likely to bring more backroom lobbying. 

Out front

The EU took an early lead in the global race to draw up AI guardrails when it unveiled the first draft of its rulebook in 2021. The recent boom in generative AI, however, sent European officials scrambling to update a proposal poised to serve as a blueprint for the world. 

The European Parliament will still need to vote on it early next year, but with the deal done, that’s a formality, Brando Benifei, an Italian lawmaker co-leading the body’s negotiating efforts, told The Associated Press late Friday. 

“It’s very, very good,” he said by text message after being asked if it included everything he wanted. “Obviously we had to accept some compromises but overall very good.”  

The eventual law wouldn’t fully take effect until 2025 at the earliest and threatens stiff financial penalties for violations of up to $38 million (35 million euros) or 7% of a company’s global turnover. 

Generative AI systems like OpenAI’s ChatGPT have exploded into the world’s consciousness, dazzling users with the ability to produce humanlike text, photos and songs but raising fears about the risks the rapidly developing technology poses to jobs, privacy and copyright protection, and even human life itself. 

Now, the U.S., U.K., China and global coalitions like the Group of Seven major democracies have jumped in with their own proposals to regulate AI, though they’re still catching up to Europe. 

‘A powerful example’

Strong and comprehensive regulation from the EU “can set a powerful example for many governments considering regulation,” said Anu Bradford, a Columbia Law School professor who’s an expert on EU and digital regulation. Other countries “may not copy every provision but will likely emulate many aspects of it.” 

AI companies that will have to obey the EU’s rules will also likely extend some of those obligations to markets outside the continent, she said. “After all, it is not efficient to retrain separate models for different markets,” she said. 

Others are worried that the agreement was rushed through. 

“Today’s political deal marks the beginning of important and necessary technical work on crucial details of the AI Act, which are still missing,” said Daniel Friedlaender, head of the European office of the Computer and Communications Industry Association, a tech industry lobby group. 

The AI Act was originally designed to mitigate the dangers from specific AI functions based on their level of risk, from low to unacceptable. But lawmakers pushed to expand it to foundation models, the advanced systems that underpin general purpose AI services like ChatGPT and Google’s Bard chatbot. 

Foundation models looked set to be one of the biggest sticking points for Europe. However, negotiators reached a tentative compromise early in the talks, despite opposition led by France, which called instead for self-regulation to help homegrown European generative AI companies competing with big U.S. rivals, including OpenAI’s backer Microsoft. 

Also known as large language models, these systems are trained on vast troves of written works and images scraped off the internet. They give generative AI systems the ability to create something new, unlike traditional AI, which processes data and completes tasks using predetermined rules. 

Under the deal, the most advanced foundation models that pose the biggest “systemic risks” will get extra scrutiny, including requirements to disclose more information, such as how much computing power was used to train the systems. 

Elevation of threats

Researchers have warned that these powerful foundation models, built by a handful of big tech companies, could be used to supercharge online disinformation and manipulation, cyberattacks or creation of bioweapons. 

Rights groups also caution that the lack of transparency about data used to train the models poses risks to daily life because they act as basic structures for software developers building AI-powered services. 

What became the thorniest topic was AI-powered facial recognition surveillance systems, and negotiators found a compromise after intensive bargaining. 

European lawmakers wanted a full ban on public use of facial scanning and other “remote biometric identification” systems because of privacy concerns, while governments of member countries wanted exemptions so law enforcement could use them to tackle serious crimes like child sexual exploitation or terrorist attacks. 

Civil society groups were more skeptical. 

“Whatever the victories may have been in these final negotiations, the fact remains that huge flaws will remain in this final text,” said Daniel Leufer, a senior policy analyst at the digital rights group Access Now. Along with the law enforcement exemptions, he also cited a lack of protection for AI systems used in migration and border control, and “big gaps in the bans on the most dangerous AI systems.” 
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Thousands of tons of dead sardines have washed up on a beach in northern Japan for unknown reasons, officials said Friday.

The sardines and some mackerel washed ashore in Hakodate on Japan’s northernmost main island of Hokkaido on Thursday morning, creating a silver blanket along a stretch of beach about a kilometer long.

Residents said they have never seen anything like it. Some gathered the fish to sell or eat.

The town, in a notice posted on its website, urged residents not to consume the fish.

Takashi Fujioka, a Hakodate Fisheries Research Institute researcher, said he has heard of similar phenomena before, but it was his first time to see it.

He said the fish may have been chased by larger fish, become exhausted due to a lack of oxygen while moving in a densely packed school, and were washed up by the waves.

The fish also may have suddenly entered cold waters during their migration, he said.

The decomposing fish could lower oxygen levels in the water and affect the marine environment, he said.

“We don’t know for sure under what circumstances these fish were washed up, so I do not recommend” eating them, Fujioka said.
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In a letter leaked to news organizations this week, OPEC Secretary-General Haitham Al Ghais urged member nations to reject any agreement from the U.N. climate summit targeting fossil fuels rather than emissions.

In the letter dated Wednesday referencing a draft agreement on climate change action at the 28th U.N. climate conference — known as COP28 — in Dubai, the OPEC leader said, “It seems that the undue and disproportionate pressure against fossil fuels may reach a tipping point with irreversible consequences.”

The letter goes on to say, “I … respectfully urge all esteemed OPEC Member Countries and Non-OPEC Countries participating in the CoC and their distinguished delegations in the COP 28 negotiations to proactively reject any text or formula that targets energy i.e. fossil fuels rather than emissions.”

The contents of the letter were reported Friday by multiple news organizations, including Agence France-Presse, Reuters and Bloomburg, which verified the letter’s authenticity. OPEC declined when asked to comment.

The reports come as negotiations among 197 countries on a final climate summit agreement are underway ahead of a deadline Tuesday, when the conference is scheduled to end.

Fossil fuels — oil, coal and natural gas — have been a focus of the discussions since COP28 opened last week, with U.N. Secretary-General Antonio Guterres calling for an end to their use.

At least 80 countries have called for a COP28 deal that calls for an eventual end to fossil fuel use, as scientists urge ambitious action to avert the worst impacts of climate change.

The focus is on meeting the goal of the 2015 Paris climate agreement: keeping global temperature increase this century less than 1.5 degrees Celsius above pre-industrial levels.

At Friday’s climate summit plenary session, COP28 President Sultan Al Jaber, from OPEC member nation and summit host United Arab Emirates, said, once again, that a shift away from fossil fuels is “inevitable” and “essential.” He added, though, that any energy transition “must be orderly and responsible.”

Some information for this report came from The Associated Press, Reuters and Agence France-Presse.
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The U.S. Food and Drug Administration (FDA) on Friday approved a pair of gene therapies for sickle cell disease, including the first treatment based on the breakthrough CRISPR gene editing technology. 

The agency approved Lyfgenia from bluebird bio, and a separate treatment called Casgevy by partners Vertex Pharmaceuticals and CRISPR Therapeutics. 

Both the therapies were approved for people aged 12 years and older. 

The Vertex/CRISPR gene therapy uses the breakthrough gene editing technology that won its inventors the Nobel Prize in 2020. 

Sickle cell disease is a painful, inherited blood disorder that can be debilitating and lead to premature death. It affects an estimated 100,000 people in the United States, most of whom are Black. 

In sickle cell disease, the body makes flawed, sickle-shaped hemoglobin, impairing the ability of red blood cells to properly carry oxygen to the body’s tissues. 

The sickle cells tend to stick together and can block small blood vessels, causing intense pain. It also can lead to strokes and organ failure. 

U.S.-listed shares of CRISPR therapeutics were up 1.6%, while Vertex Pharmaceuticals stock was down 1.4%. Shares of bluebird bio were halted for trading ahead of the news. 

Makers of both the therapies have pitched them as one-time treatments, but data on how long their effect lasts is limited. The only longer-term treatment for sickle cell disease is a bone marrow transplant. 

“I actually am very reticent to call them a cure. I prefer to call them a transformative therapy because patients will still have sickle cell disease on the other side of gene therapy,” said Dr Sharl Azar, medical director of the Comprehensive Sickle Cell Disease Treatment Center at Massachusetts General Hospital. 

Bluebird bio’s sickle cell therapy is designed to work by inserting modified genes into the body through disabled viruses to help the patient’s red blood cells produce normal hemoglobin. 

For Vertex’s therapy, patients must have stem cells harvested from their bone marrow. The cells are then sent to manufacturing facilities where they are edited using CRISPR/Cas9 technology. Once the cells are incubated, they are infused back into the patient during a month-long hospital stay. 

Both gene therapies can take several months and involve high-dose chemotherapy, but this has potential risks of infertility. 

“Not everybody who undergoes chemotherapy will end up having infertility, but the majority of them will,” said Dr Azar.  

While the risk can be managed by fertility preservation methods like freezing eggs and sperm banking, this is only covered by insurance for cancer patients who undergo chemotherapy and not those receiving gene therapy, said Dr. Azar. 

He said the out-of-pocket expense on it can be as high as $40,000. 

FDA staff in documents released ahead of an October meeting of a panel of independent experts on Vertex’s therapy had also flagged concerns of unintended genomic alterations from the treatment. 

The company plans to assess potential long-term safety risks through a 15-year follow-up study after approval. 

Vertex’s CRISPR therapy is also under an FDA review for another blood disease, transfusion-dependent beta thalassemia, with a decision expected by March 30. 
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