Scientists said Monday they have developed the first mobile printer that can produce thumbnail-sized patches able to deliver mRNA COVID-19 vaccines, hoping the tabletop device will help immunize people in remote regions.

While many hurdles remain and the 3D printer is likely years away from becoming available, experts hailed the “exciting” finding.

The device prints 2-centimeter-wide patches that each contain hundreds of tiny needles that administer a vaccine when pressed against the skin.

These “microneedle patches” offer a range of advantages over traditional jabs in the arm, including that they can be self-administered, are relatively painless, could be more palatable to the vaccine-hesitant and can be stored at room temperature for long periods of time.

The popular mRNA COVID-19 vaccines from Pfizer and Moderna need to be refrigerated, which has caused distribution complications — particularly in developing countries that have condemned the unequal distribution of doses during the pandemic.

The new printer was tested with the Pfizer and Moderna jabs, according to a study in the journal Nature Biotechnology, but the goal of the international team of researchers behind it is for it to be adapted to whatever vaccines are needed.

Robert Langer, co-founder of Moderna and one of the study’s authors, told AFP that he hoped the printer could be used for “the next COVID, or whatever crisis occurs.” 

Ana Jaklenec, a study author also from the Massachusetts Institute of Technology, said the printer could be sent to areas such as refugee camps or remote villages to “quickly immunize the local population,” in the event of a fresh outbreak of a disease like Ebola.

Vacuum-sealed

Microneedle patch vaccines are already under development for COVID-19 and a range of other diseases, including polio, measles and rubella.

But the patches have long struggled to take off because producing them is an expensive, laborious process often involving large machines for centrifugation. 

To shrink that process down, the researchers used a vacuum chamber to suck the printer “ink” into the bottom of their patch molds, so it reaches the points of the tiny needles.

The vaccine ink is made up of lipid nanoparticles containing mRNA vaccine molecules, as well as a polymer similar to sugar water.

Once allowed to dry, the patches can be stored at room temperature for at least six months, the study found. The patches even survived a month at a balmy 37 degrees Celsius (99 Fahrenheit).

Mice that were given a vaccine patch produced a similar level of antibody response to others immunized via a traditional injection, the study said.

The printed patches are currently being tested on primates, which if successful would lead to trials on humans. 

‘A real breakthrough’?

The printer can make 100 patches in 48 hours. But modelling suggested that — with improvements — it could potentially print thousands a day, the researchers said.

“And you can have more than one printer,” Langer added.

Joseph DeSimone, a chemist at Stanford University not involved in the research, said that “this work is particularly exciting as it realizes the ability to produce vaccines on demand.” 

“With the possibility of scaling up vaccine manufacturing and improved stability at higher temperatures, mobile vaccine printers can facilitate widespread access to RNA vaccines,” said DeSimone, who has invented his own microneedle patches.

Antoine Flahault, director of the Institute of Global Health at the University of Geneva, said that production and access to vaccines could be “transformed through such a printer.”

“It might become a real breakthrough,” he told AFP, while warning that this depended on approval and mass production, which could take years.

Darrick Carter, a biochemist and CEO of U.S. biotech firm PAI Life Sciences, was less optimistic. 

He said that the field of microneedle patches had “suffered for 30 years” because no one had yet been able to scale up manufacturing in a cost-effective way.

“Until someone figures out the manufacturing scale-up issues for microneedle patches they will remain niche products,” he told AFP. 
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Nine European countries held a summit on Monday aimed at scaling up wind power generation in the North Sea, spurred by the fallout from the war in Ukraine and the push for renewables. 

“We’ve seen over the past months what the impact is if you are too dependent on outsiders for the supply of energy,” said Belgian Prime Minister Alexander De Croo, who hosted the meeting in the coastal town of Ostend. 

The leaders of EU members France, Germany, Ireland, Denmark, the Netherlands and Luxembourg, along with European Commission chief Ursula von der Leyen, attended the summit. 

Norway and Britain also participated, with the latter represented by UK Energy Security Secretary Grant Shapps. 

In a joint op-ed published in Politico, the leaders of the nine nations emphasized the need to build more offshore wind turbines “to reach our climate goals, and to rid ourselves of Russian gas, ensuring a more secure and independent Europe.” 

Several leaders pointed to the need also to ensure security of offshore wind farms and their interconnectors, in the wake of recent reports of a Russian spy ship in the North Sea and last year’s sabotage of the Nord Stream gas pipelines in the Baltic Sea. 

De Croo said North Sea infrastructure, including turbines and undersea cables “are prone to sabotage or to espionage” and the topic was “an extremely important one” at the summit.

The summit’s collective goal, stated by all the leaders, is to boost offshore wind power generation to 120 gigawatts by 2030 — from just 30 GW today — and at least 300 GW by 2050.

They recognized the size of the task requires massive investment and that standardizing equipment is needed to bring down costs and timescales.

A key point, hammered by French President Emmanuel Macron, is to ensure the supply chain for the push for more North Sea wind power is anchored in Europe, rather than elsewhere, and that the jobs created are there.

“We want to secure our industrial chain, because it’s important to deploy this offshore wind power but we don’t want to repeat the errors we’ve sometimes committed in the past, of deploying equipment made on the other side of the world,” he said.

The comment appeared to be directed at China, which currently dominates the supply of critical elements, such as rare earth metals. The European Union is seeking to shift away from that reliance on China by bolstering its own industries.

German Chancellor Olaf Scholz said the “very important” summit underscored the potential to greatly expand renewable energy from the North Sea. 

Industry criticism 

WindEurope, an organization that promotes wind energy across Europe, believes the summit’s ambitions are achievable. But it highlighted a lack of “adequate funding mechanisms” and recruitment in the sector.

The organization says Europe needs to build the offshore infrastructure to add 20 GW in output per year, yet the sector currently has capacity for just seven GW annually, with supply chain bottlenecks for cables, substations and foundations, and in the availability of offshore support vessels.

Investment to get Europe where it wants to be is huge: The EU has calculated the cost of reaching 300 GW in offshore energy production by 2050 at $900 billion.

Britain has the biggest fleet of offshore wind farms, 45 of them, currently producing 14 GW, with plans to expand capacity to 50 GW by 2030.

Germany’s 30 wind farms produce 8 GW, followed by the Netherlands with 2.8 GW and Denmark and Belgium both with 2.3 GW.

The other participating countries produce less than a gigawatt from their existing installations but share ambitions to greatly ramp up wind energy capacity. 
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April 24 – April 30, is World Immunization Week.

The theme of this year’s observance is “The Big Catch-Up.”

The idea is for everyone, especially children, to catch up on the vaccinations they might have missed during the COVID outbreak.

The ultimate goal of World Immunization Week, according the World Health Organization, is for more children, adults and their communities to be protected from vaccine-preventable diseases, like polio and measles.

 
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Air pollution still causes more than 1,200 premature deaths a year in under 18’s across Europe and increases the risk of chronic disease later in life, the EU environmental agency said Monday.   

Despite recent improvements, “the level of key air pollutants in many European countries remain stubbornly above World Health Organization” (WHO) guidelines, particularly in central-eastern Europe and Italy, said the EEA after a study in over 30 countries, including the 27 members of the European Union.   

The report did not cover the major industrial nations of Russia, Ukraine and the United Kingdom, suggesting the overall death tolls for the continent could be higher.   

The EEA announced last November that 238,000 people died prematurely because of air pollution in 2020 in the EU, plus Iceland, Liechtenstein, Norway, Switzerland and Turkey.   

“Air pollution causes over 1,200 premature deaths per year in people under the age of 18 in Europe and significantly increases the risk of disease later in life,” the agency said.   

The study was the agency’s first to focus specifically on children.   

“Although the number of premature deaths in this age group is low relative to the total for the European population estimated by EEA each year, deaths early in life represent a loss of future potential and come with a significant burden of chronic illness, both in childhood and later in life,” the agency said.  

It urged authorities to focus on improving air quality around schools and nurseries as well as sports facilities and mass transport hubs.   

“After birth, ambient air pollution increases the risk of several health problems, including asthma, reduced lung function, respiratory infections and allergies,” the report noted.   

7 million dead annually 

Poor air quality can also “aggravate chronic conditions like asthma, which afflicts nine percent of children and adolescents in Europe, as well as increasing the risk of some chronic diseases later in adulthood.”   

Ninety-seven percent of the urban population were in 2021 exposed to air that did not meet WHO recommendations, according to figures released Monday.   

The EEA had last year underlined that the EU was on track to meet its target of reducing premature deaths by 50% by 2030 compared with 2005.   

In the early 1990s, fine particulates caused nearly a million premature deaths a year in the 27 EU nations. That fell to 431,000 in 2005.   

The situation in Europe looks better than for much of the planet, says the WHO, which blames air pollution for 7 million deaths globally each year, almost as many as for cigarette smoking or bad diets.   

It took until September 2021 to reach agreement to tighten limits set for major pollutants back in 2005.   

In Thailand alone, where toxic smog chokes parts of the country, health officials said last week that 2.4 million people had sought hospital treatment for medical problems linked to air pollution since the start of the year.   

Fine particulate matter, primarily from cars and trucks and which can penetrate deeply into the lungs, is considered the worst air pollutant, followed by nitrogen dioxide and ozone. 
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At age 93, struggling with the effects of a stroke, heart failure and recurrent cancer, Teri Sheridan was ready to end her life using New Jersey’s law that allows medically assisted suicide — but she was bedbound, too sick to travel.

So last Nov. 17, surrounded by three of her children, Sheridan drank a lethal dose of drugs prescribed by a doctor she had never met in person, only online. She died within minutes.

Soon, others who seek Sheridan’s final option may find it out of reach, the unintended result of a federal move to roll back online prescribing of potentially addictive drugs allowed during the COVID-19 pandemic.

“How much should one person suffer?” said Sheridan’s daughter, Georgene White, 68. “She wanted to just go to sleep and not wake up.”

Online prescribing rules for controlled drugs were relaxed three years ago under emergency waivers to ensure critical medications remained available during the COVID-19 pandemic. Now, the U.S. Drug Enforcement Administration has proposed a rule that would reinstate most previously longstanding requirements that doctors see patients in person before prescribing narcotic drugs such as Oxycontin, amphetamines such as Adderall, and a host of other potentially dangerous drugs.

The aim is to reduce improper prescribing of these drugs by telehealth companies that boomed during the pandemic. Given the ongoing opioid epidemic, allowing continued broad use of telemedicine prescribing “would pose too great a risk to the public health and safety,” the proposed rule said. It also cracks down on how doctors can prescribe other less-addictive drugs, like Xanax, used to treat anxiety, and buprenorphine, a narcotic used to treat opioid addiction.

The rule would allow some of these drugs to be prescribed with telemedicine for an initial 30-day dose, though patients would need to be seen in person to get a refill. And patients who have been referred to a new doctor by one they had previously met in person could continue to receive prescriptions for the drugs via telemedicine.

DEA Administrator Anne Milgram called the plan “telemedicine with guardrails.”

The agency, with input from the Department of Health and Human Services, is working to finalize the rule by May 11, when the COVID public health emergency officially ends, an HHS spokeswoman said. If approved by then, the new requirements would take effect in November.

The proposal has sparked a massive backlash, including more than 35,000 comments to a federal portal and calls from advocates, members of Congress and medical groups to reconsider certain patients or provisions.

“They completely forgot that there was a population of people who are dying,” said Dr. Lonny Shavelson, a California physician who chairs the American Clinicians Academy on Medical Aid in Dying, a coalition of doctors who help patients access care under so-called right-to-die laws.

Among the biggest complaints: The rule would delay or block access for patients who seek medically assisted suicide and hospice care, critics said. Many of the comments — including nearly 10,000 delivered in person to DEA offices — came from doctors and patients protesting the effect of the rule on seriously ill and dying patients.

“Please do not make the end of life harder for me,” wrote Lynda Bluestein, 75, of Bridgeport, Connecticut. In March, Bluestein, who has terminal fallopian tube cancer, reached a settlement with the state of Vermont that will allow her to be the first non-resident to use its medically assisted suicide law. By the time she’s ready to use the drugs, she expects to be too ill to travel to see a doctor in person for the prescription, she wrote.

The clash between desperate patients who need treatment and DEA’s efforts to bar telehealth companies from overprescribing dangerous medications was inevitable, said David Herzberg, a historian of drugs at the University of Buffalo.

“The balancing act is so tricky,” he said.

Laws in 10 states and Washington allow dying people with a prognosis of six months or less to end their lives with a lethal combination of medications covered by the DEA rule. But such patients are often too sick to visit a doctor in person or they live hundreds of kilometers from the nearest willing and qualified provider, Shavelson said.

There are similar issues for the 1.7 million Medicare recipients enrolled in hospice care in the United States, said Judi Lund Person, who oversees regulatory compliance for the National Hospice and Palliative Care Organization. Rolling back online prescribing flexibilities could mean a dying patient would wait for days for drugs to ease pain and other symptoms.

“They just don’t have time for that,” she said.

Shavelson and his colleagues called for an exception to the rule for the hundreds of patients a year who qualify for medically assisted suicide. Both the American Medical Association and the California Medical Association sent letters asking the DEA to carve out provisions for doctors prescribing the most dangerous category of drugs to patients receiving hospice or palliative care.

“These patients are extremely fragile and their medical conditions do not allow them to easily access a physician’s office,” wrote Dr. Donaldo D. Hernandez, president of the California group. Such people pose a “reduced risk for abuse” given their clear need for the medications.

Congress directed the DEA in 2008 to create exceptions for certain providers to permit remote prescribing, but the agency has not done so, Virginia Democrat Sen. Mark Warner said in a statement last month.

DEA officials did not respond to questions about whether COVID-19 telehealth waivers would remain in effect if the proposed rule isn’t finalized by May 11 or whether the agency will allow exceptions for remote prescribing.

During the pandemic, prescriptions for medically assisted suicide went up, in some cases significantly. In Oregon, for instance, they climbed nearly 49%, to 432 in 2022 from 290 in 2019. The number of deaths under the law in that state rose, too, to 246 from 170. Nationally, at least 1,300 people die each year using the process, according to available state figures.

Telemedicine was key to access during the COVID emergency, said Dr. Robin Plumer, the New Jersey doctor who prescribed the drugs Teri Sheridan took. Plumer has overseen 80 assisted suicide deaths since 2020. Without online prescribing, 35% to 40% of her patients wouldn’t have been able to use the law.

“I feel like we’ve taught people over the past couple of years that telemedicine does work in so many areas and it’s a great improvement for people,” especially for those who are homebound or dying, Plumer said.

“And what?” she said. “They’re suddenly going to yank that away?”
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An organ transplant surgeon from New York is planning a third trip to Ukraine, where he has been working with doctors to help patients caught up in Russia’s war on Ukraine. The surgeon, Dr. Robert Montgomery, is also working to raise money to buy medical equipment for a hospital in Lviv. Iryna Solomko has the story, narrated by Anna Rice. VOA footage by Pavlo Terekhov.
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The U.S. Supreme Court on Friday preserved access to the abortion drug mifepristone while a lawsuit challenging the use of the drug plays out in lower courts.

The high court issued a brief on Friday evening granting emergency requests from the Biden administration and the drug’s manufacturer, Danco Laboratories, to continue to allow women to access the drug. The ruling puts on hold a preliminary injunction from a federal judge in Texas, who earlier this month ordered restrictions on the abortion drug.

Two justices on the nine-member court — conservatives Clarence Thomas and Samuel Alito — dissented from the decision.

The court had set a deadline for itself of midnight Friday to either approve the Biden administration’s request — to keep the drug available while the administration challenges a lower court ruling — or allow limited access to the drug to take effect.

The lower court ruling in question was issued April 7 by a federal judge in Texas after a coalition of anti-abortion groups and doctors argued the U.S. drug regulator, the Food and Drug Administration, improperly approved mifepristone in 2000 and did not fully assess its risks and benefits.

The ruling, which strictly limits availability of the drug, was appealed, and while an appeals court halted a portion of the ruling that would have invalidated the FDA approval, it left the limits on the drug’s availability in place.

The case is expected to be further appealed and could eventually end up being decided by the Supreme Court. Friday’s high court ruling makes it likely that access to mifepristone will continue at least into next year as the appeals play out.

Used in half of all abortions in US

Mifepristone is used in about half of all abortions nationwide. It has been used by as many as 5 million women since it was first approved in 2000, and major medical organizations say it has a strong safety record. The drug is also commonly used to help manage miscarriages.

Currently, the drug can be used by women to end pregnancies in the first 10 weeks, without a surgical procedure. It is available through the mail without an in-person visit to a doctor.

At the time the lower court ruling was made restricting access to the drug, President Joe Biden said in a statement the judge substituted his own judgment for that of the FDA, the expert agency responsible for approving drugs.

Biden said if the ruling is allowed to stand, “there will be virtually no prescription approved by the FDA that would be safe from these kinds of political, ideological attacks.”

Fight follows reversal of Roe v. Wade

The judge who made the ruling, U.S. District Judge Matthew Kacsmaryk, was appointed by former President Donald Trump, as were the judges on the appeals court that maintained limits on the availability of the drug.

The fight over mifepristone comes after the conservative majority on the Supreme Court last year overturned the landmark Roe v. Wade decision that legalized abortion nationwide. The court ruled it is now up to individual states to decide whether abortion should be legal or not.

The FDA has in recent years made it easier to use mifepristone, including in 2016 approving its use to 10 weeks of pregnancy, up from seven, and in 2021 allowing it to be distributed by mail in states that allow access.

Some information for this report came from The Associated Press, Reuters and Agence France-Presse.
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The Supreme Court is facing a self-imposed Friday night deadline to decide whether women’s access to a widely used abortion pill will stay unchanged or be restricted while a legal challenge to its Food and Drug Administration approval goes on.

The justices are weighing arguments that allowing restrictions contained in lower-court rulings to take effect would severely disrupt the availability of the drug, mifepristone, which is used in the most common abortion method in the United States.

It has repeatedly been found to be safe and effective, and has been used by more than 5 million women in the U.S. since the FDA approved it in 2000.

The Supreme Court had initially said it would decide by Wednesday whether the restrictions could take effect while the case continues. A one-sentence order signed by Justice Samuel Alito on Wednesday gave the justices two additional days, without explanation.

The justices are scheduled to meet for a private conference Friday, where they could talk about the issue. The additional time could be part of an effort to craft an order that has broad support among the justices. Or one or more justices might be writing a separate opinion, and asked for a couple of extra days.

The challenge to mifepristone, brought by abortion foes, is the first abortion controversy to reach the nation’s highest court since its conservative majority overturned Roe v. Wade 10 months ago and allowed more than a dozen states to effectively ban abortion outright.

In his majority opinion, Alito said one reason for overturning Roe was to remove federal courts from the abortion fight. “It is time to heed the Constitution and return the issue of abortion to the people’s elected representatives,” he wrote.

But even with their court victory, abortion opponents returned to federal court with a new target: medication abortions, which make up more than half of all abortions in the United States.

Women seeking to end their pregnancies in the first 10 weeks without more invasive surgical abortion can take mifepristone, along with misoprostol. The FDA has eased the terms of mifepristone’s use over the years, including allowing it to be sent through the mail in states that allow access.

The abortion opponents filed suit in Texas in November, asserting that FDA’s original approval of mifepristone 23 years ago and subsequent changes were flawed.

They won a ruling on April 7 by U.S. District Judge Matthew Kacsmaryk, an appointee of former President Donald Trump, revoking FDA approval of mifepristone. The judge gave the Biden administration and New York-based Danco Laboratories, mifepristone’s maker, a week to appeal and seek to keep his ruling on hold.

Responding to a quick appeal, two more Trump appointees on the 5th U.S. Circuit Court of Appeals said the FDA’s original approval would stand for now. But Judges Andrew Oldham and Kurt Englehardt said most of the rest of Kacsmaryk’s ruling could take effect while the case winds through federal courts.

Their ruling would effectively nullify changes made by the FDA starting in 2016, including extending from seven to 10 weeks of pregnancy when mifepristone can be safely used. The court also said that the drug can’t be mailed or dispensed as a generic and that patients who seek it need to make three in-person visits with a doctor. Women also might be required to take a higher dosage of the drug than the FDA says is necessary.

The administration and Danco have said that chaos will result if those restrictions take effect while the case proceeds. Potentially adding to the confusion, a federal judge in Washington has ordered the FDA to preserve access to mifepristone under the current rules in 17 Democratic-led states and the District of Columbia that filed a separate lawsuit.

The Biden administration has said the rulings conflict and create an untenable situation for the FDA.

And a new legal wrinkle threatens even more complications. GenBioPro, which makes the generic version of mifepristone, filed a lawsuit Wednesday to preemptively block the FDA from removing its drug from the market, in the event that the Supreme Court doesn’t intervene.

For now, the Supreme Court is only being asked to block the lower-court rulings through the end of the legal case. But the administration and Danco have a fallback argument if the court doesn’t agree. They are asking the court to take up the challenge to mifepristone, hear arguments and decide the case by early summer.

The court only rarely takes such a step before at least one appeals court has thoroughly examined the legal issues involved.

The New Orleans-based 5th circuit already has ordered an accelerated schedule for hearing the case, with arguments set for May 17.
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Looking back at 2022’s weather with months of analysis, the World Meteorological Organization said last year really was as bad as it seemed when people were muddling through it.

And about as bad as it gets — until more warming kicks in.

Killer floods, droughts and heat waves hit around the world, costing many billions of dollars. Global ocean heat and acidity levels hit record highs and Antarctic sea ice and European Alps glaciers reached record low amounts, according to the United Nations’ climate agency’s State of Global Climate 2022 report released Friday.

While levels have been higher before human civilization, global sea height and the amount of heat-trapping carbon dioxide and methane in the air reached highest modern recorded amounts. The key glaciers that scientists use as a health check for the world shrank by more than 1.3 meters (51 inches) in just one year and for the first time in history no snow survived the summer melt season on Switzerland’s glaciers, the report said.

Sea level is now rising at about double the rate it did in the 1990s, WMO Secretary-General Petteri Taalas said in a news conference. Oceans can rise another half a meter to a meter (20 to 39 inches) by the end of century as more ice melts from ice sheets and glaciers and warmer water expands, he said.

“Unfortunately these negative trends in weather patterns and all of these parameters may continue until the 2060s” despite efforts to reduce emissions of heat-trapping gases because of the pollution already spewed, Taalas said. “We have already lost this melting of this glaciers game and sea level rise game. So that’s bad news.”

Last year was close to but not quite the hottest year on record, ranking fifth or sixth hottest depending on measuring techniques. But the past eight years are the hottest eight years on record globally. The world kept that warm despite the rare third year of a La Nina, a natural temporary cooling of parts of the Pacific Ocean that changes weather worldwide.

The United Kingdom, France, Ireland, Portugal, Spain, Belgium, Luxembourg, Italy, Germany, Switzerland and New Zealand had their hottest years on record.

Global heat and other weather records go back to 1850.

“In 2022, continuous drought in East Africa, record breaking rainfall in Pakistan and record-breaking heat waves in China and Europe affected tens of millions, drove food insecurity, boosted mass migration, and cost billions of dollars in loss and damage,” Taalas said.

China’s heat wave was its longest and most extensive in that country’s record with its summer not just hottest on record but smashing the old record by more than 0.5 degrees Celsius (0.9 degrees Fahrenheit), the 55-page report said.

Africa’s drought displaced more than 1.7 million people in Somalia and Ethiopia, while Pakistan’s devastating flooding — which put one-third of the nation under water at one point — displaced about 8 million people, the report said.
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President Joe Biden announced plans Thursday to increase U.S. funding to help developing countries fight climate change and curb deforestation in Brazil’s Amazon rainforest.

During a virtual meeting of the Major Economies Forum on Energy and Climate, Biden urged his counterparts to be ambitious in setting goals to reduce emissions and meet a target of limiting overall global warming to 1.5 degrees Celsius.

“We’re at a moment of great peril but also great possibilities, serious possibilities. With the right commitment and follow-through from every nation … on this call, the goal of limiting warming to 1.5 degrees can stay within reach,” Biden said.

The countries that take part in the forum account for about 80% of the world’s greenhouse gas emissions and global gross domestic product, according to the White House. Thursday’s meeting was the group’s fourth under Biden’s presidency.

Biden announced a U.S. contribution of $1 billion to the Green Climate Fund, which finances projects on clean energy and climate change resilience in developing countries, doubling the overall U.S. contribution.

“The impacts of climate change will be felt the most by those who have contributed the least to the problem, including developing nations,” Biden said. “As large economies and large emitters, we must step up and support these economies.”

Biden also announced plans to request $500 million over five years to contribute to the Amazon Fund, which works to combat deforestation in the Brazilian Amazon, and related activities. A senior administration official said Biden’s team would have to work with Congress to secure that funding.

“Together, we have to make it clear that forests are more valuable conserved than cleared,” Biden said.

Brazil welcomed the pledge.

“It is obviously a great achievement, both for what it means to have the United States contributing to a fund like the Amazon Fund and for the volume of resources to be contributed,” Brazil’s Environment Minister Marina Silva said at a news conference.

Biden’s announcement comes during a week of tension between the U.S. and Brazil after the latter’s President Luiz Inacio Lula da Silva called for Western powers to stop supplying arms to Ukraine and said Washington was encouraging the fighting between Ukraine and Russia. He later toned down his comments and condemned Russia’s violation of Ukraine’s territorial integrity.

Biden, who has made fighting climate change one of his top policy priorities, has set a goal of reducing U.S. emissions 50%-52% by 2030 compared with 2005 levels.

This month, the Environmental Protection Agency proposed sweeping emission cuts for new cars and trucks through 2032 in an effort to boost electric vehicles. Biden encouraged leaders from the group to join a collective effort to spur zero-emission vehicles and to reduce emissions from the shipping and power industries.

European Commission President Ursula von der Leyen announced a new European Union-led initiative to develop new global targets for energy efficiency and renewable energy alongside the International Energy Agency, in time for a global summit on climate change in November.

“These targets would complement other goals, such as the phaseout of unabated fossil fuels and the ambitious goals for zero-emission vehicles and ships,” she said at the meeting.

U.N. Secretary-General Antonio Guterres called on rich countries to reach net-zero emissions by 2040, a decade before the goal set in the Paris climate agreement, and developing countries to hit that milestone by 2050.

He also called for OECD countries to phase out coal by 2030 and 2040 in all other countries and end all licensing or funding — public and private — of new fossil fuel projects.

Developing countries have resisted setting specific timelines for these reductions.

The countries and entities that make up the Major Economies Forum: Argentina, Australia, Canada, Chile, China, Egypt, the European Commission, France, Germany, India, Indonesia, Italy, Japan, South Korea, Mexico, Nigeria, Norway, Saudi Arabia, Turkey, the United Arab Emirates, Britain and Vietnam.
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SpaceX’s giant week meets a fiery end. But company officials still say the launch of Starship was a success. Plus, the European Space Agency sets sail for Jupiter’s icy moons. VOA’s Arash Arabasadi brings us The Week in Space.
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The U.S. government and state legislators are ramping up efforts to limit the use of toxic chemicals known as PFAS (pronounced pee-fas) in everyday products and to regulate levels in drinking water. But as VOA’s Veronica Balderas Iglesias found out, scientists are going a step further by exploring ways to fully eliminate the so-called “forever chemicals.”
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NY-AALESUND, NORWAY — At the world’s northernmost year-round research station, scientists are racing to understand how the fastest-warming place on Earth is changing – and what those changes may mean for the planet’s future.

But around the tiny town of Ny-Aalesund, high above the Arctic circle on Norway’s Svalbard archipelago, scientific data is getting harder to access. And sometimes it’s vanishing before scientists can collect it.

Scientists hoping to harvest ice cores are finding glaciers inundated by water. Research sites are getting harder to reach, as earlier springtime melt leaves the ground too barren for snowmobile travel.

Researchers have been studying the polar region for decades — with Ny-Aalesund’s weather records going back more than 40 years. But their work has become vitally important as climate change ramps up. That’s because what happens in the Arctic can impact global sea levels, storms in North America and Europe, and other factors far beyond the frozen region.

While the Arctic is warming about four times faster than the rest of the world, in Svalbard temperatures are climbing even faster — up to seven times the global average.

Last summer was the hottest on record. August temperatures in Ny-Aalesund were on average 5.1C degrees, about 0.5C warmer than normal for the month.

Polar bear sightings in Kongsfjord over the past four years have been higher than ever before, as the animals are left hungrier due partly to the loss of their sea ice hunting grounds and are more often prowling nearby islands in search of food as eight watchmen take turns patrolling the perimeter of Ny-Aalesund for polar bears.

Resting harbor seals alongside nesting seabird colonies are drawing the hungry carnivores closer, said Joanna Sulich, a biologist with the Norwegian Polar Institute and Polar Bears International.

“For many researchers who are studying those birds, it’s something of concern,” Sulich said.

Within the last decade, four buildings have been damaged by thawing permafrost, and last year Kings Bay SA, the state-owned company that manages the town, had to close down a laboratory where scientists processed samples from fish snow and ice due to thaw cracking its foundation.  

Bracing against wind gusts up to 15 meters per second (34 miles per hour), a team of scientists pitched camp this month on the Holtedahlfonna icefield, a 3-hour snowmobile drive from Ny-Aalesund riven with dangerous crevasses.

The team hoped to drill 125 meters into Dovrebreen glacier, hoping to collect two ice cores for studying 300 years of climate records – part of an effort by the non-profit Ice Memory Foundation to collect and preserve ice cores from melting glaciers around the world. 

The team was shocked when the drill, at only 25 meters deep, suddenly sloshed into a massive pool of water.

“We did not expect such a huge water flux coming out from the glacier, and this is a clear sign of what is happening in this region,” said expedition leader Andrea Spolaor. “The glacier is suffering.”  

On a snowfield a kilometer south of Ny-Aalesund, the chemist Francois Burgay filled plastic test tubes with snow, looking for chemical signals from marine algae blooms which travel from the ocean to the atmosphere and are deposited with the snow.

Once these signals are identified, he hopes scientists will be able to use them to understand how Arctic waters have changed in the past, and project how they might change in the future.
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The U.N. children’s fund, UNICEF, warns many children are likely to die from vaccine preventable diseases because of a decline in routine immunization during the COVID-19 pandemic.

New data in UNICEF’s State of the World’s Children 2023 report show a significant drop in confidence in the importance of vaccines for children in 52 out of 55 countries studied, noting that vaccination rates have declined by more than a third in South Korea, Papua New Guinea, Ghana, Senegal, and Japan. Only in three countries — China, India, and Mexico — did the data show people remained positive about the health benefits of vaccination.

In most countries, the study said, “people under 35 and women were more likely to report less confidence about vaccines for children after the start of the pandemic.”

This is particularly worrisome as the report finds 67 million children, nearly half of them on the African continent, have missed out on one or more vaccinations due to disruptions in immunization services during the three years of the COVID-19 pandemic.

Fear and disinformation

Authors of the report warn the threat of vaccine hesitancy may be growing due to factors such as misleading information about vaccine safety, declining trust in expertise, and political polarization that are discouraging parents from vaccinating their children.

“At the height of the pandemic, scientists rapidly developed vaccines that saved countless lives,” said Catherine Russell, UNICEF Executive Director. “But, despite this historic achievement, fear and disinformation about all types of vaccines circulated as widely as the virus itself.”

Gains eroded

Health agencies report four million deaths are prevented worldwide by childhood vaccinations every year. But UNICEF warns that much of the gains made over many years in routine childhood immunization have been eroded in the past three years.

“The COVID-19 pandemic was largely responsible for the backsliding in coverage, but it also exacerbated existing inequities,” said Ephrem Lemango, UNICEF’s Associate Director of Immunization.

“As a result, a total of 67 million children missed out on routine vaccination between 2019 and 2021” and 48 million did not receive a single routine vaccine, “also known as zero-dose,” he said.

The report said India and Nigeria have the largest numbers of zero-dose children but increases in the numbers of children who did not receive a single dose of DTP-containing vaccine – against diphtheria, tetanus, pertussis — are especially notable in Myanmar and the Philippines.

Lemango said “for far too many children, especially in the most marginalized communities, vaccination is still not available, accessible, or affordable.”

“The analysis in this report clearly shows, children in the poorest households, living in rural areas, and born to a mother with no education and limited empowerment are most likely to lose one or more vaccinations, and to face multiple deprivations,” he said.

On the other hand, he noted that in some countries such as Nigeria, Angola, and Ethiopia, “you will find that the wealthiest 10 percent of the households are up to 10 to 20 times more likely to have their kids vaccinated as opposed to the poorest households.”

UNICEF is calling for urgent catch-up action for those children who have missed out on vaccinations to prevent deadly disease outbreaks, noting that the number of measles cases in 2022 was more than double the total in the previous year and that 16% more children have been paralyzed by polio.

“Immunizations have saved millions of lives and protected communities from deadly disease outbreaks,” said UNICEF Dirrector Russell. “Routine immunizations and strong health systems are our best shot at preventing future pandemics, unnecessary deaths, and suffering.”

The report is urging governments to identify and reach all children, especially the 67 million who missed vaccines because of the COVID pandemic. It is calling on states to strengthen their primary health care to better support immunization services, including by providing better conditions to the female workforce.

“We are calling on the world and global community to be able to prioritize this issue and avert a child survival crisis before it happens and before it is too late,” said UNICEF’s Ephrem Lemango.
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By day, Jessica Wade spends her time in a laboratory at Imperial College London surrounded by spectrometers, oscilloscopes — and men.

At night, she writes biographies on Wikipedia about women researchers like her who don’t have an online presence.

“We can’t just do the shouting about how we need more women in science. We have to do the point of honoring and celebrating the women scientists that we have,” she told AFP.

“And I think writing their stories, making sure the world recognizes what they’ve done is a really important way to do that.”

Wade, 34, has worked at Imperial’s imposing campus in west London since 2016.

As a physicist, she is involved in developing new generations of carbon-based semi-conductors to make optical and electronic devices such as televisions and solar panels more energy efficient.

She leads a team of five people in a wider team of about 15. Of them, only one other scientist is a woman.

Science “is very male dominated,” Wade said, lamenting the lack of interest in it among girls whose parents are not scientists.

“As soon as I walked into a physics department that had a majority of men and a majority of people from white privileged backgrounds, I suddenly realized that not everyone’s getting the opportunity to study physics, not everyone’s getting excited about it,” she added.

“That lack of diversity impacts the science we do, the questions we ask, the directions we go in, the way we translate our innovations into society, where those kinds of devices are actually used in the world and who they benefit.”

Visibility

Wade now seeks to “take science to more people” but came across “knowledge gaps” in the internet’s free, multilingual, collaborative encyclopedia.

“Wikipedia is an amazing platform because it’s used by everyone in society,” she said.

“It’s used by 15 billion access points a month. Parents, teachers, policymakers, journalists, scientists, Amazon, Alexa, Google Home, they all use Wikipedia when they’re looking for information.”

But there is one big problem, she added: “About 90% of Wikipedia contributors and editors are men, and about 19% of the biographies on English language Wikipedia are about women.”

Wade set out to redress the imbalance in 2018 and has since written almost 2,000 pages by herself at the rate of one a night, at home, after dinner.

“They take more than one hour each, so that’s already too many hours of my life,” she laughed.

But she is undeterred by the daunting task.

“I don’t see it stopping anytime soon,” she said.

In fact, the research itself creates more work, as she often discovers more women scientists when writing another biography.

Wades’ first Wikipedia biography entry was the American climatologist Kim Cobb.

She saw her at a conference but after looking her up on Wikipedia found there was nothing on her oceanographic research.

Acknowledgement

Wade, who is now part of a network of women editors and leads workshops on how to write for Wikipedia, says a person’s presence and their work on the internet means they are discoverable.

“Little girls who are googling something, let’s say about sea urchins, will click through and then land on a Wikipedia page about an awesome woman scientist who had contributed to that,” she said.

“If you’re trying to nominate someone for an award or to become a fellow or to invite someone to give a lecture, you always google them and if they’ve got a biography nicely summarized on somewhere like Wikipedia, it’s so much easier to write someone’s citation or reference.”

That happened for Gladys West, a 92-year-old black American mathematician, whose profile was one of Wade’s first.

Starting in 1956, when racial segregation was still imposed in the United States, she worked for 42 years on navy navigation systems. Her calculations eventually led to the development of GPS.

“I researched Gladys to write her page and there was so little about her online, she was almost 90 and no one had celebrated her,” she said.

“I put her Wikipedia page online in February 2018 and in May 2018 she was in the BBC top 100 women in the world.

“And then she was inducted to the US Air Force Hall of Fame, and she won the Royal Academy of Engineering Prince Philip medal, which had never before gone to a woman.”
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At least 67 million children partially or fully missed routine vaccines globally between 2019 and 2021 because of lockdowns and health care disruptions caused by the COVID-19 pandemic, the United Nations said Wednesday.

“More than a decade of hard-earned gains in routine childhood immunization have been eroded,” read a new report from the U.N.’s children’s agency, UNICEF, adding that getting back on track “will be challenging.”

Of the 67 million children whose vaccinations were “severely disrupted,” 48 million missed routine vaccines entirely, UNICEF said, flagging concerns about potential polio and measles outbreaks.

Vaccine coverage among children declined in 112 countries and the percent of children vaccinated worldwide slipped 5 percentage points to 81%, a low not seen since 2008. Africa and South Asia were particularly hard-hit.

“Worryingly, the backsliding during the pandemic came at the end of a decade when, in broad terms, growth in childhood immunization had stagnated,” the report said.

Vaccines save 4.4 million lives each year, a number the United Nations says could jump to 5.8 million by 2030 if its ambitious targets to leave “no one behind” are met.

“Vaccines have played a really important role in allowing more children to live healthy, long lives,” Brian Keeley, the report’s editor in chief, told AFP. “Any decline at all in vaccination rates is worrying.”

Before the introduction of a vaccine in 1963, measles killed about 2.6 million people each year, mostly children. By 2021, that number had fallen to 128,000.

But between 2019 and 2021, the percentage of children vaccinated against measles fell from 86% to 81%, and the number of cases in 2022 doubled compared with 2021.

The slide in vaccination rates could be compounded by other crises, Keeley warned, from climate change to food insecurity.

“You’ve got [an] increasing number of conflicts, economic stagnation in a lot of countries, climate emergencies, and so on,” he said. “This all sort of makes it harder and harder for health systems and countries to meet vaccination needs.”

UNICEF called on governments “to double-down on their commitment to increase financing for immunization” with special attention on accelerating “catch-up” vaccination efforts for those who missed their shots.

The report also raised concerns about a drop in people’s confidence in vaccines, seen in 52 out of 55 countries surveyed.

“We cannot allow confidence in routine immunizations to become another victim of the pandemic,” Catherine Russell, UNICEF’s executive director, said in a statement. “Otherwise, the next wave of deaths could be of more children with measles, diphtheria or other preventable diseases.”

Vaccine confidence can be “volatile and time specific,” the report said, noting that “further analysis will be required to determine if the findings are indicative of a longer-term trend” beyond the pandemic.

Overall, it said that support for vaccines “remains relatively strong.”

In about half of the 55 countries surveyed, more than 80% of respondents “perceived vaccines as important for children.”

“There is reason to be somewhat hopeful that services are recovering in quite a few countries,” said Keeley, who added that preliminary vaccination data from 2022 showed encouraging signs.

But even getting numbers back up to pre-pandemic levels will take years, he said, not including reaching “the children who were missing before the pandemic.”

“And they are not an insubstantial number.”

 
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Older Americans and people with weak immune systems can get an extra COVID-19 booster dose this spring.

The Centers for Disease Control and Prevention on Wednesday signed off on a more flexible booster schedule for people who remain at the highest risk from COVID-19 — giving them the choice of a second “bivalent” Pfizer or Moderna booster, the most up-to-date formula.

“Many in the population are experiencing vaccine fatigue but there is a subset who are eager to receive additional doses,” CDC’s Dr. Sara Oliver told an agency advisory panel that expressed support for the change.

The move came a day after the Food and Drug Administration took steps to make coronavirus vaccinations simpler for everyone. From now on, anyone getting a Pfizer or Moderna dose — whether it’s a booster or their first-ever vaccination — will get an updated version rather than the outdated original shots.

Here are some things to know:

Who needs a booster?

Anyone who’s gotten their original vaccinations but hasn’t had an updated booster yet can still get one. Only 42% of Americans 65 and older — and just 20% of all adults — have gotten one of those updated boosters since September.

Who can get a second updated booster?

People 65 or older who already had one Pfizer or Moderna updated booster can roll up their sleeves again, as long as it’s been at least four months since that last shot.

The schedule is a little different for people with weak immune systems. Most can choose a second Pfizer or Moderna updated booster at least two months after their first. Under the latest FDA and CDC guidelines, they also could get additional doses if and when their physician decides they need one.

Why the extra leeway?

Older adults continue to have the highest rates of hospitalization from COVID-19, even as cases have declined. But a frail 85-year-old may want another booster right away, while a robust 65-year-old may not see the need — or might instead time another shot for peak protection ahead of a summer vacation or other special event.

CDC officials stressed there’s even more variety among immune-compromised patients, from people with only mild impairment to those trying to replenish immunity that grueling cancer treatment knocked out.

The changes put the U.S. in line with Britain and Canada, which also are offering certain vulnerable populations a spring shot. It’s a reasonable choice, Dr. Matthew Laurens, of the University of Maryland School of Medicine, said before the announcement.

“We do have vaccines that are available to protect against these severe consequences, so why not use them?” he said. “They don’t do any good just sitting on a shelf.”

Will younger, healthier people get a fall dose?

Stay tuned. The FDA will hold a public meeting in June to consider if the vaccine recipe needs more adjusting to better match the latest coronavirus strains — just like it adjusts flu vaccines every year. And part of that discussion will be whether younger, healthier people also need a booster.

The updated Pfizer and Moderna shots being used now target the BA.4 and BA.5 omicron versions, which have been replaced by an ever-changing list of omicron descendants. Still, while protection against mild infections is short-lived, those updated doses continue to do a good job fighting severe disease and death even against the newest variants.

Tots are least likely to be vaccinated yet

CDC’s advisers were dismayed at how few of the youngest children are vaccinated. Just 6% of 2- to 4-year-olds have gotten their initial COVID-19 shots and 4.5% of those younger than 2. Far fewer got an updated booster.

The FDA’s new rules mean tots under 5 who’ve never been vaccinated can get the most up-to-date formula — two Moderna shots or three of the Pfizer-BioNTech version. Unvaccinated 5-year-olds can get two Moderna doses or a single Pfizer shot. And tots already fully or partially vaccinated may get a bivalent shot or two depending on their vaccination history.

What about the Novavax vaccine?

Novavax makes a more traditional type of COVID-19 vaccine, and its original formula remains available for people who don’t want the Pfizer or Moderna option. Novavax also is getting ready in case FDA urges a fall update, by manufacturing several additional formulas.
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The Supreme Court is deciding whether women will face restrictions in getting a drug used in the most common method of abortion in the United States, while a lawsuit continues.

The justices are expected to issue an order on Wednesday in a fast-moving case from Texas in which abortion opponents are seeking to roll back Food and Drug Administration approval of the drug, mifepristone.

The drug first won FDA approval in 2000, and conditions on its use have been loosened in recent years, including making it available by mail in states that allow access.

The Biden administration and New York-based Danco Laboratories, the maker of the drug, want the nation’s highest court to reject limits on mifepristone’s use imposed by lower courts, at least as long as the legal case makes it way through the courts. They say women who want the drug and providers who dispense it will face chaos if limits on the drug take effect. Depending on what the justices decide, that could include requiring women to take a higher dosage of the drug than the FDA says is necessary.

Alliance Defending Freedom, representing anti-abortion doctors and medical groups in a challenge to the drug, is defending the rulings in calling on the Supreme Court to let the restrictions take effect now.

The legal fight over abortion comes less than a year after conservative justices reversed Roe v. Wade and allowed more than a dozen states to effectively ban abortion outright.

Even as the abortion landscape changed dramatically in several states, abortion opponents set their sights on medication abortions, which make up more than half of all abortions in the United States.

The abortion opponents filed suit in November in Amarillo, Texas. The legal challenge quickly reached the Supreme Court after a federal judge issued a ruling on April 7 that would revoke FDA approval of mifepristone, one of two drugs used in medication abortions.

Less than a week later, a federal appeals court modified the ruling so that mifepristone would remain available while the case continues, but with limits. The appeals court said that the drug can’t be mailed or dispensed as a generic and that patients who seek it need to make three in-person visits with a doctor, among other things.

The generic version of mifepristone makes up two-thirds of the supply in the United States, its manufacturer, Las Vegas-based GenBioPro Inc., wrote in a court filing that underscored the perils of allowing the restrictions to be put into effect.

The court also said the drug should only be approved through seven weeks of pregnancy for now, even though the FDA since 2016 has endorsed its use through 10 weeks of pregnancy.

Complicating the situation, a federal judge in Washington has ordered the FDA to preserve access to mifepristone under the current rules in 17 Democratic-led states and the District of Columbia that filed a separate lawsuit.

The Biden administration has said the rulings conflict and create an untenable situation for the FDA.

In an order issued last Friday by Justice Samuel Alito, the court put the restrictions on hold through Wednesday to give the court time to consider the emergency appeal.

If the justices aren’t inclined to block the ruling from taking effect for now, the Democratic administration and Danco have a fallback argument, asking the court to take up the challenge to mifepristone, hear arguments and decide the case by early summer.

The court only rarely takes such a step before at least one appeals court has thoroughly examined the legal issues involved.

The 5th U.S. Circuit Court of Appeals in New Orleans already has ordered an accelerated schedule for hearing the case, with arguments set for May 17.

Mifepristone has been available for use in medication abortions in the United States since the FDA granted approval in 2000. Since then, more than 5 million women have used it, along with another drug, misoprostol, to induce abortions.
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A group of American plastic surgeons has been working in  Ukraine since the beginning of Russia’s invasion, helping  wounded soldiers and civilians recover from war injuries. Omelyan Oshchudlyak has the story. Camera: Yuriy Dankevych    
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Virtual medicine, or medical extended reality, uses virtual reality headsets and imaging software to supplement conventional medical treatments. Practitioners from around the world shared best practices at a recent conference in Los Angeles. Mike O’Sullivan reports.
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Nigeria’s National Agency for Food and Drug Administration and Control, NAFDAC, announced a provisional approval of the R21 vaccine during a media briefing on Monday.

The regulatory agency’s consent came days after Ghana approved the vaccine.

NAFDAC said the vaccine is 70 to 80 percent efficient in preventing the mosquito-borne disease and could protect millions of children.

The agency’s director general, Mojisola Adeyeye, spoke to journalists in Abuja.

“The vaccine is indicated for prevention of clinical malaria on children from five months to 36 months of age,” Adeyeye said.

NAFDAC did not say when the vaccine will be rolled out, but Adeyeye said Nigeria will conduct in-country clinical trials and pharmacovigilance study.

The WHO says some 600,000 people die of malaria every year, most of them in Africa, many of them young children.

Nigeria accounts for the highest numbers of cases and deaths from malaria globally. Health experts say the vaccine could be a game changer.

Kunle Olobayo is a lead researcher at the National Institute for Pharmaceutical Research and Development.

“A proactive, preemptive intervention will definitely be most useful especially in countries like Nigeria,” said Olobayo. “Many interventions and steps that have been taken to reduce transmission have not been very successful because of our level of development, poverty. So, it will definitely change the dynamics.

The WHO has yet to approve the vaccine. The WHO Nigeria malaria program head, Lynda Ozor, said authorities are still reviewing the vaccine’s safety and efficacy.

“The WHO is reviewing the R21 data, and it’s being supported by an independent global advisory group on immunization and malaria experts.,” said Ozor. “This group will advise the WHO on whether to recommend the R21 vaccines for use. It has to be approved by the WHO to compliment the rollout of the first vaccine.”

Last year, the WHO consented to the world’s first malaria vaccine, Mosquirix.

Olobayo said that, without donor support, African countries could struggle to acquire the vaccines.

“Vaccines in Nigeria historically tend to be dependent on donor funding,” said Olobayo. “I have a feeling there might be some substantial international funding to get these products widely used.”

Oxford University is working with the Serum Institute of India to produce up to 200 million doses of R21 every year.
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Mozambique has asked the World Health Organization to supply an additional 2 million doses of a cholera vaccine as the country struggles to control a spreading outbreak. 

The head of the Department of National Health Surveillance at the Ministry of Health, Domingos Guihole, told VOA that the government awaits the WHO’s response to the cholera vaccine request, admitting difficulties due to the high global demand for vaccines.

“At this moment in Mozambique, the cholera situation is not good,” Guihole said. “It is not good because we have 10 provinces affected by cholera. We have 53 districts in the whole country, 45 of which have active cholera disease.”

The official said the intent is to vaccinate the population in high-risk areas, such as the northern province of Nampula and Zambezia in the central part of the country.

Both provinces were hit hard by Cyclone Freddy, which tore across Mozambique twice inside two weeks last month.

All five provinces impacted by Freddy on its first and second passes have witnessed cholera outbreaks.

In addition to the risk of cholera, the government is concerned about a potential increase in cases of other waterborne diseases such as dysentery. Malaria is a concern, too; both are among the leading causes of mortality in Mozambique.

“During almost seven months from October to April 16, we have notified 27,000 cases of cholera with 124 deaths, so the situation is not good,” said Guihole. “We have to say to all Mozambicans that we must follow the recommendations from the Ministry of Health related to the hygiene of water, hygiene of food, and even the collective hygiene as well.”

In many parts of Mozambique, health workers are struggling to treat infected citizens at clinics and hospitals that were badly damaged by Cyclone Freddy.

The record-breaking storm, which lasted for several weeks, killed dozens of people in Mozambique and Malawi and destroyed many roads and bridges in addition to hospitals.
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