The World Health Organization has declared an end to Ghana’s outbreak of the deadly Marburg virus after more than six weeks without any new cases. 

Three cases of the virus were recorded in the West African country in late June, killing two people. 

 

Marburg is a highly infectious viral hemorrhagic fever in the same family as Ebola. The symptoms of Marburg include diarrhea, fever, nausea and vomiting. 

 

Speaking at a press conference Friday in Accra, head of the Ghana Health Service, Dr. Patrick Kuma-Aboagye, said having passed the mandatory 42-day period without a new case, the country is now free of the virus. 

 

“I do hereby state that, the appropriate outbreak reasons to Marburg disease have been implemented during the 42 days, following the last negative PCR test result for the sole surviving patient with recommendation from WHO,” he said. “Ghana has, therefore, successfully interrupted the first Marburg virus disease outbreak and hereby declare that the outbreak is over.”

A total of 198 people were tested for the virus when it first broke in Ghana. They all tested negative. 

 

It is the second time Marburg made a West African appearance. The first outbreak was in Guinea in September of last year. 

 

Marburg has also appeared in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda. 

 

There are no vaccines or antiviral treatments for Marburg, but WHO says supportive care — rehydration with oral or intravenous fluids — and treatment of specific symptoms improves the rate of survival. 

 
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Mount Everest base camp, a sprawling tent village that is home away from home during climbing season for hundreds of aspiring summiteers and support staff, may soon be on the move.

Nepalese officials say they are considering the move to a lower elevation because the Khumbu glacier on which the camp sits is being melted away by climate change, which is undermining its foundation and slowly releasing decades worth of frozen trash and human waste.

But some of the Sherpa climbing guides who make Everest ascents possible are not happy with the idea, arguing that the government should first consider less drastic measures such as limiting the ballooning number of climbing permits, which at around $11,000 apiece have become an important source of revenue for the country.

“I see glaciers vanishing on daily basis. Uncontrollable number of visitors is a problem and it doesn’t make any sense to shift the base camp down,” said Dawa Chhiri Sherpa, 57, who began his career as a cook for a trekking company 35 years ago.

“Consult experts and relevant stakeholders is what should be government doing and not rushing to any decision,” agreed 62-year-old Kay Sherpa, who was born in Scotland and has been living in Nepal since 2009.

He added that the government should try to reduce the influx of helicopters ferrying climbers and other visitors to landing pads at either end of the approximately 22-hectare site to minimize the damage to the ecologically fragile area.

Nepal’s Department of Tourism recommended earlier this summer that a seven-person research group be formed with National Mountaineering Association chairman Nima Nuru Sherpa as its chair. The committee’s mission would be to investigate the present base camp location and potential relocation options.

Taranath Adhikari, director general of the tourism department, said in an interview with the British Broadcasting Corp. that the idea was to move the camp entirely off the fast-receding glacier to a level some 330 meters lower on the mountain.

“It is basically about adapting to the changes we are seeing at the Base Camp, and it has become essential for the sustainability of the mountaineering business itself,” he told the BBC.

The Khumbu glacier has lost the equivalent of 2,000 years of ice in just 30 years, according to research by the 2019 National Geographic and Rolex Perpetual Planet Everest Expedition.

That problem is compounded by the sheer number of visitors to the camp, where more than 1,500 individuals stay for a minimum of two months during the climbing season. Wealthier mountaineers are able to enjoy relatively luxurious accommodations including hot showers, Wi-Fi and catered meals, while acclimatizing to the 5,364-meter altitude.

The proposed move makes sense to Shilshila Acharya, who has played a leading role in efforts to clean up the huge amount of trash that has built up around the base camp since Sir Edmund Hillary and Tenzing Norgay Sherpa first reached the summit in 1953.

“Once the waste is accumulated there, mountain cleanup is very risky and expensive work,” said Acharya, the director of Avni Ventures Pvt Ltd., which is an official recycling partner of Mountain Clean Up Campaign 2021 and 22. Moving the camp would at least temporarily facilitate the clean-up and have safety benefits, she told VOA.

Based on current estimates that the government is spending $1.5 to $2 million a year on the clean-up, “it will take another 50 to 100 years to clean up the existing waste from all mountains,” she said. “So it is going to be costly in the long run if something is not done about it.”

Shafkat Masoodi, a veteran hiker from Kashmir who visited the base camp in 2018, argued that the government must act quickly to move the camp and limit the number of climbing permits issued each season.

“It will prove disastrous in the near future” if they don’t act, he said. “Just imagine the number of climbers per season supported by almost double the number of Sherpas and porters spending at least six months in a year in these glaciers. The garbage and human waste dumped by these is just turning the Khumbu glacier into a polluted river down the mountains.”

But Anja Bagale, operations director at Hotel Himalaya in Kathmandu, pointed out that the current base camp location was selected by experienced Sherpa guides because it is the safest and most practical place from which to launch a final three- to five-day assault on the summit. He argued that the solution is to limit the traffic to the site, not to move it.

Ramesh Bhushal, the Nepal editor of Third Pole and an environment journalist based in Kathmandu, also questioned whether the underlying problems troubling the base camp would be resolved by moving it.

“I don’t see any valid point to shift Everest base camp as it won’t solve any problem as stated and possibly increase problems in [the] future,” he said. “But it is also okay to mull about how to deal with problems that have forced the government to reach into that thought of changing the base camp.”
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The 60th anniversary of President John F. Kennedy’s “moonshot” speech, which rallied a nation behind NASA. Plus, President Biden calls for a moonshot of his own, and a private spaceflight company suffers its first failure. VOA’s Arash Arabasadi brings us The Week in Space.
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Russia’s war on Ukraine has seen scores of hospitals and clinics bombed, and frequent power cuts that can turn off lifesaving machines. Medical aid groups are using a Kenyan-manufactured breathing device for premature babies that works without electricity, helping save vulnerable newborns in countries affected by conflict. Victoria Amunga reports from Nairobi, Kenya. Camera – Jimmy Makhulo.
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With monkeypox cases subsiding in Europe and parts of North America, many scientists say now is the time to prioritize stopping the virus in Africa.

In July, the U.N. health agency designated monkeypox as a global emergency and appealed to the world to support African countries so that the catastrophic vaccine inequity that plagued the outbreak of COVID-19 wouldn’t be repeated.

But the global spike of attention has had little impact on the continent. No rich countries have shared vaccines or treatments with Africa, and some experts fear interest may soon evaporate.

“Nothing has changed for us here. The focus is all on monkeypox in the West,” said Placide Mbala, a virologist who directs the global health research department at Congo’s Institute of Biomedical Research.

“The countries in Africa where monkeypox is endemic are still in the same situation we have always been, with weak resources for surveillance, diagnostics and even the care of patients,” he said.

Rich countries hoard vaccine

Monkeypox has sickened people in parts of West and Central Africa since the 1970s, but it wasn’t until the disease triggered unusual outbreaks in Europe and North America that public health officials even thought to use vaccines. As rich countries rushed to buy nearly all the world’s supply of the most advanced shot against monkeypox, the World Health Organization said in June that it would create a vaccine-sharing mechanism to help needy countries get doses.

So far, that hasn’t happened.

“Africa is still not benefiting from either monkeypox vaccines or the antiviral treatments,” said Dr. Matshidiso Moeti, WHO’s Africa director, adding that only small amounts have been available for research purposes. Since 2000, Africa has reported about 1,000 to 2,000 suspected monkeypox cases every year. So far this year, the Africa Centers for Disease Control and Prevention have identified about 3,000 suspected infections, including more than 100 deaths.

In recent weeks, monkeypox cases globally have fallen by more than a quarter, including by 55% in Europe, according to WHO.

Dr. Ifedayo Adetifa, head of the Nigeria Center for Disease Control, said the lack of help for Africa was reminiscent of the inequity seen during COVID-19.

“Everybody looked after their (own) problem and left everybody else,” he said. Adetifa lamented that monkeypox outbreaks in Africa never got the international attention that might have prevented the virus from spreading globally.

Rich countries have stretched their vaccine supplies by using a fifth of the regular dose, but none have expressed interest in helping Africa. WHO’s regional office for the Americas recently announced it had struck a deal to obtain 100,000 monkeypox doses that will start being delivered to countries in Latin America and the Caribbean within weeks. But no similar agreements have been reached for Africa.

“I would very much like to have vaccines to offer to my patients or anything that could just reduce their stay in the hospital,” said Dr. Dimie Ogoina, a professor of medicine at Niger Delta University in Nigeria and a member of WHO’s monkeypox emergency committee.

Since WHO declared monkeypox a global emergency, Nigeria has seen the disease continue to spread, with few significant interventions.

“We still do not have the funds to do all the studies that we need,” Ogoina said.

Research into the animals that carry monkeypox and spread it to humans in Africa is piecemeal and lacks coordination, said Mbala, of Congo’s Institute of Biomedical Research.

Last week, the White House said it was optimistic about a recent drop in monkeypox cases in the U.S., saying authorities had administered more than 460,000 doses of the vaccine made by Bavarian Nordic.

Cases drop in U.S.

The U.S. has about 35% of the world’s more than 56,000 monkeypox cases but nearly 80% of the world’s supply of the vaccine, according to a recent analysis by the advocacy group Public Citizen.

The U.S. hasn’t announced any monkeypox vaccine donations for Africa, but the White House did make a recent request to Congress for $600 million in global aid.

Even if rich countries start sharing monkeypox tools with Africa soon, they shouldn’t be applauded, other experts said.

“It should not be the case that countries only decide to share leftover vaccines when the epidemic is declining in their countries,” said Piero Olliaro, a professor of infectious diseases of poverty at Oxford University. “It is exactly the same scenario as COVID, and it is still completely unethical.”

Olliaro, who recently returned to the U.K. from a trip to Central African Republic to work on monkeypox, said WHO’s emergency declaration appeared to offer “no tangible benefits in Africa.”

In Nigeria’s Lagos state, which includes the country’s largest city and is hard hit by monkeypox, some people are calling for the government to urgently do more.

“You can’t tell me that the situation wouldn’t have improved without a vaccine,” said Temitayo Lawal, 29, an economist.

“If there is no need for vaccines, why are we now seeing the U.S. and all these countries using them?” he asked. “Our government needs to acquire doses as well.”
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A second U.S. death was linked to monkeypox on Tuesday as health authorities published a study describing how two previously healthy young men experienced inflammation of the brain and spinal cord as a result of the virus. 

There have been nearly 22,000 U.S. cases in the current global outbreak, which began in May, but new infections have been falling since mid-August as authorities have distributed hundreds of thousands of vaccine doses. 

The latest fatal case involved a severely immunocompromised resident of Los Angeles County who had been hospitalized, the local health department said without revealing further details. 

“Persons severely immunocompromised who suspect they have monkeypox are encouraged to seek medical care and treatment early and remain under the care of a provider during their illness,” the department said. 

The first U.S. death linked to the viral illness occurred in Texas and was announced on August 30, although authorities said that because the person was severely immunocompromised, they were investigating what role monkeypox had played. 

The current global outbreak is primarily affecting men who have sex with men. 

Historically, the virus has been spread via direct contact with lesions, body fluids and respiratory droplets, and sometimes through indirect contamination via surfaces such as shared bedding.  

But in this outbreak, there is preliminary evidence that sexual transmission may also play a role. 

Brain and spinal cord inflammation 

The U.S. Centers for Disease Control and Prevention, meanwhile, published a report about two unvaccinated men in their 30s who experienced brain and spinal cord inflammation after testing positive for the virus. 

The first, patient A, was a gay man in his 30s from Colorado whose symptoms began with fever chills and malaise and progressed to rashes on his face, scrotum and extremities, with swabs of lesions testing positive for the virus. 

He also developed lower extremity weakness and numbness, was unable to empty his bladder, experienced a persistent and painful erection, and was hospitalized. 

Magnetic resonance imaging (MRI) revealed brain and spinal cord inflammation. He was treated with the oral monkeypox antiviral tecovirimat as well as other drugs and began to improve at two weeks. 

He was released but continued to have left leg weakness and required an assistive walking device at a one-month follow-up. 

A second person, patient B, was a gay man in his 30s from Washington. His fever, rashes and muscle pain progressed to bowel and bladder incontinence and progressive flaccid weakness of both legs. 

Brain and spinal cord inflammation was confirmed on MRI, and he was intubated in an intensive care unit, where he was treated with intravenous tecovirimat as well a drug to reduce inflammation and, finally, blood plasma exchange. 

He remains in the hospital but can walk with the assistance of a device. 

The report said the underlying mechanism behind the two cases was unclear — it might have been a direct invasion of the central nervous system or an autoimmune response triggered by monkeypox infection elsewhere in the body. 
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NASA has so far been unable to launch its first Artemis mission, bringing added scrutiny to a program that is billions of dollars over budget and years behind schedule in returning humans to the moon. VOA’s Kane Farabaugh reports that despite scrubbed launches, the U.S. space agency hopes to get the Artemis program off the ground by the end of the year.
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Hoping to witness the launch of NASA’s Artemis 1 rocket to the moon is – so far – an exercise in frustration for Mark Franko. 

“I was hoping to feel the noise and the power and the sound – it would have been pretty interesting to see, I think,” Franko told VOA as he and his friends tried to watch a launch behind a local restaurant not far from Cape Canaveral. But fuel leaks and other issues have twice postponed the most powerful rocket system ever created from taking off.   

Despite the delays, Franko’s friend, Mary Jane Patterson, thinks NASA shouldn’t be in a hurry to make the next launch attempt.   

 

“I think that they should bring it back to the building and really check it out completely and then go again. I feel like it was too soon to go off after the first problem, and I think that, whether it was PR [public relations] or whatever, they were trying to push the envelope but at the same time they can’t. I don’t think you can be too cautious,” she said. 

“It’s the first time we’ve flown this rocket and this capsule,” noted astronaut Stan Love, who spoke with VOA ahead of the first unsuccessful launch attempt. “There are many, many things that can go wrong. This is a test flight. Don’t get your expectations too high.” 

But with hundreds of thousands of tourists gathering in Florida for each launch attempt, joining media from around the world assembled at Cape Canaveral, Love knows those expectations are high, at least partly because of the large price tag of the endeavor. 

The original cost for the S-L-S, or “Space Launch System,” which includes the rocket and boosters that propel the Orion capsule into space, has grown from $10 billion to $20 billion. Each successful launch will cost about $4.1 billion. NASA’s inspector general expects the overall Artemis program to reach $93 billion by the time the first astronauts return to the surface of the moon, targeted for 2025. 

That’s if NASA can get the first uncrewed mission off the ground this year. 

“We’ve got to make sure the vehicle is ready to go, we’ve got to make sure it’s safe for crew, and those things just take time,” said Doug Hurley, a retired NASA astronaut who flew on the first crewed mission of Space X’s Crew Dragon capsule to the International Space Station. He now works for Northrop Grumman, one of the contractors working on Artemis, and he is quick to respond to critics who say the current effort to return to the moon is behind schedule and over budget.   

 

“I’ve heard that my whole career. Every aircraft I’ve been involved with, every spacecraft I’ve been involved with. We heard that with Crew Dragon flying – it was six years from the time the contract was awarded to the time we flew. It takes time to build these complicated machines. But it’s worth it.” 

As NASA troubleshoots difficulties while carefully weighing the risks in launching Artemis, cost isn’t the only factor.   

“Mission success comes as we assess the flight after the fact,” said David Reynolds, a deputy program manager for NASA, who added that the future of spaceflight depends on the performance of this first uncrewed attempt to return to the moon. 

 

“As you tick off the different boxes, you buy down a certain amount of risk for the crewed flight. And so, once you have made that determination and we decide that it is safe enough to fly with crew, we will have considered it a mission success.” 

But Mark Franko, who had to return to Tempe, Arizona, before the next potential launch, wonders if the effort to see Artemis 1 in person was worth it. 

“If you watch it on TV it would probably be closer,” he told VOA. 

NASA is now looking at launch windows in late September and early October. 

 
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As temperatures reach record highs worldwide, air conditioning is becoming more of a necessity. From Somerville, Massachusetts, Matt Dibble has this story of a company hoping to make AC units more efficient.
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In an executive order signed Monday, President Joe Biden announced steps by his administration to bolster the “bioeconomy” in the United States, a classification that covers research and development across a broad swath of products, including medical supplies, sustainable new fuels and food, as well as technologies meant to help fight climate change.

The order comes barely a month after Biden signed a major piece of legislation, the CHIPS Act, meant to supercharge U.S. manufacturing of semiconductors, an area in which the U.S. has lost its once-dominant global position.

The effort to boost the U.S. biotech sector further underscores the administration’s apparent belief that deeper engagement by the federal government with domestic manufacturing operations is necessary to preserve U.S. competitiveness in the global economy.

In a briefing over the weekend, administration officials made it clear that the administration’s push to bring more U.S.-based biotechnology manufacturing online comes as a response to other countries — particularly China — investing heavily in the sector.

Administration officials stressed that biotechnology-based products and “biomanufacturing” present a promising alternative to many current products — fuel, plastics and other materials — that are currently made using the byproducts of carbon-laden petrochemicals.

Order text

The executive order reads, in part, “It is the policy of my Administration to coordinate a whole-of-government approach to advance biotechnology and biomanufacturing towards innovative solutions in health, climate change, energy, food security, agriculture, supply chain resilience, and national and economic security.”

It continues, “Central to this policy and its outcomes are principles of equity, ethics, safety, and security that enable access to technologies, processes, and products in a manner that benefits all Americans and the global community and that maintains United States technological leadership and economic competitiveness.”

Caution urged

Among the Biden administration’s promises in the executive order is a vow to “substitute fragile supply chains from abroad with strong chains at home.” But not everyone agrees that a government effort to manipulate the supply chain is the smartest strategy for the long run.

“Government can play a role in funding basic research, university labs and the rest, but when it starts micromanaging supply chains, you end up with more fragile supply chains than robust ones,” Scott Lincicome, a director for general economics and trade at the Libertarian-leaning Cato Institute, told VOA.

Similarly, he said, government decisions to privilege “onshore” production over foreign producers can be dangerous.

“There’s nothing wrong with domestic manufacturing, but as we’ve learned throughout the pandemic, there’s a big problem with putting all of your eggs in one basket, either all foreign or all domestic,” Lincicome said.

“While onshoring can insulate you from foreign shocks, it makes you far more vulnerable to domestic shocks,” he added. “And in the process, it makes you poorer and weaker overall. The best approach is to have a very open, diverse global supply chain with domestic networks, foreign suppliers, and a very light government touch on trade, investment, talent and the rest.”

Multiple aims

The executive order lays out a number of areas in which the Biden administration plans to flex the federal government’s muscle, including the domestic manufacturing of biotechnology products. The aim is to encourage both the creation of domestic manufacturing facilities, as well as the supply chains of fuel and raw materials needed to operate them.

The administration also promises to help create markets for biotechnology products by increasing mandatory purchasing requirements for federal agencies.

In addition, the executive order proposes to push more funding into research and development and to provide innovators support in the form of federal data that helps identify unmet needs. Other efforts will include job training programs, streamlined regulatory approval of new products, and cooperative programs with international partners.

Mending fences

The administration’s push to help U.S. biotechnology firms could go some way toward mending fences with the industry, which was angered by elements of the Inflation Reduction Act (IRA), which Biden recently signed into law.

The IRA, for the first time, allows Medicare, the government health insurance program for senior citizens, to bargain with pharmaceutical firms over the prices of some prescription drugs. Many in the industry strongly opposed the measure, claiming it would reduce incentives to innovate.

The executive order comes less than a week after the Biotechnology Innovation Organization sent a letter to the administration requesting it to “take additional steps to foster the development and deployment of pioneering technologies that will further reduce greenhouse gas emissions in manufacturing, transportation, and agricultural supply chains to build a stronger, more resilient, and environmentally sustainable economy.”

Biden signed the order before traveling to Boston, where he was scheduled to tout the results of the infrastructure bill he signed last year, which pumped federal money into a wide array of construction projects.

Also on Monday, Biden named Renee Wegrzyn, a biotechnology executive, to head the new Advanced Research Projects Agency for Health. The announcement came as part of a discussion of Biden’s “moonshot” initiative to drive new research on treatments for cancer.
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President Joe Biden on Monday urged Americans to come together for a new “national purpose” — his administration’s effort to end cancer “as we know it.”

At the John F. Kennedy Presidential Library and Museum, Biden channeled JFK’s famed moonshot speech 60 years ago, likening the space race to his own effort and hoping it, too, would galvanize Americans.

“He established a national purpose that could rally the American people and a common cause,” Biden said of Kennedy’s space effort, adding that “we can usher in the same unwillingness to postpone.”

Biden hopes to move the U.S. closer to the goal he set in February of cutting U.S. cancer fatalities by 50% over the next 25 years and to dramatically improve the lives of caregivers and those suffering from cancer. Experts say the objective is attainable — but with adequate investments.

The president called his goal of developing treatments and therapeutics for cancers “bold, ambitious, and I might add, completely doable.”

In his speech, Biden called on the private sector to make drugs more affordable and data more regularly available. He ticked off medical advancements possible with focused research, funding and data.

And he spoke of a new federally backed study that seeks evidence for using blood tests to screen against multiple cancers — a potential game-changer in diagnostic testing to dramatically improve early detection of cancers.

Danielle Carnival, the White House coordinator for the effort, told The Associated Press that the administration sees huge potential in the commencement of the blood diagnostic study on identifying cancers.

“One of the most promising technologies has been the development of blood tests that offer the promise of detecting multiple cancers in a single blood test and really imagining the impact that could have on our ability to detect cancer early and in a more equitable way,” Carnival said. “We think the best way to get us to the place where those are realized is to really test out the technologies we have today and see what works and what really has an impact on extending lives.”

In 2022, the American Cancer Society estimates, 1.9 million new cancer cases will be diagnosed and 609,360 people will die of cancer diseases. The Centers for Disease Control and Prevention rank cancer as the second-highest killer of people in the U.S. after heart disease.

The issue is personal to Biden, who lost his adult son Beau in 2015 to brain cancer. After Beau’s death, Congress passed the 21st Century Cures Act, which dedicated $1.8 billion over seven years for cancer research and was signed into law in 2016 by President Barack Obama.

Obama designated Biden, then vice president, to run “mission control” on directing the cancer funds as a recognition of Biden’s grief as a parent and desire to do something about it. Biden wrote in his memoir Promise Me, Dad that he chose not to run for president in 2016 primarily because of Beau’s death.

Despite Biden’s attempts to hark back to Kennedy and his space program, the current initiative lacks that same level of budgetary support. The Apollo program garnered massive public investment — more than $20 billion, or more than $220 billion in 2022 dollars adjusted for inflation. Biden’s effort is far more modest and reliant on private sector investment.

Still, he’s tried to maintain momentum for investments in public health research, including championing the Advanced Research Projects Agency for Health (ARPA-H), modeled after similar research and development initiatives benefiting the Pentagon and intelligence community.

On Monday, Biden announced Renee Wegrzyn as the inaugural director of ARPA-H, which has been given the task of studying treatments and potential cures for cancers, Alzheimer’s, diabetes and other diseases. He also announced a new National Cancer Institute scholars’ program to provide funding to early-career scientists studying treatments and cures for cancer, with a focus on underrepresented groups and those from diverse backgrounds.

The president was joined by Caroline Kennedy, the daughter of JFK who is now the U.S. ambassador to Australia. And he was expected to speak later in the day at a fundraiser for the Democratic National Committee.

Experts agree it’s far too early to say whether these new blood tests for finding cancer in healthy people will have any effect on cancer deaths. There have been no studies to show they reduce the risk of dying from cancer. Still, they say setting an ambitious goal is important.

Carnival said the National Cancer Institute study was designed so that any promising diagnostic results could be swiftly put into widespread practice while the longer-term study — expected to last up to a decade — progresses. She said the goal was to move closer to a future where cancers could be detected through routine bloodwork, potentially reducing the need for more invasive and burdensome procedures like colonoscopies, and therefore saving lives.

Scientists now understand that cancer is not a single disease, but hundreds of diseases that respond differently to different treatments. Some cancers have biomarkers that can be targeted by existing drugs that will slow a tumor’s growth. Many more targets await discovery.

“How do we learn what therapies are effective in which subtypes of disease? That to me is oceanic,” said Donald A. Berry, a biostatistician at the University of Texas M.D. Anderson Cancer Center. “The possibilities are enormous. The challenges are enormous.”

Despite the challenges, he’s optimistic about cutting the cancer death rate in half over the next 25 years.

“We can get to that 50% goal by slowing the disease sufficiently across the various cancers without curing anybody,” Berry said. “If I were to bet on whether we will achieve this 50% reduction, I would bet yes.”

Even without new breakthroughs, progress can be made by making care more equitable, said Dr. Crystal Denlinger, chief scientific officer for the National Comprehensive Cancer Network, a group of elite cancer centers.

And any effort to reduce the cancer death rate will need to focus on the biggest cancer killer, which is lung cancer. Mostly attributable to smoking, lung cancer now causes more cancer deaths than any other cancer. Of the 1,670 daily cancer deaths in the United States, more than 350 are from lung cancer.

Dr. Michael Hassett of the Dana-Farber Cancer Institute in Boston said Biden’s goal to reduce cancer deaths could be met by following two parallel paths: one of discovery and the other making sure as many people as possible are reaping the advantages of existing therapies and preventive approaches.

“If we can address both aspects, both challenges, major advances are possible,” Hassett said.
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The European Medicines Agency (EMA) on Monday recommended a COVID-19 booster designed to combat the currently circulating Omicron BA.4/5 subvariants, days after endorsing a pair of boosters tailored to target the older BA.1 Omicron variant.

The latest recommendation is for a so-called bivalent vaccine developed by Pfizer PFE.N and BioNTech 22UAy.DE, which targets BA.4/5 as well as the strain of the virus that originally emerged in China in December 2019 targeted by earlier COVID vaccines.

The EMA recommendation is to authorize the retooled booster shots for people aged 12 and above who have received at least primary vaccination against COVID. The final go-ahead will be subject to European Commission approval, which is expected to come shortly.

If authorized, the BA.4/5-tailored booster will be available in days to all 27 EU member states, Pfizer said in a statement on Monday.

While existing coronavirus vaccines provide good protection against hospitalization and death, their effectiveness, particularly against infection, was reduced as the virus evolved.

Earlier this month, the EMA endorsed both Pfizer-BioNTech and Moderna’s MRNA.O vaccines updated for BA.1.

EU officials signaled in recent months they were open to initially using boosters targeting the older BA.1 variant, given those specifically targeting the newer, now dominant Omicron BA.4/5 offshoots are further behind in development.

In contrast, the U.S. Food and Drug Administration insisted it was only interested in vaccines targeting BA.4/5. Last week, Pfizer-BioNTech and Moderna secured U.S. authorization for those despite limited available clinical data.

Given BA.1’s earlier emergence, data from human trials testing those redesigned vaccines has been submitted to EU regulators. For the BA.4/5 adapted vaccines, regulatory submissions are largely based on lab and animal studies.

Using animal and lab data to solicit regulatory approval is done regularly for flu vaccines that are revamped each year to combat the latest circulating strains.

On Monday, the EMA said its backing of the Pfizer-BioNTech updated BA.4/5 shot relied partly on data from human clinical trials available on the companies’ BA.1-tailored vaccine.

A clinical trial testing the Pfizer-BioNTech BA.4/5 vaccine in humans was initiated in early September, and data should be available later this autumn. Meanwhile, human trial data on Moderna’s BA.4/5 shot is expected by later this month or early October.

EU officials have encouraged member states to roll out boosters of the established original vaccines and the bivalent shots — whatever is readily available — for the vulnerable and elderly following a rise in summer infections, as protection waned due to the domination of BA.4 and especially BA.5.

Uptake could be limited, as people have become less worried about the disease, thanks in large part to the success of the first generation of shots. Experts also worry that the public may be suffering from vaccine fatigue and less likely to seek the boosters, which could be a fourth or fifth COVID shot for some.
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Jeff Bezos’ rocket company suffered its first launch failure Monday. No one was aboard, only science experiments. 

The Blue Origin rocket veered off course over West Texas about a minute after liftoff. The capsule’s launch abort system immediately kicked in, lifting the craft off the top. Several minutes later, the capsule parachuted onto the remote desert floor. 

Blue Origin’s launch commentary went silent when the capsule catapulted off the rocket, later announcing: “It appears we’ve experienced an anomaly with today’s flight. This wasn’t planned.” 

The mishap occurred as the rocket was traveling nearly 700 mph (1,126 kph) at an altitude of about 28,000 feet (8,500 meters). There was no video shown of the rocket — only the capsule — after the failure occurred. The rocket usually lands upright on the desert floor and then is recycled for future flights; clearly, that did not happen this time. 

Launch commentator Erika Wagner said the capsule managed to escape successfully, with the webcast showing it reaching a maximum altitude of more than 37,000 feet (11,300 meters). Thirty-six experiments were on board, half sponsored by NASA. 

“Booster failure on today’s uncrewed flight. Escape system performed as designed,” the company tweeted later. 

No further details were provided. 

It was the 23rd flight for the New Shepard program, named after the first American in space, Mercury astronaut Alan Shepard. The same kind of rocket and capsule have been used to carry paying passengers on 10-minute rides to the edge of space. It was the ninth flight for this rocket. 

Its most recent passenger flight was just last month. Bezos was on the first New Shepard crew last summer. Altogether, Blue Origin has carried 31 people to the edge of space. The company’s headquarters is in Kent, Washington. 

 
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When Emmanuel Obeng-Dankwa is worried about making rent on his New York City apartment, he sometimes holds off on filling his blood pressure medication. 

“If there’s no money, I prefer to skip the medication to being homeless,” said Obeng-Dankwa, a 58-year-old security guard. 

He is among a majority of adults in the U.S. who say that health care is not handled well in the country, according to a new poll from The Associated Press-NORC Center for Public Affairs Research.

The poll reveals that public satisfaction with the U.S. health care system is remarkably low, with fewer than half of Americans saying it is generally handled well. Only 12% say it is handled extremely or very well. Americans have similar views about health care for older adults. 

Overall, the public gives even lower marks for how prescription drug costs, the quality of care at nursing homes and mental health care are being handled, with just 6% or less saying those health services are done very well in the country. 

“Navigating the American health care system is exceedingly frustrating,” said A. Mark Fendrick, the director of the University of Michigan Center for Value-Based Insurance Design. “The COVID pandemic has only made it worse.” 

More than two years after the pandemic’s start, health care worker burnout and staffing shortages are plaguing hospitals around the country. And Americans are still having trouble getting in-person medical care after health centers introduced restrictions as COVID-19 killed and sickened millions of people around the country, Fendrick said. 

In fact, the poll shows an overwhelming majority of Americans, nearly 8 in 10, say they are at least moderately concerned about getting access to quality health care when they need it.

Black and Hispanic adults in particular are resoundingly worried about health care access, with nearly 6 in 10 saying they are very or extremely concerned about getting good care. Fewer than half of white adults, 44%, expressed the same level of worry. 

Racial disparities have long troubled America’s health care system. They have been abundantly clear during the COVID-19 pandemic, with Black and Hispanic people dying disproportionately from the virus. Black and Hispanic men also make up a disproportionately high rate of recent monkeypox infections.

Fifty-three percent of women said they are extremely or very concerned about obtaining quality care, compared to 42% of men. 

While Americans are united in their dissatisfaction with the health care system, that agreement dissolves when it comes to solutions to fix it. 

About two-thirds of adults think it is the federal government’s responsibility to make sure all Americans have health care coverage, with adults ages 18 to 49 more likely than those over 50 to hold that view. The percentage of people who believe health care coverage is a government responsibility has risen in recent years, ticking up from 57% in 2019 and 62% in 2017. 

Still, there’s not consensus on how that coverage might be delivered. 

About 4 in 10 Americans say they support a single-payer health care system that would require Americans to get their health insurance from a government plan. More, 58%, say they favor a government health insurance plan that anyone can purchase. 

There also is broad support for policies that would help Americans pay for the costs of long-term care, including a government-administered insurance plan similar to Medicare, the federal government’s health insurance for people 65 or older.

Retired nurse Pennie Wright, of Camden, Tennessee, doesn’t like the idea of a government-run health care system. 

After switching to Medicare this year, she was surprised to walk out of her annual well-woman visit, once fully covered by her private insurance plan, with a $200 bill. 

She prefers the flexibility she had on her private insurance plan. 

“I feel like we have the best health care system in the world, we have a choice of where we want to go,” Wright said. 

A majority of Americans, roughly two-thirds, were happy to see the government step in to provide free COVID-19 testing, vaccines and treatment. Roughly 2 in 10 were neutral about the government’s response. 

The government’s funding for free COVID-19 tests dried up at the beginning of the month. And while the White House says the latest batch of recommended COVID-19 boosters will be free to anyone who wants one, it doesn’t have money on hand to buy any future rounds of booster shots for every American. 

Eighty percent say they support the federal government negotiating for lower drug prices. President Joe Biden this summer signed a landmark bill into law allowing Medicare to negotiate the price of prescription drugs. The move is expected to save taxpayers as much as $100 billion over the next decade. 

“Medication costs should be low, to the minimum so that everyone can afford it,” said Obeng-Dankwa, the Bronx renter who has trouble paying for his medication. “Those who are poor should be able to get all the necessary health they need, in the same way someone who also has the money to pay for it.”
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New York Governor Kathy Hochul declared a disaster emergency Friday in a bid to accelerate efforts to vaccinate residents against polio after the virus was detected in wastewater samples taken in four counties. 

Hochul’s executive order followed the discovery of the virus last month in samples from Long Island’s Nassau County, bordering the New York City borough of Queens. Earlier this year the virus was found in samples from Rockland, Orange and Sullivan counties, all north of the city.  

In July, the first confirmed case of polio in the United States in nearly a decade turned up in an adult in Rockland County, according to the state health department. 

“On polio, we simply cannot roll the dice,” State Health Commissioner Mary Bassett said in a statement. “If you or your child are unvaccinated or not up to date with vaccinations, the risk of paralytic disease is real.” 

Polio can cause irreversible paralysis in some cases, but it can be prevented by a vaccine first made available in 1955. While there is no known cure, three injections of the vaccine provide nearly 100% immunity. 

People of all ages are under threat, though the virus primarily affects children age 3 and younger.  

Officials urged inoculations for unvaccinated adults and children as young as 2 months, and they advised that vaccinated people receive a lifetime booster dose. 

Hochul’s declaration authorizes paramedics, midwives and pharmacists to administer polio vaccinations, among other steps, to accelerate inoculation rates. The order also directs health care providers to update the state with data on immunizations. 

The state of emergency will stay in effect until October 9. Health officials set a goal of getting 90% of residents vaccinated. 

The state health department warned that people in New York City and Rockland, Orange, Sullivan and Nassau counties are at the highest risk.  

Orange County has the lowest vaccination rate of the counties of concern with less than 59% being immunized, according to the state health department. 
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NASA’s moon mission suffers another setback, this time delaying a test launch for at least a few weeks. Plus, a look back at the first color images of Mars, and we wish a very happy birthday to a TV space pioneer. VOA’s Arash Arabasadi brings us The Week in Space.  
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The introduction of a nationwide mental health hotline has increased the numbers of people calling for help in the United States and the need for more counselors to answer their calls. For VOA, Svitlana Prystynska has this story from the Western state of Colorado. Camera – Vladimir Petruniv.
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The World Health Organization is warning of a resurgence of deadly meningitis in Africa because COVID-19 has disrupted lifesaving vaccination campaigns.

The near elimination of the deadly form of meningitis type A in Africa is one of the continent’s biggest health success stories. Over the last 12 years, about 350 million Africans have received a single dose of MenAfriVac, a vaccine designed specifically for the African meningitis belt.  

The WHO regional director for Africa, Matshidiso Moeti, said not a single case of meningitis Group A has been reported on the continent in the past five years.

“Now, however, the COVID-19 pandemic has delayed vaccination campaigns targeting more than 50 million African children, raising the risk that these gains will be reversed,” she said. “In addition, major outbreaks caused by meningitis Group C have been recorded in seven of the African Sub-Saharan meningitis belt countries in the past nine years.”

Moeti noted a four-month outbreak last year in the Democratic Republic of Congo claimed more than 200 lives.  

Francois Marc Laforce, director of technical services for the Serum Institute of India, played a pivotal role in the development of the MenAfriVac vaccine at the Serum Institute nearly two decades ago. He said that besides meningitis Group C, Africa currently is contending with residual outbreaks of other forms of meningitis.

“A new vaccine again specifically designed for the African meningitis belt will, hopefully, be prequalified later this year or early next year,” he said. But this vaccine holds the promise of finishing what MenAfriVac began, such that Africa may be the first continent to be free of meningitis epidemics.”  

Meningitis is caused by inflammation of the membranes that surround the brain and spinal cord. Acute bacterial meningitis can cause death within 24 hours.  Young children are most at risk. About half the cases and deaths occur in children under age five.

The WHO launched a new strategy Thursday to defeat bacterial meningitis in the African region by 2030. The plan calls for shoring up diagnosis, surveillance, care, and vaccination. The WHO estimates $1.5 billion will be needed to implement the plan between now and 2030.
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A new malaria vaccine developed by Britain’s University of Oxford is 80% effective in preventing infection, according to trial results published Thursday in The Lancet medical journal. Scientists say it represents a huge breakthrough that has the potential to save millions of lives and eventually eradicate the disease.

The vaccine, named R21/Matrix-M, had already shown encouraging trial results after three primary doses. Maintaining that immunity has always been a big challenge and the latest trial shows that a booster dose is effective, explained Professor Adrian Hill, the director of the Jenner Institute at the University of Oxford and co-author of The Lancet paper. 

“The technology has been complex to develop because we need very strong antibody responses to get protection against malaria and those antibodies, like all responses, decline over time,” Hill told VOA. 

“One of the worries was that this would be short-term protection and only last for a few months. That’s definitely not the case with the data we’re releasing today,” Hill said. “And indeed, 80% efficacy in the second year of follow up after a booster dose is really very encouraging in that respect.” 

The latest phase II trial involved 450 children between 5 and 17 months old, recruited from the Nanoro region in Burkina Faso. The results show a higher strength booster dose was 80% effective in preventing malaria infection. No serious side effects were seen. 

“This is a parasite we’re trying to vaccinate against. It’s not a virus. It’s got thousands of genes. [So it’s] complex to design a vaccine,” Hill said. “Over 100 have been in clinical trials and this looks like the best data so far. So we’re excited.” 

The Serum Institute of India, which has produced billions of doses of the Oxford-AstraZeneca COVID-19 vaccine, is producing the R21/Matrix-M malaria vaccine. It has signed an agreement to rapidly scale up production if the vaccine receives World Health Organization (WHO) approval in coming months. 

“We’re trying to do something similar with malaria, to produce a low-cost vaccine — a few dollars a dose — and to manufacture that really upscale so we can get 100 million doses or more out there as soon as possible,” Hill told VOA. 

Malaria killed an estimated 627,000 people in 2020, the most recent available data. The majority are children under five years old in sub-Saharan Africa. 

The WHO approved the first-ever malaria vaccine in October of last year, called RTS,S. But R21 may offer even greater hope, said Hill. 

“A vaccine with high efficacy like this should be able to save hundreds of thousands of lives a year and ultimately millions of lives over the next decade or so,” he said. “After we get a vaccine rolled out for that very vulnerable population, we’ll be looking at a travelers’ vaccine and then we’ll be looking at a vaccine that could actually eliminate regionally and eradicate globally this terrible disease.” 

Results from the ongoing phase III trial involving 4,800 children are due later this year and it’s hoped that mass production and rollout can begin in 2023, following WHO approval. 
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A panel of federal health advisers voted Wednesday to recommend approval for an experimental drug to treat Lou Gehrig’s disease, a remarkable turnaround for the much-debated medication that was previously rejected by the same group earlier this year.

The Food and Drug Administration advisers voted 7-2 that data from Amylyx Pharma warranted approval, despite hours of debate about the strength and reliability of the company’s lone study. The FDA is not required to follow the group’s advice, but its positive recommendation suggests an approval is likely later this month.

The FDA has approved only two therapies for the disease, amyotrophic lateral sclerosis, or ALS, which destroys nerve cells needed for basic functions like walking, talking and swallowing.

Patients support drug

ALS patients and their families have rallied behind Amylyx’s drug, launching an aggressive lobbying campaign and enlisting members of Congress to push the FDA to grant approval.

Despite a negative review published by FDA’s internal scientists ahead of the meeting, a majority of the outside panelists said Amylyx had presented enough evidence to suggest the drug is helping patients live longer. The same group of neurology experts narrowly voted against the drug in March, because of concerns about missing data and other issues in the company’s study.

“To deprive ALS patients of a drug that might work, it’s probably not something I would feel terribly comfortable with,” said Dr. Liana Apostolova of Indiana University’s School of Medicine, who voted for approval. “At the previous meeting it wasn’t that clear and it’s still questionable.”

Amylyx also appeared to benefit from an unusual exchange in which a company executive — at the FDA’s request — committed to pull the drug from the market if its benefits aren’t confirmed by a large, ongoing study.

The FDA has the power to force companies to pull drugs from the market, though it’s generally faster if drugmakers voluntarily take that step. In cases where companies resist removal the regulatory process can drag on for years.

New data prompts second look

Wednesday’s vote concluded a rare second meeting to review several new statistical analyses submitted by Amylyx in support of the treatment’s benefit in slowing disease and extending life.

The ALS drug review is being closely watched as an indicator of FDA’s flexibility in reviewing experimental medications for the terminally ill and its ability to withstand outside pressure.

Amylyx conducted one small, mid-stage trial of its drug that showed some benefit in slowing the disease, but it was plagued by missing data and other problems, according to FDA reviewers.

“The final result — for a single study — is borderline and not very statistically persuasive,” FDA statistician Tristan Massie told panelists.

Company says data shows drug extends life

The Cambridge, Massachusetts, company says follow-up data gathered after the study concluded showed the drug extended life. Patients who continued taking the drug survived about 10 months longer than patients who never took the drug, according to a new company analysis.

Panelists favoring the drug cited that data, along with the drug’s mild side effects, to suggest there would be little downside for patients even if it doesn’t ultimately slow ALS.

Hanging over the review is FDA’s controversial approval of the Alzheimer’s drug Aduhelm last year, which was reviewed by the same agency scientists and outside advisers.

In that case, the FDA disregarded the overwhelmingly negative vote by its outside advisers, three of whom resigned over the decision. The agency’s approval — which followed irregular meetings with drugmaker Biogen — is under investigation by Congress and federal inspectors.
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As the world grapples with multiple climate-related disasters on different continents, a watchdog group in Washington is pressing the Biden administration to take more aggressive action to reduce emissions in the United States.

A report, issued by the liberal-leaning Revolving Door Project, outlines a wide number of actions that the group believes President Joe Biden can implement by executive action, meaning that he would not need to coax cooperation from U.S. lawmakers currently preoccupied with looming midterm elections.

Headlines this week underscore the challenges facing the planet. As the report was issued, Pakistan was suffering from catastrophic floods that have displaced tens of thousands and ravaged crops; a powerful typhoon recently dropped a meter of rain on South Korea; China is suffering its worst heat wave on record; and the western United States is gripped by a drought of historic severity.

The Environmental Protection Agency may seem like the most obvious focus of the report’s attention, and the list of steps that agency might take is indeed long. However, the report also homes in on actions available to many other federal agencies, such as the Department of Justice and the Department of Defense, that are not typically associated with climate change issues.

“Every part of the government should be thinking very much about how to consider climate in the work that they do — how to incorporate it into their existing mandates to protect their various domains, and to be thinking and acting very creatively and aggressively on this,” Max Moran, a research director at the Revolving Door Project and one of the report’s authors, told VOA.

EPA urged to act

The Environmental Protection Agency has the most expansive authority over climate-related issues in the federal government, but its enforcement capacity was significantly reduced during the Trump administration.

“The EPA can be one of the most powerful governmental actors in the United States when it is given the resources and direction to effectively implement its mandate,” the Revolving Door Project notes. “It has broad authority to police pollution and environmental degradation to minimize environmental destruction and public health impacts.”

The report urges the agency to be more aggressive in punishing corporations that violate environmental regulations, pointing out that penalties handed out by the agency often involve companies hiring their own auditors to assure future compliance or funding projects that have little to do with mitigating the damage they have caused.

As the agency works to reinvigorate its enforcement capacity, the report recommends multiple other ways in which it can step up its policing of rules regulating some of the most environmentally damaging emissions, including the powerful greenhouse gas methane.

 

Departments of Interior, Justice

The report notes a number of measures available to the Department of the Interior to reduce carbon emissions, one of the largest of which is capping abandoned oil and gas wells. Although old wells are not commercially viable, they still emit thousands of tons of methane into the environment every year, and capping them would greatly reduce the volume of gas that escapes.

In addition, the report calls on Interior to stop leasing federal land to energy companies for further development of fossil fuel extraction operations and to reform mining regulations to reduce damage to the environment from factors including the degradation of water sources and the runoff of dangerous chemicals.

The Department of Justice, the report argues, is insufficiently aggressive about prosecuting criminal violations of environmental laws.

“Environmental litigation is key to ensuring that companies and individuals comply with environmental laws,” it says. “Without the threat of litigation, the laws protecting ecosystems and public health are toothless.”

It notes that one government database identifies “thousands of facilities across the country with multiple significant violations” that have remained out of compliance for years without facing prosecution.

Administration shifts climate team

There is reason to believe the Biden administration is prepared to focus more on executive action than it has in the first year and a half of the president’s term. For most of that time, Biden was trying to negotiate with a balky Congress on major environmental legislation, and aggressive action by the executive branch might have made agreement more difficult to reach.

Now, however, with the passage of the Inflation Reduction Act (IRA), which included the largest investment in green energy and other climate-conscious programs in history, the likelihood of further legislation is unlikely in the near term.

Last week, Biden announced that he has hired a veteran Washington insider, John Podesta, as a senior adviser in charge of rolling out the billions in tax incentives and other programs put in place by the IRA.

At the same time, Biden announced the promotion of Ali Zaidi to national climate adviser, to replace the departing Gina McCarthy. Zaidi is a veteran of the Obama administration where, for eight years, he served in a variety of posts related to climate policy.

In a statement announcing the nomination, Biden seemed to signal that more executive action is coming.

“The Inflation Reduction Act is the biggest step forward on clean energy and climate in history, and it paves the way for additional steps we will take to meet our clean energy and climate goals,” the president said.

While the IRA earned the support of some Republicans in Congress, there is significant resistance in the GOP to greater regulation in general, and greater environmental regulation in particular. If the Biden administration does become more assertive about environmental regulation, Republicans will have little recourse in the near term. However, they are likely to use the issue to try to drive turnout in both November’s midterm elections and the 2024 presidential election.
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Electronic cigarette maker Juul Labs has agreed to pay nearly $440 million to settle a two-year investigation by 33 U.S. states into the marketing of its high-nicotine vaping products, which have long been blamed for sparking a national surge in teen vaping.

Connecticut Attorney General William Tong announced the deal Tuesday on behalf of the states plus Puerto Rico, which joined together in 2020 to probe Juul’s early promotions and claims about the benefits of its technology as a smoking alternative.

The settlement, which includes numerous restrictions on how Juul can market its products, resolves one of the biggest legal threats facing the beleaguered company, which still faces nine separate lawsuits from other states. Additionally, Juul faces hundreds of personal lawsuits brought on behalf of teenagers and others who say they became addicted to the company’s vaping products.

The states’ investigation found that Juul marketed its e-cigarettes to underage teens with launch parties, product giveaways and ads and social media posts using youthful models, according to a statement.

“We think that this will go a long way in stemming the flow of youth vaping,” Tong said at a news conference at his Hartford office.

“I’m under no illusions and cannot claim that it will stop youth vaping,” he said. “It continues to be an epidemic. It continues to be a huge problem. But we have essentially taken a big chunk out of what was once a market leader, and by their conduct, a major offender.”

The $438.5 million will be paid out over a period of six to 10 years. Tong said Connecticut’s payment of at least $16 million will go toward vaping prevention and education efforts. Juul previously settled lawsuits in Arizona, Louisiana, North Carolina and Washington.

The settlement total amounts to about 25% of Juul’s U.S. sales of $1.9 billion last year. Tong said it was an “agreement in principle,” meaning the states will be finalizing the settlement documents over the next several weeks.

Most of the limits imposed by Tuesday’s settlement won’t immediately affect Juul, which halted use of parties, giveaways and other promotions after coming under scrutiny several several years ago.

Teen use of e-cigarettes skyrocketed after Juul’s launch in 2015, leading the U.S. Food and Drug Administration to declare an “epidemic” of underage vaping among teenagers. Health experts said the unprecedented increase risked hooking a generation of young people on nicotine.

But since 2019 Juul has mostly been in retreat, dropping all U.S. advertising and pulling its fruit and candy flavors from store shelves.

The biggest blow came earlier this summer when the FDA moved to ban all Juul e-cigarettes from the market. Juul challenged that ruling in court, and the FDA has since reopened its scientific review of the company’s technology.

The FDA review is part of a sweeping effort by regulators to bring scrutiny to the multibillion-dollar vaping industry after years of delays. The agency has authorized a handful of e-cigarettes from Juul’s competitors for adult smokers looking for a less harmful alternative.

While Juul’s early marketing focused on young, urban consumers, the company has since shifted to pitching its product as an alternative nicotine source for older smokers.

“We remain focused on our future as we fulfill our mission to transition adult smokers away from cigarettes—the number one cause of preventable death—while combating underage use,” the company said in a statement.

Juul has agreed to refrain from a host of marketing practices as part of the settlement. They include not using cartoons, paying social media influencers, depicting people under 35, advertising on billboards and public transportation and placing ads in any outlets unless 85% of their audience are adults.

The deal also includes restrictions on where Juul products may be placed in stores, age verification on all sales and limits to online and retail sales.

“These are some of the toughest mandates at any point on any industry,” Tong said, “which is incredibly important because at the end of the day this is about protecting our kids and protecting all of us from a very significant public health risk.”

Juul initially sold its high-nicotine pods in flavors like mango, mint and creme. The products became a scourge in U.S. high schools, with students vaping in bathrooms and hallways between classes.

But recent federal survey data shows that teens have been shifting away from the company. Most teens now prefer disposable e-cigarettes, some of which continue to be sold in sweet, fruity flavors.

Overall, the survey showed a drop of nearly 40% in the teen vaping rate as many kids were forced to learn from home during the pandemic. Still, federal officials cautioned about interpreting the results given they were collected online for the first time, instead of in classrooms.
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