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SYDNEY — Researchers in Australia have developed a drug that could revolutionize treatment for millions of diabetes patients around the world.  

Scientists in the U.S., China and Australia are designing treatments that imitate the body’s natural response to changing blood glucose, or sugar, levels and respond instantly.  

The Australian team is handling one of several research projects that have developed different types of so-called ‘smart insulins,’ which sits in the body of a diabetes patient and is activated only when it is needed. 

The aim is to keep glucose levels within a safe range, avoiding excessively high blood glucose, which is called hyperglycaemia, and excessively low blood sugar levels, known as hypoglycaemia.    

The new treatments are not cures for diabetes but could ease the burden on patients.

Australian researchers say their new insulin delivery method would offer one injection every three days. Patients currently have to administer synthetic insulin up to 10 times a day.

Christoph Hagemeyer, a professor at the Australian Center for Blood Diseases at Monash University and a lead researcher in the study, told Australian Broadcasting Corp. Tuesday how the technology works.

“Smart insulin is responding to sugar levels in the blood,” he said. “In our case we are not actually making the insulin molecule smart, but we are loading the insulin onto a nanoparticle, which has a built-in mechanism that it changes its charge from positive to negative when the sugar levels go up. And that is the trick how we can ensure that there is enough insulin onboard and it is released in a smart manner.”   

Insulin is a type of hormone that lowers the level of glucose in the blood. Glucose is a type of sugar from food that gives people energy.

Diabetes affects glucose levels in the blood and is normally split into type 1 and type 2, the most common.  Patients have a heightened risk of heart attack, stroke, and kidney failure.  

Monash University in Melbourne is part of a global effort to develop different types of smart insulins. It includes teams at Stanford University in the United States and Zhejiang University in China.  Each project aims to develop smart insulin to act faster and more accurately to help patients with diabetes and to start trials as soon as possible.  

The World Health Organization has estimated that about 422 million people around the world have diabetes and that 1.5 million deaths are directly attributed to the chronic disease each year. 
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Harare — Zimbabwean authorities recently declared the end of a cholera outbreak which lasted nearly 18 months, but public health experts say the conditions which caused the waterborne disease still exist and need urgent attention.

After battling a cholera outbreak which began in February of last year, Zimbabwe gave the ‘all clear’ after saying no new cases were recorded in July. The last reported case was in June. During the outbreak, the country recorded 34,549 suspected cases and more than 700 deaths.  

Dr. Douglas Mombeshora is Zimbabwe’s health minister.

“What it means really is to say the interventions that we undertook as government have yielded [the] results that we wanted, that is to make sure that we suppress cholera. There are other issues that we have to continue working on. Because the bug is still in the community,” he said.

Itai Rusike, the executive director of Community Working Group on Health in Zimbabwe, said while his organization welcomed the news of a cholera-free country, more work needs to be done.

“We had major concerns about the illness and the unnecessary loss of lives from avoidable and preventable deaths. … As a country that experienced the devastation of the 2008-2009 cholera outbreak, we seem not to have derived learning from that and subsequent ones. The cholera outbreaks of 2008-2009 were a marker of the need for investment in water and sanitation infrastructure,” said Rusike.

The government and World Health Organization say Zimbabwe had 98,592 cases and 4,288 deaths during the 2008-2009 outbreak.

Speaking to VOA, Dr. Desta Tiruneh, the World Health Organization representative for Zimbabwe, said eradication means the country can now concentrate on other health concerns.

But he hastened to add, “The underlying factors that contributed to the transmission of cholera are still prevailing. These include access to safe water supply, sanitation facilities and hygiene, plus some other misconceptions among the communities that also fuel transmission. Therefore, we have to focus our priorities in addressing these issues, like provision of water supply should be prioritized for those communities where there is high risk of cholera transmission. … In addition, the government should prioritize in focusing in these high-risk communities to make sure this outbreak does not happen in near future.”

Separately, Doctors Without Borders noted that while eradicating cholera is a big win for Zimbabwe, it “believes more can be done to prevent future outbreaks.” The doctors’ group said there was a need for balance between having timely access to cholera vaccines and ensuring Zimbabwe invests in its water sanitation and hygiene infrastructure in both urban and rural communities.

The group, known by its acronym MSF, is one of the humanitarian organizations that worked with Zimbabwe’s government and U.N. agencies to control the spread of cholera.

Driving around Harare, people were seen walking through heaps of uncollected, fly-infested garbage, while sewage flowed in the streets in some places due to burst sewer pipes in need of repair. In some areas, people have complained of going for days without safe water for household chores and drinking. 
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Beersheba, Israel — At 19, Yoni, an Israeli man, has to put aside his plans to join the military and instead enter rehab for drug abuse that has worsened since Hamas’ October 7 attack.

Health professionals said Yoni’s case is not an exception in wartime Israel, noting a surge in drug and alcohol abuse as well as other addictive behaviors.

Yoni, who asked to use a pseudonym to protect his privacy, told AFP he had started taking drugs recreationally before, but “after the war it seemed to really get worse.”

“It’s just a way to escape from reality, this whole thing,” said the resident of Beersheba in southern Israel who lost a friend, Nir Beizer, in the Hamas attack that sparked the ongoing Gaza war.

Psychiatrist Shaul Lev-Ran, founder of the Israel Center on Addiction, said that “as a natural reaction to emotional stress and as a search for relief, we’ve seen a spectacular rise in the consumption of various addictive sedative substances.”

A study carried out by his team, based in the central city of Netanya, found “a connection between indirect exposure to the October 7 events and an increase in addictive substances consumption” of about 25%.

Lev-Ran told AFP they have identified a rise in the use of “prescription drugs, illegal drugs, alcohol, or addictive behavior like gambling.”

One in 4 Israelis have increased their addictive substance use, according to the study, which was conducted in November and December on a representative sample of 1,000 Israelis. In 2022, before the war, 1 in 7 struggled with drug addiction.

Contacted by AFP, the Palestinian Authority said there was no equivalent data on addiction and mental health for the Palestinian territories.

‘Shock’

The October 7 attack, when Palestinian militants stormed into southern Israel and attacked towns, communities, army bases and an outdoor rave, caused a real “shock” in Israeli society, Lev-Ran said.

The study found that “the closer individuals were to the trauma on October 7, the higher the risk” of addictive behaviors.

The Hamas attack resulted in the deaths of 1,198 people, mostly civilians, according to an AFP tally based on official Israeli figures.

Militants also seized 251 people, 111 of whom are still captive in Gaza, including 39 the Israeli military says are dead.

Israel’s retaliatory military campaign in the Gaza Strip has killed at least 39,790 people, according to health ministry of the Hamas-run territory, which does not give details of civilian and militant deaths.

The Israel Center on Addiction study found an increase in addictive substance consumption among survivors of the October 7 attack, but also among Israelis displaced since then from communities near the Gaza border or in the north, near Lebanon.

“Some who had never consumed addictive substances started using cannabis, some used substances but increased their use, and some were already treated for addiction and relapsed,” said Lev-Ran.

‘Forget’

Lev-Rab said Israel was already “at the outset of an epidemic in which large swathes of the population will develop an addiction to substances.”

The study found that the use of sleeping pills and painkillers has also skyrocketed, by 180% and 70% respectively.

The psychiatrist gave the example of one of his patients, a man who demanded “something” to help him cope and be able to sleep while his son was fighting in Gaza.

At a bar in Jerusalem, Matan, a soldier deployed to the Palestinian territory who gave only his first name for privacy concerns, told AFP that using drugs “helps forget” the harsh reality.

Yoni said that in the early months of the war, his friends and him would take “party drugs like ecstasy, MDMA, LSD” recreationally “in order not to be bored and not to be afraid.”

Then, Yoni started taking drugs “alone at home,” which he said eventually led him to realize “that I need to go to rehab.”

Once out, he wants to complete his military service, Yoni said, to “prove to myself, prove to the family, that I am indeed capable of more, and [can] contribute to the community like everyone else.” 
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Balkhash, Kazakhstan — Seen from the sky, with its turquoise waters stretching out into the desert expanses in the shape of a crescent, you can see why they call Lake Balkhash the “pearl of Kazakhstan.”

But pollution, climate change and its overuse are threatening the existence of one of the most unique stretches of water in the world.

One side of the Balkhash — the biggest lake in Central Asia after the Caspian Sea — has salt water, but on the other it is fresh. In such a strange environment, rare species have abounded. Until now.

“All the miseries of the Balkhash are right under my eyes,” fisherman Alexei Grebennikov told AFP from the deck of his boat on the northern shores, which sometimes has salty water, sometimes fresh.

“There are fewer and fewer fish. It’s catastrophic; the lake is silting up,” warned the 50-year-old.

A dredger to clear the little harbor lay anchored, rusting and unused, off the industrial town of Balkhack, itself seemingly stuck in a Soviet time warp.

“We used to take tourists underwater fishing. Now the place has become a swamp,” said Grebennikov.

In town, scientist Olga Sharipova was studying the changes.

“The Balkhash is the country’s largest fishery. But the quantity of fish goes down when the water level drops, because the conditions for reproduction are disrupted,” she told AFP.

And its level is now only a meter from the critical threshold where it could tilt toward disaster.

There was an unexpected respite this spring when unprecedented floods allowed the Kazakh authorities to divert 3.3 million cubic meters (872 million gallons) of water to the Balkhash.

The Caspian also got a 6-billion-cubic-meter fill-up.

China ‘overusing’ water

But the few extra centimeters have not changed the long-term trend.

“The level of the Balkhash has been falling everywhere since 2019, mainly due to a decrease in the flow of the Ili River” from neighboring China, said Sharipova.

All the great lakes of Central Asia, also known as enclosed seas, share a similar worrying fate.

The Aral Sea has almost disappeared, and the situation is alarming for the Caspian Sea and Lake Issyk-Kul in neighboring Kyrgyzstan.

Located on dry lands isolated from the ocean, they are particularly vulnerable to disturbances “exacerbated by global warming and human activities,” according to leading science journal Nature.

Rising temperatures accelerate evaporation, as water resources dwindle due to the melting of surrounding glaciers.

These issues are compounded by the economic importance of the Balkhash, which is on the path of a Chinese Belt and Road Initiative project, a massive infrastructure undertaking also known as the New Silk Road.

A 2021 study by Oxford University scientists published in the journal Water concluded the lake’s decline resulted from China’s overuse of the Ili River, which feeds it, for its agriculture, including cotton.

“If the hydro-climatic regime of the Ili for 2020-2060 remains unchanged compared to the past 50 years and agriculture continues to expand in China, future water supplies will become increasingly strained,” the study said.

Beijing is a key economic partner for Kazakhstan, but it is less keen to collaborate on water issues.

“The drafting and signing of an agreement with China on the sharing of water in transborder rivers is a key issue,” a spokesperson for the Kazakh Ministry of Water Resources told AFP.

“The main objective is to supply the volumes of water needed to preserve the Balkhash,” it said.

Heavy pollution

The water being syphoned away adds to “pollution from heavy metals, pesticides and other harmful substances,” authorities said, without citing culprits.

The town of Balkhash was founded around Kazakhstan’s largest copper producer, Kazakhmys.

Holiday makers bathing on Balkhash’s municipal beach have a view of the smoking chimneys of its metal plant.

Lung cancer rates here are almost 10 times the regional average, which is already among the highest in the country, health authorities said.

Despite being sanctioned for breaking environmental standards, Kazakhmys denies it is the main polluter of the lake and has vowed to reduce pollution by renewing its equipment.

“Kazakhmys is carrying out protective work to prevent environmental disasters in the Balkhash,” Sherkhan Rustemov, the company’s ecological engineer, told AFP.

In the meantime, the plant continues to discharge industrial waste into another huge body of water, right next to the lake.
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PARIS — Women’s boxing at the Paris Olympics has highlighted the complexity of drafting and enforcing sex eligibility rules for women’s sports and how athletes like Imane Khelif of Algeria and Lin Yu-ting of Taiwan are left vulnerable in the fallout.

When eligibility for women’s events has come into question, it often has been a legally difficult process for sports bodies that has risked exposing athletes to humiliation and abuse. In the 1960s, the Olympics used degrading visual tests intended to verify the sex of athletes.

The modern era of eligibility rules are widely known to have started in 2009, after South African 800-meter runner Caster Semenya surged to stardom on the track as an 18-year-old gold medalist at the world championships.

Semenya, the Olympic champion in the 800 meters in 2012 and 2016, is not competing in Paris because she effectively is banned from doing so unless she medically reduces her testosterone. She is, however, still involved in a legal challenge to track’s rules, now into its seventh year.

Here’s a look at sex tests in sports and the complexity they create amid changing attitudes toward gender identity:

What is the criteria for female participation?

Testosterone levels — not XY chromosomes, which is the pattern typically seen in men — are the key criterion of eligibility in Olympic events where the sport’s governing body has framed and approved rules.

That’s because some women, assigned female at birth and identifying as women, have conditions called differences of sex development, or DSD, that involves an XY chromosome pattern or natural testosterone higher than the typical female range. Some sports officials say that gives them an unfair advantage over other women in sports, but the science is inconclusive.

Semenya, whose medical data proved impossible to keep private during her legal cases — has a DSD condition. She was legally identified as female at birth and has identified as female her whole life.

Testosterone is a natural hormone that increases the mass and strength of bone and muscle after puberty. The normal adult male range rises to multiple times higher than for females, up to about 30 nanomoles per liter of blood compared with less than 2 nmol/L for women.

In 2019, at a Court of Arbitration for Sport hearing, track’s governing body argued athletes with DSD conditions were “biologically male.” Semenya said that was “deeply hurtful.”

Semenya’s case played out very publicly before 2021, when gender identity was a big story at the Tokyo Olympics and in society and sports in general. She took oral contraceptives from 2010-15 to reduce her testosterone levels and said they caused a myriad of unwanted side effects: weight gain, fevers, a constant feeling of nausea and abdominal pain, all of which she experienced while running at the 2011 world championships and 2012 Olympics.

Female athletes of color have historically faced disproportionate scrutiny and discrimination when it comes to sex testing and false accusations that they are male or transgender.

Why does sex verification testing differ between sports?

Each governing body of an Olympic sport is responsible for drafting its own rules, from the field of play to who is eligible to play.

Women’s boxing came to the Paris Games with effectively the same eligibility criterion — an athlete is female in her passport — as at the Rio de Janeiro Olympics in 2016 after the International Boxing Association was permanently banned from the Games following decades of troubled governance and longstanding accusations of a thorough lack of normal transparency. Much has happened in the science and debate in those eight years.

Since the Tokyo Games in 2021, track’s World Athletics tightened the eligibility rules for female athletes with DSD conditions. Starting in March 2023, it required them to suppress their testosterone levels below 2.5 nmol/L for six months, commonly through hormone-suppressing treatment, to be eligible to compete.

That was half the level of 5 nmol/L proposed in 2015 for athletes competing at distances from 400 meters to 1 mile (1.6 kilometers).

World Athletics followed another major sport — World Aquatics — in prohibiting transgender women from competing in women’s races if they had undergone male puberty. The International Cycling Union also took this step last year.

The swim body’s world-leading rules additionally require transgender women athletes who did not benefit from male puberty to maintain testosterone levels below 2.5 nmol/L.

World Aquatics is not actively testing junior athletes. The first step for athletes is that national swim federations “certify their chromosomal sex.”

Similarly, soccer’s world body FIFA defers to its national member federations to verify and register the sex of players.

“No mandatory or routine gender testing verification examinations will take place at FIFA competitions,” it said in a 2011 advisory that is still in force and has been under a lengthy review.

Why do governing bodies care about who identifies as female?

Many sports bodies try to balance inclusion for all athletes and fairness to all on the field of play. They also argue that in contact and combat sports, like boxing, physical safety is a key consideration.

In the Semenya case, the judges at the Court of Arbitration for Sport acknowledged in a 2-1 ruling against her that discrimination against some women was “a necessary, reasonable and proportionate means” to preserve fairness.

Male athletes are not required to regulate their natural levels of testosterone, and female athletes who do not have DSD conditions also can benefit.

“The idea that a testosterone test is some kind of magic bullet is actually not true,” International Olympic Committee spokesperson Mark Adams said in Paris as the women’s boxing debate has raged.

What does the IOC require?

The IOC is at times very powerful and at others not at all.

The Switzerland-based organization manages the “Olympic Charter” book of rules, owns the Olympics brand, picks the hosts and helps fund them through the billions of dollars it earns selling the broadcasting and sponsor rights.

The Olympic sports events, however, are run by the individual governing bodies, like FIFA and World Athletics. They codify and enforce their own athlete eligibility and field-of-play rules as well as disciplinary codes.

So when Olympics sports reviewed and updated how they handled sex eligibility issues, including with transgender athletes, the IOC published advice in 2021, not binding rules.

That was the organization’s framework on gender and sex inclusion that recognized the need for a “safe, harassment-free environment” honoring athletes’ identities while ensuring competitions are fair.

Boxing, however, was different, and the consequences have hit hard in Paris.

The IOC has been in a yearslong and increasingly bitter feud with the International Boxing Association, which is now Russian-led, culminating in a permanent ban from the Olympics last year.

For the second straight Summer Games, the Olympic boxing tournaments have been run by an IOC-appointed administrative committee and not a functioning governing body.

In this dysfunction, boxing eligibility rules have not kept pace with other sports, and the issues weren’t addressed ahead of the Paris Games.

At the 2023 world championships, Khelif and Lin were disqualified and denied medals by the IBA, which said they failed eligibility tests for the women’s competition but has given little information about them. The governing body has contradicted itself repeatedly about whether the tests measured testosterone.

In a chaotic press conference Monday in Paris, IBA officials said they did blood tests on only four of the hundreds of fighters at the 2022 world championships and that it tested Khelif and Lin in response to complaints from other teams, apparently acknowledging an uneven standard of profiling that is considered widely unacceptable in sports.

Who is challenging established rules in some sports?

Before Semenya, there was sprinter Dutee Chand of India who went to the Court of Arbitration for Sport. She challenged track and field’s initial testosterone rules passed in 2011 as a reaction to Semenya.

A first CAS ruling for Chand in 2015 froze the rules and led to an update in 2018, which was then challenged by Semenya. Her career in the 800 stalled because she refused to take medication to artificially suppress her testosterone levels and was barred from competing at elite events.

Semenya lost at CAS in 2019 but went through Switzerland’s supreme court to the European Court of Human Rights, where she scored a landmark, but not total, win last year.

In May, another ECHR hearing in Semenya’s case was held, and a ruling likely will come next year.

The case could be sent back to Switzerland, maybe even back to CAS in the Olympic home city of Lausanne, Switzerland. Other sports are watching and waiting.
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