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Zimbabwe Scores Another First Against HIV In Africa

In October, Zimbabwe became to first African country to approve the use of the injectable HIV prevention drug known as cabotegravir. As Columbus Mavhunga reports from Harare, Zimbabwe, many are eager for the drug to become available. Videography by Blessing Chigwenhembe.

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This HIV Prevention Drug Could Change the Game

A new, long-lasting drug could be a game-changer for preventing HIV infections, experts say.

Advocates are hopeful that those who need it most in low- and middle-income countries will not have to wait for it as long as they have for previous HIV drugs. But questions remain about access and price.

The drug is called cabotegravir and is delivered as a shot once every other month. In clinical trials, it did a better job at preventing infection than another option — a pill taken once a day.

The bimonthly injection seems to be an easier treatment regimen to stick to than daily pills, according to Mitchell Warren, executive director of AVAC, an HIV prevention advocacy organization.

“If you can take a pill every day, that’s great. But if you can’t, we see a lot of people who start [taking the pills] who don’t continue,” he said.

Aside from the inconvenience, there can be a stigma attached to taking the pills, Warren said. The drugs for prevention, called pre-exposure prophylaxis, or PrEP, are the same as the drugs used to treat HIV infection.

“If you’re a young person and your parents find your pill bottle, they say, ‘Why are you taking this pill? Are you HIV infected?’ And the young person may say, ‘No, I’m protecting myself,'” Warren said. “And they say, ‘Well, why are you having sex?'”

Long-lasting drugs like cabotegravir or another new product, a once-a-month vaginal ring, offer patients more choices, he added.

About 1.5 million people were newly infected with HIV in 2021, according to the World Health Organization, about 60% of them in Africa.

Uganda and Zimbabwe approved cabotegravir for PrEP earlier this year. They are the first countries in sub-Saharan Africa to do so.

These approvals come less than a year after the U.S. Food and Drug Administration authorized it.

That’s progress, Warren said. FDA approved PrEP pills in 2012, but “it took three years before any African regulatory agency approved it. So, we’ve already seen a condensing of that timeline.”

Cabotegravir costs $22,000 per year in the United States. ViiV Healthcare, the company that makes the drug, has not officially announced what it will cost in low- and middle-income countries, but it is expected to be much lower. Some aid groups have indicated that ViiV will offer the drug at $250 per year.

“The problem is that actually that won’t be really affordable for countries who need to roll it out and scale up,” said Jessica Burry, a pharmacist with humanitarian group Doctors without Borders.

PrEP pills cost about $54 per year, Warren said.

“The hope is that early in 2023, we can see a price point that is much closer to that 54 [dollars] than to the 250 [dollars],” he said. “Hopefully, in the $100 range per year.”

ViiV said it is working with the U.N.-backed Medicines Patent Pool to allow generic manufacturers to produce cabotegravir at a lower price for low- and middle-income countries.

ViiV said cabotegravir is more complicated to manufacture than most HIV drugs. No generic manufacturers have been selected yet. Once they are, it will take about three to five years before a generic version is on the market.

The company has filed for regulatory approval in 11 countries so far. Burry says there should be more.

“If they’re going to be the only supplier for the next four or five years until generics are available, then they really need to step up to the plate and actually file, register and get that drug available,” she said.

Demand for the drug is unclear. PrEP pills have been slow to catch on.

About 845,000 people in more than 50 countries took them in 2020, but the United Nations was aiming for 3 million by that time.

“We don’t have a ton of PrEP users, so if you’re ViiV, you’re looking at a very small market,” Warren said.

Warren said providers and advocates need to help grow that market. They need to do a better job connecting people at risk with programs that offer PrEP, he added.

“Some of the early PrEP programs began with us thinking that if you just bought the product, people would magically show up,” he said.

Warren hopes to change that as part of a coalition that includes ViiV, the Bill and Melinda Gates Foundation, the World Health Organization and others.

“There’s a huge effort in this coalition to bring in civil society from day one, and the communities that this product is meant to help and support,” he said.

The slow uptake means PrEP has not yet shown that it can make much of a real-world impact, Warren noted. He hopes to see research programs launch next year to find the best ways to reach the communities most at risk and lower infection rates.

“If we can’t show that in the next three years, then we don’t necessarily need all these generic manufacturers, because there will not be a market for this product,” he said.

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Arizona Aims to Become a Semiconductor Powerhouse

The United States is pushing to regain its position as a center for semiconductor manufacturing and research as part of a Biden administration plan to make the nation less reliant on supply chains in Asia. VOA’s Michelle Quinn reports from the Southwest state of Arizona on competition for billions of dollars in federal funding to bolster domestic chip manufacturing. Additional videographer: Levi Stallings

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Christine McVie, Fleetwood Mac Singer-Songwriter, Dies at 79

Christine McVie, the British-born Fleetwood Mac vocalist, songwriter and keyboard player whose cool, soulful contralto helped define such classics as “You Make Loving Fun,” “Everywhere” and “Don’t Stop,” has died at age 79. 

Her death was announced Wednesday on the band’s social media accounts. No cause of death or other details were immediately provided, but a family statement said she “passed away peacefully at hospital this morning” with family around her after a “short illness.” 

“She was truly one-of-a-kind, special and talented beyond measure,” the band’s statement reads in part. 

McVie was a steady presence and personality in a band known for its frequent lineup changes and volatile personalities — notably fellow singer-songwriters Stevie Nicks and Lindsey Buckingham. 

Fleetwood Mac started out as a London blues band in the 1960s and evolved into one of the defining makers of 1970s California pop-rock, with the combined talents of McVie, Nicks and Buckingham anchored by the rhythm section of founder Mick Fleetwood on drums and John McVie on bass. 

During its peak commercial years, from 1975 to 1980, the band sold tens of millions of records and was an ongoing source of fascination for fans as it transformed personal battles into melodic, compelling songs. McVie herself had been married to John McVie, and their breakup — along with the split of Nicks and Buckingham — was famously documented on the 1977 release “Rumours,” among the bestselling albums of all time. 

Fleetwood Mac was inducted into the Rock & Roll Hall of Fame in 1998. The group’s many other hit singles included Nicks’ “Dreams,” Buckingham’s “Go Your Own Way” and McVie’s “Little Lies.” One of McVie’s most beloved works, the thoughtful ballad “Songbird,” was a showcase for her in concert and covered by Willie Nelson, among others. 

McVie, born Christine Perfect in Bouth, Lancashire, had been playing piano since childhood, but set aside her classical training once she heard early rock records by Fats Domino and others. 

While studying at the Moseley School of Art, she befriended various members of Britain’s emerging blues scene, and in her 20s joined the band Chicken Shack as a singer and piano player. Among the rival bands she admired was Fleetwood Mac, which then featured the talents of blues guitarist Peter Green, along with the rhythm section of Fleetwood and McVie. By 1970, she had joined the group and married John McVie. 

Few bands succeeded so well as Fleetwood Mac, against such long odds. Green was among the many performers who left the group, and at various times, Fleetwood Mac seemed on the verge of ending or fading away. More recently, Buckingham was kicked out, replaced on tour by Mike Campbell and Neil Finn. 

McVie herself left for years, only to return for good in 2014. 

 

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Amazon Deforestation in Brazil Remains Near 15-Year High

Deforestation in the Brazilian Amazon slowed slightly last year, a year after setting a 15-year high, according to closely watched numbers published Wednesday. The data was released by the National Institute for Space Research.

The agency’s Prodes monitoring system shows the rainforest lost an area roughly the size of Qatar, about 11,600 square kilometers in the 12 months from August 2021 to July 2022.

That is down 11% compared with the previous year, when more than 13,000 square kilometers were destroyed.

For more than a decade deforestation in the Brazilian Amazon declined dramatically and never rose back above 10,000 square kilometers. Then came the presidency of far-right President Jair Bolsonaro, beginning in January 2019.

This will be the last report published under Bolsonaro, who lost his reelection bid and will leave office January 1. But part of the destruction that took place on his watch will not appear until next year, including the key months from August to October 2022. A because it is the dry season.

An analysis of the new yearly data from Climate Observatory, a network of environmental groups, shows that in the four years of Bolsonaro’s leadership, deforestation rose 60% over the previous four years. That is the largest percentage rise under a presidency since satellite monitoring began in 1998.

In one state, Para, a fierce rate of destruction fell by 21% yet it was still the center of one-third of all Brazil’s Amazon forest loss. Part of the tree cutting and burning happens in areas that are ostensibly protected. One such area is Paru State Forest, where the nonprofit Amazon Institute of People and the Environment registered 2 square kilometers of deforestation in just October.

“In recent years, deforestation has reached protected areas where previously there was almost no destruction,” Jacqueline Pereira, a researcher with the Amazon Institute, told The Associated Press. “In Paru’s region, the destruction is driven by lease of land for soybean crops and cattle.”

Another critical area is the southern part of the state of Amazonas, the only state that increased deforestation in the most recent data, by 13% compared to the year before. It’s largely attributable to Bolsonaro’s push to pave about 400 kilometers of the only road that connects Manaus, home to 2.2 million people, with Brazil’s larger urban centers further south. Most Amazon deforestation occurs alongside roads where access is easier and land value is higher.

Researchers and environmentalists have blamed Bolsonaro’s policies for the surge in deforestation. The administration weakened environmental agencies and backed legislative measures to loosen land protections in the name of economic development, paired with a view of occupying a sparsely populated territory at any cost. This policy has emboldened land robbers and spurred more illegal mining.

Bolsonaro’s successor, leftist former President Luiz Inácio Lula da Silva, promised cheering crowds at the recent U.N. climate conference in Egypt to end all deforestation in the country by 2030.

“There will be no climate security if the Amazon isn’t protected,” he said.

The last time da Silva was president, from 2003 to 2010, deforestation fell sharply. On the other hand, he backed initiatives that set in motion destruction in the long run, such as the construction of the mammoth Belo Monte hydroelectric dam and generous loans to the beef industry. Chopping down forest for pasture is the primary driver of deforestation.

The Amazon rainforest, which covers an area twice the size of India, acts as a buffer against climate change by absorbing large amounts of carbon dioxide. It’s also the most biodiverse forest in the world, and the home of tribes that have lived in the forest for thousands of years, some of them living in isolation.

“If da Silva wants to decrease forest destruction by 2023, he must have zero tolerance for environmental crime from Day One of his administration. That includes holding accountable those who sabotaged environmental governance in the country while in office over the past four years,” said Marcio Astrini, executive secretary of the Climate Observatory.

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African Women and Girls Most at Risk of HIV   

In South Africa, which has the world’s largest HIV-positive population, authorities say girls and young women are now the most at-risk demographic with many having resorted to transactional sex to pay the bills during COVID pandemic lockdowns.  Ahead of World Aids Day on Dec. 1, VOA spoke to a former sex worker and visited a clinic that treats adolescent girls and others with HIV. Kate Bartlett reports from Johannesburg, South Africa, on efforts to halt the spread. Camera: Zaheer Cassim 

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Malawi Launches Africa’s First Children’s Malaria Vaccine

Malawi and the World Health Organization are rolling out a new malaria vaccine for young children that backers say will reduce deaths from the mosquito-borne disease.

The RTSS vaccine was pilot tested on more than one million children in Ghana, Kenya and Malawi and recommended a year ago by the WHO. Despite a low effectiveness rate of 30%, the vaccine has raised hopes that some of the more than 400,000 people who die annually from malaria can be saved. 

Malaria remains a huge public health problem in Malawi, with about one third of its 20 million people getting infected each year. 

According to the ministry of health, the disease kills five Malawians every day, most of them children under the age of five or pregnant women who were not presented early enough for care.  

The health ministry says the first phase of the vaccination campaign will target 330,000 children, who were not reached during vaccine trials. 

The vaccine, sold by GlaxoSmithKline as Mosquirix, is meant for children under the age of five and requires four doses. 

“Malaria is major problem in children. They are the ones at highest risk of dying,” said Dr. Charles Mwansambo, Malawi’s secretary for health. “That’s why even when we were doing the earlier studies, we found that once we get maximum benefit, we should target this age group. The main reason is that they are the ones that are most likely to die from malaria.” 

Last year, the government launched a nationwide anti-malaria initiative known as Zero Malaria Starts with Me, aimed at eliminating the disease by 2030. 

Mwansambo said the vaccine is a key part of that initiative. 

“It actually prevents about 33 percent of deaths. Meaning that if you add the 33 to those that we can prevent using insecticide treated nets, if will also add on those [we can] prevent by indoor residual spraying, it [can] add up to something significant that will end up eliminating malaria,” he said. 

However, the Bill and Melinda Gates Foundation, backers of the vaccine, have raised concerns about whether the vaccine is worth the cost. 

In July, the Associated Press quoted Philip Welkhoff, director of malaria programs for the Gates Foundation, as saying the foundation will no longer offer direct financial support for the vaccine, although it will fund an alliance backing the vaccine. 

He said Mosquirix has much lower efficacy than the foundation would like and that the vaccine is relatively expensive and logistically challenging to deliver. 

Dr. Neema Kimambo, a WHO representative in Malawi, said the malaria vaccine itself is not a silver bullet but part of a combination of all interventions to fight the disease. 

“Where it [vaccination] was done, we have seen how it has reduced under-five deaths and we believe that as we expand now, we are definitely to save more lives of children under five,” she said. 

Maziko Matemba, a health activist and community health ambassador in Malawi, said he hopes the malaria vaccine efficacy will improve as time goes by. 

“I have an example with COVID-19. When we had AstraZeneca, the efficacy when it started — as you know it was also a new vaccine — it was less that certain percentage and people said no it was less than this. But over time, we found that the efficacy has gone up,” Matemba said. “So we are monitoring the launch of this new vaccine with keen interest.

“I know that other partners are saying the worthiness of investment is not worth it, but looking at the way we are coming from, Malawi in particular, this could be one of the tools to prevent malaria.” 

Besides WHO, other partners supporting Malawi in the fight against malaria include USAID, UNICEF, the Global Fund to Fight AIDS, Tuberculosis and Malaria and a global health nonprofit organization, PATH. 

 

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UN Puts Baguette on Cultural Heritage List

The humble baguette — the crunchy ambassador for French baking around the world — is being added to the U.N.’s list of intangible cultural heritage as a cherished tradition to be preserved by humanity.

UNESCO experts gathering in Morocco this week decided that the simple French flute — made only of flour, water, salt, and yeast — deserved U.N. recognition, after France’s culture ministry warned of a “continuous decline” in the number of traditional bakeries, with some 400 closing every year over the past half-century.

The U.N. cultural agency’s chief, Audrey Azoulay, said the decision honors more than just bread; it recognizes the “savoir-faire of artisanal bakers” and “a daily ritual.”

“It is important that these craft knowledge and social practices can continue to exist in the future,” added Azoulay, a former French culture minister.

With the bread’s new status, the French government said it planned to create an artisanal baguette day, called the “Open Bakehouse Day,” to connect the French better with their heritage.

Back in France, bakers seemed proud, if unsurprised.

“Of course, it should be on the list because the baguette symbolizes the world. It’s universal,” said Asma Farhat, baker at Julien’s Bakery near Paris’ Champs-Elysee avenue.

“If there’s no baguette, you cant have a proper meal. In the morning you can toast it, for lunch it’s a sandwich, and then it accompanies dinner.”

Despite the decline in traditional bakery numbers, France’s 67 million people still remain voracious baguette consumers — purchased at a variety sales points, including in supermarkets. The problem is, observers say, that they can often be poor in quality.

“It’s very easy to get bad baguette in France. It’s the traditional baguette from the traditional bakery that’s in danger. It’s about quality not quantity,” said one Paris resident, Marine Fourchier, 52.

In January, French supermarket chain Leclerc was criticized by traditional bakers and farmers for its much publicized 29-cent baguette, accused of sacrificing the quality of the famed 65-centimeter (26-inch) loaf. A baguette normally costs just over 90 euro cents (just over $1), seen by some as an index on the health of the French economy.

The baguette is serious business. France’s “Bread Observatory” — a venerable institution that closely follows the fortunes of the flute — notes that the French munch through 320 baguettes of one form or another every second. That’s an average of half a baguette per person per day, and 10 billion every year.

Although it seems like the quintessential French product, the baguette was said to have been invented by Vienna-born baker August Zang in 1839. Zang put in place France’s steam oven, making it possible to produce bread with a brittle crust yet fluffy interior.

The product’s zenith did not come until the 1920s, with the advent of a French law preventing bakers from working before 4 a.m. The baguette’s long, thin shape meant it could be made more quickly than its stodgy cousins, so it was the only bread that bakers could make in time for breakfast.

The “artisanal know-how and culture of baguette bread” was inscribed at the Morocco meeting among other global cultural heritage items, including Japan’s Furyu-odori ritual dances, and Cuba’s light rum masters.

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Chinese Astronauts Reach Tiangong Space Station

Three Chinese astronauts arrived Wednesday at the country’s space station as part of a six-month mission that includes the station’s first in-orbit crew rotation.

The astronauts are replacing three others who have been at the Tiangong station since early June.

China docked the last of the station’s three modules earlier this month and astronauts are working on the final phases of the construction process.

China plans to launch a powerful space telescope next year.

Some information for this report came from The Associated Press and Agence France-Presse.

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Women Enter World of Breakdancing

Breakdancing is breaking new ground with the sport’s inclusion in the 2024 Paris Olympics, and scores of women are entering the traditionally male-dominated activity. Aron Ranen has the story from New York City.

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