Day: July 13, 2023

The World Health Organization’s cancer agency has deemed the sweetener aspartame — found in diet soda and countless other foods — as a possible cause of cancer, while a separate expert group looking at the same evidence said it still considers the sugar substitute safe in limited quantities.

The differing results of the coordinated reviews were released early Friday in Europe. One came from the International Agency for Research on Cancer, a special branch of the WHO. The other report was from an expert panel selected by WHO and another U.N. group, the Food and Agriculture Organization, based in Rome.

The Lyon, France-based cancer agency periodically reviews potential cancer hazards but doesn’t determine how likely they are to cause cancer in their evaluations, which range from possibly carcinogenic to probably to cancer-causing.

Aspartame joins a category with more than 300 other possible cancer-causing agents, including things like aloe vera extract, Asian-style pickled vegetables and carpentry work.

The guidance on use of the sweetener, though, isn’t changing.

“We’re not advising consumers to stop consuming [aspartame] altogether,” said WHO’s nutrition director, Dr. Francesco Branca. “We’re just advising a bit of moderation.”

Here’s a look at the announcement:

What is aspartame?

Aspartame is a low-calorie artificial sweetener that is about 200 times sweeter than sugar. It is a white, odorless powder and the world’s most widely used artificial sweetener.

Aspartame is authorized as a food additive in Europe and the U.S. and is used in numerous foods, drinks such as Diet Coke, desserts, chewing gum, medications including cough drops, and foods intended to help with weight loss. It’s in tabletop sweeteners sold as Equal, Sugar Twin and NutraSweet.

Aspartame was approved in 1974 by the U.S. Food and Drug Administration with an acceptable daily intake of 50 milligrams per kilogram of body weight. According to the FDA, a person weighing 60 kilograms (132 pounds) would need to consume about 75 aspartame packets to reach that level.

U.N. experts evaluated the safety of aspartame in 1981 and set the safe daily limit slightly lower, at 40 milligrams of aspartame per kilogram.

David Spiegelhalter, an emeritus statistics professor at Cambridge University, said the guidance means that “average people are safe to drink up to 14 cans of diet drink a day … and even this ‘acceptable daily limit’ has a large built-in safety factor.”

What did the two groups say?

WHO’s cancer agency, the IARC, convened its expert group in June to assess the potential of aspartame to cause cancer. It based its conclusion that aspartame is “possibly carcinogenic” on studies in humans and animals that found limited evidence that the compound may be linked to liver cancer.

In a separate evaluation, experts assembled by WHO and the food agency updated their risk assessment, including reviewing the acceptable daily intake. They concluded there was “no convincing evidence” at the currently consumed levels that aspartame is dangerous; their guidelines regarding acceptable levels of consumption were unchanged.

The announcements came weeks after the WHO said that non-sugar sweeteners don’t help with weight loss and could lead to increased risk of diabetes, heart disease and early death in adults.

Should I be concerned about getting too much?

No, as long as you don’t exceed the guidelines. The FDA said scientific evidence continues to support the agency’s conclusion that aspartame is “safe for the general population,” when used within limits.

Almost any substance can be dangerous in excessive amounts, said David Klurfeld, a nutrition expert at the Indiana University School of Public Health in Bloomington.

“The dose makes the poison,” said Klurfeld, who previously served on an IARC panel. “Even essential nutrients like vitamin A, iron and water will kill you within hours if too much is consumed.”

What should consumers do?

WHO’s Branca said it was acceptable for people to consume a “pretty large” amount of aspartame without suffering any ill effects. “High consumers” might want to cut back, he said.

Dr. Peter Lurie, executive director of the Center for Science in the Public Interest, which previously nominated aspartame for IARC review, said there’s an easy choice for consumers.

“At least when it comes to beverages, our message is your best choice is to drink water or an unsweetened beverage,” he said.

The IARC has previously classified processed meat like hot dogs and bacon as cancer-causing, noting in particular its link to colon cancer. That move surprised others in the scientific community — the U.K.’s biggest cancer charity reassured Britons that eating a bacon sandwich every so often wouldn’t do them much harm.

What does this mean for the food and beverage industry?

Food and beverage producers say there’s no reason to avoid products with aspartame.

“There is a broad consensus in the scientific and regulatory community that aspartame is safe,” the American Beverage Association said in a statement.

WHO’s Branca said the agency advises food manufacturers in general to “use ingredients that do not require the addition of too much sugar.” After the latest assessments of aspartame, Branca said that using sweeteners “is probably not the way forward.”
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HIV/AIDS can end as a public health threat by 2030 if nations can muster the political will and critical financial support to completely defeat it, a new report published Thursday says. The deadly disease has killed 40.4 million people since the start of the epidemic in 1981.

“The data in this report show that the path that ends AIDS is not a mystery, but it is a choice. It is a political and a financial choice,” said Winnie Byanyima, executive director of UNAIDS.

“The report shows that HIV responses can succeed when they are anchored in strong political leadership,” she said.

The report released by UNAIDS, the United Nations AIDS program, finds that in 2022, 39 million people worldwide were living with HIV, 1.3 million became newly infected and 630,000 died from AIDS-related illnesses. 

While new infections have been declining globally over the past 10 to 12 years, rates remain high in several regions. Data show that two-thirds of all people living with HIV are found in sub-Saharan Africa, the hardest-hit region in the world. Other heavily infected regions include Asia and the Pacific, Latin America and the Caribbean, as well as Eastern Europe and Central Asia.

The report says women and girls are still disproportionately affected, particularly in sub-Saharan Africa.

“Every single week, 4,000 adolescent girls and young women were newly infected with HIV globally; 3,100 of those are from sub-Saharan Africa. It is a sub-Saharan crisis,”  Byanyima said.

At the same time, she noted that eastern and southern Africa, the region with the highest burden of HIV, is also where resources have been well-deployed and have achieved positive results.

“We see that since 2010 to now, new infections have been reduced by 57 percent. It is the region with the sharpest decline in new infections,” she said.

She said that since 2000, millions of lives have been saved through antiretroviral therapy. The number of people receiving this life-saving treatment worldwide “has risen four times since 2010 from 7.7 million to 29.8 million last year,” Byanyima said.

Another notable success has been in nearly doubling the number of pregnant and breast-feeding women living with HIV who were accessing antiretroviral treatment in 2022. Byanyima said that number has risen from 46% in 2010 to 82% last year.

“This has led to a reduction of 58 percent in new infections among children over the past 12 years,” she said.

Still, Byanyima noted that significant issues remain to be resolved before the prospect of ending AIDS can be realized. She said it is critical for governments to reach out to society’s most vulnerable, marginalized groups, including men who have sex with men, sex workers, transgender women, drug users and prisoners.

“Tackling inequalities is key to making progress,” she said, noting that several countries, including Antigua and Barbuda, the Cook Islands, Barbados, Saint Kitts and Nevis and Singapore, have decriminalized same-sex relations.

“Unfortunately, Uganda, my country, took the opposite direction, and that is not positive,” she said, referring to the country’s new anti-LGBTQ law that includes the death penalty.  

She added that stigmatizing people serves to drive the infection underground where it can blossom and grow.

The report highlights several countries as diverse as Botswana and Cambodia, as well as Eswatini, Rwanda and Tanzania, that have made considerable progress toward ending HIV/AIDS.

Sheila Tiou, Botswana’s former health minister and co-chair of the Global HIV Prevention Coalition, said the countries have succeeded in doing this “by scaling up proven interventions, addressing inequalities, enabling communities, and investing in resources.” 

“We have already heard about countries that have succeeded, but countries like Cameroon, Nepal, Zimbabwe have achieved major reductions in new HIV infections thanks to focused and scaled-up comprehensive prevention programs,” she said.

But she underscored that inequalities and inequities are blocking quicker and wider access in protecting people against HIV.

“Doing the right things will drastically improve the health and well-being of societies, it will reduce HIV vulnerabilities, and indeed, it will avert new HIV infections,” she said.

Tiou said AIDS can be ended if world leaders are courageous, tackle stigma and discrimination, empower and work with communities, and invest in what is needed.

“The data is clear. The evidence is all there,” she said.

Byanyima echoed these sentiments, emphasizing the opportunity for successfully ending the epidemic is dependent upon action.

“The facts and figures shared in this report do not show that as a world, we are already on the path.”

However, she said they show that the world can get on the right path “to save millions of lives and protect the health of everyone by putting a stop to the world’s deadliest pandemic.”
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U.S. officials have approved the first over-the-counter birth control pill, which will let American women and girls buy contraceptive medication from the same aisle as aspirin and eyedrops.

The Food and Drug Administration said Thursday it cleared Perrigo’s once-a-day Opill to be sold without a prescription, making it the first such medication to be moved out from behind the pharmacy counter. The company won’t start shipping the pill until early next year, and there will be no age restrictions on sales.

Hormone-based pills have long been the most common form of birth control in the U.S., used by tens of millions of women since the 1960s. Until now, all of them required a prescription.

Medical societies and women’s health groups have pushed for wider access, noting that an estimated 45% of the 6 million annual pregnancies in the U.S. are unintended. Teens and girls, women of color and those with low incomes report greater hurdles in getting prescriptions and picking them up.

Some of the challenges can include paying for a doctor’s visit, getting time off from work and finding child care.

“This is really a transformation in access to contraceptive care,” said Kelly Blanchard, president of Ibis Reproductive Health, a non-profit group that supported the approval. “Hopefully this will help people overcome those barriers that exist now.”

Ireland-based Perrigo did not announce a price. Over-the-counter medicines are generally much cheaper than prescriptions, but they aren’t covered by insurance.

Many common medications have made the switch to non-prescription status in recent decades, including drugs for pain, heartburn and allergies.

Perrigo submitted years of research to FDA to show that women could understand and follow instructions for using the pill. Thursday’s approval came despite some concerns by FDA scientists about the company’s results, including whether women with certain underlying medical conditions would understand they shouldn’t take the drug.

FDA’s action only applies to Opill. It’s in an older class of contraceptives, sometimes called minipills, that contain a single synthetic hormone and generally carry fewer side effects than more popular combination hormone pills.

But women’s health advocates hope the decision will pave the way for more over-the-counter birth control options and, eventually, for abortion pills to do the same.

That said, FDA’s decision has no relation to the ongoing court battles over the abortion pill mifepristone. The studies in Perrigo’s FDA application began years before the Supreme Court’s reversal of Roe v. Wade, which has upended abortion access across the U.S.

With some states curtailing women’s reproductive rights, the FDA has faced pressure from Democratic politicians, health advocates and medical professionals to ease access to birth control. The American Medical Association and the leading professional society for obstetricians and gynecologists backed Opill’s application for over-the-counter status.

An outside panel of FDA advisers unanimously voted in favor of the switch at a hearing in May where dozens of public speakers called for Opill’s approval.

Dyvia Huitron was among those who presented, explaining how she has been unable to get prescription birth control more than three years after becoming sexually active. The 19-year-old University of Alabama student said she still isn’t comfortable getting a prescription because the school’s health system reports medical exams and medications to parents.

“My parents did not let me go on the pill,” Huitron said in a recent interview. “There was just a lot of cultural stigma around being sexually active before you’re married.”

While she uses other forms of contraception, “I would have much preferred to have birth control and use these additional methods to ensure that I was being as safe as possible.”

Huitron spoke on behalf of Advocates for Youth, one of the dozens of groups that have pushed to make prescription contraceptives more accessible.

The groups helped fund some of the studies submitted for Opill and they encouraged HRA Pharma, later acquired by Perrigo, to file its application with the FDA.

Advocates were particularly interested in Opill because it raised fewer safety concerns. The pill was first approved in the U.S. five decades ago but hasn’t been marketed here since 2005.

“It’s been around a long time and we have a large amount of data supporting that this pill is safe and effective for over-the-counter use,” said Blanchard, of Ibsis Reproductive Health.

Newer birth control pills typically combine two hormones, estrogen and progestin, which can help make periods lighter and more regular. But their use carries a heightened risk of blood clots and they shouldn’t be used by women at risk for heart problems, such as those who smoke and are over 35.

Opill has only progestin, which prevents pregnancy by blocking sperm from reaching the cervix. It must be taken around the same time daily to be most effective.

In its internal review published in May, the FDA noted that some women in Perrigo’s study had trouble understanding the drug’s labeling information. In particular, the instructions warn that women with a history of breast cancer should not take the pill because it could spur tumor growth. And women who have unusual vaginal bleeding are instructed to talk to a doctor first, because it could indicate a medical problem.

Perrigo executives said the company will spend the rest of the year manufacturing the pill and its packaging so it can be available in stores nationwide and online by early next year.
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It is possible to end AIDS by 2030 if countries demonstrate the political will to invest in prevention and treatment and adopt non-discriminatory laws, the United Nations said on Thursday.

In 2022, an estimated 39 million people around the world were living with HIV, according to UNAIDS, the United Nations AIDS program. HIV can progress to AIDS if left untreated.

“We have a solution if we follow the leadership of countries that have forged strong political commitment to put people first and invest in evidence-based HIV prevention and treatment programs,” UNAIDS said in a report published on Thursday.

It said an effective response to HIV also meant adopting non-discriminatory laws and empowering community networks, among other initiatives. People living with HIV or AIDS in many countries face stigma, discrimination and violence.

“Progress has been strongest in the countries and regions that have the most financial investments, such as in eastern and southern Africa, where new HIV infections have been reduced by 57% since 2010,” the report said.

It added, however, that there has been a steep increase in new infections in eastern Europe and central Asia, as well as in the Middle East and North Africa.

“These trends are due primarily to a lack of HIV prevention services for marginalized and key populations and the barriers posed by punitive laws and social discrimination,” it said.

Last year, 1.3 million people became newly infected with HIV and 630,000 died from AIDS-related illnesses, according to UNAIDS.
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Warmer, drier weather because of an earlier-than-usual El Nino is expected to hamper rice production across Asia, hitting global food security in a world still reeling from the impacts of the war in Ukraine. 

An El Nino is a natural, temporary and occasional warming of part of the Pacific that shifts global weather patterns, and climate change is making them stronger. The National Oceanic and Atmospheric Administration announced this one in June, a month or two earlier than it usually does. This gives it time to grow. Scientists say there’s a one in four chance it will expand to supersized levels. 

That’s bad news for rice farmers, particularly in Asia where 90% of the world’s rice is grown and eaten, since a strong El Nino typically means less rainfall for the thirsty crop. 

Past El Ninos have resulted in extreme weather, ranging from drought to floods. 

There are already “alarm bells,” said Abdullah Mamun, a research analyst at the International Food Policy Research Institute or IFPRI, pointing to rising rice prices due to shortfalls in production. The average price of 5% broken white rice in June in Thailand was about 16% higher than last year’s average. 

Global stocks have run low since last year, in part due to devastating floods in Pakistan, a major rice exporter. This year’s El Nino may amplify other woes for rice-producing countries, such as reduced availability of fertilizer due to the war and some countries’ export restrictions on rice. Myanmar, Cambodia and Nepal are particularly vulnerable, warned a recent report by research firm BMI. 

“There is uncertainty over the horizon,” Mamun said. 

Recently, global average temperatures have hit record highs. Monsoon rains over India were lighter than usual by the end of June. Indonesian President Joko Widodo on Monday asked his ministers to anticipate a long dry season. And in the Philippines, authorities are carefully managing water to protect vulnerable areas. 

Some countries are bracing for food shortages. Indonesia was among the worst hit by India’s decision to restrict rice exports last year after less rain fell than expected and a historic heat wave scorched wheat, raising worries that domestic food prices would surge. 

Last month, India said it would send more than 1 million metric tons (1.1 million U.S. tons) to Indonesia, Senegal and Gambia to help them meet “their food security needs.” 

Challenges finding fertilizer

Fertilizer is another crucial variable. Last year China, a major producer, restricted exports to keep domestic prices in check after fertilizers were among exports affected by sanctions on Russian ally Belarus for human rights violations. Sanctions on Russia for its invasion of Ukraine don’t target fertilizers but the war has disrupted shipments of the three main chemical fertilizers: potash, phosphorus, and nitrogen. 

Bangladesh found suppliers in Canada to make up for lost potash shipments from Belarus, but many countries are still scrambling to find new sources. 

Farmers such as Abu Bakar Siddique, who cultivates 1.2 hectares (3 acres) in northern Bangladesh, had enough fertilizer to keep his yields steady last year. But less rainfall meant he had to rely more on electric pumps for his winter harvest at a time of power shortages due to war-related shortfalls of diesel and coal. 

“This increased my costs,” he said. 

Attempting to adapt

Each El Nino is different, but historical trends suggest scarce rainfall in South and Southeast Asia will parch the soil, causing cascading effects in coming years, said Beau Damen, a natural resources officer with the Food and Agriculture Organization based in Bangkok, Thailand. Some countries, like Indonesia, may be more vulnerable in the early stages of the phenomenon, he said. 

Kusnan, a farmer in Indonesia’s East Java, said rice farmers there have tried to anticipate that by planting earlier so that when the El Nino hits, the rice might be ready for harvest and not need so much water. Kusnan, who like many Indonesians uses only one name, said he hoped high yields last year would help offset any losses this year. 

Widodo, the Indonesian leader, stressed the need to manage water in coming weeks, warning that various factors — including export restrictions and fertilizer shortages — could combine with the El Nino to “make this a particularly damaging event.” 

Baldev Singh, a 52-year-old farmer in northern India’s Punjab state, is already worried. He typically sows rice from late June until mid-July, then needs the monsoon rains to flood the paddies. Less than a tenth of the usual rainfall had come by early this month, and then floods ravaged northern India, battering young crops that had just been planted. 

The government has encouraged Punjab farmers to grow rice along with their traditional wheat crops since the 1960s to improve India’s food security, even though farmers like Singh don’t typically eat rice and irrigation of rice fields has drained the area’s aquifers. But he keeps growing it, counting on the certainty of government purchases at fixed prices. 

With rain scarce, Singh may need to dig wells. Last year, he dug down 200 feet (60 meters) to find water. 

“Rice has been our ruin … I don’t know what will happen in the future,” he said. 

 
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Hackers, possibly linked to China’s intelligence agencies, are being blamed for a monthlong campaign that breached some unclassified U.S. email systems, allowing them to access to a small number of accounts at the U.S. State Department and a handful of other organizations.

Microsoft first announced the intrusion Tuesday, attributing the attack on its Outlook email service to Chinese threat actors it dubbed Storm-0558.

The company said in a blog post that the hackers managed to forge a Microsoft authentication token and gain access to the email accounts of 25 organizations, both in the U.S. and around the globe, starting in mid-May.

The company said access was cut off after the breach was discovered a month later.

“We assess this adversary is focused on espionage, such as gaining access to email systems for intelligence collection,” Microsoft said. “This type of espionage-motivated adversary seeks to abuse credentials and gain access to data residing in sensitive systems.”

The State Department confirmed Wednesday that it had discovered the breach and had taken “immediate steps” to secure its systems and to notify Microsoft.

Some U.S. officials, however, were hesitant to back Microsoft’s attribution for the attack while saying the U.S. “would make all efforts to impose costs” on whoever was responsible.

“The sophistication of this attack, where actors were able to access mailbox content of victims, is indicative of APT [advanced persistent threat] activity but we are not prepared to discuss attribution at a more specific level,” a senior FBI official told reporters Wednesday, briefing them on the condition of anonymity.

According to senior officials with the FBI and the Cybersecurity and Infrastructure Security Agency (CISA), the number of U.S. victims of the Microsoft Outlook breach was in the single digits and only a small number of accounts were accessed.

They added that because the breach was detected quickly, the hackers did not have access to any email account for more than a month and never had access to any classified information or systems. In many cases, their access lasted only days.

Still, the officials noted reason for concern.

“The targeting was intentional,” said a senior CISA official who spoke to reporters on the condition of anonymity.

“This appears to have been a very targeted, surgical campaign that was not seeking the breadth of access we have seen in other campaigns,” the official added.

Despite the reluctance of some U.S. cyber officials to place the blame on China, there was no hesitation Wednesday from key U.S. lawmakers.

“The Senate Intelligence Committee is closely monitoring what appears to be a significant cybersecurity breach by Chinese intelligence,” Chairman Mark Warner said in a statement.

“It’s clear that the PRC is steadily improving its cyber collection capabilities directed against the U.S. and our allies,” the Virginia Democrat added. “Close coordination between the U.S. government and the private sector will be critical to countering this threat.”

Top U.S. intelligence, security and military officials have long warned about the growing cybersecurity threat posed by China-linked hackers.

Earlier this year, CISA Director Jen Easterly warned China “will almost certainly” employ aggressive cyber operations against the U.S. should tensions between Washington and Beijing get worse.

A separate Defense Department cyber strategy likewise warned of China’s increased investments in military cyber capabilities while also empowering a growing number of cyber proxies. 

But John Hultquist, chief analyst at Google’s Mandiant cybersecurity intelligence operation, said this latest attack showed that the Chinese threat has evolved in a very dangerous way.

“Chinese cyber espionage has come a long way,” Hultquist said in an email. “They have transformed their capability from one that was dominated by broad, loud campaigns that were far easier to detect. They were brash before, but now they are clearly focused on stealth.”

VOA reached out to the Chinese Embassy in Washington about the allegations that Beijing was behind the Microsoft attack.

“China is against cyberattacks of all kinds and has suffered from cyber hacking,” Chinese Embassy spokesperson Liu Pengyu told VOA in an email. “As MFA (Ministry of Foreign Affairs) spokesperson has commented at regular press conference, the source of Microsoft’s claim is information from the U.S. government authorities.”

Liu went on to call the U.S. “the biggest hacking empire and global cyber thief,” saying it was “high time that the U.S. explained its cyberattack activities and stopped spreading disinformation to deflect public attention.”

In its blog post about the latest breach Tuesday, Microsoft said it had managed to repair its systems for all of its customers.

The FBI and CISA on Wednesday separately issued a cybersecurity advisory, urging organizations using Microsoft Exchange Online to take steps to increase their security measures and also their monitoring of their systems to catch any suspicious activity. 
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