Day: May 27, 2024

Geneva — The World Health Organization chief on Monday urged countries to nail down a landmark global agreement on handling of future pandemics after they missed a hard deadline.

Scarred by COVID-19 — which killed millions, shredded economies and crippled health systems — nations have spent two years trying to forge binding commitments on pandemic prevention, preparedness and response.

Negotiators failed to clinch a deal ahead of this week’s World Health Assembly — the annual gathering of WHO’s 194 member states — the deadline for concluding the talks.

WHO chief Tedros Adhanom Ghebreyesus opened the assembly Monday, saying he was confident that an agreement would be secured.

“Of course, we all wish that we had been able to reach a consensus on the agreement in time for this health assembly and crossed the finish line,” he said.

“But I remain confident that you still will, because where there is a will, there is a way.”

Tedros said the task before negotiators had been “immense, technically, legally, and politically”, and that they had been “operating on a very ambitious timeline.”

“You have demonstrated a clear commitment to reaching an agreement,” he said, adding that negotiators had “worked long days and nights,” closing meetings as late as 4:00 a.m.

He hailed their dedication to push forward despite “a torrent of misinformation that was undermining your negotiations.”

While missing Friday’s deadline, countries have voiced a commitment to keep pushing for an accord.

Negotiators are due on Tuesday to present the outcome of the talks to the assembly, which runs until June 1, and the assembly will take stock and decide what to do next.

“I know that there remains among you a common will to get this done, so, there must always be a way,” Tedros said.

“Meaning the solution is in your hands,” he stressed.

Parallel talks have also taken place on revising the International Health Regulations, which were first adopted in 1969 and constitute the existing international legally binding framework for responding to public health emergencies around the world.

The proposed amendments to the IHR, including adding more nuance to a system meant to alert countries to potential health emergencies of global concern, might have a better chance of being adopted during this week’s assembly, observers said.
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OFFUTT AIR FORCE BASE, Neb. — Generations of American families have grown up not knowing exactly what happened to their loved ones who died while serving their country in World War II and other conflicts.

But a federal lab tucked away above the bowling alley at Offutt Air Force Base near Omaha and a sister lab in Hawaii are steadily answering those lingering questions, aiming to offer 200 families per year the chance to honor their relatives with a proper burial.

“They may not even have been alive when that service member was alive, but that story gets carried down through the generations,” said Carrie Brown, a Defense POW/MIA Accounting Agency lab manager at Offutt. “They may have seen on the mantle a picture of that person when they were little and not really understood or known who they were.”

Memorial Day and the upcoming 80th anniversary of D-Day on June 6 are reminders of the urgency of Brown’s work. The forensic anthropologists, medical examiners and historians who work together to identify lost soldiers are in a race against time as remains buried on battlefields around the globe deteriorate.

But advances in DNA technology, combined with innovative techniques including comparing bones to chest X-rays taken by the military, mean the labs can identify more of the missing soldiers every year. Some 72,000 World War II soldiers remain unaccounted for, along with roughly 10,000 more from all the conflicts since. The experts believe about half of those are recoverable.

The agency identified 59 servicemembers in 2013, when the Offutt lab first opened. That number has steadily risen — 159 service members last year, up from 134 in 2022 — and the labs have a goal of 200 identifications annually.

The labs’ work allowed Donna Kennedy to bury her cousin, Cpl. Charles Ray Patten, with full military honors this month in the same Lawson, Missouri, cemetery where his father and grandfather are buried. Patten died 74 years ago during the Korean War, but spent decades buried as an unknown in the National Memorial Cemetery of the Pacific in Hawaii.

“I just I ached. I mean, it hurt. You know, I just felt so bad. Even though I didn’t know him, I loved him,” Kennedy said.

Patten’s funeral was a simple affair with just a few family members. But often when veterans who fought decades earlier are identified, people waving flags and holding signs line the streets of their hometowns to herald the return of their remains.

“This work is important first and foremost because these are individuals that gave their lives to protect our freedom, and they paid the ultimate sacrifice. So we’re here holding that promise that we’ll return them home to their families,” Brown said.

“It’s important for their families to show them that we’ll never stop, no matter what,” she said.

Often there are compelling details, Brown said.

One of her first cases involved the intact remains of a World War I Marine found in a forest in France with his wallet still in his pocket. The wallet, initialed G.H., contained a New York Times article describing plans for the offensive in which he ultimately died. He also had an infantryman badge with his name and the year he received it on the back.

Before leaving France with the remains, the team visited a local cemetery where other soldiers were buried and learned there were only two missing soldiers with the initials G.H.

Brown had a fair idea who that soldier was before his remains even arrived in the lab. That veteran was buried in Arlington National Cemetery and Brown often visits his grave when she is in Washington D.C.

Most cases aren’t that easy.

The experts who work at the lab must piece together identities by looking at historical records about where the remains were found and which soldiers were in the area. They then consult the list of possible names and use the bones, objects found with them, military medical records and DNA to confirm their identities. They focus on battles and plane crashes where they have the greatest chance of success because of available information.

But their work can be complicated if soldiers were buried in a temporary cemetery and moved when a unit was forced to retreat. And unidentified soldiers were often buried together.

When remains are brought to the lab, they sometimes include an extra bone. Experts then spend months or even years matching the bones and waiting for DNA and other test results to confirm their identities.

One test even can identify if the soldier grew up primarily eating rice or a corn-based diet.

The lab also compares specific traits of collar bones to the chest X-rays the military routinely took of soldiers before they were deployed. It helps that the military keeps extensive records of all soldiers.

Those clues help the experts put together the puzzle of someone’s identity.

“It’s not always easy. It’s certainly not instantaneous,” Brown said. “Some of the cases, we really have to fight to get to that spot, because some of them have been gone for 80 years.”
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LILANDA, Zambia — Extreme weather events have hit parts of Africa relentlessly in the last three years, with tropical storms, floods and drought causing crises of hunger and displacement. They leave another deadly threat behind them: some of the continent’s worst outbreaks of cholera.

In southern and East Africa, more than 6,000 people have died and nearly 350,000 cases have been reported since a series of cholera outbreaks began in late 2021. 

Malawi and Zambia have had their worst outbreaks on record. Zimbabwe has had multiple waves. Mozambique, Kenya, Ethiopia and Somalia also have been badly affected. 

All have experienced floods or drought — in some cases, both — and health authorities, scientists and aid agencies say the unprecedented surge of the water-borne bacterial infection in Africa is the newest example of how extreme weather is playing a role in driving disease outbreaks. 

“The outbreaks are getting much larger because the extreme climate events are getting much more common,” said Tulio de Oliveira, a South Africa-based scientist who studies diseases in the developing world. 

De Oliveira, who led a team that identified new coronavirus variants during the COVID-19 pandemic, said southern Africa’s latest outbreaks can be traced to the cyclones and floods that hit Malawi in late 2021 and early 2022, carrying the cholera bacteria to areas it doesn’t normally reach. 

Zimbabwe and Zambia have seen cases rise as they wrestle with severe droughts and people rely on less safe sources of water in their desperation like boreholes, shallow wells and rivers, which can all be contaminated. Days after the deadly flooding in Kenya and other parts of East Africa this month, cholera cases appeared. 

The World Health Organization calls cholera a disease of poverty, as it thrives where there is poor sanitation and a lack of clean water. Africa has had eight times as many deaths this year as the Middle East, the second-most affected region. 

Historically vulnerable, Africa is even more at risk as it faces the worst impacts of climate change as well as the effect of the El Niño weather phenomenon, health experts say. 

In what’s become a perfect storm, there’s also a global shortage of cholera vaccines, which are needed only in poorer countries. 

“It doesn’t affect countries with resources,” said Dr. Daniela Garone, the international medical coordinator for Doctors Without Borders, also known by its French acronym MSF. “So, it doesn’t bring the resources.” 

Billions of dollars have been invested into other diseases that predominantly affect the world’s most vulnerable, like polio and tuberculosis, largely because those diseases are highly contagious and could cause outbreaks even in rich countries. But that’s not the case with cholera, where epidemics remain contained. 

WHO said this month there is a “critical shortage” of oral cholera vaccines in the global stockpile. Since the start of 2023, 15 countries — the desperate few — have requested a total of 82 million doses to deal with deadly outbreaks while only 46 million doses were available. 

There are just 3.2 million doses left, below the target of having at least 5 million in reserve. While there are currently cholera epidemics in the Middle East, the Americas and Southeast Asia, Africa is by far the worst-affected region. 

Vaccines alliance GAVI and UNICEF said last month that the approval of a new cholera vaccine would boost stocks. But the result of the shortage has already been measured in deaths. 

Lilanda, a township on the edge of the Zambian capital of Lusaka, is a typical cholera hot spot. Stagnant pools of water dot the dirt roads. Clean water is like gold dust. Here, over two awful days in January, Mildred Banda saw her 1-year-old son die from cholera and rushed to save the life of her teenage daughter. 

Cholera shouldn’t be killing anyone. The disease is easily treated and easily prevented — and the vaccines are relatively simple to produce. 

That didn’t help Banda’s son, Ndanji. 

When he fell sick with diarrhea, he was treated with an oral rehydration solution at a clinic and released. He slipped back into dehydration that night at home. Banda feels terrible guilt. 

“I should have noticed earlier that my son was not feeling well,” she said, sitting in her tiny concrete house. “I should have acted faster and taken him back to the clinic. I should have taken him back to save his life.” 

Because of the vaccine shortage, Zambia couldn’t undertake a preventative vaccination campaign after neighboring Malawi’s outbreak. That should have been a warning call, said de Oliveira. Zambia only made an emergency request when its cases started mounting. 

The doses that might have saved Ndanji started arriving in mid-January. He died on Jan. 6. 

In Zimbabwe, a drought worsened by El Niño has seen cholera take hold in distant rural areas as well as its traditional hot spots of crowded urban neighborhoods. 

Abi Kebra Belaye, MSF representative for Zimbabwe, said the southern African nation normally has around 17 hard-hit areas, mostly urban. This year, cholera spread to 62 districts as the struggle to find water heightened the risk. 

“This part of Africa is paying the highest price of climate change,” Kebra Belaye said. 

Augustine Chonyera, who hails from a cholera-prone part of the capital, Harare, was shocked when he recently visited the sparsely populated rural district of Buhera. 

He said he heard grim tales of the impact of the disease: a family losing five members, a husband and wife dying within hours of each other and local businesses using delivery trucks to take the sick to a clinic several kilometers (miles) away. 

“It seems now the people in rural areas are in more danger than us. I still wonder how it happened,” Chonyera said. 

He said he returned home as soon as he could — after giving a large bottle of treated water he had brought with him to an elderly woman. 
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