Smoking: How large of a global problem is it? And how can we make progress against it?

Smoking primarily contributes to early deaths through heart diseases and cancers. Globally, more than one in five cancer deaths are attributed to smoking.

This means tobacco kills more people every day than terrorism kills in a year.

Smoking was very much a 20th century problem. It was rare at the beginning of the century, but then – decade after decade – it became steadily more common. By the 1960s it was extremely widespread: on average, American adults were buying more than 10 cigarettes every day.

The statistical work that identified smoking as the major cause of the rise in lung cancer deaths began in the post-war periods and culminated in the 1964 report of the US Surgeon General. This report is seen as a turning point in the history of smoking as it made clear to the public just how deadly it was.

Once people learned that smoking kills, they could act on it. It took some time, but they did.

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Foreign Scientist in the Wuhan Lab Speaks Out

Blomberg News reports: “Danielle Anderson was working in what has become the world’s most notorious laboratory just weeks before the first known cases of Covid-19 emerged in central China. Yet, the Australian virologist still wonders what she missed.

An expert in bat-borne viruses, Anderson is the only foreign scientist to have undertaken research at the Wuhan Institute of Virology’s BSL-4 lab, the first in mainland China equipped to handle the planet’s deadliest pathogens. Her most recent stint ended in November 2019, giving Anderson an insider’s perspective on a place that’s become a flashpoint in the search for what caused the worst pandemic in a century.

The emergence of the coronavirus in the same city where institute scientists, clad head-to-toe in protective gear, study that exact family of viruses has stoked speculation that it might have leaked from the lab, possibly via an infected staffer or a contaminated object. China’s lack of transparency since the earliest days of the outbreak fueled those suspicions, which have been seized on by the U.S. That’s turned the quest to uncover the origins of the virus, critical for preventing future pandemics, into a geopolitical minefield.

The work of the lab and the director of its emerging infectious diseases section—Shi Zhengli, a long-time colleague of Anderson’s dubbed ‘Batwoman’ for her work hunting viruses in caves—is now shrouded in controversy. The U.S. has questioned the lab’s safety and alleged its scientists were engaged in contentious gain of function research that manipulated viruses in a manner that could have made them more dangerous.

It’s a stark contrast to the place Anderson described in an interview with Bloomberg News, the first in which she’s shared details about working at the lab.”

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2020 Global Nutrition Report

The latest Global Nutrition Report has been published providing data for all around the globe. The summary for Atrica is provided below:

Africa: The burden of malnutrition at a glance

In the Africa region, there has been slight progress towards achieving global nutrition targets. The global target for overweight among children under 5 years of age has 28 countries on course to meet it, wasting among children under 5 years of age and exclusive breastfeeding among infants aged 0 to 5 months each have 17 countries on course, while stunting among children under 5 years of age has five countries on course. However, not a single country in the region is on course to meet the targets for anaemia in women of reproductive age (aged 15 to 49 years), low birth weight, diabetes among men, diabetes among women, obesity among men, and obesity among women. 20 countries in the region have insufficient data to comprehensively assess their progress towards these global targets.

The latest data shows that anaemia affects an estimated 39.0% of women of reproductive age. Some 13.7% of infants have a low weight at birth in the Africa region. The estimated average prevalence of infants aged 0 to 5 months who are exclusively breastfed is 43.6%, which is lower than the global average of 44.0%. Although it performs relatively well against other regions, Africa still experiences a malnutrition burden among children aged under 5 years. The average prevalence of overweight is 4.7%, which is lower than the global average of 5.6%. The prevalence of stunting is 29.1% – higher than the global average of 21.3%. Conversely, the Africa region’s prevalence of wasting is 6.4%, which is lower than the global average of 6.9%.

The Africa region’s adult population also faces a malnutrition burden: an average of 8.6% of adult (aged 18 and over) women live with diabetes, compared to 8.3% of men. Meanwhile, 18.4% of women and 7.8% of men live with obesity.

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Ventilation and COVID-19

The Europen Centre for Disease Prevention and Control has issued a guidance note on the importance of ventilation in reduced COVID transmission. “Poor ventilation in confined indoor spaces is associated with increased transmission of respiratory infections. There have been numerous COVID-19 transmission events associated with closed spaces, including some from pre-symptomatic cases.

Coronavirus
Coronavirus – John Hopkins University

The role of ventilation in preventing COVID-19 transmission is not well-defined (i.e. by preventing dispersal of infectious particles to minimise the risk of transmission, or preventing transfer of an infectious dose to susceptible individuals). COVID-19 is thought to be primaril y transmitted via large respiratory droplets, however, an increasing number of outbreak reports implicate the role of aerosols in COVID-19 outbreaks. Aerosols consist of small droplets an d droplet nuclei which remain in the air for longer than large droplets.

Studies indicate that SARS-CoV-2 particles can remain infectious on various materials, as well as in aerosols in indoor environments, with the duration of infectivity depending on temperature and humidity. So far, transmission through fomites has not been documented, but it is considered possible.

Several outbreak investigation reports have shown that COVID-19 transmission can be particularly effective in crowded, confined indoor spaces such as workplaces (offices, factories) and during indoor events – e.g. churches, restaurants, gatherings at ski resorts, parties, shopping centres, worker dormitories, dance classes, cruise ships and vehicles. There are also indications that transmission can be linked to specific activities, such as singing in a choir or during religious services that may be characterised by increased production of respiratory droplets through loud speech and singing.

In a study of 318 outbreaks in China, transmission in all cases except one occurred in indoor spaces. The only case of outdoor transmission identified in this study involved two people. However, outdoor events have also been implicated in the spread of COVID-19, typically those associated with crowds, such as carnival celebrations and football matches, highlighting the risk of crowding even at outdoor events. However, exposure in crowded indoor spaces is also very common during such events.

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Vertical Farms Can Out-Produce ‘Flat Farms’

Article by John Koetsier Forbes:

“According to Nate Storey, the future of farms is vertical. It’s also indoors, can be placed anywhere on the planet, is heavily integrated with robots and AI, and produces better fruits and vegetables while using 95% less water and 99% less land.

‘Plenty’ in the USA takes the flat farm and performs an Inception transformation on it: ripping up horizontal rows of plants and hanging them vertically from the ceilings. Sunlight from above is replaced by full-spectrum LED lights from all sides. Huge robots grab large hanging racks of growing vegetables and moves them where they’re needed. Artificial intelligence manages all the variables of heat and light and water, continually optimizing and learning how to grow faster, bigger, better crops. Water lost by transpiration is recaptured and reused. And all of it happens not 1,000 miles away from a city, but inside or right next to the place where the food is actually needed.

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Bioeconomy and the Sustainability Problem

“High levels of consumption in industrialised countries have far-reaching impacts on ecosystems, food security and human rights both within and beyond their borders. Low- and middle-income countries are directly affected by the policies and practices of the global North, and ordinary citizens have limited influence. Demand in the United States and the United Kingdom for beef directly drives deforestation in the Amazon; while the number of everyday products that contain unsustainable palm oil continues to increase.

…The ‘bioeconomy’ is a sophisticated sounding term, but essentially it means the things we make, use and sell that have their origins in nature; and the aim is to transition the economy from fossil resources towards renewable ones. Farming and forestry are part of the bioeconomy, as is energy produced from biomass, and services like tourism that are rooted in nature and outdoor experiences. The bioeconomy is central to what we do every day, and is an essential part of the global economy. In Europe alone the bioeconomy has an annual value of €2.4 trillion. It holds the key to a greener, more sustainable and healthy future for all — if the right practices, regulations and incentives are in place.

At the same time, the bioeconomy has the potential to drive further environmental destruction and degradation. Irresponsible pursuit of profit and unsustainable exploitation of natural resources are making climate change, biodiversity loss, infectious diseases, hunger and inequality much worse. A recent report from the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) found that unless we dramatically reduce our impact on the natural world, future pandemics will become more frequent, spread more quickly and kill more people.

An unsustainable bioeconomy also threatens the achievement of the Sustainable Development Goals (SDGs) — a global sustainability framework adopted by the United Nations in 2015. A recent report by the German Federal Environment Agency found that in order for the bioeconomy to work for, rather than against, the SDGs, the global agenda and national strategies need to focus much more on restoration of ecosystems, sustainable land-use, climate protection and food sovereignty.”
 
Read More – by Patrick Schröder – a senior research fellow in Chatham House’s energy, environment and resources programme>>>

Covid: African Experience

Wired Article: ” Two months after it opened, Khayelitsha Field Hospital abruptly closed. The facility, constructed in a sports hall in early July on the outskirts of the South African city of Cape Town, had been constructed in anticipation of a wave of Covid-19 deaths. But the infections and deaths that have overwhelmed healthcare systems across the world never came. Almost a year into the pandemic Africa has mostly been spared from a crisis that has brought much of the world to its knees.

It wasn’t meant to be this way. In April, as Covid-19 shut down country after country, the United Nations issued a stark warning: Africa might be next. Officials said Covid-19 could directly kill at least 300,000 people in Africa and possibly as many as 3.3 million. In May, with infections and deaths still surprisingly low, the World Health Organisation revised that prediction down to between 83,000 and 190,000 deaths. To date, just over 40,000 Africans have lost their lives to Covid-19. “Very few cases were identified,” says Gilles Van Cutsem, a senior HIV and tuberculosis adviser for Médecins Sans Frontières at the Southern African Medical Unit in Cape Town.

There is no single reason for Africa’s seemingly remarkable escape. For one, Africa isn’t a homogenous lump of land. Its 54 countries are ethnically and socially diverse. Yet, across the continent, there are some trends that hint at why deaths from Covid-19 remain so low. The median age in Africa, where more than 60 per cent of people are under the age of 25, is about half of that in Europe. This has played a significant role, says Denis Chopera, a public healthcare expert at the Africa Research Institute in KwaZulu-Natal, South Africa. He also points to Africa’s warm climate and the potential of pre-existing immunity in some communities. “Africa has a high burden of infectious diseases, including coronaviruses, and it is possible that there is some cross-immunity which protects Africans from severe Covid-19,” Chopera says. The WHO has made similar suggestions.

Across the continent, high rates of tuberculosis, HIV, polio and Ebola, have also ensured a wealth of well-trained medical professionals and, crucially, the infrastructure and expertise to handle a pandemic. “The experience has come in handy, especially in countries such as South Africa where contact tracing already existed for tuberculosis,” says Chopera. “These were repurposed to combat Covid-19.”

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One in six children living in extreme poverty rising during pandemic

“Global Estimate of Children in Monetary Poverty: An Update, notes that sub-Saharan Africa, with its limited social safety nets, accounts for two-thirds of children living in households that struggle to survive on an average of $1.90 a day or less per person – the international measure for extreme poverty, while South Asia accounts for nearly a fifth of these children. 

The analysis shows that the number living in extreme poverty decreased moderately, by 29 million, between 2013 and 2017. However, UNICEF and the World Bank Group warn that any progress made in recent years, has been “slow-paced, unequally distributed, and at risk” due to the economic impact of the pandemic.  

Struggling for survival 

“One in six children living in extreme poverty is one in six children struggling to survive”, said Sanjay Wijesekera, UNICEF Director of Programmes. 

“These numbers alone should shock anyone. And the scale and depth of what we know about the financial hardships brought on by the pandemic, are only set to make matters far worse. Governments urgently need a children’s recovery plan to prevent countless more children and their families from reaching levels of poverty unseen for many, many years.” 

Although children make up around a third of the global population, around half of the extreme poor are children. Furthermore, they are more than twice as likely to be extremely poor as adults. 

The youngest children are the worst off – nearly 20 per cent of all of them below the age of 5 in the developing world, live in extremely poor households, the report highlights.  

“The fact that one in six children were living in extreme poverty and that 50 per cent of the global extreme poor were children, even prior to the COVID-19 pandemic, is of grave concern to us all,” said Carolina Sánchez-Páramo, Global Director of Poverty and Equity for the World Bank. “

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COVID-19 is Decimating Health Workers

BMJ Global Health Article: “Health workers are essential for improved global health—but the COVID-19 pandemic is decimating them. Worse still, we don’t know the true toll the virus is taking on healthcare workers. In Africa, where the healthcare workforce of many countries was already desperately thin, the WHO counted nearly 42 000 sickened clinicians as of 9 September 2020, but the total number of infected surely outstrips that. And the pandemic is still unfolding: ongoing community transmission of the virus in many countries in Africa means far more casualties yet to come.

When health workers are at risk, so are their patients. In recent epidemics, health workers have unwittingly infected patients and colleagues. Of even greater concern, when the population perceives health facilities as unsafe, they delay or forgo needed care, leading to preventable deaths from other causes. Disruptions caused by the pandemic could result in millions of preventable deaths.

It doesn’t have to be this way. Health workers are endangered when they do not receive training on infection prevention and control, and when the places they work run short of PPE and testing kits, run delays in returning test results or lack basic necessities such as running water.

WHO and its partners have worked hard to improve procurement mechanisms for much-needed medical supplies. Further, WHO is advocating for the mobilisation of resources to secure PPE supplies for countries and is conducting training of healthcare workers in infection prevention and control.

Many African countries have struggled to secure PPE for their health workers, partly because there are shortages of PPE on the international market. However, we have also become aware of instances of corruption and misuse of funds including for contracts for the procurement of PPE. Corruption, particularly in procurement of supplies that are required to protect life, is unacceptable.

This isn’t the first epidemic to strike the healthcare workforce, and it won’t be the last; but we must learn from our past failures and ensure a safer future. COVID-19 presents yet another opportunity—and urgent requirement—to strengthen protection of health workforce.”

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