COVID Pandemic, Ukraine War Color WHO International Meeting

The Ukraine war, with disease and destruction following in its wake, loomed large Sunday as the WHO convened countries to address a still raging pandemic and a vast array of other global health challenges. 

“Where war goes, hunger and disease follow shortly behind,” World Health Organization chief Tedros Adhanom Ghebreyesus warned on the opening day of the U.N. agency’s main annual assembly.

The assembly, due to run through Saturday, marks the first time the WHO is convening its 194 member states for their first largely in-person gathering since COVID-19 surfaced in late 2019.

Tedros warned that important work at the assembly to address a long line of global health emergencies and challenges, including the COVID-19 crisis, could not succeed “in a divided world.” 

“We face a formidable convergence of disease, drought, famine and war, fueled by climate change, inequity and geopolitical rivalry,” he warned.

The former Ethiopian health minister said he was viewing the ravages in Ukraine through a personal lens: “I am a child of war.”

In Ukraine and elsewhere, he said, it is clear peace “is a prerequisite for health. We must choose health for peace, and peace, peace, peace.”

But it was war that dominated the high-level speeches on the first day of the assembly.

“The consequences of this war are devastating, to health, to populations, to health facilities and to health personnel,” French President Emmanuel Macron said in a video address.

He called on all member states to support a resolution to be presented by Ukraine and discussed by the assembly Tuesday, which harshly condemns Russia’s invasion, especially its more than 200 attacks on health care providers, including hospitals and ambulances, in Ukraine. 

The resolution will also voice alarm at the “health emergency in Ukraine,” and highlight the dire impacts beyond its borders, including how disrupted grain exports are deepening a global food security crisis.

But while Russia has been shunned and pushed out of other international bodies over its invasion, no such sanctions are foreseen at the World Health Assembly.

“There’s not a call to kick them out,” a Western diplomat told AFP, acknowledging the sanctions permitted under WHO rules are “very weak.”

The Ukraine conflict is far from the only health emergency up for discussion this week, with decisions expected on a range of important issues, including on reforms toward strengthening pandemic preparedness. 

“This meeting is a historic opportunity to strengthen universal architecture for security and health,” Dominican Republic President Luis Abinader Corona told the assembly. 

Among the decisions expected at the assembly is Tedros’s reappointment to a second five-year term.

His first term was turbulent, as he helped steer the global response to the pandemic and grappled with other crises, including a sexual abuse scandal involving WHO staff in the Democratic Republic of Congo.

But while he has faced his share of criticism, he has received broad backing and is running unopposed, guaranteeing him a second term.

There will be no shortage of challenges ahead, with the COVID-19 pandemic still raging and demands for dramatic reforms of the entire global health system to help avert similar threats in the future.

And new health menaces already loom, including hepatitis of mysterious origin that has made children in many countries ill, and swelling numbers of monkeypox cases far from Central and West Africa —where the disease is normally concentrated.

One of the major reforms up for discussion involves the WHO budget, with countries expected to greenlight a plan to boost secure and flexible funding to ensure the organization can respond quickly to global health threats.

The WHO’s two-year budget for 2020-21 ticked in at $5.8 billion, but only 16% of that came from regular membership fees.

The idea is to gradually raise the membership fee portion to 50% over nearly a decade, while WHO will be expected to implement reforms, which includes more transparency on its financing and hiring.

The remainder came from voluntary contributions that are heavily earmarked by countries for specific projects.

“There is no greater return on investment than health,” U.N. chief Antonio Guterres told the assembly in a video address.

The COVID pandemic laid bare major deficiencies in the global health system, and countries last year agreed numerous changes were needed to better prepare the world to face future pandemic threats.

Amendments are being considered to the International Health Regulations — a set of legally binding international laws governing how countries respond to acute public health risks.

And negotiations are underway toward a new “legal instrument” — possibly a treaty— aimed at streamlining the global approach to pandemic preparedness and response.But experts warn the reform process is moving too slowly.

Former New Zealand Prime Minister Helen Clark, who co-chaired an expert panel on pandemic preparedness, warned reporters last week little had changed.

“At its current pace, an effective system is still years away, when a pandemic threat could occur at any time,” Clark said.

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With Roe in Doubt, Some Fear Tech Surveillance of Pregnancy

When Chandler Jones realized she was pregnant during her junior year of college, she turned to a trusted source for information and advice.

Her cellphone.

“I couldn’t imagine before the internet, trying to navigate this,” said Jones, 26, who graduated Tuesday from the University of Baltimore School of Law. “I didn’t know if hospitals did abortions. I knew Planned Parenthood did abortions, but there were none near me. So I kind of just Googled.”

But with each search, Jones was being surreptitiously followed — by the phone apps and browsers that track us as we click away, capturing even our most sensitive health data.

Online searches. Period apps. Fitness trackers. Advice helplines. GPS. The often obscure companies collecting our health history and geolocation data may know more about us than we know ourselves.

For now, the information is mostly used to sell us things, like baby products targeted to pregnant women. But in a post-Roe world — if the Supreme Court upends the 1973 decision that legalized abortion, as a draft opinion suggests it may in the coming weeks — the data would become more valuable, and women more vulnerable.

Privacy experts fear that pregnancies could be surveilled and the data shared with police or sold to vigilantes.

“The value of these tools for law enforcement is for how they really get to peek into the soul,” said Cynthia Conti-Cook, a lawyer and technology fellow at the Ford Foundation. “It gives [them] the mental chatter inside our heads.”

HIPAA, hotlines, health histories

The digital trail only becomes clearer when we leave home, as location apps, security cameras, license plate readers and facial recognition software track our movements. The development of these tech tools has raced far ahead of the laws and regulations that might govern them.

And it’s not just women who should be concerned. The same tactics used to surveil pregnancies can be used by life insurance companies to set premiums, banks to approve loans and employers to weigh hiring decisions, experts said.

Or it could — and sometimes does — send women who experience miscarriages cheery ads on their would-be child’s birthday.

It’s all possible because HIPAA, the 1996 Health Insurance Portability and Accountability Act, protects medical files at your doctor’s office but not the information that third-party apps and tech companies collect about you. Nor does HIPAA cover the health histories collected by non-medical “crisis pregnancy centers, ” which are run by anti-abortion groups. That means the information can be shared with, or sold to, almost anyone.

Jones contacted one such facility early in her Google search, before figuring out they did not offer abortions.

“The dangers of unfettered access to Americans’ personal data have never been more clear. Researching birth control online, updating a period-tracking app or bringing a phone to the doctor’s office could be used to track and prosecute women across the U.S.,” Sen. Ron Wyden, D-Ore., said last week.

For myriad reasons, both political and philosophical, data privacy laws in the U.S. have lagged far behind those adopted in Europe in 2018.

Until this month, anyone could buy a weekly trove of data on clients at more than 600 Planned Parenthood sites around the country for as little as $160, according to a recent Vice investigation that led one data broker to remove family planning centers from the customer “pattern” data it sells. The files included approximate patient addresses (down to the census block, derived from where their cellphones “sleep” at night), income brackets, time spent at the clinic, and the top places people stopped before and after their visits.

While the data did not identify patients by name, experts say that can often be pieced together, or de-anonymized, with a little sleuthing.

In Arkansas, a new law will require women seeking an abortion to first call a state hotline and hear about abortion alternatives. The hotline, set to debut next year, will cost the state nearly $5 million a year to operate. Critics fear it will be another way to track pregnant women, either by name or through an identifier number. Other states are considering similar legislation.

The widespread surveillance capabilities alarm privacy experts who fear what’s to come if Roe v. Wade is overturned. The Supreme Court is expected to issue its opinion by early July.

“A lot of people, where abortion is criminalized — because they have nowhere to go — are going to go online, and every step that they take (could) … be surveilled,” Conti-Cook said.

Punish women, doctors or friends?

Women of color like Jones, along with poor women and immigrants, could face the most dire consequences if Roe falls since they typically have less power and money to cover their tracks. They also tend to have more abortions, proportionally, perhaps because they have less access to health care, birth control and, in conservative states, schools with good sex education programs.

The leaked draft suggests the Supreme Court could be ready to let states ban or severely restrict abortion through civil or criminal penalties. More than half are poised to do so. Abortion foes have largely promised not to punish women themselves, but instead target their providers or people who help them access services.

“The penalties are for the doctor, not for the woman,” Republican state Rep. Jim Olsen of Oklahoma said last month of a new law that makes performing an abortion a felony, punishable by up to 10 years in prison.

But abortion advocates say that remains to be seen.

“When abortion is criminalized, pregnancy outcomes are investigated,” said Tara Murtha, the communications director at the Women’s Law Project in Philadelphia, who recently co-authored a report on digital surveillance in the abortion sphere.

She wonders where the scrutiny would end. Prosecutors have already taken aim at women who use drugs during pregnancy, an issue Justice Clarence Thomas raised during the Supreme Court arguments in the case in December.

“Any adverse pregnancy outcome can turn the person who was pregnant into a suspect,” Murtha said.

State limits, tech steps, personal tips

A few states are starting to push back, setting limits on tech tools as the fight over consumer privacy intensifies.

Massachusetts Attorney General Maura Healey, through a legal settlement, stopped a Boston-based ad company from steering anti-abortion smartphone ads to women inside clinics there that offer abortion services, deeming it harassment. The firm had even proposed using the same “geofencing” tactics to send anti-abortion messages to high school students.

In Michigan, voters amended the state Constitution to prohibit police from searching someone’s data without a warrant. And in California, home to Silicon Valley, voters passed a sweeping digital privacy law that lets people see their data profiles and ask to have them deleted. The law took effect in 2020.

The concerns are mounting, and have forced Apple, Google and other tech giants to begin taking steps to rein in the sale of consumer data. That includes Apple’s launch last year of its App Tracking Transparency feature, which lets iPhone and iPad users block apps from tracking them.

Abortion rights activists, meanwhile, suggest women in conservative states leave their cellphones, smartwatches and other wearable devices at home when they seek reproductive health care, or at least turn off the location services. They should also closely examine the privacy policies of menstrual trackers and other health apps they use.

“There are things that people can do that can help mitigate their risk. Most people will not do them because they don’t know about it or it’s inconvenient,” said Nathan Freed Wessler, a deputy director with the ACLU’s Speech, Privacy, and Technology Project. “There are very, very few people who have the savvy to do everything.”

Digital privacy was the last thing on Jones’s mind when she found herself pregnant. She was in crisis. She and her partner had ambitious career goals. After several days of searching, she found an appointment for an abortion in nearby Delaware. Fortunately, he had a car.

“When I was going through this, it was just survival mode,” said Jones, who took part in a march Saturday in downtown Baltimore to support abortion rights.

Besides, she said, she’s grown up in the Internet age, a world in which “all of my information is being sold constantly.”

But news of the leaked Supreme Court draft sparked discussions at her law school this month about privacy, including digital privacy in the era of Big Data.

“Literally, because I have my cell phone in my pocket, if I go to a CVS, they know I went to a CVS,” the soon-to-be lawyer said. “I think the privacy right is such a deeper issue in America [and one] that is being violated all the time.”

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US High Schoolers Design Low-Cost Filter to Remove Lead From Water

When the pandemic forced schools into remote learning, Washington-area science teacher Rebecca Bushway set her students an ambitious task: design and build a low-cost lead filter that attaches to faucets and removes the toxic metal.

Using 3D printing and high school-level chemistry, the team now has a working prototype — a 7.5-centimeter-tall filter housing made of biodegradable plastic, which they hope to eventually bring to market for $1 apiece.

“The science is straightforward,” Bushway told AFP on a recent visit to the Barrie Middle and Upper School in suburban Maryland, where she demonstrated the filter in action.

“I thought, ‘We have these 3D printers. What if we make something like this?'”

Bushway has presented the prototype at four conferences, including the prestigious spring meeting of the American Chemistry Society, and plans to move forward with a paper in a peer-reviewed journal.

Up to 10 million U.S. homes still receive water through lead pipes, with exposure particularly harmful during childhood.

The metal, which evades a key defense of the body known as the blood-brain-barrier, can cause permanent loss of cognitive abilities and contribute to psychological problems that aggravate enduring cycles of poverty.

A serious contamination problem uncovered in Flint, Michigan, in 2014 is perhaps the most famous recent disaster — but lead poisoning is widespread and disproportionately impacts African Americans and other minorities, explained Barrie team member Nia Frederick.

“And I think that’s something we can help with,” she said.

The harms of lead poisoning have been known for decades, but lobbying by the lead industry prevented meaningful action until recent decades.

President Joe Biden’s administration has pledged billions of dollars from an infrastructure law to fund the removal of all the nation’s lead pipes over the coming years — but until that happens, people need solutions now.

A clever trick

Bushway’s idea was to use the same chemical reaction used to restore contaminated soil: the exposure of dissolved lead to calcium phosphate powder produces a solid lead phosphate that stays inside the filter, along with harmless free calcium.

The filter has a clever trick up its sleeve: under the calcium phosphate, there’s a reservoir of a chemical called potassium iodide.

When the calcium phosphate is used up, dissolved lead will react with potassium iodide, turning the water yellow — a sign it is time to replace the filter.

Student Wathon Maung spent months designing the housing on 3D printing software, going through many prototypes.

“What’s great about it was that it’s kind of this little puzzle that I had to figure out,” he said.

Calcium phosphate was clumping inside the filter, slowing the reaction. But Maung found that by incorporating hexagonal bevels he could ensure the flow of water and prevent clumping.

The result is a flow rate of 9 liters per minute, the normal rate at which water flows out a tap.

Next, the Barrie team would like to incorporate an instrument called a spectrophotometer that will detect the yellowing of the water even before it is visible to the human eye and then turn on a little LED warning light.

Paul Frail, a chemical engineer who was not involved in the work, said the group “deserves an incredible amount of credit” for its work, combining general chemistry concepts with 3D printing to design a novel product.

He added, however, that the filter would need further testing with ion chromatography instruments that are generally available in universities or research labs — as well as market research to determine the demand.

Bushway is confident there is a niche. Reverse osmosis systems that fulfill the same role cost hundreds to thousands of dollars, while carbon block filters available for around $20 have to be replaced every few months, which is more often than her group’s filter.

“I am over-the-moon proud of these students,” Bushway said, adding that the group hoped to work with partners to finalize the design and produce it at scale. 

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WHO Expects More Cases of Monkeypox to Emerge Globally

The World Health Organization said it expects to identify more cases of monkeypox as it expands surveillance in countries where the disease is not typically found.

As of Saturday, 92 confirmed cases and 28 suspected cases of monkeypox have been reported from 12 member states that are not endemic for the virus, the U.N. agency said, adding it will provide further guidance and recommendations in the coming days for countries on how to mitigate the spread of monkeypox.

“Available information suggests that human-to-human transmission is occurring among people in close physical contact with cases who are symptomatic,” the agency added.

Monkeypox is an infectious disease that is usually mild and is endemic in parts of west and central Africa. It is spread by close contact, so it can be relatively easily contained through such measures as self-isolation and hygiene.

“What seems to be happening now is that it has got into the population as a sexual form, as a genital form, and is being spread as are sexually transmitted infections, which has amplified its transmission around the world,” WHO official David Heymann, an infectious disease specialist, told Reuters.

Heymann said an international committee of experts met via video conference to look at what needed to be studied about the outbreak and communicated to the public, including whether there is any asymptomatic spread, who are at most risk, and the various routes of transmission.

He said the meeting was convened “because of the urgency of the situation.” The committee is not the group that would suggest declaring a public health emergency of international concern, WHO’s highest form of alert, which applies to the COVID-19 pandemic.

He said close contact was the key transmission route, as lesions typical of the disease are very infectious. For example, parents caring for sick children are at risk, as are health workers, which is why some countries have started inoculating teams treating monkeypox patients using vaccines for smallpox, a related virus.

Early genomic sequencing of a handful of the cases in Europe has suggested a similarity with the strain that spread in a limited fashion in Britain, Israel and Singapore in 2018.

Heymann said it was “biologically plausible” the virus had been circulating outside of the countries where it is endemic but had not led to major outbreaks due to COVID-19 lockdowns, social distancing and travel restrictions.

He stressed that the monkeypox outbreak did not resemble the early days of the COVID-19 pandemic because it does not transmit as easily. Those who suspect they may have been exposed or who show symptoms including bumpy rash and fever, should avoid close contact with others, he said.

“There are vaccines available, but the most important message is, you can protect yourself,” he added. 

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