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Tag: World Health Organization

  • Robert F. Kennedy Jr. announces U.S. departure from the World Health Organisation and calls it ‘independence’ | The Mary Sue

    On Jan. 23, 2026, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. posted a video on X announcing that the U.S. had formally completed its withdrawal from the World Health Organization (WHO). Weirdly enough, he framed the decision as a move to “reclaim our independence.”

    The Thursday move finalized a process initiated nearly a year earlier by President Donald Trump. Under WHO rules, a member state’s exit requires a one-year notice period, which the Trump administration triggered in early 2025. On Jan. 22, 2026, the U.S. government formally notified the WHO that the withdrawal process had concluded, ending U.S. funding, personnel participation, and governance involvement.

    But in his video statement, Kennedy framed the decision as a reclamation of sovereignty. He declared that the U.S. was leaving the WHO to “reclaim our independence” and free American public health policy from foreign bureaucracy and international power politics. Kennedy also argued that the organization no longer serves the American people and has drifted far from its original mission.

    The World Health Organization has lost its way. It’s drifted far from its founding mission, and it’s become mired in bureaucracy, in conflicts of interest, and in international power politics.

    Kennedy blames the WHO for COVID failures

    He placed much of the blame on the WHO’s handling of the COVID-19 pandemic, calling its failures “deadly.” He accused the organization of collapsing transparency and accountability during the crisis and claimed those systemic issues remain unresolved. The argument closely mirrors critiques Trump made during his first presidency, now revived as justification for a permanent break.

    Kennedy emphasized that Trump had “recognized the problems immediately,” pointing to the withdrawal order as one of the first executive actions of Trump’s second term. He described the move as a “decisive signal” that American health policy would answer only to Americans, not to “unelected foreign officials.”

    The HHS secretary insisted that leaving the WHO would not weaken U.S. health security. Instead, he claimed the administration has strengthened biosecurity, disease surveillance, outbreak preparedness, and rapid-response capabilities domestically. But only three months ago, the Trump administration fired dozens of employees at the Centers for Disease Control and Prevention. Yet, Kennedy asserts that the United States “doesn’t need outside institutions” to protect its population.

    Director-General calls the reasons cited by the Trump administration for the exit ‘untrue.’

    As part of the withdrawal, Kennedy also confirmed that all U.S. funding to the WHO has ended and that all U.S. government personnel have ceased working with the organization. Future engagement, he said, would be limited solely to completing administrative withdrawal steps and protecting American citizens abroad. Predictably, the announcement was immediately controversial.

    Public health experts have repeatedly warned that the WHO functions as the world’s central hub for disease surveillance, data sharing, vaccine coordination, and outbreak alerts. The U.S. has historically relied on these systems, even while being critical of WHO leadership. The exit now risks isolating the U.S. during future global health emergencies.

    WHO leadership has rejected the Trump administration’s claims outright. Director-General Tedros Adhanom Ghebreyesus has publicly stated that the reasons given for withdrawal are “untrue” (via Arab News). He warned that the decision could make both the world and the United States less safe, not more. On top of it, unresolved legal and financial questions also loom over the decision. 

    WHO officials have noted that the U.S. still owes hundreds of millions of dollars, roughly $260-$280 million in outstanding dues (via WHO). This raises uncertainty over whether the withdrawal will be fully recognized until those obligations are settled. But Kennedy did not address these details in his video. Instead, he closed his message by reframing the move as moral vindication. 

    He dedicated the decision to Americans who died in nursing homes during the pandemic, families harmed by lockdowns, and businesses destroyed by public health mandates. The focus was on portraying WHO not as a flawed institution, but as an unaccountable force imposed on Americans from abroad.

    “America will never withdraw from its leadership in global health,” Kennedy declared, even as the U.S. walked away from the world’s largest global health body. Whether that leadership can exist without the institutions it helped build is a question the administration left unanswered.

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  • California becomes first state to join a World Health Organization network, Newsom’s office says

    California becomes first state to join GOARN, a World Health Organization network, Newsom’s office says

    The news comes after the Trump administration withdrew the United States from the World Health Organization

    Thank you all for for joining us um and I actually want to start you, uh. You or your, you tweeted last or posted last night that this was that this was the tweets, the, the conversation, and yes, thank you for joining us, Governor and thank you so much to the WF for hosting this. This is the conversation that Donald Trump tried to cancel. Don’t miss it 11:30 Pacific. Thank you to our Pacific Time viewers. Um, in fact, this is *** different conversation in the WeF’s defense. It was the privately run USA House which is endorsed by the State Department, funded by. Big American companies which did pull *** pull an event with you with Fortune yesterday and I guess I wondered to begin with, what does that tell you about the way the US private sector, which is really very heavily represented here, so you’re gonna get me in trouble right off the bat moment. uh, I, I looked at the, I admit looking at the list McKinsey and Microsoft and *** few California companies. Uh, so you have you, what the hell are they even talking about, uh, but it’s indicative, I think, of America, uh, for those of you are not American. It gives you *** sense of what we’re up against, um, and what’s happening across my country, uh, and what happened here, um, in, in Davos. I was gonna speak last night. It was well established event at the USA House, *** simple conversation discussion after Trump’s speech. They made sure that I didn’t, uh, they made sure it was canceled, um. And that’s what’s happening in the United States of America. Freedom of expression, freedom of assembly, freedom of speech. Um, it’s America in reverse. Uh, they’re censoring historical facts. They’re rewriting history. Uh, they’re censoring books, 4340 books, libraries, and in schools banned in the United States of America. Uh, you’re watching institutions. Any institution of independent thinking is under assault and attack by the Trump administration. You’re seeing what’s playing out in the streets of American cities, what played out in California, the second largest city in the United States of America. 4000 National Guard were federalized. 700 active duty Marines were not sent overseas. They were sent to my largest city in the state of California, masked men. Guy Greg Bovino dressed up it’s as if he literally went on eBay and purchased SS garb. Greg Bovino, secret police, private army, masked men, people disappearing, quite literally no due process, windows being smashed. Seat belts on being, you know, literally just sort of cut off people dragged in the streets, kids separated from family, knocking on doors, racially profiling American citizens. So is it surprising the Trump administration didn’t like my commentary. And wanted to make sure that I was not allowed to speak. No, it’s consistent with this administration and their authoritarian tendencies. Forgive me, these are objective facts, but I would say this was not just to be clear, this was *** private enterprise endorsed by the State Department, but. These are, these are *** lot of decisions are being made by private companies right now. This is, you know, this is *** capital, this is the probably the central global gathering of CEOs, and I guess I wonder if you can give me *** review of how you see these folks, and you, you know, you know your way around this world, how you see those people behaving. Society becomes how we behave. We are our behaviors, uh, we’re not bystanders in this world. The world we’re experiencing happened on our watch. So in the relationship to your question, yeah, they’re complicit in some respects to this moment, you know, forgive me, you brought up *** tweet, but part of my approach has been *** little more aggressive than perhaps *** lot of American politicians. Uh, I created *** Patriot site. Uh, in, on the site, uh, you can go, there are knee pads that are available to purchase, um. The the last round of knee pads sold out just as our law firms are selling out. Many American universities are selling out, and yes, many corporate leaders are selling out to this administration, selling out our values, selling out our future. Selling out what makes America great. And it breaks my heart and uh and people need to stand up. Uh, people need to uh you know, courage of their damn convictions. Uh we’re the 250th anniversary of the United States of America this year. It’s the 250th anniversary. The best of the Roman Republic, Greek democracy, co-equal branches of government, the rule of law, popular sovereignty. Tell me that that reflects the America you read about today. There’s no rule of law. It’s the rule of Don. I hope it’s. Hope for Europeans, it’s dawning on you. It’s not the rule of law. You don’t have co-equal branches of government. You have *** supine Congress. You don’t have *** Speaker of the House. It doesn’t exist. Popular sovereignty and being challenged every single day by voter suppression, trying to rig elections. I mean, heck, Donald Trump tried to steal the election, the last election, tried to light democracy on fire, and then pardoned everyone that participated in that. Is anyone paying attention to what the hell is going on in the United States of America? So my state of mind is *** little different perhaps than many others. I won’t be complicit at this moment. I won’t. I can’t. I can’t look my kids in the eyes. And so I’m I’m just blessed that I get to represent *** state that’s larger than the size of 21 US states combined. Uh, where 27% of us are foreign born, we practice pluralism. That’s *** word you haven’t heard in America in *** year, uh, where we dominate in every critical category in terms of energy and daring and entrepreneurialism and innovation, uh, and, and, and look, give me *** category. In California outperforms the 4th largest economy in the world, and so we can punch above our weight. We can come here with formal authority and *** little moral authority, and I tell you, we need *** little moral authority. Our body politic in the United States of America today. Governor, you, how do you balance morning everybody. Sorry, I, I figured we would. Yeah, um. You’re ***, you’re, you’re *** tough interview, Governor. The uh the uh. and, and when I think you have chosen *** sort of if you can’t beat them join them strategy to the way you’re talking about this stuff you talk, you know, you, you know, you’re, you’re running around distributing knee pads to CEOs and, and, and, and I think it does them out and it, it does I do have *** few if you’d like, and I don’t know, and honestly it sounds, and you, by the way, I’m not kidding, they’re the new Trump signature series knee pads, um, yeah, and they are available online. I told you the last one sold out, uh, and, uh. And I, I just wanna sort of it’s *** serious moment. It actually, but we laugh, uh, anyway, these are available, uh, and in bulk too, but I wanna, I wanna read you *** couple of things the US government has said about you in, in the last 24 hours or so. The Treasury, the US government, the Treasury Secretary, when you put it, the Treasury Secretary described you as Patrick Bateman meets Sparkle Beach Ken. The White House communications director, hold on, was this, that was the US Secretary of Treasury. I have *** couple more and then, and then you can respond. Um, the White House communications director called you Gavin Newscombe, and *** and an official White House account, uh, um, you know, *** federal government account described you with ***, that’s *** very online sexual slur that people here probably don’t want to hear at 8:30 in the morning. Um, and you’re in some sense responding in kind and waving the knee pads around fire with fire. Do you think, do you should you, I mean, is that, is that kind of discourse from you, from them good for America? Oh, it’s deeply unbecoming. Come on, of course it is. It’s not what we should be doing, but you’ve got to point out the absurdity. You gotta put *** mirror up to this. This is madness. President, you, you see what he’s saying about European leaders, you talking down to people, talking past people. I mean, look at the, the comments he made yesterday we’re not even discussing because you’re discussing all the other comments about windmills or whatever else that was happening. Well, he talked about Somalia’s community. This is not normal. It’s *** deviation of normalcy. We’ve gotta call it out. So I put *** mirror up to Trump and Trumpism in all caps, and it was ironic because Pravda, Fox News in America, uh, others, you know, they got offended by it. They said, Well, where’s his mother to wash his mouth out with soap. I said, Where the hell have you been? You’ve never said *** word about Trump dressing up as the Pope, uh, tweeting out and cosplaying on the world stage, and so look, the Treasury Secretary talked about *** Barbie doll. It was as if he was reading *** diary and had just broken up with someone. I mean that was the Secretary of the Treasury using valuable time yesterday on the world stage. Some sexual, thank you for not sharing that on the official White House account. We’re deeply in their head. I think the affordability agenda appears to be, I’m living rent-free in the Trump’s head, Trump administration’s head. Um, the, um, the, the most talked about speech here in Davos actually isn’t what wasn’t Donald Trump’s address yesterday, it was, it was the Canadian Prime Minister speech. Um, it was Canadian Prime Minister, uh, Mark Carney the day before who talked about, I don’t know, in, in large terms *** bit the middle powers, everybody except for, for, for China and the US, we had to adapt permanently to *** world without. leadership, I, I guess I wonder, I mean, that’s in some sense *** pretty anti-American point of view. That’s, that’s *** view that America is gone from the world stage, that whether the next president is JD Vance, Gavin Newsom, somebody else, this isn’t *** deviation, as you said, this is permanent. Do you buy that? Do you, do you buy Carney’s point of view? I was, you know, I, I felt there were moments, and forgive me, I should be cautious making this statement. I don’t want it to be over analyzed, but when I was listening to the, uh, EU president speak, I, I, I, there were moments where I said that used to be us. I used to, I, I remember that. So am I surprised by what Carney did? Quite the contrary, I thought it was, I, I had more leaders from the United States quietly, I mean, not publicly, I’m not standing up publicly. The transcript of that speech saying wow. They were, I mean, got in Trump said yesterday he had brought it, he brought it up. You know everything about Trump because it’s what’s not in the teleprompter that tells you everything you need to know about where Trump’s head is on things. Um, it was incredibly effective. The markets were more effective markets. It’s not Mother Nature. I thought the most powerful force on Earth with Mother Nature, but it’s the markets, particularly the Trump administration. Combine that with the comments of Macron, combine that with the EU commissioner, but the clarity that came from Prime Minister of Canada. But the fact that he went to China, came back with *** deal, started introducing low cost, high quality electric vehicles not made in Michigan, Detroit. But overseas into Canada, it says everything you know about the recklessness. Of America’s foreign policy. Everything you need to know, you know it intimately, but it’s *** remarkable thing to break down 80+ years of alliances. It takes decades and decades to build trust in organizations, the architecture that it takes weeks, tweets, hours, minutes sometimes to destroy it. Destruction is not strength. The Trump administration is weakness masquerading as strength, and people need to understand that that’s reflected in the tweets, that’s reflected in canceling people, that’s reflected in sending masked men into the American cities. It’s reflected at this moment, so I respect what Carney did because he had courage of convictions. He stood up. And I think we need to stand up in America and call this out with clarity. We can lose our republic as we know it. Our country become unrecognizable in *** matter of months, just not years. It is code red blinking red. In the United States of America, so forgive me, I, I feel this with passion, some indignity that someone frankly has taken it for granted all of these years, and it’s why I came here to Davos to call it out, and I wish there were more of us doing the same because there are more of us. And on that, I just forgive me, I want you to know Donald Trump is an historic president. That’s absolutely correct. He’s historically unpopular. In the United States of America in every category, he’s underwater. He will be remembered in years, not decades. He’s not going to run again. Time of life denies that, not *** state of mind, but time of my life. But we need to manifest that, and we need to do the hard work and that hard work includes the difficult work of coming to Davos and calling that out. This is not where I wanna be spending. I love you all my time. Uh, and, and so, um, anyway, it’s an extension of the conviction I feel about this moment talking about people who, among other things, aren’t American, maybe be concerned for America, but are making decisions about their own politics, their own countries, and what Carney Carney’s core point was this is *** rupture, this isn’t an anomaly, and, and there’s no going back. And do you think that, I mean, do you think there’s *** different an American leader can bring, I think, I, I think these relationships are in dormancy, they’re not dead. I don’t use those binary terms. Don’t, don’t, don’t fall prey to that. That’s *** bit hyperbolic, and I’m prone to *** little of that at times. Uh, dormancy. We can look, he’s an invasive species, Donald Trump. He’s not. He is. Uh, he took over the Republican Party. They’re, they’re just, uh, I mean, uh, he’s got, you know, *** few of them, uh, Lindsey Graham, I mean, my, uh, speaking of the knee pads, uh. I’m sorry, this is tough stuff. It’s tough stuff. I don’t recognize these people any longer. I used to respect Lindsay. I mean, Lindsay, you think what I’m saying about Trump’s tough. How about what Lindsey Graham said about Trump? How about the Secretary of State Marco Rubio? Do you, do you I mean this is, these are the same people. And this is why we, for things to change, we need to change, and that’s why I’m changing my approach. And again I’m grateful you all took that. I mean, I suppose. Do you think post-Trump there’s *** path back because you see this everywhere to kind of unsolve politics that you’re doing here, which you, I see you said you don’t really enjoy it. You kind of seem to. I’m just putting *** mirror up. Just, you gotta. I was doing my 10 point plans before, and I don’t think any of you would have been here this morning had I done that. Oh, they would have been here. No, I, because it just, it wasn’t working. Everyone’s trying to figure this guy out. How do Mark Carney crowd? Yeah, no, but it’s, how do you, how do you, how do you communicate? How do you respond? To This moment. And it’s for me it’s about iteration. It’s an entrepreneurial spirit. It’s *** very California mindset. You gotta keep increasing the number of tries, and I was trying everything, wasn’t working, wasn’t breaking through. Democratic Party writ large, wasn’t breaking through, and we decided the only way to address Trump is quite literally to fight fire with fire. I did an initiative, Prop 50 in California was to reflect the fact that Donald Trump called an American politician and said in the middle of the decade to the governor of the state of Texas, I am entitled. Greg Abbott to 5 seats, and I need you to redraw district lines, mid-year redistricting to rig the 2026 election before 1 vote is cast. What the Trump administration expected we were going to do, as no good Democrats do, we might write an op ed. And we may, you know, all go out and just say this is just so wrong, and all of us would be applauding and say, yes, yes. You know, as he’s consolidating power, instead we went out and we redraw our maps. And we also drew *** line in the sand, and I think that’s what’s required at this moment, and uh he he susses out weakness like no one else. That’s his great strength, that’s his gift. But you punch back. You fight fire with fire, you display conviction and strength, it’s *** different relationship. And so my relationship to this moment is reflected in that. I’m not naive, these guys are gonna try to take me down, not just my state. I’m not naive about what I’ve said this morning and how that will be reflected in the official White House account. I’m not naive about the fact that he threatened to prosecute. The Fed chief in the United States of America that has subpoena against another sitting governor, Tim Waltz. Who’s literally going after his enemies with the FBI and the DOJ and these power ministries. I’m not naive about any of this. I’m not naive about the corruption and the graft at *** scale we’ve never seen in American history. I’m not naive about folks writing billion dollar checks to Witkoff, to Jared Kushner for this new peace deal they’re announcing today. I’m not naive about the fact that the President of the United States made $1.5 billion in the last 12 months personally. How the hell are we putting up with this? We have to call this out unprecedented in American history, happening in real time on our watch. We have to be held to *** higher level, all of us, myself notably, to *** higher level of accountability at this moment. And um You know 11 of what I think one of the main reasons that you know that that he has been successful is, is because the Democratic Party is so discredited in the in the eyes of so many voters. Um, I have *** couple of questions about that. One is big picture about California people, you know, you’re in the midst of ***, you know, enormous economic boom right now, and yet the state is on one hand running deficits and on the other. Not always delivering services that it’s, you know, from education to health care that your citizens are delighted with and and I guess I wonder how can you know how are voters looking at California looking at New York looking at Chicago. You know, supposed to say, yeah, this is the model we want. Well, I’m proud of my state. We have more Fortune 500 companies than any other state in America, more scientists, engineers, more more Nobel laureates in my state than any state in America, the finest system of higher public education in the world. Uh, we have 18% of the world’s R&D, China, 22%, Germany 21%, California, 18% of the world’s R&D. We’re the center of the universe as it relates to AI. 32 of 50, but, but what about the governance? Well, the governance, we’re one of the lowestinsured rates in America. You mentioned healthcare. Uh, we just did our state of education report which showed in every category, every classroom, uh, making progress with our test scores. Our investments are paying off. Just did *** big state of the state. The idea that these blue states have trouble are are spending more for less results, I don’t know, higher life expectancy, lower infant mortality, lower gun death rates, more productivity, higher wages, higher quality of life. $83.1 billion that was the net contribution that we provided to the federal government versus red state like Texas that was *** taker state of $73.1 billion so we’re producing more and people are I think creating more. Opportunities. So look, are there problems? You, for instance, you’re supporting the mayor of LA for re-election after these, these, these terrible fires that *** lot of, you know, *** lot of your citizens do feel was part in part because of government mismanagement. Do you just reject that narrative that the government has anything to do with I absolutely accept that. We all should be held to *** higher level of accountability in terms of our governance, and I think there are many areas of reforms that are necessary, so many areas of reforms that are underway. We can get into the specifics of any one of these issues, but the general notion that in the middle of winter with 100 mile an hour winds or attached to *** fire, that somehow, by the way, There were 16 major fires in Southern California over *** two week period that somehow that had to do with fire hydrants is rather preposterous and it was shape shift because of the complete *** that came from Donald Trump and Elon Musk, saying somehow the sprinklers didn’t work and the fire hydrants didn’t work because we didn’t turn on *** valve in Northern California. These are literal. Words from the Trump administration, uh, so I do reject that. Uh, do I reject this notion of being self-critical about governance and management across the spectrum? No, that’s fair game. And the probably the, the biggest governance issue policy issue fueling right wing parties in the United States around the country is immigration and, and, you know, I think liberal parties again in, in the US and around the world. Had *** posture of welcoming immigrants that it just turned out *** lot of Americans, *** lot of Californians, but more Americans are unhappy with legal illegal immigration, the out of control border, but also. It’s, it’s the last issue on which Trump, though his numbers have been sliding, remained somewhat popular, and I guess I wonder, do you think, do you think that your party went too far or that you went too far? And I think, for instance, you know, in extending, um, medical to the, the California health care program to undocumented immigrants. Like, do you, two different, I guess on the big picture and the small picture, do you feel like you went too far? Two different questions. Uh, do I believe. In universal healthcare, yes, regardless of pre-existing conditions, ability to pay, and your status, I campaigned on that. We delivered on that, and I’m proud of that. We’re one of 16 states to provide care to people regardless of their immigration status. By the way, we have universal care in emergency rooms, and you pay the price on the back end, at least Americans, uh, for that regardless of your immigration status. But the issue of immigration, uh, Donald Trump is very unpopular on immigration. He’s successful on the board. Separate issue connected and yes, the Democratic Party failed in the last few years on the border and yes, I was critical of that and yes, I put our own National Guard on the border the day I got elected into office in 2019, sent 394 National Guard down to the border, and we were very, very pointed with the Biden administration that we were failing to deliver border security for *** number of years on the larger immigration issue. I happen to share the same old office of Ronald Reagan, governor of California, who decided in his last day in office at the White House and he gave *** love letter to immigrants from around the world. It was *** love letter to America, what distinguishes America from the rest of the globe. He talked about lady Torch, Lady Liberty’s torch, and he talked about uh the vibrancy of newcomers, people coming all over the globe for riches and new beginnings, becoming Americans, and what defines our great nation. And that’s the spirit that defines my mindset. Getting first round draft choices around the rest of the world is what makes California so vibrant. It’s because of that diversity and it’s because of people’s willingness to dare and to match up with ideas and perspectives and backgrounds to come in to make *** go of it that has made California the 4th largest GDP in the world, but we have failed on the border. And Donald Trump is failing on immigration. His economic policy is not complicated. It’s tariffs, which is *** regressive tax. It’s mass deportations. Which is having *** major impact on supply chains, and you’ve seen the American jobless rate. You’re seeing it growing, the unemployment rate in America. Besson didn’t talk about this. They had the worst jobs numbers in the first year of the Trump administration outside *** recession since 2003. 49,000 jobs *** month. The Biden administration last year was averaging 168,000 jobs *** month. Inflation is not lowering, it’s still at 2.7%. Ask folks what *** pound of beef costs in the United States of America or *** brand new car. Everything you heard yesterday was BS. And it’s impacted by these policies of tariffs that are impacting ranchers and farmers and small business folks, *** major tax that they celebrate, *** tax that they celebrate collecting, which is ironic from the Republican Party. And the third leg of the stool is *** massive tax cut away from the wealthy and the privileged. Taxing now the burden on small businesses and working folks, that’s the policy easily described of America’s economic strategy, and it’s *** failed strategy, and the impacts of that strategy are being felt all throughout the United States of America, including my state that has been disproportionately impacted, uh, by, uh, these policies. So I’m, I’m very critical of those. I’m critical of our assault on institutions of higher learning research. Institutions, uh, that have literally been, I mean they’re part of that formula for success. The rest of the world gets that, uh, and he’s putting sand in the gears across that spectrum, uh, and, uh, in California again, uh, is, is fighting and pushing back and well, some of those, uh, those first round draft picks got, you know, incredible contracts and are now in, um, made quite *** lot of money and are now. Very freaked out threatening to leave California over *** proposal that just to uh be clear, you oppose to tax to for *** sort of one-time tax on, on, on the wealth of the very, very, very wealthy Californians, and I guess I wanna ask you two questions. One is I was talking to somebody progressive here who said, you know, this guy’s basically *** fake populist. He talks *** good game about the billionaires. Here is an actual proposal that they’re unhappy about, and you’re on the other side. You’re standing with, you know, Elon Musk and David Sachs on this. Why is that, uh. Or one time wealth tax at *** state level that almost exclusively goes to solve one problem, healthcare. And not solving for larger issues like education, supporting. Police officers and firefighters and starves the rest of the general fund. That has had already the impact of people moving out of our state. And impacting then the annual income tax collection is not something I support, um, and by the way, vast majority of labor does not support as well, uh, and, and that’s reflected in my opposition. What’s not reflected in my opposition, quite the contrary, is my advocacy for progressive taxes. That does tax the wealthy disproportionately. Do you have *** theory? I’ve been *** strong advocate for that. Do you have *** theory on how to tax this particular group who often kind of live in this, and I’m sure you know there are people in this room who do this, but who live on debt, you know, who have no income and live on these sort of giant revolving loans. Yeah, I mean that when you, you could have that conversation, I think the wealth tax is sort of an attempt to get at that, yeah, but at *** national level we’re competing with 50 states. Capital flows and move, that’s real. It’s not imagined. It’s very, very real. So we have *** progressive tax structure, the most progressive in the country, by the way, states like Texas and Florida, the most regressive tax structures. They tax their lowest wage earners more than we tax our highest wage earners. They are the high tax states. We have the highest tax rate for the 1%. But for working folks and middle class it’s *** very different tax structure. That’s the approach we promote. That’s the approach that we advance in our state. But again, our state of mind as it relates to the issue of *** state by state wealth tax, the impact of that has to be considered in the context of how freely capital can move and how that’s already occurred. It’s not just an assertion, it’s in evidence already in the state of California as it relates to *** proposal that hasn’t gone on the ballot. *** proposal that has never gotten through the legislature and *** proposal that likely if it did get on the ballot will lose. Would you campaign against it? I’m opposed to it. It’s already had, I think, *** very negative impact on the state and it’s *** badly drafted. Initiative again that literally takes teachers and takes our educational system out of any consideration of support and impacts other parts of our general fund. It is *** flawed initiative and then I think conversely these, these folks who control it *** ton of capital and as you said, some are actually already leaving, have been leaving. How do you, you know, over this, but I think also over *** sense that California, the Democratic leadership broadly. You know, complains about billionaires *** lot. Doesn’t, is, is, is not, does not give them the, uh, you know, love and respect that they feel that they’re entitled to. You know, how do you, what you, I mean, you actually, you, you, you talk to these folks. Some, some of them support you, some don’t. But what, what, what are you saying as you call people up and say, hey, please don’t leave California. What’s your, well, California’s population 3 years in *** row continues to grow, uh, and so does our footprint as it relates to more Fortune 500 companies than we’ve had in over, uh, 2 decades, uh, and. Our innovation ecosystem and startup ecosystem is second to none. We have half of the country’s unicorns in our state, the largest market cap private sector company, uh, OpenAI, just headquartered in San Francisco. They could have chosen any other state in the country. Look, I don’t begrudge other people’s success. I’ve never been that kind of Democrat. But I also recognize in *** world, uh, businesses can’t thrive in *** world that’s failing. 10% of the wealth is concentrated, or rather 2/3 of the wealth in the United States is concentrated in the hands of just 10%, 10% of our consumer spending. Uh, this imbalance, I mean, it was Plutarch who said it to the Athenians 2000 years ago. The imbalance between the rich and the poor is the oldest and most fatal ailment of all republics. Fast forward today, so this concentration, it’s *** very real issue, and we’re gonna have to address that. And, but we have to address it, I think, very thoughtfully and systemically, and I think we have to have it through the lens of *** national, uh, reform. What we’ve done is the exact opposite with HR 1, which is gonna explode deficits. In the United States of America and debt and again it’s transferred the tax burden to small businesses, farmers, and ranchers. Uh, it is an abomination and it’s *** policy unfortunately the Trump administration is very proud of. Do you think *** national reform is enough? I mean, *** lot of this capital is really global. It’s, I mean, this is *** challenge for all of us across the globe and so the challenge is. Do you have *** redistribution mindset or *** predistribution mindset? Do you have *** progressive tax structure that can balance these things? And this is the iteration in the state of California, and this is our approximation, and I think California’s figured it out in many respects. I mean, our economic, our, our entire entrepreneurial system is thriving. In our state where I think found that balance, we had the highest contribution of venture capital last year in our history, $106 billion 68% of it went back into the state of California, despite our progressive tax structure. Well, you know, from the tweets to Plutarch, thank you, thank you so much, Governor. Thank you guys. Thank you everybody for being here. Thank you. Thank you for the tweets.

    California becomes first state to join GOARN, a World Health Organization network, Newsom’s office says

    The news comes after the Trump administration withdrew the United States from the World Health Organization

    Updated: 4:42 PM PST Jan 23, 2026

    Editorial Standards ⓘ

    California has become the first — and so far only — state to join the World Health Organization’s Global Outbreak Alert and Response Network (GOARN), Gov. Newsom’s office announced on Friday. The news comes a day after the United States finalized its withdrawal from the WHO. (Video Above: Gov. Newsom’s full talk at the 2026 World Economic Forum)Newsom’s office said GOARN is a WHO-coordinated network that brings together hundreds of public health institutions, national governments, labs, academic centers and response organizations across the globe. “The Trump administration’s withdrawal from the WHO is a reckless decision that will hurt all Californians and Americans. California will not bear witness to the chaos this decision will bring,” Newsom said in a news release. “We will continue to foster partnerships across the globe and remain at the forefront of public health preparedness, including through our membership as the only state in WHO’s Global Outbreak Alert & Response Network.”Although the California Department of Public Health is the only state-led institution included in GOARN, there are several other U.S.-based entities, including academic institutions and crisis response organizations. The One Health Institute from UC Davis is also listed as a GOARN partner. Newsom’s office said the governor met with WHO Director-General Dr. Tedros Adhanom Ghebreyesus during his recent trip to Switzerland to discuss the collaboration. See more coverage of top California stories here | Download our app | Subscribe to our morning newsletter | Find us on YouTube here and subscribe to our channel

    SACRAMENTO, Calif. —

    California has become the first — and so far only — state to join the World Health Organization’s Global Outbreak Alert and Response Network (GOARN), Gov. Newsom’s office announced on Friday.

    The news comes a day after the United States finalized its withdrawal from the WHO.

    (Video Above: Gov. Newsom’s full talk at the 2026 World Economic Forum)

    Newsom’s office said GOARN is a WHO-coordinated network that brings together hundreds of public health institutions, national governments, labs, academic centers and response organizations across the globe.

    “The Trump administration’s withdrawal from the WHO is a reckless decision that will hurt all Californians and Americans. California will not bear witness to the chaos this decision will bring,” Newsom said in a news release. “We will continue to foster partnerships across the globe and remain at the forefront of public health preparedness, including through our membership as the only state in WHO’s Global Outbreak Alert & Response Network.”

    Although the California Department of Public Health is the only state-led institution included in GOARN, there are several other U.S.-based entities, including academic institutions and crisis response organizations. The One Health Institute from UC Davis is also listed as a GOARN partner.

    Newsom’s office said the governor met with WHO Director-General Dr. Tedros Adhanom Ghebreyesus during his recent trip to Switzerland to discuss the collaboration.

    See more coverage of top California stories here | Download our app | Subscribe to our morning newsletter | Find us on YouTube here and subscribe to our channel

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  • WHO Rebuts CDC: No Link Between Vaccines and Autism

    A new analysis from experts gathered by the World Health Organization found no link between vaccines and autism – countering a recently revised stance by the U.S. Centers for Disease Control and Prevention.

    “The conclusion reaffirms WHO’s position that childhood vaccines do not cause autism,” the organization said Thursday in a statement.

    The analysis comes after the CDC under President Donald Trump last month changed its long-held stance that vaccines don’t cause autism, now saying on its website that the consensus is “not an evidence-based claim because studies have not ruled out the possibility that infant vaccines cause autism.”

    It adds that “studies supporting a link have been ignored by health authorities” and noted that the Department of Health and Human Services has “launched a comprehensive assessment of the causes of autism, including investigations on plausible biologic mechanisms and potential causal links.” HHS Secretary Robert F. Kennedy Jr. told The New York Times that he personally instructed the CDC to make the website change.

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    Public health experts and groups strongly rejected the change, with the American Medical Association saying at the time that it “is deeply concerned that perpetuating misleading claims on vaccines will lead to further confusion, distrust and ultimately dangerous consequences for individuals and public health.”

    WHO’s Global Advisory Committee on Vaccine Safety analysis added to the chorus of objections in reaffirming its previous conclusions from 2002, 2004 and 2012 that vaccines do not cause autism.

    “WHO advises all national authorities to rely on the latest science and ensure vaccine policies are grounded in the strongest available evidence,” the organization said.

    The CDC did not respond to a request for comment on the analysis.

    What Did the WHO Panel Analyze?

    The committee of independent, international experts looked at 31 studies published between January 2010 and August 2025 that included data from multiple countries.

    It found that the data “strongly supports the positive safety profile of vaccines used during childhood and pregnancy, and confirms the absence of a causal link with (autism spectrum disorders).”

    The panel also analyzed the potential health risks associated with vaccines with aluminum adjuvants, which Kennedy has objected to. Some vaccines use small amounts of aluminum adjuvants to boost the body’s immune response.

    The experts reviewed studies conducted from 1999 through 2023 as well as a recent study of children born in Denmark that Kennedy has demanded be retracted. They found no association between autism and aluminum adjuvants in vaccines.

    What Has the CDC Said About Vaccines and Autism?

    The CDC has long said that vaccines do not cause autism. But Kennedy and the Trump administration have shifted that position in recent months.

    The splashiest development by far is the change to the CDC page on vaccines and autism. It prompted backlash from GOP Sen. Bill Cassidy of Louisiana, who voted for Kennedy’s confirmation after gaining several commitments from him, including one to not remove language on the CDC website pointing out that vaccines do not cause autism.

    But the CDC found a way around that promise by adding an asterisk to the page’s headline: “Vaccines do not cause autism.”

    The note at the bottom of the page says that the header “has not been removed due to an agreement with the chair of the U.S. Senate Health, Education, Labor and Pensions Committee that it would remain on the CDC website.”

    But Cassidy said that vaccines protecting against childhood diseases are safe and don’t cause autism, and “any statement to the contrary is wrong, irresponsible and actively makes Americans sicker.”

    “What parents need to hear right now is vaccines for measles, polio, hepatitis B and other childhood diseases are safe and effective and will not cause autism,” Cassidy said.

    Cecelia Smith-Schoenwalder

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  • Gaza Father Hopes Reopening of Medical Corridor Can Save His Injured Son

    KHAN YOUNIS, GAZA (Reuters) -The father of 18-year-old Hassan who says his son was shot in the head over two months ago in Gaza while out seeking food hopes that the reopening of the Rafah border point will save him.

    “The Rafah crossing is our lifeline, for patients and for the Gaza Strip,” Ibrahim Qlob told Reuters in Nasser Hospital in Khan Younis where Hassan lies motionless in bed, his eyes covered with bandages.

    “I’m waiting. One day passing for me feels like a year.”

    The injury caused a brain haemorrhage, necessitating the removal of part of his skull. A later infection caused him to lose sight in his right eye, his father said.

    Now that a fragile ceasefire is taking hold between Israel and Hamas after two years of war, Hassan is just one of 15,600 Gazan patients waiting evacuation, including 3,800 children, according to the World Health Organization.

    Many like him suffer from injuries sustained during the conflict. Others have chronic conditions like cancer and heart disease which the decimated health system cannot cope with.

    Israeli officials have said the Rafah crossing previously used for patients to exit via Egypt would reopen for transfers.

    Two sources told Reuters people could start crossing on Thursday. COGAT, the arm of the Israeli military that oversees aid flows into Gaza, said on Wednesday the date for reopening for people will be announced later.

    During the conflict more than 7,000 patients have been evacuated from Gaza, with Egypt taking over half of them.

    The rate of transfers slowed, however, when Rafah shut in May 2024 and Israel seized control. Since a previous ceasefire collapsed in March, fewer than four patients have exited daily, meaning it would take over 10 years to finish the list, WHO data shows.

    “What we need is more countries to accept patients from Gaza, and we need the restoration of all the medical evacuation routes,” the WHO’s Tarik Jasarevic told reporters this week.

    Mohammed Abu Nasser, 32, who survived a strike on his home in Zeitoun, Gaza City with severe injuries to both legs, said he has been on the waiting list over a year.

    “My condition is getting worse every day,” he said from Al-Ahli Hospital in Gaza City.

    Hundreds have already died waiting, medical groups and Palestinian health authorities say. The WHO, which took over management of the process last year, said 740 people including 137 children on the list have died since July 2024.

    One of them was a girl called Jana Ayad who died from severe acute malnutrition in September, the WHO told Reuters, saying no country accepted her.

    Médecins Sans Frontières project coordinator Hani Isleem said that 19 of its patients on the transfer list had died during the war, including 12 children.

    “Seeing those patients’ files, being in direct touch with these children, and then you know that you lost them because of all these challenges and difficulties, that is really painful,” he said.

    Israeli rejections have sometimes prevented transfers, Isleem added. COGAT did not respond to a request for comment. It has previously said that approvals are subject to security checks.

    “The mortality rate is tragically rising, as would be expected given the decimation of health systems and infrastructure on the ground,” said Kate Takes, a solicitor with Children Not Numbers, a UK-based charity working in Gaza and overseeing cases of children needing evacuation.

    For Hassan, there are worrying signs. His malnutrition is worsening and he now weighs just 40 kilograms (88 lbs), or nearly half his former body weight, his father said.

    “If things stay like this, it will be too late for him.”

    (Reporting by Ebrahim Hajjaj and Ramadan Abed in Gaza and Emma Farge in Geneva; Additional reporting by Olivia Le Poidevin in Geneva and Nidal Al Mughrabi in Cairo; editing by Diane Craft)

    Copyright 2025 Thomson Reuters.

    Photos You Should See – Oct. 2025

    Reuters

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  • Explainer-How Many Palestinians Has Israel’s Gaza Offensive Killed?

    By Nidal al-Mughrabi and Emma Farge

    CAIRO/GENEVA (Reuters) -Palestinian health authorities say Israel’s two-year-old ground and air campaign against Hamas militants in the Gaza Strip has killed more than 67,000 people, with nearly a third of the dead under the age of 18.

    The war, triggered by the deadly October 7, 2023 Hamas attack on Israel, has focused on Gaza City since last month and the offensive has continued despite talks on U.S. President Donald Trump’s new, 20-point plan for ending the conflict.

    HOW DO GAZA HEALTH AUTHORITIES CALCULATE THE DEATH TOLL?

    The latest detailed breakdown released by the Palestinian Ministry of Health on October 7 showed 67,173 killed, including 20,179 children, accounting for 30% of the total.

    The official ministry death toll dwarfs those killed in all previous bouts of fighting between Israelis and Palestinians in Gaza since 2005, according to data from Israeli human rights organisation B’Tselem.

    In the first months of the war, death tolls were calculated simply by counting bodies that arrived in hospitals, and data included names and identity numbers for most of those killed.

    In May 2024, the health ministry included unidentified bodies, which accounted for nearly a third of the overall toll. However, since October 2024, it has only encompassed identified bodies. 

    A Reuters examination in March of an earlier Gaza Health Ministry list of those killed showed that more than 1,200 families were completely wiped out, including one family of 14 people.  

    IS THE GAZA DEATH TOLL COMPREHENSIVE?

    The numbers do not necessarily reflect all victims, as the Palestinian Health Ministry estimates several thousand bodies are under rubble and it does not count the 460 malnutrition-related deaths it has recorded amid a famine in North Gaza.

    Official Palestinian tallies of direct deaths likely undercounted the number of casualties by around 40% in the first nine months of the war as Gaza’s healthcare infrastructure disintegrated, according to a peer-reviewed study published in The Lancet journal in January.

    The U.N. human rights office also says the Palestinian authorities’ figure is probably an undercount.

    The conflict deaths it has verified using its own methodology up to July 20 show that 40% were children and 22% were women.

    A U.N. inquiry assessed last month that Israel had committed genocide in Gaza – citing the scale of the killings as one of the acts backing up its finding. Israel called the finding biased and “scandalous.”

    HOW CREDIBLE IS THE GAZA DEATH TOLL?

    Pre-war Gaza had robust population statistics and better health information systems than in most Middle East countries, public health experts told Reuters.

    The U.N. often cites the health ministry’s death figures and says they are credible.

    DOES HAMAS CONTROL THE FIGURES? 

    While Hamas has run Gaza since 2007, the enclave’s Health Ministry also answers to the overall Palestinian Authority ministry in Ramallah in the West Bank. 

    Gaza’s Hamas-run government has paid the salaries of all those hired in public departments since 2007, including in the Health Ministry. The Palestinian Authority pays the salaries of those hired before then. 

    Israeli officials have said previously that the death toll figures are suspect because of Hamas’ control over government in Gaza, and that they are manipulated. 

    The Israeli military says 466 of its soldiers were killed in combat, and 2,951 others wounded since its Gaza ground operation began on October 27, 2023. 

    It also says it goes to great lengths to avoid civilian casualties. It says Hamas uses Gaza’s civilians as human shields by operating within densely populated areas, humanitarian zones, schools and hospitals, a repeated accusation that Hamas denies.

    The conflict began on October 7, 2023 when Hamas militants stormed across the border into Israeli communities. Israel says the militants killed 1,200 people, mostly civilians, and took 251 people into captivity in Gaza, of whom some 20 are thought to be still alive there.

    HOW MANY OF THE DEAD ARE FIGHTERS?

    The Palestinian Health Ministry figures do not differentiate between civilians and Hamas combatants, who do not wear formal uniform or carry separate identification. 

    The Israeli military said in January 2025 it had killed nearly 20,000 Hamas fighters. It has not provided an update since. Such estimates are reached through a combination of counting bodies on the battlefield, intercepts of Hamas communications and intelligence assessments of personnel in targets that were destroyed. 

    Hamas has said Israeli estimates of its losses are exaggerated, without saying how many of its fighters have been killed.

    (Compiled by Emma Farge, Nidal al-Mughrabi, Ali Sawafta, James MacKenzie and Angus McDowall; editing by William Maclean, Peter Graff, Alexandra Hudson, Mark Heinrich and Deepa Babington)

    Copyright 2025 Thomson Reuters.

    Reuters

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  • We need hospitals more than football stadiums, say Morocco’s young protesters

    Morocco is currently building what will be the globe’s largest football stadium in preparation for co-hosting the 2030 World Cup.

    But for the demonstrators who have taken to the streets each night across the country since last Saturday, this 115,000-capacity showpiece and all the other football infrastructure in development, costing a reported $5bn (£3.7bn), are an affront – an example of a government that has got its priorities wrong.

    “I am protesting because I want my country to be better. I don’t want to leave Morocco, and I don’t want to resent my country for choosing to stay,” says Hajar Belhassan, a 25-year-old communications manager from Settat, 80km (50 miles) south of Casablanca.

    A group called Gen Z 212 – the number is a reference to the country’s international dialling code – has been coordinating the demonstrations through the gaming and streaming platform Discord, as well as TikTok and Instagram.

    Apparently taking inspiration from Nepal’s recent Gen Z protests, the young Moroccans want the authorities to act with the same urgency and passion when it comes to addressing these issues as with hosting one of the world’s premier sporting events.

    Starting on 27 September with protests across 10 cities, the crowds have been building through the week, chanting slogans such as: “No World Cup, health comes first” and “We want hospitals not football stadiums”.

    The police have responded with seemingly arbitrary mass arrests and in certain places things have turned violent, leading to the death of three protesters.

    Prime Minister Aziz Akhannouch said on Thursday that he was open to dialogue, but the leaderless movement has vowed to keep going until there is concrete change.

    A list of their demands has been shared on social media. They include:

    • Free and quality education for all

    • Accessible public healthcare for everyone

    • Decent and affordable housing

    • Lower prices and subsidise basic goods

    • Improve wages and pensions

    • Provide job opportunities for youth and reduce unemployment

    • Adopt English as the second language instead of French (after Arabic)

    Anger had been growing, but what galvanised the movement was the death over a number of days in mid-September of eight women in a maternity ward of a hospital in the southern city of Agadir. There were some reports that the deaths could have been prevented if there had been better care, proper equipment and enough medical staff.

    In 2023, it was estimated that there were 7.8 doctors per 10,000 Moroccans, way below the World Health Organization recommendation of 23 per 10,000.

    Having read about the protests on social media and inspired by a friend, Ms Belhassan decided to join on Monday.

    The day before, that friend had been sending her videos from a demonstration in Casablanca that she was taking part in and Ms Belhassan was immediately uploading them onto her social media accounts.

    Hundreds of people have been arrested [AFP via Getty Images]

    Then, her friend called to say her brother had been arrested. He was not released until the early hours of the following morning. This, Ms Belhassan says, is what pushed her to go out on to the streets.

    “We are making reasonable, basic demands. Health and education are necessities that should already be prioritised,” she tells the BBC in a passionate voice.

    “It breaks my heart to see young, educated and peaceful people faced with arbitrary arrests.”

    When Ms Belhassan went out she noticed that the police were trying to stop people gathering and were making arrests.

    She says she was scared of making eye contact with officers in case she attracted their attention.

    “I was afraid for my safety but I still went out,” she says.

    On Wednesday, interior ministry spokesman Rachid El Khalfi said that 409 people had been detained up to that point.

    He also announced in a press release that 260 police officers and 20 protesters had been injured and 40 police vehicles and 20 private cars were torched in violent clashes.

    Twenty-three-year-old Hakim (not his real name) was one of those arrested.

    He says he went out onto the streets of Casablanca to protest peacefully but ended up in a police cell with around 40 people.

    “This government has been abusing their power too much,” Hakim says. “My father had a stroke a little while ago. If we didn’t have some savings to get him treated in a private hospital he would’ve died. What am I gaining from a country that is not providing healthcare for my ageing parents or educating me?”

    He describes the state-funded education system as being “far behind” what is available in the private sector.

    “We deserve a dignified life,” says Hakim. “We want to host the Fifa World Cup, but we want to do that with our heads up high, not while hiding behind a façade.”

    A police vehicle burns after being set on fire during a youth-led demonstration

    The protest organisers have distanced themselves from the violence [AFP via Getty Images]

    The police response has been heavily criticised by several Moroccan human rights organisations, protesters and the opposition.

    The Gen Z 212 protests are not the first time that young Moroccans have taken to the streets.

    Many commenters online have been drawing parallels with the country’s violent 1981 riots, where those who died became known as the Bread Martyrs as they were protesting against the soaring price of basic foods. A 2004 commission appointed by the king to investigate the country’s past human rights abuses verified 114 deaths but did not disclose how exactly they died. Reparations were then made to victims of human rights abuses and families of deceased ones.

    The country has seen other youth-led movements, notably in 2011 and 2016.

    The events of 2011 were part of the larger Arab Spring and led to reform of the constitution through a national referendum called by King Mohamed VI.

    For the first time in Moroccan history, the monarch strengthened the role of the government by ceding executive power to the prime minister and parliament. The king remains the legitimate head of state, military and religious affairs, holding the power to appoint and remove ministers if necessary.

    What makes Gen Z 212 different is that those demonstrating say they are not tied to a political party and do not appear to have a formal structure.

    “We are not a political movement. We have no leader,” Ms Belhassan says.

    “Maybe that’s why the police were arresting people, and why the government kept silent – because, in their eyes, we didn’t follow the traditional path of organisations and political parties.”

    But there is some disquiet about the violence.

    On the night of 1 October, three protesters died in the town of Lqliaa after people attempted to storm a police station. The local authorities said security forces opened fire after protesters tried to start a fire and steal weapons from the station, then subsequently released supporting CCTV footage to disprove emerging false narratives online.

    Protesters have condemned the rioting and looting that have happened in certain areas and have organised clean-up groups. They have also repeatedly called for peace and dialogue, but it seems they are not convinced by the prime minister’s apparent willingness to talk.

    On Friday, calls began to emerge for the king to dissolve the government. That may be a step too far, but the protesters do not seem to be in the mood to pull back.

    Looking ahead to 2030, protester Ms Belhassan says that “of course” Moroccans are “excited to host the World Cup”.

    “We love football, it is in our blood. But we are missing the foundations. Sure, let’s build stadiums, but let’s also build our education and health systems. Let’s take care of our people.”

    More about Gen Z protests around the world:

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  • Trump in speech to UN says world body ‘not even coming close to living up’ to its potential

    President Donald Trump returned to the United Nations on Tuesday to boast of his second-term foreign policy achievements and lash out at the world body as a feckless institution, while warning Europe it would be ruined if it doesn’t turn away from a “double-tailed monster” of ill-conceived migration and green energy policies.His roughly hour-long speech was both grievance-filled and self-congratulatory as he used the platform to praise himself and lament that some of his fellow world leaders’ countries were “going to hell.”The address was also just the latest reminder for U.S. allies and foes that the United States — after a four-year interim under the more internationalist President Joe Biden — has returned to the unapologetically “America First” posture under Trump.“What is the purpose of the United Nations?” Trump said. “The U.N. has such tremendous potential. I’ve always said it. It has such tremendous, tremendous potential. But it’s not even coming close to living up to that potential.”World leaders listened closely to his remarks at the U.N. General Assembly as Trump has already moved quickly to diminish U.S. support for the world body in his first eight months in office. Even in his first term, he was no fan of the flavor of multilateralism that the United Nations espouses.After his latest inauguration, he issued a first-day executive order withdrawing the U.S. from the World Health Organization. That was followed by his move to end U.S. participation in the U.N. Human Rights Council, and ordering up a review of U.S. membership in hundreds of intergovernmental organizations aimed at determining whether they align with the priorities of his “America First” agenda.Trump escalated that criticism on Tuesday, saying the international body’s “empty words don’t solve wars.”Trump offered a weave of jarring juxtapositions in his address to the assembly.He trumpeted himself as a peacemaker and enumerated successes of his administration’s efforts in several hotspots around the globe. At the same, Trump heralded his decisions to order the U.S. military to carry out strikes on Iran and more recently against alleged drug smugglers from Venezuela and argued that globalists are on the verge of destroying successful nations.The U.S. president’s speech is typically among the most anticipated moments of the annual assembly. This one comes at one of the most volatile moments in the world body’s 80-year-old history. Global leaders are being tested by intractable wars in Gaza, Ukraine and Sudan, uncertainty about the economic and social impact of emerging artificial intelligence technology, and anxiety about Trump’s antipathy for the global body.Trump has also raised new questions about the American use of military force in his return to the White House, after ordering U.S. airstrikes on Iranian nuclear facilities in June and a trio of strikes this month on alleged drug-smuggling boats in the Caribbean Sea.The latter strikes, including at least two fatal attacks on boats that originated from Venezuela, has raised speculation in Caracas that Trump is looking to set the stage for the ouster of Venezuelan President Nicolás Maduro.Some U.S. lawmakers and human rights advocates say that Trump is effectively carrying out extrajudicial killings by using U.S. forces to lethally target alleged drug smugglers instead of interdicting the suspected vessels, seizing any drugs and prosecuting the suspects in U.S. courts.Warnings about ‘green scam’ and migrationTrump touted his administration’s policies allowing for expanded drilling for oil and natural gas in the United States, and aggressively cracking down on illegal immigration, implicitly suggesting more countries should follow suit.He sharply warned that European nations that have more welcoming migration policies and commit to expensive energy projects aimed at reducing their carbon footprint were causing irreparable harm to their economies and cultures.“I’m telling you that if you don’t get away from the ‘green energy’ scam, your country is going to fail,” Trump said. “If you don’t stop people that you’ve never seen before that you have nothing in common with your country is going to fail.”Trump added, “I love the people of Europe, and I hate to see it being devastated by energy and immigration. This double-tailed monster destroys everything in its wake, and they cannot let that happen any longer.”The passage of the wide-ranging address elicited some groans and uncomfortable laughter from delegates.Trump to hold one-on-one talks with world leadersTrump touted “the renewal of American strength around the world” and his efforts to help end several wars. He peppered his speech with criticism of global institutions doing too little to end war and solve the world’s biggest problems.General Assembly President Annalena Baerbock on Tuesday said that despite all the internal and external challenges facing the organization, it is not the time to walk away.“Sometimes we could’ve done more, but we cannot let this dishearten us. If we stop doing the right things, evil will prevail,” Baerbock said in her opening remarks.Following his speech, Trump met with Secretary-General António Guterres, telling the top U.N. official that the U.S. is behind the global body “100%” amid fears among members that he’s edging toward a full retreat.The White House says Trump will also meet on Tuesday with the leaders of Ukraine, Argentina and the European Union. He will also hold a group meeting with officials from Qatar, Saudi Arabia, Indonesia, Turkey, Pakistan, Egypt, the United Arab Emirates and Jordan.He’ll return to Washington after hosting a reception Tuesday night with more than 100 invited world leaders.Gaza and Ukraine cast shadow over Trump speechTrump has struggled to deliver on his 2024 campaign promises to quickly end the Israel-Hamas war in Gaza and Russia’s invasion of Ukraine. His response has been also relatively muted as some longtime American allies are using this year’s General Assembly to spotlight the growing international campaign for recognition of a Palestinian state, a move that the U.S. and Israel vehemently oppose.France became the latest nation to recognize Palestinian statehood on Monday at the start of a high-profile meeting at the U.N. aimed at galvanizing support for a two-state solution to the Mideast conflict. More nations are expected to follow.Trump sharply criticized the statehood recognition push.“The rewards would be too great for Hamas terrorists,” Trump said. “This would be a reward for these horrible atrocities, including Oct. 7.”Trump also addressed Russia’s war in Ukraine.It’s been more than a month since Trump’s Alaska summit with Russian President Vladimir Putin and a White House meeting with Ukrainian President Volodymyr Zelenskyy and key European leaders. Following those meetings, Trump announced that he was arranging for direct talks between Putin and Zelenskyy. But Putin hasn’t shown any interest in meeting with Zelenskyy and Moscow has only intensified its bombardment of Ukraine since the Alaska summit.European leaders as well as American lawmakers, including some key Republican allies of Trump, have urged the president to dial up stronger sanctions on Russia. Trump, meanwhile, has pressed Europe to stop buying Russian oil, the engine feeding Putin’s war machine.Trump said a “very strong round of powerful tariffs” would “stop the bloodshed, I believe, very quickly.” He repeated his calls on Europe to “step it up” and stop buying Russian oil.Trump has Oslo dreamsDespite his struggles to end the wars in Ukraine and Gaza, Trump has made clear that he wants to be awarded a Nobel Peace Prize, repeatedly making the spurious claim that he’s “ended seven wars” since he returned to office.“Everyone says that I should get the Nobel Prize — but for me, the real prize will be the sons and daughters who live to grow up because millions of people are no longer being killed in endless wars,” Trump offered.He again highlighted his administration’s efforts to end conflicts, including between Israel and Iran, India and Pakistan, Egypt and Sudan, Rwanda and the Democratic Congo, Armenia and Azerbaijan, and Cambodia and Thailand.“It’s too bad that I had to do these things instead of the United Nations doing them,” Trump said. “Sadly, in all cases, the United Nations did not even try to help in any of them.”Although Trump helped mediate relations among many of these nations, experts say his impact isn’t as clear cut as he claims.___AP journalists Tracy Brown and Darlene Superville in Washington and Bill Barrow in Atlanta contributed to this report.

    UNITED NATIONS —

    President Donald Trump returned to the United Nations on Tuesday to boast of his second-term foreign policy achievements and lash out at the world body as a feckless institution, while warning Europe it would be ruined if it doesn’t turn away from a “double-tailed monster” of ill-conceived migration and green energy policies.

    His roughly hour-long speech was both grievance-filled and self-congratulatory as he used the platform to praise himself and lament that some of his fellow world leaders’ countries were “going to hell.”

    The address was also just the latest reminder for U.S. allies and foes that the United States — after a four-year interim under the more internationalist President Joe Biden — has returned to the unapologetically “America First” posture under Trump.

    “What is the purpose of the United Nations?” Trump said. “The U.N. has such tremendous potential. I’ve always said it. It has such tremendous, tremendous potential. But it’s not even coming close to living up to that potential.”

    World leaders listened closely to his remarks at the U.N. General Assembly as Trump has already moved quickly to diminish U.S. support for the world body in his first eight months in office. Even in his first term, he was no fan of the flavor of multilateralism that the United Nations espouses.

    After his latest inauguration, he issued a first-day executive order withdrawing the U.S. from the World Health Organization. That was followed by his move to end U.S. participation in the U.N. Human Rights Council, and ordering up a review of U.S. membership in hundreds of intergovernmental organizations aimed at determining whether they align with the priorities of his “America First” agenda.

    Trump escalated that criticism on Tuesday, saying the international body’s “empty words don’t solve wars.”

    Trump offered a weave of jarring juxtapositions in his address to the assembly.

    He trumpeted himself as a peacemaker and enumerated successes of his administration’s efforts in several hotspots around the globe. At the same, Trump heralded his decisions to order the U.S. military to carry out strikes on Iran and more recently against alleged drug smugglers from Venezuela and argued that globalists are on the verge of destroying successful nations.

    The U.S. president’s speech is typically among the most anticipated moments of the annual assembly. This one comes at one of the most volatile moments in the world body’s 80-year-old history. Global leaders are being tested by intractable wars in Gaza, Ukraine and Sudan, uncertainty about the economic and social impact of emerging artificial intelligence technology, and anxiety about Trump’s antipathy for the global body.

    Trump has also raised new questions about the American use of military force in his return to the White House, after ordering U.S. airstrikes on Iranian nuclear facilities in June and a trio of strikes this month on alleged drug-smuggling boats in the Caribbean Sea.

    The latter strikes, including at least two fatal attacks on boats that originated from Venezuela, has raised speculation in Caracas that Trump is looking to set the stage for the ouster of Venezuelan President Nicolás Maduro.

    Some U.S. lawmakers and human rights advocates say that Trump is effectively carrying out extrajudicial killings by using U.S. forces to lethally target alleged drug smugglers instead of interdicting the suspected vessels, seizing any drugs and prosecuting the suspects in U.S. courts.

    Warnings about ‘green scam’ and migration

    Trump touted his administration’s policies allowing for expanded drilling for oil and natural gas in the United States, and aggressively cracking down on illegal immigration, implicitly suggesting more countries should follow suit.

    He sharply warned that European nations that have more welcoming migration policies and commit to expensive energy projects aimed at reducing their carbon footprint were causing irreparable harm to their economies and cultures.

    “I’m telling you that if you don’t get away from the ‘green energy’ scam, your country is going to fail,” Trump said. “If you don’t stop people that you’ve never seen before that you have nothing in common with your country is going to fail.”

    Trump added, “I love the people of Europe, and I hate to see it being devastated by energy and immigration. This double-tailed monster destroys everything in its wake, and they cannot let that happen any longer.”

    The passage of the wide-ranging address elicited some groans and uncomfortable laughter from delegates.

    Trump to hold one-on-one talks with world leaders

    Trump touted “the renewal of American strength around the world” and his efforts to help end several wars. He peppered his speech with criticism of global institutions doing too little to end war and solve the world’s biggest problems.

    General Assembly President Annalena Baerbock on Tuesday said that despite all the internal and external challenges facing the organization, it is not the time to walk away.

    “Sometimes we could’ve done more, but we cannot let this dishearten us. If we stop doing the right things, evil will prevail,” Baerbock said in her opening remarks.

    Following his speech, Trump met with Secretary-General António Guterres, telling the top U.N. official that the U.S. is behind the global body “100%” amid fears among members that he’s edging toward a full retreat.

    The White House says Trump will also meet on Tuesday with the leaders of Ukraine, Argentina and the European Union. He will also hold a group meeting with officials from Qatar, Saudi Arabia, Indonesia, Turkey, Pakistan, Egypt, the United Arab Emirates and Jordan.

    He’ll return to Washington after hosting a reception Tuesday night with more than 100 invited world leaders.

    Gaza and Ukraine cast shadow over Trump speech

    Trump has struggled to deliver on his 2024 campaign promises to quickly end the Israel-Hamas war in Gaza and Russia’s invasion of Ukraine. His response has been also relatively muted as some longtime American allies are using this year’s General Assembly to spotlight the growing international campaign for recognition of a Palestinian state, a move that the U.S. and Israel vehemently oppose.

    France became the latest nation to recognize Palestinian statehood on Monday at the start of a high-profile meeting at the U.N. aimed at galvanizing support for a two-state solution to the Mideast conflict. More nations are expected to follow.

    Trump sharply criticized the statehood recognition push.

    “The rewards would be too great for Hamas terrorists,” Trump said. “This would be a reward for these horrible atrocities, including Oct. 7.”

    Trump also addressed Russia’s war in Ukraine.

    It’s been more than a month since Trump’s Alaska summit with Russian President Vladimir Putin and a White House meeting with Ukrainian President Volodymyr Zelenskyy and key European leaders. Following those meetings, Trump announced that he was arranging for direct talks between Putin and Zelenskyy. But Putin hasn’t shown any interest in meeting with Zelenskyy and Moscow has only intensified its bombardment of Ukraine since the Alaska summit.

    European leaders as well as American lawmakers, including some key Republican allies of Trump, have urged the president to dial up stronger sanctions on Russia. Trump, meanwhile, has pressed Europe to stop buying Russian oil, the engine feeding Putin’s war machine.

    Trump said a “very strong round of powerful tariffs” would “stop the bloodshed, I believe, very quickly.” He repeated his calls on Europe to “step it up” and stop buying Russian oil.

    Trump has Oslo dreams

    Despite his struggles to end the wars in Ukraine and Gaza, Trump has made clear that he wants to be awarded a Nobel Peace Prize, repeatedly making the spurious claim that he’s “ended seven wars” since he returned to office.

    “Everyone says that I should get the Nobel Prize — but for me, the real prize will be the sons and daughters who live to grow up because millions of people are no longer being killed in endless wars,” Trump offered.

    He again highlighted his administration’s efforts to end conflicts, including between Israel and Iran, India and Pakistan, Egypt and Sudan, Rwanda and the Democratic Congo, Armenia and Azerbaijan, and Cambodia and Thailand.

    “It’s too bad that I had to do these things instead of the United Nations doing them,” Trump said. “Sadly, in all cases, the United Nations did not even try to help in any of them.”

    Although Trump helped mediate relations among many of these nations, experts say his impact isn’t as clear cut as he claims.

    ___

    AP journalists Tracy Brown and Darlene Superville in Washington and Bill Barrow in Atlanta contributed to this report.

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  • Trump to take aim at ‘globalist institutions,’ make case for his foreign policy record in UN speech

    Watched by the world, President Donald Trump returns to the United Nations on Tuesday to deliver a wide-ranging address on his second-term foreign policy achievements and lament that “globalist institutions have significantly decayed the world order,” according to the White House.Watch live video from the United Nations in the video player aboveWorld leaders will be listening closely to his remarks at the U.N. General Assembly as Trump has already moved quickly to diminish U.S. support for the world body in his first eight months in office. Even in his first term, he was no fan of the flavor of multilateralism that the United Nations espouses.After his latest inauguration, he issued a first-day executive order withdrawing the U.S. from the World Health Organization. That was followed by his move to end U.S. participation in the U.N. Human Rights Council, and ordering up a review of U.S. membership in hundreds of intergovernmental organizations aimed at determining whether they align with the priorities of his “America First” agenda.“There are great hopes for it, but it’s not being well run, to be honest,” Trump said of the U.N. last week.The U.S. president’s speech is typically among the most anticipated moments of the annual assembly. This one comes at one of the most volatile moments in the world body’s 80-year-old history. Global leaders are being tested by intractable wars in Gaza, Ukraine and Sudan, uncertainty about the economic and social impact of emerging artificial intelligence technology, and anxiety about Trump’s antipathy for the global body.Trump has also raised new questions about the American use of military force in his return to the White House, after ordering U.S. airstrikes on Iranian nuclear facilities in June and a trio of strikes this month on alleged drug-smuggling boats in the Caribbean Sea.The latter strikes, including at least two fatal attacks on boats that originated from Venezuela, has raised speculation in Caracas that Trump is looking to set the stage for the ouster of Venezuelan President Nicolás Maduro.Some U.S. lawmakers and human rights advocates say that Trump is effectively carrying out extrajudicial killings by using U.S. forces to lethally target alleged drug smugglers instead of interdicting the suspected vessels, seizing any drugs and prosecuting the suspects in U.S. courts.“This is by far the most stressed the U.N. system has ever been in its 80 years,” said Anjali K. Dayal, a professor of international politics at Fordham University in New York.Trump to hold one-on-one talks with world leadersWhite House press secretary Karoline Leavitt said Trump would tout “the renewal of American strength around the world” and his efforts to help end several wars.“The president will also touch upon how globalist institutions have significantly decayed the world order, and he will articulate his straightforward and constructive vision for the world,” Leavitt said.Following his speech, Trump will hold one-on-one meetings with U.N. Secretary-General António Guterres and the leaders of Ukraine, Argentina and the European Union. He will also hold a group meeting with officials from Qatar, Saudi Arabia, Indonesia, Turkey, Pakistan, Egypt, the United Arab Emirates and Jordan.He’ll return to Washington after hosting a reception Tuesday night with more than 100 invited world leaders.Gaza and Ukraine cast shadow over Trump speechTrump has struggled to deliver on his 2024 campaign promises to quickly end the Israel-Hamas war in Gaza and Russia’s invasion of Ukraine. His response has been also relatively muted as some longtime American allies are using this year’s General Assembly to spotlight the growing international campaign for recognition of a Palestinian state, a move that the U.S. and Israel vehemently oppose.France became the latest nation to recognize Palestinian statehood on Monday at the start of a high-profile meeting at the U.N. aimed at galvanizing support for a two-state solution to the Mideast conflict. More nations are expected to follow.Leavitt said Trump sees the push as “just more talk and not enough action from some of our friends and allies.”Trump, for his part, in the lead-up to Tuesday’s address has tried to keep focus on getting agreement on a ceasefire that leads Hamas to releasing its remaining 48 hostages, including 20 still believed be alive.“I’d like to see a diplomatic solution,” Trump told reporters Sunday evening. “There’s a lot of anger and a lot of hatred, you know that, and there has been for a lot of years … but hopefully we’ll get something done.”Leaders in the room will also be eager to hear what Trump has to say about Russia’s war in Ukraine.It’s been more than a month since Trump’s Alaska summit with Russian President Vladimir Putin and a White House meeting with Ukrainian President Volodymyr Zelenskyy and key European leaders. Following those meetings, Trump announced that he was arranging for direct talks between Putin and Zelenskyy. But Putin hasn’t shown any interest in meeting with Zelenskyy and Moscow has only intensified its bombardment of Ukraine since the Alaska summit.European leaders as well as American lawmakers, including some key Republican allies of Trump, have urged the president to dial up stronger sanctions on Russia. Trump, meanwhile, has pressed Europe to stop buying Russian oil, the engine feeding Putin’s war machine.Trump has Oslo dreamsDespite his struggles to end the wars in Ukraine and Gaza, Trump has made clear that he wants to be awarded a Nobel Peace Prize, repeatedly making the claim that he’s “ended seven wars” since he returned to office.He points to his administration’s efforts to end conflicts between Israel and Iran, India and Pakistan, Egypt and Sudan, Rwanda and the Democratic Congo, Armenia and Azerbaijan, and Cambodia and Thailand.Although Trump helped mediate relations among many of these nations, experts say his impact isn’t as clear cut as he claims.Still, Trump’s Nobel ambitions could have impact on the tenor of his address, said Mark Montgomery, an analyst at the Foundation for Defense of Democracies in Washington.“His speech is going to be driven by how much he really believes he has a chance of getting a Nobel Peace Prize,” Montgomery said. “If he thinks that’s still something he can do, then I think he knows you don’t go into the U.N. and drop a grenade down the tank hatch and shut it, right?”___AP journalists Tracy Brown and Darlene Superville in Washington contributed to this report.

    NEW YORK —

    Watched by the world, President Donald Trump returns to the United Nations on Tuesday to deliver a wide-ranging address on his second-term foreign policy achievements and lament that “globalist institutions have significantly decayed the world order,” according to the White House.

    Watch live video from the United Nations in the video player above

    World leaders will be listening closely to his remarks at the U.N. General Assembly as Trump has already moved quickly to diminish U.S. support for the world body in his first eight months in office. Even in his first term, he was no fan of the flavor of multilateralism that the United Nations espouses.

    After his latest inauguration, he issued a first-day executive order withdrawing the U.S. from the World Health Organization. That was followed by his move to end U.S. participation in the U.N. Human Rights Council, and ordering up a review of U.S. membership in hundreds of intergovernmental organizations aimed at determining whether they align with the priorities of his “America First” agenda.

    “There are great hopes for it, but it’s not being well run, to be honest,” Trump said of the U.N. last week.

    The U.S. president’s speech is typically among the most anticipated moments of the annual assembly. This one comes at one of the most volatile moments in the world body’s 80-year-old history. Global leaders are being tested by intractable wars in Gaza, Ukraine and Sudan, uncertainty about the economic and social impact of emerging artificial intelligence technology, and anxiety about Trump’s antipathy for the global body.

    Trump has also raised new questions about the American use of military force in his return to the White House, after ordering U.S. airstrikes on Iranian nuclear facilities in June and a trio of strikes this month on alleged drug-smuggling boats in the Caribbean Sea.

    The latter strikes, including at least two fatal attacks on boats that originated from Venezuela, has raised speculation in Caracas that Trump is looking to set the stage for the ouster of Venezuelan President Nicolás Maduro.

    Some U.S. lawmakers and human rights advocates say that Trump is effectively carrying out extrajudicial killings by using U.S. forces to lethally target alleged drug smugglers instead of interdicting the suspected vessels, seizing any drugs and prosecuting the suspects in U.S. courts.

    “This is by far the most stressed the U.N. system has ever been in its 80 years,” said Anjali K. Dayal, a professor of international politics at Fordham University in New York.

    Trump to hold one-on-one talks with world leaders

    White House press secretary Karoline Leavitt said Trump would tout “the renewal of American strength around the world” and his efforts to help end several wars.

    “The president will also touch upon how globalist institutions have significantly decayed the world order, and he will articulate his straightforward and constructive vision for the world,” Leavitt said.

    Following his speech, Trump will hold one-on-one meetings with U.N. Secretary-General António Guterres and the leaders of Ukraine, Argentina and the European Union. He will also hold a group meeting with officials from Qatar, Saudi Arabia, Indonesia, Turkey, Pakistan, Egypt, the United Arab Emirates and Jordan.

    He’ll return to Washington after hosting a reception Tuesday night with more than 100 invited world leaders.

    Gaza and Ukraine cast shadow over Trump speech

    Trump has struggled to deliver on his 2024 campaign promises to quickly end the Israel-Hamas war in Gaza and Russia’s invasion of Ukraine. His response has been also relatively muted as some longtime American allies are using this year’s General Assembly to spotlight the growing international campaign for recognition of a Palestinian state, a move that the U.S. and Israel vehemently oppose.

    France became the latest nation to recognize Palestinian statehood on Monday at the start of a high-profile meeting at the U.N. aimed at galvanizing support for a two-state solution to the Mideast conflict. More nations are expected to follow.

    Leavitt said Trump sees the push as “just more talk and not enough action from some of our friends and allies.”

    Trump, for his part, in the lead-up to Tuesday’s address has tried to keep focus on getting agreement on a ceasefire that leads Hamas to releasing its remaining 48 hostages, including 20 still believed be alive.

    “I’d like to see a diplomatic solution,” Trump told reporters Sunday evening. “There’s a lot of anger and a lot of hatred, you know that, and there has been for a lot of years … but hopefully we’ll get something done.”

    Leaders in the room will also be eager to hear what Trump has to say about Russia’s war in Ukraine.

    It’s been more than a month since Trump’s Alaska summit with Russian President Vladimir Putin and a White House meeting with Ukrainian President Volodymyr Zelenskyy and key European leaders. Following those meetings, Trump announced that he was arranging for direct talks between Putin and Zelenskyy. But Putin hasn’t shown any interest in meeting with Zelenskyy and Moscow has only intensified its bombardment of Ukraine since the Alaska summit.

    European leaders as well as American lawmakers, including some key Republican allies of Trump, have urged the president to dial up stronger sanctions on Russia. Trump, meanwhile, has pressed Europe to stop buying Russian oil, the engine feeding Putin’s war machine.

    Trump has Oslo dreams

    Despite his struggles to end the wars in Ukraine and Gaza, Trump has made clear that he wants to be awarded a Nobel Peace Prize, repeatedly making the claim that he’s “ended seven wars” since he returned to office.

    He points to his administration’s efforts to end conflicts between Israel and Iran, India and Pakistan, Egypt and Sudan, Rwanda and the Democratic Congo, Armenia and Azerbaijan, and Cambodia and Thailand.

    Although Trump helped mediate relations among many of these nations, experts say his impact isn’t as clear cut as he claims.

    Still, Trump’s Nobel ambitions could have impact on the tenor of his address, said Mark Montgomery, an analyst at the Foundation for Defense of Democracies in Washington.

    “His speech is going to be driven by how much he really believes he has a chance of getting a Nobel Peace Prize,” Montgomery said. “If he thinks that’s still something he can do, then I think he knows you don’t go into the U.N. and drop a grenade down the tank hatch and shut it, right?”

    ___

    AP journalists Tracy Brown and Darlene Superville in Washington contributed to this report.

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  • Mpox

    Mpox

    Geneva — The mpox outbreak is not another COVID-19, the World Health Organization said Tuesday, because much is already known about the virus and the means to control it. While more research is needed on the Clade 1b strain which prompted the United Nations agency to declare a public health emergency of international concern (PHEIC), the spread of mpox can be reined in, the WHO’s European director Hans Kluge said.

    In July 2022, the WHO declared a PHEIC over the international outbreak of the less severe Clade 2b strain of mpox, which mostly affected gay and bisexual men. The alarm was lifted in May 2023.

    “Mpox is not the new COVID,” Kluge insisted. “We know how to control mpox and, in the European region, the steps needed to eliminate its transmission altogether,” he told a media briefing in Geneva, via video-link.

    “Two years ago, we controlled mpox in Europe thanks to the direct engagement with the most affected communities,” he said. We put in place robust surveillance; we thoroughly investigated new cases contacts; and we provided sound public health advice. Behavior change, non-discriminatory public health action, and mpox vaccination contributed to controlling the outbreak.”


    Advocates use end of Pride Month to warn about mpox

    02:42

    Kluge said the risk to the general population from the virus was low.

    “Are we going to go in lockdown in the WHO European region, [as if] it’s another COVID-19? The answer is clearly no,” he said.

    Kluge said the predominant route of transmission remained close skin-to-skin contact, but he said it was possible that someone in the acute phase of mpox infection, especially with blisters in the mouth, could transmit the virus to close contacts by droplets, in circumstances such as in the home or in hospitals.

    “The modes of transmission are still a bit unclear. More research is required,” he said.

    WHO spokesman Tarik Jasarevic said the agency was not recommending the use of masks.

    “We are not recommending mass vaccination. We are recommending to use vaccines in outbreak settings for the groups who are most at risk,” he added.

    Mpox surge in Central Africa exposes awareness gap
    Internally displaced women listen to Nathalie Kipenzi, a hygiene promoter, during an awareness campaign for mpox, an infectious disease that causes a painful rash, enlarged lymph nodes and fever, at the Muja camp for the internally displaced in Nyiragongo territory, near Goma in North Kivu province, Democratic Republic of Congo, Aug. 19, 2024.

    Arlette Bashizi/REUTERS


    The WHO declared an international health emergency on August 14, concerned by the rise in cases of Clade 1b in the Democratic Republic of Congo and its spread to nearby countries.

    The WHO declaration came after the Africa Centers for Disease Control and Prevention declared the outbreaks of mpox (formerly known as monkeypox) a public health emergency, with more than 500 deaths attributed to the disease, and called for international help to stop it spreading.

    “This is something that should concern us all,” WHO director-general Tedros Adhanom Ghebreyesus said at the time. “The potential for further spread within Africa and beyond is very worrying.”

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  • How Much Added Sugar Is Okay?  | NutritionFacts.org

    How Much Added Sugar Is Okay?  | NutritionFacts.org

    Public health authorities continue to lower the upper tolerable limit of daily added sugar intake.

    Dating back to the original “Dietary Goals for the United States” in 1977, also known as the so-called McGovern Report, leading nutrition scientists didn’t only call for a reduction in meat and other sources of saturated fat and cholesterol, such as dairy and eggs, but also sugar. The goal was to reduce America’s sugar intake to no more than 10 percent of our daily diet.

    “The conclusions would hang sugar,” reported the president of the Sugar Association. “The McGovern Report has to be neutralized.” The National Cattlemen’s Association was on its side and, just like Big Sugar, appealed to the Senate Select Committee to withdraw the report.

    “The Sugar Industry Empire Strikes Back”—and it appeared to work. When the official U.S. Dietary Guidelines were released in 1980 and again in 1985, it was without a specific limit, like 10 percent. It “said, simply, and in just four words, ‘Avoid too much sugar.’” (Whatever that means.) “In 1990, it went to five words, ‘Use sugars only in moderation,’ and in 1995 to six: ‘Choose a diet moderate in sugars.’” In 2000, it at least went back to limiting intake—specifically, “‘Choose beverages and foods to limit your intake of sugars’ (ten words), but even that was too strong. Under pressure from sugar lobbyists, the government agencies substituted the word ‘moderate’ for ‘limit’ so it read ‘Choose beverages and foods to moderate your intake of sugars.’” Then, the 2005 guidelines committee dropped the s-word completely, encouraging Americans to “Choose carbohydrates wisely…” Again, what does that mean? If only there were a dietary guidelines committee that could guide us….

    The Sugar Association expressed optimism about that 2005 Committee. In its Sugar E-News, it wrote that Sugar Association Incorporated (SAI) “is committed to the protection and promotion of sucrose [table sugar] consumption. Any disparagement of sugar will be met with forceful, strategic public comments”—and it wasn’t kidding. “In 2003, [the World Health Organization] WHO released a joint report with the Food and Agriculture Organization entitled Diet, nutrition and the prevention of chronic diseases which, for the first time [since the McGovern Report], called for a reduction in sugar intake to under 10% of total dietary energy [caloric] consumption.” The Sugar Association responded by threatening to get the United States to withdraw all funding from the WHO. You can see it yourself in black and white at 2:22 in my video Friday Favorites: The Recommended Daily Added Sugar Intake. The Sugar Association threatened to pressure Congress to withdraw funding from the World Health Organization—polio vaccinations and AIDS medications be damned! Don’t mess with the candy man. The threat was described as “tantamount to blackmail and worse than any pressure exerted by the tobacco lobby.” 

    Fifteen years later and 40 years after the first proposed McGovern Report, the 2015 to 2020 Dietary Guidelines for Americans lays out the 10 percent limit as a key recommendation: “Consume less than 10 percent of calories per day from added sugars.” This is currently exceeded by every age bracket in the United States starting at age one, as you can see in the graph below and at 2:58 in my video, with adolescents averaging 87 grams of sugar a day. That means the average teen is effectively eating 29 sugar packets a day. 

    The Sugar Association describes the 10 percent limit as “extremely low.” Well, I mean, it is only up to about a dozen spoonsful a day. Of course, there is no dietary requirement for added sugar at all, and every single calorie we get from added sugar is a wasted opportunity to get calories from sources that provide nutrition. To the American Heart Association’s credit, it went further by trying to push added sugar intake down to about 6 percent of calories, for which a single can of soda could send you over the limit. That’s an added sugar limit exceeded by 90 percent of Americans.

    In 2017, the American Heart Association (AHA) released its guidelines for children, recommending they get no more than about six teaspoons per day. In that case, a single serving of nearly a hundred cereals on the U.S. market would exceed the entire recommended daily limit. The AHA recommends no added sugars at all for children under the age of two, a recommendation that’s violated in up to 80 percent of toddlers, as you can see below and at 4:20 in my video. 

    In the United States, “at least 65 countries have implemented dietary guidelines or public health policies to curb sugar consumption to encourage maintenance of healthy body weight.” In the United Kingdom, the Scientific Advisory Committee on Nutrition made new recommendations to reduce added sugars down to 5 percent, which is also the direction the World Health Organization is headed. The WHO always seems to be ahead of the curve. Why? Because its policy-making process is at least partially protected “against industry influence.” Unlike governments, which may have competing interests in commerce and trade, “WHO is exclusively concerned with health.”

    I spoke at a hearing of the 2020 Dietary Guidelines Committee. Watch the highlights and my speech here: Highlights from the 2020 Dietary Guidelines Hearing.

    The sugar industry keeps pretty busy, as you’ll see from my recent videos, Friday Favorites: Are Fortified Kids’ Breakfast Cereals Healthy or Just Candy? and Flashback Friday: Sugar Industry Attempts to Manipulate the Science.

    Check the related posts below for my other popular videos and blogs on sugar.

    Michael Greger M.D. FACLM

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  • The Return of Measles

    The Return of Measles

    Measles seems poised to make a comeback in America. Two adults and two children staying at a migrant shelter in Chicago have gotten sick with the disease. A sick kid in Sacramento, California, may have exposed hundreds of people to the virus at the hospital. Three other people were diagnosed in Michigan, along with seven from the same elementary school in Florida. As of Thursday, 17 states have reported cases to the CDC since the start of the year. (For comparison, that total was 19, plus the District of Columbia, for all of 2023, and just 6 for 2022.) “We’ve got this pile of firewood,” Matthew Ferrari, the director of the Center for Infectious Disease Dynamics at Penn State, told me, “and the more outbreaks that keep happening, the more matches we’re throwing at it.”

    Who’s holding the matchbook? There’s an easy answer to who’s at fault. One of the nation’s political parties, and not the other, turned against vaccines to some extent during the pandemic, leading to voter disparities in death rates. One party, and not the other, has a presumptive presidential candidate who threatens to punish any school that infringes on parental rights by requiring immunizations. And one party, but not the other, appointed a vaccine-skeptical surgeon general in Florida who recently sidestepped standard public-health advice in the middle of an outbreak. The message from Republicans, as The Washington Post’s Alexandra Petri joked in a recent column, can sound like this: “We want measles in the schools and books out of them!”

    But the politics of vaccination, however grotesque it may be in 2024, obscures what’s really going on. It’s true that vaccine attitudes have become more polarized. Conservative parents in particular may be opting out of school vaccine requirements in higher numbers than they were before. In the blood-red state of Idaho, for example, more than 12 percent of kindergartners received exemptions from the rules for the 2022–23 school year, a staggering rate of refusal that is up by half from where it was just a few years ago. Politicized recalcitrance is unfortunate, to say the least, and it can be deadly. Even so, America’s political divides are simply not the cause of any recent measles outbreak. The virus has returned amid a swirl of global health inequities. Any foothold that it finds in the U.S. will be where hyperlocal social norms, not culture-war debates, are causing gaps in vaccine access and acceptance. The more this fact is overlooked, the more we’re all at risk.

    Consider where the latest measles cases have been sprouting up: By and large, the recent outbreaks have been a blue-state phenomenon. (Idaho has so far been untouched; the same is true for Utah, with the nation’s third-highest school-vaccine-exemption rate.) Zoom into the county level, and you’ll find that the pattern is repeated: Measles isn’t picking on Republican communities; if anything, it seems to be avoiding them. The recent outbreak in Florida unfolded not in a conservative area such as Sarasota, where vaccination coverage has been lagging, but rather in Biden-friendly Broward County, at a school where 97 percent of the students have received at least one MMR shot. Similarly, the recent cases in Michigan turned up not in any of the state’s MAGA-voting, vaccine-forgoing areas but among the diverse and relatively left-wing populations in and around Ann Arbor and Detroit.

    Stepping back to look at the country as a whole, one can’t even find a strong connection—or, really, any consistent link at all—between U.S. measles outbreaks, year to year, and U.S. children’s vaccination rates. Sure, the past three years for which we have student-immunization data might seem to show a pattern: Starting in the fall of 2020, the average rate of MMR coverage for incoming kindergarteners did drop, if only by a little bit, from 93.9 to 93.1 percent; at the same time, the annual number of reported measles cases went up almost tenfold, from 13 to 121. But stretch that window back one more year, and the relationship appears to be reversed. In 2019, America was doing great in terms of measles vaccination—across the country, 95.2 percent of kindergartners were getting immunized, according to the CDC—and yet, in spite of this fantastic progress, measles cases were exploding. More than 1,200 Americans got sick with the disease that year, as measles took its greatest toll in a generation.

    It’s not that our high measles-vaccination coverage didn’t matter then or that our slightly lower coverage doesn’t matter now. Vaccination rates should be higher; this is always true. In the face of such a contagious disease, 95 percent would be good; 99 percent much better. When fewer people are protected, more people can get sick. In Matthew Ferrari’s terms, a dropping immunization rate means the piles of firewood are getting bigger. If and when the flames do ignite, they could end up reaching farther, and burning longer, than they would have just a year or two ago. In the midst of any outbreak large enough, where thousands are affected, children will die.

    Read: The good news about vaccine hesitancy

    Despite America’s fevered national conversation about vaccines, however, rates of uptake simply haven’t changed that much. Even with the recent divot in our national vaccine rates, the country remains in broad agreement on the value of immunity: 93 percent of America’s kindergartners are getting measles shots, a rate that has barely budged for decades. The sheer resilience of this norm should not be downplayed or ignored or, even worse, reimagined as a state of grace from which we’ve fallen. Our protection remains strong. In Florida, the surgeon general’s lackadaisical response to the crisis at the Broward County elementary school did not produce a single extra case of the disease, in spite of grim predictions to the contrary, almost certainly thanks to how many kids are already vaccinated.

    At the same time, however, measles has been thriving overseas. Its reemergence in America is not a function of the nation’s political divides, but of the disease’s global prevalence. Europe had almost 60,000 cases last year, up from about 900 in 2022. The World Health Organization reports that the number of reported cases around the world surged to 306,000, after having dropped to a record low of 123,000 in 2021. As the pandemic has made apparent, our world is connected via pathogens: Large outbreaks in other countries, where vaccination coverage may be low, have a tendency to seed tiny outbreaks in the U.S., where coverage has been pretty high, but narrow and persistent cracks in our defenses still remain. (In 2022, more than half of the world’s unvaccinated infants were concentrated in just 10 countries; some of these are measles hotspots at this moment.) This also helps explain why so many Americans got measles in 2019. That was a catastrophic year for measles around the world, with 873,000 reported cases in total, the most since 1994. We had pretty good protection then, but the virus was everywhere—and so, the virus was here.

    Read: Florida’s experiment with measles

    In high-income countries such as the U.S., Ferrari told me, “clustering of risk” tends to be the source of measles outbreaks more than minor changes in vaccine coverage overall. Even in 2019, when more than 95 percent of American kindergarteners were getting immunized, we still had pockets of exposure where protection happened to be weakest. By far the biggest outbreak from that year occurred among Hasidic Jewish populations in New York State. Measles was imported via Israel from the hot spot of Ukraine, and took off within a group whose vaccination rates were much, much lower than their neighbors’. In the end, more than 1,100 people were infected during that outbreak, which began in October 2018 and lasted for nearly a year. “A national vaccination rate has one kind of meaning, but all outbreaks are local outbreaks,” Noel Brewer, a professor at the University of North Carolina at Chapel Hill and a member of the federal Advisory Committee on Immunization Practices, told me. “They happen on a specific street in a specific group of houses, where a group of people live and interact with each other. And those rates of vaccination in that specific place can drop well below the rate of coverage that will forestall an outbreak.”

    We’ve seen this time and time again over the past decade. When bigger outbreaks do occur in the U.S., they tend to happen in tight-knit communities, where immunization norms are radically out of sync with those of the rest of American society, politics aside. In 2014, when an outbreak of nearly 400 cases took hold in Ohio, almost entirely within the Amish community, the local vaccination rate was estimated to be about 14 percent. (The statewide number for young children at that time was more than 95 percent.) In 2011 and 2017, measles broke out among the large Somali American community in Minnesota, where anti-vaccine messaging has been intense, and where immunization rates for 2-year-olds dropped from 92 percent 20 years ago to 35 percent in 2021. An outbreak from the end of 2022, affecting 85 people in and around Columbus, Ohio, may well be linked to the nation’s second-biggest community of Somalis.

    Care must be taken in how these outbreaks are discussed. In Minnesota, for example, state health officials have avoided calling out the Somali community, for fear of stigmatizing. But another sort of trouble may arise when Americans overlook exactly who’s at risk, and exactly why. Experts broadly agree that the most effective way to deal with local outbreaks is with local interventions. Brewer pointed out that during the 2019 outbreak in New York, for example, nurses who belonged to local Jewish congregations took on the role of vaccine advocates. In Minnesota, the Department of Health has brought on more Somali staff, who coordinate with local Somali radio and TV stations to share its message. Yet these efforts can be obscured by news coverage of the crisis that points to a growing anti-science movement and parents giving up on vaccination all across the land. When measles spread among New York’s orthodox Jews, The New York Times reported on “an anti-vaccine fervor on the left that is increasingly worrying health authorities.” When the virus hit Columbus, NBC News noted that it was “happening as resistance to school vaccination requirements is spreading across the country.”

    Two different public-health responses can be undertaken in concert, the experts told me: You treat the problem at its source, and you also take the chance to highlight broader trends. A spate of measles cases in one community becomes an opportunity for pushing vaccination everywhere. “That’s always an important thing for us to do,” Ferrari said. Even so, the impulse to nationalize the problem will have its own, infelicitous effects. First, it’s meaningfully misleading. By catastrophizing subtle shifts in vaccination rates, we frighten many parents for no reason. By insisting that every tiny outbreak is a product of our national politics, we distract attention from the smaller measures that can and should be taken—well ahead of any upsurge of disease—to address hyperlocal vaccination crises. And by exaggerating the scale of our divisions—by asserting that we’ve seen a dangerous shift on a massive scale, or an anti-vaccine takeover of the Republican Party—we may end up worsening the very problem that worries us the most.

    We are a highly vaccinated nation, our politics notwithstanding. Telling people otherwise only fosters more division; it feeds the feeling that taking or refusing measles shots is an important mode of self-expression. It further polarizes health behavior, which can only widen the cracks in our defenses. “We have become quite militant and moralistic about vaccination,” Brewer told me, “and we probably would do well to be less absolute.” Measles outbreaks overseas are growing; measles outbreaks here will follow. Their specific causes ought not be ignored.

    Daniel Engber

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  • WHO chief warns ‘future generations may not forgive us’ if pandemic treaty not agreed upon: ‘There will be a next time’

    WHO chief warns ‘future generations may not forgive us’ if pandemic treaty not agreed upon: ‘There will be a next time’

    Future generations may not forgive the World Health Organization’s member nations, should they fail to agree on a pandemic treaty, the organization’s chief said Saturday at the Warwick Economic Summit, calling the agreement “mission critical for humanity.”

    Despite lessons that should have been learned during COVID-19, the world is unprepared for the next pandemic, be it an influenza virus, another coronavirus, or “Disease X”—a term the organization has used since 2018 to refer to a yet-unknown pandemic pathogen, Director General Tedros Adhanom Ghebreyesus said, speaking virtually from Geneva at the summit, held in Coventry, England.

    Already, the world was unprepared for the COVID-19 pandemic—and because of this, “the poorest countries were left behind, waiting for scraps,” he said, regarding access to tests, therapeutics, and vaccines.

    “We cannot allow the same thing to happen next time, and there will be a next time,” he warned.

    WHO member states met in Geneva in 2022 and agreed to develop an international agreement on pandemic preparation and response that would become international law, “a legally binding pact between countries working together,” Ghebreyesus said.

    A draft has been developed after “extensive consultations” with member states, public health experts, academic groups, and citizens, and public hearings have been held regarding it, he said. Countries have set themselves a deadline to agree on that draft, ahead of the annual World Health Assembly, to be held May 27 through June 1 in Geneva, Switzerland.

    Treaty not unprecedented in scope, WHO chief says

    But two major obstacles stand in the way of agreement, Ghebreyesus said. One, a group of issues that, though not insurmountable, need further negotiation. The second: “a torrent of fake news, lies, and conspiracy theories.”

    Among them, he said: that the agreement is a “power grab by the WHO” and a “conspiracy” that would give the international health organization the ability to initiate lockdowns and/or vaccine mandates.

    Objections to the pandemic treaty were recently fueled by online rumors regarding “Disease X” ahead of a January session on the topic at the World Economic Forum in Davos, Switzerland, which Ghebreyesus attended. 

    The run-of-the mill pandemic preparation session was blown out of proportion when right-wing social media accounts slammed the session, charging that world leaders were convening to discuss plans to impose vaccine mandates, restrict free speech, and even plan pandemics themselves.

    Among concerned parties: former Trump-era Assistant Secretary for Public Affairs for the U.S. Treasury Department and Fox News analyst Monica Crowley, who, ahead of the January session, tweeted a baseless warning that “unelected globalists at the World Elected Forum will hold a panel on a future pandemic 20x deadlier than COVID.”

    “Just in time for the election, a new contagion to allow them to implement a new WHO treaty, lock down again, restrict free speech and destroy more freedoms,” she wrote. “Sound far-fetched? So did what happened in 2020.”

    Such claims are “completely false,” Ghebreyesus said Saturday. “We don’t have the power to do that. We don’t want it. We’re not trying to get it.”

    What’s more, nations who sign onto the agreement would be able to withdraw at any time, he said, adding that the agreement would “affirm nations’ sovereignty.”

    He encouraged skeptical parties to review a draft of the treaty on the organization’s website.

    Similar international treaties have been formed regarding chemical, nuclear, and biological weapons, in addition to tobacco and climate change, he added.

    Public health experts supportive, but not without concerns

    The world needs a “robust” pandemic treaty, Dr. Georges Benjamin, executive director of the American Public Health Association, told Fortune on Saturday. He is concerned, however, that when nations finally approve such an agreement, “it will be watered down so it is meaningless.”

    “Currently we have difficulty getting nations to comply with the agreements from the international health regulations,” he said. “Accountability is key here, but we will have to see.”

    The legally binding treaty would need to have “teeth,” he added, “but they rarely do.”

    What’s more, in the U.S., an approved treaty would need to be passed by the Senate to be binding. While the nation signed on to a WHO treaty on tobacco control adopted in 2003, it never ratified it.

    Even if a treaty is agreed upon and the Biden administration agrees to it, “What will the U.S. do with it?” Benjamin asked. “We have not approved the tobacco treaty yet.”

    Dr. Amesh Adalja—an infectious disease specialist and senior scholar at the Johns Hopkins Center for Health Security—told Fortune that an international treaty or similar mechanism is critical for optimal preparation and response to future pandemics.

    He worries, however, that such a mechanism could be used to “undermine intellectual property rights in the name of pandemic preparedness.”

    “It is intellectual property rights that facilitate the development of the tools that are the ultimate solutions to minimizing the impact of a pandemic,” he said.

    Subscribe to Well Adjusted, our newsletter full of simple strategies to work smarter and live better, from the Fortune Well team. Sign up for free today.





    Erin Prater

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  • World leaders are gathering to discuss Disease X. Here’s what to know about the hypothetical pandemic.

    World leaders are gathering to discuss Disease X. Here’s what to know about the hypothetical pandemic.

    World leaders gathered at the World Economic Forum’s annual meeting in Davos, Switzerland, on Wednesday to discuss Disease X, a hypothetical virus 20 times deadlier than COVID-19.

    While such a virus isn’t known to currently exist, researchers, scientists and experts are hoping to proactively come up with a plan of action to combat such a virus and prepare the health system if it were to emerge as a pandemic — a possibility one expert told CBS News could happen sooner than we think.

    “There are strains of viruses that have very high mortality rates that could develop the ability to transmit efficiently from human to human,” said Dr. Amesh Adalja of the Johns Hopkins Center for Health Security.

    What is Disease X?

    In 2022, the World Health Organization brought together 300 scientists to look into 25 virus families and bacteria to create a list of pathogens that they believe have the potential to wreak havoc and should be studied more. Included on that list is Disease X, which was first recognized by the organization in 2018.

    The WHO says the virus “represents the knowledge that a serious international epidemic could be caused by [an unknown] pathogen.” 

    WHO Director-General Tedros Adhanom Ghebreyesus said Wednesday in Davos that COVID-19 may have been our first “Disease X,” and that scientists and experts are actively learning from that experience.

    From where could a pathogen like Disease X originate?

    A deadly pathogen like Disease X, which would likely be a respiratory virus, according to Adalja, could already be circulating in animal species and is just not able to be transmitted to humans yet.

    “That could be bats like COVID-19, it could be in birds like bird flu, or it could be some other type of animal species, swine for example,” he said. “It’s really about that interface between humans and animals, where interactions are occurring, that these types of viruses get a foothold.”

    How are experts preparing for Disease X?

    If we are unprepared, it is likely a disease of that scale could cause even more damage than we experienced with COVID-19, which has killed more than 7 million people, according to the WHO.

    “If we did so poorly with something like COVID-19, you can imagine how poorly we would do with something like a 1918-level event,” Adalja said, referring to the influenza pandemic of 1918 that killed an estimated 50 million people around the world, according to the Cleveland Clinic.

    That’s why experts from around the world have been working on a robust and effective plan to prepare for the worst-case scenario. Ghebreyesus said an early-warning system and a plan for health infrastructure, which was overburdened during the COVID-19 pandemic, leading to many deaths, could help in a future scenario. 

    “Whether it’s in health systems or even the private sector, by the way — research and development — you can prepare for it,” he said.

    Another major lesson from COVID-19 is the importance of transparency, Adalja said.

    “I think what we see now is this distrust between infectious disease physicians, public health practitioners and the general public, because what happened is politicians injected themselves into this,” he said. “People may not actually be receptive to the protective actions that are being recommended by public health officials.”

    Ghebreyesus said the WHO, in partnership with other global organizations, has already put initiatives in place in preparation for the next major pandemic or epidemic. These efforts include the pandemic fund to help nations with resources, the mRNA vaccine technology transfer hub to ensure vaccine equity for low-income nations and the hub for pandemic and epidemic intelligence to improve collaborative surveillance between countries.

    Simrin Singh

    Simrin Singh is a social media producer and trending content writer for CBS News.

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  • ‘Disease X’ could cause the next pandemic, according to the WHO—or Ebola, SARS, or Nipah. 9 pathogens researchers are keeping a watchful eye on

    ‘Disease X’ could cause the next pandemic, according to the WHO—or Ebola, SARS, or Nipah. 9 pathogens researchers are keeping a watchful eye on

    The annual meeting of the World Economic Forum—to be held in Davos, Switzerland, next week—is on more radars than usual this year, thanks to the name of one of the sessions: “Preparing for Disease X.”

    What is ‘Disease X’?

    “Disease X,” according to the World Health Organization, “represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease.”

    Indeed, the organization’s head, Director General Tedros Adhanom Ghebreyesus, will speak at the event, in addition to Michel Demaré, chair of the board of AstraZeneca, Brazil Minister of Health Nisia Trindade Lima, and Jamil Edmond Anderlini, editor in chief of Politico Europe, among others.

    The run-of-the-mill pandemic preparation session was blown out of proportion late this week, leading to the phrase “Disease X” trending on both Twitter and Google at times. Right-wing social media accounts slammed the session, charging that world leaders would convene to discuss plans to impose vaccine mandates, restrict free speech, and even plan pandemics themselves.

    On Thursday night, former Trump-era Assistant Secretary for Public Affairs for the U.S. Treasury Department and Fox News analyst Monica Crowley tweeted a baseless warning that “unelected globalists at the World Elected Forum will hold a panel on a future pandemic 20x deadlier than COVID.”

    “Just in time for the election, a new contagion to allow them to implement a new WHO treaty, lock down again, restrict free speech and destroy more freedoms,” she wrote. “Sound far-fetched? So did what happened in 2020.”

    Dr. Amish Adalja, senior scholar at the Johns Hopkins Center for Health Security, tells Fortune that those in the medical and public health professions “have always conducted thought experiments and tabletop exercises to prepare for pandemics.”

    “These exercises serve the vital function of identifying strengths and weaknesses, as well as highlighting important aspects of response that merit further refinement,” he says.

    “To arbitrarily suggest these exercises and meetings are part of some kind of conspiracy evades the actual purpose they serve and the problems on which they are trying to gain traction, all for the nihilistic purpose of compromising pandemic preparedness and brazen pandering,” he added.

    Dr. Stuart Ray, vice chair of medicine for data integrity and analytics at Johns Hopkins’ Department of Medicine, told Fortune that it would be “irresponsible” for world leaders not to meet at the forum.

    “There have been multiple such events in recorded history, and the recent coronavirus pandemic taught us that rapid response can save millions of lives,” he said. “Coordination of public health response is not conspiracy, it’s simply responsible planning.”

    Such meetings should be publicized because “such planning requires oversight, appreciation for personal impact on personal and economic freedom, and impact on special populations,” he added. “It makes good sense for a global public health organization, scientific leaders, and interested private individuals to be involved.”

    The WHO’s ‘priority pathogens,’ aside from ‘Disease X’

    The WHO maintains a list of “priority pathogens” that “pose the greatest public health risk due to their epidemic potential and/or whether there are no, or insufficient, countermeasures” available.

    Last updated in 2018, an updated list was expected last year and is now expected during the first half of 2024, according to the group.

    While the list is far from exhaustive and doesn’t necessarily indicate the most likely cause of the next epidemic or pandemic, here are the known pathogens global public health officials are keeping an eye on, in addition to “Disease X.”

    Ebola & Marburg virus diseases

    Viruses in this family cause hemorrhagic, or bloody, fevers, which are typically accompanied by bleeding from bodily orifices and/or internal organs. The family consists of five strains of Ebola in addition to Marburg—an extremely similar virus that made headlines during an outbreak in Equatorial Guinea earlier this year. 

    On average, Ebola kills about 50% of those it sickens, though case fatality rates have ranged from 25%-90%, according to the WHO. Marburg also kills around 50% of those it infects, though case fatality rates range from around 24% to 88%, experts say. While there are two licensed vaccines for the deadliest strain of Ebola, Zaire, there aren’t any for the four other strains. Nor is there an approved vaccine for Marburg, though some are in development.

    Crimean-Congo hemorrhagic fever

    Like Ebola and Marburg, Crimean-Congo hemorrhagic fever is an acute viral hemorrhagic illness that can cause bleeding from bodily orifices. Symptom onset is sudden and can include fever, muscle ache, dizziness, neck pain, back ache, headache, sore eyes, and light sensitivity. Nausea, vomiting, diarrhea, abdominal pain, and sore throat may also occur, followed by sharp mood swings and confusion. 

    Two to four days later, agitation may turn into sleepiness, depression, and lassitude; abdominal pain may concentrate in the upper right quadrant; and the liver might become enlarged, according to the WHO. 

    Other symptoms may include fast heart rate, enlarged lymph nodes, and a petechial rash (caused by bleeding into the skin) on internal mucosal surfaces like the mouth and throat, and on the skin. The rash may grow. Hepatitis is usually present. After the fifth day of illnesses, patients may suffer the failure of organs like the kidneys, liver, or lungs.

    The case fatality rate for this illness—spread by ticks and the tissue of infected animals during and after slaughter—is around 30%. Most patients who die do so in the second week of illness. Those who recover generally begin to improve after the ninth or tenth day of illness.

    Lassa fever

    Like Ebola, Marburg, and Crimean-Congo hemorrhagic fever, Lassa fever is an acute viral hemorrhagic illness. But with a case fatality rate of 1%, it’s far less deadly. The vast majority of those infected with Lassa fever—80%—have no symptoms.

    For the other 20%, disease is severe. Symptoms usually start with non-specific ailments not unlike COVID or the flu—fever, weakness, and malaise—and then progress to headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhea, cough, and stomach pain. Facial swelling, collection of fluid in the lung cavity, and low blood pressure may develop, in addition to shock, seizures, tremor, disorientation, and coma. Multiple organ systems are often damaged. Those who survive may suffer from temporary or permanent deafness, in addition to transient hair loss and gait disturbance.

    Those who die of the virus usually do so within two weeks of onset, according to the WHO. Eighty percent of pregnant women in their third trimester who are infected die, in addition to their fetus. Rodents carry the virus and also shed it in their urine and feces.

    Severe Acute Respiratory Syndrome (SARS)

    The world’s first known coronavirus pandemic occurred in 2002, when SARS-CoV-1 was reported in China. It spread to more than two dozen countries in North and South America and Europe before being contained seven months later. SARS is thought to have originated in an animal population, perhaps bats, before being passed to civet cats—a tropical animal that looks like a mix of a dog and an ocelot—and then to people. A spillover could happen again, experts say.

    Symptoms include headache, body aches, mild respiratory symptoms, possible diarrhea, an eventual dry cough, and pneumonia in most. SARS sickened nearly 8,100 people and killed just under 10% of them from 2002 to 2003. There is no licensed vaccine for SARS, though researchers are working on universal coronavirus vaccines that could target both SARS and COVID, among other coronaviruses.

    Middle East respiratory syndrome coronavirus (MERS)

    SARS was the world’s first identified killer coronavirus, and MERS was the second. Discovered in 2012 in Saudi Arabia, it caused about 2,500 cases and 800 deaths. SARS has not been detected since 2004, but MERS continues to be reported sporadically, with the latest report—of three infections and two deaths—occurring in Saudi Arabia in August 2023.

    Nipah and other henipaviral diseases

    Nipah is a henipavirus, the most lethal of paramyxoviruses. It was first identified in pigs in Malaysia and Singapore in the late 1980s, though its natural reservoir is fruit bats. The other henipavirus known to infect people, Hendra, was first noted in racehorses and humans in Australia in 1994. Both feature respiratory illness and severe flu-like symptoms, and may progress to encephalitis—inflammation of the brain—along with other neurologic symptoms and death.

    Nipah kills between 45% and 75% of the people it infects. No licensed vaccines exist, though a vaccine by Moderna, in coordination with the U.S. National Institute of Allergy and Infectious Diseases Vaccine Research Center, is being evaluated.

    Rift Valley fever

    This virus is known for causing massive devastation among livestock. While it can be transmitted from animals to other animals and to humans as well, it’s not yet known to transmit from humans to other humans. But with viral evolution, that could change.

    Human infections occur through inoculation—for instance, via a wound through an infected knife, or through broken skin. Humans can also be infected via aerosols produced during the slaughter of infected animals. Human infection may also be possible through drinking unpasteurized or uncooked milk of infected animals, according to the WHO. Additionally, human infection could occur through the bites of infected mosquitoes or blood-feeding flies.

    Most infected humans don’t develop symptoms; if they do, cases are mild. Symptoms include the sudden onset of a flu-like fever, muscle pain, joint pain, and headache. Neck stiffness, light sensitivity, appetite loss, and vomiting are also possible. Such cases may be mistaken for meningitis.

    Around 3% of cases will develop severe disease, and less than 1% will die. Severe disease usually takes one of three forms: ocular, meningoencephalitis, or hemorrhagic.

    Zika virus

    Like COVID, Zika virus-related microcephaly (a brain-related birth defect) was once declared a public health emergency of international concern (PHEIC) by the WHO, from February through November of 2016. Most who are infected with the virus—transmitted primarily by Aedes mosquitoes—don’t develop symptoms. Those who do usually experience rash, fever, conjunctivitis, muscle and joint pain, malaise, and headache for two to seven days.

    More troubling, infection during pregnancy can result in infants with congenital malformations, in addition to early birth and miscarriage. It can also result in Guillain-Barré syndrome, neuropathy, and myelitis in adults and children, according to the WHO.

    Erin Prater

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  • Mpox in the United States Fast Facts | CNN

    Mpox in the United States Fast Facts | CNN



    CNN
     — 

    Here’s a look at mpox, formerly known as monkeypox, in the United States. In 2022, an outbreak was declared a public health emergency of international concern by the World Health Organization (WHO). The virus originated in Africa and is the cousin of the smallpox virus.

    In November 2022, WHO renames the monkeypox virus as mpox after working with International Committee on the Taxonomy of Viruses (ICTV) to rename the the virus using non-stigmatizing, non-offensive social and cultural nomenclature.

    (Source: Centers for Disease Control and Prevention)

    Mpox is a poxvirus. It generally causes pimple- or blister-like lesions and flu-like symptoms such as fever. The disease is rarely fatal.

    Mpox spreads through close contact. This includes direct physical contact with lesions as well as “respiratory secretions” shared through face-to-face interaction and touching objects that have been contaminated by mpox lesions or fluids. The virus may also pass to a fetus through the placenta.

    Anyone can become ill from mpox, but the US Centers for Disease Control and Prevention (CDC) says that more than 99% of mpox cases in the United States in the 2022 outbreak have been among men who have sex with men. However, mpox is not generally considered a sexually transmitted disease.

    Mpox is usually found in West and Central Africa, but additional cases have been seen in Europe, including the United Kingdom, and other parts of the world in recent years. Those cases are typically linked to international travel or imported animals infected with the poxvirus.

    CDC Mpox Map and Case Count

    WHO Situation Reports

    Timeline and 2022 Outbreak

    1958 – Mpox is discovered when monkeys kept for research cause two outbreaks in Copenhagen, Denmark.

    1970 – The first human case is recorded in Zaire (now the Democratic Republic of Congo).

    2003 – An outbreak in the United States is linked to infected pet prairie dogs imported from Ghana and results in more than 80 cases.

    July 16, 2021 – The CDC and local health officials in Dallas announce they are investigating a case of mpox in a traveler from Nigeria. “The individual is a City of Dallas resident who traveled from Nigeria to Dallas, arriving at Love Field airport on July 9, 2021. The person is hospitalized in Dallas and is in stable condition,” the Dallas County Department of Health and Human Services says in a statement.

    May 17, 2022 – The first confirmed US case of mpox in the 2022 outbreak is reported to the CDC in a traveler who returned to Massachusetts from Canada.

    May 19, 2022 – WHO reports that death rates of the outbreak have been between 3% and 6%.

    May 23, 2022 – The CDC announces the release of mpox vaccine doses from the nation’s Strategic National Stockpile for “high-risk people.” In the United States, the two-dose Jynneos vaccine is licensed to prevent smallpox and specifically to prevent mpox.

    May 26, 2022 – CDC Director Dr. Rochelle Walensky announces that the United States is distributing the vaccine to states with reported cases and recommends vaccination for people at highest risk of infection due to direct contact with someone who has mpox.

    June 22, 2022 – The CDC announces a partnership with five commercial laboratories to ramp up testing capacity in the United States.

    June 23, 2022 – New York City launches the first mpox vaccination clinic in the United States.

    June 28, 2022 – The US Department of Health and Human Services (HHS) and the Biden administration announce an enhanced vaccination strategy and report that more than 9,000 doses of vaccine have been distributed to date.

    July 22, 2022 – Two American children contract mpox – a first in the United States. According to the CDC, the two cases are unrelated.

    July 23, 2022 – WHO declares mpox a public health emergency of international concern, “an extraordinary event that may constitute a public health risk to other countries through international spread of disease and may require an international coordinated response.”

    July 27, 2022 – After weeks of mpox vaccines being in limited supply, more than 786,000 additional doses are made available in the United States, according to HHS.

    July 29, 2022 – New York declares a state disaster emergency in response to the mpox outbreak.

    August 1, 2022 – California and Illinois declare states of emergency. California has reported more than 800 cases, while Illinois has had more than 500, according to data from the CDC.

    August 2, 2022 – An mpox response team is created by the Biden administration. President Joe Biden names Robert Fenton from the Federal Emergency Management Agency (FEMA) as the White House national mpox response coordinator.

    August 2, 2022 – A report from Spain’s National Institute for Microbiology indicates two men, ages 31 and 44, who died from mpox in unrelated cases had both developed encephalitis, or swelling of the brain, which can be triggered by viral infections. Encephalitis is a very rare condition known to be associated with mpox. It has been reported in people with mpox in West Africa and in a patient in the United States in 2003 during the small outbreak linked to imported prairie dogs.

    August 4, 2022 – The Biden administration declares the mpox outbreak a national public health emergency.

    August 5, 2022 – A report published by the CDC finds that 94% of cases were among men who had recent sexual or close intimate contact with another man. Further, 54% of cases were among Black Americans and Latinos.

    August 9, 2022 – In an effort to stretch the limited supply of the Jynneos mpox vaccine, federal health officials authorize administering smaller doses using a different method of injection. The new injection strategy allows health-care providers to give shallow injections intradermally, in between layers of the skin, with one-fifth the standard dose size instead of subcutaneously, into the fatty layer below the skin, with the larger dose.

    August 18, 2022 – The White House announces the acceleration of the HHS vaccine distribution timeline, with an additional 1.8 million doses of the Jynneos vaccine being made available. Additional vaccines will be distributed to communities hosting large LGBTQI+ events.

    August 19, 2022 – Washington’s King County, which includes Seattle, declares mpox a public health emergency, with more than 270 recorded cases.

    September 12, 2022 – The first US death due to mpox is confirmed in Los Angeles County, California.

    May 11, 2023 – WHO declares the mpox outbreak is no longer a global health emergency.

    October 26, 2023 – CDC’s Advisory Committee on Immunization Practices, or ACIP, votes unanimously to recommend that certain individuals ages 18 and older who are at high risk for getting mpox continue to get the vaccine as a routine part of their sexual health care.

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  • Keeping the hope for health alive

    Keeping the hope for health alive

    2023 was a year of milestones and challenges in global public health.

    In May, I declared an end to COVID-19 as a public health emergency of international concern.

    This marked a turning point for the world following three years of crisis, pain and loss for people everywhere.

    I am glad to see that life has returned to normal.

    WHO also announced the Mpox outbreak no longer represented a global health emergency.

    And we approved new vaccines for malaria, dengue and meningitis, diseases that threaten millions around the world, mainly the most vulnerable.

    Azerbaijan, Tajikistan and Belize were declared malaria-free, and a range of neglected tropical diseases were eliminated in multiple countries, including sleeping sickness in Ghana, trachoma in Benin, Mali and Iraq, and lymphatic filariasis in Bangladesh and Laos.

    The path to eradicating another vaccine-preventable disease – polio – has reached its last mile.

    Thirty more countries introduced the HPV vaccine as the world advances towards eliminating cervical cancer.

    The need to address the health impacts of the climate crisis were elevated to the highest political levels, with governments, scientists and advocates putting health, for the first time, prominently on the COP28 agenda, and issuing a global declaration on climate and health.

    Heads of state at the United Nations General Assembly committed to advancing universal health coverage, ending tuberculosis and protecting the world from future pandemics.

    Each of these achievements, and many more, demonstrated the power of science, solutions and solidarity to protect and promote health.

    But 2023 has also been a year of immense and avoidable suffering and threats to health.

    The barbaric attacks by Hamas on Israel on October 7 left around 1,200 people dead and more than 200 taken hostage. Reports of gender-based violence and mistreatment of hostages are deplorable.

    This was followed by the unleashing of a devastating attack on Gaza, which has killed more than 21,000 people – mainly women and children – and injured over 55,000.

    At the same time, hospitals and health workers have been repeatedly attacked, while relief efforts are not coming close to meeting the needs of people.

    As of December 22, only nine of 36 health facilities in Gaza were partially functional, with only four offering the most basic of services in the north.

    For this reason, we call again for an immediate ceasefire.

    War and armed hostilities, sadly, have plagued too many other locations around the world, including Sudan, Ukraine, Ethiopia and Myanmar, to name but a few.

    I saw first-hand the suffering of war-weary people in northwest Syria who, like communities I also visited in neighbouring Türkiye, were devastated by the terrible earthquake in February.

    Without peace, there is no health, and without health, there can be no peace.

    Insecurity, poverty and lack of access to clean water and hygiene fanned the spread of infectious diseases in many countries.

    The resurgence of cholera is especially concerning, with a record number of 40-plus outbreaks around the world.

    And in terms of emergency preparedness and response, gaps remain in the world’s readiness to prevent the next pandemic.

    But 2024 offers a unique opportunity to address these gaps.

    Governments are negotiating the first-ever global agreement to protect communities, countries and the world from the threat posed by pandemics.

    The Pandemic Accord is being designed to bridge the gaps in global collaboration, cooperation and equity.

    The accord, and plans to strengthen the International Health Regulations, represent monumental actions by governments to create a safer and healthier world.

    And as WHO closes out our 75th year as the “world’s” health organisation, I extend by my sincere gratitude to health workers, partners and WHO colleagues, on our shared journey to achieve Health for All.

    Lastly, during this holiday season, I am sure that everyone will join me in hoping that the New Year will bring peace, health and prosperity for all people around the world.

    The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera’s editorial stance.

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  • One of Tuberculosis’s Biggest, Scariest Numbers Is Probably Wrong

    One of Tuberculosis’s Biggest, Scariest Numbers Is Probably Wrong

    Growing up in India, which for decades has clocked millions of tuberculosis cases each year, Lalita Ramakrishnan was intimately familiar with how devastating the disease can be. The world’s greatest infectious killer, rivaled only by SARS-CoV-2, Mycobacterium tuberculosis spreads through the air and infiltrates the airways, in many cases destroying the lungs. It can trigger inflammation in other tissues too, wearing away bones and joints; Ramakrishnan watched her own mother’s body erode in this way. The sole available vaccine was lackluster; the microbe had rapidly evolved resistance to the drugs used to fight it. And the disease had a particularly insidious trait: After entering the body, the bacterium could stow away for years or decades, before erupting without warning into full-blown disease.

    This state, referred to as latency, supposedly afflicted roughly 2 billion people—a quarter of the world’s population. Ramakrishnan, now a TB researcher at the University of Cambridge, heard that fact over and over, and passed it down to her own students; it was what every expert did with the dogma at the time. That pool of 2 billion people was understood to account for a large majority of infections worldwide, and it represented one of the most intimidating obstacles to eradicating the disease. To end TB for good, the thinking went, the world would need to catch and cure every latent case.

    In the years since, Ramakrishnan’s stance on latent TB has shifted quite a bit. Its extent, she argues, has been exaggerated for a good three decades, by at least an order of magnitude—to the point where it has scrambled priorities, led scientists on wild-goose chases, and unnecessarily saddled people with months of burdensome treatment. In her view, the term latency is so useless, so riddled with misinformation, that it should disappear. “I taught that nonsense forever,” she told me; now she’s spreading the word that TB’s largest, flashiest number may instead be its greatest, most persistent myth.

    Ramakrishnan isn’t the only one who thinks so. Together with her colleagues Marcel Behr, of Quebec’s McGill University, and Paul Edelstein, of the University of Pennsylvania (“we call ourselves the three BERs,” Ramakrishnan told me), she’s been on a years-long crusade to set the record straight. Their push has attracted its fair share of followers—and objectors. “I don’t think they’re wrong,” Carl Nathan, a TB researcher at Cornell, told me. “But I’m not confident they’re right.”

    Several researchers told me they’re largely fine with the basic premise of the BERs’ argument: Fewer than 2 billion isn’t that hard to get behind. But how many fewer matters. If current latency estimates overshoot by just a smidge, maybe no practical changes are necessary. The greater the overestimate, though, the more treatment recommendations might need to change; the more research and funding priorities might need to shift; the more plans to control, eliminate, and eventually eradicate disease might need to be wholly and permanently rethought.

    Read: A historical lesson in disease containment

    The muddled numbers on latency seem to be based largely on flawed assumptions about certain TB tests. One of the primary ways to screen people for the disease involves pricking harmless derivatives of the bacterium into skin, then waiting for an inflamed lump to appear—a sign that the immune system is familiar with the microbe (or a TB vaccine), but not direct proof that the bacterium itself is present. That means that positive results can guarantee only that the immune system encountered something resembling MTB at some point—perhaps even in the distant past, Rein Houben, an epidemiologist at the London School of Hygiene & Tropical Medicine, told me.

    But for a long time, a prevailing assumption among researchers was that all TB infections had the potential to be lifelong, Behr told me. The thought wasn’t entirely far-fetched: Other microbial infections can last a lifetime, and there are historical accounts of lasting MTB infections, including a case in which a man developed tuberculosis more than 30 years after his father passed the bacterium to him. Following that logic—that anyone once infected had a good enough chance of being infected now—researchers added everyone still reacting to the bug to the pool of people actively battling it. By the end of the 1990s, Behr and Houben told me, prominent epidemiologists had used this premise to produce the big 2 billion number, estimating that roughly a third of the population had MTB lurking within.

    That eye-catching figure, once rooted, rapidly spread. It was repeated in textbooks, academic papers and lectures, news articles, press releases, government websites, even official treatment guidelines. The World Health Organization parroted it too, repeatedly calling for research into vaccines and treatments that could shrink the world’s massive latent-TB cohort. “We were all taught this dogma when we were young researchers,” Soumya Swaminathan, the WHO’s former chief scientist, told me. “Each generation passed it on to the next.”

    But, as the BERs argue, for TB to be a lifelong sentence makes very little sense. Decades of epidemiological data show that the overwhelming majority of disease arises within the first two years after infection, most commonly within months. Beyond that, progression to symptomatic, contagious illness becomes vanishingly rare.

    The trio is convinced that a huge majority of people are clearing the bug from their body rather than letting it lie indefinitely in wait—a notion that recent modeling studies support. If the bacteria were lingering, researchers would expect to see a big spike in disease late in life among people with positive skin tests, as their immune system naturally weakens. They would also expect to see a high rate of progression to full-blown TB among people who start taking immunosuppressive drugs or catch HIV. And yet, neither of those trends pans out: At most, some 5 to 10 percent of people who have tested positive by skin test and later sustain a blow to their immune system develop TB disease within about three to five years—a hint that, for almost everyone else, there may not be any MTB left. “If there were a slam-dunk experiment, that’s it,” William Bishai, a TB researcher at Johns Hopkins, told me.

    Read: Tuberculosis got to South America through … seals?

    Nathan, of Cornell, was less sold. Immunosuppressive drugs and HIV flip very specific switches in the immune system; if MTB is being held in check by multiple branches, losing some immune defenses may not be enough to set the bacteria loose. But most of the experts I spoke with are convinced that lasting cases are quite uncommon. “Some people will get into trouble in old age,” Bouke de Jong, a TB researcher at the Institute of Tropical Medicine, in Antwerp, told me. “But is that how MTB hangs out in everybody? I don’t think so.”

    If anything, people with positive skin tests might be less likely to eventually develop disease, Ramakrishnan told me, whether because they harbor defenses against MTB or because they are genetically predisposed to clear the microbe from their airway. In either case, that could radically change the upshot of a positive test, especially in countries such as the U.S. and Canada, where MTB transmission rarely occurs and most TB cases can be traced from abroad. Traditionally, people in these places with positive skin tests and no overt symptoms have been told, “‘This means you’ve got sleeping bacteria in you,’” Behr said. “‘Any day now, it may pop out and cause harm.’” Instead, he told me, health-care workers should be communicating widely that there could be up to a 95 percent chance that these patients have already cleared the infection, especially if they’re far out from their last exposure and might not need a drug regimen. TB drugs, although safe, are not completely benign: Standard regimens last for months, interact with other meds, and can have serious side effects.

    At the same time, researchers disagree on just how much risk remains once people are a couple of years past an MTB exposure. “We’ve known for decades that we are overtreating people,” says Madhu Pai, a TB researcher at McGill who works with Behr but was not directly involved in his research. But treating a lot of people with positive skin tests has been the only way to ensure that the people who are carrying viable bacteria get the drugs they need, Robert Horsburgh, an epidemiologist at Boston University, told me. That strategy squares, too, with the goal of elimination in places where spread is rare. To purge as much of the bug as possible, “clinicians will err on the side of caution,” says JoAnne Flynn, a TB researcher at the University of Pittsburgh.

    Elsewhere in the world, where MTB transmission is rampant and repeat infections are common, “to be honest, nobody cares if there’s latent TB,” Flynn told me. Many people with very symptomatic, very contagious cases still aren’t getting diagnosed or treated; in too many places, the availability of drugs and vaccines is spotty at best. Elimination remains a long-term goal, but active outbreaks demand attention first. Arguably, quibbling about latency now is like trying to snuff stray sparks next to an untended conflagration.

    Read: The dangers of ignoring tuberculosis

    One of the BERs’ main goals could help address TB’s larger issues. Despite decades of research, the best detection tools for the disease remain “fundamentally flawed,” says Keertan Dheda, a TB researcher at the London School of Hygiene & Tropical Medicine and the University of Cape Town. A test that could directly detect viable microbes in tissues, rather than an immune proxy, could definitively diagnose ongoing infections and prioritize people across the disease spectrum for treatment. Such a diagnostic would also be the only way to finally end the fuss over latent TB’s prevalence. Without it, researchers are still sifting through only indirect evidence to get at the global TB burden—which is probably still “in the hundreds of millions” of cases, Houben told me, though the numbers will remain squishy until the data improve.

    That 2 billion number is still around—though not everywhere, thanks in part to the BERs’ efforts. The WHO’s most recent annual TB reports now note that a quarter of the world’s population has been infected with MTB, rather than is infected with MTB; the organization has also officially discarded the term latent from its guidance on the disease, Dennis Falzon, of the WHO Global TB Programme, told me in an email. However subtle, these shifts signal that even the world’s biggest authorities on TB are dispensing with what was once conventional wisdom.

    Losing that big number does technically shrink TB’s reach—which might seem to minimize the disease’s impact. Behr argues the opposite. With a huge denominator, TB’s mortality rate ends up minuscule—suggesting that most infections are benign. Deflating the 2 billion statistic, then, reinforces that “this is one of the world’s nastiest pathogens, not some symbiont that we live with in peace,” Behr told me. Fewer people may be at risk than was once thought. But for those who are harboring the microbe, the dangers are that much more real.

    Katherine J. Wu

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  • WHO calls for immediate passage of humanitarian relief into Gaza

    WHO calls for immediate passage of humanitarian relief into Gaza

    Chief Tedros Adhanom Ghebreyesus says he hopes resolution will be starting point for further UN action on crisis.

    The World Health Organization has agreed on a resolution, the first by any United Nations agency, calling for immediate access to vital humanitarian aid and an end to the fighting in Gaza.

    The resolution – calling for the “immediate, sustained and unimpeded passage of humanitarian relief, including the access of medical personnel” – was adopted by consensus at the end of a special session of the WHO’s Executive Board on Sunday.

    It also called on “all parties to fulfill their obligations under international law” and reaffirmed “that all parties to armed conflict must comply fully with the obligations applicable to them under international humanitarian law related to the protection of civilians in armed conflict and medical personnel.”

    The special meeting of the executive board was only the seventh in the WHO’s 75-year history.

    The passage of the resolution “underscores the importance of health as a universal priority, in all circumstances, and the role of healthcare and humanitarianism in building bridges to peace, even in the most difficult of situations,” the WHO said in a statement after the meeting.

    The United Nations Security Council (UNSC) has struggled to respond to the deepening crisis in Gaza that erupted after the Palestinian armed group Hamas launched an unprecedented attack on Israel killing 1,200 people and taking more than 200 captive.

    In response, Israel declared war on Hamas and has subjected Gaza, which Hamas has controlled since 2006, to relentless attack, killing at least 18,000 people.

    The UN says about 80 percent of the population has been displaced and faces shortages of food, water and medicine along with a growing threat of disease.

    On Friday, a resolution for a humanitarian ceasefire put forward by the United Arab Emirates and co-sponsored by 100 other countries failed to pass in the UNSC after the United States vetoed the proposal. The US is one of five permanent members of the council with a veto.

    The vote came after UN Secretary-General Antonio Guterres invoked Article 99 on Wednesday to formally warn the 15-member council of a global threat from the two-month-long war.

    WHO Director-General Tedros Adhanom Ghebreyesus said the UN health agency resolution could be a starting point for further action.

    “It does not resolve the crisis. But it is a platform on which to build,” he said in his closing remarks to the board.

    “Without a ceasefire, there is no peace. And without peace, there is no health. I urge all Member States, especially those with the most influence, to work with urgency to bring an end to this conflict as soon as possible.”

    Fighting resumed this month after a week-long pause in hostilities that allowed some Israeli and foreign captives to be released in exchange for a number of Palestinians held in Israeli jails, as well as for the supply of humanitarian aid into Gaza.

    With Israel now stepping up its military actions in the south of the territory of more than 2 million people, calls for an end to the fighting have intensified.

    The UN General Assembly (UNGA) is expected to vote as soon as Tuesday on a resolution for an immediate ceasefire, after Egypt and Mauritania invoked Resolution 377 “Uniting for Peace” in the wake of the US veto.

    Adopted by the UNGA in 1950, Resolution 377 allows the 193-member body to act where the UNSC has failed to “exercise its primary responsibility for the maintenance of international peace and security”.

    Their letter also referred to Guterres’s invoking Article 99 of the UN Charter on December 6.

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  • BMI Won’t Die

    BMI Won’t Die

    If anything defines America’s current obesity-drug boom, it’s this: Many more people want these injections than can actually get them. The roadblocks include exorbitant costs that can stretch beyond $1,000 a month, limited insurance coverage, and constant supply shortages. But before all of those issues come into play, anyone attempting to get a prescription will inevitably confront the same obstacle: their body mass index, or BMI.

    So much depends on the simple calculation of dividing one’s weight by the square of their height. According to the FDA, people qualify for prescriptions of Wegovy and Zepbound—the obesity-drug versions of the diabetes medications Ozempic and Mounjaro—only if their BMI is 3o or higher, or 27 or higher with a weight-related health issue such as hypertension. Many who do get on the medication use BMI to track their progress. That BMI is the single biggest factor determining who gets prescribed these drugs, and who doesn’t, is the result of how deeply entrenched this metric has become in how both doctors and regular people approach health: Low BMI is good and high BMI is bad, or so most of us have come to think.

    This roughly 200-year-old metric has never been more relevant—or maligned—than it is in the obesity-drug era. BMI has become like the decrepit car you keep driving because it still sort of works and is too much of a hassle to replace. Its numerous shortcomings have been called out for many years now: For starters, it accounts for only height and weight, not other, more pertinent measures such as body-fat percentage. In June, the American Medical Association formally recognized that BMI should not be used alone as a health measure. Last year, some doctors called for BMI to be retired altogether, echoing previous assertions.

    The thing is, BMI can be an insightful health metric, but only when used judiciously with other factors. The problem is that it often hasn’t been. Just as obesity drugs are taking off, however, professional views are changing. People are so accustomed to seeing BMI as the “be-all, end-all” of health indicators, Kate Bauer, a nutritional-sciences professor at the University of Michigan, told me. “But that’s increasingly not the way it’s being used in clinical practice.” A shift in the medical field is a good start, but the bigger challenge will be getting everyone else to catch up.

    BMI got its start in the 1830s, when a Belgian astronomer named Adolphe Quetelet attempted to determine the properties of the “average” man. Using data on primarily white people, he observed that weight tended to vary as the square of height—a calculation that came to be known as Quetelet’s index.

    Over the next 150 years, what began as a descriptive tool transformed into a prescriptive one. Quetelet’s index (and other metrics like it) informed height-weight tables used by life-insurance companies to estimate risk. These sorts of tables formed “recommendations for the general population going from ‘average’ to ‘ideal’ weights,” the epidemiologist Katherine Flegal wrote in her history of BMI; eventually, nonideal weights were classified as “overweight” and “obese.” In 1972, the American physiologist Ancel Keys proposed using Quetelet’s index—which he renamed BMI—to roughly measure obesity. We’ve been stuck with BMI ever since. The metric became embedded not only in research and doctor’s visits but also in the very definitions of obesity. According to the World Health Organization, a BMI starting at 25 and less than 30 is considered overweight; anything above that range is obese.

    But using BMI to categorize a person’s health was controversial from the start. Even Keys called it “scientifically indefensible” to use BMI to judge someone as overweight. BMI doesn’t account for where fat is distributed on the body; fat that builds up around organs and tissues, called visceral fat, is linked to serious medical issues, while fat under the skin—the kind you can pinch—is usually less of a problem. Muscularity is also overlooked: LeBron James, for example, would be considered overweight. Both fat distribution and muscularity can vary widely across sex, age, and ethnicity. People with high BMIs can be perfectly healthy, and “there are people with normal BMIs that are actually sick because they have too much body fat,” Angela Fitch, an assistant professor at Harvard Medical School and the president of the Obesity Medicine Association, told me.

    For all its flaws, BMI is actually useful at the population level, Fitch said, and doctors can measure it quickly and cheaply. But BMI becomes troubling when it is all that doctors see. In some cases, the moment when a patient’s BMI is calculated by their doctor may shape the rest of the appointment and relationship going forward. “The default is to hyper-focus on the weight number, and I just don’t think that that’s helpful,” Tracy Richmond, a pediatrics professor at Harvard Medical School, told me. Anti-obesity bias is well documented among physicians—even some obesity specialists—and can lead them to dismiss the legitimate medical needs of people with a high BMI. In one tragic example, a patient died from cancer that went undiagnosed because her doctors attributed her health issues to her high BMI.

    But after many decades, the medical community has begun to use BMI in a different way. “More and more clinicians are realizing that there are people who can be quite healthy with a high BMI,” Kate Bauer said. The shift has been gradual, though it was given a boost by the AMA policy update earlier this year: “Hopefully that will help clinicians make a change to supplement BMI with other measures,” Aayush Visaria, an internal-medicine resident at Rutgers Robert Wood Johnson Medical School who researches BMI’s shortcomings, told me.

    Physicians I spoke with acknowledged BMI’s flaws but didn’t seem too concerned about its continued use in medicine—even as obesity drugs make this metric even more consequential. BMI isn’t a problem, they said, as long as physicians consider other factors when diagnosing obesity or prescribing drugs to treat it. If you go to a doctor with the intention of getting on an obesity drug, you should be subject to a comprehensive evaluation including metrics such as blood sugar, cholesterol levels, and body composition that go “way beyond BMI,” Katherine Saunders, a clinical-medicine professor at Weill Cornell Medicine, said. Because Wegovy and other drugs come with side effects, she told me, doctors must be absolutely sure that a patient actually needs them, she added.

    But BMI isn’t like most other health metrics. Because of its simplicity, it has seeped out of doctor’s offices and into the mainstream, where this more nuanced view still isn’t common. Whether we realize it or not, BMI is central to our basic idea of health, affecting nearly every aspect of daily life. Insurance companies are notorious for charging higher rates to people with high BMI and lowering premiums for people who commit to long-term weight loss. Fertility treatments and orthopedic and gender-affirming surgery can be withheld from patients until they hit BMI targets. Workplace wellness programs based on BMI are designed to help employees manage their weight. BMI has even been used to prevent prospective parents from adopting a child.

    The rise of obesity drugs may make these kinds of usages of BMI even harder to shake. Determining drug eligibility by high BMI supports the notion that a number is synonymous with illness. Certainly many people using obesity drugs take a holistic view of their health, as doctors are learning to do. But focusing on BMI is still common. Some members of the r/Ozempic Subreddit, for example, share their BMI to show their progress on the drug. Again, high BMI can be used to predict who has obesity, but it isn’t itself an obesity diagnosis. The problem with BMI’s continued dominance is that it makes it even harder to move away from simply associating a number on a scale with overall health, with all the downstream consequences that come along with a weight-obsessed culture. As obesity drugs are becoming mainstream, “there needs to be public education explaining that BMI by itself may not be a good indicator of health,” Visaria said.

    In another 200 years, surely BMI will finally be supplanted by something else. If not much sooner: A large effort to establish hard biological criteria for obesity is under way; the goal is to eliminate BMI-based definitions once and for all. Caroline Apovian, a professor at Harvard Medical School, gives it “at least 10 years” before a comparably cheap or convenient replacement arises—though any changes would take longer to filter into public consciousness.” Until that happens, we’re stuck with BMI, and the mess it has wrought.

    Yasmin Tayag

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  • Dozens of babies’ lives at risk as incubators at Gaza’s Al Shifa hospital run out of power, Hamas-run health ministry says

    Dozens of babies’ lives at risk as incubators at Gaza’s Al Shifa hospital run out of power, Hamas-run health ministry says

    Gaza’s Hamas-run Ministry of Health said the health sector in Gaza was “in a state of complete collapse” on Monday, as three major hospitals, including the enclave’s largest medical center, Al Shifa Hospital, all went “out of service.” At Al Shifa, dozens of babies requiring intensive care were at grave risk after their incubators shut off due to lack of electricity, the ministry said.

    “Aluminum foil is kept around the babies to protect them from the cold weather,” Mehdat Abbas, director general of the Hamas-run Ministry of Health, told CBS News. “It’s becoming winter and the weather is becoming colder now. For that reason, without having proper temperature for them, they immediately die. I hope — I hope — that they will remain alive despite the disaster this hospital is passing through.”

    Premature babies at Gaza’s Al Shifa hospital are laid on aluminum foil for warmth after their incubators shut down due to lack of electricity on Sunday, November 12th 2023.

    Medical Aid for Palestinians


    World Health Organization Director-General Dr. Tedros Adhanom Ghebreyesus said in a statement on Sunday that the situation was “dire and perilous,” and that “the constant gunfire and bombings in the area have exacerbated the already critical circumstances.” He said the number of patient fatalities had tragically increased, and called for a ceasefire.

    “The world cannot stand silent while hospitals, which should be safe havens, are transformed into scenes of death, devastation, and despair,” he said.

    Israel said that it would transfer babies in need of intensive care from Al Shifa to another, safer hospital, but the nonprofit Medical Aid for Palestinians, which said it had been supporting the neonatal unit at Al Shifa for years, disputed that such a transfer would be possible.

    “With ambulances unable to reach the hospital — particularly those with the skills and equipment needed to transfer these babies — and no hospital with capacity to receive them, there is no indication of how this can be done safely,” Melanie Ward, CEO of Medical Aid for Palestinians, said in a statement. “The only safe option to save these babies would be for Israel to cease its assault and besiegement of Al Shifa, to allow fuel to reach the hospital, and to ensure that the surviving parents of these babies can be reunited with them.”

    The Israeli army, which had surrounded the Al Shifa compound on Monday, says Hamas is using the hospital as a base, and that Hamas complexes lie under the hospital compound, which the group denies. The Israeli claim is a possible prelude to a direct attack on the facility. Under international law, hospitals are protected during wartime, unless they are “misused,” when they can become legitimate targets. 

    People stand outside the emergency ward of Al-Shifa hospital in Gaza
    People stand outside the emergency ward of Al-Shifa hospital in Gaza City on Nov. 10, 2023, amid ongoing battles between Israel and Hamas.

    AFP via Getty Images


    Al Shifa was already in crisis after more than a week of Israeli bombardment around the facility. Outside, bodies of the dead were numbered and laid on the street. Without anesthesia or light, doctors carried on trying to help patients inside.

    Israel’s military said it tried to deliver 80 gallons of fuel to power the generators at Al Shifa, but it says Hamas prevented a pickup. The hospital director said that amount of fuel would only have been enough for between 15 and 30 minutes of power for the hospital.

    “History will judge us,” the U.N. head for Humanitarian Affairs in the Occupied Palestinian Territories, Andrea de Domenico, told CBS News. “[The Israel Defense Forces] have to balance out the military advantage with precaution. Even when the need is justifiable, then you have to make any effort possible to protect civilians,” de Domenico said.

    Most who could still move south in Gaza were trying to do so. Hundreds of thousands had already evacuated from the north of the enclave, including a 6-hour old baby with her grandmother. It was a “journey of torment,” the grandmother said, as the child’s mother was left behind.

    Meanwhile, Israel’s military was pushing deeper south. At one refugee camp, Israeli troops displayed what they said were Hamas weapons being stored there, and further evidence that civilians are being used as human shields, a violation of international law.

    “Both parties have the obligation to respect international humanitarian law,” Andrea de Domenico from the U.N. said. “Nobody, in reality, is taking care of civilians.”

    Emmet Lyons contributed to this report.

    Ramy Inocencio


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    Ramy Inocencio is a foreign correspondent for CBS News based in London and previously served as Asia correspondent based in Beijing.

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