The hidden death toll of flooding in Bangladesh sends a dark signal about climate and health

December 12, 2023 

 BY ZOYA TEIRSTEIN

People push an auto rickshaw through a flooded road in Sylhet, Bangladesh. | AP

In the summer of 2022, one of the worst monsoons on record turned swaths of Bangladesh, a low-lying country in South Asia, into huge, muddy lakes. When the brunt of the flooding finally eased, at least 141 people had died and millions of others throughout the region had been injured, impoverished, or displaced. The sheer scale of the destruction made 2022 an outlier year, but data from the past few decades signals that the historic monsoon was part of a larger trend: Climate change is making South Asia’s rainy season more intense and inconsistent. Unusually fierce floods have plagued the region earlier in the year and more often than they used to — a pattern that research shows will continue, and worsen, as the planet warms in the years ahead.

A study published last week shows Bangladesh’s intensifying monsoons come with a staggering death toll, both in the immediate aftermath of the flooding itself and, more significantly, in the months that follow. The true scale of the toll has not been fully captured by local officials, aid organizations, or the international research community.

The same is likely true for other parts of the world that experience recurrent climate disasters. “In the climate and health field, we often evaluate the health effects of specific acute events, because it’s easier to account for all the other potential factors that could be confounding the association,” said Lara Schwarz, an epidemiologist at the University of California, San Diego, who was not involved in the study. But a focus on the short-term obscures the larger picture. “Most climate events don’t occur only once and are likely to harm vulnerable populations over and over, through years, decades, and generations,” she said.

In the new study, researchers from the University of California in San Diego and in San Francisco found that flooding contributed to the deaths of 152,753 infants — defined as children 11 months and younger — in Bangladesh in the three decades between 1988 and 2017. The researchers used health surveys conducted by the United States Agency for International Development to collect data on more than 150,000 births over the course of the 30 years. They compared that data against high-resolution maps of major floods over that time span and found a stark difference in mortality risk: There were 5.3 more infant deaths per 1,000 births in flood-prone areas than in non-flood-prone areas. The authors extrapolated from this finding to estimate how many infant deaths, overall, were attributable to flooding in Bangladesh over the time period they studied.

Infants are an especially vulnerable subset of the population, and changes in infant health can reflect the prevalence of health issues in the wider population. “Death is the most severe health outcome,” said Schwarz. “The increased risk of infant mortality suggests that populations living in a flood-prone region may also be at higher risk of other adverse health problems such as improper nutrition, water-borne diseases, and poor mental health.”

The majority of the deaths were likely linked to three flooding-related conditions. The first, diarrheal disease, often spreads when flooding overwhelms local sanitation infrastructure and causes drinking water supplies to be contaminated. Cholera, one of the most common and deadliest water-borne bacterial diseases, is a particular concern in poor countries where sanitation infrastructure is underdeveloped. Flooding also contributes to outbreaks of mosquito-borne diseases like dengue, because standing water creates ample breeding ground for mosquitoes. Finally, flooding turns agricultural fields into bogs and can lead to massive crop losses, which contribute to existing food insecurity in Bangladesh. Babies are extremely vulnerable to hunger. The Lancet, a leading medical journal that publishes an annual analysis of the impacts of climate change on human health around the world, has identified bacterial and vector-borne diseases and malnutrition as top areas of concern.

Drownings and other injuries from the flooding also led to a small percentage of the deaths, the study’s authors told Grist. All of the health-related risks posed by flooding, from the first drowning to the last case of dengue, were exacerbated by socioeconomic factors like food security, family income, vaccination history, access to medical care, and the condition of local infrastructure such as sewage systems and drinking-water treatment facilities.
The authors of the study told Grist that their results indicate that the risks of environmental health hazards are shifting as climate change worsens. Government health agencies and researchers often collect information on the immediate public health impacts of a single extreme weather event. But, because a warmer world also means a world plagued by more frequent and intense disasters, communities are being affected by extreme weather repeatedly. The long-term, cumulative health consequences of events that occur on a yearly or sometimes even more frequent basis are not well understood by the scientific community. And as such, the world has a flawed understanding of the true human cost of extreme weather.


“We need to understand this kind of long-term impact in the context of climate change because communities are going to be repeatedly and systematically exposed to these hazards,” said Tarik Benmahria, an environmental health researcher at the University of California, San Diego, and one of three authors of the Bangladesh study. “These types of issues used to be exceptional by definition,” he added. “They’re not anymore.”

The method used by the researchers to determine the burden of flooding on communities in Bangladesh over multiple years, Schwarz said, “has the potential to be applied to evaluate the long-term effects of other climate exposures.” Extreme heat, hurricanes, and drought, to name a few of the environmental disasters being exacerbated by climate change, can also have compounding health effects that occur weeks, months, even years after the event takes place. If future research pinpoints how and when these effects occur, it could potentially save lives. “The approach is very relevant to other areas of the world that are vulnerable to recurrent climate hazards,” Schwarz said.

This article was reposted from Grist.org.

UK MP criticises government for inaction during a UN resolution for ceasefire in Gaza

UK Green Party MP Caroline Lucas said the UK’s abstention during a UN vote seeking a ceasefire in Gaza last week is ‘unforgivable’. She stressed the need for immediate and creative diplomacy given the ongoing humanitarian crisis in Gaza, where starvation is rife, and violence affects both the Palestinian and Israeli civilian populations. Lucas added that there is no military solution to this conflict, highlighting the necessity of a political resolution to bring an end to the decades of suffering and repeated violence.


December 12, 2023 

Health Fears As Wildfires Can Spread Cancer-Causing Toxic Metal

Dec 12, 2023 
By Jess Thomson
Science Reporter

A heavy metal that can cause cancer may be spread far and wide via the smoke of wildfires, new research has found.

The carcinogenic form of the metal chromium and other cancer-associated chemicals were found to be present in large quantities in ash after wildfires across Northern California, a new paper in the journal Nature Communications reveals.

In dry environments, this ash may easily be blown towards population centers in the wind, and could therefore pose a long-term public health hazard.


The researchers analyzed the soil after wildfires across Northern California in 2019 and 2020, including in Sonoma, Napa and Lake Counties, finding that there were dangerous levels of chromium in the ash. The chromium was discovered to be most prevalent in areas with an underlying metal-rich geology, and in areas where the fires were more severe.
A stock image of a wildfire near South Lake Tahoe in California. Wildfires have been found to leave behind ash rich in the carcinogenic form of the metal chromium.ISTOCK / GETTY IMAGES PLUS

"We demonstrate that high temperatures during California wildfires catalyzed widespread transformation of chromium to its carcinogenic form in soil and ash, as hexavalent chromium, particularly in areas with metal-rich geologies (e.g., serpentinite)," the authors, hailing from Stanford University, wrote in the paper.


NEWSLETTERThe Bulletin
Your daily briefing of everything you need to know


"In wildfire ash, we observed dangerous levels (327-13,100 µg kg−1 [micrograms per kilograms]) of reactive hexavalent chromium in wind-dispersible particulates," they said.

Chromium is an essential element in the human body, but only in the form of trivalent chromium (Cr III). Hexavalent chromium (Cr VI), however, is carcinogenic, and is the form of chromium that has been found in the wildfire ash. According to the United States Environmental Protection Agency, Cr VI exposure is strongly linked to lung cancers in humans and animals, as well as acute effects including coughing and wheezing, and even gastrointestinal and neurological effects in high dosages.

The researchers also found that drier weather in the aftermath of the fires caused the chromium to stay in the soil and dust for nearly a year.

"Relatively dry post-fire weather contributed to the persistence of elevated hexavalent chromium in surficial soil layers for up to ten months post-fire," the authors wrote.
Sign up for Newsweek’s daily headlines

Wildfires release large quantities of other dangerous substances, including PM2.5 pollution. PM2.5 particles are 2.5 micrometers or less in diameter, and include soot, black carbon, ammonia, sodium chloride and mineral dust, which can all cause respiratory irritation.

A stock image of a man wearing a face mask to protect himself against wildfire smoke in Australia in 2020. Wildfires release large quantities of dangerous substances that can cause respiratory irritation.

The researchers suggest that the chromium left behind in the ash may also pose a large health hazard to people living nearby and first responders, as it will get blown around in the wind. While the study focused on California wildfires, the authors estimate that other regions of the world where soils are rich in heavy metals and fires are frequent face similar problems, including large swaths of West, East and Southeast Africa, Northern Australia and Russia.

As the chromium appears to persist in the soil for longer in drier environments, the effects of climate change may therefore play into both the frequency and severity of wildfires, as well as exacerbating the damaging effects of wildfire pollution in the future.

"Our findings provide new insights into why wildfire smoke exposure appears to be more hazardous to humans than pollution from other sources," the authors wrote.

Jess Thomson is a Newsweek Science Reporter based in London UK. Her focus is reporting on science, technology and healthcare. She has covered weird animal behavior, space news and the impacts of climate change extensively. Jess joined Newsweek in May 2022 and previously worked at Springer Nature. She is a graduate of the University of Oxford. Languages: English.

California wildfires could be transforming natural metals into cancer-causing compounds

BY SHARON UDASIN - 12/12/23 

Forest burns in the Carr Fire on July 30, 2018 west of Redding, California. (Getty Images)


Wildfires in parts of the U.S. West may be transforming a benign form of chromium into its cancer-causing counterpart — potentially endangering first responders and surrounding communities, a new study has found.

The research, published Tuesday in the journal Nature Communications, identified high levels of the hazardous metal hexavalent chromium, or chromium-6, at specific types of burn sites along California’s North Coast.


Also known as “the Erin Brockovich chemical,” chromium-6 emerged in the public eye in the 1990s after Brockovich — then a legal aid — found that it was contaminating drinking water and sickening residents of Hinkley, Calif.

This toxic compound, which raises cancer risk when inhaled or ingested, was not present at the sites of interest for the study before they burned.

Rather, soils and plants at these locations were rich in naturally-occurring trivalent chromium — chromium-3 — an essential nutrient that helps the human body break down glucose.

While chromium-6 can also exist naturally in the environment, this toxic form of the metal more often contaminates communities via runoff and wastewater from industrial processes.

Wildfire smoke plumes are known to transport dangerous pollutants such as aerosols, gases and fine particulate matter, but the researchers wondered whether the same could be said for heavy metals, and what the risk might be to firefighters and those who reside downwind.

“In the complex mixture of gasses and particles that wildfires spew out as smoke and leave behind as dust, heavy metals such as chromium have largely been overlooked,” senior author Scott Fendorf, a professor at Stanford University’s Doerr School of Sustainability, said in a statement.


Laboratory experiments conducted by Australian researchers in 2019 had already shown that chromium-6 could form rapidly from chromium-3 in surface soils set ablaze.

This transformation occurs through a process known as oxidation — or in this scenario, a reaction between chromium and atmospheric oxygen in which electrons are lost.

Because that process is slow at low temperatures, it “effectively doesn’t happen,” Fendorf, who is also a senior fellow at the Stanford Woods Institute for the Environment, told The Hill.


“But when you start heating the samples up through in this case wildfires, that causes that reaction to occur,” he said. “And so, you’ve transformed from the benign to the really toxic form.”

With that in mind, Fendorf and his colleagues decided to test the theory that wildfires could leave soils contaminated with chromium-6 in their stead.

The scientists focused their attention on California’s North Coast, where they identified four recently burned ecological preserves that contain chromium-rich rocks, such as serpentinite.


While the southern Sierra Nevada tends to have more granite and less chromium content, the northern Sierra has more serpentinite — California’s state rock, Fendorf noted.

“When you bring the wildfire through, that then leads to much higher levels of chromium-6 being produced,” he said.

The four research sites — Pepperwood Preserve, White Rock Preserve, Modini Preserve and Sylvia McLaughlin Natural Reserve — were all partly or completely burned during the Kincade or Hennessey fires, which respectively occurred in Nov. 2019 and Sept. 2020, per the study.


Lead author Alandra Lopez, a postdoctoral scholar in Earth system science at Stanford’s Doerr School, collected soil from these sites and then separated out the smallest particles that are most sensitive to wind transport.

She then measured the levels of chromium-6 in this ultra-fine dust from both burned and unburned areas, while also gathering data on local fire severity, prevailing soil conditions, underlying geology and ecosystem traits.

In chromium-rich sites where vegetation fueled long-lasting fires at high heat, the scientists found that toxic chromium concentrations were 6.5 times higher than those in unburned areas.


“Our study suggests far more attention should be paid to wildfire-modified chromium, and we presume additional metals as well,” Lopez said in a statement.

Doing so, she added, is necessary “to more thoroughly characterize the overall threats wildfires pose to human health.”

As far as these potential threats are concerned, the authors said they believe that fire-induced toxic chromium exposure has the most acute impacts on first responders and people who live near the blazes.


In comparison to exposure to chromium-6 via contaminated drinking water, as discovered in Hinkley by Brockovich, Fendorf stressed that “inhalation is far worse.”

“Toxicologists are really clear on that,” he said. “If you had the choice, you want to drink it before you breathe it. And not that they suggest either one.”

The extent of the threat also varies based on which plants are fueling the fire, according to Fendorf.

Grasslands, for example, don’t produce sufficiently high temperatures to create a lot of chromium-6, but shrubs and tree canopies do provide ample heat, he explained.

Even after the fires end, strong winds could expose nearby populations to fine particles of chromium-laced soil, the researchers noted.

The brunt of the risk associated with inhaling airborne chromium-6 likely declines following the first big rainfall, which can wash the metal underground, according to Fendorf.

But in an arid environment like that of the U.S. West, which is facing increasing and prolonged droughts due to climate change, exposure risks could persist for those rebuilding and revegetating burned areas, he warned.

While chromium has been Fendorf’s biggest toxin of interest due to “the radical transformation that takes place,” he said he is also concerned about other metals, such as manganese, certain forms of iron, nickel and cadmium.

Stressing the need for further research into wildfire-related exposure to heavy metals, Fendorf noted that the time being, wearing an N95 at such a burn site could be beneficial.

Fendorf said that he and his team are now creating predictive maps, so that firefighters have more awareness as to where they might encounter fine particulate matter and where they might also face chromium-6 exposure risk.

He and his colleagues have been preparing for the past two years to deploy active monitoring devices that are capable of monitoring contaminants amid a blaze, but such conflagrations have been minimal during this period.

Ed Burton, who led the 2019 research on the transformation of chromium-3 to chromium-6, credited the new study for showing “that wildfires cause a dramatic shift in chemistry of chromium in fire-impacted soil.”

“Significantly, the authors show that newly-formed hexavalent chromium can persist in surface soil and ash for many months after wildfires,” Burton, a professor of environmental geochemistry and mineralogy at Australia’s Southern Cross University, told The Hill in an email.

In addition to describing the potential health risks to those exposed to soil particles or ash, he stressed his “particular concern” as to the impacts of these findings on the U.S. West.

The region could be at particular risk because “large areas of land are naturally rich in soil chromium and because wildfires appear to be increasing in severity and frequency due to climate change,” said Burton, who was not involved with the Stanford study.

Dimitrios Alexakis, a professor of geology and geochemistry at Greece’s University of West Attica, likewise described “a broad global threat of dust-born metal and wildfire smoke to humans,” stemming from the mix of these blazes and chromium-rich soils.

“This study demonstrates an underrecognized health threat to humans associated with the geology and fire severity,” he told The Hill in an email.

Alexakis, who was also not involved in this research, has studied both the dispersion of toxins from burned vegetation and the impacts of fire-fueled land contamination on human health.

The Stanford study, he observed, could help offer “fresh perspectives on the reasons behind the heightened health risks associated with exposure to wildfire smoke compared to pollution from other sources.”

Understanding how environmental factors contribute to the creation of chromium-6 through fire could also help scientists devise predictive tools to mitigate exposure risk and guide policymaking, according to Alexakis.

As further research on the subject unfolds, the Stanford team stressed that the results will be applicable not just to California’s North Coast, but to fire-prone areas with metal-rich landscapes around the world.

“With wildland fires expected to increase in frequency and severity in many geographic regions due to a combination of climate change and past fire management, post-fire dust emissions are likely to rise,” the authors stated.

Both the Pacific Rim and Mediterranean areas have geologies that are higher in chromium, as do other parts of Europe, Australia, South Africa and Brazil, according to the study.

“Every continent has areas that are quite high at risk, so it’s not a small point,” Fendorf said. “It’s really a broadly distributed problem.”

Exclusive Q&A: Myanmar's Exiled Opposition Chief Says Battle Against Junta Has Turned

December 12, 2023 11:39 AM
Ingyin Naing

Duwa Lashi La, the acting president of Myanmar’s democratic parallel government, the National Unity Government, speaks from an undisclosed location in Myanmar via Zoom with VOA on Dec. 8, 2023.

WASHINGTON —

The people of Myanmar are “determined to fight until the end,” the acting president of Myanmar’s opposition government has told VOA.

“The door to dialogue is not closed,” said Duwa Lashi La, while questioning whether conditions are right for peace talks amid ongoing attacks on civilians by the Southeast Asian country's military junta.

Speaking via Zoom from an undisclosed location within Myanmar on December 8, the head of Myanmar's National Unity Government, or NUG, which views itself as a shadow government, also discussed its relationship with China, which recently called for national reconciliation in Myanmar.

The following interview, which took place after a string of defeats for the country’s military junta, has been translated into English and edited for lengthy and clarity.

VOA: Have you determined that Myanmar has reached the stage of civil war? And are the ethnic armed groups on the ground in Myanmar, with help of the NUG, gaining momentum against the military junta?

Acting President Duwa Lashi La: When we look at the current situation on the ground, we can see that the battle has turned in our favor. As I have said before, it will come wave after wave, and the speed is only going to get higher and higher. The public and our [People’s Defense Forces, or PDF] have absolutely nothing to back down from. Very quickly now, [junta leader] Min Aung Hlaing will be completely removed from leadership. He knows his military coup was wrong. The power of the people will be returned to the hands of the people. Until that time, the war will escalate.

As we all know, especially since the beginning of the 1027 operation by the Three Brotherhoods Alliance, we have advanced step by step, and now we have occupied more than 200 [junta] military bases. In addition, many townships have been retaken, such as Kawlin, a very important town in Sagaing region. Many parts of Kokang region have also been retaken, so northern Shan state is in a very good position.

SEE ALSO:
Ethnic Rebel Groups Attack Military Targets in Myanmar

I cannot define the current situation in Myanmar as a civil war. What I can say is that, no matter what, we will continue to fight until Min Aung Hlaing and his military dictatorship are completely removed. However, because the speed of the battle is increasing, I am worried that the suffering of the people will also increase. The people have endured many hardships, yet they continue to encourage and support us. They are determined to fight to the end.

VOA: Since the end of October, we have seen the offensive operations such as Operation 1027, Operation 1111, among other operations in Chin, Rakhine and Karen states against the Myanmar military by anti-junta resistance forces around the country. Is there any NUG connection to these operations?

Duwa Lashi La: Yes, we are cooperating and coordinating, not only politically, but also operationally. Actually, what we want — and what is best — is to have military operations under one chain of command, such as in the future, when we rebuild our federal army.

Currently, even though we don’t have that chain of command, we are able to coordinate operations between different groups. For example, we have designated the north of the country as military region [1], and the PDF are fighting together with EAOs [Ethnic Armed Organizations] there. In the south, Karenni state, Karen state, Tanintharyi division, Yangon division and Bagu division have been designated as the Southern Military Region, and the EAOs and the PDF have been working together there.

It was clear to us since the beginning that our PDF could not stand alone, that we needed military training and bases. So, in the KNU [Karen National Union] area, the PDF participated in joint operations under the command of KNU forces. Similarly, in Karenni State, the PDF has been conducting operations in cooperation with the Karenni Nationalities Defense Force, which is an armed organization. The PDF are everywhere — in the north, in the south and the central regions.

The center of the country is very important because Naypyidaw [the military-built capital and base of operations for the junta] is there. If we can all cooperate to strengthen the central region, we can threaten Naypyidaw. That is our goal.

VOA: From a military point of view, there are those who say it is still too early to conclude that guerrilla forces like PDF can win against the well-trained and armed Burmese army. On the other hand, you have said that the revolutionary forces are winning. Can you explain why?

Duwa Lashi La: When we first started, the whole world asked how it could be possible for us to defeat such a powerful army. My answer is that people are more important than weapons. It is a war with the participation of all our people, so we can win.

Members of an ethnic armed forces group, one of the three militias known as the Three Brotherhood Alliance, check weapons the group said it seized from Myanmar's army outpost in Hsenwi, Myanmar, on Nov. 24, 2023. (Kokang online media via AP)

According to a research paper done by the United States Institute of Peace, it is believed that the military cannot return to their previous position. That is a fact. Now so many places in the north have been occupied by revolutionary groups, it is absolutely impossible for the junta to recapture those places. At first, there was nothing to this revolution. We started working with only the belief that we must change things to the way we want them to be. No one had any weapons. Gradually, we have improved, and now we can say that we are equal to, or even more than, the military junta troops.

VOA: Operation 1027, led by the Three Brotherhood Alliance in northern Shan State, included shutting down lucrative criminal activity in enclaves along the Chinese frontier, that was also aligning with China’s anti-transnational crime efforts. So, China backed their operation against the junta, some analysts said. What is your response to this? What is the relationship between the Chinese government and the NUG?

Duwa Lashi La: The NUG's stance is clear. We have a policy of having friendly relations with all neighboring countries: China, India, Thailand and Bangladesh, and we will look after their interests, not only our own. With China, we have three or four different channels available, and we are continually in communication with them. We haven’t seen any clear evidence that China is supporting Operation 1027. They have announced that they want to suppress the criminal gangs that are doing these online scams, which also aligns with the Three Brotherhood’s goals, but they have also said that they respect Myanmar’s sovereignty and won’t meddle in our internal affairs.

VOA: Would you say that the relationship between the NUG and China is strong?

Duwa Lashi La: China still recognizes the existence of the National League for Democracy [NLD] party. The NLD was the people's government in the past. The NUG is in contact with China’s diplomats through their embassies, and we have responded to their concerns. For example, we will not interfere with China's projects in Myanmar; we will help as much as possible. As we have often said, we want to do business with China in the future, so our relationship is generally good.

VOA: There are voices, such as in a recent Washington Post editorial, calling for the U.S. government to officially recognize the NUG as the government of Myanmar due to international media reports that the junta is not doing well and is on the verge of collapsing. Do you feel that the U.S. is effectively supporting the NUG?

Duwa Lashi La: The international community has begun to recognize the NUG. At first, neighboring countries and world did not think we could fight such a strong institutional army. Now that they have become more interested, people are starting to ask what we will do after the junta is finally dissolved. So, in regards to the United States recognizing us, yes, that would clearly be welcomed. We will always welcome support from the U.S. if it is offered. The sooner the U.S. recognizes the NUG, the more helpful it will be toward defeating the junta. Once we accomplish that, we will be able to quickly solve many of the problems that the people are currently experiencing, and establish a new, stable and peaceful Myanmar. International recognition is very important. Since the U.S. is a country that is always encouraging the development of democracy, their encouragement is greatly appreciated, and provides moral support for our struggle.

Myanmar junta leader Min Aung Hlaing delivers a speech in Moscow, Russia, on June 23, 2021.

VOA: Recent statements by members of the international community, including China and the United Nations, have called for a peaceful resolution in Myanmar. When do you think the time will be right to start dialogue to bring the conflict to an end and begin rebuilding the country?

Duwa Lashi La: We always say the door to dialogue is not closed. However, we must think about whether the right environment exists for peace talks. We cannot simply use the same formula used in other countries such as South Africa or Cambodia. Even if they were successful there, the situation in Myanmar is different, so the solution must be different. We have never said that we will not meet with them. In contrast, Min Aung Hlaing says that he will not meet with us because, he says, we are terrorists. He has continued to lie by saying that the Nationwide Cease-fire Agreement is a real attempt for peace talks. The talks are merely for show; they aren’t sincere in their claims. They are essentially asking the ethnic armed groups to simply surrender.

If he truly wants peace talks, then he needs to show the people that he is earnest in his desire for change. Right now, our people are being bombed and killed by airstrikes. He must stop the attacks on civilians and the detentions before we can begin thinking about peace talks. To be clear, the public do not trust what Min Aung Hlaing and his military junta have to say. In order to create a situation where the people can believe that [the military] truly want peace, they must announce to the world that they will live under the rule of the people. They must make a clear commitment that they will never again interfere in the politics of Myanmar. Only then we can talk about peace.

A Lifesaving Loan: A New Investment to Help Curb the U.S. Overdose Crisis

HARM REDUCTION FOR ALL
DECEMBER 12, 2023
BY SARAH EVANS & GEORGIA LEVENSON KEOHANE

Volunteers distribute naloxone in Atlanta, Georgia, on April 18, 2023.

 © Erik Lesser/EPA-EFE/Shutterstock

As the impact investment arm of the Open Society Foundations, the Soros Economic Development Fund (SEDF) has committed more than $500 million to private-sector projects around the world. We look for innovative business ideas that will deliver positive social outcomes—and we take on more risk than mainstream investors in pursuit of that impact.

As an investment fund, we typically focus on large, systemic societal challenges where we believe businesses and markets can help deliver broad, transformative impact. Some of our more recent investments have been in large scale public-private partnerships focused on climate change in the Global South that seek to de-risk entire sectors and catalyze significant follow-on investment.

So why are we lending a million dollars to Remedy Alliance/For the People, a small nonprofit?

Remedy Alliance is a remarkable organization supporting community groups that in turn provide lifesaving healthcare and support for people who use drugs. It has been at the heart of the struggle against an ongoing epidemic of overdose deaths in the U.S. linked to the use of fentanyl and other synthetic opioids—an epidemic that surged during the COVID-19 lockdowns, and that claimed over 100,000 lives last year.

Remedy Alliance began in 2012 as a “buyers’ club” for the overdose reversal treatment naloxone—working on behalf of small, local organizations throughout the U.S.—that recognized the desperate need for access to the treatment as part of their harm reduction approach to drug use.

With their direct experience of—and trusted relationships with—people who use drugs, these groups were ahead of the medical establishment and public health authorities in grasping how naloxone could save lives when it was put in the hands of people who use drugs themselves. Remedy Alliance (which was supported by Open Society Foundations and other grant makers), also pooled their combined demand and purchasing power for naloxone, driving expanded production of the drug and securing lower, bulk prices.

As it grew into a significant purchaser of naloxone from pharmaceutical company manufacturers, Remedy Alliance also developed an innovative and successful business model—using its sales to state, county, and public health institutions to subsidize free distribution of the treatment to local, under-funded harm reduction groups. Today, Remedy Alliance is the largest distributor of injectable naloxone to over 200 established harm reduction partners across the United States, with around 30 percent of the market. Since 2012, it has distributed over 6 million doses in more than 44 states.

SEDF’s loan will now help Remedy Alliance respond to an important development in the naloxone marketplace, making the treatment easier to use: the U.S. Food and Drug Administration (FDA) approval of over-the-counter, non-prescription sales of a nasal spray version in 2023.

The FDA said the move would pave the way for naloxone “to be sold directly to consumers in places like drug stores, convenience stores, grocery stores and gas stations, as well as online”—part of what the Biden administration describes as a “saturation” approach to the treatment’s availability. Remedy Alliance, with its network of harm reduction partners, provides a way to overcome the continuing barriers to access—they can reach people who use drugs who lack the money to buy the treatment from pharmacies or other retailers, or who may be unwilling to face the stigma of even asking for the product, and who distrust public healthcare providers.

Remedy Alliance has also used its power as a distributor to work with a nonprofit generic manufacturer, which produced an even lower-cost version that it can sell at significantly lower prices to institutions, increasing the delivery of free doses to underfunded harm reduction groups.

For Remedy Alliance, the SEDF loan, offered at concessionary rates, will support this effort to ramp up the purchase, distribution, and sale of nasal naloxone, and to continue to expand sales and distribution of injectable treatments, which remain significantly cheaper than the nasal spray.

SEDF’s low-interest loan will give Remedy Alliance the working capital to surge its operations. It will also test an innovative financing mechanism that, if successful, can help Remedy Alliance attract support from additional lenders, allowing it to grow further. The model could also be replicated with other lifesaving medicines.

In the short term, this will result in more overdoses reversed, and more lives saved.

Sarah Evans
Sarah Evans is division director of Equity for the Open Society Global Programs.

Georgia Levenson Keohane is chief executive of the Soros Economic Development Fund, Open Society’s impact investment fund.

Asia lags behind pre-pandemic levels of food security, UN food agency says

December 12, 2023 

 BY MORNING STAR

A farmer fertilizes rice seedlings in fields located along a highway in Pyongyang, North Korea, on June 13, 2017. | Morning Star

Hunger remains a chronic problem in Asia, with 55 million more people undernourished in 2022 than before the COVID-19 pandemic, the United Nations’ Food & Agriculture Organisation (FAO) says in its latest assessment of food security in the region.

Most of those living without enough to eat are in South Asia, and women tend to be less food-secure than men, the report says.

The study focuses on food supply, consumption, and dietary energy needs and is designed to capture a state of chronic energy deprivation that stunts growth and saps productivity and quality of life.

The share of people in the region suffering from such undernourishment fell to 8.4 percent in 2022 from 8.8 percent the year before. But that’s higher than the 7.3 percent of people who were undernourished before the coronavirus pandemic began in 2020, sending some economies into a tailspin and depriving millions of people of their livelihoods.

Natural disasters and disruptions to food supplies, often linked to climate change, have added to those pressures.

The FAO data shows the share of people in the region facing moderate food insecurity, uncertain of their ability to obtain food and having to sometimes eat less or poorer food due to a lack of money, or those experiencing hunger that puts their well-being at serious risk, still hovers near 30 percent for the world and above 25 percent for Asia and the Pacific.

The problem is worst for women: more than one in five women in Asia, excluding East Asia, face moderate or severe food insecurity.

The rates are slightly lower for men in most regions, but in southern Asia, the gap grows to more than 42 percent for women and more than 37 percent for men.

Higher food, fuel, fertilizer, and livestock feed prices mean that progress has stagnated after the pandemic reversed a longstanding trend beginning in the early 2000s toward alleviation of hunger.

It is a global problem, made worse by disruptions to supplies of grain, edible oil, and fertilizer partly due to the war in Ukraine.

Worldwide, the number of people having precarious access to food rose to nearly 2.4 billion in 2022 from just over 1.6 billion in 2015, the report said.

In Africa, the UN says at least three of every four Africans can’t afford a healthy diet because of an “unprecedented food crisis.”

More than half of the 735 million people who are nourished worldwide live in the Asia-Pacific, most of them in South Asia.

But North Korea has the largest regional share of people who are undernourished, the report says, at about 45 percent, followed by Afghanistan at 30 percent.

The world average for undernourishment is 9.2 percent, while in the Pacific islands of Oceania, excluding Australia and New Zealand, it was nearly 21 percent or more than one in five people.

In southern Asia, about 16 percent of people are undernourished, the report says.

Bandit Romance Brings Discord for Putin’s Sidekicks

By Kseniya Kirillova
December 12, 2023

Are mobsters and street thugs role models, or a they terrible models for the new Russia? Cultural critics and censors can’t quite decide.

State Duma deputy Nina Ostanina called for a ban on the broadcast of the TV series Word of a Homeboy, which is rapidly gaining popularity in Russia, and which portrays the youth gangs that roamed Kazan in Tatarstan in the late 1980s.

Ostanina, the head of the committee on family protection, fatherhood, motherhood, and childhood, has already filed two complaints against the series — one with the Investigative Committee and another with Roskomnadzor, the federal communications regulator. She expressed concerns that teenagers may begin to romanticize crime, leading to instances of murder and suicide.

Some critics and the series director argue that the production truthfully depicts the reality of the late Soviet era, including its horrors. Interestingly, a significant portion of the “patriotic” elite has come to the defense of the series. For instance, State Duma deputy and well-known propagandist Yevgeny Popov stated that the series was a fair depiction and that he would do everything “to ensure that such dark times never return.”

On the official Russian website “Ukraine.ru,” a lengthy article asserts that Word of a Homeboy has become a stellar manifestation of Russian soft power in Ukraine, gaining popularity despite the ongoing war. Russian military analysts also support the series, suggesting that similarly popular Russian series about criminals like Brigada, Brother, Boomer, Gangster Petersburg, and others could likewise be banned if the new series becomes a victim of censorship.

But this is not a tale of Russians unifying around the right to free speech and to resist censorship. As so often in Putin’s Russia, it illustrates something much darker.

“For many individuals from the 70s and 80s, the Word of a Homeboy has transformed into the word of an officer. Yesterday’s heroes of street gangs stormed Panjshir [in Afghanistan], took Grozny, and now engaged in special operations against the enemy. That’s why the drama about Kazan youth is so popular — older comrades see themselves in the characters on the screen,” notes military sources.

Indeed, the romanticization of the criminal underworld has become one of the foundations of the modern image of the “Russian hero,” as depicted by Russian propaganda. Films created in the 1990s that reflected a challenging era are now presented as an informal anthem of the “Russian national idea” and a profound philosophy revealing the mysteries of the enigmatic “Russian soul.”

Interestingly, religious advocates for Russkiy Mir  (Russian world) have become the primary propagandists of the gangster romantic genre.

The 2012 film The Nightingale Bandit is particularly illustrative, authored by one of the best-known propagandists of the war in Ukraine in 2014, former priest Ivan Okhlobystin. The characters in the film form a gang, engage in murders, and burn down entire villages while delving into philosophical and religious topics. Okhlobystin himself referred to his character as an embodiment of the “Russian national character,” and critics enthusiastically wrote about the “element of the Russian rebellion” in the film.

A year and a half later, the creator of The Nightingale Bandit actively traveled to Donbas, expressing his desire to “fight for Novorossiya,” in an area where the scenes depicted in his film unfolded in reality, with the same cruelty, lawlessness, and religious justification as on screen. The image of the “ordinary Russian person,” destroying everything in the pursuit of justice and shedding rivers of blood, was in high demand for propaganda to justify “Russian volunteers” fighting in Donbas.

And yet it is religious preachers who are most fervently calling for the ban on the new series Word of a Homeboy. Some claim that its broadcast is nothing more than part of the “Zionist plan” to destroy Russian spiritual values and reduce the global population. In opposition to the plan, Orthodox propagandists advise actively participating in the war in Ukraine and involving children in “aiding the front” from an early age.

If it seems that nationalist religious groups are contradicting themselves, that’s because they are. The level of obscurantism and censorship has increased so much over the past 10 years that church propagandists have begun to condemn the same things that they previously supported.

The conflict between “traditional values” and bandit romantic represents just one of the clashes between and within the various factions of Russian propaganda. Even before the full-scale invasion of Ukraine, the contributors to the Orthodox channel “Tsargrad” actively criticized state-funded Russian cinema, denouncing it as “vulgar and empty junk.” They attributed this situation to corruption and cronyism within the Ministry of Culture and the Film Foundation.

However, the creation of vulgar and empty content is not accidental. Modern Russia is a highly repressive state and cultural expression is limited.

These ugly and bloody TV programs and movies are more likely tolerated by the authorities to divert attention from the war and erode moral barriers.

For instance, on New Year’s Eve of 2023, major Russian channels featured a mix of glamor, lowbrow jokes, and military propaganda, seemingly trying to project a “festive and homelike” image of aggression among Russians. The Kremlin’s investments in producing glossy magazines also suggest an effort to portray a comfortable and “bohemian” image of Moscow, maintaining a familiar level of entertainment for both affluent and less privileged segments of society.

Simultaneously, as the war began, Russian Prime Minister Mikhail Mishustin emphasized the need for high-quality patriotic films. Attacks on various “subversive” projects, deemed “contrary to Russian traditional values,” have intensified.

Deputies increasingly call for the verification of compliance with Russian legislation for new films, and the Ministry of Culture and Roskomnadzor have become more proactive in banning and blocking them. According to estimates by independent journalists, the “League of Safe Internet,” led by Yekaterina Mizulina, filed 3,915 reports on online content since the beginning of 2022, addressing issues such as “extremism” in song lyrics and even search queries.

It appears that Russian authorities are encountering growing difficulties in reconciling different factions within their own propagandist circles — religious radicals and enthusiasts of bandit romantic, “ideological moralists,” and “glamorous cynics.”

Each group is deemed necessary in fostering a tolerant societal attitude toward the war, but maintaining tolerance among these factions is becoming increasingly challenging.

Kseniya Kirillova is an analyst focused on Russian society, mentality, propaganda, and foreign policy. The author of numerous articles for the Jamestown Foundation, she has also written for the Atlantic Council, Stratfor, and others. 

The Gulf states push for renewables but face challenges in climate diplomacy

Saudi Arabia and the United Arab Emirates have pledged to invest substantial sums in clean energy by 2030, but they also face an imperative to continue developing oil and gas infrastructure, while some aspects of regional climate diplomacy have been disrupted by the Hamas–Israel war.

ONLINE ANALYSIS
12th December 2023

Gulf-state leaders have been emphasising their significant clean-energy investment pledges during the 2023 United Nations Climate Change Conference, COP28, in Dubai. Saudi Arabia and the United Arab Emirates (UAE) have said that they will spend up to US$266.6 billion and US$54.5bn, respectively, by 2030 to upgrade their energy infrastructure and begin a long-term transition towards achieving net-zero carbon emissions. Climate-related investments are also a major factor driving Gulf-state diplomacy.

Saudi Arabia’s state-owned ACWA Power announced a US$10bn investment in Egypt’s green-energy sector in August 2023. The company is already participating in the construction of the Suez Gulf wind farm and the Kom Ombo photovoltaic plant, with ambitions to hold a 50% share in Egypt’s renewable-energy market by 2026. It also plans to expand into China and Central Asia. Qatar’s sovereign wealth fund, Qatar Investment Authority, agreed to invest US$2.4bn in Germany’s largest power producer, RWE AG, so that it could acquire the American firm Con Edison Inc.’s clean-energy subsidiary. And, in Central Asia, Abu Dhabi’s clean-energy company, Masdar, has become a leading player, recently signing agreements in Azerbaijan for three renewable-energy projects with a combined capacity of 1 gigawatt and valued at US$1bn. Masdar’s joint investment project in the Eastern Mediterranean will produce renewable electricity for the Greece–Egypt subsea power link through its affiliate Infinity Power and Greece’s Copelouzos Group.

Despite this burgeoning activity, however, two perennial issues continue to impede the regional push towards green energy: the continuing imperative to expand Gulf-state oil production and the intractable Hamas–Israel conflict. Firstly, regarding oil production, the UAE this year simultaneously held the COP28 presidency while also planning a major expansion of its oil-production capacity. This tension was apparent in the country’s much-criticised appointment of Sultan Ahmed Al Jaber, chair of the Abu Dhabi National Oil Company, as COP28 president.

Despite the Gulf states’ potential as future producers of clean energy, their economies currently depend on maintaining or increasing oil exports, which is also necessary for preserving the stability of the global oil market. Domestic consumption of oil has increased significantly in recent years, and governments have begun tapping new natural-gas fields to boost gas exports and offset the cost of the oil that is now used at home rather than exported. Solar- and wind-energy exports could eventually play a similar role as gas – as a substitute for lower oil exports – but the technology is not yet scalable or cost competitive.

Saudi Arabia and the UAE have both begun investing in carbon-capture technology to offset their continuing production and use of fossil fuels. The technology is especially useful because one form, carbon-dioxide injection, can increase the lifespan of old oil-drilling sites once they are deemed economically unviable. Many benefits of carbon capture remain notional, however, and using current technology at the scale required to meet global climate goals would require unfeasibly large amounts of electricity.

Secondly, efforts towards regional integration that had been underway prior to Hamas’s October 2023 attack against Israel, including multiple climate-related investment deals, have now been paused or cancelled. On 16 November, Jordan announced its withdrawal from an ‘energy for water’ deal with Israel, which was supposed to have been formalised during COP28. Under the deal, solar energy produced in Jordan would have been sold to Israel and the occupied Palestinian Territories for the production of desalinised water, which would then have been sold back to Jordan.

The death toll from Israeli airstrikes in Gaza has exacerbated popular anti-Israel sentiment throughout the region, complicating the path for government-to-government normalisation and for existing and future climate-related deals involving Israel. Given the multi-year timescale for realising most climate-infrastructure projects, it is unclear how any regional projects involving Israel can proceed without a political solution for, or at least greater stability in, relations between Israelis and Palestinians.

Author

Laith Alajlouni
Research Associate for the Middle East Programme

ABOUT LAITH

Amnah Ibraheem
Research Analyst, IISS–Middle East

ABOUT AMNAH


Asna Wajid
Research Assistant, Middle East Programme

 

Consumer group presses for stronger Botox warnings

BY TARA SUTER - 12/12/23 

A shop offers ‘Botox to go’ in Berlin, Germany, Wednesday, Jan. 4, 2017. (AP Photo/Michael Sohn)

A consumer group is pushing the Food and Drug Administration (FDA) for stronger Botox warnings, pointing to the danger of negative health effects from the cosmetic injections.

In a Tuesday petition, Public Citizen asks the agency to “take action to strengthen the risk warning on the labeling of all approved botulinum toxin biological products.”

It warns that the use of “cosmetic and therapeutic” versions of the aforementioned products at “recommended doses” can still result in negative health effects.

“The petition asks that the black box warning of both cosmetic and therapeutic Botox and related drugs should make it clear that they are associated with systemic iatrogenic botulism and related symptoms, even when used at recommended doses, in initial or subsequent (repeated) treatment,” a press release by Public Citizen on the petition reads. 

It specifically points to the risk of “descending muscle paralysis or weakness.”

“Our petition is based on clear postmarketing evidence that refutes industry propaganda claiming that Botox and related drugs are ‘always safe’ and that no ‘definitive’ cases of botulism have occurred with recommended doses,” said Azza AbuDagga, health services researcher at Public Citizen’s Health Research Group, in a statement.

The Hill has reached out to the FDA for comment on the petition.

The usage of Botox recently came into the national spotlight, with former Rep. George Santos (R-N.Y.) allegedly inappropriately using campaign funds on the drug, according to a House Ethics Committee report. 

In an emailed statement to The Hill, the FDA said it “will review the petition and respond directly to the petitioner.”

Updated at 12:42 pm.

PA Says Netanyahu Comment on Possible War in West Bank Shows Premeditation


TEHRAN (FNA)- Prime Minister Benjamin Netanyahu’s statement that the Israeli army is preparing for a possible confrontation with the Palestinian Authority (PA) in the occupied West Bank clearly shows premeditation, The Official Spokesman for the Palestinian Presidency, Nabil Abu Rudeineh said on Tuesday.

The Israeli Public Broadcasting Corporation earlier quoted Netanyahu as saying that the Israeli government did not rule out the possibility of a war with the PA and was making contingency plans to respond to such an event, Al-Jazeera reported.

Abu Rudeina said the comments indicated the existence of an Israeli decision to attack the West Bank and the continuation of the comprehensive war waged by Israeli authorities in the Gaza Strip and occupied East Jerusalem.

Netanyahu also indicated that the Gaza Strip would be under Palestinian civilian authority but under Israeli military control after the war. Rudeina condemned and rejected this view, arguing that Israel would drag the region into endless wars and threaten international peace and security.

Meanwhile, the Palestinian movement Hamas said that Netanyahu’s latest statements about the Palestinian Authority (PA) confirm that he is “not interested in a the political settlement and wants to consolidate the occupation, especially of Jerusalem and Al-Aqsa Mosque”.

The Israeli prime minister also accused the PA of seeking to destroy Israel “in stages”.

“The difference between Hamas and the PA is only that Hamas wants to destroy us here and now, the PA wants to do it in stages,” Netanyahu said as cited by Israeli Channel 12.

Hamas called on the PA and its agencies “to shun the Oslo Accords, stop security coordination, and transition to armed resistance”.

Israel launched relentless air and ground attacks on the Gaza Strip following a cross-border attack by Hamas on October 7. Thousands of buildings, including hospitals, mosques and churches, have been damaged or destroyed in the Israeli offensive.

According to Gaza’s Health Ministry more than 18,400 Palestinians have been killed and over 50,000 others wounded since the beginning of Israel’s genocidal war on the coastal territory.