Study looks to Africa to best support Aussies living with chronic conditions

Curtin University researchers will lead an international study in South Africa aimed at implementing community-delivered interventions that address mental health and substance use-related barriers to staying engaged in treatment for chronic conditions

Curtin University

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Professor Bronwyn Myers (second from left) with some of the community health workers Curtin researchers will be working with in South Africa.

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Credit: Curtin University

Curtin University researchers will lead an international study in South Africa aimed at implementing innovative community-delivered interventions that address mental health and substance use-related barriers to staying engaged in treatment for chronic conditions such as diabetes and high blood pressure.

 

Led by Curtin enAble Institute Director Professor Bronwyn Myers, the project will run for five years after being awarded a $2.1 million National Health and Medical Research Council Global Alliance for Chronic Diseases Strengthening Health Systems grant.The project is being conducted in partnership with the South African Medical Research Council.

 

Professor Myers said despite healthcare being available, many people stopped treatment for chronic conditions because untreated mental health or substance use disorders made it harder to stay engaged.

 

“Community health workers already visit people in their homes, so they’re often the first to see when someone has missed appointments or stopped taking medication but they haven’t always had the training or support to respond effectively to mental health and substance use issues,” Professor Myers said.

 

“This study will test what happens when those home visits are backed by better training and peer support for mental health and substance use recovery, so community care teams can recognise the problem early, respond without stigma and help people reduce mental health and substance use barriers to staying connected to care instead of falling through the cracks.”

 

The study will test a program named Siyakhana - an isiXhosa word meaning ‘we build each other up’. It involves skills-based mental health and substance use training for community health workers and embeds peer recovery coaches with lived experience directly into community health teams to deliver additional mental health and substance use supports to patients.

 

The study will follow the outcomes of more than 5000 patients, measuring whether the approach helps people re‑engage with care and delivers value for money at a health‑system level.

 

Professor Myers said South Africa was the best place to conduct the study before applying the findings to Australia.

 

“As South Africa already has a large, established community health worker program, this is the ideal place for testing this health system strengthening intervention properly, at scale and much faster than we currently could in Australia where community health worker programs are only beginning to be implemented,” Professor Myers said.

 

Professor Myers said the approach responded to pressures facing both countries.

 

“Australia faces rising chronic disease rates, workforce shortages and growing demand for community‑based care, particularly in regional and underserved areas,” she said.

 

“By generating strong, real‑world evidence in South Africa, we can guide smarter, more cost‑effective decisions about how Australia expands community health workers and peer‑supported care.”

 

For more information about the Curtin enAble Institute, visit here.

Synthetic drugs reshape global markets, putting health systems under pressure

WHO Director-General delivers a speech at the forum World Health Organisation

By Rushanabonu Aliakbarova

Published on 23/04/2026 - EURONEWS

Emerging patterns of substance use are creating more complex and less predictable health risks. Experts warn that health systems are struggling to keep pace, while access to treatment and prevention services remains limited.

Synthetic drugs are rapidly reshaping global drug markets, creating new and less predictable health risks while placing growing pressure on already strained health systems.

Speaking at an international forum on countering transnational drug threats in Samarkand, the World Health Organization's director Tedros Adhanom Ghebreyesus, warned that substance use disorders are a major and expanding public health challenge, affecting individuals, families and communities across all regions.

Globally, an estimated 300 million people used drugs at least once in the past year, according to the United Nations Office on Drugs and Crime, with between 40 and 64 million people living with drug use disorders. Each year, around 600,000 deaths are linked to drug use, including from overdose and drug-related diseases such as HIV and viral hepatitis.

“These lives can be saved,” he noted, pointing to evidence-based prevention, treatment and harm reduction. Yet access remains limited, with only a small proportion of people receiving the care they need.

Barriers such as stigma, discrimination, and criminalisation continue to push vulnerable groups away from health services. Women, young people and people with co-existing conditions face particularly high risks.

Synthetic drugs reshape the landscape

Health systems in Central Asia are also struggling to keep pace with the rapid evolution of drug markets.

According to Salome Flores, Head of the UNODC Information Centre for researching and analysing transnational drug threats, the region has undergone a significant shift in recent years.

The decline in opium production in Afghanistan has altered supply patterns, while synthetic drugs are becoming more widespread. Unlike traditional substances, synthetics can be produced locally using precursor chemicals, making them harder to monitor and control.

At the same time, another trend is emerging: the misuse of pharmaceuticals.

“We’re also talking about the use of pharmaceuticals for non-medical purposes,” Salome Flores told Euronews. “People go to pharmacies and buy tranquilizers, antidepressants, sleeping pills, and in certain doses they can produce certain effects.”

This combination of synthetic substances and pharmaceutical misuse is creating a more complex health challenge, requiring both stronger regulation and expanded medical responses.

Rethinking health responses

Experts say current health system responses are no longer adequate.

Many national approaches were originally developed to address heroin, cocaine and amphetamines. But the rise of synthetic drugs, combined substance use and new distribution channels, has changed the nature of the problem.

Health systems now need to integrate services for mental health, substance use and infectious diseases, particularly at the primary care level. Community engagement is also seen as critical to reaching vulnerable populations and improving outcomes.

Treatment, experts emphasise, should be voluntary, evidence-based and grounded in human rights. Punitive approaches alone are unlikely to reduce dependence or improve public health outcomes.

Uzbekistan shifts focus to treatment and rehabilitation

In Uzbekistan, officials are increasingly framing drug use as a health and social issue rather than solely a criminal one.

According to Asilbek Khudayarov, Uzbekistan’s Minister of Health, the forum highlighted the need for new approaches.

He said the discussions reinforced that drug addiction is a complex issue linked to human health and the future of younger generations, requiring coordinated and comprehensive responses.

“In the context of the spread of synthetic drugs, it is necessary to further improve treatment and rehabilitation systems,” he said.

Khudayarov also stressed the importance of combining international medical experience and providing integrated care including medical, psychological and social support for people affected by drug dependence.

Strengthening prevention, early detection and outpatient care services is also seen as critical, placing additional responsibility on healthcare systems.

As part of this approach, Uzbekistan has proposed creating a Central Asian Association of Narcologists to support knowledge exchange and improve rehabilitation practices across the region.

Prevention and youth engagement

Prevention is another key pillar, particularly in a region with a relatively young population.

According to Zhandos Aktayev, Chairman of the Public Fund “Esbol Qory” in Kazakhstan, engaging young people directly is essential.

“Central Asia is a region with a very young population, so all our countries must focus on youth and engage them as subjects and actors of prevention work,” he said.

Evidence-based programmes and training are being used to raise awareness and help young people develop the skills needed to avoid risky situations.

Experts say early prevention can reduce long-term health risks and limit the social impact of drug use

Towards a health-centred approach

The discussions in Samarkand reflect a broader shift in how drug-related challenges are being understood.

Rather than focusing solely on law enforcement, there is growing recognition that effective responses must address the underlying health, social and economic dimensions of drug use.

This includes improving access to treatment, strengthening health systems and reducing stigma, while also adapting to new risks posed by synthetic substances.

As drug markets continue to evolve, experts say the effectiveness of responses will depend on how quickly health systems can adapt and how well countries can work together to protect the most vulnerable.

4PROFIT HEALTHCARE

Millions of Americans now consult AI before, after — and sometimes instead of — seeing a doctor

Over half of recent AI users say they research health questions before or after seeing a doctor, though most still prefer a provider for sensitive conversations

West Health Institute

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WASHINGTON, D.C. — April 15, 2026 — One in four U.S. adults — the equivalent of over 66 million Americans — report having used artificial intelligence tools or chatbots for physical or mental healthcare information or advice, according to new research released today from the West Health-Gallup Center on Healthcare in America. Rather than replacing traditional care, more than half say they turn to AI to supplement their healthcare experiences, using the technology before or after seeing a doctor.

The findings are based on a nationally representative survey of more than 5,500 U.S. adults conducted from October through December 2025.

In the past 30 days, did you use an AI tool or chatbot for health-related information or advice for any of the following reasons?

% Yes, among adults who have used AI tools or chatbots for health-related information or advice in the past 30 days

Category	Reason	U.S. adult AI health users
Speed and self-directed research	I wanted answers quickly	71%
	I wanted additional information	71%
	I was curious about what AI would say	67%
	I prefer to research on my own before seeing a doctor	59%
	I prefer to research on my own after seeing a doctor	56%
Cost barriers	I didn’t want to pay for a doctor’s visit	27%
	I was unable to pay for a doctor’s visit	14%
Access barriers	I didn’t have time to make an appointment	21%
	I couldn’t access a doctor or provider	16%
	I wanted help outside normal business hours	42%
Quality and stigma barriers	I felt dismissed or ignored by a provider in the past	21%
	I was too embarrassed to talk to a person	18%

Note. Categories are for descriptive purposes only and were not shown on the survey.             

Among Americans who have used AI for health-related information or advice in the past 30 days, the most frequently cited motivations are wanting answers quickly (71%) and wanting additional information (71%). Nearly seven in 10 (67%) say they were curious about what AI would say, and roughly six in 10 report using AI to do research on their own before (59%) or after (56%) seeing a doctor.

Regardless of the reason, almost half (46%) of Americans who used AI for healthcare information say the AI tool or chatbot made them feel more confident talking with or asking questions of a provider. Others say it helped them identify issues earlier (22%) or avoid unnecessary medical tests or procedures (19%).

“Artificial intelligence is already reshaping how Americans seek health information, make decisions and engage with providers, and health systems must keep pace,” said Tim Lash, President, West Health Policy Center, a nonprofit and nonpartisan organization focused on aging and healthcare affordability. “The risk isn’t that AI is moving too fast — it’s that health systems may move too slowly to guide its use in healthcare responsibly.”

A Smaller Share Turn to AI in Place of a Provider

While self-directed research is the primary driver of AI health use, a smaller but notable share of recent users report turning to AI instead of seeing a healthcare provider, particularly when faced with cost, access or quality barriers. Among recent AI health users, 27% say they didn't want to pay for a doctor's visit and 14% say they were unable to pay. One in five (21%) say they didn't have time to make an appointment, and 16% say they couldn't access a doctor or provider. Another 21% say they felt dismissed or ignored by a provider in the past, and 18% say they were too embarrassed to talk to a person.

 

In the past 30 days, did you use an AI tool or chatbot for health-related information or advice for any of the following reasons?

% Yes, among adults who have used AI for health-related information and advice in the past 30 days

I was unable to pay for a doctor’s visit

Household Income	% Yes, Among adults who have used AI for health-related information and advice in the past 30 days
<$24k	32%
$24k - <$48k	21%
$48k - <$90k	14%
$90k - <$120k	9%
$120k - <$180k	8%
$180k+	2%

Among recent AI health users, 84% still saw a healthcare provider, but 14% report not seeing a provider they otherwise would have seen because of information or advice they received from AI. When projected to the full U.S. adult population, this represents roughly 14 million Americans who did not see a provider after receiving AI-generated health information.

Trust in that AI-generated health information, however, remains divided. Among those who consulted it in the past 30 days, roughly one-third say they trust it (33%), one-third neither trust nor distrust it (33%), and about one-third distrust it (34%). However, only 4% say they strongly trust the accuracy, indicating that many Americans are making healthcare decisions based on AI-generated information without full confidence in its accuracy.

About one in 10 (11%) who report using AI for health information or advice in the past 30 days say that AI recommended healthcare information or advice they believed was unsafe.

"This data indicates that while some Americans may be using artificial intelligence as a substitute for going to the doctor's office, many see it as a tool to complement their healthcare, helping them understand symptoms they might be feeling and clarify any diagnosis they receive from their doctors," said Joe Daly, Global Managing Partner at Gallup.

Motivations Vary by Age and Income

While information-seeking is the dominant reason Americans turn to AI for health purposes, use patterns differ by demographics. Younger adults are more likely than older adults to use AI for self-directed research — 69% of adults aged 18 to 29 say they do research before seeing a doctor, compared with 43% of those 65 and older.

Income differences are most visible in barrier-driven motivations. Among adults earning less than $24,000 annually, 32% say they used AI because they could not pay for a doctor's visit, compared with just 2% among those earning $180,000 or more.

Everyday Health Questions Top the List of AI Use Cases

Americans who used AI for health information or advice in the past 30 days most often report using it to gather information about everyday health concerns, including physical symptoms (58%) and nutrition or exercise (59%). But AI use extends beyond symptom-checking — Americans who used AI in the past 30 days also report using AI to understand medication side effects (46%), interpret medical information (44%), or research a diagnosis or medical condition (38%). Nearly one in four (24%) report using AI to explore mental health or emotional concerns.

Methodology

West Health-Gallup Center on Healthcare, October-December 2025

Results are based on a Gallup Panel study conducted Oct. 27-Dec. 22, 2025, with a sample of 5,660 adults aged 18 and older who are members of the Gallup Panel, a nationally representative, probability-based panel of U.S. adults. Gallup uses random selection methods to recruit Panel members, including random-digit-dial (RDD) phone interviews that cover landlines and cellphones and address-based sampling (ABS) methods. Respondents with internet access completed the questionnaire as a web survey, and those without regular internet access were sent a printed questionnaire to complete and return by mail. The sample for this study was weighted to be demographically representative of the U.S. adult population, using the most recent Current Population Survey figures. For results based on this sample, one can say that the maximum margin of sampling error is ±2.1 percentage points at the 95% confidence level. Margins of error are higher for subsamples. In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error and bias into the findings of public opinion polls.

About the West Health-Gallup Center on Healthcare in America

The Center on Healthcare in America is a joint initiative from West Health and Gallup dedicated to elevating the voices and experiences of Americans within the healthcare system. Through rigorous research and human-centered storytelling, the Center aims to drive actionable insights and inform policy solutions nationwide. Visit westhealth.gallup.comhttp://www.westhealth.gallup.com/.

About West Health

Solely funded by philanthropists Gary and Mary West, West Health is a family of nonprofit and nonpartisan organizations that include the Gary and Mary West Foundation and Gary and Mary West Health Institute in San Diego and the Gary and Mary West Health Policy Center in Washington, D.C. West Health is dedicated to lowering healthcare costs to enable seniors to successfully age in place with access to high-quality and affordable health and support services that preserve and protect their dignity, quality of life and independence. Learn more at westhealth.org.

About Gallup

Gallup delivers analytics and advice to help leaders and organizations solve their most pressing problems. Combining 90 years of experience with its global reach, Gallup knows more about the attitudes and behaviors of employees, customers, students and citizens than any other organization in the world.

 

African swine fever is quietly spreading across Nepal's pig sector

Shanghai Jiao Tong University Journal Center

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Between 2022 and 2025, Nepal recorded 48 ASF outbreaks resulting in 17,005 confirmed pig deaths (CFR: 92.91%), a 14.5% decline in pig population, a 9.8% reduction in pork output, and the first confirmed case in wild boar. Epidemiological evidence points to swill feeding, cross-border livestock trade, inadequate biosecurity, unhygienic slaughter practices, and monsoon-associated transmission dynamics as primary drivers of outbreak spread. To address these vulnerabilities, the study recommends a multi-pronged response encompassing strengthened veterinary services, enhanced surveillance, rigorous biosecurity enforcement, public awareness campaigns, and greater regional cooperation. Collectively, these findings underscore the need for a coordinated One Health strategy that bridges policy, epidemiological monitoring, and community engagement to safeguard livestock production, rural livelihoods, and public health.

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Credit: Sameer Thakur, Kshitiz Shrestha, Ram Chandra Acharya, Parikshya Gurung, Surendra Karki.

A new study provides the first comprehensive analysis of African swine fever outbreaks in Nepal, revealing a disease that has quietly dismantled livelihoods, disrupted food security, and exposed deep gaps in the country's animal health system — with no vaccine in sight.

 

Since its first detection in March 2022, African swine fever (ASF) has swept through Nepal's pig farming sector with alarming speed and lethality. A new study published in Science in One Health offers the most thorough epidemiological account of the outbreak to date, documenting 48 confirmed outbreaks, 17,005 officially reported pig deaths — and warning that the true toll is likely far worse.

A disease that kills almost everything it touches

ASF is caused by a highly resilient virus for which there is currently no commercially available vaccine or cure. In Nepal, the case fatality rate has reached 92.91% — meaning that when ASF enters a farm, virtually no pig survives. Official figures record 17,005 confirmed pig deaths through June 2025, but the research team estimates the actual number may be closer to 70,000, as widespread underreporting — driven by fears of stigma and the absence of compensation schemes for affected farmers — has masked the true scale of the crisis.

The consequences have rippled through Nepal's entire pig sector. Between fiscal years 2021/22 and 2022/23, the national pig population fell by 14.5% (a loss of approximately 231,000 animals), while pork production dropped 9.8%, erasing years of steady growth. For a sector that had been expanding at roughly 10% per year and was increasingly central to Nepal's meat economy, the reversal has been stark.

Who bears the burden?

The human cost is inseparable from the numbers. Pig farming in Nepal is not merely an agricultural activity — for ethnic communities such as the Rai, Limbu, Tharu, and Magar, it is deeply woven into cultural identity, ritual practice, and daily nutrition. Pigs feature in religious ceremonies, communal festivals, and ancestral rites. When ASF strikes, it does not simply reduce income; it severs a thread connecting communities to their heritage.

At the market level, disrupted supply chains have pushed up pork prices, threatening food security for rural households that depend on pork as an affordable source of protein. Nepal's credibility in international trade has also taken a hit: the United States imposed a ban on Nepali pork products in response to ongoing outbreaks, underlining the global reach of what might otherwise appear to be a local problem.

The estimated direct economic loss stands at USD 20 million — and that figure accounts only for the market value of pigs lost. Indirect costs, including the loss of breeding stock, reduced restocking due to persistent fear of reinfection, and the burden placed on an already overstretched veterinary system, are expected to push the real figure considerably higher.

Why is ASF spreading so fast?

The study identifies a web of interconnected risk factors that together create ideal conditions for the virus to persist and spread. Swill feeding — the common practice of feeding pigs kitchen scraps and food waste from hotels and restaurants — is one of the most significant entry points: improperly treated waste containing ASF-contaminated pork products can transmit the virus directly. Informal cross-border trade with India and China, where ASF is also present, provides a near-constant route for reintroduction. Poor on-farm biosecurity — inadequate fencing, uncontrolled animal movement, and substandard slaughter practices — allows the virus to spread once it arrives.

Timing also matters. Outbreaks peak during the monsoon season, when flooding, higher humidity, and the movement of pigs for cultural festivals converge to accelerate transmission. The disease is disproportionately concentrated in high-density pig farming regions, particularly in Koshi Province, which holds over half of Nepal's domestic pig population.

Perhaps most concerning, the study documents ASF's confirmed spread to wild boar — a development with long-term implications. Wild boar can act as a reservoir, sustaining the virus in the environment and making eradication far more complex.

A system under strain

The outbreak has exposed structural vulnerabilities that predate ASF itself. Nepal's veterinary infrastructure is thinly spread and under-resourced, already managing simultaneous outbreaks of Lumpy Skin Disease, Glanders, avian influenza, and Classical Swine Fever. Diagnostic capacity is concentrated in central laboratories, slowing outbreak confirmation in rural areas. Legislation governing biosecurity and slaughter hygiene exists on paper but is inconsistently enforced. And at the community level, many smallholder farmers simply lack the knowledge or resources to implement basic protective measures.

Together, these gaps mean that ASF control in Nepal has been reactive rather than preventive — and reactive is rarely sufficient against a virus this lethal.

A roadmap for resilience

The study does not stop at diagnosis. It proposes a concrete, multi-layered response strategy built around eight priority areas: strengthening surveillance and early detection, expanding veterinary and diagnostic infrastructure, enforcing farm-level biosecurity, tightening cross-border movement controls, raising public awareness, developing a dedicated legal framework for ASF, monitoring wild boar–domestic pig interactions, and deepening community and stakeholder engagement.

Crucially, the authors frame these recommendations within a One Health approach — recognizing that ASF cannot be effectively controlled by the animal health sector alone. The virus sits at the intersection of animal health, human livelihoods, food security, and ecosystem dynamics. Sustainable control requires coordinated action across government ministries, local communities, regional neighbors, and international organizations such as FAO and WOAH.

Lessons for a region at risk

Nepal's experience is a cautionary tale for other resource-limited countries navigating transboundary animal diseases. As the authors note, the country's challenges are not unique — limited veterinary capacity, porous borders, smallholder-dominated farming systems, and low biosecurity awareness are common across South and Southeast Asia. What Nepal offers, through this study, is a documented record of what happens when a highly lethal, vaccine-preventable-in-principle disease enters such a system — and a practical framework for building resilience before the next outbreak strikes.

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Journal

Science in One Health

DOI

10.1016/j.soh.2026.100150 

Method of Research

News article

Article Title

African swine fever in Nepal: risk factors, impacts, and strategies for control

 

Family-led firearm strategy goes 'beyond the screen' to curb suicide risk

University of Michigan

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A family-centered approach to firearm safety can change how guns are kept in homes and may offer a new path to reducing suicide risk.

A new University of Michigan study, published in Injury Prevention, tested a method called the Family Safety Net in Alaska, which shifts suicide prevention away from individual screening and toward household action. This change, researchers say, could help reach people who are often missed by standard tools. 

"Currently, suicide is a leading cause of death, particularly for young people, and is not getting better with the same old approaches. said Lisa Wexler, research professor at the U-M Institute for Social Research and professor of social work. "Our typical suicide screening tools rely on individual self-report and miss people who are suicidal for a number of reasons, such as suicide behavior can be impulsive, not sure they want help, fear of losing personal agency in service of safety, etc." 

The approach suggests that caregivers take three actions. First, they answer brief screening questions about whether someone in the home may be at risk of suicide. Second, they participate in a brief motivational interviewing session, and receive free firearm safety and mental health awareness resources. Lastly, participants receive positive text messages for a month afterward that emphasize the person's good intentions in fun, culturally based ways. 

Wexler and colleagues developed this program with Alaska Native partners. They enrolled 62 adults who had firearms in the home and a young person under 29 in the household.

The average number of guns per household was 3.12.

The results showed high levels of feasibility and community support:

• 93% of participants completed the follow-up study

• 33% of participants identified concern for a household member and received the full Family Safety Net intervention

• Safe storage scores increased across all participant groups

• 15.5% of participants moved firearms to a different household to increase safety

"The vast majority of people who participated in the Family Safety Net gave us a 10 out of 10 in their experience," Wexler said. "The intervention really builds on family members' love for each other and helps to keep them safe. In this way, the intervention is universal and reduces suicide risk by helping people do what they want to do."

The study found that both delivery methods, such as a 30‑minute motivational interview or a 15‑minute scripted session, were practical in rural clinics. The scripted version requires less training and may be easier to scale.

Participants said the program also helped them talk with family members about safety and reduced their concerns. One participant said learning the "10‑minute rule," delaying access to a gun by even a few minutes, was a key lesson. 

"We know that if you can interrupt a suicidal impulse, make it 10 minutes harder to act on that impulse, you can save a life," Wexler said. "Half of the suicide deaths in the U.S. are by firearms, which cause more suicide deaths than any other kind of death." 

Findings point to a new direction for suicide prevention in high gun‑ownership regions and firearm injury prevention is essential to prevent suicide. The program also builds on family concern, household action and avoids stigma by focusing on safety rather than diagnosis. 

"Most people who die by suicide see a primary care provider in the year before their death, making this approach a potential fit for clinical settings," Wexler said. "Offering resources and support, without control, to help other people and teens in their lives is a promising, less professionalized and novel way to prevent suicide." 

Study: Are you worried someone in your household is at risk of suicide? Piloting ways to acceptably and feasibly increase safe firearm storage in rural Alaska (DOI: 10.1136/ip-2025-045917)

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Journal

Injury Prevention

DOI

10.1136/ip-2025-045917