Expert panel calls for nutrition competencies in US medical education

Group of medical and nutrition experts recommends 36 competencies to address concern that many U.S. physicians are not trained to advise patients about nutrition and food choices.

Harvard T.H. Chan School of Public Health

Key points:

• There are no nationally required nutrition competencies within medical education in the U.S. In that context, researchers surveyed a professionally diverse panel of medical and nutrition experts to reach a consensus on proposed nutrition competencies for medical students and physician trainees, as well as recommendations for how to evaluate them. 
• The proposed competencies directly respond to Congress’ bipartisan resolution H. Res. 1118, which calls for “meaningful physician and health professional education on nutrition and diet.”
• According to the researchers, incorporating competencies into medical education has the potential to improve human and planetary health by equipping physicians with the knowledge they’ve long needed to advise patients about nutrition and food choices.

Boston, MA—A professionally-diverse panel of medical and nutrition experts have proposed a set of recommended nutrition competencies for medical students and physician trainees. The study addresses a longstanding concern that most physicians in the U.S. are not equipped to advise patients about nutrition and food choices. 

The proposed competencies are a call to action in response to the U.S. House of Representatives’ bipartisan resolution H. Res. 1118, which calls for “meaningful physician and health professional education on nutrition and diet.” The resolution cited concerns about the increasing prevalence of diet-related diseases and Medicare costs, which totaled $800 billion in 2019. Congressional annual financial support for medical trainees in U.S. hospitals was estimated at $16.2 billion in 2020.

“It’s shocking that there are no nationally required nutrition competencies within medical education,” said lead author David Eisenberg, adjunct associate professor of nutrition and director of culinary nutrition at Harvard T.H. Chan School of Public Health. “This is a surprising and important gap, considering the epidemics of obesity, diabetes, and other diet-related chronic diseases in this country, as well as their ever-increasing financial and societal costs. My guess is that most patients assume their doctors are trained to advise them about nutrition and food choices, but this has simply not been part of their required training.”

The study will be published September 30 in JAMA Network Open.

The researchers—Eisenberg, Alexis Cole at Tufts University, and Edward Maile and Matthew Salt, both at U.K.-based consultancy Sprink Ltd.—compiled a list of 354 nutrition competencies included in the academic literature and recruited an expert panel made up of 37 medical educators, nutrition scientists, practicing physicians, medical residency directors, and registered dietician nutritionists from across the country. Over the course of four rounds, the panelists ranked the competencies and provided comments and ideas.

After analyzing the survey results, the researchers identified 36 nutrition competencies on which the panel had reached consensus and recommended for undergraduate and graduate medical school and training. The competencies span six categories: foundational nutritional knowledge (“Demonstrates knowledge of the nutritional content of foods including the major dietary sources of macronutrients and micronutrients); assessment and diagnosis (“Assesses the nutritional status of a patient with a brief diet and food history/questionnaire, anthropometric measurements, and appropriate laboratory tests”); communication skills (“Listens carefully, compassionately, and non-judgmentally while taking a nutrition history”); public health (“Demonstrates knowledge of public health nutrition, including the social determinants of health, and how it can reduce the burden of disease and improve access to adequate, healthy food”); collaborative support and treatment for specific conditions (“Works with other health professionals to deliver a multidisciplinary approach to nutrition care”); and indications for referral (“Makes appropriate referrals to a range of professionals to support the patient to achieve their health goals”).

In addition, 97% of the panelists called for formal nutrition testing on licensing and certification exams for future physicians. Other highlights included:

• 95% of panelists agreed that institutions should report on their teaching relating to nutrition competencies.
• 92% agreed that surveys of students should be used to assess their competency and confidence in this area.
• 73% of panelists recommended a competency related to the environmental and planetary health impact of food choices for inclusion.

The research team also identified 12 possible gaps that were not addressed in the recommended competencies, as these were not identified in a review of the existing medical literature. These included topics such as when and how to discuss glucagon-like peptide 1 (GLP-1) agonists (anti-obesity drugs) with patients and how to responsibly use artificial intelligence to provide patients practical advice about nutrition and food choices. 

“The competencies represent the greatest efforts thus far to address H. Res. 1118, and their adoption will undoubtedly significantly enhance public health,” Eisenberg said. “Ensuring physicians are equipped with the necessary knowledge to advise patients in practical terms about nutrition and food choices will increase referrals to and collaboration with a range of nutrition experts and programs, promote health equity, and improve planetary health.”

The researchers noted that the competencies’ international generalizability may be limited, given that the panel was U.S.-based. However, the consensus-building approach through which the recommended competencies were developed could inform similar efforts by medical educators and regulators worldwide, as nutrition-related health challenges and limited nutrition training for physicians are global problems.

The study was funded by the Vitamix Foundation, the David R. and Margaret C. Clare Foundation, the Shaich Family Foundation, and the Ardmore Institute of Health. These philanthropic grants were provided to, and administered by, the Teaching Kitchen Collaborative.

“Proposed Nutrition Competencies for Medical Students and Physician Trainees,” David M. Eisenberg, Alexis Cole, Edward J. Maile, Matthew Salt, Elizabeth Armstrong, Emily Broad Leib, Trevor Findley, Jennifer Massa, Jaclyn Albin, Meredith Alston, Hope Barkoukis, Fred Buckhold, Robert Danoff, Helen Delichatsios, Stephen Devries, Stephanie Dewar, Jennifer DiRocco, Christopher P. Duggan, Kofi Essel, Elizabeth Frates, Pamela Hansen, Aviad Haramati, Timothy S. Harlan, Michelle E. Hauser, David Leopold, Joanna Lewis, Amy Locke, Joshua R. Mann, Auden McClure, John Wesley McWhorter, Saroj Misra, Tiffany Murano, Amy Oxentenko, Stacey Pierce-Talsma, Stacy Potts, Jo Marie Reilly, Melinda Ring, Suzanne Sampang, Kate Shafto, Linda Shiue, Wendelin Slusser, Terri Stone, Karen Studer, Olivia Thomas, Jennifer Trilk, Laura Edgar, JAMA Network Open, September 30, 2024, doi: 10.1001/jamanetworkopen.2024.35425

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Harvard T.H. Chan School of Public Health brings together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. As a community of leading scientists, educators, and students, we work together to take innovative ideas from the laboratory to people’s lives—not only making scientific breakthroughs, but also working to change individual behaviors, public policies, and health care practices. Each year, more than 400 faculty members at Harvard Chan School teach 1,000-plus full-time students from around the world and train thousands more through online and executive education courses. Founded in 1913 as the Harvard-MIT School of Health Officers, the School is recognized as America’s oldest professional training program in public health.

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Journal

JAMA Network Open

DOI

10.1001/jamanetworkopen.2024.35425 

Method of Research

Systematic review

Subject of Research

Not applicable

Article Title

Proposed Nutrition Competencies for Medical Students and Physician Trainees

Article Publication Date

30-Sep-2024

Trends in female physicians entering high-compensation specialties

JAMA Network

About The Study: 

This study found that female physicians were underrepresented among residents entering high-compensation specialties compared with non–high-compensation specialties. 

However, while high-compensation surgical specialties experienced a steady increase in the proportion of female applicants and matriculants over time, high-compensation nonsurgical specialties experienced an overall decrease in the proportion of female applicants and no significant changes in the proportion of female matriculants.

Corresponding Author: To contact the corresponding author, Karina Pereira-Lima, PhD, MSc, email pereiral@med.umich.edu.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jama.2024.17516)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

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Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2024.17516?guestAccessKey=82ebefa9-095e-4e96-956c-e36e9ee3aebf&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=093024

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Journal

JAMA

Female representation improves in high paying medical specialties

Michigan Medicine - University of Michigan

Despite continuing overall inequities, the number of female residents matriculating to high paying medical specialties has increased with a notable rise in women entering high compensation surgical fields.  

University of Michigan researchers first reported these findings in “Trends in female physicians entering high-compensation specialties, 2008 to 2022,” published in JAMA. 

While women constituted 55% of incoming United States medical students, there exists a significant pay gap between male and female doctors, driven in part by overrepresentation of men in high paying specialties. 

Lately, however, the proportion of female matriculants to high compensation residency specialties has increased, from 32.7% in 2008 to 40.8% in 2022.  

Matriculation to high compensation surgical specialties drove that increase, with women representing 28.8% of applicants in 2008 and 40.8% in 2022.  

Over the same 14-year period, the number of female applicants to non-surgical, high compensation specialties dropped from 36.8% to 34.3%. 

“That programs have been successful in attracting more women to enter surgery despite low levels of intervention is surprising and great to see,” said Amy S. B. Bohnert, Ph.D., M.H.S., professor in U-M’s department of Anesthesiology and senior author on the paper. 

“I think it's encouraging that this trend could eventually lead to parity, since women make up more than half of people going into medicine now.” 

The research team was motivated to investigate these trends after noticing the proportion of women now entering the medical profession and continuing inequities in pay compared to men.  

In addition to now constituting the majority of incoming medical students, women still make up a larger percentage of people entering non-high-compensation specialties. (53.0% in 2008 and 53.3% in 2022.) 

“There’s been a lot of research on disparities in physician salaries and the underrepresentation of women in high compensation specialties among practicing physicians. But with more women entering medicine, we wanted to see if that trend was also happening with those starting their training in these highly compensated specialties,” said Karina Pereira-Lima, Ph.D., research fellow in the U-M Department of Neurology and lead author of the paper. 

“There is also prior research showing that women tend to be underrepresented in surgical residencies, but it looks like this isn’t just a surgical issue–it’s something we’re seeing across high-paying specialties in general.” 

One possible explanation for the relative increase in female surgical residents is the growing spotlight on the issue through both research and social media campaigns such as #ILookLikeASurgeon in 2015, which attempted to combat stereotypes of surgery as a male specialty by celebrating women in the field.  

The researchers behind the paper highlight the need for future investigations to determine to what extent, if at all, these efforts explain current application trends. 

“An important aspect of the trend that we identified is that it seems to be driven by more women applying to surgical specialties, rather than increased acceptance rates,” said Srijan Sen, M.D., Ph.D., principal investigator of the Intern Health Study and director of the Eisenberg Family Depression Center.  

“Going forward it will be important to identify why the specialties and programs that drove the trend have been successful in increasing applications from women.” 

Another potential future area of study is the ability of high-compensation specialties to retain and support women as they progress through the career pathway. While the number of female residents entering high-compensation specialties has increased, the overall numbers remain far below parity, a reality showing that much work is still needed to achieve gender equality in physician representation and compensation across different specialties.  

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Journal

JAMA

DOI

10.1001/jama.2024.17516 

Method of Research

Data/statistical analysis

Subject of Research

Not applicable

Article Title

Trends in Female Physicians Entering High-Compensation Specialties

Article Publication Date

30-Sep-2024

 

From embers to crisis: the expanding threat of wildfires under global warming

Higher Education Press

 

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Credit: Guochao Chen , Minghao Qiu , Peng Wang , Yuqiang Zhang , Drew Shindell , Hongliang Zhang

Globally, wildfires are on the rise, driven by climate change, which exacerbates droughts and high temperatures. These fires contribute significantly to carbon emissions and particulate matter (PM2.5), with severe consequences for both climate stability and public health. While some regions have experienced a decline in burned areas, high-latitude regions are facing more intense wildfire events. In response to these challenges, there is a pressing need for in-depth research to understand and mitigate the impacts of wildfires.

A study (DOI: 10.1007/s11783-024-1890-6) led by researchers from Fudan University, published on July 19, 2024, in Frontiers of Environmental Science & Engineering examines global wildfire trends and impacts over the past two decades. The study analyzes data on burned areas, carbon dioxide (CO2) emissions, and PM2.5 across continents, highlighting the urgent need to address the escalating threats posed by wildfires, especially in high-latitude regions where climate change has significantly intensified fire activity.

The study reveals that wildfires globally burn approximately 3%–4% of land each year, leading to massive emissions of greenhouse gases and pollutants. Although global burned areas have generally declined, particularly in Africa, high-latitude regions in Asia and North America have seen increased variability and severe wildfire events in recent years. The research points to climate change as a key driver of these trends, particularly in high-latitude regions. These fires are major sources of CO2 and PM2.5, contributing to climate warming and posing significant health risks, especially in poorly managed areas. The study highlights the need for targeted research and effective management strategies to mitigate the impacts of wildfires.

Dr. Hongliang Zhang, a leading researcher, stated, “Our findings underscore the urgent need for global collaboration to combat the rising threat of wildfires. The variability in wildfire activity across continents reflects the complex interactions between climate change, vegetation, and human factors. By focusing on high-risk areas and improving fire management practices, we can reduce the severe health and environmental impacts of these fires.” Dr. Zhang’s comments emphasize the importance of targeted efforts to manage and mitigate wildfire risks.

The study’s findings have significant implications for shaping future wildfire management strategies. By identifying the key drivers of wildfire activity and their health impacts, the research provides a solid foundation for developing more effective policies and practices. These insights are vital for policymakers, environmental agencies, and public health organizations in planning and implementing measures to reduce wildfire risks and enhance resilience in vulnerable regions. The study also highlights the ongoing need for research to adapt to the evolving challenges posed by climate-driven wildfires.

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Journal

Frontiers of Environmental Science & Engineering

DOI

10.1007/s11783-024-1890-6 

Method of Research

Experimental study

Subject of Research

Not applicable

Article Title

Continuous wildfires threaten public and ecosystem health under climate change across continents

 

Online misinformation most likely to be believed by ideological extremists, new study shows

Findings reveal the importance of quickly addressing the spread of falsehoods

New York University

Political observers have been troubled by the rise of online misinformation—a concern that has grown as we approach Election Day. However, while the spread of fake news may pose threats, a new study finds that its influence is not universal. Rather, users with extreme political views are more likely than are others to both encounter and believe false news. 

“Misinformation is a serious issue on social media, but its impact is not uniform,” says Christopher K. Tokita, the lead author of the study, conducted by New York University’s Center for Social Media and Politics (CSMaP).

The findings, which appear in the journal PNAS Nexus, also indicate that current methods to combat the spread of misinformation are likely not viable—and that the most effective way to address it is to implement interventions quickly and to target them toward users most likely to be vulnerable to these falsehoods.

“Because these extreme users also tend to see misinformation early on, current social media interventions often struggle to curb its impact—they are typically too slow to prevent exposure among those most receptive to it,” adds Zeve Sanderson, executive director of CSMaP. 

Existing methods used to assess the exposure to and impact of online misinformation rely on measuring views or shares. However, these fail to fully capture the true impact of misinformation, which depends not just on spread, but also on whether users actually believe the false information.

To address this shortcoming, Tokita, Sanderson, and their colleagues developed a novel approach using Twitter (now “X”) data to estimate not just how many users were exposed to a specific news story, but also how many were likely to believe it. 

“What is particularly innovative about our approach in this research is that the method combines social media data tracking the spread of both true news and misinformation on Twitter with surveys that assessed whether Americans believed the content of these articles,” explains Joshua A. Tucker, a co-director of CSMaP and an NYU professor of politics, one of the paper’s authors. “This allows us to track both the susceptibility to believing false information and the spread of that information across the same articles in the same study.”

The researchers captured 139 news articles (November 2019-February 2020)—102 of which were rated as true and 37 of which were rated as false or misleading by professional fact-checkers—and calculated the spread of those articles across Twitter from the time of their initial publication. 

This sample of popular articles was drawn from five types of news streams: mainstream left-leaning publications, mainstream right-leaning publications, low-quality left-leaning publications, low-quality right-leaning publications, and low-quality publications without an apparent ideological lean. To establish the veracity of the articles, each article was sent to a team of professional fact checkers within 48 hours of publication. The fact-checkers rated each article as “true” or “false/misleading.” 

To estimate exposure to and belief in these articles, the researchers combined two types of data. First, they used Twitter data to identify which users on Twitter were potentially exposed to each of the articles; they also estimated each potentially exposed user’s ideological placement on a liberal-conservative scale by using an established method that infers a user’s ideology from the prominent news and political accounts they follow. 

Second, to determine the likelihood that these exposed users would believe an article to be true, they deployed real-time surveys as each article spread online. These surveys asked Americans who are habitual internet users to classify the article as true or false and to provide demographic information, including their ideology. From this survey data, the authors calculated the proportion of individuals within each ideological category that believed the article to be true. With these estimates for each article, they could calculate the number of Twitter users exposed and receptive to believing the article to be true. 

Overall, the findings showed that while false news reached users across the political spectrum, those with more extreme ideologies (both conservative and liberal) were far more likely to both see and believe it. Crucially, these users, who are receptive to misinformation, tend to encounter it early in its spread through Twitter.  

The research design also allowed the study’s authors to simulate the impact of different types of interventions designed to stop the spread of misinformation. One takeaway from these simulations was that the earlier interventions were applied, the more likely they were to be effective. Another was that “visibility” interventions—whereby a platform makes flagged misinformation posts less likely to appear in users’ feeds—appeared more likely to reduce the reach of misinformation to susceptible users than did interventions aimed at making users less likely to share misinformation.

“Our research indicates that understanding who is likely to be receptive to misinformation, not just who is exposed to it, is key to developing better strategies to fight misinformation online,” advises Tokita, now a data scientist in the tech industry.

The study’s other authors included Kevin Aslett, a CSMaP postdoctoral researcher and University of Central Florida professor at the time of the study who now works as a researcher in the tech industry, William P. Godel, an NYU doctoral student at the time of the study and now a researcher in the tech industry, as well as CSMaP researchers Jonathan Nagler and Richard Bonneau.

The research was supported by a graduate research fellowship from the National Science Foundation (DGE1656466).

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Journal

PNAS Nexus

DOI

10.1093/pnasnexus/pgae396 

Method of Research

Survey

Article Title

Measuring receptivity to misinformation at scale on a social media platform

 

A river is pushing up Mount Everest’s peak

Mount Everest is about 15 to 50 metres taller than it would otherwise be because of uplift caused by a nearby eroding river gorge, and continues to grow because of it, finds a new study by UCL researchers.

University College London

Mount Everest is about 15 to 50 metres taller than it would otherwise be because of uplift caused by a nearby eroding river gorge, and continues to grow because of it, finds a new study by UCL researchers.

The study, published in Nature Geoscience, found that erosion from a river network about 75 kilometres from Mount Everest is carving away a substantial gorge. The loss of this landmass is causing the mountain to spring upwards by as much as 2 millimetres a year and has already increased its height by between 15 and 50 metres over the past 89,000 years.

At 8,849 metres high, Mount Everest, also known as Chomolungma in Tibetan or Sagarmāthā in Nepali, is the tallest mountain on Earth, and rises about 250 metres above the next tallest peak in the Himalayas. Everest is considered anomalously high for the mountain range, as the next three tallest peaks – K2, Kangchenjunga and Lhotse – all only differ by about 120 metres from each other.

A significant portion of this anomaly can be explained by an uplifting force caused by pressure from below Earth’s crust after a nearby river eroded away a sizeable amount of rocks and soils. It’s an effect called isostatic rebound, where a section of the Earth’s crust that loses mass flexes and “floats” upwards because the intense pressure of the liquid mantle below is greater than the downward force of gravity after the loss of mass. It’s a gradual process, usually only a few millimetres a year, but over geological timeframes can make a significant difference to the Earth's surface.

The researchers found that because of this process Mount Everest grew by about 15 to 50 metres over the last 89,000 years, since the nearby Arun river merged with the adjacent Kosi river network.

Co-author, PhD student Adam Smith (UCL Earth Sciences) said: “Mount Everest is a remarkable mountain of myth and legend and it’s still growing. Our research shows that as the nearby river system cuts deeper, the loss of material is causing the mountain to spring further upwards.”

Today, the Arun river runs to the east of Mount Everest and merges downstream with the larger Kosi river system. Over millennia, the Arun has carved out a substantial gorge along its banks, washing away billions of tonnes of earth and sediment.

Co-author Dr Jin-Gen Dai of the China University of Geosciences, said: "An interesting river system exists in the Everest region. The upstream Arun river flows east at high altitude with a flat valley. It then abruptly turns south as the Kosi river, dropping in elevation and becoming steeper. This unique topography, indicative of an unsteady state, likely relates to Everest's extreme height."

The uplift is not limited to Mount Everest, and affects neighbouring peaks including Lhotse and Makalu, the world’s fourth and fifth highest peaks respectively. The isostatic rebound boosts the heights of these peaks by a similar amount as it does Everest, though Makalu, located closest to the Arun river, would experience a slightly higher rate of uplift.

Co-author Dr Matthew Fox (UCL Earth Sciences) said: “Mount Everest and its neighbouring peaks are growing because the isostatic rebound is raising them up faster than erosion is wearing them down. We can see them growing by about two millimetres a year using GPS instruments and now we have a better understanding of what’s driving it.”

By looking at the erosion rates of the Arun, the Kosi and other rivers in the region, the researchers were able to determine that about 89,000 years ago the Arun river joined and merged with the Kosi river network, a process called drainage piracy. In doing so, more water was funnelled through the Kosi river, increasing its erosive power and taking more of the landscape’s soils and sediments with it. With more of the land washed away, it triggered an increased rate of uplift, pushing the mountains’ peaks higher and higher.

Lead author Dr Xu Han of China University of Geosciences, who carried out the work while on a China Scholarship Council research visit to UCL, said: “The changing height of Mount Everest really highlights the dynamic nature of the Earth’s surface. The interaction between the erosion of the Arun river and the upward pressure of the Earth’s mantle gives Mount Everest a boost, pushing it up higher than it would otherwise be.”

 

Notes to Editors

For more information or to speak to the researchers involved, please contact Michael Lucibella, UCL Media Relations. T: +44 (0)75 3941 0389, E: m.lucibella@ucl.ac.uk

Xu Han, Jin-Gen Dai, Adam G. G. Smith, Shi-Ying Xu, Bo-Rong Liu, Cheng-Shan Wang, Matthew Fox, ‘Recent uplift of Chomolungma enhanced by river drainage piracy’ will be published in Nature Geoscience on Monday 30 September 2024, 16:00 UK time, 11:00 US Eastern time and is under a strict embargo until this time.

The DOI for this paper will be 10.1038/s41561-024-01535-w.

After publication, the paper will be available at the following URL: https://www.nature.com/articles/s41561-024-01535-w

 

Additional material

• Adam Smith’s academic profile
• Dr Matthew Fox’s academic profile
• UCL Department of Earth Sciences
• UCL Faculty of Mathematical & Physical Sciences
• China University of Geosciences (Beijing)

 

About UCL – London’s Global University

UCL is a diverse global community of world-class academics, students, industry links, external partners, and alumni. Our powerful collective of individuals and institutions work together to explore new possibilities.

Since 1826, we have championed independent thought by attracting and nurturing the world's best minds. Our community of more than 50,000 students from 150 countries and over 16,000 staff pursues academic excellence, breaks boundaries and makes a positive impact on real world problems.

The Times and Sunday Times University of the Year 2024, we are consistently ranked among the top 10 universities in the world and are one of only a handful of institutions rated as having the strongest academic reputation and the broadest research impact.

We have a progressive and integrated approach to our teaching and research – championing innovation, creativity and cross-disciplinary working. We teach our students how to think, not what to think, and see them as partners, collaborators and contributors.  

For almost 200 years, we are proud to have opened higher education to students from a wide range of backgrounds and to change the way we create and share knowledge.

We were the first in England to welcome women to university education and that courageous attitude and disruptive spirit is still alive today. We are UCL.

www.ucl.ac.uk | Follow @uclnews on X (formerly Twitter) | Read news at www.ucl.ac.uk/news/ | Listen to UCL podcasts on SoundCloud | View images on Flickr | Find out what’s on at UCL Mind

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Journal

Nature Geoscience

DOI

10.1038/s41561-024-01535-w 

Method of Research

Imaging analysis

Article Title

Recent uplift of Chomolungma enhanced by river drainage piracy

Article Publication Date

30-Sep-2024

GENOCIDE JOE

Israel likely used US-made 2,000-pound bombs to kill Hezbollah leader, analysts say

By Annika Burgess


The IDF has said that more than 80 bombs were dropped over a period of several minutes to kill Hezbollah leader Hassan Nasrallah in Beirut. (AP: Hassan Ammar)

In short:

A US senator has said an American heavy bomb was used in the strikes that killed Hezbollah's leader.

Several analysts also suggested it was likely the US bombs, known as "bunker busters", were involved in the Beirut attack.
What's next?

The US said it stopped shipping the bombs to Israel in May, but experts said the Biden administration was unlikely to "punish" Israel ahead of the presidential elections.

Days after massive Israeli air strikes killed Hezbollah's leader Hassan Nasrallah, new information has emerged to piece together how it unfolded.

Footage from the scene shows the blasts levelled multiple high-rise apartment towers in the densely populated suburb known as Dahiyeh.

Other buildings sank into the ground, surrounded by pancaked concrete and twisted metal spanning an area larger than a soccer field.

Although the Pentagon has not confirmed, a US senator who chairs a defence committee has said an American-made 2,000-pound (900-kg) bomb was used in the strikes.

And several analysts say it's likely the US "bunker busters" were involved in the biggest attack to hit Beirut since the start of the current conflict in the Middle East, almost a year ago.

More than 80 bombs dropped

Israel Defense Forces (IDF) said they were aware of Nasrallah's whereabouts for months and conducted the air strike to exploit a brief window of opportunity.

Photo shows A large amount of rubble, with smoke also visible rising from it

Israel's attacks in Lebanon will continue for the foreseeable future, a military spokesperson and the country's PM say, despite confirmation Hassan Nasrallah, the leader of the country's main adversary there, had been "eliminated".

Two IDF officials told the New York Times that more than 80 bombs were dropped over a period of several minutes to kill the 64-year-old leader of the Iran-backed militant group.

They did not confirm the weight or make of the bombs.

The Israeli military told residents in parts of Beirut's southern suburbs to evacuate late on Friday.

That night, it carried out what the IDF called a "precise strike" on Hezbollah's headquarters, which it said were "embedded under residential buildings in the heart of the Dahiyeh in Beirut".

At least six people were killed, and 91 others injured, according to the Lebanese Health Ministry.


"Bunker buster" bombs penetrate underground, then produce shock waves that topple buildings. (AP: Hassan Ammar)

Among those killed were the commander of Hezbollah’s southern front, Ali Karaki, and the Islamic Revolutionary Guards Corp's commander in Lebanon.

AP reported some people at the scene on Sunday were still searching for missing relatives.
US-made bombs appear in IDF video

The IDF released videos and photos following attacks it said showed the warplanes that took part in the strike.

Analysts who examined the footage for the Washington Post said it appeared the fighter jets were carrying multiple 2,000-pound-class bombs, some of which were US-made BLU-109s.


They added that they were equipped with Joint Direct Attack Munition (JDAM) guidance kits, which convert "dumb bombs" into precision-guided munitions that can attack a specific target.

Michael Shoebridge, director and founder of Strategic Analysis Australia, agreed with the analysis.

"The pictures released by the IDF show F-15s equipped with those heavy bombs," he told the ABC.


"And you can see the strike is consistent with those aircraft having used those weapons."


People gather to mourn the death of Lebanon's Hezbollah leader Sayyed Hassan Nasrallah, in Tehran.

US officials said they did not know Israel was going to launch an air strike aimed at killing Nasrallah.

But President Joe Biden praised the move as "a measure of justice for his many victims".

Hezbollah has been designated as a terrorist group by the US and Australia.
US halted heavy bomb supply

The US is Israel's longtime ally and biggest arms supplier.

What we know about US pause on heavy bomb supply to Israel

Photo shows A Palestinian man stands looking through a opening in a building, watching as smoke rises after Israeli strikes

.

The US acknowledges its 2,000-pound bombs cause civilian deaths in Gaza and will pause supply on a shipment of the heavy weapons to Israel over concerns about their use in Rafah.

In May, the Biden administration announced it had paused a shipment of US-made 2,000-pound bombs to Israel because of concerns over civilian safety in Gaza.

Mr Biden acknowledged that the bombs, which military experts say turn "earth into liquid", had killed civilians.

Over the weekend, Senator Mark Kelly, chair of the Senate Armed Services Airland Subcommittee, said Israel had used a US 2,000-pound Mark 84 series bomb in the strikes that killed Nasrallah.

"We see more use of guided munitions, JDAMs, and we continue to provide those weapons," Mr Kelly said in an interview with NBC.

"That 2,000-pound bomb that was used, that's a Mark 84 series bomb, to take out Nasrallah."

Neither the Israeli military nor the Pentagon have commented on the weapons used in the attack.

Although the US announced that it had halted shipments of heavy bombs to Israel, Mr Shoebridge said Israel would likely have a stockpile.

Bombs designed to explode underground

The Mark 84, or BLU-117, is the largest in the Mark 80 series of weapons known as "bunker busters".

It has a lethal fragmentation that can extend for up to 365 metres.

Malcolm Davies, senior analyst in defence capability at the Australian Strategic Policy Institute (ASPI), said there were different variations of the heavy bombs.

But he was confident Friday's strikes in the Dahiyeh neighbourhood used bunker busters.

"The high-yield, 2,000-pound weapons were designed to penetrate deep underground where Nasrallah was hiding with his cronies," he told the ABC.

"So I think that that's how the Israelis did this."

The bombs slice through concrete, then explode underground.

The explosions then create shock waves that immediately collapse structures above.


"Anyone who's not killed by the explosion on the ground is then killed by the rubble falling on them," Dr Davis said.

Sizes of the US-made MK 84 and MK 82 bombs. (ABC News: Digital Graphics team)
Largest Israeli strike

Trevor Ball, a former explosive ordnance disposal technician for the US Army, told the Washington Post that videos of the aftermath showed it was possible dozens of 2,000-pound bombs were used.

Mr Shoebridge said in kinetic terms, the strikes that killed Nasrallah were the largest single strike by Israel over the past year.

And although the US had voiced concerns about heavy bombs being used in Gaza, the US would likely argue that the strikes were "a clearly targeted strike which had the intended effect".

"Despite its the devastation, this was a precisely targeted attack that killed the most senior leader of this long-term terrorist organisation, plus a bunch of his associated most senior leaders," Mr Shoebridge said.

"I would suspect that the US government position would be that this was a proportional use of force."


More than 1,000 people have been killed and thousands more injured as Israel has ramped up its attacks on Hezbollah over the last two weeks. (AP: Hassan Ammar)

Israel and Hezbollah are locked in their most intense round of fighting in decades, teetering on the brink of all-out war.

They have been trading fire across the border since the start of the war in Gaza, which was triggered by the October 7 attack on Israel by Hamas militants.


Hamas militants killed about 1,200 people during the October 7 terrorist attacks on Israel, and took at least 250 hostages back to Gaza, according to Israeli authorities.
Nasrallah turned Islamist militia into political force

Photo shows A man speaks into a microphone with his hand in the air

The leader of the region's most powerful militia and Iran's strongest ally is gone, and Hezbollah, the group he headed, has been decimated by intense Israel attacks. But that doesn't mean it will die with him.

Israel responded by invading the Gaza Strip in an ongoing conflict that has claimed the lives of more than 40,000 Palestinians, according to the Gaza health ministry.

Over the past two weeks, Israel has ramped up its attacks on Hezbollah, carrying out strikes across Lebanon that have killed more than 1,000 people and injured thousands more, according to official government updates from Beirut.

Israel says it aims to make its northern areas of the country safe for 60,000 residents to return to their homes after a year of Hezbollah bombings.
'Israel's not going to stop'

With the US presidential elections looming, experts say it is unlikely the Biden administration will take any further action against Israel.

Hussein Ibish, senior resident fellow at the Arab Gulf States in Washington, said restricting weapons sales to Israel could only go so far.
Israel's long history of assassination plots

Photo shows An injured person is wheeled on a stretcher

While Israel's alleged involvement in the pager and hand-held radio attacks in Lebanon may never be confirmed, the country's security and intelligence agencies have been linked to a string of assassination plots over the years.

Israel already rejected global calls for a 21-day ceasefire, instead vowing to "continue fighting with full force".

And even after Nasrallah's death, Prime Minister Benjamin Netanyahu said Israel's attacks across Lebanon would not be slowing down.

"The United States and its allies were pushing very hard for a ceasefire and Israel decided 'no, they are just going to go ahead with major escalations anyway because it served their interests'," Professor Ibish told ABC's RN Breakfast.

"The United States is not going to punish Israel five weeks before an election."

Dr Davis said even though Israel had already taken out several of Hezbollah's senior and mid-level leadership, it appeared they were determined to "finish the job".

"They've cut the head off the snake … but Israel's not going to stop," he said.

"So if there's no ceasefire, and no peace settlements, it's just going to keep going."

Africa: It's Time for Rich Polluters to Pay for the Climate Crisis They Created

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WFP

Azimi Abubakar, 50, a resident of Gasamu, wades through the floodwater in Jakusko LGA of Yobe State, Nigeria, on 01 October 2022.

30 September 2024

Inter Press Service

By Hilda Flavia Nakabuye

New York — The world is standing at a critical juncture. Climate change is not just a future threat--it's here, and it's already devastating lives. From record-breaking heat waves to floods and landslides, the planet is sending us clear signals that we cannot afford to ignore.

But for many of us in the Global South, this crisis is not new. It is a daily reality that we have been living with for years, despite contributing almost nothing to the problem.

I am from Uganda, a country that contributes less than 0.02% of global CO2 emissions and ranks as the 36th most vulnerable country to the impacts of climate change. I grew up on a farm, and I saw firsthand how changing weather patterns--flooded roads and mudslides--kept me from attending school.

What was once a reliable planting season turned into a guessing game of whether the rains would come at all or whether they'd wash away everything in their path.

Our plantation didn't survive. Neither did many others in my region. And in the end, it wasn't just our farm that was lost--it was our livelihood, our food security, and for me, an entire year of education.

What frustrates me most is that Africa, a continent rich in resources and biodiversity, continues to bear the brunt of a crisis we did not create. Our people are paying with their lives and futures for the emissions and actions of the world's wealthiest.

According to Oxfam, the richest 1% emit as much planet-heating pollution as the poorest two-thirds of humanity and their carbon emissions are enough to cause 1.3 million excess deaths due to heat. The richest continue to be indifferent to the fact that it is the poorest and frontline communities who pay the price.

According to UNICEF, girls worldwide spend 200 million hours every single day collecting water. Think about that for a moment--200 million hours. The climate crisis is making this burden even heavier.

As water sources dry up, girls are forced to walk further and further, giving up education and opportunities to secure the most basic human need. By 2030, water insecurity is expected to displace 700 million people globally--most of them girls and women. This is not just a climate crisis; it's a social justice crisis.

Africa, despite its negligible carbon footprint, is on the frontlines of environmental disasters, while the fossil fuel industry continues to rake in record profits. This system is built on injustice. A system where the few benefit while the rest of us suffer. It's a system where the powerful can pollute, and the poor pay the price.

But it doesn't have to be this way.

In Uganda, we're organizing. I founded Fridays for Future Uganda to demand climate justice and to fight for a sustainable future where communities can thrive, not just survive. And we're not alone. Across the world, movements like Make Rich Polluters Pay are calling for those responsible for the climate crisis--the fossil fuel giants and the ultra-wealthy--to be held accountable.

The solutions are within reach, but it requires the political will to act. Right now, in New York, there's a bill sitting on Governor Kathy Hochul's desk that could set a powerful precedent. The Climate Change Superfund Act would force major fossil fuel companies to pay their fair share for climate damages in the state.

Governor Hochul has the power to sign this into law and ensure that everyday people aren't left footing the bill for the climate crisis. We need similar actions across the globe.

This November, at COP29 in Baku, leaders from the Global North, including the United States, must agree on a new goal for climate finance that includes taxing the ultra-wealthy and fossil fuel companies. Rich countries, whose emissions have fueled the climate crisis, must step up and take the lead. It's time for rich polluters to pay for the destruction they've caused.

We cannot wait any longer. The climate crisis is here. The people who have contributed the least to this crisis are the ones suffering the most. We need to hold those responsible to account and demand that they pay for the loss and damage we are experiencing.

The future we want is equal--one where renewable energy powers our economies, where girls are in classrooms instead of walking miles for water, and where communities in Uganda, New York, and beyond can thrive.

I urge you to take action. There are many ways you can do that. One is to support the Make Rich Polluters Pay campaign by signing the petition and raising your voice. Climate justice isn't just a demand--it's our right. Together, we can build a better, fairer future for everyone.

Hilda Flavia Nakabuye is a Ugandan climate and environmental rights activist and founder of Fridays for Future Uganda.

IPS UN Bureau

Africa: Ruto Urges United African Push for Fair Climate Financing At COP29

WFP
Azimi Abubakar, 50, a resident of Gasamu, wades through the floodwater in Jakusko LGA of Yobe State, Nigeria

30 September 2024
Business Day Africa (Nairobi)

African leaders must present a united front at the upcoming United Nations climate change conference to demand a fairer global climate financing system, Kenyan President William Ruto said.

Speaking at a meeting of the Committee of African Heads of State and Government on Climate Change (CAHOSCC), held alongside the 79th United Nations General Assembly in New York, Ruto urged the continent to push for reforms that would increase investment in Africa's energy transition and boost its climate adaptation efforts.

"The focus at COP29 in Baku, Azerbaijan, should be on securing an equitable climate financing mechanism that addresses the needs of Africa and other developing nations," said Dr Ruto, who chairs CAHOSCC.

He emphasised that the current level of investment--just three percent globally in energy transition--falls far short of what is needed to combat the worsening impacts of climate change.

President Ruto's comments come as African nations face mounting climate challenges, from droughts to floods, with the continent contributing the least to global carbon emissions yet suffering the most severe consequences.

He underscored the need for investments in renewable energy, sustainable agriculture, green transport, and nature-based solutions to ensure Africa's transition to a low-carbon, climate-resilient future.

"These investments are not only vital for Africa but also the entire global community," Ruto said.

The Kenyan president also stressed the importance of debt sustainability and reforms in the international financial system, highlighting the strain high debt servicing costs place on African nations' ability to fund climate-resilience projects.

"As climate-related shocks increase in frequency and severity, coupled with high interest rates and credit downgrades, refinancing becomes more expensive, and governments' capacity to invest in green resilience is constrained," he added.

The CAHOSCC meeting, attended by African Union Commission Chairperson Moussa Faki Mahamat and Mauritanian President Mohamed Ould Ghazouani, set the stage for Africa's strategy ahead of COP29.

Mr Mahamat echoed Ruto's call for unity, stressing the importance of a cohesive African stance to secure increased climate financing.

Earlier, Dr Ruto hosted the inaugural Steering Committee Meeting of the African Green Industrialisation Initiative (AGII), a platform aimed at unlocking investments for large-scale green industrial and infrastructure projects across the continent.

The initiative seeks to foster partnerships between African leaders and stakeholders in finance, industry, and philanthropy.

"This initiative aligns value chains across the continent and is key to driving Africa's economic transformation through green industrialisation," Ruto said.

The African Union has warned that some countries on the continent have already experienced GDP losses of up to five percent due to the effects of climate change, underlining the urgent need for concrete action at COP29.