Five newly discovered proteins patrol cell nuclei
These proteins might shed light on how to treat diseases like progeria
Five newly discovered proteins patrol cell nuclei
These proteins might shed light on how to treat diseases like progeria
Sanofi et Google renforcent leurs liens dans l’e-santé
Le premier groupe pharmaceutique français Sanofi et le géant mondial du numérique Google ont annoncé ce mardi une nouvelle collaboration sous la forme d’un laboratoire « virtuel » d’innovation, pour développer de futurs médicaments et services en tirant parti des technologies de données.
Sanofi compte notamment recourir à des techniques d’intelligence artificielle de Google afin d’établir « de meilleures projections des ventes » de ses traitements et répercuter ces enseignements sur ses activités commerciales et logistiques.
Sanofi drives digital transformation with Google Cloud
Sanofi and Google will work closely on two core initiatives. The first will be to build an Innovation Lab to test and explore solutions focused on how technology can:
– Enhance the understanding of patients and diseases
– Drive productivity gains for business operations
– Promote patient outcomes and access to healthcare through the use of technology
The Innovation Lab will bring together Sanofi executives and experts across Google to discuss challenges in the healthcare space and how we can create solutions together.
Secondly, Sanofi will leverage Google Cloud Platform to modernize their infrastructure, migrating workloads to the Google Cloud, and building an analytics and machine learning platform to glean better insights from their data.
What it means to be a ‘refugee’ in South Sudan and Uganda
After decades of armed conflict in South Sudan and Uganda, labels of ‘refugee’ and ‘internally displaced person’ fail to reflect the complex realities of the people they refer to. Leben Moro examines the history of movement across the region’s borders, and argues refugees are not the passive recipients of aid as often presented by humanitarian initiatives.
Since independence from British colonial rule, large numbers of South Sudanese and Ugandans have repeatedly crossed the shared border to escape civil wars. These forced movements of large populations have created shifting labels of ‘refugees’ and ‘internally displaced persons’ (IDPs), with tremendous social, economic and political repercussions for the persons to which these labels are applied.
In August 1955, months before Sudan’s independence, the largely Christian Southern Sudanese took up arms against Muslim rulers in the North to achieve a vision of greater regional autonomy, which sparked a mass flight of people from their homes. By the end of the First Sudanese Civil War in 1972, the Sudanese government estimated that 500,000 people had hidden in the bush, and another 180,000 had crossed into neighbouring countries, with 74,000 settling in four official camps (Onigo, Agago, Acholpii and Nakapiripirit) in northern Uganda. Many of the displaced persons, including my own family members, self-settled in other parts of Uganda, mainly near cotton ginning mills and other businesses operated by Ugandans of Indian origin, who employed them as casual labourers.
My own family members settled near Gulu, the largest town in northern Uganda, among the Acholi ethnic group. Some South Sudanese journeyed southwards to Bwelye in the centre of Uganda, where there was plentiful fertile land and jobs in Indian enterprises. Others travelled further south into the heartland of the Baganda, the largest tribe in the country, to work in sugar plantations and different enterprises, including fields where locals grew coffee, bananas and other crops.
Over time, many newcomers acquired land with their earnings and became poll taxpayers. Their receipt documentation allowed them to move across land in relative safety. In general, however, life was hard as they lacked citizenship and were vulnerable to exploitation and harassment.
The United Nations High Commissioner for Refugees (UNHCR) coordinated a programme of official repatriation, supported by public authorities in Sudan and Uganda, including a mandate that supported Sudan’s IDPs. Many people, however, chose not to leave.
In 1979, Uganda became embroiled in a bitter civil war following the overthrow of President Idi Amin Dada, forcing Southern Sudanese, including my own family members, and many Ugandans from the north of the country, to flee into the relatively peaceful Southern Sudan. The UNHCR and other humanitarian organisations as well as public authorities in Sudan helped settle many refugees in camps, but some Ugandans settled among local people, initially without external support.
The relative peace in Southern Sudan was disrupted in 1983 when the Sudan People’s Liberation Movement/Army (SPLM/A) was founded to lead another armed struggle against Sudan’s newly declared Islamic state under President Gaafar Nimeiry – which came to be known as the Second Sudanese Civil War. The violence forced Ugandan peoples living in Southern Sudan back into Uganda and many Southern Sudanese also made the crossing. Some of the refugees returned to locations they had lived in during the first civil war or joined relatives or friends who had remained in Uganda. People used their established networks.
The new wave of refugees received generous assistance from the UNHCR and the Ugandan government, whose policy was the settlement of refugees in camps and dedicated areas. Effectively, the policy redefined a refugee as ‘someone receiving assistance and living in a camp’. Many displaced Southern Sudanese avoided encampment, with its associated restrictions of movement, by self-settling among locals or dividing their family members or time between camps and outside locations.
As in the first civil war, many displaced persons in Southern Sudan did not cross international borders, but remained behind in dire circumstances. Their plight forced the United Nations to launch another initiative, Operation Lifeline Sudan, in the 1980s to assist those trapped in the war zone. This suffering formally ceased in 2005 with the conclusion of the much-lauded Comprehensive Peace Agreement between the Sudanese government and the SPLM/A, enabling the return of the IDPs to their original homes and refugees back to the country.
In 2011, Southern Sudan seceded from Sudan. About two years later, the world’s newest country relapsed into a vicious civil war. Sparked by divisions among the country’s key leaders, ethnic identities were subsequently exploited to mobilise fighters with devastating consequences for national unity and the wellbeing of civilians.
During the conflict, many Nuer people, an ethnic group primarily inhabiting South Sudan’s Nile Valley, fled into areas created on UN Mission in South Sudan (UNMISS) bases, called Protection of Civilians Sites (PoCs), to escape killing by members of the Dinka, the largest ethnic group, who had effectively taken over the country with the support of Ugandan soldiers. Nuer fighters retaliated against Dinka civilians, forcing many to flee to the Uganda border and other locations.
Many South Sudanese headed north into the new Republic of Sudan, where public authorities labelled them ’arrivals’, a new term with no precedent in refugee policy or literature, and confined them to ‘waiting stations’. Uganda also received a large number of displaced persons, among them refugees placed in settlements with international assistance. Many displaced persons settled among locals without external assistance, thus avoiding the label of ‘refugee’.
What it means to be ‘refugees’ in Uganda
The 1951 Refugee Convention states a person becomes a refugee after crossing an internationally recognised border in search of protection, recognition and status by public authorities in the asylum country or the UNHCR. When the circumstances that forced the person to seek refuge cease to exist, the refugee re-avails themselves of the country’s protection they had fled. Thus defined concrete international borders are characterised as integral to becoming a refugee or ending refuge.
For South Sudanese displaced persons, the border between their country and Uganda is not a clearly defined line separating two jurisdictions. Many parts of the border are contested by ordinary people and public authorities on both sides. Consequently, people inhabiting locations along these contested areas are not always on peaceful terms despite often belonging to the same ethnic groups, such as the Acholi of South Sudan and Uganda.
Different ethnic groups that have seen clashes over contested territories have also been forced into settling in areas of close proximity following unrest in their respective homelands. My own research reveals the Kuku of Kajokeji in South Sudan were so suspicious of the Madi in the Ugandan Moyo district that, when they settled in the latter’s region, they avoided treatment in the Moyo hospital for fear of maltreatment by Madi medical personnel. The history of conflict over certain borders has a direct bearing on the welfare of refugees in the present.
Armed groups and criminals also operate along the border, posing serious security problems, with some people losing their lives at the hands of unknown gunmen. Despite this danger, refugees and other South Sudanese cross in and out of South Sudan for matters of family and livelihoods, such as to harvest crops in their old fields due to food shortages in their new home. Others return their deceased kin to bury them decently on their old compounds and, further, trips are made to the national capital, Juba, to visit relatives or deal with administrative issues.
These movements defy the legal meaning of ‘refugee’, who is supposed to return home when the threat of persecution that caused the flight is over. They demonstrate that refugees are not the passive and docile recipients of aid, as often presented, but active individuals who exercise agency. Studies remind us that were refugees only to eat the ‘food which is distributed to them, they would die’.
What it means to stay behind as an IDP
Because IDPs are citizens living in their native county they are entitled to the same rights and legal protections as fellow citizens as stipulated by the constitution. In reality, IDPs do not always enjoy citizenship rights because those in power consider them enemies or supporters of enemies.
During the second civil war, the Sudanese government branded IDPs as rebel supporters and subjected them to all kinds of punitive measures, including starvation and denial of basic services. Many IDPs consequently starved to death or died due to deadly diseases, such as kala azar, as the already rudimentary healthcare system in pre-war Southern Sudan was destroyed by repeated military bombardments as well as frequent obstructions of international humanitarian access.
When South Sudan gained independence and descended into civil war, IDPs did not fare any better. Following shocking atrocities and the continued risk of further violence, many Nuer civilians remain in PoCs on UNMISS bases under the protection of peacekeepers in refugee-like situations. Deprived of state protection, their situation has become worse than most refugees in South Sudan, deprioritised over the dominant Dinka.
The labels of ‘refugee’ and ‘internally displaced person’ do not reflect the experiences of most South Sudanese refugees in Uganda, and IDPs within South Sudan. These terms present refugees and IDPs as powerless recipients of aid when, in reality, refugees and IDPs are active agents in efforts to improve their situation. In some cases, they creatively manipulate borders and the systems in place to satisfy their basic needs.
It has been expressed that South Sudanese refugees have shown an extraordinary creativity and resourcefulness that can form a blueprint for future refugee assistance programmes. When ‘official legal categories rarely match realities on the ground’, aid workers should now appreciate and encourage the active involvement of refugees and IDPs to address the challenges that confront them.
U.S. is using unreliable dental exams to hold teen migrants in adult detention
The young Bangladeshi sitting in the dentist’s chair last October thought he was getting checked for diseases.
Dental staff examined his teeth, gave him a cleaning and sent him back to the juvenile facility where he had been held for months since illegally crossing the border in July.
But a checkup wasn’t the real purpose of the dental work. The government wanted to figure out if “I.J.,” as the young migrant has been identified, really was 16, as he said, or an adult.
The use of dental exams to help determine the age of migrants increased sharply in the last year, one aspect of the Trump administration’s crackdown on immigration and illegal border crossings.
The accuracy of forensic testing to help determine the age of migrants is very much a subject of the debate. And with the stakes so high, the exams are becoming another legal battleground for the government.
Federal law prohibits the government from relying exclusively on forensic testing of bones and teeth to determine age. But a review of court records shows that in at least three cases – including I.J.’s – the government did just that, causing federal judges to later order the minors released from adult detention.
In a case last year, a Guatemalan migrant was held in adult detention for nearly a year after a dental exam showed he was likely 18, until his attorneys fought to get his birth certificate, which proved he was 17.
For I.J., the results had serious ramifications. Based on the development of his teeth, the analysis showed an 87.70% probability that he had turned 18.
An immigration official reported that it was apparent to the case manager that I.J. “appeared physically older than 17 years of age,” and that he and his mother had not been able to provide a second type of identification that might prove his age.
The next month, Immigration and Customs Enforcement agents took him away in shackles and placed him in a medium-security prison that houses immigrant detainees.
He spent about five months in adult detention and 24 of those days in segregated custody. Whenever he spoke with an officer, he would say he was a minor — unaware for more than a month that his teeth had landed him there.
“I came to the United States with a big dream,” I.J. said. “My dream was finished.”
But when the Arizona-based Florence Immigrant and Refugee Rights Project took I.J.’s case to federal court, a district judge found that the Office of Refugee Resettlement’s age re-determination violated federal law and the agency’s own guidelines.
In April, the judge ordered I.J. released back into Office of Refugee Resettlement custody, a program responsible for unaccompanied migrant children. He has since reunited with his family in New York. The Florence Project also filed another case in federal court that resulted in the government voluntarily returning a Bangladeshi minor to ORR custody and rescinding his age re-determination.
As the government grappled with an influx of the number of families and children arriving at the border in fiscal year 2018, approvals of ORR age determination exams more than doubled.
These handful of cases where a minor was released from adult detention is almost certainly an undercount, as most migrants held in adult detention do not have legal representation and are unlikely to fight their cases.
It is unclear how often migrants pretend to be minors and turn out to be adults. In a call with reporters earlier this year, a Customs and Border Protection official said that from April 2018 to March 25 of this year, his agents had identified more than 3,100 individuals in family units making fraudulent claims, including those who misrepresented themselves as minors.
Unaccompanied minors are given greater protections than adults after being apprehended. The government’s standard refers migrants to adult custody if a dental exam analysis shows at least a 75% probability that they are 18 or older. But other evidence is supposed to be considered.
Dr. David Senn, the director of the Center for Education and Research in Forensics at UT Health San Antonio, has handled more than 2,000 age cases since 1998.
A program that Senn helped develop estimates the mean age of a person and the probability that he or she is at least 18. In addition to looking at dental X-rays, he has also looked at skeletal X-rays and analyzed bone development in the hand and wrist area.
He handled a larger number of cases in the early 2000s, but last year he saw his caseload triple — rising to 168. There appears to be a slowdown this calendar year for Senn, one of a few dentists the government uses for these analyses.
He said making an exact age determination is not possible.
“We can only tell you what the statistics say,” Senn said. “I think the really important thing to note is that most people who do this work are not trying to be policemen or to be Border Patrol agents or immigration …. what we’re trying to do is help. What we’re trying to do is protect children.”
In 2007 and again in 2008, the House Appropriations Committee called on the Department of Homeland Security to stop relying on forensic testing of bones and teeth. But it was the Trafficking Victims Protection Reauthorization Act of 2008 that declared age determinations should take into account “multiple forms of evidence, including the non-exclusive use of radiographs.”
In a Washington state case, an X-ray analysis by Senn showed a 92.55% probability that Bilal, a Somali migrant, already had reached 18 years of age. ICE removed him from his foster home and held him in an adult detention center.
“Not only were they trying to save themselves money, which they paid to the foster family, but they were wrecking this kid’s life,” said Matt Adams, legal director for the Northwest Immigrant Rights Project, which represented Bilal. “They were just rolling the dice.”
In 2016, a federal judge found that the Office of Refugee Resettlement relied exclusively on the dental exam and overturned the age determination for the young Somali.
Last year, in the case of an Eritrean migrant who said he was 17, Senn’s analysis of dental X-rays showed a 92.55% probability that he had turned 18, and provided a range of possible ages between 17.10 and 23.70.
It was enough to prompt his removal from a juvenile facility and placement into an adult one.
Again, a district judge found that the government had relied exclusively on the dental exam to determine his age and ordered the migrant released back into ORR custody.
Danielle Bennett, an ICE spokeswoman, said the agency “does not track” information on such reversals.
“We should never be used as the only method to determine age,” Senn said. “If those agencies are not following their own rules, they should have their feet held to the fire.”
Similar concerns over medical age assessments have sprung up in other countries, including the United Kingdom and Sweden.
The United Nations High Commissioner for Refugees’ guidance about how adolescent migrants’ ages should be analyzed says that if countries use scientific procedures to determine age, that they should allow for margins of error. Michael Bochenek, an attorney specializing in children’s rights at Human Rights Watch, said that for adolescents, the margin of error in scientific tests is “so big that it doesn’t tell you anything.”
An influx of Bangladeshi migrants claiming to be minors has contributed to the government’s recent use of dental exams. From October through March 8, more than 150 Bangladeshis who claimed to be minors and were determined to be adults were transferred from the Office of Refugee Resettlement to ICE custody, according to the agency.
In fiscal year 2018, Border Patrol apprehensions of Bangladeshi migrants went up 109% over the year before, rising to 1,203. Similarly, the number of Bangladeshi minors in ORR custody increased about 221% between fiscal 2017 and fiscal 2018, reaching 392.
Ali Riaz, a professor at Illinois State University, said Bangladeshis are leaving the country for reasons including high population density, high unemployment among the young, a deteriorating political environment and the “quest for a better life.”
In October, Myriam Hillin, an ORR federal field specialist, was told that ICE had information showing that a number of Bangladeshi migrants in their custody claiming to be underage had passports with different birth dates than on their birth certificates.
Bochenek said it’s common for migrant children to travel with fake passports that make them appear older, because in some countries minors are more likely to be intercepted or questioned by immigration agents.
While I.J. was able to regain status as a minor, three Bangladeshi migrants who crossed the U.S.-Mexico border illegally in the San Diego area in October 2018 are still trying to convince the government they are underage.
Their passports didn’t match their birth certificates. Dental exams ordered by immigration officials found that each of them had about an 89% likelihood of being adults.
“Both subjects were adamant that the passports were given to them by the ‘agent’ (smuggler), however, there is little reason to lie to any of the countries they flew into,” wrote one Border Patrol agent, describing the arrest of two of the migrants. “Also, it is extremely difficult to fake a passport, especially for no reason. I have seen [unaccompanied children] fly into each of the countries (except for Panama and Costa Rica) and pass through with no problem. This is a recent trend with Bangladeshis. They do it in order to be released from DHS custody faster.”
During interviews, the young migrants, Shahadat, Shahriar and Tareq, told asylum officers that smugglers had given them the passports, according to records from the interviews.
When asked why they had been given those birth dates, they said it had something to do with smugglers’ plans for their travel.
“I don’t have that much idea,” Shahadat told an asylum officer, according to the officer’s notes in a summary-style transcript. “When I asked why, they told me that if I don’t give this [date of birth] there will be problems with travel.”
Shahriar told the officer that the smuggler became aggressive when questioned.
The migrants have submitted copies of birth certificates, school documents and signed statements from their parents attesting to their claimed birth dates. An online database of birth records maintained by the government of Bangladesh appears to confirm their date of birth claims.
Shahriar also provided his parents’ birth certificates. If he were as old as immigration officials believe him to be, his mother would have been 12 years old when she had him.
In each case, immigration officials stood by the passport dates.
Shahadat and Shahriar are being held in Otay Mesa Detention Center. Tareq was held at the facility for months before being released on a $7,500 bond. All three are moving through the immigration system as adults, with asylum proceedings their only option to stay in the U.S..
At least one of the migrants, Shahadat, was placed in administrative segregation, a version of solitary confinement in immigration detention, when his age came into question, according to documents provided by their attorney.
A judge ordered him deported.
#tests_osseux #os #âge #USA #Etats-Unis #mineurs #enfants #enfance #rétention #détention_administrative #dents #migrations #asile #réfugiés #USA #Etats-Unis
#MSF Access Campaign sur Twitter : “#Big_pharma uses undisclosed ? research and development costs to justify sky-high prices for medicines. Why do these countries ?? ?? ?? ?? ?? ?? want pharma corporations to keep these costs a secret? #TransparencyResolution #WHA72 #NoMoreSecrets” / Twitter
Marche arrière toute:
WHO agrees watered-down resolution on transparency in drug costs - Reuters
Et un Big prix Pinocchio à Big pharma:
Drug companies argue that cost information is a commercial secret. They say new drugs should be priced according to the benefits they bring to patients, regardless of production and development costs, to ensure companies have a commercial incentive to tackle disease.
Medicine price transparency is a sticky issue at WHA | Health-e
Gaelle Krikorian, MSF Access Campaign Head of Policy, blamed “a small minority of wealthy countries” including “Germany, the United Kingdom, Switzerland, the United States, and Japan” for “working to weaken or block the resolution despite the challenges that exist with high prices in their own countries”.
Long-Term Use of Antibiotics Tied to Heart Risks - The New York Times
Using antibiotics for two months or longer may be linked to an increase in a woman’s risk for cardiovascular disease.
The finding, published in the European Heart Journal, applied to women who used the drugs when they were 40 and older.
Researchers used data on 36,429 women free of cardiovascular disease at the start of the study who were participating in a continuing long-term health study. Beginning in 2004, the women reported their use of antibiotics.
Over seven years of follow-up, there were 1,056 cases of cardiovascular disease. Compared with women who never used them, women who used antibiotics for two months or longer during their 40s and 50s had a 28 percent increased risk for cardiovascular disease, and women over 60 who used them that long had a 32 percent increased risk.
The study controlled for family history of heart attack, body mass index, hypertension, the use of other medications and other factors.
“It’s difficult to distinguish the effect of the antibiotic on cardiovascular disease from the effect of the disease for which the antibiotic was taken, and that’s a potential limitation of the study,” said the lead author, Lu Qi, now a professor of epidemiology at Tulane University. “But that we are seeing the effect of the disease instead of the antibiotic is unlikely, because we see the effect in so many different diseases where antibiotics are used.”
Tom Stevenson reviews ‘AngloArabia’ by David Wearing · LRB 9 May 2019
It is a cliché that the United States and Britain are obsessed with Middle East oil, but the reason for the obsession is often misdiagnosed. Anglo-American interest in the enormous hydrocarbon reserves of the Persian Gulf does not derive from a need to fuel Western consumption . [...] Anglo-American involvement in the Middle East has always been principally about the strategic advantage gained from controlling Persian Gulf hydrocarbons, not Western oil needs. [...]
Other parts of the world – the US, Russia, Canada – have large deposits of crude oil, and current estimates suggest Venezuela has more proven reserves than Saudi Arabia. But Gulf oil lies close to the surface, where it is easy to get at by drilling; it is cheap to extract, and is unusually ‘light’ and ‘sweet’ (industry terms for high purity and richness). It is also located near the middle of the Eurasian landmass, yet outside the territory of any global power. Western Middle East policy, as explained by Jimmy Carter’s national security adviser, Zbigniew Brzezinski, was to control the Gulf and stop any Soviet influence over ‘that vital energy resource upon which the economic and political stability both of Western Europe and of Japan depend’, or else the ‘geopolitical balance of power would be tipped’. In a piece for the Atlantic a few months after 9/11, Benjamin Schwarz and Christopher Layne explained that Washington ‘assumes responsibility for stabilising the region’ because China, Japan and Europe will be dependent on its resources for the foreseeable future: ‘America wants to discourage those powers from developing the means to protect that resource for themselves.’ Much of US power is built on the back of the most profitable protection #racket in modern history.
It is difficult to overstate the role of the Gulf in the way the world is currently run. In recent years, under both Obama and Trump, there has been talk of plans for a US withdrawal from the Middle East and a ‘#pivot’ to Asia. If there are indeed such plans, it would suggest that recent US administrations are ignorant of the way the system over which they preside works.
The Arab Gulf states have proved well-suited to their status as US client states, in part because their populations are small and their subjugated working class comes from Egypt and South Asia. [...] There are occasional disagreements between Gulf rulers and their Western counterparts over oil prices, but they never become serious. [...] The extreme conservatism of the Gulf monarchies, in which there is in principle no consultation with the citizenry, means that the use of oil sales to prop up Western economies – rather than to finance, say, domestic development – is met with little objection. Wearing describes the modern relationship between Western governments and the Gulf monarchs as ‘asymmetric interdependence’, which makes clear that both get plenty from the bargain. Since the West installed the monarchs, and its behaviour is essentially extractive, I see no reason to avoid describing the continued Anglo-American domination of the Gulf as #colonial.
Saudi Arabia and the other five members of the Gulf Co-operation Council are collectively the world’s largest buyer of military equipment by a big margin. [...]. The deals are highly profitable for Western arms companies (Middle East governments account for around half of all British arms sales), but the charge that Western governments are in thrall to the arms companies is based on a misconception. Arms sales are useful principally as a way of bonding the Gulf monarchies to the Anglo-American military. Proprietary systems – from fighter jets to tanks and surveillance equipment – ensure lasting dependence, because training, maintenance and spare parts can be supplied only by the source country. Western governments are at least as keen on these deals as the arms industry, and much keener than the Gulf states themselves. While speaking publicly of the importance of fiscal responsibility, the US, Britain and France have competed with each other to bribe Gulf officials into signing unnecessary arms deals.
Control of the Gulf also yields less obvious benefits. [...] in 1974, the US Treasury secretary, William Simon, secretly travelled to Saudi Arabia to secure an agreement that remains to this day the foundation of the dollar’s global dominance. As David Spiro has documented in The Hidden Hand of American Hegemony (1999), the US made its guarantees of Saudi and Arab Gulf security conditional on the use of oil sales to shore up the #dollar. Under Simon’s deal, Saudi Arabia agreed to buy massive tranches of US Treasury bonds in secret off-market transactions. In addition, the US compelled Saudi Arabia and the other Opec countries to set oil prices in dollars, and for many years Gulf oil shipments could be paid for only in dollars. A de facto oil standard replaced gold, assuring the dollar’s value and pre-eminence.
For the people of the region, the effects of a century of AngloArabia have been less satisfactory. Since the start of the war in Yemen in 2015 some 75,000 people have been killed, not counting those who have died of disease or starvation. In that time Britain has supplied arms worth nearly £5 billion to the Saudi coalition fighting the Yemeni Houthis. The British army has supplied and maintained aircraft throughout the campaign; British and American military personnel are stationed in the command rooms in Riyadh; British special forces have trained Saudi soldiers fighting inside Yemen; and Saudi pilots continue to be trained at RAF Valley on Anglesey. The US is even more deeply involved: the US air force has provided mid-air refuelling for Saudi and Emirati aircraft – at no cost, it emerged in November. Britain and the US have also funnelled weapons via the UAE to militias in Yemen. If the Western powers wished, they could stop the conflict overnight by ending their involvement. Instead the British government has committed to the Saudi position. As foreign secretary, Philip Hammond pledged that Britain would continue to ‘support the Saudis in every practical way short of engaging in combat’. This is not only complicity but direct participation in a war that is as much the West’s as it is Saudi Arabia’s.
The Gulf monarchies are family dictatorships kept in power by external design, and it shows. [...] The main threat to Western interests is internal: a rising reminiscent of Iran’s in 1979. To forestall such an event, Britain equips and trains the Saudi police force, has military advisers permanently attached to the internal Saudi security forces, and operates a strategic communications programme for the Saudi National Guard (called Sangcom). [...]
As Wearing argues, ‘Britain could choose to swap its support for Washington’s global hegemony for a more neutral and peaceful position.’ It would be more difficult for the US to extricate itself. Contrary to much of the commentary in Washington, the strategic importance of the Middle East is increasing, not decreasing. The US may now be exporting hydrocarbons again, thanks to state-subsidised shale, but this has no effect on the leverage it gains from control of the Gulf. And impending climate catastrophe shows no sign of weaning any nation from fossil fuels , least of all the developing East Asian states. US planners seem confused about their own intentions in the Middle East. In 2017, the National Intelligence Council described the sense of neglect felt by the Gulf monarchies when they heard talk of the phantasmagorical Asia pivot. The report’s authors were profoundly negative about the region’s future, predicting ‘large-scale violence, civil wars, authority vacuums and humanitarian crises persisting for many years’. The causes, in the authors’ view, were ‘entrenched elites’ and ‘low oil prices’. They didn’t mention that maintenance of both these things is US policy.
One in six people dying of lung #cancer in UK are non-smokers, experts say | Society | The Guardian
Growing numbers of non-smokers are being diagnosed with lung cancer, many at a stage when it is incurable, experts in the disease have revealed.
They blame the rise on car fumes, secondhand smoke and indoor air #pollution, and have urged people to stop using wood-burning stoves because the soot they generate increases risk.
About 6,000 non-smoking Britons a year now die of the disease, more than lose their lives to ovarian or cervical cancer or leukaemia, according to research published on Friday in the Journal of the Royal Society of Medicine.
That is about a sixth of the 36,000 deaths a year from lung cancer.
A beginner’s guide to Deep Learning Applications in Medical Imaging
Let us first understand what medical imaging is before we delve into how deep learning and other similar expert systems can help medical professional such as radiologists in diagnosing their patients.This is how Wikipedia defines Medical Imaging:Medical imaging is the technique and process of creating visual representations of the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to reveal internal structures hidden by the skin and bones, as well as to diagnose and treat disease. Medical imaging also establishes a database of normal anatomy and physiology to make it possible to identify abnormalities. Although imaging of removed organs and tissues can be (...)
Cause of #cancer is written into DNA of tumours, scientists find, creating a ’black box’ for origin of disease
Even with lung cancer, it is not known just how much can be attributed to smoking and how much could be linked to other factors, such as living by a busy road, or inhaling pollutants at work.
But now scientists at Cambridge University and King’s College London have shown that tumours hold information like a ’black box’ pointing to the cause of disease.
They exposed stem cells to dozens of known carcinogens and recorded how each alters its DNA code as cancer forms. It provides a ‘fingerprint’ or ‘mutational signature’ of the underlying cause and could even show which was the biggest culprit.
A Mysterious Infection, Spanning the Globe in a Climate of Secrecy - The New York Times
Antibiotics and antifungals are both essential to combat infections in people, but antibiotics are also used widely to prevent disease in farm animals, and antifungals are also applied to prevent agricultural plants from rotting. Some scientists cite evidence that rampant use of fungicides on crops is contributing to the surge in drug-resistant fungi infecting humans.
Opinion | This Is the Truth About Vaccines - The New York Times
Vaccinations save lives, protect our children and are one of our greatest public health achievements. As public health officials, our role is to advance the health of the American people. This must include championing vaccinations.
Diseases like polio, measles, diphtheria and rubella were once common in the United States, afflicting hundreds of thousands of infants, children and adults, and killing thousands each year. Some older Americans may remember the fear associated with polio outbreaks and the era of iron lungs and leg braces — a time when swimming pools and movie theaters closed over concerns about the spread of the crippling disease. Others may recall the heartbreaking wave of rubella in the 1960s that resulted in thousands of newborn deaths, with thousands more born blind, deaf or with other lifelong disabilities.
We cannot let America be faced with these fears again. For those of us who have treated critically ill children with vaccine-preventable diseases, we know firsthand the devastation to the child — and to the family and community — of a death, limb amputation or severe brain damage that could have been avoided by a simple vaccination.
Consider measles. The World Health Organization estimates that measles vaccination prevented more than 21 million deaths worldwide since 2000. Although routine childhood vaccination for measles remains high in the United States (greater than 91 percent for preschool children), localized dips in vaccination coverage have resulted in a recent resurgence of measles in parts of the country. A total of 17 measles outbreaks affecting more than 370 individuals have been confirmed in 2018 alone, and 10 states are already reporting cases this year. Unfortunately, many more communities are at risk for outbreaks because of areas with low vaccine coverage.
How #cbd Market is moving in the right direction according to the Clinical Research and Market…
How CBD Market is moving in Right Direction According to Clinical Research and Market Analysis?Use of #cannabis to treat sick has been documented in history. The ancient healers and doctors prescribed it to their patients seeing the healing properties cannabis contained.The modern medical science only took notice of this magical family a few decades back and has been advancing to apply it in treating diseases. It is however recently the plant’s popularity picked up the pace and the market started seeing CBD or cannabis based products.CBD shouldn’t be mixed with marijuana. Though both are derived from cannabis sativa hence the term. The former does not contain enough THC (tetrahydrocannabinol) to operate as a psychoactive agent that intoxicates or causes euphoria aka the “High.” Instead, (...)
“These displaced people live in fear of being attacked at any time”
After increased insecurity in the Tillabéry region of Niger caused large numbers of people to flee their homes, MSF carried out an emergency response in early January 2019.
A state of emergency was declared recently in the department of Tillabéry, in the region of the same name. Like many other departments in the region, Tillabéry faces many security challenges.
The people living in this border area between Mali and Niger find themselves trapped in violence that comes from two directions: on one side, the community conflict; on the other, the activities of non-state armed groups.
After receiving information about people being displaced in the region, an MSF team visited the immediate area, where they saw first-hand the precarious situation in which the displaced people were living.
We are talking about a total of 1,287 people at three sites within a five-kilometre radius. These people were already vulnerable, having been displaced several times already.
What were people’s main needs?
These people had been forced to leave their homes, their fields and often their animals in order to escape the violence orchestrated by armed groups and other opportunists. Because of the hostilities in the area, basic services such as schools and health centres have been closed.
The displaced people lack shelter, food, healthcare and protection. They are also drinking untreated river water, which brings the risk of various diseases.
Given the urgency of their needs, and in the absence of other humanitarian organisations, the MSF team decided to launch a response.
What did MSF’s response involve?
Our medical team conducted 170 medical consultations, mainly for respiratory infections, malaria, dermatitis and severe malnutrition, as well as 20 antenatal consultations.
We also assessed the nutritional status of children and vaccinated nearly 130 children against measles. Five mental health promotion sessions were organised for approximately 160 people.
Several patients were referred to the health centre for follow-up care, which MSF was also involved in. Our team distributed essential relief items to 220 families, including blankets, cooking utensils, washing kits, mosquito nets and jerry cans.
To make sure that people have safe drinking water, the teams distributed 4,000 water purification tablets, and ran sessions on how to use them.
Who are the displaced people?
“Most of the people who fled the violence are women, children and the elderly, of different ethnicities, living in the border area between Mali and Niger. There are also a number of young people who reject violence and want to settle in places that are considered more secure.
The displaced include refugees from Mali and internally displaced people from Niger.
The majority of the displaced people live in fear of being attacked at any time, because of what they have already experienced – their villages being attacked, assassinations, their markets burned down, their animals stolen, and living with the threat of death.
Other than this emergency response, what is MSF doing in Tillabéry region?
MSF has been working in Niger’s Bani-Bangou department, near the border with Mali, since November 2018. Long before the state of emergency was declared, schools, health centres and other social infrastructure were not functioning because of the violence.
MSF is working in the area to ensure access to free quality medical care for displaced people and local communities. We support two health centres and five health posts.
We are also monitoring the situation in other areas which could potentially receive newly displaced people, or where there are needs not covered by other organisations, particularly in the area around Innates. MSF also supports medical services, from health posts to hospitals, in Bani-Bangou and Ouallam.
Our teams work in collaboration with the Ministry of Health. In December 2018, we treated 4,599 people, provided 452 antenatal consultations and assisted 22 births. In addition, 588 children under the age of two received routine immunisations, and 34 women of childbearing age were vaccinated against tetanus. We also referred to hospital seven patients in need of emergency treatment.
What are people’s main needs in this region? And what are the challenges of assisting them?
People in this region need food, essential relief items, physical and mental healthcare, clean water, good sanitation and hygiene, and protection.
The main challenge we face is the climate of insecurity in the region, which can make it difficult to reach the people who need assistance.
Amazon, AI and Medical Records: Do the Benefits Outweigh the Risks? - Knowledge Wharton
Last month, Amazon unveiled a service based on AI and machine-learning technology that could comb through patient medical records and extract valuable insights. It was seen as a game changer that could alleviate the administrative burden of doctors, introduce new treatments, empower patients and potentially lower health care costs. But it also carries risks to patient data privacy that calls for appropriate regulation, according to Wharton and other experts.
Branded Comprehend Medical, the Amazon Web Services offering aims “to understand and analyze the information that is often trapped in free-form, unstructured medical text, such as hospital admission notes or patient medical histories.” Essentially, it is a natural language processing service that pores through medical text for insights into disease conditions, medications and treatment outcomes from patient notes and other electronic health records.
The new service is Amazon’s latest foray into the health care sector. In June, the company paid $1 billion to buy online pharmacy PillPack, a Boston-based startup that specializes in packing monthly supplies of medicines to chronically ill patients. In January, Amazon teamed up with Berkshire Hathaway and JPMorgan Chase to form a health care alliance that aims to lower costs and improve the quality of medical care for their employees.
“Health care, like everything else, is becoming more of an information-based industry, and data is the gold standard — and Amazon knows as well as anyone how to handle and analyze data,” said Robert Field, Wharton lecturer in health care management who is also professor of health management and policy at Drexel University. “It’s a $3.5 trillion industry and 18% of our economy, so who wouldn’t want a piece of that?”
AI offers “enormous” promise when it comes to bringing in new and improved treatments for patient conditions, such as in the area of radiology, added Hempstead. Machine learning also potentially enables the continual improvement of treatment models, such as identifying people who could participate in clinical trials. Moreover, Amazon’s service could “empower a consumer to be more in charge of their own health and maybe be more active consumer of medical services that might be beneficial to their health,” she said.
On the flip side, it also could enable insurers to refuse to enroll patients that they might see as too risky, Hempstead said. Insurers are already accessing medical data and using technology in pricing their products for specific markets, and the Amazon service might make it easier for them to have access to such data, she noted.
The controversial case of a rogue scientist responsible for the world’s the first gene-edited babies | Alternet
This backlash may have caught He by surprise. According to one report, He commissioned a large-scale public opinion survey in China a few months prior to the announcement. The survey found that over 70 percent of the Chinese public was supportive of using gene editing for HIV prevention. This is roughly in line with a recent Pew poll in the United States that found 60 percent of Americans support using gene editing on babies to reduce lifetime risk of contracting certain diseases.
But polling tells only part of the story. The same Chinese poll also found very low levels of public understanding of gene editing and did not mention the details of He’s study. Abstract polling questions ignore the risks and state of the science, which were crucial to most objections to He’s experiment. It also obscures the involvement of embryos in gene editing. In the American Pew poll, despite overall support for gene editing, 65 percent opposed embryonic testing – a necessary step in the process of gene editing to address disease.
Moreover, polling is a crude and simplistic way to engage in public debate and deliberation over the controversial issue of gene editing. Various bodies, such as the National Academies of Sciences, Medicine and Engineering in the U.S. and the Nuffield Council on Bioethics in the U.K., have emphasized that, for gene editing to proceed to human trials, a robust public discussion is first needed to establish its legitimacy.
But looking a little closer reveals other, more problematic motivations.
For such couples, it is possible to safely conceive an HIV-negative child using robust IVF procedures. Such therapy is expensive, prohibitively so for many couples. But He’s study offered a particularly enticing carrot – free IVF treatment and supportive care, along with a daily allowance and insurance coverage during the treatment and pregnancy. According to the consent form, the total value of treatments and payments was approximately US$40,000 – over four times the average annual wage in urban China.
This raises a serious concern of undue inducement: paying research participants such a large sum that it distorts their assessment of the risks and benefits. In this gene editing context, where the risks are incredibly uncertain and there is substantially limited general understanding of genetics and gene editing, society should be especially concerned about the distorting effect of such a large reward on the participants’ provision of free and informed consent.
Chinese scientists are creating #CRISPR babies - MIT Technology Review
According to Chinese medical documents posted online this month (here and here), a team at the Southern University of Science and Technology, in Shenzhen, has been recruiting couples in an effort to create the first gene-edited babies. They planned to eliminate a gene called CCR5 in hopes of rendering the offspring resistant to #HIV, smallpox, and cholera.
Despite CRISPR baby controversy, Harvard University will begin gene-editing sperm
Amid the condemnation, though, it was easy to lose track of what the key experts were saying. Technology to alter heredity is for real. It is improving very quickly, it has features that will make it safe, and much wider exploratory use to create children could be justified soon.
[...] At Harvard, Neuhausser says he and a research fellow, Denis Vaughan, will in the next few weeks begin editing sperm to change a gene called ApoE, which is strongly linked to Alzheimer’s risk. A person who inherits two copies of the high-risk version of the gene has about a 60% lifetime risk of getting Alzheimer’s.
Neuhausser, an Austrian fertility doctor who came to the US to do his research and practice at Boston IVF, predicts that in not so many years, embryos will be deeply analyzed, selected, and in some cases altered with CRISPR before they are used to create a pregnancy. “In the future, people will go to clinics and get their genomes tested, and have the healthiest baby they can have,” he says. “I think the whole field will switch from fertility to disease prophylaxis”—preventing illness.
The CRISPR Baby Scandal Gets Worse by the Day, by Ed Yong
The alleged creation of the world’s first gene-edited infants was full of technical errors and ethical blunders. Here are the 15 most damning details.
A vaccine that could block mosquitoes from transmitting malaria
For some decades, researchers have being working on a novel idea called a “transmission-blocking vaccine.” This vaccine is different from traditional vaccines that protect the recipient from getting the disease. Here, the vaccine blocks the transmission of the parasite that causes malaria from an infected human host to mosquitoes.
When a human receives such a vaccine, specific antibodies are generated in the blood. When a mosquito bites and ingests the blood of an infected human, both the parasite and antibody are taken up into the mosquito’s stomach. Once inside the mosquito, the antibody attaches to the parasite and inhibits its development. This prevents the mosquito from transmitting the disease to another person.
The concept is bold but has not yet been tested in large-scale trials.
Méfiance... les occidentaux utilisent l’Afrique comme terrain d’expérimentation... Voir par exemple :
et autres liens sur ce post
Une belle histoire pour changer : comment le DNDi a trouvé et développé un nouveau médicament contre la #maladie_du_sommeil.
Drugs for Neglected Diseases initiative (DNDi) is a collaborative, patients’ needs-driven, non-profit drug research and development (R&D) organization that is developing new treatments for neglected patients.
A doctor’s dream
#Fexinidazole, the first all-oral drug for both stages of sleeping sickness was approved in November 2018
Here are the stories of the doctors, patients, and scientists who contributed to this story
Un peu de #pharma quand même, puisque Sanofi est dans le coup, et doit bien y trouver son intérêt. Lors du développement d’un médicament contre la Malaria par DNDi il y a 10 ans, Sanofi en était déjà, et on pouvait lire dans Fortune :
Sanofi’s aim was not entirely altruistic, says Bernard Pécoul, executive director of DNDi, a doctor and public health specialist who spearheaded the antimalaria project. “It’s good for their image,” he says, “but it will also help with the penetration of these countries’ markets.”
Mais aussi :
[…] a nonprofit organization in Geneva, Drugs for Neglected Diseases Initiative (DNDi), had figured out a way to combine the two antimalaria drugs and was looking for a corporate partner to conduct clinical trials and market and produce the drug on a large scale. “It was the marriage of both of our needs,” says Robert Sebbag, a vice president for Sanofi.
Je me suis intéressé à DNDi à cette époque pour mon mémoire de master sur la question des communs immatériels dans la coopération internationale (inspiré alors du logiciel libre). Une interrogation, posée un peu vite en fin de chapitre : l’open source en matière de recherche médicale est-elle soluble dans les monopoles ?
Fexinidazole was developed by Sanofi-Aventis in partnership with the Drugs for Neglected Diseases initiative (DNDi), a nonprofit drug research and development organization based in Switzerland. Fexinidazole is intended exclusively for markets outside the European Union.
This is the tenth medicine recommended by the EMA under Article 58, a regulation that allows the CHMP to assess and give opinions on medicines that are intended for use in countries outside the European Union.
“The scientific opinion from the CHMP helps to support regulators in countries where regulatory capacity may be limited, by providing an expert evaluation of the medicine when used in local practice. National regulators can use the CHMP’s scientific assessment to decide on the use of the medicine in their countries,” the EMA explains.
“Is curing patients a sustainable business model?” Goldman Sachs analysts ask | Ars Technica
One-shot cures for diseases are not great for business—more specifically, they’re bad for longterm profits—Goldman Sachs analysts noted in an April 10 report for biotech clients, first reported by CNBC.
The investment banks’ report, titled “The Genome Revolution,” asks clients the touchy question: “Is curing patients a sustainable business model?” The answer may be “no,” according to follow-up information provided.
Analyst Salveen Richter and colleagues laid it out:
The potential to deliver “one shot cures” is one of the most attractive aspects of gene therapy, genetically engineered cell therapy, and gene editing. However, such treatments offer a very different outlook with regard to recurring revenue versus chronic therapies... While this proposition carries tremendous value for patients and society, it could represent a challenge for genome medicine developers looking for sustained cash flow.
For a real-world example, they pointed to Gilead Sciences, which markets treatments for hepatitis C that have cure rates exceeding 90 percent. In 2015, the company’s hepatitis C treatment sales peaked at $12.5 billion. But as more people were cured and there were fewer infected individuals to spread the disease, sales began to languish. Goldman Sachs analysts estimate that the treatments will bring in less than $4 billion this year.
“[Gilead]’s rapid rise and fall of its hepatitis C franchise highlights one of the dynamics of an effective drug that permanently cures a disease, resulting in a gradual exhaustion of the prevalent pool of patients,” the analysts wrote. The report noted that diseases such as common cancers—where the “incident pool remains stable”—are less risky for business.
A game of chicken: how Indian poultry farming is creating global #superbugs
On a farm in the Rangareddy district in India, near the southern metropolis of Hyderabad, a clutch of chicks has just been delivered. Some 5,000 birds peck at one another, loitering around a warehouse which will become cramped as they grow. Outside the shed, stacks of bags contain the feed they will eat during their five-week-long lives. Some of them gulp down a yellow liquid from plastic containers - a sugar water fed to the chicks from the moment they arrive, the farm caretaker explains. “Now the supervisor will come,” she adds, “and we will have to start with whatever medicines he would ask us to give the chicks.”
The medicines are antibiotics, given to the birds to protect them against diseases or to make them gain weight faster so more can be grown each year at greater profit. One drug typically given this way is colistin. Doctors call it the “last hope” antibiotic because it is used to treat patients who are critically ill with infections which have become resistant to nearly all other drugs. The World Health Organisation has called for the use of such antibiotics, which it calls “critically important to human medicine”, to be restricted in animals and banned as growth promoters. Their continued use in farming increases the chance bacteria will develop resistance to them, leaving them useless when treating patients.
Yet thousands of tonnes of veterinary colistin was shipped to countries including Vietnam, India, South Korea and Russia in 2016, the Bureau can reveal. In India at least five animal pharmaceutical companies are openly advertising products containing colistin as growth promoters.
One of these companies, Venky’s, is also a major poultry producer. Apart from selling animal medicines and creating its own chicken meals, it also supplies meat directly and indirectly to fast food chains in India such as KFC, McDonald’s, Pizza Hut and Dominos.
Advanced #analytics and its Importance in the #healthcare Sector
It is understandable that anyone can feel intimidated by the huge influx of data that keeps flowing through healthcare systems every second of the day. But to draw meaningful insights from it, and use it to treat patients and prevent diseases is a big step in healthcare. This is what Big Analytics or Advanced Analytics does. The data you receive on your machines is just a jumble of ones and zeros, and you have no use for it unless you can understand what it is trying to convey.According to the survey conducted by Health Catalyst, a whopping 90% of the respondents admitted that analytics is going to be either “extremely important” or “very important” to their organization within the next few years. And the respondents also rated the importance of healthcare trends and the role played by (...)
#Angola : Les migrants africains en danger de mort
Les autorités angolaises lancent « la chasse aux ressortissants sub-sahariens en situation irrégulière ». Une #opération dénommée « #expatriado » est en cours en ce moment. Elle vise à « expulser tous les immigrés en situation irrégulière en Angola ». Des ressortissants maliens témoignent des « cas d’#emprisonnement suivis de pires formes de #maltraitance et d’#humiliation ». Pour l’instant, difficile d’avoir des chiffres officiels sur le nombre de Maliens victimes. Mais ceux joints sur place appellent à l’aide des autorités maliennes.
Selon certains Maliens, ces opérations d’expulsion ont débuté dans les zones minières. Elles se déroulent maintenant dans toutes les villes du pays, et concernent toutes les nationalités y compris les Maliens, qui sont parmi les plus nombreux. « Cela fait des jours que nous ne pouvons plus sortir pour aller au boulot par peur de nous faire arrêter », explique un ressortissant malien sur place. Selon lui, cette opération qui ne devrait concerner que les #sans-papiers, est aussi menée par les forces de l’ordre angolaises contre ceux qui sont en situation régulière. L’objectif, selon notre interlocuteur, est de soutirer de l’argent aux migrants.
« Une fois entre les mains des autorités angolaises, il faut payer de l’argent ou partir en prison », témoignent certains migrants maliens, avant de confirmer que plusieurs d’entre eux sont actuellement en prison. En Angola certains Maliens ont l’impression d’être « laissés pour compte par les autorités maliennes ». Pour l’Association Malienne des Expulsés, « il est inacceptable qu’un pays membre de l’Union Africaine expulse d’autres africains de la sorte ». L’AME qui juge la situation « grave » en Angola, appelle les autorités maliennes à réagir.
Pourquoi l’Angola expulse massivement ses ressortissants congolais ?
Briefing: Problems multiply in Congo’s Kasaï
The Kasaï region in the Democratic Republic of Congo is struggling to recover from two years of intense conflict. The influx last month of more than 300,000 people from Angola, most of them long-standing migrant workers, has made a fragile humanitarian situation worse.
Here’s our briefing on the risks for the region and the new challenges for the humanitarian response.
In attempts to clamp down on what it called illegal diamond mining operations, Angola’s government ordered the expulsion of more than 360,000 Congolese nationals, forcing them to flee in October into the Kasaï region of neighbouring DRC.
"This new shock is compounding an already dire situation in the same area that was the epicentre of the Kasaï crisis over the last couple of years,” explained Dan Schreiber, head of coordination in Congo for the UN’s emergency aid body, OCHA.
Congolese migrants and officials said the crackdown was violent, telling Reuters that dozens of people were killed, with the worst attacks occurring in Lucapa in Angola’s diamond-rich Lunda Norte province. Angolan security forces denied the allegations.
Where did they go?
Most of those expelled crossed into Kamako in Kasaï province, where aid organisations are responding to the tail-end of the Kamuina Nsapu insurgency that first erupted in 2016. Some of the returnees include refugees who fled violence in Kasaï over the last two years, the Norwegian Refugee Council said.
The NRC said conditions returnees face in Congo are “shocking”, including the risk of waterborne disease due to ineffective water and sanitation; thousands sleeping outdoors because of insufficient shelter; food prices tripling; and extortion of goods on both sides of the border.
“Hundreds of thousands of people have been robbed of their right to a dignified existence,” said Ulrika Blom, NRC’s country director in DRC. “This is not a crisis that is about to begin, it is a full-blown emergency.”
What has the reaction been?
While local communities have generally been welcoming to the returnees, OCHA’s Schreiber said skirmishes erupted in certain villages, mainly over the strain on limited food resources.
“Experience in the DRC does show that when you have a large influx of people arriving in an area it can generate tensions between host communities and the people who arrive,” he said.
Schreiber said OCHA has seen most returnees wanting to move away from the border areas and toward other destinations inland, which could help ease the humanitarian strain in Kasaï, but he also warned that more returnees could arrive from Angola.
“We don’t expect the first wave to be the last wave,” he said. “Expulsions from Angola are a cyclical phenomena that go all the way back to 2002-2003. It’s not a new phenomenon, but in this case we are seeing a major influx, and clearly the absorption capacity is not there.”
Why is their arrival in Kasaï in particular such a problem?
Kasaï was a relatively stable region in an unstable country – one currently dealing with multiple conflicts, an Ebola outbreak in North Kivu province, and one of the world’s most neglected displacement crises.
The situation in Kasaï changed dramatically in 2016 when conflict erupted between the Kamuina Nsapu anti-government movement and Congolese security forces. The inter-communal clashes spread far and wide, soon engulfing the entire region.
The conflict escalated in 2017, with massacres and mass graves, as well as general insecurity marked by banditry, and poor harvests that led to food insecurity and malnutrition.
An estimated 5,000 people have since been killed and more than 1.4 million displaced.
Toward the end of 2017 and into 2018, the crisis eased slightly, as national authorities regained control over large parts of the region. Despite isolated bouts of violence, aid groups say most militias have been formally disbanded and displaced communities are tentatively returning home.
“But those returns are accompanied by many needs, because people are returning to burned villages, destroyed homes, and a lot of destruction,” said OCHA’s Schreiber.
Two years of violence and displacement also mean locals have been unable to grow crops for three seasons, which has led to concerns over malnutrition. “We have really seen food insecurity skyrocket. So even in areas where returns have occurred, humanitarian needs have not come to an end,” Schreiber added.
What are the risks?
Although the current influx of people from Angola isn’t directly linked to the Kamuina Nsapu rebellion, aid groups are concerned about the implications of piling one problem on top of another in the same geographic area.
For the most vulnerable groups, specifically women and children, the challenges that affect those displaced by the insurgency also pose risks for the new returnees from Angola.
In May for instance, UNICEF reported that 400,000 children were “at risk of death” in the Kasaïs, because of food shortages.
Yves Willemot, a spokesman for UNICEF in Congo, said the rate of severe acute malnutrition among children living in the region has improved slightly since earlier this year but “remains challenging”.
“The security situation has clearly improved, but the impact on children is not ending in the short term,” he said.
Among those newly returned from Angola are 80,000 children. They now are also at risk, forced to walk long distances while exposed to inclement weather, hunger, and the threat of violence. Willemot said basic services are lacking for them, including access to drinking water, schooling, and treatment for diseases like malaria and measles.
Médecins Sans Frontières is among the NGOs initiating primary healthcare services for the recent arrivals, while also continuing interventions to assist the local population.
In a recent report, MSF documented alarming levels of rape in the Kasaï region, saying it treated 2,600 victims of sexual violence between May 2017 and September 2018; 80 percent of those interviewed said armed men raped them.
“The sexual violence committed in Kasaï was perpetrated largely by armed groups against non-armed people,” Philippe Kadima, MSF’s humanitarian advisor for the Great Lakes region, told IRIN. “Although the main conflict is over, we still see some violence happening in Kasaï.”
For the more than 300,000 returnees, he said there are clear humanitarian concerns, but also the risk of insecurity. “The question is, how do you keep people secure?”
“Displaced people become vulnerable, so it’s not that different to what the existing IDPs in Kasaï are going through… Security concerns, humanitarian needs, and risks of sexual violence are all factors when people become vulnerable,” he said.
What about the longer-term challenges?
Humanitarian needs remain critically underfunded in the Kasai region, said OCHA’s Shreiber, emphasising that beyond the immediate concerns are much broader needs in the region and the DRC as a whole.
He added that the humanitarian response must help minimise the long-term impact of the crisis on those affected.
“The longer we remain in this critical phase, the more we can expect to see humanitarian needs spiral out of control,” he said. “The current trigger of new humanitarian needs (the returnees from Angola) may be time-bound, but I think the impact will be lasting.”
Schreiber said the Kasaï region remains vulnerable because it faces particular challenges, including decades of underdevelopment and inaccessibility as a result of poor road infrastructure, and he urged more development actors to get involved.
“People in the Kasaïs are eager to rebound, to be back on their feet, and move on. There is no expectation that humanitarian assistance should continue forever in the Kasaï region,” he said. “People want to be autonomous, but what they need is support to build up their resilience and be able to move towards a situation where their most basic needs are met and they are able to think about their futures again.”
Les violations des droits humains des migrants africains en Angola
Les violations des droits humains des migrants africains en Angola
Depuis un certain moment, la communauté africaine vivant sur le territoire angolais est l’objet de toute sorte de violation de ses droits les plus fondamentaux par les autorités de ce pays. La Charte Africaines des Droits de l’Homme et des Peuples protège les droits des migrants dans tous ses aspects contre les violations des droits et l’Angola est justement membre de l’Union Africaine. Ainsi, ces violations se matérialisent par des arrestations musclées et arbitraires, des emprisonnements dans des conditions inhumaines et dégradantes (art.5 de la Déclaration Universelle des Droits de l’Homme et de la Charte Africaine des Droits de l’Homme et des Peuples) de même que les expulsions collectives pourtant interdites par la Charte Africaine dans son article 12.5.
L’AME est vivement préoccupée par les récentes arrestations, détentions et expulsions des centaines de milliers de migrants africains dont des maliens. Selon des informations recueillies auprès de nos sources sur place, une centaine de maliens sont concernés par cette situation qui évolue et change de jour en jour.
Nous attirons l’attention de l’Union Africaine et de ses pays membres sur la situation inacceptable que vivent les étrangers sur la terre africaine d’Angola et rappeler que les droits de l’homme sont des droits inaliénables de tous les êtres humains, quels que soient leur nationalité, leur lieu de résidence, leur sexe, leur origine ethnique ou nationale, leur couleur, leur religion…
L’Angola comme la plupart des pays africains s’est engagé à protéger, respecter et réaliser les droits de l’homme, non seulement de ses nationaux, mais de toute personne sous sa juridiction. Dans ce contexte, tous les étrangers se trouvant sur le sol angolais auraient dû bénéficier de la protection des autorités angolaises quelque soient les raisons qu’elles mettent en avant pour justifier ces expulsions.
L’Organisation des Nations Unies (ONU) n’est pas resté silencieuse comme la plupart des pays africains, le Haut-Commissaire des Nations Unies aux droits de l’homme a mis en garde sur les conséquences des expulsions massives de réfugiés depuis l’Angola, au cours des trois dernières semaines de ce mois d’octobre.
Par ailleurs, le Secrétaire Général des Nations Unies a rappelé le 19 septembre 2017 que : « tout pays a le droit de contrôler ses frontières. Mais cela doit se faire de telle sorte que les droits des personnes ‘en mouvement’ soient protégés ».
Au regard de tout ce qui vient d’être évoqué :
1. L’Association Malienne des Expulsés (AME) pour sa part, exhorte le gouvernement Malien à tout mettre en œuvre pour la sécurisation de nos compatriotes et de leurs biens dans les pays d’accueil ;
2. Appelle le gouvernement à communiquer davantage sur cette situation en donnant beaucoup plus d’informations aux familles des maliens vivants en Angola ;
3. Encourage le gouvernement de continuer à œuvrer pour le respect des droits des migrants maliens et aussi pour le développement d’une relation franche entre les Etats africains en vue de la réalisation de l’unité africaine comme le prévoit l’article 117 de la Constitution ;
4. Invite l’Union Africaine à dénoncer et prendre des mesures contre les violations des droits humains dans les pays membres ;
5. Invite également les Etats membres de l’Union Africaine à renoncer aux expulsions massives des ressortissants d’autres pays africains et à mettre fin sans délais aux opérations actuelles en cour ;
6. Exhorte l’U.A et les Etats à une plus grande implication des organisations de la société civile aux différents processus pour la gestion de la migration.
Gaza’s drinking water spurs blue baby syndrome, serious illnesses
Contaminated and scarce water owing to Israel’s brutal siege and bombing of infrastructure leads to death and disease.
Independent, peer-reviewed medical journals have also documented increased infant mortality, anaemia, and an “alarming magnitude” of stunting among Gaza’s children.
A Rand Corporation study has found that bad water is a leading cause of child mortality in Gaza.
Simply put, Gaza’s children are facing a deadly health epidemic of unprecedented proportions.
The Real Reasons Saudi Crown Prince Mohammed bin Salman Wanted Khashoggi ‘Dead or Alive’
Christopher Dickey 10.21.18
His death is key to understanding the political forces that helped turn the Middle East from a region of hope seven years ago to one of brutal repression and slaughter today.
The mind plays strange tricks sometimes, especially after a tragedy. When I sat down to write this story about the Saudi regime’s homicidal obsession with the Muslim Brotherhood, the first person I thought I’d call was Jamal Khashoggi. For more than 20 years I phoned him or met with him, even smoked the occasional water pipe with him, as I looked for a better understanding of his country, its people, its leaders, and the Middle East. We often disagreed, but he almost always gave me fresh insights into the major figures of the region, starting with Osama bin Laden in the 1990s, and the political trends, especially the explosion of hope that was called the Arab Spring in 2011. He would be just the man to talk to about the Saudis and the Muslim Brotherhood, because he knew both sides of that bitter relationship so well.
And then, of course, I realized that Jamal is dead, murdered precisely because he knew too much.
Although the stories keep changing, there is now no doubt that 33-year-old Saudi Crown Prince Mohammed bin Salman, the power in front of his decrepit father’s throne, had put out word to his minions that he wanted Khashoggi silenced, and the hit-team allegedly understood that as “wanted dead or alive.” But the [petro]buck stops with MBS, as bin Salman’s called. He’s responsible for a gruesome murder just as Henry II was responsible for the murder of Thomas Becket when he said, “Who will rid me of that meddlesome priest?” In this case, a meddlesome journalist.
We now know that a few minor players will pay. Some of them might even be executed by Saudi headsmen (one already was reported killed in a car crash). But experience also tells us the spotlight of world attention will shift. Arms sales will go ahead. And the death of Washington Post columnist Jamal Khashoggi risks becoming just one more entry in the annals of intensifying, murderous repression of journalists who are branded the “enemy of the people” by Donald Trump and various two-bit tyrants around the world.
There is more to Khashoggi’s murder than the question of press freedom, however. His death holds the key to understanding the political forces that have helped turn the Middle East from a region of hope seven years ago to one of brutal repression and ongoing slaughter today. Which brings us back to the question of the Saudis’ fear and hatred of the Muslim Brotherhood, the regional rivalries of those who support it and those who oppose it, and the game of thrones in the House of Saud itself. Khashoggi was not central to any of those conflicts, but his career implicated him, fatally, in all of them.
The Muslim Brotherhood is not a benign political organization, but neither is it Terror Incorporated. It was created in the 1920s and developed in the 1930s and ‘40s as an Islamic alternative to the secular fascist and communist ideologies that dominated revolutionary anti-colonial movements at the time. From those other political organizations the Brotherhood learned the values of a tight structure, party discipline, and secrecy, with a public face devoted to conventional political activity—when possible—and a clandestine branch that resorted to violence if that appeared useful.
In the novel Sugar Street, Nobel Prize-winning author Naguib Mahfouz sketched a vivid portrait of a Brotherhood activist spouting the group’s political credo in Egypt during World War II. “Islam is a creed, a way of worship, a nation and a nationality, a religion, a state, a form of spirituality, a Holy Book, and a sword,” says the Brotherhood preacher. “Let us prepare for a prolonged struggle. Our mission is not to Egypt alone but to all Muslims worldwide. It will not be successful until Egypt and all other Islamic nations have accepted these Quranic principles in common. We shall not put our weapons away until the Quran has become a constitution for all Believers.”
For several decades after World War II, the Brotherhood’s movement was eclipsed by Arab nationalism, which became the dominant political current in the region, and secular dictators moved to crush the organization. But the movement found support among the increasingly embattled monarchies of the Gulf, including and especially Saudi Arabia, where the rule of the king is based on his custodianship of Mecca and Medina, the two holiest sites in Islam. At the height of the Cold War, monarchies saw the Brotherhood as a helpful antidote to the threat of communist-led or Soviet-allied movements and ideologies.
By the 1980s, several of the region’s rulers were using the Brotherhood as a tool to weaken or destroy secular opposition. Egypt’s Anwar Sadat courted them, then moved against them, and paid with his life in 1981, murdered by members of a group originally tied to the Brotherhood. Sadat’s successor, Hosni Mubarak, then spent three decades in power manipulating the Brotherhood as an opposition force, outlawing the party as such, but allowing its known members to run for office in the toothless legislature, where they formed a significant bloc and did a lot of talking.
Jordan’s King Hussein played a similar game, but went further, giving clandestine support to members of the Brotherhood waging a covert war against Syrian tyrant Hafez al-Assad—a rebellion largely destroyed in 1982 when Assad’s brother killed tens of thousands of people in the Brotherhood stronghold of Hama.
Even Israel got in on the action, initially giving Hamas, the Brotherhood branch among the Palestinians, tacit support as opposition to the left-leaning Palestine Liberation Organization (although PLO Chairman Yasser Arafat once identified with the Brotherhood himself).
The Saudi royals, too, thought the Brotherhood could be bought off and manipulated for their own ends. “Over the years the relationship between the Saudis and the Brotherhood ebbed and flowed,” says Lorenzo Vidino, an expert on extremism at George Washington University and one of the foremost scholars in the U.S. studying the Brotherhood’s history and activities.
Over the decades factions of the Brotherhood, like communists and fascists before them, “adapted to individual environments,” says Vidino. In different countries it took on different characteristics. Thus Hamas, or its military wing, is easily labeled as terrorist by most definitions, while Ennahda in Tunisia, which used to be called terrorist by the ousted Ben Ali regime, has behaved as a responsible political party in a complex democratic environment. To the extent that Jamal Khashoggi identified with the Brotherhood, that was the current he espoused. But democracy, precisely, is what Mohammed bin Salman fears.
Vidino traces the Saudis’ intense hostility toward the Brotherhood to the uprisings that swept through much of the Arab world in 2011. “The Saudis together with the Emiratis saw it as a threat to their own power,” says Vidino.
Other regimes in the region thought they could use the Brotherhood to extend their influence. First among these was the powerful government in Turkey of Recep Tayyip Erdogan, who has such longstanding ties to the Islamist movement that some scholars refer to his elected government as “Brotherhood 2.0.” Also hoping to ride the Brotherhood wave was tiny, ultra-rich Qatar, whose leaders had used their vast natural gas wealth and their popular satellite television channel, Al Jazeera, to project themselves on the world stage and, they hoped, buy some protection from their aggressive Saudi neighbors. As one senior Qatari official told me back in 2013, “The future of Qatar is soft power.” After 2011, Jazeera’s Arabic channel frequently appeared to propagandize in the Brotherhood’s favor as much as, say, Fox News does in Trump’s.
Egypt, the most populous country in the Arab world, and the birthplace of the Brotherhood, became a test case. Although Jamal Khashoggi often identified the organization with the idealistic hopes of the peaceful popular uprising that brought down the Mubarak dynasty, in fact the Egyptian Brotherhood had not taken part. Its leaders had a modus vivendi they understood with Mubarak, and it was unclear what the idealists in Tahrir Square, or the military tolerating them, might do.
After the dictator fell and elections were called, however, the Brotherhood made its move, using its party organization and discipline, as well as its perennial slogan, “Islam is the solution,” to put its man Mohamed Morsi in the presidential palace and its people in complete control of the government. Or so it thought.
In Syria, meanwhile, the Brotherhood believed it could and should lead the popular uprising against the Assad dynasty. That had been its role 30 years earlier, and it had paid mightily.
For more than a year, it looked like the Brotherhood’s various branches might sweep to power across the unsettled Arab world, and the Obama administration, for want of serious alternatives, was inclined to go with the flow.
But then the Saudis struck back.
In the summer of 2013, Gen. Abdel Fattah al-Sissi, the commander of the Egyptian armed forces, led a military coup with substantial popular support against the conspicuously inept Brotherhood government, which had proved quickly that Islam was not really the “solution” for much of anything.
Al-Sissi had once been the Egyptian military attaché in Riyadh, where he had many connections, and the Saudis quickly poured money into Egypt to shore up his new regime. At the same time, he declared the Muslim Brotherhood a terrorist organization, and launched a campaign of ruthless repression. Within weeks of the coup, the Egyptian military attacked two camps of Brotherhood protesters and slaughtered hundreds.
In Syria, the efforts to organize a credible political opposition to President Bashar al-Assad proved virtually impossible as the Qataris and Turks backed the Brotherhood while the Saudis continued their vehement opposition. But that does not mean that Riyadh supported moderate secular forces. Far from it. The Saudis still wanted to play a major role bringing down the Syrian regime allied to another arch enemy, the government of Iran. So the Saudis put their weight behind ultra-conservative Salafis, thinking they might be easier to control than the Muslim Brothers.
Riyadh is “okay with quietist Salafism,” says Vidino. But the Salafis’ religious extremism quickly shaded over into the thinking of groups like the al Qaeda spinoff called the Nusra Front. Amid all the infighting, little progress was made against Assad, and there to exploit the chaos was the so-called Islamic State (which Assad partially supported in its early days).
Then, in January 2015, at the height of all this regional turmoil, the aged and infirm Salman bin Abdelaziz ascended to the throne of Saudi Arabia. His son, Mohammed bin Salman, began taking into his own hands virtually all the reins of power, making bold decisions about reforming the Saudi economy, taking small measures to give the impression he might liberalize society—and moving to intimidate or otherwise neutralize anyone who might challenge his power.
Saudi Arabia is a country named after one family, the al Saud, and while there is nothing remotely democratic about the government, within the family itself with its thousands of princes there traditionally has been an effort to find consensus. Every king up to now has been a son of the nation’s founder, Abdelaziz ibn Saud, and thus a brother or half brother of the other kings.
When Salman took over, he finally named successors from the next generation. His nephew Mohammed bin Nayef, then 57 and well known for his role fighting terrorism, became crown prince. His son, Mohammed bin Salman, became deputy crown prince. But bin Nayef’s position between the king and his favorite son clearly was untenable. As one Saudi close to the royals put it: “Between the onion and the skin there is only the stink.”
Bin Nayef was pushed out in 2017. The New York Times reported that during an end-of-Ramadan gathering at the palace he “was told he was going to meet the king and was led into another room, where royal court officials took away his phones and pressured him to give up his posts as crown prince and interior minister. … At first, he refused. But as the night wore on, the prince, a diabetic who suffers from the effects of a 2009 assassination attempt by a suicide bomber, grew tired.” Royal court officials meanwhile called around to other princes saying bin Nayef had a drug problem and was unfit to be king.
Similar pressure was brought to bear on many of the richest and most powerful princes in the kingdom, locked up in the Ritz Carlton hotel in 2017, ostensibly as part of an extra-legal fight against corruption. They were forced to give allegiance to MBS at the same time they were giving up a lot of their money.
That pattern of coerced allegiance is what the Saudis now admit they wanted from Jamal Khashoggi. He was no prince, but he had been closely associated in the past with the sons of the late King Faisal, particularly Turki al-Faisal, who was for many years the head of the Saudi intelligence apparatus and subsequently served as ambassador to the United Kingdom, then the United States.
Although Turki always denied he had ambitions to be king, his name often was mentioned in the past as a contender. Thus far he seems to have weathered the rule of MBS, but given the record of the crown prince anyone close to the Al Faisal branch of the family, like Khashoggi, would be in a potentially perilous position.
Barbara Bodine is a former U.S. ambassador to Yemen, which has suffered mightily since MBS launched a brutal proxy war there against Iran. Both MBS and Trump have declared the regime in Tehran enemy number one in the region. But MBS botched the Yemen operation from the start. It was dubbed “Decisive Storm” when it began in 2015, and was supposed to last only a few weeks, but the war continues to this day. Starvation and disease have spread through Yemen, creating one of the world’s greatest humanitarian disasters. And for the moment, in one of those developments that makes the Middle East so rich in ironies, in Yemen the Saudis are allied with a branch of the Muslim Brotherhood.
“What drives MBS is a ruthless effort toward total control domestically and regionally; he is Putin of the Desert,” says Bodine. “He has basically broken the back of the princelings, the religious establishment and the business elite, brought all ministries and agencies of power under his sole control (’I alone can fix it’), and jailed, killed or put under house arrest activists and any and all potential as well as real opposition (including his mother).”
In 2017, MBS and his backers in the Emirates accused Qatar of supporting “terrorism,” issuing a set of demands that included shutting down Al Jazeera. The Saudis closed off the border and looked for other ways, including military options, to put pressure on the poor little rich country that plays so many angles it has managed to be supportive of the Brotherhood and cozy with Iran while hosting an enormous U.S. military base.
“It was Qatar’s independent streak—not just who they supported but that they had a foreign policy divorced from the dictates of Riyadh,” says Bodine. “The basic problem is that both the Brotherhood and Iran offer competing Islam-based governing structures that challenge the Saudi model.”
“Jamal’s basic sin,” says Bodine,“was he was a credible insider, not a fire-breathing radical. He wrote and spoke in English for an American audience via credible mainstream media and was well regarded and highly visible within the Washington chattering classes. He was accessible, moderate and operated within the West. He challenged not the core structure of the Kingdom but the legitimacy of the current rulers, especially MBS.”
“I do think the game plan was to make him disappear and I suspect the end game was always to make him dead,” said Bodine in a long and thoughtful email. “If he was simply jailed within Saudi there would have been a drumbeat of pressure for his release. Dead—there is certainly a short term cost, whether more than anticipated or longer than anticipated we don’t know yet, but the world will move on. Jamal will become a footnote, a talking point perhaps, but not a crusade. The dismembered body? No funeral. Taking out Jamal also sends a powerful signal to any dissident that there is no place safe.”