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    W.H.O. Authorizes Mpox Vaccine, Clearing Way for Use in Africa

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    The decision is a crucial step in getting shots to the Democratic Republic of Congo, the center of the outbreak.The World Health Organization has given its authorization to a first vaccine to protect against mpox, a decision announced in such haste on Friday that it caught even the head of the company that makes the vaccine by surprise.The vaccine, made by the Danish company Bavarian Nordic, has been approved by the regulatory authorities in Europe as well as the United States and other high-income countries since a global mpox outbreak in 2022. But low- and middle-income countries rely on the W.H.O., through a process called prequalification, to determine which drugs, vaccines and health technologies are safe and efficient uses of limited health funding, and the organization had declined to act until now.The W.H.O. had come under increasing criticism for declaring a global public health emergency for mpox last month without giving a vaccine that prequalification stamp of approval, or a more provisional form of approval called emergency use authorization. Bavarian Nordic first submitted its safety and effectiveness data on the vaccine, called Jynneos, to the W.H.O. in 2023. The W.H.O. had defended its slow pace of review, saying that it needed to subject the vaccine to careful study because it, and two others that have been used to protect against mpox, were originally designed as smallpox immunizations, and because delivering it in low-resource settings such as Central Africa would involve factors different from those relating to its use in high-income countries.But on Friday morning, the W.H.O. suddenly said it was authorizing the shot.“This first prequalification of a vaccine against mpox is an important step in our fight against the disease, both in the context of the current outbreaks in Africa, and in future,” Dr. Tedros Adhanom Ghebreyesus, the W.H.O. director general, said in a statement.Paul Chaplin, Bavarian Nordic’s chief executive, said he was among the many who had been caught off guard.“We’ve got there eventually — I don’t know quite how,” he said. “But it’s good news. It’s going to make the regulatory pathway much easier.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      China Woos Africa, Casting Itself as Global South’s Defender

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      More than 50 African leaders have gathered in Beijing for a summit aimed at projecting the influence of China’s leader, Xi Jinping, in the developing world.African flags have been flown over Tiananmen Square. Leaders of African nations have been greeted by dancers, honor guards and children waving flags. They have been escorted in extensive motorcades past banners celebrating “A Shared Future for China and Africa” and giant, elaborate flower arrangements.China has pulled out all the stops for a gathering of leaders and top officials from more than 50 African nations this week in Beijing, welcoming them with pomp and pageantry. “After nearly 70 years of hard work, China-Africa relations are at the best period in history,” China’s leader, Xi Jinping, told the gathering on Thursday. Mr. Xi has cast his country as a defender of the developing world, one that can push the West to listen to the voices of poorer countries. He hosted a banquet for the leaders at the start of the event on Wednesday, after three straight days of back-to-back bilateral talks with nearly two dozen leaders of nations ranging from impoverished Chad to the continental economic powerhouse of Nigeria. The three-day forum is meant to demonstrate Beijing’s global clout despite rising tensions with the West. Mr. Xi’s courtship of African countries is part of a great geopolitical competition with the United States that has intensified in recent years over Russia’s war in Ukraine and China’s aggressive posture toward Taiwan.China is “trying to take advantage of the space left by the U.S. and Europe, which are increasingly disengaged with Africa,” said Eric Olander, the editor in chief of the China-Global South Project website. “China sees an opportunity to really step up its engagement, and not necessarily just with money.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Gilead Shot Provides Total Protection From HIV in Trial of Young African Women

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      An injection given just twice a year could herald a breakthrough in protecting the population that has the highest infection rates.Researchers and activists in the trenches of the long fight against H.I.V. got a rare piece of exciting news this week: Results from a large clinical trial in Africa showed that a twice-yearly injection of a new antiviral drug gave young women total protection from the virus.“I got cold shivers,” said Dr. Linda-Gail Bekker, an investigator in the trial of the drug, lenacapavir, describing the startling sight of a line of zeros in the data column for new infections. “After all our years of sadness, particularly over vaccines, this truly is surreal.”Yvette Raphael, the leader of a group called Advocacy for Prevention of H.I.V. and AIDS in South Africa, said it was “the best news ever.”The randomized controlled trial, called Purpose 1, was conducted in Uganda and South Africa. It tested whether the every-six-months injection of lenacapavir, made by Gilead Sciences, would provide better protection against H.I.V. infection than two other drugs in wide use in high-income countries, both daily pills.The results were so convincing that the trial was halted early at the recommendation of the independent data review committee, which said all participants should be offered the injection because it clearly provided superior protection against the virus.None of the 2,134 women in the arm of the trial who received lenacapavir contracted H.I.V. By comparison, 16 of the 1,068 women (or 1.5 percent) who took Truvada, a daily pill that has been available for more than a decade, and 39 of 2,136 women (1.8 percent) who received a newer daily pill called Descovy were infected.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      $29 Trillion: That’s How Much Debt Emerging Nations Are Facing

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      A decades-long crisis is getting worse, and now dozens of nations are spending more on interest payments than on health care or education.The Vatican’s meeting on the global debt crisis last week was not quite as celebrity-studded as the one that Pope John Paul II presided over 25 years ago, when he donned sunglasses given to him by Bono, U2’s lead singer.But the message that the current pope, Francis, delivered this time — to a roomful of bankers and economists instead of rock stars — was the same: The world’s poorest countries are being crushed by unmanageable debt and richer nations need to do more to help.Emerging nations are contending with a staggering $29 trillion in public debt. Fifteen countries are spending more on interest payments than they do on education, according to a new report from the United Nations Conference on Trade and Development; 46 spend more on debt payments than they do on health care.Unmanageable debts have been a recurring feature of the modern global economy, but the current wave may well be the worst so far. Overall, government debt worldwide is four times higher than what it was in 2000.Government overspending or mismanagement is one cause, but global events out of most nations’ control have pushed their debt problems into overdrive. The Covid-19 pandemic slashed business profits and worker incomes at the same time health care and relief costs were increasing. Violent conflicts in Ukraine and elsewhere contributed to rising energy and food prices. Central banks raised interest rates to combat soaring inflation. Global growth slowed.Pope Francis earlier this week in Rome.Fabio Frustaci/EPA, via ShutterstockWe are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      The Disease Detectives Trying to Keep the World Safe From Bird Flu

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      As Dr. Sreyleak Luch drove to work the morning of Feb. 8, through busy sunbaked streets in Cambodia’s Mekong river delta, she played the overnight voice messages from her team. The condition of a 9-year-old boy she had been caring for had deteriorated sharply, and he had been intubated, one doctor reported. What, she wondered, could make the child so sick, so fast?“And then I just thought: H5N1,” she recalled. “It could be bird flu.”When she arrived at the airy yellow children’s ward at the provincial hospital in Kratie, she immediately asked the child’s father if the family had had contact with any sick or dead poultry. He admitted that their rooster had been found dead a few days before and that the family had eaten it.Dr. Luch told her colleagues her theory. Their responses ranged from dubious to incredulous: A human case of avian influenza had never been reported in their part of eastern Cambodia. They warned her that if she set off the bird flu warning system, many senior government officials might get involved. She risked looking foolish, or worse.Anxious but increasingly certain, Dr. Luch phoned the local public health department, located just across the street. Within minutes, a team arrived to collect a sample from the child, Virun Roeurn, for testing in a lab.By then, Virun’s distraught parents had lost faith in the hospital. They demanded that he be sent by ambulance to the capital, Phnom Penh. His flu swab sample traveled with him.Virun died on the journey. At 8 p.m., Cambodia’s National Public Health Laboratory confirmed Dr. Luch’s suspicion: He had died of highly pathogenic avian influenza.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Millions of Girls in Africa Will Miss HPV Shots After Merck Production Problem

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      The company has told countries that it can supply only 18.8 million of the 29.6 million doses it was contracted to deliver this year.Nearly 1.5 million teenage girls in some of the world’s poorest countries will miss the chance to be protected from cervical cancer because the drugmaker Merck has said it will not be able to deliver millions of promised doses of the HPV vaccine this year.Merck has notified Gavi, the international organization that helps low- and middle-income countries deliver lifesaving immunizations, and UNICEF, which procures the vaccines, that it will deliver only 18.8 million of the 29.6 million doses it was contracted to deliver in 2024, Gavi said.That means that more than 10 million girls will not receive their expected HPV shots this year — and 1.5 million of them most likely will never get them because they will be too old to qualify for the vaccine in subsequent years.Patrick Ryan, a spokesman for Merck, said the company “experienced a manufacturing disruption” that required it to hold and reinspect many doses by hand. He declined to give further details about the cause of the delay.“We are acting with urgency and rigor to deploy additional personnel and resources to resolve this matter as soon as possible,” he said.Mr. Ryan said that Merck would deliver the delayed doses in 2025. He also said the company would ship 30 million doses of the vaccine to Gavi-supported countries this year. However, about a third of these are doses that were supposed to have been sent in 2023, leaving Gavi with the 10.7 million dose shortfall.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Global Warming Is Particularly Bad for Women-Led Families, Study Says

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      New U.N. research shows that climate change disproportionately erodes income in households led by women in poorer countries. But there are ways to fix it.Extreme heat is making some of the world’s poorest women poorer.That is the stark conclusion of a report, released Tuesday, by the United Nations Food and Agriculture Organization, based on weather and income data in 24 low- and middle-income countries.The report adds to a body of work that shows how global warming, driven by the burning of fossil fuels, can magnify and worsen existing social disparities.What does the report find?The report concludes that while heat stress is costly for all rural households, it is significantly more costly for households headed by a woman: Female-headed households lose 8 percent more of their annual income compared to other households.That is to say, extreme heat widens the disparity between households headed by women and others. That’s because underlying disparities are at play.For instance, while women depend on agricultural income, they represent only 12.6 percent of landowners globally, according to estimates by the United Nations Development Program. That means women-headed households are likely to lack access to essential services, like loans, crop insurance, and agricultural extension services to help them adapt to climate change.The report is based on household survey data between 2010 and 2020, overlaid with temperature and rainfall data over 70 years.The long-term effect of global warming is also pronounced. Female-headed households lose 34 percent more income, compared to others, when the long-term average temperature rises by 1 degree Celsius.The average global temperature has already risen by roughly 1.2 degrees Celsius since the start of the industrial age.Flooding similarly suppress the incomes of female-headed households more than it does other kinds of households, according to the report, but to a lesser degree than heat.“As these events become more frequent, the impacts on peoples’ lives will deepen as well,” said Nicholas Sitko, an economist with the Food and Agriculture Organization and the lead author of the report.Why does it matter?There’s been growing attention in recent years to the disproportionate harms of extreme weather, sometimes aggravated by climate change, on low-income countries that produce far less greenhouse gas emissions, per person, than wealthier, more industrialized countries.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      The Teacher Shortage: Why, and What to Do?

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      More from our inbox:Mr. McCarthy, Put Country Before EgoDebate, Yes, but Without an AudienceReauthorize PEPFARHow Unions Help Companies Eleanor DavisTo the Editor:Re “People Don’t Want to Be Teachers Anymore. Can You Blame Them?,” by Jessica Grose (newsletter, nytimes.com, Sept. 13):As a retired teacher, I read this with heartfelt interest. Ms. Grose noted the cost of getting a degree, low pay and lack of respect as leading causes for our current shortage of teachers.Then again, when I entered the College of Education at the University of Minnesota in 1980, my friends thought I was crazy. There was little respect even then. Pay was even worse.I began as a pre-law student my freshman year in college. And then it happened. I saw the light. I remembered those teachers who had saved me. Teachers who had seen potential in me that I could not see for myself. My life was transformed by teachers.The courtroom seemed like a selfish ambition. The classroom felt like a journey of love, an opportunity to be inspired and to inspire each and every day. I walked into my college guidance counselor’s office and asked to transfer into the College of Education.No regrets. The 35 years I spent in the classroom taught me so many important lessons. I learned the importance of believing in excellence. I learned that I could help others become excellent. And most important, I discovered that belonging to a professional learning community was eternally gratifying.I understand that people don’t want to be teachers anymore. That was true in the 1980s, too. But for many of us who did become teachers, bliss. Can you say the same in your job today?Dan LarsenBarrington, Ill.To the Editor:Jessica Grose is spot on that financial barriers, mental wellness, culture wars and a profession that is out of step with the wants and needs of this generation are all contributing to teacher shortages across the country, especially in low-income communities.She also notes that people who consider teaching later in life could be a source of optimism. Don’t count Gen Z out. We just welcomed over 2,200 new Teach for America teachers — 40 percent more than last year, and most are recent college graduates.This generation is giving us so much optimism: They understand the experiences and needs of today’s students, and want careers that have meaningful impact, align with their values and foster community. Collectively we have to create the conditions for this generation to say yes to careers in education.Jemina R. BernardStamford, Conn.The writer is president and chief operating officer of Teach for America.To the Editor:I agree with everything Jessica Grose has to say in this piece about the current decline in the number of college graduates who choose to become teachers. I would, however, suggest an additional reason for this decline. Simply put, women graduates today have more career choices than in the past.When I graduated in 1962, most of my friends and I became teachers. What were our choices? Teaching, nursing, or go to Katharine Gibbs and learn to type. Today I have two 24-year-old granddaughters; one is an architectural engineer, the other is enrolled in a graduate program that will enable her to become a clinical researcher.Neither even considered a career as a teacher. Nor did my 51-year-old daughter, who is an attorney.Beverly StautzenbachVenice, Fla.Mr. McCarthy, Put Country Before Ego Kenny Holston/The New York TimesTo the Editor:Re “Hard Right in Congress Sows Havoc,” by Carl Hulse (news analysis, front page, Sept. 25):Mr. Hulse’s article is deeply disturbing insofar as 20 or so radical conservative Republicans can force a government shutdown.There is a simple solution if Speaker Kevin McCarthy would choose to put the country before his own political ego and his party: Walk across the aisle with willing Republicans and speak with Hakeem Jeffries, the Democratic minority leader, to vote with the Democrats to approve the budget.Mr. McCarthy should ask himself what a leader and patriot like Senator John McCain would do in a similar situation. Mr. McCarthy’s constituents might surprise him with their support if he demonstrates some real courage.Brian HousealBrunswick, MaineDebate, Yes, but Without an Audience Brian Snyder/ReutersTo the Editor:My suggestion to improve the debates being broadcast on TV would be to get rid of the audience. Then candidates would no longer waste time throwing out these sound bites for the applause and cheers.Perhaps that may help them to listen to the question posed to them by the moderator and possibly answer it.In addition, getting rid of the audience might even force people watching the debates at home to think for themselves when making a decision regarding a candidate, since they would have no idea what everyone else is thinking.Imagine that.Laura KleinPinecrest, Fla.Reauthorize PEPFARAdministering an H.I.V. test in 2012 at a Johannesburg clinic supported by PEPFAR.Foto24/Gallo Images, via Getty ImagesTo the Editor:Re “Will Republicans Abandon This Medical Triumph?” (column, Sept. 21):Nicholas Kristof’s piece about PEPFAR is spot on: PEPFAR’s work to prevent and treat H.I.V. and AIDS around the world has saved over 25 million lives, and should absolutely be reauthorized by Congress.But even beyond that extraordinary achievement, PEPFAR has ushered in a culture of accountability and efficiency across virtually all sectors of global health, not just H.I.V. and AIDS care.PEPFAR’s accountability standards require foreign governments and implementing NGOs to use data, evaluations (such as randomized control trials), and advanced analytics to measure results and demonstrate value for money.The result: It now costs PEPFAR dramatically less to save each life. In 2014, it cost $315 to give lifesaving treatment to one person for one year. By 2022, that had fallen to $59. Those are industry-changing results.Countries are now using tactics developed by PEPFAR for other health programs, from disaster response to seasonal outbreaks.With PEPFAR’s focus on efficiency and results, the American people can be confident that another five-year authorization would be money well spent.Hannah CooperTyler SmithThe writers are the co-founders of Cooper/Smith, an organization focused on using data to improve the efficiency and effectiveness of foreign aid programs.How Unions Help Companies Evan Cobb for The New York TimesTo the Editor:What has been missing in articles about the current United Auto Workers strike at General Motors, Ford and Stellantis is that having a union is not just about fighting for good wages and benefits but also about fighting for its important role in helping companies.Having a union, whether it’s at G.M., Starbucks or a hospital, can help management avoid making bad decisions, create innovative changes by utilizing the skills and knowledge of the frontline staff, and optimize the use of new technologies.Having a “collective voice” to pressure management to avoid making bad decisions and consider alternative approaches has resulted in improving productivity and the quality of products in companies and hospitals up to 30 percent, reducing costs and at times creating new jobs and additional revenue.Maybe the current strike can help U.S. managers realize that unions can be of benefit to them, too, rather than view them as a burden?Peter LazesWest Stockbridge, Mass.The writer is a visiting professor at the School of Labor and Employment Relations, Penn State, and co-author of the book “From the Ground Up: How Frontline Staff Can Save America’s Healthcare.” More