WHO warns of spread of cholera from Sudan to Chad refugee camps
The more than two-year-old war between the Sudanese army — which took full control of Khartoum state this week — and the paramilitary Rapid Support Forces has spread hunger and disease and destroyed most health facilities. Drone attacks in recent weeks have interrupted electricity and water supplies in the capital Khartoum, driving up cases there.
"Our concern is that cholera is spreading," Dr Shible Sahbani, WHO representative for Sudan, told reporters in Geneva by video link from Port Sudan.
He said cholera has reached 13 states in Sudan, including North and South Darfur which border Chad, and 1,854 people have already died in the latest wave as the dangerous, rainy season sets in.
"We assume that if we don't invest in the prevention measures, in surveillance, in the early warning system, in vaccination and in educating the population, for sure, the neighbouring countries, but not only that, it can maybe spread to the sub-region," he said.
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Daily Maverick
20 hours ago
- Daily Maverick
‘Vapes are safe alternatives to smoking' — and other lies they told us
A World Health Organization report released this week has some ideas on how to fight Big Tobacco's influence machine, just as an SA Bill regulating newer tobacco products has finally reached the health committee in Parliament. It's about time, says Lekan Ayo-Yusuf, a University of Pretoria professor who is a member of the WHO study group on tobacco product regulation. Smoking a cigarette on a plane was normal until tobacco control laws put a stop to it. The new normal: taking a puff on any of the latest electronic devices in a shopping centre where smoking isn't allowed. Big Tobacco is good at adapting. With fewer people smoking cigarettes globally, the industry has pivoted its playbook toward electronic devices like vapes and heated tobacco products (HTP). The World Health Organization's (WHO) Global Tobacco Epidemic report, which was released at this week's World Conference on Tobacco Control in Dublin, shows how graphic warnings on packaging and anti-tobacco campaigns can fight against the tobacco industry influence machine, including these new product lines. It is a timely release for South Africa. Our own Bill, meant to better regulate tobacco products, including new ones such as electronic delivery systems, is finally — nearly seven years after first being gazetted — in front of Parliament's health committee hearing oral submissions from stakeholders. The WHO report shows what we are up against. Pages from the playbook The report lays out how Big Tobacco's well-honed tactics — and some new ones — are being used to sell new products and keep legislation to slow sales down at bay. Among these are co-opting the term harm reduction — an evidence-based way to help lower the effects of drug use or risky behaviours on someone's health — to push the newer products as 'safer alternatives' to traditional cigarettes. The industry has also funded its own science to discredit existing independent research on its products, and pays the media to publish sponsored articles it has written, such as this one which appeared on TimesLIVE in November 2024, arguing there is sufficient evidence that electronic tobacco products are safe and effective harm-reduction tools, or this one published by News24 in January, boosting British American Tobacco-sponsored studies that underplay the potential harm of the chemical contained in electronic products, says Lekan Ayo-Yusuf, public health expert from the University of Pretoria and a member of the WHO's study group on tobacco product regulation. The industry also exaggerates the size of the illicit market to keep taxes low, arguing that if government increases taxes on tobacco products, it will drive smuggling. It says plain packaging — which is what South Africa's current draft Bill calls for — will also increase illicit trade, although the WHO says it can actually help with enforcement by making illicit products easier to detect. In many countries, illicit trade can refer to counterfeit products or smuggled foreign cigarettes. But a 2023 study in the South African Crime Quarterly showed that in South Africa, it's more about legitimate domestic manufacturers who find ways to avoid paying proper taxes while producing branded cigarettes. Ayo-Yusuf agrees: 'It's got nothing to do with tobacco legislation and everything to do with the criminal element in the industry.' Where there's smoke E-cigarettes and vapes — electronic devices that heat a liquid containing additives and chemicals, which are often flavoured to appeal to children and adolescents — and HTPs, tobacco devices that electronically heat products that contain actual tobacco instead of burning it, are defined in our draft regulation as electronic delivery systems and tobacco devices. While some of the liquids don't contain nicotine, many do, making them no less addictive than cigarettes. In fact, inhaling the aerosol from vapes can cause lung damage and heart problems, while HTPs still emit 'tobacco smoke' with harmful chemicals — some at lower levels than cigarettes, others higher, and some not even found in cigarettes. Yet HTPs dodge tobacco rules in South Africa that bar the promotion of tobacco and public area smoking, even though they contain tobacco. 'They're violating the current tobacco laws in broad daylight,' says Ayo-Yusuf. 'You cannot market or promote tobacco products. But you see people smoking in public places and you have whole HTP stores and stands in shopping malls.' That's what the Bill is trying to put an end to. It will apply strict laws to newer devices: no use in public spaces; no advertising, online sales or claims that they're less harmful than cigarettes; and regulations will require graphic health warnings as well as plain packaging to deter people from using them. If it is passed in its current form, it will also be the end of fruit-flavoured vapes, which have been heavily marketed to children — only tobacco and menthol flavours will be allowed. We spoke to Ayo-Yusuf about the growing market for heated tobacco, harm reduction and how regulation can keep pace. This is an edited version of our conversation. Zano Kunene (ZK): How well does SA do in tobacco control? Lekan Ayo-Yusuf (LAY): Not well, relative to other countries in Africa and globally. The Bill is very good and will change the whole tobacco and nicotine control landscape, but we have been waiting [seven years for it]. Since it was introduced in 2018, we have seen the number of smokers grow from 9.5-million to 14.9-million in 2024. ZK: Which smoking products are tobacco companies pushing in SA? LAY: Vapes are a big one as we had 4.1% of people between 16 and 34 using [them] in 2018, and now we are sitting at 7.7%. Heated tobacco use is also increasing, which I've been monitoring since 2021, and using data from Nielsen to pick up on which products are being sold. ZK: What are HTPs and how do they differ from conventional cigarettes? LAY: Traditional cigarettes burn tobacco so you can inhale nicotine, which makes the brain release dopamine and makes you feel good, but comes with harmful chemicals from the tobacco and the paper. HTPs have a coil that is charged by a battery that heats a stick filled with tobacco leaves. The difference is that you do not have the chemicals that come from the burning process, otherwise you have everything else. ZK: Why does the industry call them harm reduction tools? LAY: The industry has jumped ahead to say they reduce harm, but what we actually know is it reduces exposure to harmful chemicals. In theory, they could lower harm over time, but it is not a linear process. Whether lowering toxins from 100 to 20, for example, is enough to reduce your harm from cardiovascular disease or cancer will take you a long time to find out. The industry says they are targeting smokers trying to quit. The easiest evidence for this would be a drop in cigarette smoking. But since e-cigarettes entered the market in 2010, there is no evidence showing that smoking has reduced.
Daily Maverick
20 hours ago
- Daily Maverick
Don't panic about new SARS-CoV-2 variant, experts say
Covid has largely dropped out of the headlines, but the virus that causes it is still circulating. We ask what we should know about a new variant of SARS-CoV-2, the state of the Covid pandemic in 2025, and the lack of access to updated vaccines in South Africa. In the leafy Johannesburg suburb of Sandringham, the National Institute for Communicable Diseases (NICD) bears a deceptive facade. Do not be fooled by its sleepy campus, clustered face brick buildings and shade-cloth parking, this government facility is home to state-of-the-art biosafety laboratories and some of South Africa's top virologists, microbiologists and epidemiologists. Here, 71 scientists are tasked daily with laboratory-based disease surveillance to protect the country from pathogen outbreak events. advertisement Don't want to see this? Remove ads On 5 March 2020, then health minister Dr Zweli Mkhize announced South Africa's first Covid infection at an NICD press briefing. At the time, the NICD was an obscure acronym for many, but that quickly changed as the institution became central to the country's pandemic response. While the Covid pandemic may have waned, the NICD hasn't stopped monitoring. That is because there remains a global public health risk associated with Covid. The World Health Organization (WHO) states: 'There has been evidence of decreasing impact on human health throughout 2023 and 2024 compared to 2020-2023, driven mainly by: High levels of population immunity, achieved through infection, vaccination, or both; Similar virulence of currently circulating JN.1 sublineages of the SARS-CoV-2 virus as compared with previously circulating Omicron sublineages; and The availability of diagnostic tests and improved clinical case management. SARS-CoV-2 circulation nevertheless continues at considerable levels in many areas, as indicated in regional trends, without any established seasonality and with unpredictable evolutionary patterns.' Thus, while SARS-CoV-2 is still circulating, it is clearly not making remotely as many people ill or claiming nearly as many lives as it did four years ago. Asked about this, Foster Mohale, spokesperson for the National Department of Health, says, 'There are no reports of people getting severely sick and dying due to Covid in South Africa at the current moment.' advertisement Don't want to see this? Remove ads 'Variant under monitoring' As SARS-CoV-2 circulates, it continues to mutate. The WHO recently designated variant NB.1.8.1 as a new variant under monitoring. There is, however, no reason for alarm. Professor Anne von Gottberg, laboratory head at the NICD's Centre for Respiratory Diseases and Meningitis, tells Spotlight that NB.1.8.1 is not a cause for panic, particularly not in South Africa. Von Gottberg says no cases of the new variant have been detected in South Africa. She refers to her unit's latest surveillance of respiratory pathogens report for the week of 2 to 8 June 2025. It states that out of 189 samples tested, 41 (21.7%) cases were influenza, another 41 (21.7%) cases were respiratory syncytial virus (RSV), and three (1.6%) cases were earlier strains of SARS-CoV-2. These figures suggest much greater circulation of influenza and RSV in South Africa than SARS-CoV-2. Over the past six months, 3,258 samples were tested, revealing 349 (10.7%) cases of influenza, 530 (16.3%) cases of RSV, and 106 (3.3%) cases of SARS-CoV-2. Since most people who become sick because of these viruses are not tested, these figures do not paint the whole picture of what is happening in the country. As of 23 May 2025, the WHO considered the public health risk of NB.1.8.1 to be 'low at the global level', with 518 iterations of the variant submitted from 22 countries, mainly around Asia and the Pacific islands. advertisement Don't want to see this? Remove ads The WHO report states: 'NB.1.8.1 exhibits only marginal additional immune evasion over LP.8.1 [first detected in July 2024]. While there are reported increases in cases and hospitalisations in some of the WPR [Western Pacific Region] countries, which has the highest proportion of NB.1.8.1, there are no reports to suggest that the associated disease severity is higher as compared to other circulating variants. The available evidence on NB.1.8.1 does not suggest additional public health risks relative to the other currently circulating Omicron descendent lineages.' advertisement Don't want to see this? Remove ads Combating misinformation Von Gottberg says that the NICD plays a critical public health communication role in combating misinformation and warns against alarmist and inaccurate online depictions of NB.1.8.1, the Omicron-descendent lineage dubbed 'Nimbus' by some commentators. 'There's fake news about NB.1.8.1 going around on social media,' she says. 'For example, supposed symptoms. I have been trying to look for articles and have not seen anything from [reliable sources],' she says. 'In fact, there is no information about whether there are any differences in symptoms, because there are so few cases and it is not causing more severe disease.' Von Gottberg implores members of the public to check information sources. 'We try hard – and the Department of Health does the same – to put media releases out so that accurate information is shared. What we ask is that all our clients, the public, verify information before they start retweeting or resending.' advertisement Don't want to see this? Remove ads Covid vaccines in South Africa The WHO recommends that countries ensure continued equitable access to and uptake of Covid vaccines. They also note that the currently approved Covid vaccines are expected to remain effective against the new variant. But contrary to WHO advice, newer Covid vaccines are not available in South Africa and continued access to older vaccinations seems to have ceased. When Spotlight called two branches of two major pharmacy retailers in Cape Town, asking for available Covid vaccines, the answer at both was that they had none. advertisement Don't want to see this? Remove ads Several recently approved Covid vaccines are being used in other countries but are not available in South Africa. These include Moderna's updated mRNA boosters, approved in the United States and parts of Europe, Novavax's Nuvaxovid vaccine, approved in the United States, and Arcturus Therapeutics's self-amplifying mRNA vaccine Zapomeran, approved in Europe. Self-amplifying mRNA vaccines have the additional capacity to induce longer-lasting immune responses by replicating the spike-proteins of SARS-CoV-2. None of these vaccines are under review for registration in South Africa, according to the South African Health Products Regulatory Authority (Sahpra). Vaccines may not be made available in the country without the green light from Sahpra. 'It may be advisable to contact the owners of the vaccines to obtain clarity on whether they intend to submit for registration,' says Sahpra spokesperson Yuven Gounden. advertisement Don't want to see this? Remove ads Spotlight on Friday sent questions to Moderna, Novavax and Arcturus, asking whether they planned to submit their vaccines for registration with Sahpra, and if not, why not. None of the companies responded by the time of publication. Von Gottberg explains that vaccines can become available in South Africa only if their manufacturers submit them to Sahpra for approval. 'So, if a vaccine provider, a vaccine manufacturer, does not want to sell in our country because they do not see it as a lucrative market, they may not even put it forward for regulation so that it can be made available.' Professor of Vaccinology at the University of the Witwatersrand, Shabir Madhi, says the major concern with the lack of licensed SARS-CoV-2 vaccines in South Africa is that 'high-risk individuals remain susceptible to severe Covid, as there is waning of immunity'. 'High-risk individuals should receive a booster dose every 6-12 months, preferably with the vaccine that is updated against current or most recent variants,' he says. Von Gottberg has similar concerns. 'My hope as a public health professional is that these vaccine manufacturers take us seriously as a market in South Africa and in Africa, very importantly, and put these vaccines and products through our regulatory authorities so that they can be made available both in the public and in the private sector for all individuals who are at risk and should be receiving these vaccines,' she says. Gounden notes that should a public health need arise, 'Sahpra is ready to respond in terms of emergency use approval.' Concerns over vaccine expert dismissals in the United States Earlier this month in the United States, Health and Human Services (HHS) Secretary Robert F Kennedy Jr. fired all 17 members of the Advisory Committee on Immunisation Practices (ACIP) – an expert body responsible for recommending vaccines for 60 years. He then appointed eight new members, some known for vaccine scepticism. Commenting on this, Von Gottberg says: 'I am hoping there will be those who will think about what he [Kennedy] is doing and question it. It is an unusual situation in the United States, you cannot call it business as usual.' In an article published in the Journal of the American Medical Association, former ACIP members voice grave concerns over the dismissals. 'Vaccines are one of the greatest global public health achievements. Vaccine recommendations have been critical to the global eradication of smallpox and the elimination of polio, measles, rubella, and congenital rubella syndrome in the US. 'They have also dramatically decreased cases of hepatitis, meningitis, mumps, pertussis (whooping cough), pneumonia, tetanus, and varicella (chickenpox), and prevented cancers caused by hepatitis B virus and human papilloma viruses. Recent scientific advancements enabled the accelerated development, production and evaluation of Covid vaccines…' they write. The article also questioned the announcement by Kennedy Jr on X that he had signed a directive to withdraw the recommendation for Covid vaccination in healthy children and healthy pregnant people. '[R]ecent changes to Covid vaccine policy, made directly by the HHS secretary and released on social media, appear to have bypassed the standard, transparent and evidence-based review process. Such actions reflect a troubling disregard for the scientific integrity that has historically guided US immunisation strategy,' the authors warn. Von Gottberg adds: 'We hope that this anti-vax, the denialism of vaccines and the good they do, won't come to South Africa.' In addition, she cautions public healthcare professionals to take heed of this discourse. 'We must take seriously that people have questions, and that they want to see us doing things correctly, transparently, always telling people of our conflicts of interest, being very upfront when things are controversial, when it's difficult to make decisions,' she says 'So I think what this teaches us is not to be complacent in the way we talk and write about vaccines, discuss vaccines, and we must take our clients, the public out there, seriously and hear their voices, listen to their questions.' DM This article was first published by Spotlight – health journalism in the public interest. Sign up to the Spotlight newsletter.
Mail & Guardian
21 hours ago
- Mail & Guardian
Are procedures in negotiations for the WHO's international public health legal instruments being violated?
The World Health Organisation must recommit to the democratic principles in the Universal Declaration of Human Rights. (Reuters) According to a World Health Organisation But health freedom advocates are deeply concerned that in one or both instances, the WHO has broken its own rules for negotiating and voting for its legal instruments. As I explained However, as In the run-up to the Furthermore, the authors of the had been shown to be contradicted by the data and citations on which WHO and other agencies had relied. The authors were alluding to the WHO's contention that shortening the four-month statutory window for countries to review proposed amendments to the IHRs was justifiable on the grounds that due to 'climate change' and other drivers of zoonotic spillover, the risk of another spillover from animals to humans was very high. In other words, the WHO was using under-substantiated assumptions of an imminent 'existential threat' to justify sidestepping official procedures. Thus some health freedom advocates hold that the WHO's assumption of increased risk of pandemics relies on a weak evidence-base, demonstrated by a University of Leeds Moreover, analysis of the evidence used by WHO and others gave much longer outbreak risk profiles, highlighting inconsistencies between WHO estimates and the research estimates in their cited evidence. All this undermines the WHO's justifications for side-stepping its own procedures. Furthermore, according to th WHA in 2024], the WHO moved the Coordinating Financing Mechanism (CFM) from Article 20 of the Thus the hasty adoption of the amendments to the Furthermore, some health freedom advocates hold that the negotiations for the In early 2024, the WHO released a April 2025, which was the last day of negotiations for the Pandemic Agreement, the European Union (EU) Furthermore, According to Nevertheless, on the first day of the I am not adequately acquainted with the role of Committee A as distinct from that of the full assembly, but Article 19 of the WHO Yet while all the health freedom advocates I know agree that the The WHO has In essence, the PABS system is to be designed to facilitate the sharing of pathogens with 'pandemic potential', purportedly to enable pharmaceutical companies to develop 'vaccines' in good time while 'equitably' sharing the profits or products derived with the states that shared the pathogens with them. Yet, health freedom advocates are pointing out that since the Annex must be negotiated before the In view of the foregoing reflections, there is an urgent need for WHO to renew its commitment to the democratic principles that had set it apart from other United Nations bodies. Unlike the UN, the WHO does not have a provision of veto power for any nation, and thus is meant to uphold the doctrine of the equality of sovereign states. After all, the UN, of which the WHO is a specialised body, claims to be committed to democratic principles in line with the Reginald MJ Oduor is an associate professor of philosophy at the University of Nairobi and a member of the Pan-African Epidemic and Pandemic Working Group and of the International Health Reform Project, as well as the co-founder of the Society of Professionals with Visual Disabilities.
