Friday marks World AIDS Day, and the World Health Organization is promoting a campaign of universal health coverage to help the 36.7 million people around the world living with HIV/AIDS. Gabrielle Weiss reports for VOA on the efforts of a Washington, D.C., clinic, Whitman Walker Health.
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A fast color-changing test that detects fluoride in drinking water could help prevent the crippling bone disease skeletal fluorosis in developing countries. Faith Lapidus has details.
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New, long-acting drugs may offer hope to millions of people who suffer from migraines. Studies of two of these medicines, given as shots every month or so, found they cut the frequency of the notoriously painful and disabling headaches.

The drugs are the first preventive medicines developed specifically for migraines. They work by interfering with a substance involved in modifying nerve signaling and progression of pain and symptoms.

“It’s a whole new direction” for treatment and an important advance for people who don’t want to take or aren’t helped by the daily pills sometimes used now to prevent recurrences, said Dr. Andrew Hershey, neurology chief at Cincinnati Children’s Hospital Medical Center.

He had no role in the research but has tested other migraine drugs and wrote a commentary published with the studies Wednesday by the New England Journal of Medicine.

Migraines plague more than a billion people worldwide, more than 38 million in the U.S. alone. They’re more severe than an ordinary headache — throbbing, squeezing pain and pressure, often accompanied by vision problems, sensitivity to light, noise or smells, and nausea. They can leave people unable to work or do simple things like cooking or even holding a conversation.

What studies show

One study tested erenumab, from Amgen and Novartis, in about 900 people who averaged eight migraines a month. Nearly half had already tried other preventive medicines.

For six months, they were given monthly shots into the abdomen of a high dose of the drug, a low dose or a dummy medicine. The number of days they suffered migraines each month dropped by three to four in the drug groups and nearly two in the placebo group. Half of the patients on the higher dose saw their migraine days cut at least in half.

“I very definitely benefited,” said Anne Vickers, who got the lower dose through one of the study leaders at Mercy Hospital St. Louis in Missouri.

“I can have anywhere from 15 to 18 headaches per month, and probably five of those days are migraines,” but that dropped 40 percent on the drug, she said. “I have three kids, so for me it meant having more days when I was able to live my everyday life, cook a meal at home, go to events at school.”

The second study tested fremanezumab, from Teva Pharmaceutical, for chronic migraines, defined as headaches on 15 or more days per month, at least eight of them migraines.

About 1,000 patients were given monthly shots for three months: One-third got the drug each time, another third got the drug the first time and then dummy shots the next two times, and the rest got dummy shots each time.

Monthly headache days dropped by four to five in the groups given the drug and by two to three for those given dummy treatments.

The caveats

Average reductions of one or two days a month are modest, but “there are some patients who have had a complete response — they become headache-free,” Hershey said.

No worrisome side effects emerged, but the studies were very short, so long-term safety and effectiveness are unknown.

The new drugs were not tested against existing ones, only placebo treatments.

Many study leaders work for or have other financial ties to the drugmakers, and the companies helped analyze results.

Biotech drugs like these tend to be very expensive, and if they’re approved, insurers may set big co-pays or require patients to try older medicines first, Hershey said. When the drugs did work, the benefit was seen right away, so there’s less financial risk in trying one or two doses.

“The patient will know quickly if this is a drug for them, and if not, move on to something else,” Hershey said.

Both drugs have been submitted to the U.S. Food and Drug Administration for approval. Eli Lilly and Co. and Alder Biopharmaceuticals also are testing similar drugs.
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The U.S. Drug Enforcement Agency is targeting opioid abuse in Appalachia by establishing a new field office in Kentucky to oversee a region ravaged by overdose deaths.

Acting DEA Administrator Robert Patterson says the new Louisville field office will have a special agent in charge to oversee investigations in Kentucky, Tennessee and West Virginia. The agency says the new office will enhance efforts in the Appalachian mountain region and streamline drug trafficking investigations under a single office. D. Christopher Evans, an associate agent in charge in the DEA’s Detroit field office, will lead the new Louisville office.

Overdose deaths were 65 percent higher among residents in Appalachia than in the rest of the country in 2015, a recent Appalachian Regional Commission study found.
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After decades of legal challenges and political battles that have pitted states against the federal government, U.S. wildlife managers on Wednesday finally adopted a plan to guide the recovery of a wolf that once roamed parts of the American Southwest and northern Mexico.

 

The plan sets a goal of having an average of 320 Mexican gray wolves in the wild over an eight-year period before the predator can shed its status as an endangered species. In each of the last three years, the population would have to exceed the average to ensure the species doesn’t backslide.

 

Officials estimate recovery could take another two decades and cost nearly $180 million.

 

The U.S. Fish and Wildlife Service considered tens of thousands of public comments – from state lawmakers and business groups to independent scientists and environmentalists – as it worked to meet a court-ordered deadline to craft the recovery plan. It was a long time coming as the original guidance for restoring the wolf was adopted in 1982.

 

“This plan really provides us a roadmap for where we need to go to get this species recovered and delisted and get its management turned back over to the states and tribes,” Sherry Barrett, the Mexican wolf recovery coordinator, told The Associated Press in an interview.

 

Barrett said state wildlife officials reviewed the scientific data and the models used to calculate the best way forward for the agency as it works to bolster genetic diversity and continue building the wild population.

 

There are now more of the wolves roaming the Southwest than at any time since the federal government began trying to reintroduce the animals in 1998. The most recent annual survey shows at least 113 wolves spread between southwestern New Mexico and southeast Arizona.

There are about 31 wolves in the wild in Mexico, officials said.

 

Under the recovery plan, those numbers would be expected to grow to 145 in the U.S. and 100 in Mexico over the next five years.

 

Barrett said targeted releases of captive-bred wolves and translocations are necessary to make the program work.

 

In an effort to avoid future skirmishes with states, the plan calls for coordination with wildlife officials in New Mexico and Arizona when it comes to the timing, location and circumstances of the releases.

 

Environmentalists are voicing concerns, suggesting there needs to be more than 700 wolves in the wild if the population is to withstand illegal shootings, genetic issues and other challenges.

 

They have pushed for years for more captive wolves to be released, but ranchers and elected leaders in rural communities have pressed back because the predators sometimes attack domestic livestock and wild game.

 

Last year, the U.S. Interior Department’s internal watchdog said the Fish and Wildlife Service had not fulfilled its obligation to remove Mexican gray wolves that preyed on pets and cattle.

 

Barrett said with the new plan and other rules that give the agency flexibility in managing problem wolves, there is optimism among officials that progress can be made.

 

“I know that with most things having to do with wolves, there’s going to be a lot of strong opinions on both sides,” she said. “But to us, it is a big step forward for us to have something in place to start working toward and working with the public to achieve.”
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In a square in a poor eastern Tehran neighborhood known for its drug addicts and dealers, psychologist Atefeh Azimi draws another drop of blood from a worried passer-by’s finger.

 

She works on a nearby bench, where a sign next to her in English and in Farsi urges the public to receive free voluntary counseling and HIV testing.

 

But her worries, as well as those of her aid group called Reviving Values, are not confined these days just to those sharing needles to inject heroin that comes across the border from Afghanistan’s thriving opium trade.

 

Iran has seen a surge in the number of HIV infections spread by sex, especially among its youth. What’s more, authorities say many have no idea that they are infected.

 

That has led to growing uncomfortable questions in the Islamic Republic, where sex outside of marriage is prohibited and those who practice it can face arrest and severe punishment.

 

Some have dared challenge the long-standing taboos in Iran surrounding sex, speaking publicly about the need for safe sex, sex education and regular HIV testing.

 

“Everybody has a very bad attitude toward this disease,” said Mahboobeh Zeinali, an HIV-positive woman living in Tehran. “They even think if they wash their hand where I do they can be infected, but they can’t.”

 

According to government estimates, 66,000 people out of Iran’s 80 million people have HIV, though about 30,000 of them have no idea they have the virus. Iranian authorities blame that on how little general knowledge many have about the virus.

 

By comparison, in the United States, government statistics suggest 1.1 million people live with HIV, with one in seven not knowing it.

 

More than 50 percent of those with HIV in Iran are between 21 and 35, said Parvin Afsar Kazerouni, the head of the Health Ministry’s AIDS department. That’s despite that age group representing about 28 percent of Iran’s population as a whole.

 

The number of those infected through sex continues to rise.

 

“If we look at five or six years ago, the rate of infection through sex was around 16 or 17 percent, to 20 percent at the most. … Now it is up to 40 percent or even more in some provinces,” Dr. Mohammad Mahdi Gouya, Iran’s deputy health minister, told The Associated Press. “This is an alert for us, the people and the officials. They are addressing this issue very seriously.”

 

Societal mores play a part in the rise of HIV infections. As a Muslim country, Iranian clerics preach against sex outside of marriage and sex isn’t often discussed among children and parents. Schools offer little sexual education as well.

 

Sex outside of marriage is illegal and some have been prosecuted for merely shaking hands with a member of the opposite sex under Iran’s strict interpretation of Islamic law, or Shariah. However, police rarely interfere with young couples in Tehran walking hand-in-hand and whispering to each other.

 

The government blames drugs in part for the increase in HIV infections — though not those narcotics that are injected with a needle.

 

“Ecstasy drugs, synthetic addictive drugs and amphetamine combinations dramatically and abnormally raise sexual desire,” Gouya said.

 

Views on sex are also changing in Iran.

 

Previously, Iran allowed so-called “temporary marriages” or “sigheh” — a legal contract under Sharia law that allows a couple to share a hotel room or travel together, though it’s not publicly or officially backed by the government. The contracts last anything between several hours to a few years but are increasingly abandoned in mainstream life in most of the Muslim world.

 

Lately, Tehran has seen a quiet move toward so-called “white marriages,” or couples living together before being married even though it remains illegal.

 

Mohammad Mohammadi Golpayegani, Supreme Leader Ayatollah Ali Khamenei’s chief of staff, has criticized the practice, warning the “loose generation” that its offspring will “be illegitimate.”

 

Widespread access to satellite television, which in theory remains banned by authorities, also offers young Iranians access to images of Western culture, as does the internet.

 

About 60 percent of divorces across Iran come from those unhappy with sex in their marriages, said Mohammad Mahdi Labibi, a sociology professor at Tehran’s Azad University.

 

“When one of them is not satisfied, they will look for it outside their marriage,” in secret, Labibi said. Such “hidden sex increases the chance of being infected by any disease, including HIV.”

 

Prostitution also has been acknowledged by the government as a problem. Members of parliament have discussed the issue before, along with other “social problems,” according to Iranian media reports.

 

Today, Iran’s government treats some 10,000 people either infected with HIV or those with already developed AIDS, which weakens the immune system and gradually destroys the body’s ability to fight infections and certain cancers. It typically costs the government $16,000 a year to treat a patient, Gouya said.

 

Iranian society often ostracizes HIV-positive people, especially women.

 

“Most women here are in charge of their families, and unfortunately finding a job for them is very difficult,” said Najimeh Babagol, a psychologist who works with HIV-positive women. “Many of them get rejected went they reveal [they are HIV positive] at work. I can say this stigma and discrimination is the biggest problem they are facing.”

 

Khosro Mansourian, who leads the Reviving Values aid group, said sex education and better understanding can help solve that.

 

“Sex education should start from the kindergarten age,” he said. “Every child should have full knowledge about sexual characteristics so that they can protect themselves and especially learn they have the ability to say no.”

Gouya agrees that the young should have sex education.

 

“Our youth must learn about sexual issues in schools,” he said. “Prevention is much easier than treatment of AIDS.”

 

 
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Scientists say they’ve unearthed fossil remains of a sea cow that lived in the shallow waters off Southern California’s Channel Islands some 25 million years ago.

 

The fossil skull and rib cage were discovered this summer on Santa Rosa Island, in the Pacific Ocean about 50 miles northwest of Los Angeles, the National Park Service announced Tuesday.

 

Scientists say the remains may be from a previously unknown sea cow species but they won’t know for sure until the skull is analyzed by an expert.

 

Some fossilized remnants of at least from four other sea cows also were found nearby.

 

Sea cows are torpedo-shaped plant-eaters that graze in shallow waters and can grow up to 13 feet long. The only living species are the dugong and three types of manatee.

 

Two researchers from the U.S. Geological Survey found the skull and rib cage in a steep ravine while mapping earthquake faults, said Yvonne Menard of the park service. Erosion may have only recently revealed them.

 

“This sea cow may have only been exposed the past few years after being buried for millions of years,” said Jonathan Hoffman with the Santa Barbara Museum of Natural History, which is protecting the fossils.

 

“They’re embedded in rock and the top surface has been exposed,” Menard said.

 

That surface has been covered with plaster-impregnated bandages and burlap to protect the fossils until work to excavate them can resume in late spring, Menard said.

 

The work is slow because researchers need to obtain permits to excavate.

 

Researchers hope to uncover the teeth of the sea cow, which could help determine the animal’s diet and its age when it died.
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