💉 Bad news on the climate front; The rich are making it worse; Experts want to prepare for bird flu

#562 | A new diabetes emerges; Rich kids can't read, or count; Covid brings life expectancy down

May 16, 2025

Hello, and welcome back to The Kable after what must've been a relentlessly dull couple of weeks for all those who missed us. We promise this week's edition will make up for the absence in the past couple of weeks. We have a lot of stories and a whole lot more doom and gloom to share.

First, some good news though. Nigerian health tech company Codix Bio has signed a sublicensing agreement with the Medicines Patent Pool (MPP) to locally produce rapid diagnostic tests (RDTs) using tech from South Korea's SD Biosensor. Backed by WHO and MPP, this move not just amps up Africa’s manufacturing capacity for essential tests, it also furthers the continent's aim to strengthen regional health security. The RDT tech is especially suited for low- and middle-income countries (LMICs) because there is no need for additional equipment. Codix will initially use the tech to produce RDTs for HIV but it can quickly be adapted to other diseases including malaria and syphilis, among others.

Uganda declared its Ebola outbreak over a little while ago and, at that time, there were rumblings that the Africa CDC might consider calling the ongoing mpox outbreak quits too. However, cases have been ramping up again with Sierra Leone now taking it upon itself to fuel the outbreak. Things aren't all hunky dory in the original epicenter of the Democratic Republic of Congo (DRC) either.

Could the vacuuming up of all available oxygen in the area by a certain orange someone be a factor behind the two recent MERS deaths reported in Saudi Arabia?

Kinda quiet on the SDG front lately, isn’t it? Maybe that’s because we’re nowhere near meeting them. A recent study specific to Southeast Asia certainly says so.

If MERS and missing SDGs don't get your pulse racing, maybe bird flu will. China has reported more cases of the H9N2 and H10N3 variants in humans. Because, why not?

So we're already seeing the impact of the recent aid and funding cuts around the world, especially when it comes to HIV/AIDS and TB. It is likely malaria won't suffer the same fate because Novartis, surprisingly, says it will keep producing malaria drugs even with no orders.

Raising hope that Novartis' initiative above may not be in vain is the announcement Gavi made this week of a new partnership with the Asian Infrastructure Investment Bank (AIIB). The partnership will see Gavi combine its grants with loans from the AIIB to improve access to health financing. The funding - with AIIB pledging up to $1 biilion - will support vaccine rollout, procurement, and strengthening of immunisation systems.

And okay, the world may have agreed on terms of a pandemic pact last month. But we're still miles away from having a workable plan in place.

Enraged by the lack of quality control measures on cough syrup production that resulted in deaths of children across Africa not long ago, Indian authorities had imposed stringent tests on all cough syrups made for export. However, an industry body associated with the political party that runs the Indian government is now asking for these tests to be scrapped "because they're leading to delays and increased cost."

Look, a universal snake venom might still be years away. But, if you want to hear something hardcore, how about this man who got himself bit by 200 snakes, thus helping scientists create an antivenom using antibodies from his blood? How many snakes would you let bite you?

Eat the rich. No, really. Why? Here is one more reason: The richest 10% of the global population have caused two-thirds of global warming since 1990, fuelling droughts and heatwaves in the world’s poorest regions, a new study finds.

Speaking of heat, the month just past was the second-warmest April ever on record. And yes, the global temperature remained in excess of the 1.5°C threshold that was once believed unattainable.

And finally, good news. You need to work less. Because excess work is literally reshaping your brain. And not in a good way.

Stories Of The Week

Net zero? More like not-not. Unlikely to happen, we know, but even if, by some miracle, the world hits net zero by 2050, extreme heat won’t disappear overnight. Southern Africa, especially, may not get the relief it needs. New climate models suggest that while many regions will see a drop in heat extremes, southern Africa’s future remains uncertain and potentially dangerous. Some projections show little to no improvement in extreme heat, and rainfall patterns could either ease or worsen local conditions. With the region already highly vulnerable to droughts and temperature spikes, this uncertainty could leave millions exposed to escalating climate risks, even in a net zero world. Which means policymakers need to plan for multiple futures, not just the most hopeful one. In fact, we would go so far as to bet that the most hopeful future is merely a mirage. Hey, you don't read The Kable for good cheer, do you now?
(The Conversation, AGU)

Prepare for the worst. And hope for the best. Ancient juju, we know. But that is the state of affairs we're facing when it comes to bird flu. H5N1 bird flu is edging closer to becoming a human pandemic, and it is not us but top virologists around the world making that claim. Once confined to birds, the virus is now increasingly infecting mammals and while human-to-human spread hasn’t happened yet (that we know of), experts warn it’s only a matter of time. This new report from the Global Virus Network outlines glaring global gaps in surveillance, preparedness, and response. With historic mortality rates of up to 50% in humans, failing to prepare for H5N1 could trigger a disaster far worse than Covid. But we've largely succeeded in minimising Covid so one holds out no hope that bird flu will be approached with any more diligence.
(The Lancet Regional Health – Americas)

Born unequal. Where you live, work, and grow up can shape your health more than your genes or access to healthcare, and in some cases, it can cost you decades of life. A sweeping new WHO report - World report on social determinants of health equity (yeah, the name's a mouthful) - shows that social determinants like income, education, housing, and discrimination are driving massive health gaps both within and between countries. With high debt, weak social protection, and climate shocks compounding these inequities, the agency says, forget 2030, even global health targets for 2040 are likely to be missed. Unless governments worldwide take urgent action to address the root causes. Which, as recent history indicates, would mean we're well and truly ducked. Hey, The Kable is a family publication.
(WHO)

The WHO pats its own back. Despite rising financial strain, the WHO’s 2024 Results Report shows surprising (emphasis ours) global progress on key health indicators, from expanded mental health access to better emergency response. Nearly half the target for universal health coverage has been reached, and more than a billion people are now living healthier lives. But looming funding cuts and missed SDG targets cast a long shadow, especially with new threats like H5N1 emerging and pandemic preparedness still lagging. What does the agency need to get global health goals back on track? Why, stronger, sustained investment, of course. Of course.
(WHO)

You win some. In the same week in which the agency claimed the gains mentioned above, the WHO released a report - the 2025 World Health Statistics report - that says global life expectancy dropped by 1.8 years between 2019 and 2021, the sharpest decline in recent history. All of this is ostensibly due to the fallout from Covid with a sprinkling of rising noncommunicable diseases, and a dash of stalled progress on maternal and child health. And add in a helping of uneven recovery to boot. Using culinary teams in this summary has made us hungry. And since bananas and chocolate are both going extinct and with bird flu making eggs dangerous, it might just be the best time to make a loaf of chocolate banana bread.
(WHO)

Even the rich kids aren't alright. There hasn't really been much emphasis laid by governments, corporations and health authorities around the world on the fact that Covid is oncogenic and a vascular illness and a respiratory illness and causes all manners of neurological issues. A new UNICEF report - another mealy-mouthed title - Report Card 19: Child Wellbeing in an Unpredictable World - says Covid has done a number on children's, well, wellbeing too. Children in the world’s richest countries, in fact, are now worse off than before the pandemic. Falling academic scores. Rising obesity. Declining mental health. And half of all 15-year-olds across 43 countries are not even functionally literate or numerate. Life satisfaction? Yeah, that has dropped as well.
(UNICEF)

Breakthroughs

And then there were five. Usually, this section covers advances that might prove life-saving or life-changing or herald new treatments for illnesses. This week's breakthrough breaks the norm. The International Diabetes Federation has officially recognised Type 5 diabetes - a malnutrition-linked form affecting up to 25 million people, mostly in low-income countries. Unlike other types, it stems from poor childhood nutrition stunting pancreas development. This reclassification brings the known types of diabetes to over a dozen, each with different causes, treatments, and outcomes.
(The Conversation)

Bottom line

A whole new (hot) world. Half of the children born in 2020 will face unprecedented exposure to extreme heat, even under the most optimistic climate scenario, a recently-published study in Nature reveals. That figure jumps to 92% under a 3.5°C warming future, compared to just 16% for those born in 1960. Intergenerational inequality? Check. Social inequity? Check because the poorest children will bear the worst of the heat. And no, this isn’t just about the climate. This is a failure of our duty of care. But hey, at least the future will be short-lived, eh?
(Nature)

Too hot to carry. If children are bound to suffer heat, what about the people who deliver them? They aren't gonna get it any easier, are they? Extreme heat is becoming a serious threat to pregnancy, with nearly a third of countries seeing at least a month’s worth of added “pregnancy heat-risk days” since 2020, according to a new Climate Central analysis. Even one hot day can raise the risk of complications like preterm birth, hypertension, or maternal death - risks that are now multiplying with climate change. The toll is heaviest in places already facing gaps in healthcare access, making climate action not just environmental, but deeply maternal.
(Climate Central)

At least meds will continue to work. Well, think again. Climate change is intensifying antimicrobial resistance (AMR) in low- and middle-income countries. A study published in Nature Medicine projects that AMR could increase by over 4% in these regions by 2050, compared to a global average of 2.4%. Factors such as rising temperatures, extreme weather events, and inadequate sanitation contribute to this surge. Flooding and droughts can contaminate water sources, facilitating the spread of resistant bacteria. Limited access to clean water and healthcare exacerbates the problem, making it harder to treat infections effectively.
(Nature Medicine)

More climate woe for Africa. From floods that displaced nearly a million people to heatwaves that shut schools and scorched crops, climate change is battering Africa on every front, warns the UN’s latest WMO report - State of the Climate in Africa 2024. The continent saw record land and sea temperatures in 2024, with extreme weather fuelling hunger, displacement, and economic instability, especially in already fragile countries like South Sudan. With droughts and floods now forming a relentless cycle, scientists say adaptation is the only sustainable way forward.
(WMO)

Reversing climate losses. Amid all this climate doom and gloom comes this study with a hopeful alternative: a first-of-its-kind analysis in Nature shows that with bold, coordinated action - across emissions cuts, diet shifts, food waste reduction, and water and nitrogen efficiency, humanity could bring global environmental pressures back to 2015 levels by mid-century. Bold, coordinated action? Not off to a winning start there. The researchers also say this possibility needs fast, systemic change on a near-global scale. Hehehe. Even then, not all planetary boundaries can be safely restored by 2050 but we might be able to bend the curve enough to keep Earth livable.
(Nature)

Long reads

A cure for Africa. Like a lot of other illnesses, diabetes too is on the rise in Africa. This piece in Wired wonders out loud how this could possibly lead to breakthrough cures.
(Wired)

The African quest for independence. An interesting tete-a-tete with the brilliant experts at Senegal's Institut Pasteur de Dakar (IPD) who are actually driving Africa towards a self-reliant vaccine future.
(CEPI)

The change in Africa. While much of the "developed" world is turning antivax with fervour, Africa is a pleasant outlier, with vaccination rates increasing and zero-dose children decreasing. This piece in Gavi's VaccinesWork talks about how this makes for better health systems.
(Gavi)

Bye-bye malaria? We commemorated World Malaria Day recently. This Devex piece explores whether we are on course to finally bid goodbye to this relentless scourge.
(Devex)

Oh, and Gopal Nair doesn't want you to see this.