💉The world gets less hungry, but Africa gets hungrier; Don't take that antibiotic, unless you're a child; El Niño is coming for your house and hearth
#614 | Climate change is also economic; We don't spend enough on animals; Dengue goes global
Hello, and welcome back to The Kable. After a couple of weeks of relatively light issues, we’ve got a really heavy (in all senses) edition to gently lull you into the weekend.
As has been the norm for the past several weeks, we begin with Ebola and an update from Congo where confirmed cases as of last reporting have reached 2,905 with 1,269 deaths. “If we do not stop this outbreak today, it could become one of the worst Ebola outbreaks the world has ever documented,” said Africa CDC Director-General Dr. Jean Kaseya. The outbreak, however, shows no signs of even slowing down, much less being controlled. Violence and medicine shortages continue to hamper the response as well, even as Congo’s neighbours amp up border control measures. Amid all this comes this new article in The Lancet with the discovery of a novel clade of the Bundibugyo virus. A teeny-tiny ray of sunshine comes from another study that says the existing Zaire ebolavirus vaccine could offer some protection in the current outbreak too. Not that other diseases have taken a backseat, mind. Congo recorded nearly 32,000 suspected cholera cases as well in the latest update from the Africa CDC.
In more news from Africa, the war in Sudan continues, with North Kordofan, El Obeid in particular, as the new epicentre. A drone attack in a market killed and injured many, including children, while the Sudanese Armed Forces were accused of using banned chemical weapons in an airstrike on Umm Garfa. To no one’s surprise, El Obeid is now Sudan’s nucleus for hunger and displacement.
Kenya is looking to launch a new biotech park, worth $216 million, to not only reduce reliance on imported medicines but also to make the country a regional manufacturing hub. Bahati njema, Kenya.
Heads of state, and health ministers, and other stakeholders gathered in Accra, Ghana for a two-day health summit - the Extraordinary Session of the AU Assembly - to end AIDS and TB by 2030. Neither is likely to happen but it is encouraging to see Africa come together and have a plan for a future that is not dependent on international aid, or imported medicines.
It was a busy week for the Africa CDC too, who released a framework for controlling AMR on the continent over the next five years, and another for ensuring food safety. The agency also released a toolkit for healthcare workers responding to Hepatitis B, with a companion mobile app as well. The Africa CDC also launched a call for applications for anybody interested in a 3-day residential training program in mRNA technologies at its HQ. Apply now, if that is you.
Just a short while ago, we were bemoaning the very little time that hantavirus got to occupy the limelight. But this week, it raised its head again, with three confirmed deaths being reported from Venezuela. Health authorities said these cases are not likely linked to the devastating twin earthquakes the country recently experienced.
Ebola, hantavirus, Covid (which is still around), bird flu... so many potential pandemics in the wings. Great that our leaders have agreed on a pandemic pact. Not exactly but like we said when the latest round of talks began, they’ve agreed on deferring an agreement to the next round of talks. This time though, we’re so close, really close, like, unbelievably close, to an actual agreement because now we have two pathogen sharing models to choose from.
The UN Security Council also met this week to discuss whether critical minerals can fuel peace and prosperity instead of conflict. Heh!
In Gaza, food security and child nutrition both remain critical, while settler-terrorists continue attacks on people and property. And in south Lebanon, people can’t find a way home. And the ones who do find a way, find that they no longer have a home. Hey, homes are Hezbollah.
Elsewhere, a new report from two late-stage trials exploring a once-weekly HIV pill, combining Merck’s islatravir and Gilead’s lenacapavir, suggested that this regimen kept the virus suppressed. And in even better news, long-term data from two trials with lenacapavir with thousands of people, showed that only one person actually contracted the disease. Gilead still won’t sell the drug to MPP though.
India got its first dengue vaccine, with regulatory approval for Takeda’s Qdenga, making it the 43rd country to approve this jab. Talking about India, USFDA censure over quality control and manufacturing issues, we’ve seen a lot of those. This week, Alembic Pharma was at the receiving end of the regulator’s ire for not seeking explicit consent from patients involved in a study. Variety, as they say, is the spice of life.
Over in the US, the world’s foremost expert on pulling numbers out of one’s sun-starved rear end decided to impose 100%, going up to 200%, tariffs on generic drug imports beginning 2027. The US is also determined to ensure that we don’t see the back of AIDS, because ideology. Apropos of nothing, PAHO also released a report saying two out of five people in the Americas live with a neurological disorder.
The WHO has launched seven strategies to prevent drowning. We’re guessing swim, and stay afloat, are two of those. One other might be don’t enter water.
In the UK, in continuation of a centuries-long pattern, a woman was taken to the hospital where staff thought she was overreacting and they gave her an oxygen mask, attached to nothing. She died of a pulmonary embolism not long after.
And finally, it is time for good news. And is often the case in The Kable, the good news is caffeinated. A new review says three to five cups of regular black coffee is generally safe and may even be linked to lower risks of heart disease, stroke, heart failure, and Type 2 diabetes. Personally speaking, this editor can vouch for this. Because we have not suffered a single stroke or heart failure in over 30 years of drinking coffee. Go on then, brew yourselves a cup. It is science, after all.
Before we dive into the stories of the week...
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Stories Of The Week
The law of averages. Global hunger is falling for the third year running. Great news, unless you happen to live where hunger is increasingly concentrated. The latest UN figures show 645 million people experienced hunger in 2025, down from 659 million the previous year. But while Asia and Latin America are pulling the global average in the right direction, Africa has quietly inherited an unenviable title: the world’s hunger capital. More than 300 million people on the continent are undernourished, and nearly two-thirds of Africans still cannot afford a healthy diet.
It’s a reminder, if one were needed, that global averages can be spectacularly misleading. Progress in India, Southeast Asia and parts of Latin America masks a widening geographic divide, where conflict, climate shocks, debt pressures and soaring food import bills continue to squeeze African food systems. The challenge is no longer producing enough calories. Globally, we already do. The challenge is making nutritious food affordable and resilient to increasingly frequent shocks. And that’s a much harder problem to solve with emergency food aid alone.
The uncomfortable truth is that hunger is becoming less of a global crisis and more of an African one. Unless investment shifts from short-term relief to local agriculture, infrastructure and regional food systems, the world may well hit its hunger targets on paper while leaving the continent carrying an ever-larger share of the burden. Statistics, after all, are remarkably good at hiding where the pain actually lives.
(UN)
Use it, don’t abuse it. A new global analysis, published in The Lancet, found that almost every country is overusing WHO’s “Watch” antibiotics, the powerful medicines meant to be reserved for specific infections. Instead, they’re increasingly becoming the default, accelerating the very problem they were designed to prevent. Meanwhile, many lower-income countries still struggle to access basic first-line antibiotics, creating a dangerous double standard: overuse where restraint is needed, and scarcity where access is essential. And it is not down to any one factor. Weak diagnostics, over-the-counter sales, fragmented surveillance and under-resourced health systems mean clinicians often prescribe broad-spectrum antibiotics because they have little else to go on. The result is a perfect breeding ground for antimicrobial resistance that doesn’t respect borders. Superbugs may be a global problem, but without stronger stewardship and better access to diagnostics, the next chapter of the AMR story will be written where health systems can least afford it.
(The Lancet Public Health)
A gift for our future. They say we don’t inherit the world but borrow it from future generations. It is apt then that antibiotic resistance in children is on the up. And getting worse. A global study analysing more than 106,000 samples from 82 countries found resistance rising across every region between 2004 and 2022, with dangerous pathogens such as Klebsiella and Acinetobacter baumannii becoming increasingly difficult to treat. Worse still, resistance to last-line antibiotics is projected to climb sharply by 2035, threatening to turn routine childhood infections into life-threatening illnesses.
Children have fewer antibiotic options than adults, yet they’ve largely been an afterthought in AMR surveillance and drug development. That’s a costly oversight. The bugs aren’t waiting for better paediatric formulations, more clinical trials or improved stewardship programmes. They’re evolving anyway. And unlike childhood, antimicrobial resistance is something we don’t simply grow out of.
(JAMA Pediatrics)
Disease in the water. Ah so you thought climate change is making the weather harder to predict and that’s it, eh? Well, it is also rewriting the rulebook for waterborne diseases because why the hell not! A new review warns that rising temperatures, floods and droughts could undo decades of progress against illnesses such as cholera and diarrhoea, particularly as shifting weather patterns make outbreaks more frequent, less predictable and harder to contain. The old assumptions about where and when these diseases emerge may no longer hold. Great news for quacks. Not so much for public health planners who already struggle to stay one step ahead. Investing in clean water and sanitation continues to remain essential (and we aren’t doing enough of that) but the study argues this needs to be paired with climate adaptation, better surveillance and more resilient health systems. Or, if you’re a believer, we could wait for the rapture or qayamat or pralaya and continue on our merry way till then.
(Nature Reviews Microbiology)
Boil and bubble. Who came up with the name El Niño? Sounds like such a cute, widdle thing. Not a name one would associate with large-scale destruction. But that is exactly what El Niño is promising this time around. Scientists are saying this could become the strongest El Niño in at least 150 years. Like we even know what happened 150 years ago. But we digress. Forecasts are that 2027 could be the hottest year ever recorded. And if the forecasts hold, it won’t be just broken temperature records. Crops will fail where they once thrived. Diseases will appear in places they didn’t before. Droughts, floods and wildfires will become less like disasters and more like seasons. Food prices, insurance costs and migration pressures will all follow. Climate change, even today, is often framed as tomorrow’s problem. Well, maybe El Niño circa 2026 is a time traveller from the future. All of the above was the good news though. The real danger is that this El Niño is unprecedented now but won’t in the future. Because every “once-in-a-century” event is already starting to sound like an annual record, simply waiting to be broken.
(Nature)
Breakthroughs
Old drugs, new tricks. The world’s antibiotic cupboard isn’t exactly overflowing, so perhaps it’s time we stopped throwing out the old ones. And, for a change, scientists have done useful research. They’ve shown that vancomycin – one of medicine’s last lines of defence – can be given a second life. Rather than inventing a brand-new antibiotic, they paired it with a small companion molecule that blocks a bacterial enzyme responsible for resistance, allowing the drug to do what it used to do best: kill bacteria. Considering that Big Pharma isn’t really breaking the bank chasing the next blockbuster antibiotic, one should be grateful maybe that researchers are building libraries of clever molecules that can restore the potency of existing drugs.
(Nature Communications)
Bottom line
A drain on the national wallet. Yes, we’re back to talking about climate change. Because India’s informal workforce is currently subsidising climate change by burning through roughly $78 billion in lost wages annually, roughly 2% of the national GDP. These workers, mostly migrants trapped in construction, brick-making, and agriculture, are losing up to 9% of their income because their bodies simply shut down in the sweltering conditions. The misery extends well beyond the workday, as many return to cramped, airless shelters that offer zero relief from the daytime furnace. With nearly a fifth of surveyed workers suffering from heat-induced kidney issues due to a lack of basic sanitation and hydration, the situation highlights a systemic failure to protect those doing the most physically demanding jobs. In a country like India, these numbers are still deceptive. Because these workers, this informal workforce, they’re the ones making all the buildings and the bridges and the tunnels and all the private and public infrastructure around the country. Right now, climate change is only accounting for 2% of national GDP bleed from them but if the country doesn’t make living conditions better for them, we might discover that all the castles we’ve built will come crumbling down around us.
(IIED)
The comeback kid. Just a few stories up, we spoke about how disease patterns are no longer what they once were. Here is proof by way of dengue which is enjoying a remarkable career resurgence thanks to climate change and chaotic urban planning, with warmer temperatures effectively turning previously safe zones into mosquito playgrounds. A systematic review of recent studies confirms that rising heat accelerates viral replication and extends the transmission season, allowing Aedes mosquitoes to thrive in highland and temperate regions that were once immune. This biological upgrade is compounded by unplanned urban sprawl, deforestation, and inadequate sanitation infrastructure, creating perfect breeding grounds in densely populated areas where residents have little control over their environment or health outcomes. The geographic expansion of the virus means that communities in low- and middle-income countries (LMICs) are facing a dual threat of hotter weather and more aggressive disease vectors, often without the resources to implement effective early warning systems or vector control.
(PLOS Neglected Tropical Diseases)
Woah, woah, woah! So many human illnesses in recent history can be attributed to animals. One would think this would’ve resulted in an increased budget for global animal health. But no, it is still being treated as an afterthought, receiving a mere fraction of a per cent of worldwide health spending. So what if it is the primary defence against pandemics and food insecurity. The latest report from the World Organisation for Animal Health (WOAH) highlights that diseases wipe out over 20% of global animal production yearly, devastating livelihoods in developing nations where livestock are essential for survival. Yet, veterinary services remain critically underfunded, with many countries seeing declines in capacity just as outbreaks of avian influenza, foot-and-mouth disease, and screwworm fly threaten to spiral out of control. The report also has a nod to irony, saying that bringing every country’s veterinary system up to international standards would cost less than a tenth of one per cent of the economic losses incurred as a result of the Covid pandemic, which likely originated from animals. Without integrating animal health into broader economic and security strategies, the world remains dangerously exposed to the next spillover event. But hope can move mountains, right? Who needs robust surveillance then?
(WOAH)
Long reads
A legacy unsought. We have a fair few items in this section as well today. Beginning with this piece in The Conversation talking about how political violence impacts the lives of young Africans for many, many years. The young people surveyed for this piece are from Côte d’Ivoire, Kenya, Malawi, Mozambique, Namibia, Nigeria, Uganda, Zambia and Zimbabwe. One dreads to think what a similar survey would present from respondents in Congo and Sudan.
(The Conversation)
Everything everywhere all at once. Another sobering read from The Conversation about the confluence of crises affecting the Greater Horn of Africa. Take your pick. Conflict. Climate change. Disease. Famine. Inflation. There is nothing that is off the table.
(The Conversation)
Gumming up the works. A brilliant exposé by The Reporters’ Collective on the loopholes that allow for a flourishing cannabis delivery business in India’s alternative medicine ecosystem.
(The Reporters’ Collective)
Tying ‘em up in knots. An investigation by Lighthouse Reports into Big Food and how much they care for public health around the world. Hint: Big Food cares about as much as Israel cares about people in Gaza.
(Lighthouse Reports)
And finally, speaking of Israel, a new report by Palestinian Feminist Collective traces Israel’s history of predatory, sexual violence. History that began in 1948.
(Palestinian Feminist Collective)