The death rate from malaria dropped by 45 percent globally between 2000 and 2012, the World Health Organization reported Wednesday. In Africa, the rate fell by almost half.
Despite this progress, the mosquito-borne disease remains a serious problem in the developing world, said Dr. Robert Newman, who heads WHO's global malaria program. There were more than 200 million cases of malaria in 2012, and the disease killed an estimated 627,000 people last year.
"The burden is not equally distributed," Newman told reporters at a briefing in Washington Wednesday. Seventeen countries in the world account for 80 percent of the malaria deaths, he said. Sixteen of those countries are in Africa. The other country in that group is India.
Nevertheless, Newman calls the 45 percent reduction in malaria deaths a huge turnaround. "That's pretty astonishing for a disease that had been neglected and abandoned," he said. "People had decided that [malaria] is just something you have to live with in Africa, in Asia, in the Americas."
The other good news in WHO's report is that, compared with 12 years ago, more kids in Africa are sleeping under insecticide-treated bed nets and more people have access to malaria drugs that actually work. Plus, rapid diagnostic tests are now widely available in most low-income countries.
The billions of dollars spent by governments and foundations over the last decade to fight malaria are paying off, Newman says.
Still though, challenges from malaria remain huge. Resistance to some of the most effective malaria drugs has started to develop in Southeast Asia. Efforts to produce an effective vaccine, so far, haven't panned out.
Although the number of malaria cases is going down, it's clear that the world will fall far short of the World Health Assembly's goal to slash the number of malaria cases by 75 percent by 2015.
And malaria isn't just a just a deadly disease in Africa, said Joy Phumaphi, the former health minister of Botswana. It's also a tremendous economic burden on the continent.
"Once a child presents with a fever, a mother has to take care of that child," Phumaphi told Shots. "The mothers are the main breadwinners in rural communities." They plow the fields, and they go and sell produce in the markets, she says.
"As soon as the child becomes sick, the mother cannot do that anymore," Phumaphi said. "So her income shrinks. And she has to take the limited money that she was going to spend on food or educating her children to now go and buy medicines."
If drug companies follow "guidance" issued Wednesday by the Food and Drug Administration, within three years it will be illegal to use medically important antibiotics to make farm animals grow faster, or use feed more efficiently.
The FDA's announcement wasn't a big surprise; a draft version of the strategy was released more than a year ago.
The bigger news is that the two biggest veterinary drug companies, Elanco and Zoetis, said Wednesday that they will, in fact, follow the FDA's advice and make it illegal for farmers to use their drugs for growth promotion. The Animal Health Institute, which represents most of the industry, likewise expressed enthusiastic support for the FDA's move.
Wednesday's announcement is the latest step in a long-running, sometimes convoluted effort by the FDA to reduce the use of antibiotics in agriculture. As we've reported in our series Pharmed Food, public health advocates are concerned that livestock producers' widespread use of antibiotics could produce more drug-resistant bacteria, first in animals and eventually infecting people. They're especially concerned about the industry's practice of giving animals low doses of the drugs when they're not sick to make them put on weight faster. Those low doses are more likely to create resistance than high doses for animals that are sick, they argue.
In the newly official guidance, the FDA is hoping to reduce the "subtherapeutic" use by revising drug labels, which define the legal uses of each drug. The FDA is asking companies to remove "growth promotion" or "feed efficiency" as a legal use of any drug that is also used in human medicine. If those uses do not appear on the label, farmers can no longer legally use the drug for those purposes.
The label changes are supposed to happen within three years. Companies have 90 days to say whether they intend to do this or not.
The FDA's announcement inspired diverse reactions. The Animal Health Institute, which has downplayed the risks of farm antibiotic use, promised to support the FDA's initiative — in part for public relations reasons. The AHI's Richard Carnevale told reporters in a conference call that it could help to dispel the common, but incorrect, belief that growth promotion accounts for most antibiotic use in agriculture. He says that most antibiotics are used to prevent or treat disease.
It's impossible to know how many of the antibiotics that farmers use are for growth promotion. The government doesn't collect that information.
Some critics of antibiotic use on the farm condemned the FDA strategy for not going far enough. The Natural Resources Defense Council called it "a free pass to industry" because it relies on voluntary cooperation, rather than binding regulations. The Johns Hopkins Center for a Livable Future predicted that the re-labeling exercise will fail to reduce antibiotic use because farmers may just continue to give animals the drugs at low doses for "disease prevention" instead.
Other public health advocates were cautiously optimistic. Laura Rogers, who directs the Pew Charitable Trusts' human health and industrial farming campaign, called it a "promising start."
Veterinarians will play a key role in enforcing the new labels, and making sure that antibiotics aren't used to promote growth under the guise of disease prevention. They also may be required to sign off on all uses of medically important drugs, if another draft regulation released Wednesday is adopted.
Currently, many of these drugs, such as tetracycline, are available over-the-counter. If the FDA caught a veterinarian prescribing these drugs for growth promotion purposes, that veterinarian could lose his or her license.
John Morse was president of the Colorado Senate until September, when he became the first elected official recalled in the state's history.
Three months later, he's climbing the rotunda steps of the gold-domed Capitol building — his office for seven years. He hasn't been here since October. Gazing up at the dome, he says, "This is one of my favorite things to do. That's my version of smelling the roses."
Morse's political career ended over the gun bills he pushed through these chambers eight months ago. But he says he would do it all again.
"I have zero regrets," he says. "Keeping people safe is my No. 1 priority, and if that costs me my political career, that's a really small price to pay to keep people from dying at the hands of an M16 in a schoolhouse or in a theater."
One year ago, a gunman killed 26 people, most of them children, in Newtown, Conn. The attack came just months after a shooter killed 12 in a movie theater in Aurora, Colo. The attacks prompted a push for state and federal legislation to address gun violence across the country. Colorado moved quickly, passing new limits on ammunition magazines and implementing universal background checks for gun purchases.
But there's been a big backlash from some Colorado voters. Morse and state Sen. Angela Giron, a fellow Democrat from a similar conservative-leaning district, were recalled in the months after those bills became law. And another Democratic state senator facing the threat of a recall, Evie Hudak, resigned in November.
The recall efforts that ousted Morse and Giron garnered a lot of national attention. The National Rifle Association and other gun groups poured in tens of thousands of dollars, as did New York Mayor Michael Bloomberg on the other side.
But it wasn't just Newtown or Aurora that drove Morse to push for the gun legislation. He's a former cop and was a paramedic before that.
"So I have been to literally hundreds of shootings," he says. "I don't think people understand at all ... the state of gun laws in this country that make it so easy for people to die and/or be seriously injured by a gun."
From Recall Leader, A Different View
But just as Morse was driven by personal experiences with gun violence, so was another Colorado man on the opposite side of the spectrum.
Sixty miles north of the Capitol, in conservative Weld County, is the farming town-turned-suburb of Windsor. It's where Joe Neville heads up political organizing for the Rocky Mountain Gun Owners, the group that led the Morse recall effort.
"I went to Columbine High School," Neville says. "I wasn't there the day of the tragedy, but I had left a few months earlier. I did have a brother in the school that day, a sister-in-law in the school that day."
Neville, young and clearly passionate, is sitting on a leather couch at the back of the office. The wood-paneled walls are adorned with Revolutionary War paintings and pictures of Ronald Reagan.
Gun-free zones around schools, he says, "are really just target-rich zones for criminals. And that's exactly what happened that day, is that you had a bunch of students there that had no defense around them."
Since the Columbine shootings, Neville says he's worked tirelessly for gun rights. He says armed teachers with the right training could have saved lives on that day back in 1999, or last year in Newtown.
Asked about the recall campaign that he helped coordinate, Neville's face widens into a proud grin.
"Any time you can get tens of thousands of people across a state, in each district, to come out and fight for freedom, yeah, it makes me happy," Neville says. "It gives me hope that the radical leftists that are controlling Washington, D.C., and all the way down to the state and county levels, they don't control the people. Which is what they want to do, they want to control the people."
Listening to these two men — the gun-rights activist and the ousted state senator — you get a real sense of the two Colorados: deep red and deep blue. It's not unlike the way people talk about national politics these days.
But in Colorado, there is a middle ground. Polls have shown support for some gun-control measures, like expanded background checks. Still, three months after the recalls, eight months after the bills passed, a year after Newtown and 17 months after Aurora, Neville and Morse are still as dug in as ever.
"Second Amendment is, as written in the Constitution, we don't compromise on our gun rights, at all," Neville says.
Morse says that's "ridiculous. I mean, that's just asinine. And yet that's where the Republicans are: 'Nope, we don't need background checks. Everybody that wants a gun gets a gun.' "
Looking Forward, From Different Corners
Morse, the ousted Senate president, packed up and moved out of his hometown, Colorado Springs, after he was recalled. He's now living in Denver, where he's starting a new group to push for universal background checks across the country.
"In Colorado, we fixed the problem," Morse says. "But there are plenty of other states in this country where you can go to a gun show and buy a gun without a background check, much less go to the trunk of someone's car on a street corner and buy a gun. That's just not a good idea."
And for Neville, there are no more recall efforts on his agenda right now. He's focused on more Democrats in swing districts whom his group considers vulnerable on guns.
"The individuals, the people, the citizens in Colorado specifically, are standing up. We're going to move things back in the right direction," he says.
There is one thing these two men agree on: The fight over gun control versus gun rights is going to continue in Colorado. They're both looking to the 2014 elections as the next battleground.
Meatpacking plants used to be located in urban centers like Kansas City and Chicago. Over the past few decades, many plants have moved to rural Midwestern towns, which have seen a huge influx of immigrants as a result. Yesterday, we reported on tiny Noel, Mo., which has struggled to help assimilate the newcomers who work at a large poultry plant. Today, we have this report from Garden City, Kans., a meatpacking town that embraces its new cultures.
The chemistry lab at Garden City Community College is buzzing, and Binh Hua and My Nguyen are at the front of the class. The two young women wear protective goggles, their long black hair pulled into ponytails, as they wait for the professor to bring the class to order.
These Vietnamese 18-year-olds have both benefited from the beef industry since their parents moved here to work in the huge Tyson Food, Inc., plant. Now they dream of computer and medical degrees as their parents do the hard work of turning animals into beef at a slaughterhouse on the outskirts of town. Both students graduated from high school in just three years and they're trying to earn associate degrees by next year.
"We really like to graduate early because we think high school wasn't challenging enough and we were looking for challenging courses and stuff —" Hua says.
"— And we get a head start in college," Nguyen adds.
Hua and Nguyen represent the newest chapter in an age-old American story: immigrants have always worked in the meatpacking plants, lured by steady — if hard — work. Since 1980, when the first slaughterhouse was built in Garden City, Kans., the newcomers have doubled the population to roughly 30,000, and turned a white cowtown into a cultural crossroads where minorities are now the majority. But Garden City's response differed from many in the rural Midwestern towns. City leaders decided early on that they would embrace these newcomers.
"The vision was: we have these people here, are we going to accept them as a blessing or are we going to consider them a curse?" asks Levita Rohlman, who was part of a faith-based group that helped usher in the new wave of Garden City's immigrants.
Joining many Mexican-Americans here in the early 1980s were Vietnamese and other Southeast Asians. And then came immigrants from South America. Now it's Somali and Burmese refugees who are settling.
Abdifatah Abdullahi is a 25-year-old Somali who landed in Garden City almost a year ago. He works the second shift at Tyson, is a part-time Somali translator at the local refugee center and attends college. Abdullahi says it should be obvious why he came here: "To look for a better life and to look for a better education. That's what I come to look for here."
What he and others found was a large network of social services: Food banks, shelters, English classes and job assistance.
Take one of Garden City's "newcomer" classes, located at a local elementary school. In this class, kids are temporarily separated from the rest of the school so they can try to assimilate into their new surroundings. Many were born in refugee camps and have never seen basic plumbing, let alone a pencil. And some of them are simply hungry. The starting pay at the Garden City Tyson plant is $13.50 an hour, but it's difficult to support a family on that. Three-quarters of the students get free or reduced-price lunch and requests for food stamps are up 230 percent in just the last five years.
Garden City's refugee and immigrant population is expected to grow, as Tyson continues recruiting more workers. And those who arrive here will get lots of help and a hand up toward a better life.
Back at the chemistry lab, Binh Hua says that she's doing OK in the class and that she doesn't leave the library until it closes every night at 10 p.m.. Even then, she still gets home before her parents who work the late shift at the Tyson plant, her father on the hot, bloody kill floor, her tiny mother using a razor-sharp knife to cut the hulks of beef.
"My mom and dad just always said, 'I'm doing this for you,'" Hua says.
Giant batteries are coming to a power grid near you. In fact, they're already starting to appear on the grid in California.
That's because California is planning to rely increasingly on power supplies that aren't necessarily available every minute of every day. The state plans to get one-third of its electricity from wind and solar energy by 2020.
Utilities in the state are trying to figure out how they can cope with that uncertain power supply. Batteries aren't a panacea, but they could help.
Pacific Gas & Electric Co. is already starting to figure out how to make the most of batteries with a test at its Vaca-Dixon substation, near the Northern California town of Vacaville.
"Unfortunately there are no dancing bears, no mice running on wheels, so it's not that exciting," jokes PG&E's Dave Fribush, as he leads us to two gray cabinets the size of moving vans.
Inside is enough battery power to store the amount of energy that two large wind turbines generate over the course of seven hours. It's only a small fraction of California's energy need, but it's part of a bigger experiment that the California Public Utilities Commission has launched. The commission has called for hundreds of batteries of this scale to be connected to the grid over the next seven years, with a potential price tag of $5 billion.
Here's the catch. Nobody really knows how the batteries can best smooth out the irregular power supply from wind and solar power.
"There are many possible different uses for a battery on an electric grid," says Todd Strauss, Senior Director for Energy Policy Planning and Analysis at PG&E. "And the question becomes, how does it get used in practice in those different ways? What are the relative costs of actually using a battery in those different ways?"
Looking at the batteries looming over us, Strauss adds, "This is one attempt to try to get some sense of that."
You can think of a fully charged battery as a source of energy, ready to sell its product to the electric grid, just the way a power plant does. For that to work, battery owners would need to buy electricity to charge the battery when the price is low, and then sell that electricity back to the grid when the price is high.
But that idea turns out to be a dud.
"I think in the hour we did it the battery made nine dollars," say Fribush, who manages battery storage integration at PG&E. "So we have a long way to go. We're not even making (San Francisco's) minimum wage with the system yet!"
That's partly because batteries aren't very efficient. Batteries waste about 25 percent of the energy in the process of being charged and discharged. These sodium-sulfur batteries need to be heated to 600 degrees Fahrenheit to work.
Considering this battery setup cost $10 million, they need to find a more valuable use of its time.
Strauss expects batteries could be useful in keeping the overall electric grid reliable — and the grid operators will pay for that service, too. Electricity supply needs to match electricity demand second by second, and batteries can provide some of that essential fine-tuning.
"So there's no doubt," Strauss says, "that as we get more renewables — particularly more wind, and especially more solar photovoltaics — on the system, there needs to be a lot more flexibility on the system." Power supply and demand will need to be adjusted — hour by hour, as well as minute by minute — to deal with passing clouds and fickle winds.
And batteries can't fill in if the wind stops blowing for days or weeks, as sometimes happens. Instead, PG&E will fall back on its gas-fired power plants during those stretches, or it might import more energy from out-of-state.
"And also we'd look to the customer side," Strauss says.
Industrial customers can sometimes scale back their power demands. And - maybe, someday — home appliances will be able to reduce their power consumption automatically when supply is lean.
Batteries aren't the only storage option for short-term needs. PG&E owns two reservoirs in the High Sierra that are connected to one another. When there's abundant power on the grid, the utility pumps water uphill. And when the demand for power rises, they can let the water flow through turbines to generate electricity.
Utilities are also experimenting with flywheels as a way to store energy. And PG&E is thinking about pumping compressed air into underground caverns. They can then release that pressurized air to power a turbine. And thermal solar energy is a method of storing energy in the form of heat — molten salt.
Strauss says they have lots of choices. "It all seems technologically possible," he says, "but at the end of the day the question is, 'What will it cost?' "
Batteries will find some role, but they are still very expensive. Strauss says for batteries to succeed, the technology needs the kind of revolution that brought down the price of solar panels by about 75 percent over the past decade.
"If we get that for batteries, terrific," he says. "If battery costs remain what they are today, that's not so good and we're likely to look for different kinds of technology."
And there's not much time to figure this out. Utilities like PG&E are preparing for a huge surge of on-and-off power supplies in the next six years, as California's wind and solar industries ramp up to meet the state's 2020 renewable energy goal.
The lessons learned in California can inform the decisions of many other states, as they ponder how to deploy their own renewable energy resources.