Ebola treatment center in Congo reopens after attack

(Reuters) – An Ebola treatment center located at the epicenter of the current outbreak in eastern Democratic Republic of Congo has resumed operations after it was attacked last month, the country’s health ministry said on Saturday.

The center run by Medecins Sans Frontieres (MSF) in the district of Katwa was set on fire on Feb. 24 by unknown attackers, forcing staff to evacuate patients.

It re-opened on Saturday, the ministry said in a statement.

“For now it is managed by the ministry in collaboration with the World Health Organisation (WHO) and UNICEF,” it said, referring to the United Nations children’s fund.

Aid workers have faced mistrust in some areas as they seek to contain the Ebola outbreak, which has become the most severe in Congo’s history. The WHO has said the distrust is fueled by false rumors about treatments and preference for traditional medicine.

Another MSF center in Butembo was also attacked in late February but reopened a week later.

MSF has pulled out from the area since the two attacks and has not said when it might resume medical activities.

The current Ebola epidemic, first declared last August, is believed to have killed at least 561 people so far and infected over 300 more.

Reporting by Fiston Mahamba; Writing by Juliette Jabkhiro; Editing by Marie-Louise Gumuchian

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Cholera cases increase to 271 in Mozambique’s cyclone-hit Beira

Medical staff wait to treat patients at a cholera centre set up in the aftermath of Cyclone Idai in Beira, Mozambique, March 29, 2019. REUTERS/Mike Hutchings

MAPUTO (Reuters) – The number of confirmed cases of cholera in Mozambique’s cyclone-hit port city of Beira has nearly doubled to 271 in the last 48 hours, the southern African nation’s government said on Saturday.

Government and aid workers are seeking to contain the spread of the disease after cyclone Idai smashed into Beira on March 14, unleashing catastrophic flooding and killing more than 700 people in Mozambique, Zimbabwe and Malawi.

At the opening of a temporary treatment center in Beira, Environment Minister Celso Correia said there had been 271 cases of cholera reported. He said 138 of those had arrived at medical centers in the last 48 hours.

“We don’t have any deaths registered within our hospitals,” Correia said.

On Friday, he said at least two people had died outside hospitals with symptoms including dehydration and diarrhea.

Many areas in Mozambique and Zimbabwe that were heavily hit by the storm still cannot be accessed by road.

Cholera is endemic to Mozambique, which has had regular outbreaks over the past five years. About 2,000 people were infected in the last outbreak, which ended in February 2018, according to the WHO.

Mozambican authorities said on Saturday the number of deaths from the cyclone stood at 501, bringing the total of fatalities across Mozambique, Zimbabwe and Malawi to 746.

Reporting by Manuel Mucari; Writing by Mfuneko Toyana; Editing by Marie-Louise Gumuchian

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CMS Ignores Federal Judge Ruling To Approve Medicaid Work Rules in Utah

Less than 48 hours after a federal judge struck down Medicaid work requirements, the Centers for Medicare & Medicaid Services on Friday gave Utah permission to use those mandates.

CMS Administrator Seema Verma said in her approval letter that requiring Medicaid enrollees to work was allowed because it helps make them healthier.

“Therefore we believe an objective of the Medicaid program, in addition to paying for services, is to advance the health and wellness needs of its beneficiaries, and that it is appropriate for the state to structure its demonstration project in a manner that prioritizes meeting those needs,” she wrote.

Verma’s stance runs directly counter to U.S. District Court Judge James Boasberg, who in twin rulings Wednesday said work requirements in Arkansas and Kentucky are illegal under the 1965 Medicaid law. Boasberg said several times that promoting health was not the objective of Medicaid, despite that opinion from Verma and Health and Human Services Secretary Alex Azar.

In his Kentucky ruling, Boasberg wrote that using health as an objective would be “arbitrary and capricious.”

Promoting health, he added, is “far afield of the basic purpose of Medicaid: ‘reimbursing certain costs of medical treatment for needy persons.’”

Verma noted that Utah is structuring its program somewhat differently than other states.

Sara Rosenbaum, professor of health law and policy at George Washington University in Washington, D.C., said the Trump administration is “doubling down” by allowing a state to add work requirements.

“This is such a remarkable example of sticking a finger in the eye of the court,” Rosenbaum said. “We will see what happens. Because when you disrespect a court, it can backfire.”

CMS’ approval also allows Utah to cap enrollment if the state runs out of money.

Health experts said Utah’s letter clearly shows that the Trump administration plans to appeal Boasberg’s decision.

In addition to Kentucky, Arkansas and Utah, CMA has approved Medicaid work requirements in Arizona, Indiana, Michigan, New Hampshire, Ohio and Wisconsin.

Verma’s approval was for an application that Utah made in 2018. It will partly expand Medicaid to cover all adults under the poverty level ($12,490 for an individual this year). Enrollees will be asked to make some job searches but they will not be required to report a certain number of hours of work.

In November, Utah voters approved a ballot measure calling for the expansion to 138 percent of the federal poverty level (about $17,200) as allowed under the Affordable Care Act.

State officials expect about 90,000 people to gain coverage under the expansion approved Friday. About 150,000 people would have been covered under the plan approved by voters.

The plan approved Friday will require Utah to pay a bigger portion of the costs for the new enrollees because they will enter Medicaid under the traditional program and the state will get a 70 percent contribution from the federal government to cover their care. If the state had expanded to 138 percent of poverty, the federal government would have paid 90 percent of the costs.

November’s vote raised concerns among state officials, who have opposed Medicaid expansion for years. They have opted instead to prepare another request to CMS that seeks the full 90 percent funding for the new enrollees. But to secure that, Utah is offering to accept unprecedented annual limits on federal and state spending.

Allison Hoffman, a law professor at the University of Pennsylvania, said getting a federal judge to accept the premise that Medicaid is improving health is vital to getting work requirements through the courts. Federal officials “need a judge to buy that,” Hoffman said. “They are going to fish for a different jurisdiction to push this opinion.”

What’s most compelling about the Utah approval, Hoffman said, is how the state legislature ignored the will of voters who approved the referendum. “The legislature is blocking what people voted for … and it appears to be an anti-democratic move.”

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Cholera cases jump to 138 in Mozambique’s Beira after cyclone

BEIRA, Mozambique (Reuters) – The number of confirmed cases of cholera in the cyclone-hit Mozambican port city of Beira jumped from five to 138 on Friday, as government and aid agencies battled to contain the spread of disease among the tens of thousands of victims of the storm.

Cyclone Idai smashed into Beira on March 14, causing catastrophic flooding and killing more than 700 people across three countries in southeast Africa.

Many badly affected areas in Mozambique and Zimbabwe are still inaccessible by road, complicating relief efforts and exacerbating the threat of infection.

Although there have been no confirmed cholera deaths in medical centers in Mozambique yet, at least two people died outside hospitals with symptoms including dehydration and diarrhea, the country’s environment minister Celso Correia said.

A Reuters reporter saw the body of a dead child being brought out of an emergency clinic in Beira on Wednesday. The child had suffered acute diarrhea, which can be a symptom of cholera.

“We expected this, we were prepared for this, we’ve doctors in place,” Correia told reporters.

The government said for the first time that there had been confirmed cholera cases on Wednesday.

Mozambique’s National Disaster Management Institute said the local death toll from the tropical storm had increased to 493 people, from 468 previously.

That takes the total death toll across Mozambique, Zimbabwe and Malawi to 738 people, with many more still missing.

“Stranded communities are relying on heavily polluted water. This, combined with widespread flooding and poor sanitation, creates fertile grounds for disease outbreaks, including cholera,” the International Committee of the Red Cross said in a statement.

The World Health Organization’s Tarik Jasarevic said 900,000 doses of oral cholera vaccine were expected to arrive on Monday.

The U.S. Defense Department said on Friday it had authorized an additional $8.5 million in humanitarian assistance for Mozambique, bringing the total to $15 million. About 50 U.S. military personnel have been sent to Mozambique to assist with logistics, including transporting food and medical supplies.

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Cholera is endemic to Mozambique, which has had regular outbreaks over the past five years. About 2,000 people were infected in the last outbreak, which ended in February 2018, according to the WHO.

But the scale of the damage to Beira’s water and sanitation infrastructure, coupled with its dense population, have raised fears that another epidemic would be difficult to put down.

Reporting by Stephen Eisenhammer in Beira and Stephanie Nebehay in Geneva; Additional reporting by Idrees Ali in Washington; Writing by Alexander Winning; Editing by Alison Williams and Rosalba O’Brien

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Factbox: Cyclone Idai’s death toll rises to 746, hundreds of thousands displaced

BEIRA, Mozambique (Reuters) – Hundreds of thousands of people are in need of food, water and shelter after Cyclone Idai battered Mozambique, Zimbabwe and Malawi.

FILE PHOTO: A woman walks past a small concrete slaughterhouse as waters begin to recede in the aftermath of Cyclone Idai, in Buzi near Beira, Mozambique, March 24, 2019. REUTERS/Mike Hutchings/File Photo

As of Saturday, at least 746 people had been reported killed by the storm, the flooding it caused and heavy rains before it hit. Following is an outline of the disaster, according to government and United Nations officials:


Cyclone Idai landed on the night of March 14 near the port city of Beira, bringing heavy winds and rains. Two major rivers, the Buzi and the Pungue, burst their banks, submerging entire villages and leaving bodies floating in the water.

People killed: 501

People injured: 1,523

Houses damaged or destroyed: 99,317

Crops damaged: 669,903 hectares

People affected: 1.85 million


On March 16, the storm hit eastern Zimbabwe, where it flattened homes and flooded communities in the Chimanimani and Chipinge districts.

People killed: 185, according to government. The U.N. migration agency puts the death toll at 259.

People injured: 200

People displaced: 16,000 households

People affected: 250,000


Before it arrived, the storm brought heavy rains and flooding to the lower Shire River districts of Chikwawa and Nsanje, in Malawi’s south. The rains continued after the storm hit, compounding the misery of tens of thousands of people.

People killed: 60

People injured: 672

People displaced: 19,328 households

People affected: 868,895

Reporting by Emma Rumney and Stephen Eisenhammer in Beira, Tom Miles in Geneva, MacDonald Dzirutwe in Harare and Frank Phiri in Blantyre; Writing by Alexandra Zavis; Editing by Catherine Evans

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Podcast: KHN’s ‘What The Health’ Health Care’s Back (In Court)

A federal district court judge in Washington, D.C., has blocked work requirements for Medicaid recipients in Arkansas and Kentucky. Since the Arkansas program took effect in 2018, more than 18,000 people have lost health coverage because they failed to report their work hours to the state.

Meanwhile, the Trump administration changed its position in a lawsuit filed by Republican state officials challenging the constitutionality of the Affordable Care Act. The administration is now officially supporting cancellation of the entire health law in light of Congress’ elimination in the 2017 tax bill of the penalty for failing to have insurance.

This week’s panelists are Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Margot Sanger-Katz of The New York Times, and Kimberly Leonard of the Washington Examiner.

Also, Rovner interviews filmmaker Mike Eisenberg about his movie “To Err Is Human: A Patient Safety Documentary.”

Among the takeaways from this week’s podcast:

  • In blocking the Arkansas Medicaid and Kentucky work requirements (Kentucky for the second time), U.S. District Judge James Boasberg said the Trump administration’s approval “did not address … whether and how the project would implicate the ‘core’ objective of Medicaid: the provision of medical coverage to the needy.”
  • A last-minute Department of Justice filing in another pending court case — this one renewing questions of whether the Affordable Care Act is constitutional — has thrown the national health care debate on its ear. The Trump administration Monday night changed its position on the case. Last summer, it refused to defend the health law in full, but said the tax law changes eliminating the penalty for not having insurance should result in only a few closely related provisions being declared unconstitutional. Now the administration agrees with the lower-court ruling in the case that the entire ACA is invalid.
  • Democrats were thrilled by what they see as a political misstep by the president. Democrats rode the health issue to victory in many 2018 elections and see this as an opening to pursue the issue even more strongly in 2020. House Democrats this week also unveiled proposals to expand and shore up the ACA.
  • The final sign-up numbers are in for individuals purchasing coverage on the ACA’s health exchanges. While enrollment dropped slightly, to 11.4 million, the continued stability of the individual insurance market suggests that eliminating the tax penalty is having less of an impact than some supporters of the law had feared.

Ask Us Anything!

Do you have a health policy question you’d like the panelists to answer? You can send it to whatthehealth@kff.org. Please include where you’re from and how to pronounce your name.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too:

Julie Rovner: The New York Times’ “My Friend’s Cancer Taught Me About a Hole in Our Health System,” by Aaron E. Carroll

Joanne Kenen: The Dallas News’ “Pain & Profit: Investigating Medicaid Managed Care in Texas,” by J. David McSwane and Andrew Chavez

Margot Sanger-Katz: Kaiser Health News’ “Medicaid Expansion Boosts Hospital Bottom Lines — And Prices,” by Phil Galewitz

Kimberly Leonard: CNN’s “The Inside Story of How John Roberts Negotiated to Save Obamacare,” by Joan Biskupic

To hear all our podcasts, click here.

And subscribe to What the Health? on iTunes, Stitcher or Google Play.

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Congo registers record 15 new Ebola cases in one day

GOMA, Democratic Republic of Congo (Reuters) – Democratic Republic of Congo on Friday recorded 15 new confirmed cases of Ebola, the biggest one-day rise since the current outbreak was declared last August, the health ministry said.

Coming a day after 14 new cases were confirmed, the number means the outbreak is on track to register one of its highest weekly case totals, despite health officials saying as recently as two weeks ago that it was largely contained and could be stopped by September.

Health workers have brought new tools to the fight against the latest epidemic of the hemorrhagic fever, including a vaccine and several treatments, but community mistrust of first responders and militia violence have set back the campaign.

Five Ebola centers have been attacked since last month, sometimes by armed assailants. The violence led French medical charity Medecins Sans Frontieres (MSF) to suspend its activities at the epicenter of the outbreak last month.

The current outbreak of the virus, which causes severe vomiting, diarrhea and bleeding, is the second largest in history behind the 2013-16 West African epidemic that killed more than 11,000 people.

Congo’s health ministry said that as of Friday the outbreak was believed to have killed 660 people and infected 399 more.

Reporting By Fiston Mahamba; Writing by Aaron Ross; Editing by Gareth Jones

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Red Cross says it sees conditions for humanitarian work in Venezuela

Francesco Rocca, President of the International Federation of Red Cross and Red Crescent Societies (IFRC), attends a news conference in Caracas, Venezuela Mach 29, 2019. REUTERS/Ivan Alvarado

CARACAS (Reuters) – Venezuela has met the necessary conditions for the Red Cross to carry out humanitarian work in the South American nation, the president of the International Federation of Red Cross and Red Crescent Societies said in a news conference on Friday.

Francesco Rocca said the group was in a position to help some 650,000 people in Venezuela, which has suffered rising incidence of malnutrition and preventable disease amid an economic collapse.

Reporting by Brian Ellsworth

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FDA approves treatment for adults with non-radiographic axial spondyloarthritis

The U.S. Food and Drug Administration today approved Cimzia (certolizumab pegol) injection for treatment of adults with a certain type of inflammatory arthritis called non-radiographic axial spondyloarthritis (nr-axSpA), with objective signs of inflammation. This is the first time that the FDA has approved a treatment for nr-axSpA.

“Today’s approval of Cimzia fulfills an unmet need for patients suffering from non-radiographic axial spondyloarthritis as there has been no FDA-approved treatments until now,” said Nikolay Nikolov, M.D., associate director for rheumatology of the Division of Pulmonary, Allergy, and Rheumatology Products in the FDA’s Center for Drug Evaluation and Research.

Nr-axSpA is a type of inflammatory arthritis that causes inflammation in the spine and other symptoms. There is no visible damage seen on x-rays, so it is referred to as non-radiographic.

The efficacy of Cimzia for the treatment of nr-axSpA was studied in a randomized clinical trial in 317 adult patients with nr-axSpA with objective signs of inflammation, indicated by elevated C-reactive protein (CRP) levels and/or sacroiliitis (inflammation of the sacroiliac joints) on MRI. The trial measured the improvement response on the Ankylosing Spondylitis Disease Activity Score, a composite scoring system that assesses disease activity including patient-reported outcomes and CRP levels. Responses were greater for patients treated with Cimzia compared to patients treated with placebo. The overall safety profile observed in the Cimzia treatment group was consistent with the known safety profile of Cimzia.

The prescribing information for Cimzia includes a Boxed Warning to advise health care professionals and patients about the increased risk of serious infections leading to hospitalization or death including tuberculosis (TB), bacterial sepsis (infection in the blood steam), invasive fungal infections (such as histoplasmosis, an infection that affects the lungs), and other infections. Cimzia should be discontinued if a patient develops a serious infection or sepsis. Health care providers are advised to perform testing for latent TB and, if positive, to start treatment for TB prior to starting Cimzia. All patients should be monitored for active TB during treatment, even if the initial latent TB test is negative. The Boxed Warning also advises that lymphoma (cancer in blood cells) and other malignancies, some fatal, have been reported in children and adolescent patients treated with tumor necrosis factor (TNF) blockers, of which Cimzia is a member. Cimzia is not indicated for use in pediatric patients. Cimzia must be dispensed with a patient Medication Guide that describes important information about the drug’s uses and risks.

Cimzia was originally approved in 2008 and is also indicated for adult patients with Crohn’s disease, moderate-to-severe rheumatoid arthritis, active ankylosing spondylitis (AS) and moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy.

The FDA granted the approval of Cimzia to UCB.



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How to transfer iBooks to Windows Computers

iBooks represents the Apple eBooks or eBook peruser. Alluding to the iBooks peruser, it is the authority incorporated application for clients to purchase and peruse Apple eBooks, yet as of not long ago it is still accessible for IOS 8.4 and Mac OSX 10.10 Yosemite or higher variants, this implies just the Apple clients with iPhone/iPad/iPod Touch or Mac computer can gain admittance to the iBooks truly. Contrasted with the thin screen IOS gadgets, numerous clients like to peruse on greater screen gadgets like Mac and Windows computers. It is remarkably agreeable to peruse iBooks on the desktop for its high clearness and goals screen, however, you may not utilize Mac computers constantly, so what would you be able to would in the event that you like to peruse iBooks, for example, the ePub documents on a Windows desktop? As a rule, you simply need to exchange iBooks to your PC and locate an alternative peruser.

The most effective method to exchange iBooks to Windows Computers

There are numerous approaches to exchange iBooks to Windows PC, following are the main three ones:

Exchange iBooks from Mac computer. For the iBooks which areas of now downloaded through iBooks application on a Mac computer, it is really simple to exchange. You can connect a USB streak drive, install ibooks on windows pc 10 & 8.1 to the glimmer drive by basic drag and drop from iBooks application, after that you can do it in the comparable method to duplicate the records from the blaze drive to your Windows desktop.

Exchange iBooks from IOS gadgets. On the off chance that you have just obtained and downloaded iBooks from the iPhone/iPad/iPod contact, you can straightforwardly associate your IOS gadget to the iTunes to match up the records to your Windows. It isn’t troublesome in any way. Subsequent to associating your IOS gadget to the iTunes like iPhone, you will see the gadgets tab menu from the correct side of the iTunes. If you don’t mind click menu ‘Document’ – > ‘Gadgets’ – > ‘Exchange Purchases from Administrator’s iPhone’ to exchange the iBooks to your Windows desktop. Or on the other hand alternatively, you can utilize a free IOS exchanging apparatus called iTools which is progressively adaptable to exchange the substance.

What you have to do is to dispatch the iTunes on your Windows computer, at that point login with the iTunes account from which you have just acquired the iBooks and snap ‘Account’- > ‘Bought’ to open the obtained substance list, next you can go to ‘Books’ tab and get the iBooks you need to download. Along these lines, you don’t have to interface any outside gadgets yet please ensure you have a decent web speed. Else it may require a long investment to download.