Venezuela’s Health Care System Continues Downward Spiral

U.N. and international health agencies say Venezuela’s health care crisis is causing a rise in infectious diseases and the re-emergence of illnesses such as malaria and tuberculosis, once considered vanquished.

The World Health Organization (WHO) blames Venezuela’s complex political and socio-economic situation for the virtual collapse of the country’s health care system.  It says the system is under stress because of a shortage of doctors and nurses who have left the country, as well as a lack of medical supplies and other factors.

WHO spokesman Tarek Jasarevic says this is having an adverse impact on many essential programs, including those related to disease prevention and control.  He told VOA immunizing children against killer diseases has been a major casualty of the deteriorating health services in the country.  

He said the first recent case of measles in the country was reported in July 2017. Since then, he said, there have been nearly 6,400 confirmed cases, including 76 deaths.  Jasarevic said a similar situation has arisen with diphtheria, and that an outbreak of the disease in July 2016 lasted until January of this year, causing more than 2,500 cases and 270 deaths.

“That is why there was a push for vaccination, and as a result of a concerted effort to halt the measles outbreak between April and December 2018, more than 8 million children between the ages of six months and 15 years were vaccinated against measles, and 4.8 million children between the ages of seven and 15 years were vaccinated against diphtheria,” Jasarevic said.

WHO reports malaria cases in Venezuela have increased significantly over the past three years, nearly tripling from over 136,000 in 2015 to more than 400,000 cases in 2017.  It attributes this rise to the migration of people infected in the mining areas of Bolivar state into other areas of the country, as well as a shortage of antimalarial drugs.

Jasarevic said the WHO is supporting 23 hospitals, training health personnel and preventing infectious diseases.  He said about 50 tons of supplies and medicines have been distributed across all hospitals.

More than 3 million Venezuelans have fled to Colombia, Ecuador, Peru and Brazil to escape what is considered the worst humanitarian crisis in the Western Hemisphere.

 

 


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China Faces Challenges in Containing Swine Flu Infection

The Year of the Pig is getting off to a rough start in China as the world’s largest consumer of pork and home to half the world’s pigs struggles to contain the spread of the African swine fever (ASF) virus.

Recent incidents, where traces of the virus were found in samples of frozen pork dumplings, suggest the outbreak is more widespread than has been reported, analysts said.

They add that the disease could have devastating socioeconomic consequences for both Chinese consumers and the global pig industry.

Latest outbreaks

Over the weekend, food safety regulators in southern Hunan and northwest Gansu provinces identified traces of the virus in pork products, including frozen dumplings.

The first outbreaks of African swine flu showed up in the northeastern province of Liaoning in August of last year.

Since then, China has reported more than 100 outbreaks from 25 of the country’s 34 provincial-level administrative units, according to the Food and Agricultural Organization under the United Nations.

Of China’s population of 430 million pigs, nearly one million have been culled because there’s not yet a vaccine to prevent and halt the spread of the virus.

The losses have added pressure to local pig farmers, who are already be set with rising feed costs brought on by U.S.-China trade frictions.

Food scare

Chinese authorities have worked with food manufacturers to address the latest outbreaks, but it remains unclear if all contaminated frozen pork products have been located and destroyed.

Although the virus poses no risk to human health, people are likely to be one of the carriers of the disease and can spread the virus through contaminated water or waste food.

The disease is highly contagious among domestic and wild pigs and the virus is very difficult to eradicate. It can survive for an hour at boiling temperatures, days in the environment, weeks in meat or even months in frozen meat products.

It has taken some European countries more than a decade to eradicate the virus after it was first introduced to Georgia in 2007.

Under control?

Prior to recent outbreaks, Chinese authorities claimed the country’s infection had been brought under control  an assertion analysts find unlikely.

“This is not impossible, but unlikely given the enormously high density of domestic pigs in China over a geographical space larger than France, Germany, Belgium and the Netherlands combined,” Dirk Pfeiffer, the chair professor of One Health from the City University of Hong Kong’s college of veterinary medicine and life sciences, said in an email to VOA.

Another challenge is China’s “high proportion of small to medium size pig farms with low biosecurity which don’t have the financial means to invest into better facilities,” he added.

The professor expressed concern over the possibility of under-reporting by Chinese farmers as they may not be provided an adequate level of compensation when pigs are culled.

China offers $179 (1,200 yuan) for each culled pig.

The dilemma lies in the balance, he said. If the compensation is too low, farmers are less likely to report. But too high, some may be incentivized to introduce the disease themselves and collect the fee.

Chinese officials have called on all stakeholders in the industry to cooperate with its efforts in stopping the virus’ spread.

Although few of its neighbors, such as Hong Kong, Macau and Mongolia, import pork from China, the epidemic still puts many other Asian countries at high risk. Vietnam, in particular, is one of the 10 largest pork producers in the world and shares a border with China.

Cross-border transmission

On Tuesday,the Animal Health Department of Vietnam, confirmed the country’s first outbreaks of the infection on three farms located in Hung Yen and Thai Binh provinces, southeast of the capital, Hanoi, claiming that all pigs had been culled.

Analysts said the epidemic will change the landscape of pig industries in China and globally.

“There will be a shift towards larger farms which can afford better facilities and that also means they are able to implement better biosecurity,” professor Pfeiffer said.

The feeding of waste food to pigs will decline because the practice is a common mechanism for spreading this virus, he added.

Deng Jinping, an animal science professor at South China Agricultural University, said he’s confident China has taken all necessary steps, including a ban on kitchen waste to pigs.

Enforcement, however, is always key for a sprawling country like China.

But the crisis, he added, will present opportunities for the country’s massive pork industry to foster a better future.

“The butchery industry may be forced to seek a better development. Many would hope that the [long distance] transport of live pigs will be replaced by the use of refrigerated transportation. That will better manage risks for the third parties or across different regions. So, big changes to the industry can be expected,” Deng said.


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China Faces Challenges in Containing African Swine Fever

The Year of the Pig is getting off to a rough start in China as the world’s largest consumer of pork and home to half the world’s pigs struggles to contain the spread of the African swine fever (ASF) virus.

Recent incidents, where traces of the virus were found in samples of frozen pork dumplings, suggest the outbreak is more widespread than has been reported, analysts said.

They add that the disease could have devastating socioeconomic consequences for both Chinese consumers and the global pig industry.

Latest outbreaks

Over the weekend, food safety regulators in southern Hunan and northwest Gansu provinces identified traces of the virus in pork products, including frozen dumplings.

The first outbreaks of African swine fever showed up in the northeastern province of Liaoning in August of last year.

Since then, China has reported more than 100 outbreaks from 25 of the country’s 34 provincial-level administrative units, according to the Food and Agricultural Organization under the United Nations.

Of China’s population of 430 million pigs, nearly one million have been culled because there’s not yet a vaccine to prevent and halt the spread of the virus.

The losses have added pressure to local pig farmers, who are already be set with rising feed costs brought on by U.S.-China trade frictions.

Food scare

Chinese authorities have worked with food manufacturers to address the latest outbreaks, but it remains unclear if all contaminated frozen pork products have been located and destroyed.

Although the virus poses no risk to human health, people are likely to be one of the carriers of the disease and can spread the virus through contaminated water or waste food.

The disease is highly contagious among domestic and wild pigs and the virus is very difficult to eradicate. It can survive for an hour at boiling temperatures, days in the environment, weeks in meat or even months in frozen meat products.

It has taken some European countries more than a decade to eradicate the virus after it was first introduced to Georgia in 2007.

Under control?

Prior to recent outbreaks, Chinese authorities claimed the country’s infection had been brought under control  an assertion analysts find unlikely.

“This is not impossible, but unlikely given the enormously high density of domestic pigs in China over a geographical space larger than France, Germany, Belgium and the Netherlands combined,” Dirk Pfeiffer, the chair professor of One Health from the City University of Hong Kong’s college of veterinary medicine and life sciences, said in an email to VOA.

Another challenge is China’s “high proportion of small to medium size pig farms with low biosecurity which don’t have the financial means to invest into better facilities,” he added.

The professor expressed concern over the possibility of under-reporting by Chinese farmers as they may not be provided an adequate level of compensation when pigs are culled.

China offers $179 (1,200 yuan) for each culled pig.

The dilemma lies in the balance, he said. If the compensation is too low, farmers are less likely to report. But too high, some may be incentivized to introduce the disease themselves and collect the fee.

Chinese officials have called on all stakeholders in the industry to cooperate with its efforts in stopping the virus’ spread.

Although few of its neighbors, such as Hong Kong, Macau and Mongolia, import pork from China, the epidemic still puts many other Asian countries at high risk. Vietnam, in particular, is one of the 10 largest pork producers in the world and shares a border with China.

Cross-border transmission

On Tuesday,the Animal Health Department of Vietnam, confirmed the country’s first outbreaks of the infection on three farms located in Hung Yen and Thai Binh provinces, southeast of the capital, Hanoi, claiming that all pigs had been culled.

Analysts said the epidemic will change the landscape of pig industries in China and globally.

“There will be a shift towards larger farms which can afford better facilities and that also means they are able to implement better biosecurity,” professor Pfeiffer said.

The feeding of waste food to pigs will decline because the practice is a common mechanism for spreading this virus, he added.

Deng Jinping, an animal science professor at South China Agricultural University, said he’s confident China has taken all necessary steps, including a ban on kitchen waste to pigs.

Enforcement, however, is always key for a sprawling country like China.

But the crisis, he added, will present opportunities for the country’s massive pork industry to foster a better future.

“The butchery industry may be forced to seek a better development. Many would hope that the [long distance] transport of live pigs will be replaced by the use of refrigerated transportation. That will better manage risks for the third parties or across different regions. So, big changes to the industry can be expected,” Deng said.


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From Smarter Energy to Less Plastic, Caribbean Resorts Go Green

At home in the United States, Kerrie Springer takes pride in being environmentally conscious. So when she booked a week’s getaway at the Bucuti and Tara Beach Resort in Aruba, she choose the “green stay” option, agreeing to reuse her sheets and towels rather than have them changed each day.

“You don’t do that at home, so why do it at a resort?” asked Springer, who visited the resort with her husband. “Water in the Caribbean is precious, so why use it if you do not have to?”

Environmentally friendly tourism options — available at a growing string of hotels across the Caribbean — are proving popular with tourists, helping curb climate change and waste, industry groups say.

The Bucuti and Tara resort last August was certified as 100 percent carbon neutral by Natural Capital Partners, an international organization that works to promote low-carbon sustainable development.

The resort, established by Austrian Ewald Biemans in 1987, after he moved to Aruba in the 1960s, is known for its use of renewable energy, smaller portions at meal time to reduce food waste, and reuseable containers for everything from ketchup to shampoo.

Those kinds of changes are catching on around the Caribbean, with a range of hotels and resorts eliminating single-use plastics such as straws, water bottles and shampoo containers.

Others are switching to more efficient air conditioners and refrigerators and installing LED lights, officials say.

The push is part of an ongoing effort to make tourism in the region greener, said Amanda Charles, a sustainable tourism development specialist at the Caribbean Tourism Organization (CTO).

Less Energy, Lower Bills

Loreto Duffy-Mayers, who works with Charles on hotel energy audits, said efforts to improve energy efficiency, for instance, have helped many hotels cut their energy bills 30 to 50 percent.

The Paradise Island Beach Club in the Bahamas was able to slash its energy costs, saving about a quarter million dollars a year, through measures such as installing air conditioners that turn off when a room is cool enough and unplugging unused refrigerators, she said.

The CTO’s members are 24 countries throughout the English, French and Dutch Caribbean whose economies are heavily dependent on tourism.

Charles said the group encourages members to focus on providing three kinds of benefits in their countries: environmental, social and economic.

In Aruba, for instance, tourism provides over 90 percent of the country’s Gross Domestic Product – and, by extension, most of its employment and tax revenue, said Frank Comito, director general of the Caribbean Hotel and Tourism Association (CHTA).

That revenue in turn funds schools, healthcare and other public services, he said.

Because the country’s sea, sun and natural beauty is the primary driver for tourism, places like Aruba also have enacted policies to conserve water and electricity and protect the environment, he said.

Comito said the hotel and tourism association offers regular webinars on sustainability issues, including waste management, sustainable design, and climate change, and guides members through environmental certification programs.

It also holds disaster risk preparedness workshops for its members – from the U.S. Virgin Islands to Jamaica – to help them prepare for worsening climate-related risks.

Charles acknowledges, however, that raising environmental awareness in the tourism sector remains a work in progress.

“Most of the CTO’s member countries have a higher budget for marketing than one for sustainable tourism initiatives,” she admitted.

High turnover among hotel staff – particularly housekeepers – can also make it difficult to ensure that green changes brought in continue to be fully implemented, she said.

But changes slowly are taking root. Biemans, of the Bucuti and Tara, said water at his resort is recycled and solar panels provide 20 percent of the facility’s electricity needs.

The resort also buys another 22 percent of its energy from a wind farm operated by the Aruban government, he said.

“We reuse every drop of water. Our meal portions are about 30 percent less and people are actually pleased with it. We do not have a single complaint. And our food waste is reused by pig farms on the island,” Biemans said. “It is good for business, the staff and customers. It saves the environment as much as it saves money. The customer has to pay less for the room, we have to pay less for energy — and in the end everybody benefits.”


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New NASA Lander to Post Daily Reports on Red Planet Winter

And now for the weather on Mars: NASA’s newest lander is offering daily reports on the red planet’s frigid winter.

Starting Tuesday, NASA’s Jet Propulsion Laboratory is posting the highs and lows online, along with wind speed and atmospheric pressure from the InSight lander.

On Sunday, InSight recorded a high of 2 degrees Fahrenheit (minus 17 Celsius) and a low of minus 138 degrees Fahrenheit (minus 95 Celsius). Compare that with Sunday’s coldest U.S. temperature: minus 27 degrees (minus 3 Celsius) in Taylor Park, Colorado.

Scientists need to know the local Mars weather to determine if InSight’s seismometer is registering real marsquakes or simply wind or pressure changes.

InSight landed near the Mars equator in November. NASA’s Curiosity rover is also providing weather updates, while roaming around Mars.


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Meet the Sea Squirt, Sucking Up Plastic Particles From the Sea

A rubbery sea creature with an irritating habit of clinging to ships and invading beaches could help measure plastic pollution as it can filter tiny particles from the ocean and store them in its soft tissue.

Israeli researchers have found that ascidians – round, palm-sized animals also known as sea squirts can thrive in dirty industrial areas and pristine waters alike, allowing them to detect and analyze waste and its impact in various regions.

A staggering amount of plastic flows into the ocean each year. The United Nations says it is as if a garbage truck full of plastic was dumped into the water every minute, a rate some estimates show could lead to oceans carrying more plastic than fish in 30 years.

But the long-term impact of the waste, particularly tiny pieces called microplastic, is still not fully understood.

“[Sea squirts] just sit in one place all their life and filter the water, like a pump,” said Gal Vered of Tel Aviv University, and who co-published the researchers’ findings in the journal Marine Pollution Bulletin.

“They can really give us a picture of what the whole reef, the whole ecosystem felt during its life.”

As a bonus, sea squirts are related in evolutionary terms to human beings. So studying them and the plastic inside them could be more insightful than looking at creatures like fish or clams.

“Although we don’t look alike at all, we have similar systems,” said Noa Shenkar, of Tel Aviv University’s zoology department and museum of natural history.

Durable and dangerous

Plastic never disappears. Over time it breaks down into microplastics, ranging from the size of a grain of rice on down. They mix with tiny plastic beads found in products like cosmetics and cleaners that were flushed away.

These are eaten by wildlife, filling their bellies, exposing them to chemical additives and, potentially, entering the food chain, said Vered.

Vered searched piers and rocks in the Red Sea resort of Eilat, eventually finding a cluster of sea squirts on a brick.

Back in her lab, a gentle push on one squirt’s belly saw the creature let loose the eponymous squirt of water. Invisible to the naked eye are the microplastics, perhaps once part of a bag or bottle, and that were found at all the sites they tested along Israel’s coasts.

“We as humans invented a material that can last for hundreds, thousands of years, and then we use it as a single-use product. It’s quite a paradox,” she said.

 


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Report: US Doctors Overprescribed Deadly Drug Fentanyl to Patients

Fentanyl, a highly dangerous painkiller at the heart of the U.S. opioid epidemic, has been overprescribed by doctors, according to a report Tuesday that accused health authorities and manufacturers of being too lax in their oversight.   

The drug is a synthetic opioid up to 100 times more powerful than morphine and which is largely sold on the black market.

But it is prescribed in certain cases of cancer under what are supposed to be very tight restrictions, in the form of lozenges, lollipops or sprays under the tongue. It is supposed to be used only on cancer patients for whom other opioid painkillers have been insufficient.

The report in Journal of the American Medical Association, or JAMA, said that this was not the case, however.

The investigation, carried out by experts from Johns Hopkins University, said that of the thousands of patients who had been prescribed fentanyl, between a third and half of them should never have received the drug.

One doctor in five did not know that fentanyl was only supposed to be used by opioid-tolerant cancer patients, the researchers found.

As a result, it has been wrongly prescribed for far less serious conditions like lower back pain or chronic headaches.

“The drug can kill you,” said one of the authors of the report Caleb Alexander, co-director at the Center for Drug Safety and Effectiveness at Johns Hopkins.

“There’s no question that individuals have died from inappropriate prescribing of these products,” he said.

“The whole point of this program was to prevent exactly the use that commonly occurs,” he said of fentanyl, which has become the deadliest drug in an epidemic that killed 70,000 people in the United States in 2016.

The team of researchers battled for four and a half years to get 5,000 pages of documents on the fentanyl program from the FDA.

Legally, doctors are allowed to prescribe a drug for an ailment other than the one it is indicated for. The role of the FDA is to regulate the laboratories that make the drugs, not the doctors.

But as part of their oversight responsibility, manufacturers “were supposed to monitor and potentially disenroll prescribers who violated the terms of the program. And yet not a single prescriber was identified and disenrolled,” said Alexander.

An FDA spokesperson said the agency shared the concerns raised in the report.

“The FDA will soon be sharing planned next steps … to make sure the program is working to mitigate the risks of these medicines and that they’re prescribed only to opioid-tolerant patients,” the spokesperson said.


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Scientist Who Popularized Term ‘Global Warming’ Dies at 87

A scientist who raised early alarms about climate change and popularized the term “global warming” has died. Wallace Smith Broecker was 87.

 

The longtime Columbia University professor and researcher died Monday at a New York City hospital, according to a spokesman for the university’s Lamont-Doherty Earth Observatory. Kevin Krajick said Broecker had been ailing in recent months.

 

Broecker brought “global warming” into common use with a 1975 article that correctly predicted rising carbon dioxide levels in the atmosphere would lead to pronounced warming. He later became the first person to recognize what he called the Ocean Conveyor Belt, a global network of currents affecting everything from air temperature to rain patterns.

 

“Wally was unique, brilliant and combative,” said Princeton University professor Michael Oppenheimer. “He wasn’t fooled by the cooling of the 1970s. He saw clearly the unprecedented warming now playing out and made his views clear, even when few were willing to listen.”

 

In the Ocean Conveyor Belt, cold, salty water in the North Atlantic sinks, working like a plunger to drive an ocean current from near North America to Europe. Warm surface waters borne by this current help keep Europe’s climate mild.

 

Otherwise, he said, Europe would be a deep freeze, with average winter temperatures dropping by 20 degrees Fahrenheit or more and London feeling more like Spitsbergen, Norway, which is 600 miles north of the Arctic Circle.

 

Broecker said his studies suggested that the conveyor is the “Achilles heel of the climate system” and a fragile phenomenon that can change rapidly for reasons not understood. It would take only a slight rise in temperature to keep water from sinking in the North Atlantic, he said, and that would bring the conveyor to a halt. Broecker said it is possible that warming caused by the buildup of greenhouse gases could be enough to affect the ocean currents dramatically.

“Broecker single-handedly popularized the notion that this could lead to a dramatic climate change ‘tipping point’ and, more generally, Broecker helped communicate to the public and policymakers the potential for abrupt climate changes and unwelcome ‘surprises’ as a result of climate change,” said Penn State professor Michael Mann.

 

In 1984, Broecker told a House subcommittee that the buildup of greenhouse gases warranted a “bold, new national effort aimed at understanding the operation of the realms of the atmosphere, oceans, ice and terrestrial biosphere.”

 

“We live in a climate system that can jump abruptly from one state to another,” Broecker told the Associated Press in 1997. By dumping into the atmosphere huge amounts of greenhouse gases, such as carbon dioxide from the burning of fossil fuels, “we are conducting an experiment that could have devastating effects.”

 

“We’re playing with an angry beast — a climate system that has been shown to be very sensitive,” he said.

 

Broecker received the National Medal of Science in 1996 and was a member of the National Academy of Science. He also served a stint as the research coordinator for Biosphere 2, an experimental living environment turned research lab.

 

Broecker was born in Chicago in 1931 and grew up in suburban Oak Park.

 

He joined Columbia’s faculty in 1959, spending most of his time at the university’s laboratory in Palisades, New York. He was known in science circles as the “Grandfather of Climate Science” and the “Dean of Climate Scientists.”

 

“His discoveries were fundamental to interpreting Earth’s climate history,” said Oppenheimer. “No scientist was more stimulating to engage with: he was an instigator in a good way, willing to press unpopular ideas, like lofting particles to offset climate change. But it was always a two-way conversation, never dull, always educational. I’ll miss him.”


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The Real ‘Jaws’: Great White Shark’s Genetic Secrets Revealed

The great white shark, one of the most fearsome predators in the world’s oceans in both fact and fiction, is a formidable creature — right down to its genes.

Scientists on Monday said they have decoded the genome of Earth’s largest predatory fish, detecting numerous genetic traits that help explain its remarkable evolutionary success, including molecular adaptations to enhance wound healing as well as genomic stability such as DNA repair and DNA damage tolerance.

The great white shark, whose scientific name is Carcharodon carcharias, boasts a very large genome, 1-1/2 times bigger than the human genome.

In theory, large genomes with a lot of repeated DNA, like this shark possesses, and its large body size should promote a high incidence of genome instability, with much more DNA and many more cells seemingly vulnerable as targets for damage through an accumulation of routine mutations.

Just the opposite seems to be the case for this shark, thanks to adaptations in genes involved in preserving genome integrity.

“This knowledge, in addition to providing understanding into how sharks work at their most fundamental level — their genes — may also be useful in downstream applications to human medicine to combat cancers and age-related diseases that result from genome instability,” said Mahmood Shivji, director of the Save Our Seas Foundation Shark Research Center and Guy Harvey Research Institute at Nova Southeastern University in Florida.

This species, star of the 1975 Hollywood blockbuster “Jaws” and its multiple sequels, roams the world’s oceans, primarily in cool coastal waters.

Gray with a white underbelly and torpedo-shaped body, it can reach 20 feet (6 meters) long, weigh 7,000 pounds (3.18 tons) and dive to nearly 4,000 feet (1,200 meters) deep. It uses its mouthful of large, serrated teeth to rip into prey including fish, seals and dolphins, swallowing mouth-sized chunks of flesh whole.

Sharks are an evolutionary success story, thriving for more than 400 million years. Our species appeared roughly 300,000 years ago.

The great white shark also displayed genetic adaptations in several genes that play fundamental roles in wound healing. For example, a key gene involved in producing a major component of blood clots was found to have undergone adaptations.

“These adaptations and enrichments of essential wound-healing genes may underlie the ability of sharks to heal from wounds so efficiently,” said Cornell University’s Michael Stanhope, co-leader of the research published in the Proceedings of the National Academy of Sciences.


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Philadelphia Mulls Supervised Injections to Cut Drug Deaths

For nearly two decades, Vancouver, the epicenter of Canada’s increasingly deadly drug epidemic, has embraced an initiative that was once dismissed as a reckless experiment but has since won over some of its fiercest critics: a walk-in facility where addicts can inject heroin under the watch of medical professionals.

Allowed as an exemption under Canada’s drug laws, Insite operates out of a storefront in the drug- and crime-ridden neighborhood of Downtown Eastside. Inside is a quiet, spacious “injection room” with 12 booths where addicts can shoot up their own drugs using freely supplied clean needles and tourniquets.

Nurses keep watch from a nearby station. And in case of an overdose, a medical team is on hand to administer naloxone, the overdose-reversing drug.In the center’s 16-year history, not a single user has died of an overdose.

Now, as a deadly opioid epidemic wrecks American communities, Philadelphia, a city with over 1,100 overdose deaths last year and one of the most active heroin markets in the country, wants to be the first in the nation to adopt the Canadian model.

The mayor and the district attorney have endorsed the initiative. A former governor of Pennsylvania has incorporated a nonprofit organization called Safehouse to run the facility. And advocates have scouted locations with an eye on Kensington, an impoverished neighborhood that has borne the brunt of opioid-related deaths in recent years.

But the plan faces stiff opposition from federal prosecutors who say it violates a law against setting up facilities for illegal drug use. To prevent the facility from opening, William McSwain, the U.S. attorney for the Eastern District of Pennsylvania, last week asked a federal judge to declare the site illegal under a 1986 “crack house statute.”

“Normalizing the use of deadly drugs like heroin and fentanyl is not the answer to solving the epidemic,” McSwain told reporters.

Worth trying

McSwain wants advocates to change the laws not break them. But supporters of the project say changing the laws takes time and the time to embrace a concept with a proven track record of saving lives is now.

“All of these [facilities] have had a similar result: they’ve lowered the number of overdoses associated with the immediate area,” said Jose Benitez, a co-founder of Safehouse and executive director of Prevention Point, a needle exchange program. “We see the same thing happening in Philadelphia.

With more than 800 daily visits, Insite is the busiest facility of its kind in the world.In the 16 years since it opened its doors, Insite has recorded more than 1,000 overdoses, many potentially fatal without intervention. But not a single one has resulted in death. What’s more, researchers have found Insite users are more likely to seek out treatment.

“There are people who say that Insite sets a bad example and supports the initiation of drugs, but in fact what we found was that people who used Insite were more likely to stop using drugs,” said M-J Milloy, a research scientist at the British Columbia Center on Substance Use.

Milloy was part of a multiyear scientific evaluation of Insite mandated by the government of Canada. Among the study’s key findings: a 35 percent drop in overdose fatalities in the surrounding community.

He said scientists also examined whether the facility can encourage drug use and degrade the quality of life in the surrounding communities, as critics have claimed. They found the criticisms “to be wholly lacking in empiric support,” he added.

“There is a scientific consensus that these facilities can have important benefits, not only on the health and well-being of the clientele who use them, but also, indeed, in the surrounding community itself,” Milloy said.

“Based on our research, we believe Insite and other injection facilities to be important interventions that should be considered by any city or setting which is dealing with the negative consequences of injection drug use,” he added.

But Insite has not been without its critics who have questioned the scientific research. These critics say that while Insite has prevented overdose deaths, it has not led to a reduction in crime or drug use in the community.

The facility was designed as a three-year scientific experiment, but it has been allowed to operate indefinitely after a landmark ruling by Canada’s Supreme Court in 2011.

US cities interested

Inspired by the Insite’s success, nearly a dozen American cities and counties battling an opioid epidemic have taken up the idea in an apparent violation of federal law. In several cities, including New York, San Francisco and Seattle, local governments have worked out concrete plans for injection facilities, but it remains unclear if they can surmount opposition from federal and state authorities.

The controversy not only has pitted cities against the federal government but also localities against their state governments.

In California, the state Legislature last year passed a bill that would have allowed the city of San Francisco to operate a safe injection site on a pilot basis. But then-Governor Jerry Brown, a Democrat, vetoed the bill, citing the threat of federal prosecution.

Two state lawmakers reintroduced the bill recently, and current Governor Gavin Newsom, also a Democrat, has said he is “very, very open” to the idea.

Philadelphia, a storied Northeast city with a population of 1.6 million, has been hit especially hard by the opioid epidemic. Overdose deaths have more than doubled in the past five years.

Two years ago, Mayor Jim Kenney set up a task force to study the drug addiction scourge and make recommendations. Task force members traveled to Vancouver, to visit Insite, and Seattle, to learn about its plans to offer safe injection services out of a van. Among other recommendations, the task force suggested that the city explore a safe injection site on a pilot basis.

That led Ronda Goldfein, executive director of AIDS Law Project of Pennsylvania, and Benitez to set up Safehouse and enlist former Governor Ed Rendell’s support. Rendell, who as mayor of Philadelphia in the 1990s allowed the city’s first needle exchange program, agreed to incorporate Safehouse and sit on its board.

A study commissioned by the task force estimated that the opening of a safe injection site could potentially avert between 24 and 76 opioid overdose deaths each year.

“There are people who fear that we’re somehow promoting drug use, but there’s evidence from these facilities worldwide that they don’t encourage drug use,” Thomas Farley, the city’s health commissioner who sits on the board of Safehouse, told VOA last year. Many “people have an immediate negative reaction, but the evidence is quite strong that they have a real positive effect on users and in the neighborhoods,” he added.

Federal government hurdles

Unlike some other states, Pennsylvania doesn’t have a law against setting up a facility for drug use, and Safehouse is not seeking public funding. For those reasons, the initiative does not face state opposition, Goldfein said.

“Our biggest impediment is not the state government but the federal government,” Goldfein said, adding that the state governor has indicated that he won’t take any steps against the planned facility.

The federal opposition was long coming. In an op-ed in The New York Times last August, Deputy Attorney General Rod Rosenstein wrote that safe injection sites were illegal and he threatened “swift and aggressive action” against cities and counties opening them.

Goldfein said the site’s primary purpose is to prevent overdose deaths, not facilitate drug use, which would be illegal under federal law.

“We’re opening up a facility for the purpose of saving lives and for the secondary purpose of getting people into treatment,” she said. “That is a completely different intent from the reasoning behind crack house laws.”

Safehouse has 30 days to file its response to the federal complaint. The case is being closely watched by other cities and counties considering safe injection facilities.

If the federal judge hearing the case rules in Safehouse’s favor, “it will certainly be an important piece of information for other jurisdictions to go forward with,” Goldfein said.

Meanwhile, in Philadelphia, not everyone is convinced that an injection facility run by Safehouse is a good idea. David Oh, a Philadelphia City Councilman At-Large, said the center could spell trouble for the city.

“We’re the largest, poor big city in America with a lot of poverty issues, job issues and education issues,” said Oh, a Republican. “We’re inviting people to come live in our city and do their drugs here, and we’re going to service and provide for them, and the communities are trying to exist and don’t want them there.”


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