Africa should step up own vaccines, says cholera-hit Angola
"To enable a strong and sustainable response to this crisis and future crises, it is essential to put production of medicines and vaccines on our continent," Angolan President Joao Lourenco, who also heads the African Union, told a videoconference with other African leaders, his office said.
"Total dependence on external imports limits our ability to respond and compromises our health sovereignty," Lourenco said during a conference which included World Health Organization (WHO) director general Tedros Adhanom Ghebreyesus.
More than 90 percent of vaccines, medicines, medical tests, and other essential health supplies used in Africa are imported, according to a report by the African Centre for Disease Control and Prevention (ACDCP) published in April.
Several African countries are battling cholera outbreaks with Sudan, South Sudan, Democratic Republic of Congo and Angola among the worst hit.
As of 2 June, Angola had recorded more than 24,530 cases this year, with 718 deaths, according to the Angolan presidency.
On 27 May, the Sudanese health ministry reported 172 deaths from the disease in a single week in the war-torn country.
Africa's dependence on imported health products has proven disastrous during previous epidemics, including COVID-19, Ebola, Marburg and mpox, the ACDCP report said.
That leaves the continent at the mercy of global trade tensions, geopolitical disruption and logistical delays, it said.
Public health emergencies have significantly increased in Africa, rising from 152 in 2022 to 213 in 2024, the report added.
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eNCA
17 hours ago
- eNCA
Reclusive Turkmenistan bids to go tobacco-free in 2025
ASHGABAT - When he was a teenager, Bekmurad Khodjayev used to hide from his parents to smoke. Fifty years later, the Turkmen pensioner is still hiding, but this time from the police. "I smoke in my apartment. But if I feel like smoking in town, I find a place without surveillance cameras to avoid a fine -- an alleyway, a dead end, behind some tall bushes or trees, a deserted spot," the 64-year-old builder told AFP. The reclusive Central Asian state of seven million people, where the rate of smoking is already very low, has vowed to eradicate the habit altogether by the end of the year. Khodjayev said he had already been fined for smoking near his home. "Since then, I try not to get caught anymore," he said. The target of going tobacco-free was set in 2022 by the country's supreme leader, Gurbanguly Berdymukhamedov, a former dentist. Only four percent of Turkmens smoke, according to the World Health Organization. AFP | STRINGER, STRINGER There are heavy taxes and restrictions on cigarettes and smoking in almost all public places is now banned. Khodjayev says he buys cigarettes at private kiosks since state shops run by the ministry of commerce do not have them. In his kiosk in the capital Ashgabat, seller Meilis said the cigarettes came from Uzbekistan, Kazakhstan and Iran. "Most of the time, I sell single ones. Not everyone can afford an entire pack, it's too expensive," the 21-year-old told AFP. - Steep fines - According to several smokers in Turkmenistan, a pack can cost between 50 and 170 manats ($14.20 to $48.50), while individual cigarettes cost between two and five manats. A pack is therefore around 11 percent of an average monthly salary, which was roughly 1,500 manats in 2018, according to the most recent official Turkmen statistics. Comparisons with other countries are complicated because of the double exchange rate in Turkmenistan -- an official one controlled by the state and the real one which operates on the black market. In a hospital in Ashgabat, Soltan, a doctor, welcomed the government's "active fight against tobacco". "We treat tobacco addiction. The health ministry has created centres where smokers can get free advice on quitting," she said. The authorities rely on more coercive methods with a variety of smoking bans, import restrictions and fines that can reach 200 manats. "After receiving several fines, I decided to stop definitively after the time I got caught smoking in my car in a public car park," said Ilyas Byashimov, a 24-year-old entrepreneur. - Public apologies - The Berdymukhamedovs -- Gurbanguly and his son Serdar -- have ruled the country for almost 20 years with almost absolute power. After Serdar Berdymukhamedov called in 2023 for a "no compromise" fight against smoking, around 20 people were shown on state television promising not to smoke water pipes or import tobacco illegally. There are also regular public burnings of contraband cigarettes, accompanied by shows of traditional Turkmen dancing and singing. AFP | STRINGER With just a few months to go until the end of 2025, the authorities are not claiming victory in rooting out smoking. Contacted by AFP, the health ministry declined to reply -- not surprising in a country where obtaining and verifying any official information is extremely hard. Smokers seemed doubtful about a total ban. "Cigarettes will not disappear completely but will become much more expensive and there will be a black market," said Haidar Shikhiev, 60, a builder. Seller Galina Soyunova said that cigarettes "will always be available under the counter but even more expensive". "Who will buy cigarettes for the price of gold? Nobody. The question of tobacco addiction will resolve itself," she said. al-bk/dt/mmp/phz/jhb By Anton Lomov
Daily Maverick
18 hours ago
- Daily Maverick
Comedian Celeste Ntuli's weight of truth encompasses laughter, stigma and the obesity crisis
'In African families, losing weight invites suspicion. 'Are you okay? Are you sick?' they'll ask. Gain weight? 'Oh, you're happy and being taken care of.' That's the framework many of us grew up with,' says comedian Celeste Ntuli. South Africa's beloved comedian, Celeste Ntuli, has built a career on making people laugh. But when she speaks about her lifelong struggle with obesity, the humour carries an edge of truth. Experts warn that the condition is a chronic disease driving hypertension, type 2 diabetes and more than 230 health complications. The 46-year-old comedian and actress, who grew up in rural Empangeni, KwaZulu-Natal, recalls being the only overweight child in her family. Ntuli grew up in a family of four sisters, but was the only one who carried extra weight. 'All my sisters are slim — I was the odd one out,' she said. 'At home, it was always, 'What happened to you?' as if I'd done something wrong.' She believes her body type comes from her aunts, rather than her parents. 'I inherited their curves and size — it's in my DNA. I didn't choose this body; I was born into it.' However, in her community, size was never stigmatised. 'Being big was not just acceptable — it was celebrated. I watched my aunts, and older women, proudly carry their size. From them, I learnt that shame can be attached to your body, yes — but I also learnt to carry it with dignity,' she said. But things changed when she went to school in Durban. Her quick wit became both shield and weapon. 'Humour became my armour. I learnt to crack a joke before anyone else could, or expose their weakness, to disarm any body shaming at school.' As Ntuli's career grew, public scrutiny of her body sharpened. 'On stage, my size was part of the punchline — sometimes mine, sometimes theirs. Off stage, it became a conversation about health, beauty and worth. And those are not easy conversations in a world obsessed with body image.' She highlighted the cultural nuance that still frames weight in South Africa. 'In African families, losing weight invites suspicion. 'Are you okay? Are you sick?' they'll ask. Gain weight? 'Oh, you're happy and being taken care of.' That's the framework many of us grew up with.' Now prediabetic, Ntuli has shifted her focus. 'We must separate health from this narrow definition of beauty,' she said. Food, for her, has always carried deep meaning. 'Food for me is love — it's family, it's comfort, it's culture.' Her tastes remain rooted in tradition. She laughed as she described inyama yenhloko — the whole cow's head — as one of the best meals, 'with no translation in English'. This dish, a staple in many South African cultures, is often prepared for special occasions and celebrations. Friends and family, she added, know her for a good curry. At the same time, her most nostalgic food memory is a bowl of maas, the fermented milk she affectionately calls 'rural couscous', a staple from her childhood. She insisted: 'I love food — who doesn't? But loving food shouldn't mean I hate my body. The two can coexist — enjoyment and health — but it takes knowledge, access to resources and, at times, medical intervention.' In a battle to lose weight, Ntuli admitted to trying everything from intermittent fasting to boot camps, gym and even attempting a gruelling 15km run. 'I died after an hour at that boot camp,' she joked. Her search for quick fixes once took a bizarre turn. 'I once drank urine because someone said it would help me lose weight,' she recalled, pulling a face. 'It was the most horrible thing I've ever done — I'll never do that again.' Despite the missteps, she remains pragmatic. 'I try to stay disciplined, but sometimes my working schedule, previous injuries, or just life get in the way. I've learnt to give myself grace.' Ntuli spoke to Daily Maverick on the sidelines of the Novo Nordisk Wegovy media launch last week in Rosebank. A public health emergency Ntuli's story is far from unique. South Africa has one of the highest obesity rates in sub-Saharan Africa: two in three women (68%) and nearly one in three men (31%) are overweight or obese, according to Statistics South Africa (StatsSA). The consequences go beyond aesthetics — obesity is a chronic disease recognised by the World Health Organization (WHO) linked to more than 230 health conditions, from type 2 diabetes to cardiovascular disease and certain types of cancer. The International Diabetes Federation estimates that 2.4 million adults in South Africa live with type 2 diabetes, with most cases directly linked to excess body fat. The financial cost is staggering: overweight and obesity cost the public health system R33-billion annually, about 15% of the government health expenditure, a figure that should raise concerns about the economic impact of this public health crisis. Dr Kershlin Naidu, a Midrand-based specialist endocrinologist with decades of experience treating type 2 diabetes and obesity, has sounded the alarm: 'We are dealing with a public health crisis hiding in plain sight.' Naidu added: 'Obesity is not simply a matter of willpower or lifestyle choice — it is a chronic, relapsing condition.' Sara Norcross, general manager of Novo Nordisk South Africa, added: 'Obesity is not a choice — no one wakes up and decides to be obese. It is a chronic disease, and we must stop reducing it to myths and moral failings.' Moving beyond blame Experts stress that focusing on 'eat less, move more' oversimplifies the issue. Professor Arya M Sharma, Emeritus Professor of Medicine at the University of Alberta, told the Cardio-Kidney-Metabolic (CKM) Africa Summit 2025 in Cape Town: 'Some people are naturally slender, but most sit on a spectrum where genetics and biology dictate weight gain, even with identical diets and activity levels.' He explained that the brain's powerful homeostatic system was designed to defend body weight against loss. 'The minute you stop dieting, your weight fights to return,' he said. Another brain system, the hedonic or reward system, drives eating for pleasure rather than hunger, making sustained weight loss a complex battle against deeply rooted biology. Living with the weight of stigma For Ntuli, stigma often bites deeper than the medical realities. 'Your body tells your story, but it's not the whole book. We deserve to write chapters about joy, movement, breathing easily when we walk upstairs — not just how we look in photos.' Her honesty struck a chord during the Rosebank obesity awareness event, at which she spoke of the guilt, excuses and exhaustion that often come with fluctuating weight. She admitted she sometimes avoids exercise, not out of laziness, but because of injury fears, long workdays, or sheer fatigue. 'I genuinely feel like my life is one long treadmill — up at five, home after midnight. So sometimes I just can't.' Yet she carries her size with humour and defiance. She quipped about body shaming: 'I've got comebacks for days. If someone comments on my weight at a family gathering, I remind them of their faults (like not finishing matric) — and they keep quiet.' Ntuli reflected on how weight filters into her personal life, particularly dating. 'I've dated guys who actually prefer big women,' she said, laughing. 'But society doesn't always allow you to believe that love and attraction can exist outside narrow beauty standards. I've had to learn to carry myself confidently — because if I don't, people assume size means insecurity.' Yet, as she put it, 'I am single and I don't have children.' She explained herself in unprovoked honesty: 'I am a leaver,' she said, explaining that if something doesn't feel right in relationships or life, she chooses to walk away rather than remain unhappy. While the pharmaceutical company hosted the Rosebank event, Ntuli's presence underscored a broader message: obesity is not only about new medications, but about lived experiences, culture, stigma and survival. Ntuli's voice — mixing mischief, vulnerability, and insight — places human stories at the centre of a national crisis too often reduced to statistics or industry product launches. Minister of Health, Dr Aaron Motsoaledi, told Daily Maverick: 'Endocrine disorders, including diabetes mellitus (type 2 diabetes), have been prioritised for review in the current phase of the Standard Treatment Guidelines and Essential Medicines List. All identified medicines — including glucagon-like peptide-1 agents such as semaglutide (Wegovy®) — will undergo rigorous health technology assessments as part of a comprehensive package for diabetes, obesity and cardiovascular disease management in South Africa.' DM
TimesLIVE
a day ago
- TimesLIVE
The science of starvation: this is what happens to your body when it's deprived of food
Hunger exists on a spectrum. On the one end is food insecurity, where people are forced to adjust to fewer meals. As food becomes scarce, the body consumes its own reserves. The journey from hunger to starvation starts with a drop in energy levels, then the body breaks down fat, then muscle. Eventually, critical organs begin to fail. From undernourishment, to acute malnutrition and finally starvation, the process reaches a point where the body can no longer sustain life. In Gaza today, thousands of children under five and pregnant or lactating women are experiencing acute malnutrition. In Sudan, conflict and restricted humanitarian access have pushed millions to the brink of starvation, with famine warnings growing more urgent by the day. We asked nutritionists Ola Anabtawi and Berta Valente to explain the science behind starvation and what happens to your body when it's deprived of food. What is the minimum nutrition a body needs to survive? To survive, people need more than clean water and safety. Access to food that meets daily energy, macronutrient and micronutrient requirements is essential to preserve health, support recovery and prevent malnutrition.t According to the World Health Organization (WHO), adults require different amounts of energy depending on age, sex and level of physical activity. A kilocalorie (kcal) is a measure of energy. In nutrition, it tells us how much energy a person gets from food or how much energy the body needs to function. Technically, one kilocalorie is the amount of energy needed to raise the temperature of one kilogram of water by one degree Celsius. The body uses this energy to breathe, digest food, maintain body temperature, and — especially in children — to grow. Total energy needs come from: resting energy expenditure: the energy used by the body at rest to maintain vital functions such as breathing and circulation; physical activity: may vary during emergencies depending on factors such as displacement, caregiving or survival tasks; thermogenesis: the energy used to digest and process food. Resting energy expenditure usually forms the biggest portion of energy needs, especially when physical activity is limited. Other factors including age, sex, body size, health status, pregnancy, or cold environments also influence how much energy a person requires. Energy needs vary throughout life. Infants require about 95 kcal to 108 kcal per kilogram of body weight per day during the first six months and between 84 kcal and 98 kcal per kilogram from six to 12 months. For children under the age of 10, energy needs are based on normal growth patterns without distinction between boys and girls. For example, a two-year-old child typically requires about 1,000 kcal to 1,200 kcal daily. A five-year-old needs about 1,300 to 1,500 and a 10-year-old generally requires between 1,800 and 2,000 kilocalories per day. From age 10 onward, energy requirements begin to differ between boys and girls due to variations in growth and activity, and allowances are adjusted based on body weight, physical activity and rate of growth. For adults with light to moderate physical activity, the average daily energy requirement for men aged 19 to 50 is about 2,900 kcal, while women in the same age group require roughly 2,200 kcal per day. These values include a range of plus or minus 20% to account for individual differences in metabolism and activity. For adults over 50 years, energy needs decrease slightly, with men requiring about 2,300 kcal and women around 1,900 kcal daily. In humanitarian emergencies, food aid provision needs to guarantee the widely accepted minimum energy intake to maintain basic health and function, which was set to 2,100 kcal per person per day. This level aims to meet fundamental physiological needs and prevent malnutrition when food supply is limited. This energy must come from a balance of macronutrients, with carbohydrates supplying 50%-60% (such as rice or bread), proteins 10%-35% (like beans or lean meat), and fats 20%-35% (for example, cooking oil or nuts). Fat requirements are higher for young children (30%-40%), as well as for pregnant and breastfeeding women (at least 20%). In addition to energy, the body requires vitamins and minerals, such as iron, vitamin A, iodine and zinc, which are critical for immune function, growth and brain development. Iron is found in foods like red meat, beans and fortified cereals. Vitamin A comes from carrots, sweet potatoes and dark leafy greens. Iodine is commonly obtained from iodised salt and seafood. Zinc is present in meat, nuts and whole grains. When food systems collapse, this balance is lost. What physically happens when your body is starved? Physiologically, the effects of starvation on the human body unfold in three overlapping stages. Each reflects the body's effort to survive without food. But these adaptations come at great physiological cost. In the first stage, which lasts up to 48 hours after food intake stops, the body draws on glycogen stored in the liver to keep blood sugar levels stable. This process, called glycogenolysis, is a short-term solution. When glycogen runs out, the second stage begins.
