A recent study has highlighted a disturbing connection between smoking and the prevalence of harmful bacteria in the mouth, underscoring the health risks tobacco poses beyond lung cancer and respiratory disease. According to findings by researchers examining the oral health of 128 participants in a previous vascular and metabolic health study, smokers demonstrated higher concentrations of harmful bacteria like Fusobacterium, Campylobacter, and Tannerella forsythia, which can exacerbate gum disease and potentially heighten the risk of cardiovascular disease due to their inflammation-inducing properties.

The study adds to mounting evidence from the World Health Organization (WHO), which reports that smoking-related complications claim an estimated 8 million lives annually. Despite these risks, an estimated 1.3 billion people worldwide continue to use tobacco, with a large majority residing in low- to middle-income countries. Furthermore, smoking has been linked not only to lung disease but also to oral health disorders, where it disrupts the oral microbiome—a critical, balanced community of microorganisms that aids digestion, regulates immunity, and maintains health in the mouth.

The findings indicate that tobacco’s toxic chemicals, including nicotine, tar, and ammonia, create a breeding ground for harmful bacteria by reducing oxygen levels, altering pH, and hindering saliva production. Saliva plays an essential role in the mouth, not only aiding in digestion but also combating germs through antibacterial properties. A dry mouth, common among smokers, allows harmful bacteria to thrive, tipping the balance against beneficial microorganisms.

Nicotine further compounds this disruption. It fosters the growth of P. gingivalis, a bacterium known for its ability to bind to tooth surfaces and proliferate in dental biofilms—complex bacterial colonies that form plaque. If unchecked, these biofilms contribute to periodontitis and tooth decay, impacting both oral and systemic health.

Research suggests that the overgrowth of bacteria in smokers’ mouths may lead to slow healing, chronic inflammation, and even antibiotic resistance, increasing susceptibility to broader health issues such as cardiovascular disease and oral cancer. Streptococcus mutans, another bacterium, typically exists in balance within a healthy mouth but, under the conditions created by smoking, can contribute to dental biofilms and lead to tooth decay and, in some cases, cancer.

The study also suggests caution for those who view vaping as a safer alternative. Although e-cigarettes do not contain tobacco, early evidence indicates they may similarly disrupt the oral microbiome. Harmful bacteria like Fusobacterium and Bacteroidales, known to contribute to gum disease, are reportedly more prevalent in individuals who vape. While research on vaping’s impact on oral health is still emerging, preliminary findings cast doubt on its safety as a smoking substitute.

However, the study brings a hopeful message: quitting smoking can restore the oral microbiome’s natural balance over time, reducing the risk of gum disease and improving saliva production. Health experts advocate for ongoing public health campaigns, especially aimed at younger populations, to promote awareness of these risks.

Somalia, a country beset by protracted conflict, environmental crises, and economic instability, faces a hidden yet formidable challenge: a rising mental health epidemic. The impact of these crises, coupled with the scarcity of mental health services, has left many Somalis grappling with psychological distress in silence, as explained by Alberto Macin, the mental health activity manager for Médecins Sans Frontières (MSF) in the region. His work sheds light on the reality that Somalia’s health crisis extends far beyond the visible and requires urgent, coordinated action.

Macin, who has worked on mental health initiatives in some of the world’s most challenging regions, underscores that mental health needs in Somalia are inextricably linked to wider socio-political and economic conditions. His team’s interactions with residents in Galkayo and Baidoa districts illustrate the spectrum of mental health challenges Somalis face: individuals recount displacement due to climate crises, trauma from sexual violence, and the burden of caring for family members afflicted with severe mental illness without sufficient resources.

According to the World Health Organization (WHO), the prevalence of mental disorders in conflict zones stands at approximately 13%, with both mild and moderate cases of depression, anxiety, PTSD, and bipolar disorder frequently documented. Yet, the stigma around mental health, compounded by limited access to clinical support, prevents many from seeking help. Vulnerable groups, especially women, children, and the elderly, remain disproportionately affected. The breakdown of traditional community support networks further exacerbates feelings of isolation, stress, and despair among displaced populations who now reside in overcrowded camps with little privacy or security.

The mental health needs MSF encounters in Somalia range from psychosomatic complaints to severe conditions like psychosis and substance abuse. However, the overwhelming distress stemming from trauma and ongoing insecurity often leads to the development of new conditions, including PTSD and acute stress reactions. While the humanitarian response to Somalia’s crisis focuses on critical needs like food, shelter, and basic health care, mental health remains under-prioritized. Consequently, the psychological toll of these hardships risks growing unchecked, with limited pathways to recovery for those affected.

MSF’s efforts to address this gap include integrating mental health services within its broader health programs, collaborating with the Ministry of Health (MoH) to provide psychological support, and running group activities aimed at promoting healthy coping mechanisms. Since the beginning of 2024, MSF has conducted nearly 5,000 mental health consultations and has reached over 38,000 people through group activities, community training sessions, and psychological first aid. Despite these initiatives, the scope of the problem is immense, and current resources are insufficient to meet the demand for mental health services across the country.

Beyond the immediate support that MSF and other agencies provide, Macin emphasizes the need for a sustainable and community-driven approach. Building mental health capacity within Somali communities could alleviate the demand for clinical specialists, who are scarce. Empowering communities to offer peer support and reestablishing traditional support systems could help fill the gaps. Encouragingly, community self-help groups can provide a sense of normalcy, fostering resilience among individuals and reducing the overall impact of psychological trauma.

For those in the early stages of trauma, access to psychological first aid—offered by trained volunteers, teachers, and health staff—can provide essential relief. By equipping community members with basic skills to support individuals in crisis, the response can be scaled to reach larger groups. This grassroots approach not only strengthens community ties but also helps alleviate the psychological burden of Somali families.

Despite the resilience demonstrated by many Somalis, the absence of widespread mental health support risks perpetuating a cycle of suffering. Macin’s appeal calls for mental health to be fully integrated into humanitarian efforts, encompassing both immediate relief and long-term care. He advocates for comprehensive strategies that address basic needs like food and shelter alongside psychological first aid and a clear referral system to mental health services.

Somalia’s future stability hinges not only on rebuilding its infrastructure but on healing the minds and lives of its people. As the international community and local authorities grapple with these pressing needs, prioritizing mental health within the humanitarian response is essential. The lives of millions hang in the balance, and failure to act could leave a generation struggling with the scars of trauma and loss.

The World Health Organization (WHO) has commended Rwanda’s robust response to the ongoing Marburg virus outbreak, which has so far resulted in 62 confirmed cases and 15 deaths. Speaking in the Rwandan capital, Kigali, WHO Director-General Tedros Adhanom Ghebreyesus emphasized the importance of sustained vigilance, even as the number of new cases has slowed. Rwanda has recorded no new infections in the past six days, with 44 people recovering from the virus.

“We are encouraged by the fact that no new cases have emerged in recent days, but we must remember that we are dealing with one of the world’s deadliest viruses,” Tedros said during a press conference. “Enhanced surveillance, contact tracing, and infection control measures must continue at full scale until the outbreak is declared officially over.”

Marburg virus, a highly infectious pathogen similar to Ebola, has a fatality rate of up to 88%. The virus causes hemorrhagic fever, with symptoms including severe bleeding and organ failure. However, the mortality rate in the current Rwandan outbreak has been notably lower, at 24%, largely due to the country’s swift and effective response.

Tedros visited a treatment center over the weekend, where he praised the medical staff for saving the lives of two critically ill patients who had suffered multiple organ failure. “These patients were successfully intubated, placed on life support, and have since been extubated and are now recovering,” he noted. This marks the first time patients with Marburg virus have been successfully extubated in Africa, a significant milestone in the treatment of the disease.

While there are no approved vaccines or antiviral treatments for Marburg, potential therapies, including blood products and immune treatments, are currently being evaluated. Earlier this month, Rwanda also initiated a vaccination trial in a bid to curb the outbreak.

Tedros cautioned that an official declaration that the outbreak is over can only be made after 42 days—equivalent to two incubation periods—without any new confirmed cases. He reiterated that continued vigilance is critical, stressing that the nature of the virus leaves no room for complacency.

The Marburg virus is transmitted to humans via fruit bats and can spread between humans through direct contact with bodily fluids or contaminated surfaces. With Rwanda making strides in containing the outbreak, the country’s efforts are being closely watched as a potential model for managing future outbreaks of similar diseases.

Taiwan has pledged a total of $24 million to support critical sectors in Somaliland, further solidifying ties between the two diplomatically unrecognized states. Of this amount, $22 million will go towards the reconstruction of Hargeisa General Hospital, a vital healthcare facility in Somaliland’s capital, while an additional $2 million will be directed to bolstering the nation’s electoral process ahead of upcoming elections.

The agreement to revamp Hargeisa General Hospital was formalized on Friday with Somaliland’s Minister of Health and Taiwan’s Representative signing the accord. The investment will focus on modernizing healthcare infrastructure, improving the quality of medical services, and expanding access to healthcare for residents in Hargeisa and its surrounding areas.

Alongside this healthcare initiative, Taiwan’s $2 million electoral support package aims to reinforce democratic governance in Somaliland. The funding will aid in election preparations, emphasizing transparency, voter education, and logistical arrangements.

In a statement, Taiwan’s Representative Office in Hargeisa underscored the values underpinning the partnership between the two territories: “Democracy is a language we share, and freedom is a common goal that unites us. Freedom and democracy are the core principles that connect Somaliland and Taiwan to the global community.” This shared commitment to democratic principles has been central to the burgeoning relationship between Taiwan and Somaliland, which began in August 2020 when the two entities formalized diplomatic ties.

Both Taiwan and Somaliland face significant challenges to their international legitimacy. Taiwan has been governed independently from China since 1949 but is still claimed by Beijing, which opposes any formal recognition of the island’s sovereignty. Similarly, Somaliland declared back its 1960 independence from Somalia in 1991 but has yet to be officially recognized by any country or major international organization. Their diplomatic relationship has therefore attracted notable geopolitical attention, especially as China and Somalia have condemned the partnership, citing concerns about territorial integrity.

Despite the criticism, Taiwan has steadily worked to enhance Somaliland’s key economic sectors, focusing on agriculture, fisheries, and small-scale industries that are essential to the country’s economic stability. This latest round of healthcare and electoral support is part of Taiwan’s broader strategic effort to build alliances in regions where Chinese influence is expanding, particularly in Africa.

As Taiwan deepens its ties with Somaliland, both entities hope to enhance their standing in the international arena, leveraging their partnership to strengthen domestic institutions and promote democratic ideals. The projects funded through Taiwan’s investments will not only improve healthcare and democracy in Somaliland but may also signal the potential for further collaboration in other areas crucial to both nations’ development.

Sex workers in Kamituga face health risks and stigma as mpox spreads through the mining hub, threatening livelihoods.

Sex workers in Kamituga, eastern Congo, are at the center of an mpox outbreak, grappling with health risks, stigma, and economic hardship. With around 40,000 sex workers in this mining hub, the majority of mpox cases are contracted through sexual contact, exacerbating vulnerabilities. Despite the outbreak, many sex workers continue working due to economic necessity, while facing stigma from clients and the wider community. The lack of vaccines and condoms, along with social and legal barriers, hinders efforts to control the virus’s spread. Health officials push for intervention, but the response remains limited.

The outbreak in Kamituga highlights broader systemic issues, such as poverty, the precarious situation of women, and the sex industry’s entanglement with mining economies. As sex work remains the primary income source for many women, particularly single mothers, stopping the spread of mpox without providing economic alternatives remains a challenge.

Health officials warn that without targeted support for sex workers, the virus could extend further into Congo and the region.

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At 86, Edna Adan Ismail stands as a living testament to the power of resilience, courage, and determination. A nurse, midwife, and advocate for women’s health and human rights, she has spent decades breaking barriers and shattering cultural taboos—particularly those surrounding female genital mutilation (FGM). She became the recipient of the prestigious Templeton Prize, a recognition of her lifelong commitment to transforming the lives of women and girls in Somaliland and across Africa.

Ismail’s journey is not just one of personal triumph, but of creating systemic change in a region historically plagued by instability and gender inequality. As Somaliland’s first trained nurse and midwife, and later as its first foreign minister, Ismail has dedicated her life to the fight against FGM and the advancement of maternal health. Today, her proudest achievement is the Edna Adan Maternity Hospital, which she founded in 2002 to address the health crisis left in the wake of the Somali civil war. The hospital is now a beacon of hope in Somaliland, training hundreds of healthcare workers and providing life-saving maternal and child healthcare services.

A Battle Against FGM

For Ismail, the battle against FGM is deeply personal. Having suffered the practice herself, she has fought tirelessly to ensure that no more girls endure the same trauma. “I’m a midwife, and my job is to deliver babies in a safe way,” she explains. “I fight [FGM] because all the girls in my country are subjected to it, and because anybody who has any compassion for human values and the rights of the girls should be fighting it.”

Female genital mutilation, often performed in secret, is recognized globally as a violation of human rights and a form of gender-based violence. Yet, it remains a widespread practice, affecting over 200 million women and girls, according to the World Health Organization. The physical and emotional scars left by FGM are lifelong, increasing the risk of complications during childbirth and posing severe health risks.

But Ismail has seen progress. In the 45 years she has been involved in advocacy, discussions about FGM have gone from unspoken to mainstream. “In my culture, and I’m sure in many African countries, girls are brought up to be ‘respectful,’” she says. “We didn’t talk about a part of the body that is considered to be indecent to speak about… But nowadays, discussions are being held about FGM on the radio, in schools, even in places of worship.”

For Ismail, the breaking of these taboos is a victory in itself, but there is still much work to be done. Her relentless advocacy, however, continues to raise awareness and challenge deep-seated cultural norms, making it increasingly difficult for the practice to remain hidden.

A Legacy of Healthcare and Empowerment

Ismail’s dedication to maternal health is just as profound. When she returned to Somaliland in 1997, the country was in shambles after years of civil war. There were only 18 qualified nurses serving a region the size of England and Wales, and no formal training institutions. Driven by her father’s example—himself a pioneering doctor in Somaliland—Ismail decided to take on the challenge of rebuilding the country’s healthcare infrastructure.

“When I came back, we had 18 qualified nurses. Today, Somaliland has over 1,000 midwives and eight training schools,” she says proudly. Thanks to her efforts, maternal mortality in Somaliland has steadily, if slowly, decreased, and the country now boasts over 15 hospitals, 200 maternal-child health centers, and private clinics. The Edna Adan Maternity Hospital has become the foundation of this transformation, serving as both a medical facility and a training institution.

In a country where healthcare was once practically non-existent, the changes have been monumental. Somaliland’s healthcare workforce has not only grown but has also started attracting medical professionals from abroad. Ismail’s hospital, and the university that grew alongside it, have become pillars of Somaliland’s recovery, ensuring that women receive the care they need while fostering the next generation of health workers.

Inspiring Future Generations

Throughout her career, Ismail has broken numerous glass ceilings. She was Somalia’s first lady, Somaliland’s first foreign minister, and one of the first women in her region to receive a formal education. But her impact reaches far beyond titles and accolades.

“I wish to be remembered as an experimental animal,” Ismail says, with her characteristic humility. “In the experiment of teaching a girl to read and write, to become a nurse and a midwife, to hold community and national responsibility… And the experiment was a success.”

Her life is a story of perseverance and possibility, a living example of how education, determination, and a deep sense of responsibility can change lives and inspire others. By paving the way for women in healthcare and leadership, Ismail has become a role model for girls across Africa, proving that no cultural or societal barrier is insurmountable.

Edna Adan Ismail’s work is not yet done. As she continues to raise awareness about FGM, advocate for women’s rights, and build healthcare infrastructure, her legacy grows. For the girls and women whose lives she has touched, she is not just a healthcare provider or an advocate—she is hope personified. In a world that often dismisses the contributions of women, particularly in places like Somaliland, Ismail’s example is proof that change is not only possible—it is inevitable when driven by a force as unyielding as hers.

Her dream is simple, yet profound: to ensure that the doors she has opened remain open for future generations of women, so they, too, can change the world.

 Mental health issues prevents many Somalis from seeking treatment or assistance.

As antimicrobial resistance (AMR) surges, new antibiotics are scarce. With global leaders set to discuss the crisis, why is the development pipeline so dry and what can be done to address the growing threat?

As the world faces an escalating crisis of antimicrobial resistance (AMR), the need for new antibiotics has never been more urgent. Yet, despite the looming threat of drug-resistant infections, the pipeline for novel treatments remains alarmingly thin. This paradox is set to be a focal point at the upcoming UN General Assembly, where global leaders will grapple with strategies to address AMR and revitalize antibiotic development.

The rise of drug-resistant infections is a stark reminder of how modern medicine’s triumphs are increasingly under threat. The death toll from drug-resistant bacteria reached 1.27 million in 2019, and the economic costs of AMR are projected to surpass $1 trillion by 2030. Sub-Saharan Africa bears a disproportionate burden, particularly among children under five, where drug resistance compounds an already dire public health situation.

The crisis is exacerbated by a troubling stagnation in antibiotic development. Since 1990, only one new class of antibiotics has been discovered, a significant drop from the more than 25 new classes identified between 1940 and 1979. This slowdown is largely due to severe financial constraints and disinterest from major pharmaceutical companies, which have pivoted to more profitable ventures.

One major issue is the financial model for antibiotics. Unlike chronic medications for conditions like diabetes or hypertension, which generate sustained revenue from long-term use, antibiotics are typically used for short durations. This transient use makes it challenging for companies to recoup the substantial costs associated with developing new drugs. As a result, many smaller companies involved in AMR research are struggling financially, with several facing bankruptcy despite their promising breakthroughs.

The landscape of antibiotic research and development is also fraught with difficulties. Of the 112 commercial institutions engaged in preclinical research on AMR, 97 have fewer than 50 employees. This fragility poses a significant risk to the continuity of research efforts and innovation.

To tackle the crisis, experts argue for the need to enhance incentives for both research and market introduction of new antibiotics. In the UK, a subscription model has been introduced, providing drug companies with a fixed annual fee for new antibiotics, regardless of usage. This model aims to ensure that critical drugs remain available while reducing the financial risks for companies.

However, similar approaches are still under consideration in other regions, and there are concerns about their potential impact on global access. Health campaigners fear that such models might drive up the costs of antibiotics worldwide, making it even harder for developing countries to obtain these essential medications.

Addressing the AMR crisis requires a multifaceted approach. Governments and the private sector need to collaborate on funding and incentives that support both early-stage research and the market introduction of new antibiotics. Moreover, efforts must be made to ensure that these innovations are accessible and affordable across all countries and populations.

The UN General Assembly’s discussions on AMR will be crucial in shaping the future of global health policy. As the world grapples with this mounting challenge, a renewed focus on innovation, investment, and equitable access will be essential to preserving the effectiveness of antibiotics and safeguarding public health.

In the face of this critical situation, the call to action is clear: the global community must rally to overcome the barriers to antibiotic development and ensure that life-saving treatments remain within reach for all.