The Weekly Wrap for Saturday, 17 August 2019

Talking points India's Narendra Modi hails Kashmir 'breakthrough'. PHOTO: AFP A lull (and an apology) followed violent protests in Hong Kong Russian villagers were urged to leave a radioactive blast site In Argentina, Fernández's primary victory roiled market-watchers Quelle surprise: Facebook admitted to another privacy breach India celebrated Independence Day; Kashmir did not Rwanda was found to be manipulating its economic and poverty data Matteo Salvini began his long-awaited tilt at Italy's top job A new offensive in Idlib brought misery to hundreds of thousands A plane crash-landed after a bird strike; thankfully no one died Conservative commentators raged over Greta Thunberg's yacht trip Deep Dive Sizwe Tropical Diseases Hospital in Johannesburg. PHOTO: AFP This week, amidst the deluge of news stories about geo-political posturing and ominous economic signals, there were breakthroughs in the treatment of three major infectious diseases. These are not just individual examples of substantially good news; taken together they could save, or better, the lives of millions.   XDR-TB    Tuberculosis (TB) is the world's leading infectious cause of death: last year it killed 1.6 million people out of the 10 million living with the disease. It is caused by a bacterial infection of the lungs and is spread by airborne saliva, coughing and spitting. Most people living with TB have a latent form of the disease which mutates into a fatal version, in one out of every ten cases. There are, however, multi-drug-resistant (MDR-TB) variants and even an extensively drug-resistant (XDR-TB) strain that, as its name implies, has a mortality rate of nearly 80%. South Africa is particularly badly afflicted with TB – some 300,000 people are living with it presently. Until recently, the best-practice treatment for extreme TB cases was a daily prescription of up to 40 pills, and painful injections. But the plight of sufferers has been eased now by the staff at the Sizwe Tropical Diseases Hospital in Johannesburg. Over the past four years, the hospital has developed a three-drug concoction that has proven (in a trial of 109 people) to have a success rate of 90%. Known as the BPaL regimen (for its constituent Bedaquiline, Pretomanid and Linezolid) this novel treatment also halves treatment time. From these 109 patients, a global solution may blossom. This week the U.S. Federal Drug Administration (FDA) voted 14-4 to approve pretomanid for domestic use – a sign that those living with XDR-TB around the world may soon have access to the treatment.    Trial and Ebola   You should need no preamble for Ebola: it is simply one of the most formidable infectious diseases facing pathologists in 2019. The current outbreak in the Democratic Republic of Congo (DRC) is the second-worst in recorded history. It has claimed over 1900 lives in the last year. A clinical trial was undertaken late in 2018 to test the efficacy of four Ebola drugs – a study that now has actionable results. Two of the drugs, REGN-EB3 and mAb114 resulted in a "significant diminution in mortality" in their tests. Both are known as monoclonal antibodies and they work by attaching themselves to glycoprotein in the virus itself, preventing it from spreading to new cells. The drugs' success has effectively ended the trial, and now all patients have been shifted to the two functioning treatments. A note of caution. As regular readers of this column will know, a successful response to an Ebola outbreak must do more than just treat the disease. In the DRC, a complex set of cultural and social beliefs – particularly pertaining to death rituals – has made quarantining patients a devilish task. Even the most efficacious treatments will prove inadequate unless their benefits can be explained and delivered in a culturally sensitive manner.   Vaccine milestones    Chlamydia is the most common sexually transmitted infection (STI) in the world due to the fact that it is asymptomatic in most people. Those infected with the bacterium may not become aware for weeks, months or even years after transmission. This delay can mask the long-term damage that chlamydia is capable of inflicting on the cervix and penile urethra. It can also be passed from mother to child during pregnancy.  While there is already an effective course of treatment for Chlamydia – antibiotics do the trick – a comprehensive vaccine has proved elusive. This week the results of a clinical trial offered a first glimpse at such a vaccine. A preliminary test on 35 women showed that a test vaccine had provoked a targeted immune response in a safe manner. The path ahead consists of further trials to gauge efficacy en masse with an aim to one day deliver a chlamydia vaccine at the same time as HPV shots to young people.  Worldlywise Boundless growth finds a boundary. PHOTO: SMH Worrying curves There is a reason that economics is called a "soft" science. There are simply too many inputs and variables (not to mention conflicting theories and a lack of controlled experiments) for the global economy to be describable with certainty. And so Economists are forced to rely on educated guesses, models and trends. But the economy also trades on "animal spirits", which is why even the best models can be laid low by fluctuating levels of anxiety. That anxiety manifested in dramatic fashion across stock markets this week. By "dramatic" we mean that markets fell as much as 3% midweek. Cue the usual photos of harried traders on the floors of stock exchanges. Asian share indices copped the worst of it, prompting fears that Donald Trump and Xi Jingping's will-they-or-won't-they theatre of tariffs was reaching a negative denouement. A clawback late in the week didn't do enough to convince observers of near-term safety: gold remains up, and oil is still down as growth outlooks are slashed across Asia, and production levels slide in both Germany and China. And yet, those stock markets falls were from levels that were near all-time highs, and most major economies are still growing.  This week you may also have heard about the "inverted yield curve". This refers to a phenomenon – currently observable in the U.S. – in which the yield (what people are willing to pay) for long-term government bonds drops below the yield on short-term bonds. It happens when future inflation rates are expected to drop (because growth is expected to slow).  The retreat of investors to the safety of government bonds is also a sign of collapsing faith in the near-term prospects of stock markets. In this there is a trend worth paying attention to: every U.S. recession has been preceded by an inversion in the yield curve, with an average lapse of 14 months between inversion and recession. Great.   Storming the presidential palace. PHOTO: AP The end of Yemen The United Arab Emirates once lived in the shadow of its much larger Saudi neighbour. Their foreign policy was largely subservient to that of the Kingdom, but this has changed dramatically in the last few years. Lately, the U.A.E. has been picking its own battles (the Qatar diplomatic crisis was almost certainly whisked up by the Emiratis), and making new allies. One of those allies, a loose group of militias based in southern Yemen, has just started a second civil war in a country that was already ravaged by its first. The U.A.E. has been part of the the Saudi-led coalition in Yemen for many years, ostensibly to restore the Hadi government to power. But where Riyadh was fighting a credible threat from the Houthis (who are currently having a field day bombing the Saudi city of Abha), the Emiratis were really there for prestige and weapons-testing. Now that its officer corps is a little heavier with newly-won medals and its newly-bought American tanks have been tested, the U.A.E. has started making new friends and funding proxies, like the Southern Transitional Council (STC) in Yemen. For its part, the STC was more than happy to accept the weapons and help fight the Houthis. Simply put, the STC is one of several groups in southern Yemen who want to split the country in two. They were displeased when the country was unified in 1990 (before which North Yemen and South Yemen were separate nations). There are also significant political and religious distinctions. This week, the STC stormed the presidential palace in the southern port of Aden and demanded that all northerners be removed from power. They did so with the approval of Abu Dhabi. And so the internationally-recognised government of Yemen is suddenly at war with a good portion of itself. Again. The Best of Times . PHOTO: Envision Energy What's Russian for "wind"? Research has identified that 4.9 million square kilometres of Europe – much of it in Scandinavia and Eastern Europe – would be suitable for wind turbines. If filled, the 11 million turbines would produce enough energy for the entire world. Yes, that might not leave room for much else, but we're not citing this information as a prescription, more so as a reminder that the world's energy needs do not necessitate destruction of the planet's climate.   What's bigger than a King and an Emperor?  Last week we made note of a very big parrot. This week we pay homage to the monster penguin, as tall as an adult human, and also a resident of New Zealand. It seems the lack of natural predators allowed birds to grow ludicrously large in the land of the long white cloud. But before you get too excited: this one is also extinct.  The Worst of Times An ice-core sample. PHOTO: Duncan Clark / Reuters There are micro plastics inside Arctic ice-core samples We're running out of pejoratives for this situation.   Cradle to the grave marketing China's state-run tobacco company has a monopoly over 300 million smokers. The China National Tobacco Corporation (CNTC) is required – as all state-run businesses are – to engage in charitable works. For the CNTC, one such avenue for charity is building schools in rural China... with their branding on them. The proliferation of schools with names like 'Sichuan Tobacco Hope primary school' has public health academics in something of a bother. Weekend Reading Quote of the week "The $38bn in accounting fraud amounts to over 40% of GE's market capitalization, making it far more serious than either the Enron or WorldCom accounting frauds." – Harry Markopolos accuses an American titan of massive fraud. While General Electric has responded with swift denouncements, the statement has sent shockwaves through the business community. Markpolos was, after all, the man who toppled Bernie Madoff's $65b pyramid scheme.   Headline of the week Tencent Video sorry for message that Typhoon Lekima nearly wiped out population of Chinese province Shandong – South China Morning Post   Special mention The gay penguins at Berlin zoo that adopted an egg abandoned by its mother. We dare you to try and not anthropomorphise that!   Some choice long-reads   Foreign Policy argues that Prime Minister Boris Johnson needs a second referendum to stay in power (his opponents one for very different reasons),   Businessweek probes the American state of Montana and its shocking suicide rate, and   Financial Times follows Germany's right-wing AfD as the upstart party struggles with unity at a critical juncture. EDITOR'S NOTE: We haven't included Jeffrey Epstein's death in the main body of the Wrap because there are frankly too many unknowns at this point to take any of the narratives seriously. His apparent suicide could have been a result of overworked guards, an under-resourced prison system, errors in protocol, or something more nefarious. A lot now rests on the testimony of Ghislaine Maxwell, Epstein's one-time partner and alleged recruiter. That is, if she can be found. Tom Wharton @trwinwriting