The World’s Penicillin Problem

Late in November 2016 I received news I had been granted generous funding from the European Journalism Centre to investigate an ongoing penicillin shortage affecting multiple countries.

With this project I aim to investigate the causes and consequences of a long worldwide shortage of this essential medicine, especifically the injectable form of the antibiotic Benzathine Penicillin G.

Lack of access to this medicine, listed as an essential drug by the World Health Organization, can have dire consequences as it is the primary treatment for syphilis and for rheumatic fever – illnesses that affect millions of people worldwide.

The stories will look into the supply chain of this medicine to understand what is leading to shortages; into the victims who can’t access this drug; and will examine what are the risks of antibiotic resistance associated with penicillin shortage and misuse of substitute drugs.

The funding will allow me to do fieldwork in a few countries, including India, South Africa, Brazil and England, UK.

I have been lucky to assemble a great coalition of news partners, including Al Jazeera English (international), El Mundo (Spain), Folha de S. Paulo (Brazil), Quartz (international) and The Bureau of Investigative Journalism (UK), which have all agreed to run the stories.

While I am the project lead, I will also have the support of Ashley Kirk, data journalist at The Telegraph, who will be assisting me with everything data-related.

This is a longer term news project, expected to be released between March and April 2017. More details about what I will be working on for the next few months can be found here.

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Zika is not the only disease plaguing pregnant women in Brazil

Recently I wrote a news story for Quartz about the increasing numbers of syphilis infections among pregnant women and newborns in Brazil.

While the country’s spotlight is on the microcephaly-linked Zika virus, cases of pregnant women and newborn babies suffering from syphilis silently jumped year after year as a shortage in penicillin hits the country.

Both diseases are linked to birth defects, such as severe brain damage and deformities – but press coverage and public investment have been disproportionately targeting the mosquito-borne virus.

Syphilis is currently more deadly than Zika infection – it leads to one in every 10 infected pregnancies ending in either fetal or baby death. In 2013 alone, the disease led to 695 neonatal and infant deaths in Brazil.

“People don’t see syphilis as a serious disease as much as they see HIV and Zika, and we are seeing a comeback of the infection, which is now routinely detected in pregnant women,” says Jorge Senise, infectologist at a health center for women with STIs at Federal University of Sao Paulo.

The full story can be read at Quartz.

#CarnavalSemAssédio: How Women in Brazil Are Fighting Harassment

A group of men gathers around a girl, one grabs her arm and try stealing a kiss. She refuses it and the group shouts: “slut, slut, slut“.  

The scene, in the historic town of São Luiz do Paraitinga, 115 miles from São Paulo, should be labelled as harassment, but it is common during Carnival in almost every part  of Brazil.

In an attempt to stop aggressive behaviour towards women, three Paraitinga residents bought and distributed whistles to females, who should blow it in case they felt intimidated by men. 

The initiative “Apito Contra o Assédio” (“Whistle Against Harassment”) is one of a few recent examples of how women are fighting against normalized violence in Brazil.

“I believe information is important”, said Lia Marques, one of the founders of the campaign, in an interview with BBC Brasil. “Harassment is a culture, they [men] believe it is normal, they are used to it. But actions such as this one will help people to understand how this [behaviour] is disrespectful.”

This Wednesday a group of women in Rio de Janeiro took the streets with the paradeMulheres rodadas” (Women who have been around). The title mocks a slang expression used by Brazilian men to humiliate women about their sexual history. 

The parade is supporting the campaign Carnaval sem Assédio (Carnival Without Harassment), launched by website Catraca Livre.

Bringing light to the issue is necessary

A survey by Instituto Data Popular, a think-tank based in São Paulo, shows that almost half of Brazilian men believe that carnival parades are not for “decent women”.

Sixty-one per cent of the men surveyed also said single women taking part in carnival couldn’t complain of being flirted with.

Debates around violence against women gained a boost last October, when thousands of Brazilian women shared their stories of harassment under the hashtag #firstharassment (#meuprimeiroassédio).

The campaign was launched by São Paulo-based journalist Juliana de Faria after a 12-year-old contestant of MasterChef Junior was the target of sexualised online abuse during her appearance in the TV show.

In the chart below from Google Trends it is possible to see the spike in searches for both the terms “harassment” (assédio) and “violence against women” (violência contra a mulher) in mid-October, period when the the #firstharassment hashtag was launched.

Captura de tela 2016-02-10 13.00.21

Such initiatives illustrate how women in Brazil are fighting against a topic deeply buried in Brazilian society.

With mobilization on social media and honest testimonials, women are bringing to light daily cases of abuse suffered by females across the country.

Carnival is just another stage to gather attention to a topic that can no longer stay in the shadow.  

London Launches First Wide-Campaign to Fight HIV Amidst Rise in Infections

The U.K. has now the largest HIV population ever in UK’s history and new infections are again rising. A group in particular has been challenging prevention programs: diagnosis amongst gay men aged 15-24 almost doubled over the last decade.

“There is now a danger that has become a threat to us all. It is a deadly disease and there is no known cure.” These were the first lines of the public information commercial “Don’t die of ignorance” launched in 1987 by Thatcher’s government to inform Britons about the risks of the HIV. Almost 30 years after the initiative, London’s first wide campaign tries to address a new HIV rise in the UK.

In May a £1,3 million media campaign was launched by London HIV Prevention Programme to increase testing and condom use in the capital.

The initiative, called Do It London, includes advertising in 200 phone boxes across the capital and the distribution of 1.5 million condoms and lubricant sachets to a minimum of 80 gay men at specific venues across London and at events, such as the Pride London parade.

DoItLondonPhonebox“London boroughs are determined to reduce the prevalence of HIV and the launch of the ‘Do It London’ campaign marks an important step in raising awareness of testing across the capital,” said Teresa O’Neill, London Councils’ Executive member for health, in a press statement.

Around 107,000 people live now with the infection in the UK, the largest HIV population ever in UK’s history, and more than a third of people living with the disease are Londoners.

New infections are also higher in the capital compared to other regions in the country. According to Public Health England (PHE), 33 per cent of the 6,000 new HIV cases diagnosed in the UK in 2013 were in London.

In the map below it is possible to see the HIV prevalence for each borough in the capital. The darker the area, the higher is the prevalence of positive diagnosis. Click in the image for accessing an interactive version of the map:

HIV in London_Map

Challenge in reaching young gay men

Amongst those new infected, gay and bissexual men are at greater risk of contracting new infections. According to PHE, this group was responsible for 62 per cent of new HIV cases in 2013.

But is the rise in infections amongst young gay men that has been challenging prevention programs.

New infections among those aged 15-24 have almost doubled over the last decade, from 8.7 per cent to 16 per cent of new cases identified in the UK.

In the graphic bellow it is possible to see the evolution of new infections involving this group:

YoungGayMen_NewProviding information for this group has been a challenge and social media has been a crucial platform for getting across prevention messages.

“In reaching young men who have sex with men, it is important that we adapt and change our approach to ensure our message stays relevant,” says Justin Harbottle, programme officer at Terrence Higgins Trust (THT), which manages the HIV Prevention Program in the UK.

“We know increasingly that social media is particularly important for young men who have sex with men especially, with a very high proportion using sites like Facebook, and with apps like Grindr and Tinder becoming the most important places for guys to meet other men.”

Organizations have also been experimenting with dating apps such as Grindr and Tinder, which are widely used by gay men for meeting new partners.

“All of our campaigns have been promoted on smartphone apps and websites like Grindr, with a single Grindr push message generating over 1,000 postal tests. We know for over a third of people who ordered a kit, this was their first HIV test, and for many, was a first easier step before going to a GUM clinic,” says Harbottle.

Sex education in schools

Another crucial tool for HIV prevention among young gay men is more information, especially at schools. A recent survey by National Aids Trust revealed that over a quarter of gay men aged 15-24 did not know how HIV was passed on.

A research by Ofsted conducted in 2013 identified that sex and relationships education required improvement in over a third of schools, adding that lack of proper sex education leave “some children and young people unprepared for the physical and emotional changes they will experience during puberty, and later when they grow up and form adult relationships.”

For THT, there is a clear correlation between HIV rise among young gay men and lack of appropriate information at schools.

“The increase in HIV infections reinforces the need for statutory sex and relationships education that is inclusive of different sexualities and genders. It can fully equip all young people with the skills they need, not only to prevent pregnancies, but also to protect themselves from STIs and realise enjoyable and healthy relationships.

“Until we have this in place, we will always be playing catch up with young gay men in terms of sexual health education,” highlights Harbottle.

London’s campaign adds to national initiatives for fighting the rise in HIV in the UK such as It Starts with Me and the National HIV Testing Week, which promotes testing and condom use at a national-level.

PHP estimates that almost a quarter of HIV positive in the UK don’t know they are infected. Increased testing is seen as key for fighting the spread of the virus as people who are not tested may be infected and can pass on the virus without knowing it. Later diagnosis can also increase the chances of death by Aids.