little hill attack in a letter to the committee law is finished abandoned say he is ready to set to testify publicly. he was summoned to speak about what he knew leading up to the right. but until now, he'd refused to comply ban and served as trump's chief strategist in 2017 select committee is conducted a nearly year long investigation into how tromp support has invaded congress. on the 6th of january 2021. ah! look at the main stories are following. now you ends. hg says people will die if much needed food. medicine and shelter cannot be delivered to serious last rebel held enclave authorization for you and deliveries at the bubble. how a crossing expired on monday. because russia vetoed efforts to extend it. that 8 is a lifeline. and it lip providing 70 percent of the food needs and the enclave words

help. 2.4000000 people so far this year. some cars your glue has more from the border crossing the you and trucks are not allowed to enter and it is either leather, which is a religious holiday among muslim people. that's why commercial trucks are not passing through this corridor. however, turkish and deos are able to cross the border even though it's a holiday. or even if the u. n. a u. n. trucks are bent from crossing the borders. why do you and security council menu of the angels i have spoken so far. tell me that the system that was established by the u. n. is the most effective. one is the fast, this one cheapest one. and it reaches the many, many people inside a north west syria, number of people killed in a russian missile strike on an apartment block in easton, ukraine has risen to 35 story building in the town of chess of yar was destroyed. after being hit by russian rockets on saturday, emergency work as

a continuing to search for survivors underneath the rubble with 9 people found alive so far. speakers should anchors parliament says a new president will be chosen next week. after negotiations to form a new unity government. as follows, unprecedented protest, tens of thousands of people, storm the residences of the president and prime minister, good by roger boxer and primaries, to run away from his singer say they will resign after being blamed for the nation's worst in economic crisis in decades. and at the rules and time table have been announced for the contest to be, britons next prime minister 11 candidates seeking to replace for is johnson will need at least 20 supporters just to get on the ballot. nominations will close on tuesday, but the winner won't be known till september. loza headlines this hour the stream as the program coming up next. but i have another update for you in about 30 minutes time.

ah ah. well come to the stream. i am at sabbath dean, and today we look at monkey pox. it's spreading faster than ever before. and while it's not as deadly as coven 19 health experts warn that without a proactive approach to testing vaccinations and building public awareness. the disease could very well become endemic in many more countries. if you have a question about monkey pox or you want to jump into our youtube chat, you too can be part of today's conversation. ah,

new cases of monkey pox continue to spread to countries where the virus is typically not seen. thousands of cases have been found in at least $57.00 countries already. and mainly among men who are gay and bisexual. here with us to talk about the global outbreak, we have benjamin ryan, a science journalist based in new york city in geneva, dr. rosamond lewis of the world health organization. and then you owned a cameroon. yeah, boom, a micro biology professor and regional representative for api song. that's the research arm of doctors without borders. i thank you all for being with us. i to kick things off. i was hoping to just make you listen to a video comment that we here at the stream received from a science journalist based in san francisco. her name is liz. hi, lehman take, listen. we still have a lot to learn about monkey pox, but right now it does appear to be spreading among primarily among gay, bisexual and other management of sex with men in the united states and other

countries where it hasn't been endemic. but we do know that it transmits from close personal contact, including sexual contact, which could include on skin to skin contact, kissing contact with close or betting that have been in touch with the source of someone with monkey pox. so anyone could potentially get it. and what we need now is more testing and more widespread testing. so we can see where this epidemic going because that's the only way we're going to be able to contain it. so rosamond, you heard her say we need more testing and if i'm not mistaken, i understand it's primarily transmitted through skin to skin contact. what do we need to know about monkey pox in your mind? well, monkey pox is a disease. it's that is related to what used to be smallpox which was eradicated in 1980. right. so we spent 40 years with a learning about monkey pox as it has arisen in the african setting where

it was 1st discovered some time back. and so it's not a new disease, that's one important feature. it's not, you know, but it is something that has been emerging over a long period of time. and so what we're seeing now is a completely different outbreak. it's not been seen in this way before. it's manifesting in a completely new way, and i appreciate you bringing that up. i see benjamin nodding when you say it's manifesting in a completely new way, anecdotally, i've heard what those ways are. i'm curious benjamin, for our audience. why is it spreading to new countries in your mind? and what do you think rosamond was referring to? what, what shocks you most about how it is spreading? i think what i can really comment on is that what we're thinking from the data is that this is primarily spreading among sexual networks of men with men. it seems to be what's happened is it made its way into western europe about 2 months ago and into groups of gatherings of gay men parties, group sex activities. a lot of these guys have done a lot of traveling, and they engage in multiple sites with multiple partners in short periods of time,

which is a great way for pathogen to transmit. so it's hard to know without a lot more testing, but it's the data that we do see suggest that 95 percent or more of the cases may be in minutes with men. and i've heard a lot of public health officers kind of downplaying that they'll leave with this concept that anyone can get a monkey pox. but i feel a bit simplistic because it's not necessarily a binary question, which is the most important question. but who is the most likely to encounter the virus and who is the most likely to then contract it and why? and boom, when you hear benjamin explain this outbreak, this global outbreak, which is unprecedented. what comes to mind based on your experience with this in africa, particularly in cameroon. yeah. forgive me, forgive me. yeah. i actually can go if you have a booming get. thank you. so what is quite interesting is that

more people are breaking remaining, how we are connected, and how dependent within was mentioned, or have been doing the many african countries and now out of the blue, you can see up any all over the world. so it remind us how we miss make sure that we control or do emergent even when we don't think that they will join the western countries. now. yeah, and you know, when we talk about that, it's kind of unfortunate. i mean, you know, there's a lot of stigma and concerns around how to talk about this with the l g b t q plus community. but also it's a bit disappointing that it's only now getting attention that it's spread in europe as we heard. and amongst western countries. i'm curious though, in the meantime, you know, whether to call it a pandemic or not rosamond, i know there have been people like eric fargo being on twitter. he wrote an article for the washington post saying it's time for the global public health community to

recognize a growing reality that it is, in fact that, yes, benjamin being is a doomsday profit. who leverages this area to gain followers on twitter, and i don't think use anyone that we submitted to about the topic. ok. fair enough . i appreciate you. i appreciate you jumping in there and you know very well that i feel that way. no, no, no, i don't me any minute. i know i'm happy to answer the question. all the same, row them. don't answer the question but, but let me add just one last thing. for example, he's saying this comparison right over 30 years, we've only tracked 2000 and monkey pox case in case of globally in total. in the last 2 months. in contrast, we have tracked 7000 new cases. now. the provide some contact either let's, let's start with rosamond. i mean on the face of it, if you don't know much about either of these things that's quite alarming. is it true? okay, so there's a number of the components in his statement there. so the 2nd part is correct,

that today's figures are over $7000.00. well, $7107.00 confirmed cases in 60 countries since the beginning of may essentially i'm so the case smith started before that but they would be getting to be reported to the world health organization at the beginning of may. the 1st part of this case of a statement is not entirely correct. um, because there are cases that have been reported and, and yep, we'll talk about these, i'm sure, but, and tens of thousands of cases reported in places like the democratic republic of the congo in central africa. but of course, they don't have access to testing. so as liz mentioned, access to testing is, is critical in responding to this outbreak. but it has been critical and responding to monkey pox for decades. and, and so though, met the some countries can only report suspected cases. they don't have the ability to report confirmed cases and, and that is a critical feature and distinguishing between, you know, a,

what do we really know about this? so there are a number of, of, you know, features around monkey pox which there, there's a classic description which you've all heard about, the type of the rash, the way it progresses. the pre drummel syndrome that begins with fever that begins with a, of course will. and lymph nodes is very classic, that was what was used 40 years ago to distinguish monkey blocks from smallpox. and so these are the classic descriptions of the disease and we're, we're, so we are hearing some deviation from that today. but there's always been a wide range of clinical manifestation from sub clinical infection, which means people could be exposed in mount her antibody response, but never have symptoms to very severe illness and death. so it's not only a mile disease, it's a disease that can affect it. can affect many, it can affect any one. the way it transmits is primarily on face to face skin to skin. but we, you know, we're not ruling out other possibilities and we have a lot to learn. we all like to learn about this, about this outbreak. first of all, i think words are really super important, right?

so pandemic is one of those words that everybody uses a differently. and what does it mean? and in international public health, the word pandemic is used specifically in the context of pandemic influenza, which has been known for a long time. you've all heard in the last few years about waves of influenza pandemic. it's not something that is actually used to trigger global response. ok. the world health organization under the international health regulation has something called a public health emergency of international concern, which was called free book, which was called procedure, which was called for sars, which was called for covert 19. so, so essentially, i mean, i understand and appreciate that it's important, you know, how we talk about this with that in mind. i do wonder benjamin, you've interviewed several people from the gay community in particular, including a man in london who had quite a harrowing case. we'd seen online as people are kind of describing their journey,

either worried about having it or eventually that getting diagnosed. there's been a lot of miss diagnosis. what can you share with us about what they, they've told you? well, some of the day that we're seeing is that perhaps up to maybe about 10 percent of people who attract movie parks in a global outbreak or being hospitalized. know, some of that could be to treat severe pain or infections of legion. and some of that maybe if they can't isolate otherwise, but somebody will, they've talked to have experienced this pain. it's pretty uncanny what they're going through. and this could be a bias of the kind of people who are talk to be i might be seeing over representation of worst cases. but i mean, the reports in, you're coming out of the cdc, you k saying the w h. i was saying that these are generally a mild presentation of legions across the body compared to perhaps what we've seen the past in the a den in countries in africa. but i'm hearing a lot of cases of men are getting very severe lesions in the interact or, or general regions that make going to the bathroom extremely painful somebody's man, where the hospital taking opioid treatment. so i have a suspicion and you know,

this is not necessarily borne out by the research. i wanted to thoroughly categorize that and that way that i'm not sure, but it seems like pain may be a much bigger problem than some of the port might be suggesting. at this time, all right, well it seems like at least rosamond and yap are nodding and agree with that assertion. yep. i'm curious in cameroon and across africa. i mean how challenging is it to diagnose and to test currently? what are the barriers his points trying to throw in the most of the keys up and in a very rural environment. so to the father. so you need to have to be able to call the family and then to bring to the various bits. i select the term, for example, there were only one love which you to, for the best done, was able to take those one. imagine for one of the fall, 2, you have one or 2. not able to make it there. so that's really meet the number of

so eventually out of 30 to pick the case we have only 5. confirm if you can be maybe the same. so it was mentioned before, we really need to know if rich are available so that we can capture to people and rosa ones. when we go ahead please, i just wanna jump into the u. s. you know, we're getting expansion right now into $10000.00 cases per commercial lab. we're getting 5 brought online by the cdc as we speak. so that's going to increase testing for ortho pox virus, which is the family which virus market box virus belongs to $58000.00 per week. and then positive cases go under the cdc for confirmation. so that will help, but you have to have stores as far as i understand or to test. so you can't test very well in the earlier earlier stages, which makes it harder to make sure people isolated, prevent and do the contact rating. so at the very low process even now, right. and with that in mind, rosamond, you know,

when we talk about testing and the importance of testing with any virus that spreading at this kind of unprecedented rate, you know, i know that they're there, for example, in new york city, which is one of the kind of epa centers of the outbreak in the united states. there have been, even in the u. s. such huge barriers, they could only test, i think, 10 people a day. the cdc has a monopoly over testing or used to at least of the early days. and i'm curious when you look at testing what, what is most important to you in terms of what needs to happen now, how countries can prepare to prevent that from, from getting out of hand. so testing is, is critical and it's difficult because at the moment we only have uh, pcr rate. so everyone's really with the pcr. but with covered 19, we moved quickly to, well, let me know as quick as we would like to, but to rapid tests, we don't have rapid tests for ortho bucks, viruses they, it's been worked on for it for years. and it's not that easy apparently. and so i, we have to rely for the moment on p c r. so what that means is that you require

a laboratory in most situations, you require a laboratory setting. there are other technologies that can be brought to bear, but you also need the reagents. you need the, the primers and the probes everything that goes into doing a p c r test and it does take time. it's lab time. it's human resource time it's personnel time. and so that is challenging. what's interesting about this is that it's proving challenging as challenging almost in america as it is in africa. yeah, this is an unusual situation, right? right. so it, i'm sorry that you're a challenge. if i've aren't interested in or jacked on that point. i mean, it's kind of shocking the for decades, you know, it's not like corona virus which has appeared to, you know, i know it's related to other viruses but appeared just 2 years ago. i mean, we've known about this as we've heard from, from my job. it's been around and africa and as you know for decades. so. so why did it, why is there no rapid task, for example? and why don't we know more? because to have her go ahead wrap. yup. go ahead. okay, so i was gonna to have all those dates available, you need a lot of money noon,

look the front fools and research lab institution to find those rub because simply for the vaccine thinking for drugs. so because now they have not been in any funding, oh, it's a good funding and also no market because if you want to produce that, that you need to have a big market for that. and if you have, are you sure getting them figured anyone out there? i agree with. yep. go ahead. run your investment. yeah, i completely agree. he's been under investment in research and i surveillance and in, in africa in general, where the, this disease has, has been emerging for the past 40 years, a half. what there is, there is an upside to, to the story. and that's that said, oh, every country in the world did eradicate smallpox in 19 lives declared eradicated 1980. but since that time there, you know, just been 40 years of ongoing research, which has led to what we have to day. the tests we do have to day,

the vaccines we do have to day the treatments. we do have to day, which are still all relatively new. many of them relatively new products. they're still not widely available, although a lot of work is going into that right now. they are the product of actually smallpox preparedness. and so in the, when you are, the good news is we're starting to roll those out as well. so we're not so far behind as we were recovered at this time. there's a lot more hope involved in addition to the fact that no one has died from this disease. there's over, i think, 8000 cases globally outside of africa. there been 3 deaths recently in africa, but no one has died outside of out. so of this disease so far, so that's encouraging. i mean, when we wrote, when we on youtube, some people are sending us questions and comments. one of which i'll read george mitchell saying the global response seems very similar to h i. v and aids in the eighty's. i disagree entirely really? well, that's why we did this. what is different about it? what is different? well, i hear a lot of talk on twitter. there's a misconception that the problem in the early days of aids was that people over

emphasized of how much aid was occurring amongst men insect men. i think it's really the opposite. the problem was people ignored aids because it was affecting their sex with men. and in the united states, in western countries, it has always been predominant amongst as those of men. so i don't understand how people got that backwards. and this, this is occurring for donnelly, as we understand it right now, amongst nasdaq men month monkey fox is. and it may fill out more in other populations. we don't know, we need to be on the watch for that. we also need to speak frankly, about what kind of behaviors are associated with threatening this virus at this time. and what people can do to start to think about how they can maybe mitigate their own risk of those of their partners and their members, their community, through vaccinations or change their sexual behavior or whatever it might be. no. and i think it's important that we're candid about all aspects of this conversation . so to help us doing that, we have a video comment sent to us from dr. mike ryan. he's the executive director of the w h o help emergencies program. he's talking about how prepared or not nations are as

they assess what to do about this. take a look. so each country has gaps in its readiness gaps in this preparedness capture that surveillance, no countries without those gaps. some of those gaps are more extreme. and many of those gaps are because of lack of access and lack of equity, we will see differential impacts and countries. so depending on how strong that wall of immunity is in your community, depending on how well you deal with the vulnerabilities of people have. and depending on how well you're prepared to deal with that, i think we're going to see further ways of disease. and i think we will see them have a very differential impact between countries. and there was so much the countries can do now. in preparation and in readiness. so rosa yes, go ahead for a question. what do we feel about the long standing impact of people who were vaccinated for small when they were younger people up to 50 years ago? what do we think that will do to protect people again? monkey fox, now, if anything. well,

what we've been seeing over the last 40 years is that when the m monkey pops 1st emerge, it was 970, and a small boxes eradicate and ancient 80. so as the cases began to emerge in central africa, but also west africa, we're talking about different plates, different strains of the virus here and, and, and the age was infants, 2 year olds, 5 year olds, young children, and over those 4 decades, the average age of the, at the cases appearing, they're all ages actually in africa, but the average age, the median age has actually risen to be young and late adolescents young adults. and this is in part i bought the size to be because any one, as you had mentioned, anyone under the age of 50 or depending on the country, 4250 has not been immunized against small clock. so, the hypothesis is there may be some remaining immunity, but of course, you know, i've had that vaccines, but that's a, you know, a long time ago. and, and we don't actually really know whether it was a very,

very powerful vaccine. but we don't actually really know whether that immunity is still there. we think that there may be some and unity remaining in that population group. and so there may be some protection and people over 50 around the world. well, were you know, what's interesting to me, i was in brazil and i recently arrived in the u. s. and it's interesting to see how certain cities are major cities in the world, new york, washington, dc. i known canada as wells london. they're starting to vaccinate, vaccinate people from the algebra t community, particularly men who have sex with man, or have multiple partners. and it's, it's, i've already seen people doing the sort of traveling to the us trying to get vaccines. but vaccines are, are short even in the us and, and other i've heard of a man's going from new york to montreal, detroit again. yeah, yeah. i mean, we're seeing this sort of, you know, traveling to get this vaccine. is that, is that a positive step? you know, is that something that shocks you ah, ah yeah. am, i'm so sorry. i keep getting your name. forgive me. if i try to remind me when we

were talking, the recognition in the sense that you will have western countries who will feel the highest. we will keep the adult, it's critical that you have a talk of those that you make sure that all the countries will have to do the thing . because now you're focusing on the, on the gate a little bit for the work done. but you also remember that what you're seeing in africa is only the people that i brought because of the testing. so we have to make sure that those backseat also remain available for population as to now. we don't have many knows when to virus we eat more population. what's going to happen? yeah. do you have faith that you know now, even though it's frustrating that there is maybe more attention on funding in the importance to fund this, not only in the west where it's happening now, but where it's been happening for decades. do you have faith that that will change, that this is an opportunity for countries in africa to receive the funding they've

been missing? this is the, i think if i've already thought that there is a clinical look, i thought that in the central african republic on, on one of the drugs are to do to treat which was used for more. but that may be used for market book. so it's coming, it's coming, but we actually want not to come only when everyone emergency we want the front of the board to fight and to prevent those imagine need because what we are realizing, we've quote, leave the ball or monkey book is that being removed from one place one unit. yes. and you know with that in mind, i want to mention that we have many questions and youtube, so our audience is interested in this john beam asking, what is the mutation rate of the virus? rosamond, i'm going to ask you about that, but before i do, i want to just piggyback this tweet from jennifer news though about whether or not this is being contained and what needs to be done to do so it says some type of

genes are biologically not well suited to containment, but monkey pox is a decent candidate for containment. but the u. s. is slow to respond. posture makes her deeply worried that containment of the past pathogen maybe out of reach. so what is the mutation rate and is it out of reach? does jennifer news? i have a point here it's, it's definitely a challenge i've made. so you know this, this disease is as you say, affecting men who have sex with men right now. it's not the only people who can be susceptible to this. providing the right message is really super important and whether the virus is mutating or not. it, it, it, i apparently had, there had been some changes that were unexpected because normally this dna virus is a very stable virus. it doesn't change as quickly as our neighbors do. hack, so we have a lot to learn about the virus itself, but also how was it transmitting on through as was mentioned by benjamin by through certain behaviors, but also to not stigmatize we, we need to describe the epidemic as it's happening. we need to describe the

epidemic as it's happening in different contexts and each one of each country, each, each community in different contexts, you know, are best served if they are understand they seek information, understand, try to understand what's happening in their community, who may be at risk provide information for those people who are at risk. i was on a call today with colleagues who were concerned that even if we, we spent a huge amount of effort actually trying to communicate through community groups through a l, g, b to q, community associations through representatives, a specific communities really getting the message out social media tiles special and unco created messages, language that is is accepted and, and, and preferred by, by the community. yeah. and yet somehow, right somehow, some pride of festivals. you, he some, some, some of them you see monkey rice, everywhere and other others. you don't see it at all, what vol. and so it's still uneven. the message is getting out unevenly. of course,

of course, another. and that's why rosamond, we had the show and why i want to thank you for taking the time to join us. that's all the time we have for today. thanks for watching. so your next time. ah ah. ah.

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impact their land and to seek their consent. the tiny cine annoy community has won a huge battle, but it may not necessarily have the last word. since the court ruling does leave room for exceptions in the name of overriding national interests. ah, hello, i'm mary. i'm no mozy in london, our main story. now. the u. n. a chief is wanting that people will die if much needed food, medicine and shelter could not be delivered to syria's last rebel held enclave authorization for you and deliveries at the bubble. how a crossing expired on monday. because russia vetoed efforts to extend it. that aid is a lifeline and in lib, providing 70 percent of the food needs and the enclave, or it's helped $2400000.00 people so far this year. some because your glue is at

the border crossing the you and trucks are not allowed to enter and it says it will allow which is.