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Opioid addiction settlement reached with US Consultancy firm; The latest health stories from around the world

Article by Lalita Panicker, Consulting Editor, Views and Editor, Insight, Hindustan Times, New Delhi 

Consulting firm McKinsey & Co has agreed to pay $78 million to resolve claims by U.S. health insurers and benefit plans that it fuelled an epidemic of opioid addiction through its work for drug companies including OxyContin maker Purdue Pharma. https://www.reuters.com/legal/mckinsey-pay-78-million-us-opioid-settlement-with-health-plans-2023-12-30/ 

The settlement was disclosed in papers filed on Friday (29 Dec) in federal court in San Francisco. It marked the last in a series of settlements McKinsey has reached resolving lawsuits over the U.S. opioid epidemic. 

Plaintiffs accused McKinsey, one of the leading global consulting firms, of contributing to the deadly drug crisis by helping drug manufacturers including Purdue Pharma design deceptive marketing plans and boost sales of painkillers. 

McKinsey previously paid $641.5 million to resolve claims by state attorneys general and another $230 million to resolve claims by local governments. It has also settled cases by Native American tribes. 

Friday’s class action settlement, which requires a judge’s approval, resolves claims by so-called third-party payers like insurers that provide health and welfare benefits. 

Paul Geller, a lawyer for the plaintiffs, in a statement said the drug crisis was caused by an oversupply of dangerous addictive drugs, and the case aimed to “recover some of the money spent on the over-prescribed pills.” 

McKinsey did not admit wrongdoing. In a statement, the firm said it continued to believe its past work was lawful. It also noted it had committed in 2019 to no longer advise clients on any opioid-related business. 

Thousands of lawsuits have been filed by states, local governments and Native American tribes accusing drug companies of downplaying the risks of opioid painkillers, and distributors and pharmacies of ignoring red flags that they were being trafficked illegally. 

The litigation has resulted in more than $50 billion in settlements with drugmakers, distributors and pharmacy chains

Nearly 645,000 people died in the U.S. from overdoses involving opioids, both prescription and illicit, from 1999 to 2021, according to the U.S. Centers for Disease Control and Prevention (CDC). 

The U.S. Supreme Court earlier this month heard a challenge by President Joe Biden’s administration to Purdue Pharma’s multi-billion-dollar bankruptcy settlement resolving related claims against the drugmaker. 

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The world population grew by 75 million people over the past year and on New Year’s Day it would be more than 8 billion people, according to figures released by the U.S. Census Bureau on Thursday 28 December. https://apnews.com/article/world-population-census-bureau-growth-b2a32ff77b9f3ae977c943014fe2b853 

The worldwide growth rate in the past year was just under 1%. At the start of 2024, 4.3 births and two deaths are expected worldwide every second, according to the Census Bureau figures. 

The growth rate for the U.S. in the past year was 0.53%, about half the worldwide figure. The U.S. added 1.7 million people taking the population up to 335.8 million by New Year’s Day. 

According to United Nations’ projections the world’s population hit an estimated 8 billion people on 15 November last year, more than a month before the US Census Bureau calculations with much of the growth coming from developing nations in Africa. 

Among them is Nigeria, where resources are already stretched to the limit. More than 15 million people in Lagos compete for everything from electricity to light their homes to spots on crowded buses, often for two-hour commutes each way in this sprawling megacity. Some Nigerian children set off for school as early as 5 a.m. 

And over the next three decades, the West African nation’s population is expected to soar even more: from 216 million this year to 375 million, the U.N. says. That will put Nigeria in a tie for third place with the United States after India and China. 

The upward trend threatens to leave even more people in developing countries further behind, as governments struggle to provide enough classrooms and jobs for a rapidly growing number of youth, and food insecurity becomes an even more urgent problem. 

Nigeria is among eight countries the U.N says will account for more than half the world’s population growth between now and 2050 — along with fellow African nations Congo, Ethiopia and Tanzania. 

“The population in many countries in sub-Saharan Africa is projected to double between 2022 and 2050, putting additional pressure on already strained resources and challenging policies aimed to reduce poverty and inequalities,” the U.N. report said. 

It projected the world’s population will reach around 8.5 billion in 2030, 9.7 billion in 2050 and 10.4 billion in 2100. 

Other countries rounding out the list with the fastest growing populations are Egypt, Pakistan, the Philippines and India, which is set to overtake China as the world’s most populous nation in 2024. 

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As Congo copes with its biggest outbreak of mpox, scientists warn discrimination against gay and bisexual men on the continent could make it worse. https://apnews.com/article/congo-monkeypox-outbreak-gay-discrimination-mpox-bdfbae117989cfa41f5e7e36d583c036 

In November, the World Health Organization reported that mpox, also known as monkeypox, was being spread via sex in Congo for the first time. That is a significant departure from previous flare-ups, where the virus mainly sickened people in contact with diseased animals. 

Mpox has been in parts of central and west Africa for decades, but it was not until 2022 that it was documented to spread via sex; most of the 91,00 people infected in approximately 100 countries that year were gay or bisexual men. 

In Africa, unwillingness to report symptoms could drive the outbreak underground, said Dimie Ogoina, an infectious diseases specialist at the Niger Delta University in Nigeria. 

“It could be that because homosexuality is prohibited by law in most parts of Africa, many people do not come forward if they think they have been infected with mpox,” Ogoina said. 

WHO officials said they identified the first sexually transmitted cases of the more severe type of mpox in Congo last spring, shortly after a resident of Belgium who “identified himself as a man who has sexual relations with other men” arrived in Kinshasa, the Congolese capital. The U.N. health agency said five other people who had sexual contact with the man later became infected with mpox. 

“We have been underestimating the potential of sexual transmission of mpox in Africa for years,” said Ogoina, who with his colleagues, first reported in 2019 that mpox might be spreading via sex. 

Gaps in monitoring make it a challenge to estimate how many mpox cases are linked to sex, he said. Still, most cases of mpox in Nigeria involve people with no known contact with animals, he noted. 

In Congo, there have been about 13,350 suspected cases of mpox, including 607 deaths through the end of November with only about 10% of cases confirmed by laboratories. But how many infections were spread through sex isn’t clear. WHO said about 70% of cases are in children under 15. 

During a recent trip to Congo to assess the outbreak, WHO officials found there was “no awareness” among health workers that mpox could be spread sexually, resulting in missed cases. 

WHO said health authorities had confirmed sexual transmission of mpox “between male partners and simultaneously through heterosexual transmission” in different parts of the country. 

Mpox typically causes symptoms including a fever, skin rash, lesions and muscle soreness for up to one month. It is spread via close contact and most people recover without needing medical treatment. 

During the 2022 major international outbreak, mass vaccination programs were undertaken in some countries, including Canada, Britain and the U.S., and targeted those at highest risk — gay and bisexual men. But experts say that’s not likely to work in Africa for several reasons, including the stigma against gay communities. 

Dr. Jean-Jacques Muyemba, general director of Congo’s National Institute of Biomedical Research, said two provinces in Congo had reported clusters of mpox spread through sex, a concerning development. 

There’s no licensed vaccine in Congo, and it would be hard to get enough shots for any large-scale program, Muyemba said. The country is trying to get a Japanese mpox vaccine, but regulatory issues are complicating the situation, he said. 

Globally, only one vaccine has been authorized against mpox, made by Denmark’s Bavarian Nordic. Supplies are very limited and even if they were available, they would have to be approved by the African countries using them or by WHO. To date, the vaccine has only been available in Congo through research. 

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