Bad medicine: the toxic fakes at the heart of an international criminal racket

The trade in counterfeit drugs is a lucrative and dangerous global industry, but there are hopes that on-the-spot screening technology can provide a remedy

Sometimes the vials are filled with dirty water. Occasionally they contain saline and a tiny amount of antibiotic, so as not to infect the site of the vaccination and draw attention to its true ingredients. But however good or bad the disguise, the fact is that these “vaccines” will actually have no effect at all.

The recent news that another batch of fake meningitis vaccine had been discovered in Niger is just the most recent incidence of a particularly dangerous and cruel criminal racket. As many as 1,500 cases have been reported to a surveillance database launched by the World Health Organization in 2013, and that’s probably an underestimate, says Mick Deats, head of the substandard and falsified medicines group at WHO.

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Jeffrey Sachs: ‘The US doesn’t lead the world any more’

The US is now a ‘rogue nation’, believes economist Jeffrey Sachs, but he is optimistic that the rest of the world is still trying to make progress

The US is becoming a ‘rogue state’, economist Jeffrey Sachs has told a Guardian audience. “But let’s not assume that everything is catastrophic right now”.

Sachs spoke at the Guardian’s annual UNGA seminar after seeing President Trump speak at the UN, and said he was “shaken” by what he had heard. “I could not believe that the President of the United States could talk with such vulgarity at the podium of the UN,” said Sachs, adding that Trump represented “the bravado of a country that thinks it runs the show.” But the UN adviser and Columbia University professor said he does not believe the US leads the world anymore.

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How banana skins turned on the lights in Lagos … and then turned them off again

For a while it looked as if a plan to turn fruit waste into electricity might bring light for a giant Nigerian market – but then, like so many other power plans, nothing happened. When will renewables really come on line?

Two kids run across the road shouting, “Thief! Thief!” as a big rat races away into a nearby hole for refuge. It has rained and the drains are clogged with waste: the water pools on the road and fills the potholes along the thoroughfare leading to Lagos’s famous Ikosi fruit market.

One of the largest of its kind in the city, the market is a popular spot for trading vegetables and fruit like pineapples, bananas and plantains. But here, like most parts of Nigeria, there is rarely a steady power supply – according to the World Bank, 75 million people in a country of 186 million don’t have access to electricity.

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Low blood pressure: tackling the donation shortfall in Nigeria

Using persistence and innovation, a few NGOs are persuading more people to donate and transforming distribution

She did everything she was supposed to during the pregnancy. Went for regular check-ups, got plenty of sleep, made sure she ate well, got a lot of exercise and did everything else they asked.

Ifetayo Owoseni, already a mother of two, was 34 when she went into labour, with no warning signs of trouble or danger. But halfway through, she began haemorrhaging. Owoseni needed a blood transfusion to deal with the excessive blood loss – without a transfusion she might die or lose her baby, or even both.

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Pains and needles: brain scans point to hidden effects of acupuncture

Placebo acupuncture can ease short-term pain but the real thing might help to reverse the underlying pathology of a disease

Doctors in China have been pushing needles into patients’ skin, supposedly to restore the flow of healing “qi energy”, for more than 4,000 years. Sometimes it feels as though researchers in the west have been arguing about the practice for almost as long. After more than 3,000 clinical trials of acupuncture, many scientists are convinced that despite the benefits that patients might think they experience, the whole thing is simply a highly convincing placebo (pdf).

But are the sceptics missing something? A steady trickle of neuroscience studies suggests that relying on patients’ pain ratings in acupuncture trials might be hiding important changes in the brain.

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The pre-teen superstars stopping disease in Iraqi refugee camps

Junior health workers are raising awareness about handwashing and drinking clean water to prevent diseases like polio, typhoid, measles and cholera

In the 45-degree heat and billowing dust of Kapartu camp in northern Iraq, staying neat and tidy presents a challenge, but there is one group of people who are always immaculately turned out and easily identifiable as humanitarians: a collection of children aged 11 to 13 who take great pride in their roles as junior health workers (JHWs). Smartly dressed in clean black T-shirts, black caps, and with lanyards round their necks, these children help fight the spread of infection, promote healthy habits and humanitarian ideals.

“I like wearing it, and my friends also like me wearing it,” says Hyatt, who is unsure of her age but thinks she is 12. “They wish they could dress like me and be a junior health worker.”

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Secret aid worker: do I have imposter syndrome or am I just not good enough?

Six years in to my humanitarian career, I’m still struck by Sunday night anxiety and sleepless nights about my ability to do my job. Is this normal?

Six years ago, a loosely structured internship quickly turned into a programme management job for a faith-based NGO. On my first day flying solo I received a copy of a child-protection grant, the signatures at the end slightly smudged. Apparently, the grant manager had been in a hurry to send it.

Reading through the contract was like trying to decipher the operational instructions for my new camera. I had never seen a grant before and didn’t know anything about the importance of indicators or budgets. Like I’d always done in my own life, I aimed to save money, not realising that my goal was to spend it.

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The low-cost device saving newborns in India

Birth asphyxia – lack of oxygen – is the cause of 20% of newborn deaths in India. A simple piece of equipment is helping revive babies and prevent long-term damage

Farzana Qureshi’s happiness over a smooth and uncomplicated pregnancy ended abruptly the day she went into labour. Tired by the end of eight hours of contractions, the 30-year-old was unable to push out her baby, whose umbilical cord was wrapped around its neck.

When the baby emerged, he was limp and bluish, and did not cry for 15 minutes. “For a while I was scared that something may go wrong with my child because of my lack of effort,” Qureshi says.

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From giving orders to making suggestions: one man’s journey from soldier to aid worker

As a young officer Laurence Knoop enjoyed working with local communities so much he decided on a career change – but the transition would not be simple

As Britain was emerging from winter in early 2014, I was camped out in the dustbowl that is the Rift Valley in Kenya in 30 degree plus heat, with a daunting array of diggers, bulldozers and other earthmoving equipment before me and 30 of Her Majesty’s finest Royal Engineers at my disposal. As a young army officer, less than a year out of training, I was tasked with the construction of an airstrip for the local community, part of the British army’s efforts to maintain favour and access to training grounds in Kenya. It ended up giving me a taste for humanitarian work that I knew the army wouldn’t be able to satisfy and was the trigger for a career change.

Three years later, I am back in east Africa, this time in Uganda, working as a construction manager for an international NGO, and I am continually surprised at the similarities to my role in the military. Notwithstanding the significant cultural differences, my crew of Ugandan labourers often display similar attitudes to the British soldiers I worked with: neither group want to wear safety equipment if they can avoid it; they will cut corners to get the job done quicker; getting their pay packets is often their main focus … but equally, they work extremely hard and are proud of what they do.

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