Researchers develop innovative way to detect fake malaria drugs that could save lives, deter counterfeiting
It looks like a simple piece of paper and it’s nearly as cheap, ideally costing just pennies. But despite its small size, it’s poised to make an enormous impact and potentially save thousands of lives.
It’s a new test to spot counterfeit versions of the drug artesunate, which is one of the most important drugs used to treat malaria, a mosquito-borne disease that affects hundreds of millions of people every year. Based on the science of microfluidics, researchers at Oregon State University developed an easy-to-use and inexpensive testing kit that patients and health care providers can use to determine if the malaria drug they receive is genuine and how much artesunate is present. Here’s how it works: a single pill is crushed and dissolved in water and then a drop is placed on the testing paper. Users then consult a simple color chart for the results — if the paper turns yellow, artesunate is present. The test takes just minutes and can be done just about anywhere. Findings on the innovative technique were recently published in the journal Talanta.
As the researchers noted in the journal article, drug counterfeiting is responsible for about 20 percent of the 1 million malaria deaths that happen each year. They also cited surveys finding that artesunate counterfeits make up between 38 percent and 53 percent of malaria drugs in Cambodia, Laos, Myanmar, Thailand and Vietnam. The Fake Malaria Drugs Kill project of the Dutch Malaria Foundation estimates that one-third of all malaria drugs sold in Africa are fake. And if that weren’t awful enough, counterfeit drugs can also contribute to the emergence of multidrug-resistant malaria. That’s why this little test could be a really big deal.
“It’s the first time we’ve tried to tackle a public health problem,” Vincent Remcho, an author of the Talanta study and a professor of chemistry and the Patricia Valian Reser Faculty Scholar in the Oregon State University College of Science, said about himself and his colleagues. “(Microfluidics) is a technology that is near and dear to us…to see it be useful in a public health setting is really gratifying.”
So, where did the idea come from? Interestingly, “it all started with a cool radio story,” Remcho told me. His wife, a veterinarian, was driving home when she heard a radio story about counterfeit medicines and malaria in particular. When she got home, she told Remcho that it reminded her of the kind of problems he tackles in his lab, where he and his colleagues build microfluidic devices that perform chemical analyses. Remcho agreed.
In turn, he and his colleagues set out with the intention of creating a test that was cheap, easy to use and wasn’t dependent on a person’s literacy level. The Centers for Disease Control and Prevention had previously developed a colorimetric test for artesunate, but it involved adding and mixing together chemicals in test tubes and isn’t easy to use outside a laboratory. In contrast, the test Remcho helped develop can be easily conducted in resource-poor settings, in remote locations and in the field. Remcho and study co-authors Myra Koesdjojo, Yuanyuan Wu, Anukul Boonloed and Elizabeth Dunfield write:
The chemicals required to perform the assay cost approximately US $.02 per test, which makes it a very practical solution to detect counterfeits. Since the reagents for the colorimetric test are stored on paper in dry form, they are more stable and easier to transport, which provides advantages of easy handling and longer shelf life. Furthermore, while most counterfeiters are producing fake drugs that lack of artesunate, some drugs are made with significantly lower active ingredients, which are incapable of killing all the parasites. This is an effort by the counterfeiters to misleadingly pass the test when a qualitative (positive/negative) evaluation is made to determine the presence of artesunate in the drug. Our test kit allows for quantitative analysis of artesunate tablets by providing a key that comes along with the kit and allows for comparison of the developed yellow color with the intensity of the yellow color corresponding to the approximate concentration of artesunate.
In addition to the test, students working on the project also developed an iPhone app that can more precisely measure the presence and level of artesunate. The app works by using the phone’s camera to analyze the intensity of the yellow that shows up on the paper strip. Of course depending on the setting, Remcho said the iPhone app may be most useful to health care providers and not necessarily patients. Still, the paper test results can be easily read with the naked eye, he added.
But can the test be cheated? Certainly not easily, Remcho said. If the criminals who manufacture and sell counterfeit malaria drugs wanted to cheat the test badly enough, they might be able to figure out a way. But Remcho hopes the time, effort and cost of finding a way to fool the test will be a deterrent.
Now that the test has been developed and assessed, Remcho is working to get the testing kit out to the people who need it. Beginning this fall and with funding from Grand Challenges Canada, which supports global health projects, Remcho and his colleagues are partnering with the National Institute for Metrology in Thailand to explore the feasibility of widespread use and distribution of the testing kit as well as the ease with which actual malaria patients can use the test. Remcho said he feels very hopeful.
“We want this test to be reliable and trustworthy,” he said. “I’m really hopeful that it goes in that direction. For right now, it kind of remains to be seen how it will evolve…but we’re excited that this technology can do some good.”
According to the World Health Organization, there were an estimated 207 million cases of malaria in 2012 and 627,000 malaria deaths.
To read more about the new counterfeit test, read this press release from Oregon State University or visit the Talanta journal. To watch a video about the toll of counterfeit malaria drugs, visit www.fakedrugskill.org.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.
by Anthony Robbins, MD, MPA
I first heard the name Thomas Piketty on a trip to France. Now his immense book, Le capital au XXIe siècle (Capital in the Twenty-First Century) sits on my bedside table (in both the original French and the English translation). It is a best seller in the US and in France. I have read reviews (here, here), attacks, defenses, and other essays that take off from Piketty’s work. I even had the opportunity to hear him live, addressing a class at MIT.
Having learned Piketty’s major observations and arguments with the MIT students and followed the debate about his work, I sheepishly admit that I have barely cracked open the book. Perhaps I overestimated my capacity to read the book. Could a book so large and dense ever have been bedtime reading?
This has not stopped me from thinking, based on his methods and conclusions, Piketty might have something to offer us in public health. He describes how over the last two centuries, as income flowed to the richest people, the distribution of wealth in industrial societies has become increasingly concentrated in a very small minority–increasing wealth inequality. There was one brief period, from the 1940s to the 1980s, where wealth inequality declined, but Piketty suggests that this was an historical aberration, not the long-term trend. He predicts increasing wealth inequality in the 21st Century, a feature of capitalist economies, unless we do something about it.
Public health scholars have concluded that environmental factors–both the physical and social environments–affect health. They have imported the word determinant from mathematics to describe these causal situations. They have also chosen to use the adjective “social”, although I don’t think they means to exclude physical exposures like housing and workplaces. And since the Report on the WHO Commission on the Social Determinants of Health, researchers are more attentive to what influences the health of populations. This is a salutary trend, as it constitutes a countervailing force against the tendency to attribute health to medical care effectiveness and lack of health to medical care deficiencies–a very narrow view.
To study social determinants of health, most researchers have compared people exposed to different environments, often using income as a variable. Because it is easier, these studies usually look at different populations at one time in history. The studies are cross-sectional, not longitudinal (over time).
If we adopted Piketty’s research strategy and focused on changes in health and in social determinants over time, would we be able to learn more about the causes of health inequality? Surely more has changed over time than the medical care system. And just as Piketty urges policies that alter wealth directly, such as wealth taxes, to achieve a more equitable distribution of wealth, public health advocates would be advised to urge policies that attack the most unhealthy aspects of our societies’ environments.
Here I make a plea for public health leaders to avoid having public health get lost in the term health systems, where the public immediately thinks medical care. Surely we must attend to workplaces and employment, housing and the living environment, and toxic and physical exposures throughout society. These exposures are rarely spread evenly across the population. Following changes over time in both health and exposures may encourage policies that bring more health in the future. It may be a powerful antidote to the conventional thinking that usually attributes inequality in health to unequal access to medical care.
Anthony Robbins, MD, MPA is co-Editor of the Journal of Public Health Policy. He directed the Vermont Department of Health, the Colorado Department of Health, the U.S. National Institute for Occupational Safety and Health, and the U.S. National Vaccine Program.
Mapping the lives and deaths of workers: An emerging way to tell the story of occupational health and safety
When Bethany Boggess first debuted her online mapping project, she didn’t expect it to attract so much attention. But within just six months of its launch, people from all over the world are sending in reports and helping her build a dynamic picture of the lives and deaths of workers.
The project is called the Global Worker Watch and it’s quite literally a living map of worker fatalities and catastrophes from around the globe. When you go to the site, you’ll see a world map speckled with blue dots, each representing a reported occupational death, illness or disaster. Here are just a few I randomly clicked on: In March in Pakistan, four workers died and 18 were injured when a gas cylinder exploded at a gas company. Also in March in Gujarat, India, two workers died of silicosis, an occupational disease caused by the inhalation of silica dust. Three workers have died in the mines of Coahuila, Mexico, since January. In February, a worker at an Iron County mine site in Utah died after getting trapped on a conveyer belt. Just a few days ago, a worker in the United Kingdom died after falling from an electricity tower. And in May, police in Cambodia opened fire during a labor protest, killing four people.
“Obviously, I’m only capturing the tip of the iceberg,” said Boggess, a 26-year-old epidemiology student at the University of Texas School of Public Health in Austin. “But if I’m just one person and I can do this in six months…then with more and more people contributing, we can get a much more complete and accurate picture (of worker deaths and injuries).”
The idea for Global Worker Watch grew out of Boggess’ experience investigating the global supply chain in the aftermath of the Rana Plaza building collapse in Bangladesh in 2013 that killed more than 1,000 people and injured thousands more. The building housed a number of garment factories and nearly all those who died in the collapse were garment workers. In the wake of the disaster, Boggess began working with data analysts in the United Kingdom to figure out which U.S. and U.K. companies sourced their products from factories in Bangladesh. In particular, Boggess analyzed several million import and export records from Wal-Mart and it piqued her interest in working with unusual data sets and in presenting data in visually appealing mediums. Shortly after the Bangladesh project, she partnered with an Austin-based worker center, Workers Defense Project, to map incidents of wage theft and worker injury using weekly reports from OSHA. Both experiences as well as the skills she’s gained as an amateur computer programmer and hacker eventually led her to build Global Worker Watch and its interactive maps.
Here’s how it works. Boggess finds data for the maps from three main sources: news sources using Google Alerts, government data (“Kind of a pain and not always useful,” she tells me), and people from all around the world who submit stories and data directly to Boggess through the website. Boggess is fluent in Spanish and Italian and can read and understand French, so she’s able to map stories and data arriving in those languages. For right now, language is definitely a hurdle in creating more complete and accurate maps, she said. But she hopes that as more people hear about the project and want to participate, it’ll become less of a barrier.
When a worker incident comes in, Boggess typically gets it on the map within a week, through sometimes it’s within hours. Sometimes, the story behind the dot on the map is somewhat vague — with little known about the workers involved or even the name of the workplace — while others are much more detailed, listing the worker’s name, age, gender, cause of death and the name of the company where he or she worked. Boggess told me that about 10 percent to 15 percent of the mapped data come directly from people contacting her with reports of worker deaths. The Global Worker Watch site also offers visitors its data in the raw as well as a gallery of recent and historical photos of workers from around the world.
“I wanted to put a face to this,” she said of the photo gallery. “The maps are nice but there’s no human face to them.”
Boggess said she doesn’t know of other projects attempting to map worker deaths worldwide. However, the idea of using mapping to more easily illustrate a public health problem isn’t entirely new. For instance, HealthMap mines the Internet to map disease outbreaks and emerging public health threats and Google Flu Trends does the same with flu activity. (We’ve written about HealthMap here.) In the worker safety arena, CPWR – The Center for Construction Research and Training launched its Fatality Map in 2011 and may have been the first to use the mapping technique in an occupational health and safety application.
Fatality Map, which is part of the center’s falls prevention campaign, maps overall construction fatalities and fatal construction falls in the United States. Data for the maps are collected from ongoing OSHA investigations and supplemented with media reports, said Gavin West, a research analyst at the center, which grew out of a series of cooperative agreements with the National Institute for Occupational Safety and Health and is dedicated to generating research and training resources to promote safe working conditions for construction workers. Each pinpoint on the Fatality Map tells the story of a construction fatality. For example, in April 2013, two workers in Hendersonville, Tennessee, died after being pinned underneath a section of a concrete block wall that collapsed during construction of a new building. Fatality Map data are collected in real time, and the online maps are updated quarterly.
West told me that in 2011, the mapping project was able to capture 78 percent of official construction-related fatalities and 69 percent of fatal fall numbers when compared to data from the Bureau of Labor Statistics. In 2012, the maps captured 74 percent of overall fatalities and 68 percent of falls. West said that while Fatality Map isn’t the best tool for making state-based comparisons, it can show — “very plainly” — where more construction workers are dying and falling on the job.
“(The maps) help bring life to the data instead of just looking at the numbers,” West told me. “The visual aspect and the ability to interact help draw some attention to the problem.”
Fatality Map also lets visitors access its raw data so that people can create even more specific profiles of construction-related deaths. For example, Chris Trahan, the center’s deputy director, told me that the open data was recently used to research fall-related fatalities among industrial painters in California. Trahan said in addition to raising awareness about construction worker deaths, Fatality Map is also a useful training tool. She said she’s heard from safety trainers who use the maps to drive home lessons and reinforce safety messages — “it’s become another tool in their toolbox.”
“We hope we can put a face to the numbers,” Trahan said.
Back in Austin, Boggess said most of the responses to Global Worker Watch have been positive. She said she’s received a particularly excited response from corporate transparency activists, such as United Students Against Sweatshops. The experience is also providing some fascinating insights and anecdotes.
For instance, she said that “Spain is incredible, they report everything — every time a worker gets a scrape, it’s reported.” Interestingly, she said she often learns about a U.S.-based incident involving an immigrant worker in news reports from the worker’s native country before reading about it in an American media outlet. Boggess noted that the lack of data also tells a compelling story. One quick glimpse at Global Worker Watch and you’ll notice hardly any blue pinpoints in the entire African continent. Partially that’s because of the language barriers that Boggess hopes to overcome as more people take part; but it’s also because of insufficient workplace oversight.
Boggess has received some criticism about the accuracy of Global Worker Watch. But she believes that the more open her site is the more likely people will help verify stories of worker conditions. And once you start clicking on the little blue dots and reading about workers dying from suffocation, workplace violence, chemical exposure, drowning, building collapse — you just can’t stop, which seems to be exactly the point.
“I hope the map will help consumers and the public realize just how important it is for workers to be treated with some basic human rights,” Boggess said. “I hope I can visually show how big the issue is and how it shouldn’t be ignored.”
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.
Flashback to February 2009. The economy was in the tank. President Obama was marking his second month in office. Congress passed and the President signed H.R. 1, the “American Recovery and Reinvestment Act of 2009,” which authorized $800 billion in government spending to stimulate the economy. $800 Billion is not chump change, and who would get the money was on people’s minds. The President understood
“It’s your money. You deserve to know where it’s going and how it’s spent.”
I never had a reason to visit the site until this week. The nudge came from an OSHA news release out of Coolville, Ohio. The agency announced citations for a willful and eight serious violations issued against Morlan Enterprises a firm doing cell tower work in Meigs County, Ohio. An OSHA inspector observed two workers climbing up a 195-foot communication tower without adequate fall protection. The news release notes:
“Morlan Enterprises was contracted by New Era Broadband Services of Coolville to perform tower construction and antenna installation services at 20 locations in the Meigs County area. The New Era Broadband construction project is being funded by a grant, administered through the U.S. Department of Agriculture — Rural Utilities Service, to bring broadband services to underserved communities in the area.”
I didn’t know what kind of grant the firm might have received so I first poked around on the USDA’s website. I got frustrated after a while and picked up the phone. I called the USDA’s Rural Utilities Service (RUS) to ask if the names of grant recipients are posted on the agency’s website. After getting bounced around a few times, I learned, they aren’t. The stimulus money website is unique, at least as far as RUS grants and loans are concerned.
Well maybe the grant referred to by OSHA was part of that $800 billion in stimulus money? Afterall, the bill authorized $7.2 billion in spending to expand broadband and wireless Internet access. My reason to visit Recovery.gov had arrived. Here’s what Recovery.gov tells me about New Era Broadband and Morlan Enterprises:
- In September 2010, New Era Broadband was awarded a grant for $2.2 million and a loan of $739,000 under the stimulus program.
- The firm has been paid to-date $1.87 million on the grant and $623,000 for the loan.
- The project is more than 50% complete.
- Morlan Enterprises appears on the Recovery.gov website as a vendor providing consulting services to New Era Broadband. The website shows payments to Morlan Enterprises totaling $3,938.
A few thousand dollars is small potatoes in the stimulus-money scheme of things, but not necessarily meaningless when picking apart of worker safety problem. And there’s a big worker safety problem in the cell tower industry. A 2012 analysis by ProPublica calculated a death rate for cell tower workers that was more than 10 times that for construction workers. And holding companies responsible for the deaths and injuries has floundered. As ProPublica noted
“cell phone carriers and tower owners have insulated themselves from legal and regulatory liability for on-the-job injuries by delegating this work to layers of subcontractors.”
OSHA’s been trying to get a handle on the problem.
The agency told its inspectors last year that if they became aware of cell tower work in their area, they should go and inspect the site. Inspectors were also instructed to obtain any relevant contracting agreements that show business relationships between the tower owner, wireless carrier, repair service companies, etc. That’s an important step needed to identify who is influencing how the job is being done, and more importantly, how decisions will affect safety. But with deaths of cell tower workers continuing, OSHA put the industry on notice in February: It would consider classifying violations of its fall protection standard as “willful.” OSHA’s Columbus, OH area office is keeping the agency at its word: (1) a willful violation issued to Morlan Enterprises, and (2) documentation of who hired the firm for the work. In this case, at the top of the contracting food chain is the USDA.
What I don’t know (but OSHA probably does) is whether this particular project—-the subject of the OSHA inspection—-was funded with the stimulus money, or another USDA grant. The RUS has been funding telecommunication improvements for years. USDA Secretary Tom Vilsack announced recently the availability of $13 million to fund broadband projects in unserved areas. The announcement notes:
“Since it was created in 2003, USDA has approved more than $142 million in more than 240 Community Connect projects to bring broadband service to rural communities that lacked it.”
Seems that USDA is part of the tangled web of players in the cell industry. I had no clue.
Companies that apply for these USDA grants are asked to provide evidence that they comply with certain federal statutes. The USDA’s most recent announcement for telecommunication grants mentions laws on lobbying, a drug-free workplace, and flood hazard precautions. Maybe it’s time to specifically mention compliance with OSHA regulations, including those on fall protection and a 100 percent tie-off rule.
By Anthony Robbins, MD, MPA
So screams a headline in the New York Times business section on July 12, 2014. Two of the three tobacco companies in the $100 billion US market plan to merge.
Fifty years after the Surgeon General’s first report on Tobacco and Health, the US tobacco industry is working to grow its profits. Will the universal consensus that cigarettes kill have any effect on a government decision whether to intervene in the proposed merger? The Government usually gets involved when a merger would reduce the number of sellers in the market, possibly reducing competition and raising prices. But does it matter whether society needs the product or whether it damages health. I know of no precedent for invoking health considerations.
Anti-trust laws are likely to be the basis for a government review of the proposed merger. Under anti-trust theory, competition helps consumers by lowering prices… but that hurts consumers of cigarettes. If competition makes it less expensive for Americans to feed their deadly addictions created by tobacco companies, should the same government that has found cigarettes to be killers decide how to act without considering health, based instead on an assessment of competition and cigarette prices? Surely the two companies who want to merge will claim, as companies always do, that the merger will not result in higher prices. I suspect they will not mention or be proud that today’s unconscionable level of damage to health will be maintained.
At the very least the Department of Justice’s anti-trust division should request a simple study. What effect will the merger have on the health of the American population? The Office of the Surgeon General of US Public Health Service could carry out such a study. The same data that the two tobacco companies and their opponents will provide to the Anti-trust Division to show that the merger will or will not maintain, raise or lower prices, and thus “benefit” or “harm” consumers can be available to the Surgeon General. It is not hard to extrapolate from data on projected prices, sales, and use to estimate the health effects. The public health goal should be to make sure any action proposed by tobacco companies is seen as a way to advance a business that harms people.
Perhaps a faint silver lining is hiding in the merger plans, as both companies are seeking to strengthen their footing in the electronic cigarette business. (Remember, studies have not found e-cigarette vapor to be safe.) How eager are they to transfer America’s collective addiction from the tar-containing and cancer-causing smoke of burning tobacco to the tar-free vapor in e-cigarettes? Would they agree, as part of a merger approval, to close their tobacco businesses entirely by a date certain?
As we discuss this merger, it will be important to remember that our public health goal is an endgame, where tobacco, that serves no useful purpose, disappears from our environment and society.
Serious health problems are driving workers at a car part manufacturer in Alabama to call for a union. In an in-depth article for NBC News, reporter Seth Freed Wessler investigated occupational exposures at the Selma-based Renosol Seating plant, where workers make foam cushions for Hyundai car seats and headrests. According to the story, at least a dozen current and former employees report sinus infections, chronic coughs, bronchitis, shortness of breath and asthma since working at the factory. The story begins with worker Denise Barnett:
Denise Barnett was thankful seven years ago when she started a job at the Renosol Seating plant, one of 90 hourly workers making foam cushions for Hyundai car seats and headrests.
“Here in Selma, a job is hard to find,” said Barnett, 37. In Dallas County, where Selma is the county seat, the unemployment rate is about 12 percent, and 60 percent of children live below the poverty line.
Before landing this position, Barnett, who like most Renosol workers is African American, worked at a gas station for minimum wage. For Selma residents like her, a job at Renosol—$11 an hour plus healthcare—is like gold.
But in early 2013, Barnett developed a nagging cough that kept her up at night. One evening last July, Barnett came home after picking up her two young boys from her sister’s house and had a serious coughing attack. “I made the kids run back into the car and rushed to the hospital,” she said. When Barnett arrived in urgent care, she said, she could barely breathe and spent two nights in the hospital.
“They say I have asthma,” said Barnett, who said she’d never been a smoker and now uses two inhalers and a nasal spray. “I never had that before.”
Wessler reports that Barnett and other sick workers have a theory about what’s causing the respiratory complications — a chemical called toluene diisocyanate, or TDI, which is used to make the car seat foam and is a documented cause of work-induced asthma. The story notes that companies are largely left on their own to regulate exposure to TDI. OSHA head David Michaels told Wessler that “OSHA’s workplace exposure limits for many chemicals are out of date and not adequately protective.”
Perhaps not surprisingly, the plant’s parent company, Lear Corporation, claims the Selma plant is a safe environment for employees. So in conjunction with occupational medicine researchers at Yale University, NBC News coordinated independent testing of workers’ TDI exposure. Of the six workers whose blood had been tested at the time the article was published, four showed exposure to TDI and one showed a low level of exposure. Wessler quoted one of the researchers:
“This is a high frequency of exposure, and it’s cause for concern,” said Adam Wiznewski, PhD, senior research scientist at Yale. He said that the workers may not be representative of the rest of the Renosol’s 90-person hourly workforce, but that exposure in even four workers indicates a problem. “The company definitely needs to be looking at its industrial hygiene, and they probably need to look into personal protective equipment for workers, and medical surveillance of health issues.”
To read the full article, which includes more worker stories as well as a history of longtime health and safety complaints from Renosol workers, click here.
In other news:
ProPublica: In collaboration with Univision, reporter Michael Grabell wrote about the death of Janio Salinas, a 50-year-old temp worker who lost his life after being buried alive in a mountain of sugar at a sugar plant in Pennsylvania. Grabell reports that federal investigators recently found that just two weeks prior to the incident, a safety device that would have saved Salinas’ life was removed because a manager believed it was slowing down production. The company was fined just $18,000 for Salinas’ death. In a related article, Grabell reported that Sen. Robert Casey, D-Pa., has written OSHA’s director about the growing number of workplace injuries and fatalities involving temporary workers. The articles are part of ProPublica’s “Temp Land: Working in the New Economy” series.
Food Safety News: Reporter Cookson Beecher writes about the connection between poor housing conditions among farmworkers and food safety. He started the article with a housing example that’s sadly not surprising to advocates in the field: A farmworker and her kids living in a decommissioned walk-in freezer. In interviewing Bobbi Ryder, CEO and president of the National Center for Farmworker Health, about the type of housing farmworkers need to stay healthy and maintain food safety on the job, the answer was simple: “They need the same things that you and I need. Clean running water for drinking and bathing, access to washers and driers so when they come out of the field after a hard day’s work they can wash their clothes, enough space so communicable diseases aren’t a problem.”
Slate: Need a laugh and a remarkably good breakdown of income inequality in America? Check out this clip from John Oliver’s show, “Last Week Tonight.” It is so worth 15 minutes of your time.
Los Angeles Times: Activists in Los Angeles are taking the first steps toward raising the city’s minimum wage to $15 an hour. Emily Alpert Reyes writes that the Los Angeles Workers Assembly has submitted a proposed ballot initiative to city officials. If voters approve the initiative, the wage hike would go into effect immediately for larger businesses.
Mother Jones: Congratulations ladies! Workplace discrimination is officially over! Just ask Sen. Mitch McConnell, R-Ky., who recently said: “We’ve come a long way in pay equity and there are a ton of women CEOs now running major companies.” Writer Patrick Caldwell noted that McConnell has repeatedly opposed federal measures to address the gender pay gap.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.
the world’s major carbon dioxide-emitting nations can slash those emissions by mid-century. Called the Deep Decarbonization Pathways Project, the initiative aims to provide leaders with a plan of action in advance of a UN summit in September and climate negotiations in Paris in late 2015. Yale Environment 360 asked Jeffrey Sachs, director of Columbia University’s Earth Institute and a key player in the decarbonization project, five questions about the initiative and the prospects for global action on the climate front.