November 2018

World AIDS Day 2018 – Key Facts

…

Fear, Stigma, Ignorance Keep AIDS Epidemic Going

There’s been a lot of progress in the fight against AIDS over the past 30 years, but as the 30th World AIDS Day is observed on Dec. 1 — people still die from the disease. And others are newly infected every day even though the tools are available to end the epidemic.

Fear, stigma and ignorance. The World Health Organization says these are the reasons the AIDS epidemic is not over because doctors can treat HIV, the virus that causes AIDS. 

With treatment, no one needs to die from AIDS, and those with the virus can’t give it to someone else. In addition, with prevention therapy, no one needs to get infected.  

Dr. Jared Baeten, an HIV specialist at the University of Washington, spoke to us via Skype and says even with these tools we’re not there yet.

“… because the ability to deliver those at the scale and with the coverage needed to be able to get HIV to go away is not nearly where it should be,” said Baeten. 

Nearly a million people still die every year from AIDS. Professor Steffani Strathdee at the University of California San Diego says one of the biggest challenges is that HIV often affects people on the fringes of some societies around the world.  

“There are populations all over the world that are underserved and these include injection drug users and sex workers, in particular,” Strathdee said.

It also includes men who have sex with men, transgender people, prisoners and the sexual partners of these people. Professor Strathdee says people who are hungry or need shelter are more concerned about their immediate needs than they are about HIV.

“My research and research in this field really shows you have to address the whole person and their needs in order to address HIV as one of their health concerns,” Strathdee said.

Strathdee says unless this happens, countries will have to bear the heavy social and economic costs of AIDS.

In addition, Baeten says testing and treatment have to be available to everyone.    

“The biggest thing that we’ve learned for preventing HIV in the last decades is that there is no magic bullet, but when you put a whole bunch of really good things together and it has exactly the kind of impact that a magic bullet can give you,” Beaten said 

Scientists say using these tools, educating people and getting more people into treatment will reduce stigma, and then, when a vaccine comes along, we can finally put an end to AIDS.
…

UN Official: Polio Remains Global Threat

Tremendous progress has been made in efforts to wipe out polio around the world. Before a global eradication program began 30 years ago, about 350,000 children became paralyzed from polio each year. The figure dropped to 28 in 2018. 

Nevertheless, Helen Rees, chair of the World Health Organization’s emergency committee, said Friday that polio remained an international threat. She said every available health strategy must be used to prevent the wild polio virus from spreading across borders. 

“The fear is that we might well see a resurgence, that we could see exportation again and a reversal of all of the work and all of the country global efforts that have gone into trying to eradicate polio,” Rees said. “And we certainly cannot allow that to happen.” 

Polio remains endemic in Afghanistan, Pakistan and Nigeria. Rees said that over the last few months, there has been a worrying exportation of the wild polio virus to and from Pakistan and Afghanistan. 

“We have got widespread, positive environmental sampling in Pakistan,” she said. “And in Afghanistan, because of the more difficult situation there in terms of security, we are unable to access probably as many as a million children for vaccination.”  

Separately, there is good news from the African region. The director of WHO’s polio eradication program, Michel Zaffran, noted that the wild polio virus has not been seen in Nigeria since it was last detected more than two years ago. 

If this keeps up, he said, the regional certification commission could be able to declare the wild polio virus eradicated from the African region at the end of 2019 or early 2020. He said $4.2 billion would be needed over the next five years to see the last of this disease. 

Polio, which has no cure, invades the nervous system and can cause irreversible paralysis within hours. The WHO says polio is transmitted from one person to another through the fecal-oral route, or less frequently by a common vehicle like contaminated food and water. Fever, fatigue, headache, vomiting, stiffness in the neck and limb pain are among polio’s symptoms. 
…

WHO: Fear, Stigma and Ignorance Keep AIDS Epidemic Going

As the 30th World AIDS Day approaches, the World Health Organization says fear, stigma and ignorance are the reasons the AIDS epidemic is not over, because doctors can treat HIV, the virus that causes AIDS.

With treatment, no one needs to die from AIDS, and those with the virus can’t give it to someone else. In addition, with prevention therapy, no one needs to get infected. 

Dr. Jared Baeten, an HIV specialist at the University of Washington, says even with these tools more people still contract the HIV virus and eventually die from AIDS each year, “because the ability to deliver those at the scale and with the coverage needed to be able to get HIV to go away is not nearly where it should be.”

Nearly a million people still die every year from AIDS. Professor Steffani Strathdee at the University of California San Diego says one of the biggest challenges is that HIV often affects people on the fringes of some societies around the world. 

“There are populations all over the world that are underserved and these include injection drug users and sex workers, in particular,” she said.

It also includes men who have sex with men, transgender people, prisoners and the sexual partners of these people. Strathdee says people who are hungry or need shelter are more concerned about their immediate needs than they are about HIV.

“My research and research in this field really shows you have to address the whole person and their needs in order to address HIV as one of their health concerns,” she said.

Strathdee says unless this happens, countries will have to bear the heavy social and economic costs of AIDS.

In addition, Baeten says testing and treatment have to be available to everyone.

“The biggest thing that we’ve learned for preventing HIV in the last decades is that there is no magic bullet, but when you put a whole bunch of really good things together and it has exactly the kind of impact that a magic bullet can give you,” he said.

Scientists say using these tools, educating people and getting more people into treatment will reduce stigma, and then, when a vaccine comes along, we can finally put an end to AIDS.
…

Stigma, Fear and Ignorance Keep AIDS Epidemic Going

On Dec. 1, we observe the 30th World AIDS Day. There’s been a lot of progress over the past 30 years, but people still die from AIDS. And others are newly infected every day. As VOA’s Carol Pearson reports, we have the tools to end the epidemic, but it’s far from over.
…

Space Force: To Stand Alone or Not to Stand Alone

Top administration officials are debating whether to create a stand-alone Space Force to handle space defense or a Space Force that falls within the Air Force, officials tell VOA.

Either option requires congressional approval, which could prove difficult with a Democratic-led House and a Republican-led Senate.

An Oct. 26 memo obtained by VOA directs that the Department of Defense create the “optimal organizational construct to meet (the president’s) intent.” 

The memo, signed by Executive Secretary of the National Space Council Scott Pace and National Security Council official Earl Matthews, instructs the Pentagon to focus on whether the Space Force is most efficient as a new independent department or as “a separate service within the Department of the Air Force, along the lines of the U.S. Marine Corps within the Department of the Navy or the U.S. Coast Guard within the Department of Homeland Security.”

Support in the House

This latter organizational structure has bipartisan support in the House, but the former has often been seen by Democrats as an expensive solution. 

Vice President Mike Pence and Deputy Secretary of Defense Patrick Shanahan met Thursday to discuss how to build the first new military branch since 1947, as President Donald Trump has directed. 

A National Space Council official told VOA Thursday the October memo does not represent a shift in White House guidance. 

“The direction to create the U.S. Space Force remains exactly the same, and the Space Council is continuing to work with the departments and agencies responsible for implementing the president’s direction to develop the sixth branch of the Armed Forces,” the official said.

Space Command next?

Officials say the president also intends to establish a U.S. Space Command, a move already directed by Congress.

The U.S. military is organized into 10 combatant commands based on either geography, such as Indo-Pacific Command and European Command, or unified functions, such a Transportation Command and Cyber Command.

This new, 11th combatant command would oversee space defense much like U.S. Cyber Command oversees cyber defense. Space Command is expected to start in mid-2019 with initial operation capability.

Officials familiar with Space Force deliberations have raised concerns to VOA that a new military branch could duplicate the work of the new combatant command. They say a separate military service may not be needed once the combatant command is fully operational. 

“You don’t see a Cyber Force in addition to Cyber Command,” one official said on condition of anonymity.

Cost estimates for the Space Command have been modeled after the creation of U.S. Strategic Command, which was set up in the early 1990s. The biggest expense will be the creation of a new headquarters for the combatant command in order to make room for providing new capabilities, according to one official.
…

Questions Mount About Chinese Scientist’s Gene Editing Experiment

The Chinese scientist who claims to be the world’s first to edit the genetic code of a pair of recently born twin baby girls, to make them resistant to HIV, the AIDS virus, has defended his work and says there is another potential pregnancy.

But assurances he has given that the experiment will be reviewed by a scientific journal have done little to set aside growing questions. He Jiankui’s research, which was suddenly revealed shortly before an international gene editing summit in Hong Kong, has sparked a wide range of questions about the safety and ethics of the experiment, as well as the funding of the research.

A group of more than 120 Chinese scientists, who spoke out earlier in the week has grown. In a statement released Thursday, which has now been signed by more than 300 scientists both in China and overseas, the petition asks 10 pointed questions, including what is the real point of the experiment? Where did the funding come from and who will guarantee the rights of the two baby girls – known as Lulu and Nana – are looked after?

“We not only need to ask was the experiment really carried out to help the couples involved? Or was it just use them as innocent lab rats to fulfill his (He Jiankui’s) own personal ambition or potentially huge business interests?” the statement asked.

During a question and answer session in Hong Kong on Wednesday at the Second International Summit on Human Genome Editing, He said the interests of the families and the babies were his first concern.

He also said the research was largely self-funded, a claim other Chinese scientists find hard to believe.

“All the patients medical care expenses was paid by myself and a small amount of (gene) sequencing costs was covered by staff funding at the university (Southern University of Science and Technology),” He said.

He’s university said he has been on leave from his position since February.

In their statement, scientists estimated that such an experiment with staffing and in vitro fertilization costs, as well as monkey test subjects, could cost millions of dollars.

Scientists also expressed concern the research would not only set a dangerous precedence, but went against Chinese law and an international consensus regarding gene editing.

“We demand that these questions receive a swift, rigorous and comprehensive investigation and response,” the statement said. “If there is no punishment, it will send the wrong message that anyone with ambition and funding, much like He can carry out experiments in the dark.”

Participants at the Human Genome Editing Summit in Hong Kong issued a strong statement on Thursday, blasting their colleague’s experiment, calling it “deeply disturbing” and “irresponsible.”

In its response, the organizing committee of the summit said: “Even if the modifications are verified, the procedure was irresponsible and failed to conform with international norms.”

In comments on Wednesday, Nobel Prize-winning biologist David Baltimore also shared his concern. Baltimore is the chair of the conference.

“I don’t think it has been a transparent process, we’ve only found out about it after it has happened and after the children are born,” he said, speaking before the question and answer session for He Jiankui. “I think there has been a failure of self-regulation by the scientific community because of a lack of transparency.”

The big question that comes next is how Chinese authorities will handle the incident and He Jiankui. China’s National Health Commission and Ministry of Science and Technology have made it clear that punishment must be handed down in accordance with the law.

Lawyers in China, however, have already begun to point out the legal loopholes that exist and could frustrate efforts to take legal action. In an online blog, Guangzhou-based lawyer Zhou Xiaoyun noted that while there are administrative regulations for gene modifications, such clauses could not be found in criminal law.

Zhou suggests that a national level investigation should be launched into the case and that a probe into all of those involved, not at the local level.

“A criminal law should be quickly established banning the human experimentation of gene editing,” he said. “However, given that Pandora’s box has already been opened, such measures to remedy the problem will only slightly delay its impact.”

So far, the Guangdong Province’s Health Commission and Shenzhen City have set up an investigation into his case as has the Southern University of Science and Technology, where He is an assistant professor.

A clinical database shows that He did receive an ethical review for his research from a hospital in Shenzhen, but that facility denies ever meeting to discuss his work.

Chen Hsin-fu, a gynecologist at National Taiwan University Hospital in Taipei, said that while it is hard to say how authorities in China will ultimately handle the case, he expects some punishment to be handed down.

“Clearly the case has exposed both moral and scientific flaws,” Chen said. “And if his claims are true, the long term care of these two babies will be a big concern and problem because some unexpected problems could come up.”

 
…

China Orders Halt to Research in Gene Editing

China’s science ministry on Thursday ordered that anyone conducting research in gene editing halt their activities.

The order came as organizers of a biomedical conference where a Chinese scientist defended his claim that he has created the world’s first genetically-edited babies denounced his work as irresponsible.

The leaders of the Second International Summit on Human Genome Editing issued a statement Thursday on the last day of their conference in Hong Kong criticizing He Jiankui’s claim as “deeply disturbing.”

Dr. He spoke to the summit on Wednesday about his work in claiming to have used a gene-editing technology dubbed CRISPR to alter the DNA of twin girls born to an HIV-positive father to prevent them from contracting the virus that causes AIDS.  The researcher first made the claim in an online video posted Monday.  

Dr. He told his colleagues he conducted his research in secret.  His work has not been independently verified, and Dr. He has not submitted his report to any scientific journals where it could be examined by experts.  

In their statement Thursday, the summit’s organizers said that even if “the modifications are verified, the procedure was irresponsible and failed to conform with international norms.”  Dr. He was supposed to speak before the summit again Thursday, but canceled his appearance.

He’s claims has set off a firestorm of skepticism and criticism.  The Southern University of Science and Technology, the university in the southern Chinese city in Shenzhen that employs him, says he has been on unpaid leave since February.  The school denounced his research for violating “academic ethics and codes of conduct,” and the Chinese government is urging local authorities to launch an investigation into He’s work.

Genetic editing has the potential to remove inherited diseases from the gene pool, but scientists and ethicists worry it could be used to create so-called “designer babies.”  They also worry any genetic changes could lead to other genes being altered in unpredictable ways.

 
…

Suicide, Overdoses Help Cut US Life Expectancy

Suicides and drug overdoses helped lead a surge in U.S. deaths last year, and drove a continuing decline in how long Americans are expected to live.

Overall, there were more than 2.8 million U.S. deaths in 2017, or nearly 70,000 more than the previous year, the Centers for Disease Control and Prevention said Thursday. It was the most deaths in a single year since the government began counting more than a century ago.

The increase partly reflects the nation’s growing and aging population. But it’s deaths in younger age groups — particularly middle-aged people — that have had the largest impact on calculations of life expectancy, experts said.

The suicide death rate last year was the highest it’s been in at least 50 years, according to U.S. government records. There were more than 47,000 suicides, up from a little less than 45,000 the year before.

​A general decline

For decades, U.S. life expectancy was on the upswing, rising a few months nearly every year. Now it’s trending the other way: It fell in 2015, stayed level in 2016, and declined again last year, the CDC said.

The nation is in the longest period of a generally declining life expectancy since the late 1910s, when World War I and the worst flu pandemic in modern history combined to kill nearly 1 million Americans. Life expectancy in 1918 was 39.

Aside from that, “we’ve never really seen anything like this,’’ said Robert Anderson, who oversees CDC death statistics.

In the nation’s 10 leading causes of death, only the cancer death rate fell in 2017. Meanwhile, there were increases in seven others: suicide, stroke, diabetes, Alzheimer’s, flu/pneumonia, chronic lower respiratory diseases and unintentional injuries.

An underlying factor is that the death rate for heart disease, the nation’s No. 1 killer, has stopped falling. In years past, declines in heart disease deaths were enough to offset increases in some other kinds of death, but no longer, Anderson said.

The CDC’s numbers do sometimes change. This week, CDC officials said they had revised their life expectancy estimate for 2016 after some additional data came in.

What’s driving this?

CDC officials did not speculate about what’s behind declining life expectancy, but Dr. William Dietz, a disease prevention expert at George Washington University, sees a sense of hopelessness.

Financial struggles, a widening income gap and divisive politics are all casting a pall over many Americans, he suggested. 

“I really do believe that people are increasingly hopeless, and that that leads to drug use, it leads potentially to suicide,’’ he said.

Drug overdose deaths also continued to climb, surpassing 70,000 last year, in the midst of the deadliest drug overdose epidemic in U.S. history. The death rate rose 10 percent from the previous year, smaller than the 21 percent jump seen between 2016 and 2017.

That’s not quite a cause for celebration, said Dr. John Rowe, a professor of health policy and aging at Columbia University.

“Maybe it’s starting to slow down, but it hasn’t turned around yet,’’ Rowe said. “I think it will take several years.”

Accidental drug overdoses account for more than a third of the unintentional injury deaths, and intentional drug overdoses account for about a tenth of the suicides, said Dr. Holly Hedegaard, a CDC injury epidemiologist.

Other findings

The CDC figures are based mainly on a review of 2017 death certificates. The life expectancy figure is based on current death trends and other factors.

The agency also said:

A baby born last year in the U.S. is expected to live about 78 years and 7 months, on average. An American born in 2015 or 2016 was expected to live about a month longer, and one born in 2014 about two months longer than that.
The suicide rate was 14 deaths per 100,000 people. That’s the highest since at least 1975.
The percentage of suicides from drug overdose has been inching downward.
Deaths from flu and pneumonia rose by about 6 percent. The 2017-2018 flu season was one of the worst in more than a decade, and some of the deaths from early in that season appeared in the new death dates.
West Virginia was once again the state with the highest rate of drug overdose deaths. The CDC did not release state rates for suicides.
Death rates for heroin, methadone and prescription opioid painkillers were flat. But deaths from the powerful painkiller fentanyl and its close opioid cousins continued to soar in 2017.
The CDC did not discuss 2017 gun deaths in the reports released Thursday. But earlier CDC reports noted increase rates of suicide by gun and by suffocation or hanging.

…

Scientist Claiming Gene-edited Babies Reports 2nd Pregnancy

A Chinese researcher who claims to have helped make the world’s first genetically edited babies says a second pregnancy may be underway.

The researcher, He Jiankui of Shenzhen, revealed the pregnancy Wednesday while making his first public comments about his controversial work at an international conference in Hong Kong.

He claims to have altered the DNA of twin girls born earlier this month to try to make them resistant to infection with the AIDS virus. Mainstream scientists have condemned the experiment, and universities and government groups are investigating.

The second pregnancy is in a very early stage and needs more time to be monitored to see if it will last, He said.

Leading scientists said there are now even more reasons to worry, and more questions than answers, after He’s talk. The leader of the conference called the experiment “irresponsible” and evidence that the scientific community had failed to regulate itself to prevent premature efforts to alter DNA.

Altering DNA before or at the time of conception is highly controversial because the changes can be inherited and might harm other genes. It’s banned in some countries including the United States except for lab research.

He defended his choice of HIV, rather than a fatal inherited disease, as a test case for gene editing, and insisted the girls could benefit from it.

“They need this protection since a vaccine is not available,” He said.

Scientists weren’t buying it.

“This is a truly unacceptable development,” said Jennifer Doudna, a University of California-Berkeley scientist and one of the inventors of the CRISPR gene-editing tool that He said he used. “I’m grateful that he appeared today, but I don’t think that we heard answers. We still need to understand the motivation for this.”

“I feel more disturbed now,” said David Liu of Harvard and MIT’s Broad Institute, and inventor of a variation of the gene-editing tool. “It’s an appalling example of what not to do about a promising technology that has great potential to benefit society. I hope it never happens again.”

There is no independent confirmation of He’s claim and he has not yet published in any scientific journal where it would be vetted by experts. At the conference, He failed or refused to answer many questions including who paid for his work, how he ensured that participants understood potential risks and benefits, and why he kept his work secret until after it was done.

After He spoke, David Baltimore, a Nobel laureate from the California Institute of Technology and a leader of the conference, said He’s work “would still be considered irresponsible” because it did not meet criteria many scientists agreed on several years ago before gene editing could be considered.

“I personally don’t think that it was medically necessary. The choice of the diseases that we heard discussions about earlier today are much more pressing” than trying to prevent HIV infection this way, he said.

If gene editing is ever allowed, many scientists have said it should be reserved to treat and prevent serious inherited disorders with no good alternatives, such as sickle cell anemia and Huntington’s disease. HIV is not an appropriate candidate because there are already safe ways to prevent transmission, and if contracted it can be kept under control with medications, researchers said.

The case shows “there has been a failure of self-regulation by the scientific community” and said the conference committee would meet and issue a statement on Thursday about the future of the field, Baltimore said.

Before He’s talk, Dr. George Daley, Harvard Medical School’s dean and one of the conference organizers, warned against a backlash to gene editing because of He’s experiment. Just because the first case may have been a misstep “should in no way, I think, lead us to stick our heads in the sand and not consider the very, very positive aspects that could come forth by a more responsible pathway,” Daley said.

“Scientists who go rogue … it carries a deep, deep cost to the scientific community,” Daley said.

Regulators have been swift to condemn the experiment as unethical and unscientific.

The National Health Commission has ordered local officials in Guangdong province to investigate He’s actions, and his employer, Southern University of Science and Technology of China, is investigating as well.

On Tuesday, Qui Renzong of the Chinese Academy of Social Science criticized the decision to let He speak at the conference, saying the claim “should not be on our agenda” until it has been reviewed by independent experts. Whether He violated reproductive medicine laws in China has been unclear; Qui contends that it did, but said, “the problem is, there’s no penalty.”

He called on the United Nations to convene a meeting to discuss heritable gene editing to promote international agreement on when it might be OK.

Meanwhile, more American scientists said they had contact with He and were aware of or suspected what he was doing.

Dr. Matthew Porteus, a genetics researcher at Stanford University, where He did postdoctoral research, said He told him in February that he intended to try human gene editing. Porteus said he discouraged He and told him “that it was irresponsible, that he could risk the entire field of gene editing by doing this in a cavalier fashion.”

Dr. William Hurlbut, a Stanford ethicist, said he has “spent many hours” talking with He over the last two years about situations where gene editing might be appropriate.

“I knew his early work. I knew where he was heading,” Hurlbut said. When he saw He four or five weeks ago, He did not say he had tried or achieved pregnancy with edited embryos but “I strongly suspected” it, Hurlbut said.

“I disagree with the notion of stepping out of the general consensus of the scientific community,” Hurlbut said. If the science is not considered ready or safe enough, “it’s going to create misunderstanding, discordance and distrust.”

Jennifer Doudna and David Liu are paid by the Howard Hughes Medical Institute, which also supports AP’s Health & Science Department.
…

Chinese Scientist Faces Firestorm Over Genetic Editing

A Chinese researcher has publicly defended his claim he has created the world’s first genetically-edited babies.

He Jiankui addressed a crowd of fellow scientists Wednesday at a biomedical conference in Hong Kong, two days after he posted a video online claiming to have used a gene-editing technology dubbed CRISPR to alter the DNA of twin girls born to an HIV-positive father to prevent them from contracting the virus that causes AIDS.

Dr. He said he conducted his research in secret. His work has not been independently verified, and Dr. He has not submitted his report to any scientific journals where it could be examined by experts. But he told his colleagues that he felt “proud…proudest” of his achievement.

His claims have set off a firestorm of skepticism and criticism. The Southern University of Science and Technology, the university in the southern Chinese city in Shenzhen that employs him, says he has been on unpaid leave since February. The school denounced his research for violating “academic ethics and codes of conduct,” and the Chinese government is urging local authorities to launch an investigation into He’s work.

Shortly after He’s speech before the Second International Summit on Human Genome Editing, American biologist David Baltimore, a Nobel laureate in physiology or medicine and a leader of the summit, called Dr. He’s work “irresponsible” and a “failure of self-regulation by the scientific community.”

Genetic editing has the potential to remove inherited diseases from the gene pool, but scientists and ethicists worry it could be used to create so-called “designer babies.” They also worry any genetic changes could lead to other genes being altered in unpredictable ways.
…

UN Report Says Fragile Climate Puts Food Security at Risk

Feeding a hungry planet is growing increasingly difficult as climate change and depletion of land and other resources undermine food systems, the U.N. Food and Agricultural Organization said Wednesday as it renewed appeals for better policies and technologies to reach “zero hunger.”

Population growth requires supplies of more nutritious food at affordable prices, but increasing farm output is hard given the “fragility of the natural resource base” since humans have outstripped Earth’s carrying capacity in terms of land, water and climate change, the report said.

About 820 million people are malnourished. The FAO and International Food Policy Research Institute released the report at the outset of a global conference aimed at speeding up efforts to achieve zero hunger around the world.

“The call for action is very clear. It is possible in our lifetime and it is also realistic to end hunger and malnutrition,” Inonge Wina, vice president of Zambia, told the gathering.

Food security remains tenuous for many millions of people who lack access to affordable, adequately nourishing diets for a variety of reasons, the most common being poverty.

But it’s also endangered by civil strife and other conflicts. In Yemen, where thousands of civilians have died in airstrikes by a Saudi-led coalition, the aid group Save the Children says 85,000 children under 5 may have died of hunger or disease in the civil war.

In Afghanistan, severe drought and conflict have displaced more than 250,000 people, according to UNHCR, the U.N. refugee agency.

FAO Director-General Jose Graziano da Silva noted that the number of hungry and malnourished people in the world has risen to levels last seen a decade ago.

“After decades of gains in fighting hunger, this is a serious setback and FAO and the U.N. sister agencies, together with member governments and other partners, are all very concerned,” Graziano da Silva said in a videotaped address to the conference.

Hunger is still most severe in Africa, but the largest number of undernourished people live in the Asia-Pacific region, the report said. It said good public policies and technology are the keys to improving the situation.

The FAO estimates that global demand for food will jump by half from 2013 to 2050. Farmers can expand land use to help make up some of the difference, but that option is constrained in places like Asia and the Pacific and urbanization is eating up still more land that once may have been used for agriculture.

Increasing farm output beyond sustainable levels can cause permanent damage to ecosystems, the report said, noting that it often causes soil erosion, pollution with plastic mulching, pesticides and fertilizers, and a loss of biodiversity.

China destroys 12 million tons of tainted grain each year, at a loss of nearly $2.6 billion, according to the report.

 
…