Is this the moment Greece's suffering starts to ease?

The new Syriza government has won a little breathing space to tackle Greece's public health crisis. Alexander Kentikelenis examines the new landscape

Six years after economic crisis hit Greece, a new agreement between the government and its debtors offers a glimmer of hope for the country's ravaged health services.

Greece's initial bailout by the European Union, European Central Bank and International Monetary Fund stipulated extensive austerity measures and structural reforms for the health sector. Many people saw their health insurance entitlements reduced and health provision cut, at a time when it was most needed as unemployment soared and incomes dropped. Many struggled to afford adequate food or to properly heat their homes.

As a result there were large increases in unmet medical needs, a marked worsening of mental health, and a sharp deterioration in the health status of vulnerable groups, particularly drug users and migrants. As of now, nearly a quarter of the Greek population lacks health insurance.

Last month, a new coalition government formed under Alexis Tsipras, leader of left-wing party Syriza, promised to put an end to this situation and wage a war against what his party terms a "humanitarian crisis".

This week, after a round of intense negotiations with European institutions and the IMF, Tsipras's government was granted breathing space to put its programme into action. Pending the approval of parliaments in six EU member states, Greece's creditors agreed to extend financial assistance for a further four months.

So how might Tsipras ease the health crisis? In its interim promises to creditors, the government committed to "control health expenditure and improve the provision and quality of medical services, while granting universal access". It has rightly emphasised the importance of expanding access to healthcare as a means to end the health crisis. The details have yet to be spelled out, but one thing it can do is learn from the legacy of recent failed policies.

The previous government introduced two programmes to try to improve access to healthcare, but both fell short. First, a health voucher scheme was intended to provide access to a limited number of medical services for 230,000 uninsured citizens for two years beginning in 2013. Yet, by March 2014 a maximum of just 23,000 vouchers were issued. The reason? The scope of services covered was too limited and eligibility criteria overly strict.

A second – more promising – legislative reform began in the summer of 2014 to grant uninsured people access to primary, in-hospital and pharmaceutical care. However, the initial evidence suggests that this too failed to deliver, because of poor advertising, inadequate organisation, and stigmatising and bureaucratic means testing. And those intended to benefit were not exempt from high payments for any medicines they might need.

To tackle health inequities requires universal provision, as a recent major report for the World Health Organization made clear.

Aside from health system policies, the government has also pledged to invest in active labour market programmes and provide targeted assistance to those in absolute poverty – all without harming public finances. It hopes the funds will come from curbing tax evasion, fighting corruption, and improving fiscal management, all persistent weaknesses in the Greek economy.

Beyond Greece, the broader issues raised by Syriza's stand – defending the welfare state and putting an end to austerity – resonate elsewhere in Europe. Notably, Italian prime minister Matteo Renzi and the newly powerful Podemos party in Spain have challenged the EU policy of hardline austerity in response to the European crises and have called for growth-oriented policies in their countries that include public investment in health and social protection.

Yet, in the context of continuing economic difficulties in southern Europe and no apparent change of heart in Germany or other strong European economies on the mantra of imposed austerity, challenging the status quo will be difficult. The outcome of the Spanish elections, due before the end of the year, will set the stage for how the Eurozone moves ahead on such issues.

For now, the new Greek government has been given valuable policy space to implement its attempts to invigorate the economy and bolster social protection. Recent signs of a budding economic recovery and the government's pro-welfare state rhetoric suggest a possible end to Greece's health crisis is finally in sight.

After half a decade of declining health status and defunding the health system, overcoming the catastrophic legacy of austerity will require years of persistent and systematic effort. Ensuring universal access to health services would be a first step in the right direction.

Alexander Kentikelenis is a research associate in the department of sociology at the University of Cambridge, who studies the social consequences of economic crises, austerity, and structural reforms

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Putting animals online: Does it protect or destroy?

Digital Animals Conference at New York University, 20 February 2015

A shark has been killed because tagging data revealed it was regularly near a popular swimming area (Image: Stuart Westmorland/Getty)

Even in the digital realm, observation and conservation make uncomfortable bedfellows

"We hear a lot of talk about the 'internet of things'," says Etienne Benson, "and, increasingly, some of them are living things."

Benson, from the University of Pennsylvania's department of History and Sociology of Science, was speaking at Digital Animals, a one-day conference aimed at examining what digital perspectives and technologies means for the future of animal protection.

Benson was describing the Sharksmart tracking system that uses data from sharks tagged by researchers to provide interactive maps, alerts and warnings – via its website and automated tweets – about shark activity near Western Australia's beaches.

The system made headlines worldwide recently when the decision was made to destroy a shark based purely on tagging data that showed it was frequenting a popular swimming and surfing area, despite there being no visual sightings. The move sparked outrage from some sections of the media and the scientific community – the latter feeling betrayed at how its data had been used to kill the very sharks it was studying.

To Benson, the incident reveals a worrying shift in the philosophy behind the tagging of animals. Tags can be a nuisance for the animals fitted with them, and tagging has always been viewed as a sacrifice made by that particular animal for the greater good of its species. Now, argues Benson, in the case of West Australian sharks at least, the tags have become a technology of control and punishment.

Go fly zones

Also tracking animals, although for different reasons, is Thomas Snitch, whose company, Air Shepherd, flies fixed-wing drones across central and southern Africa to protect rhinos and elephants from poachers.

Snitch, a mathematician, previously worked as an analyst for the US military, studying maps of Iraq and Afghanistan to work out where insurgents were likely to have placed explosive devices. The drones are less important than the algorithms that decide where they should be flown, he says.

A continuous stream of geographical data, LIDAR scans and the movements of animals and poachers are fed into a supercomputer by Air Shepherd's team back at the University of Maryland. Predictive models are then used to direct a relatively small fleet of drones to the right places at the right times.

Snitch's brash, military language seemed somewhat inappropriate at an animal rights conference, even while he was demonstrating a nuanced understanding of the social and economic issues behind the ivory trade. And it is hard to argue with his results. On average, 1200 rhinos are slaughtered by poachers every year in Africa. Since October 2014, not one has been killed in areas patrolled by Air Shepherd.

Pet hate

Digital technologies change how we watch animals. Anna Frostic of the Humane Society of the United States threw social media's obsession with cute animal videos into a serious, and often depressing, light when she explained the role they play in creating demand for exotic and endangered pets. Couple this demand with websites and networks that actually allow ill-equipped members of the public to easily purchase animals they would traditionally have had difficulty finding, and it's a recipe for disaster.

There are now more tigers in domestic captivity in the US than there are anywhere in the wild. Similarly, she pointed to research showing that people didn't realise species such as chimpanzees were endangered because they are so used to seeing them online, which in turn has had a devastating impact on their willingness to donate to charities and conservation efforts.

There is little doubt that networks can help raise awareness of animal protection issues. Digital Animals went further, though, by asking how digital media formats have transformed the way we view, consider and treat animals – and by considering the inadvertent damage this technology has already done.

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Kenya's electrified route to human-wildlife harmony

"WE REMEMBER the elephants. It was frightening," 10-year-old Moses told me as we walked amid the tea gardens on the lower southern slopes of Mount Kenya, the second-highest mountain in Africa. "But they are locked up now. We are safe when we walk to school."

The first 70 kilometres or so of the world's longest conservation fence has been completed in the area (see map). Stretching 500 kilometres when finished, and electrified to 8000 volts, it will surround the entire mountain – one of the world's great refuges for wildlife – and keep animals away from villages.

The rights and wrongs of electric fences that keep humans and wildlife apart have become a battleground in the debate about how best to preserve megafauna.

A couple of hours' drive to the west, beneath the Aberdare mountains, which have been encircled by a 400-kilometre fence since 2009, the people of Bondeni village sing the barrier's praises. "Once this place was dangerous; people were killed by water buffalo and leopards ate their livestock," said village head Peter Kibuka. "We needed food aid because the animals trampled our crops. But now we are safe and can grow all our own food."

This goes against the traditional view among conservation scientists that fences damage wildlife by isolating populations, preventing migration and causing inbreeding. But those who oppose fences may be basing their views on the ideal of unspoiled and remote places, losing perspective on what's happening in human-modified landscapes with intense land use pressures, Marion Pfeifer of Imperial College London told me. In fact, wildlife can thrive in fenced areas: one study by Pfeifer and colleagues found that African lions had significantly denser populations in fenced reserves.

The Aberdares fence was initiated by a local charity, Rhino Ark, to protect rhinos on the mountain. The group is also largely funding and building the fence around Mount Kenya.

Fence-building has now been adopted by government agencies like the Kenya Wildlife Service, which approve and help maintain the fences. "The big issue here is conflicts between wildlife and communities," says Simon Gitau, the warden of Mount Kenya National Park. "The fence will bring harmony, so I am in favour of it."

Local wardens say that reducing conflicts between farmers and animals encourages villagers to report poachers and the outsiders that recruit them, meaning fences may also help keep animals safer. And there are plans to create new migration corridors to other wildlife areas, which should alleviate problems such as inbreeding caused by isolating populations of large animals.

The next step will be to maintain the fences, says Christian Lambrechts, who runs Rhino Ark. He is installing remote monitors that can identify the location of power outages. Often they can also indicate whether the problem is a stray branch, which would cause a continuous outage, or a poacher, which would cause a brief one.

Not everybody is happy with the fences, though. Members of the Ogiek tribe traditionally lived in one newly fenced upland, the Eburu forest, west of the Aberdares. In a heavy-handed government operation, they were thrown out of the fenced area. But they are now negotiating, with the help of Rhino Ark, to be given land close to the fence that will allow them access to their hundreds of forest beehives.

The last Ogiek still living in the forest with his family, Maseto Mebarne, does so with the consent of local officials and now has a job as a fence warden. "If it wasn't for us the forest wouldn't be there. But there are so many outsiders round here today that we need the fence to conserve the forest."

This article appeared in print under the headline "Fencing up wildlife in Kenya's forests"

Rhino Ark funded Fred Pearce's trip

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Why your brain needs touch to make you human

Touching communicates emotions (Image: Meyer/Tendance Floue)

Being touchy-feely isn't just nice – caresses build social worlds from families to sports teams and may even give us our sense of self

FIST bumps and bum slaps, high fives and back pats – most sports teams can't keep their hands off each other. Watch a group of players on a winning streak and you'll see a lot of touching. Keep a tally and it might even give you a way to pick the champions. The teams at the top of the rankings at the end of the US National Basketball Association season, for example, engage in more hands-on interaction from the start than those who ended up at the bottom, according to work by a group at the University of California, Berkeley. Not only does touch seem to signal trust and cooperation, it creates them.

Examples like this are ...

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Drug-resistant malaria poised to cross into India

Resistance to a vital drug against malaria has spread across Burma, reaching the Indian border. Unless contained, it could spread into India, then Africa, which has 90 per cent of the world's malaria cases.

In the 1970s, resistance to classic antimalarial drugs such as chloroquine appeared in South-East Asia, and spread through Burma to India, then to Africa, where it trebled malaria deaths, killing 1.6 million people in 2004. That has been partly beaten back by a new class of drugs, artemisinins.

Resistance to artemisinins first appeared in Cambodia in 2007, then reached southern Burma. Resistant malaria parasites have mutations in a gene called K13. Now the mutant genes have been found in the blood of people with malaria in northern and eastern Burma. In fact, the genes showed up in more than a fifth of samples from seven of Burma's 10 provinces – and in nearly half the samples from a clinic only 25 kilometres from the border with India.

"The main threat is the spread of artemisinin resistance from Burma to India," says Didier Menard of the Pasteur Institute in Phnom Penh, Cambodia. Because of widespread infection and the sheer size of the population, the burden of malaria in India is huge. Recent studies suggest there is little resistance there so far – but, says Menard, a study like the one in Burma needs to be done as soon as possible.

Mapping resistance

As well as genetically analysing blood samples, the researchers who carried out the study used geographical models to estimate the prevalence of resistance in areas where no samples were available. The resulting map shows where efforts to contain the spread of resistant malaria should be targeted. "Just getting people to complete the normal three-day treatment would certainly slow it down," says team member Charles Woodrow of Mahidol University in Bangkok, Thailand.

Longer treatment or the use of a wider selection of drugs might also help, but Woodrow is pessimistic. Burma spends $20 per person a year on healthcare, the sixth-lowest outlay in the world.

Still, being able to track resistance by following the spread of mutant K13 genes means we can stop it. We need to avoid the situation in Cambodia, says Menier, where the once-potent combination of artemisinin with a second antimalarial is now failing in more than 40 per cent of cases. He says researchers in Burma should now designate a central laboratory to collect and standardise tests for resistance, map it as it emerges and lead the fight to contain it.

Journal reference: The Lancet Infectious Disease, DOI: 10.1016/S1473-3099(15)70032-0

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Today on New Scientist

Ancient black hole had an inexplicable growth spurt

Reaching 12 billion times the mass of the sun just a billion years after the big bang, a black hole has astronomers mystified about its rapid growth

First human head transplant could happen in two years

A radical plan for transplanting a head onto someone else's body is set to be announced. But is such ethically sensitive surgery even feasible?

Watch desert dust cross the ocean as seen from space

For the first time, a satellite has calculated the whopping amount of Saharan dust that is blown over the ocean to reach the Amazon rainforest every year

Climate change sceptic's work called into question

Wei-Hock "Willie" Soon failed to disclose funding from the fossil fuel industry, says Greenpeace, as journals get ready to re-examine his work

Indians lose billions of life years to air pollution

Over half of India's population lives in areas with dangerous levels of air pollution. Now that has been translated into years of life lost overall

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Ancient black hole had an inexplicable growth spurt

THAT sure is a flaming big hole. Astronomers have discovered a black hole with a mass 12 billion times that of the sun. It seems to have reached that size when the universe was less than a billion years old, which creates a puzzle. Current models suggest that it could not have grown so big so soon after the big bang.

Xue-Bing Wu of Peking University in Beijing, China, and his colleagues found the black hole by searching through data from sky surveys, looking for bright objects called quasars.

One candidate, J0100+2802, looked particularly promising, so the team used telescopes in China and the US to analyse its light. By measuring how much the light had been stretched out by the expansion of the universe, they calculated that it is 12.8 billion light years from Earth.

Quasars, which emit vast quantities of light, are thought to surround black holes and be powered by gas heating up and glowing as it falls into the hole. Measuring the properties of this gas can in turn determine the black hole's mass. J0100+2802 is about four times as bright as the previous brightest quasar at this distance, and its black hole is a monster at 12 billion times the mass of our sun (Nature DOI: 10.1038/nature14241).

There are bigger black holes out there, but it is the age of this one that's troubling. It reached this size just 900 million years after the big bang – which in black hole terms isn't very long.

"Everyone thinks of black holes as these great dangerous things that swallow up anything in their vicinity," says Daniel Mortlock of Imperial College London. But that's not the case. "If you try to force-feed it you get a traffic jam on the way in and it gets very dense."

This heating creates quasars, but if too much material falls in too quickly, it becomes hot enough to force new material out of the gravitational pull of the black hole. Such an early giant breaks the theorised growth limits, says Wu. "It either requires very special ways to grow the black hole, or requires that a huge seed black hole existed when the universe was less than 300 million years old."

Another explanation is that small black holes somehow form in clusters in the early universe, and grow massive by merging with each other rather than sucking up gas, says Mortlock. But large black holes made this way won't glow, so we can't see them.

None of these solutions is fully supported by existing theories, says Mortlock, so we will probably need bigger telescopes to peer even further back into the past. "You're coming up with theories to try to explain what are pretty close to the most distant objects we can see," he says.

This article appeared in print under the headline "Giant black hole grew too fast"

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First human head transplant could happen in two years

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A radical plan for transplanting a head onto someone else’s body is set to be announced. But is such ethically sensitive surgery even feasible?

IT'S heady stuff. The world's first attempt to transplant a human head will be launched this year at a surgical conference in the US. The move is a call to arms to get interested parties together to work towards the surgery.

The idea was first proposed in 2013 by Sergio Canavero of the Turin Advanced Neuromodulation Group in Italy. He wants to use the surgery to extend the lives of people whose muscles and nerves have degenerated or whose organs are riddled with cancer. Now he claims the major hurdles, such as fusing the spinal cord and preventing the body's immune system from rejecting the head, are surmountable, and the surgery could be ready as early as 2017.

Canavero plans to announce the project at the annual conference of the American Academy of Neurological and Orthopaedic Surgeons (AANOS) in Annapolis, Maryland, in June. Is society ready for such momentous surgery? And does the science even stand up?

The first successful head transplant, in which one head was replaced by another, was carried out in 1970. A team led by Robert White at Case Western Reserve University School of Medicine in Cleveland, Ohio, transplanted the head of one monkey onto the body of another. They didn't attempt to join the spinal cords, though, so the monkey couldn't move its body, but it was able to breathe with artificial assistance. The monkey lived for nine days until its immune system rejected the head. Although few head transplants have been carried out since, many of the surgical procedures involved have progressed. "I think we are now at a point when the technical aspects are all feasible," says Canavero.

This month, he published a summary of the technique he believes will allow doctors to transplant a head onto a new body (Surgical Neurology International, doi.org/2c7). It involves cooling the recipient's head and the donor body to extend the time their cells can survive without oxygen. The tissue around the neck is dissected and the major blood vessels are linked using tiny tubes, before the spinal cords of each person are cut. Cleanly severing the cords is key, says Canavero.

The recipient's head is then moved onto the donor body and the two ends of the spinal cord – which resemble two densely packed bundles of spaghetti – are fused together. To achieve this, Canavero intends to flush the area with a chemical called polyethylene glycol, and follow up with several hours of injections of the same stuff. Just like hot water makes dry spaghetti stick together, polyethylene glycol encourages the fat in cell membranes to mesh.

Next, the muscles and blood supply would be sutured and the recipient kept in a coma for three or four weeks to prevent movement. Implanted electrodes would provide regular electrical stimulation to the spinal cord, because research suggests this can strengthen new nerve connections.

When the recipient wakes up, Canavero predicts they would be able to move and feel their face and would speak with the same voice. He says that physiotherapy would enable the person to walk within a year. Several people have already volunteered to get a new body, he says.

The trickiest part will be getting the spinal cords to fuse. Polyethylene glycol has been shown to prompt the growth of spinal cord nerves in animals, and Canavero intends to use brain-dead organ donors to test the technique. However, others are sceptical that this would be enough. "There is no evidence that the connectivity of cord and brain would lead to useful sentient or motor function following head transplantation," says Richard Borgens, director of the Center for Paralysis Research at Purdue University in West Lafayette, Indiana.

If polyethylene glycol doesn't work, there are other options Canavero could try. Injecting stem cells or olfactory ensheathing cells – self-regenerating cells that connect the lining of the nose to the brain – into the spinal cord, or creating a bridge over the spinal gap using stomach membranes have shown promise in helping people walk again after spinal injury. Although unproven, Canavero says the chemical approach is the simplest and least invasive.

But what about the prospect of the immune system rejecting the alien tissue? Robert White's monkey died because its head was rejected by its new body. William Mathews, chairman of the AANOS, says he doesn't think this would be a major problem today. He says that because we can use drugs to manage the acceptance of large amounts of tissue, such as a leg or a combined heart and lung transplant, a head transplant should be possible. "The system we have for preventing immune rejection and the principles behind it are well established."

Canavero isn't alone in his quest to investigate head transplants. Xiao-Ping Ren of Harbin Medical University in China recently showed that it is possible to perform a basic head transplant in a mouse (CNS Neuroscience & Therapeutics, doi.org/2d5). Ren will attempt to replicate Canavero's protocol in the next few months in mice, and monkeys.

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Watch desert dust cross the ocean as seen from space

Video: Saharan dust caught crossing the Atlantic Ocean

Huge clouds of dust from the Sahara desert are blown across the Atlantic Ocean every year, creating massive plumes that can be seen from space. Now, for the first time, a NASA satellite has calculated how much of it ends up in the Amazon rainforest, which depends on the delivery to keep its soil fertile.

(Image: NASA Goddard's Scientific Visualization Studio)

The glowing arcs above are slices of dust clouds in the atmosphere, imaged along lines of longitude. Between 2007 and 2013, the satellite, called CALIPSO, bounced lasers off the dust and analysed reflected light to find that about 27.7 million tons of dust reaches the Amazon basin every year.

Due to the region's high rainfall, phosphorus in the soil – which is essential for plant growth – is washed away by local rivers. But luckily, the Saharan delivery contains about the same amount of the lost element, replenishing its supply.

Close to 43 million tons of dust is carried even farther than the Amazon, settling over the Caribbean Sea.

Journal reference: Geophysical Research Letters, DOI: 10.1002/2015GL063040

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Climate change sceptic's work called into question

A prominent climate change sceptic may see his work re-examined by journals after Greenpeace revealed that he had not disclosed funding from fossil-fuel companies.

Wei-Hock "Willie" Soon, an aerospace engineer with the Harvard-Smithsonian Center for Astrophysics, has published several papers arguing that global warming is caused by solar activity. His work is cited by climate sceptics such as US senator James Inhofe.

This week, Greenpeace disclosed papers revealing that Soon had received more than $1 million in funding from fossil fuel interests, including Exxon Mobil, the American Petroleum Institute, the Charles Koch Foundation and Southern Company – an energy company that generates half of its power from burning coal.

Greenpeace says Soon repeatedly failed to disclose his funding to academic journals – which may have violated the ethical guidelines for those journals – yet later referred to the papers as "deliverables" in communications with his funders.

Journals investigating

Kenneth Heideman of the American Meteorological Society, which published one of Soon's papers, says: "AMS is investigating the facts and will make a decision regarding the disposition of the paper once all of these have been considered."

Several of Soon's papers appeared in the Journal of Atmospheric and Solar-Terrestrial Physics . "While we have not yet determined what action the journal will take, the publisher has made it clear that such allegations are taken very seriously," says Robert Strangeway, its editor.

Greenpeace said its collaborator on the probe, the Climate Investigations Center, would be in touch with all the journals involved to notify them of the probe's findings.

Climate scientists contacted by New Scientist were divided on the issue. "I think it is quite fundamental to disclose conflict of interest," says Corinne Le Quéré, director of the Tyndall Institute for Climate Change Research in Norwich, UK. "Although failure to do so doesn't necessarily mean the science if flawed, it is important to let the reviewers know what is the context in which the research was done."

Not transparent

Le Quéré adds that some level of scrutiny may be missing if a potential conflict of interest has not been disclosed.

"People should declare interests for the sake of transparency," says Myles Allen of the University of Oxford. "But the evidence is unaffected by where people's funding comes from. I have received a very small grant from Shell. More importantly, I get a lot of money from the UK government. Does this mean I am automatically biased to support UK climate policy? I hope not."

Joanna Haigh of Imperial College London, who has studied solar impacts on climate change and natural variations in the climate, points out that the reality of science publishing can be subtle. If Soon submits to journals that have expertise in climate and atmospheric science then any weaknesses should be picked up by reviewers, she says. However, she adds, he has tended to publish elsewhere.

"The revelations about the undeclared funding lead one to consider what motivates the science," she says.

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