Apple Store in Shanghai, China

Inside Apple’s Impossible War On Child Exploitation

In a somber announcement, South African retail giant Pick n Pay shared the news that its founder Raymond Ackerman has passed away at the age of 92. Ackerman, a retail legend and visionary entrepreneur, not only left an indelible mark on the business landscape but also touched the hearts of many as a humanitarian known for his philanthropic work.



“With profound sadness we announce that Pick n Pay founder Raymond Ackerman has passed away. A visionary entrepreneur, humanitarian and a great South African. Our country has lost a brilliant patriot who always saw a positive future for South Africa” the company said on X, formerly Twitter, in a statement. 



Beginning his life in Cape Town, Ackerman began working in the retail chain of the same name founded by his father. Its subsequent sale in 1946 paved the way for the birth of another massive supermarket chain – Checkers. In 1967, Ackerman himself began his own retail empire, purchasing four stores that would eventually bear the name Pick n Pay.&nbsp;



With investor support, the chain rapidly expanded across the country, transforming the South African retail landscape, with more than 2,000 stores in operation today. The company also boasts a market cap of almost $1 billion.



His incredible business acumen let Ackerman pioneer several innovations now commonplace in the South African retail market, such as ‘no name’ food brands and in-store banking at retail outlets.



Condolences poured in from all corners of South African society, with politicians, celebrities and citizens alike sharing messages.&nbsp;



“… he left an enormous legacy,” said John Steenhuisen, leader of the Democratic Alliance. “His positive contribution to our society will be his legacy.”&nbsp;&nbsp;&nbsp;



Ackerman was equally known beyond the brick and mortar of his businesses for his philanthropic endeavors, actively championing fuel price deregulation, and founding the Raymond Ackerman Academy for Entrepreneurial Development in collaboration with the Universities of Cape Town and Johannesburg.



Ackerman received the CNBC Africa All Africa Business Leaders Awards&#8217; Lifetime Achievement award in 2011.



In a poignant reflection shared when he celebrated his 90th birthday in 2021, Ackerman acknowledged South Africa&#8217;s challenges but remained hopeful. He saw a resilient nation in the midst of adversity, citing the resilience and compassion displayed by its people as a beacon of hope for the future.



As South Africa bids farewell to Ackerman, the retail industry and the nation as a whole mourn the loss of a visionary leader, philanthropist, and patriot. His life&#8217;s journey exemplified the power of perseverance, innovation, and a commitment to a brighter future.&nbsp;

Pick n Pay and BP announce points partnership for smart shoppers

Visionary South African Retail Icon Raymond Ackerman Passes Away

<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



Google plans to require verified election advertisers to make “clear and conspicuous” disclosures when their advertisements contain AI-generated content, according to a&nbsp;<a href="https://support.google.com/adspolicy/answer/13755910?hl=en&amp;ref_topic=29265" target="_blank" rel="noreferrer noopener">blog post</a>&nbsp;from the tech giant, which will institute the changes as artificial intelligence becomes more commonplace in the leadup to the 2024 presidential election.



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



The update to Google’s political content policy will arrive in mid-November and will require disclosures to be placed in clear locations on images and videos.



Audio content is included in the disclosure requirements, though AI generated content “inconsequential to the claims made in the ad,” such as color corrections, image resizing and cropping, are exempt.



Videos uploaded to YouTube that aren’t paid advertising are also exempt, even if the content is uploaded by political campaigns.



Election advertisers who want to run election ads through Google are already required to go through a&nbsp;<a href="https://support.google.com/adspolicy/troubleshooter/9973345" target="_blank" rel="noreferrer noopener">verification process</a>&nbsp;requiring basic information from applicants.



A mix of human and tech tools will be used to enforce the disclosure requirements.



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



Google is one of several tech companies that has faced scrutiny over its handling of misinformation. YouTube, which was acquired by Google in 2006, faced backlash after announcing this year it would&nbsp;<a href="https://www.nbcnews.com/tech/tech-news/youtube-will-stop-removing-false-claims-2020-election-fraud-rcna87503" target="_blank" rel="noreferrer noopener">stop taking down content</a>&nbsp;containing false claims about the 2020 presidential election—when former President Donald Trump baselessly claimed voter fraud was rampant in an election he still considers rigged. YouTube said in a blog post it made the decision to protect its “community” and provide “a home for open discussion and debate.” The company was also criticized in 2020 for slowly removing or labeling videos with election misinformation.



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



X, formerly known as Twitter, does not have specific guidelines for AI-generated ad content. Meta, the owner of Instagram and Facebook, does not have similar policies either, though it does have a ban against “<a href="https://about.fb.com/news/2020/01/enforcing-against-manipulated-media/" target="_blank" rel="noreferrer noopener">manipulated media</a>” such as deepfakes—videos that typically use digital alterations to copy someone&#8217;s likeness and convey false information.



Forbes Daily: Get our best stories, exclusive reporting and essential analysis of the day’s news in your inbox every weekday.Sign Up



By signing up, you accept and agree to our&nbsp;<a href="https://www.forbes.com/terms-and-conditions" target="_blank" rel="noreferrer noopener">Terms of Service</a>&nbsp;(including the class action waiver and arbitration provisions), and&nbsp;<a href="https://www.forbes.com/privacy" target="_blank" rel="noreferrer noopener">Privacy Statement</a>.



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<a href="https://www.nbcnews.com/tech/tech-news/youtube-will-stop-removing-false-claims-2020-election-fraud-rcna87503" target="_blank" rel="noreferrer noopener">YouTube will stop removing false claims about 2020 election fraud</a>&nbsp;(NBC News)



<a href="https://www.axios.com/2023/09/06/google-ai-election-ads-disclosure" target="_blank" rel="noreferrer noopener">Google to require disclosure for AI in election ads</a> (Axios)

In this photo illustration, a woman holds a smartphone with

Google Will Require Advertisers To Add Disclosures For AI-Generated Election Ads

Kalycia Urquhart was seven when she was diagnosed with an extra vertebra. It all began when she bent over to pick up her baby brother who had just begun to crawl.



Something in her neck tweaked causing an excruciating amount of pain and she couldn’t move. “I first got put into traction in hospital by a specialist,” she says. “They put weights on a pulley system in an attempt to stretch my neck out. I was in hospital for about two weeks in this contraption and it was the worst possible thing that could have been done as they were putting weights on a bone that was fused to other bones.”



Urquhart was in pain, but the doctors didn’t understand exactly what was going on. It was only after Urquhart’s mother found a neurosurgeon, an expert in spinal osteoporosis anomalies, who x-rayed her at a specific angle and exposed an extra vertebra.



It was an extremely rare condition, she was one in the 600,000 people born with a spinal anomaly and at that point, the only person with her condition in the world.


<div class="wp-block-image">
<figure class="alignleft size-large is-resized"><img decoding="async" loading="lazy" src="https://cms.forbesafrica.com/wp-content/uploads/2023/08/Kalycia-Urquhart-946x1024.jpg" alt="" class="wp-image-59399" style="width:375px;height:406px" width="375" height="406" srcset="https://cms.forbesafrica.com/wp-content/uploads/2023/08/Kalycia-Urquhart-946x1024.jpg 946w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Kalycia-Urquhart-277x300.jpg 277w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Kalycia-Urquhart-768x832.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Kalycia-Urquhart-1418x1536.jpg 1418w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Kalycia-Urquhart-1891x2048.jpg 1891w" sizes="(max-width: 375px) 100vw, 375px" /><figcaption class="wp-element-caption">Kalycia Urquhart. Image Supplied</figcaption></figure></div>


“It was quite an ordeal. It took us a very long time to get an actual diagnosis because no one could see what was wrong with me or find the issue,” she says. “The neurosurgeon changed my life. He explained that it would be a lifelong issue for me and that there was no potential for surgery. I also have a high chance of paralysis because I am double-jointed.” Urquhart couldn’t play sports. If she got knocked hard enough, she could be paralyzed. 



“My parents freaked out. Their response was ‘oh my God, bubblewrap her’. It was scary. There was not a lot of information or cases to reference,” she adds. Urquhart found herself in medical journals and her case is still the one referenced today.



After being on chronic, schedule five painkillers for over a decade, Urquhart had semi-kidney and liver failure at 19. Even though she was taking anti-inflammatories, painkillers and probiotics to protect her stomach lining, she developed ulcers. “My kidneys and liver were basically shutting down and my doctor said I have to get of everything, I had to detox.



It was terrifying because I didn’t know how I would cope with the level of pain – just carrying a handbag is hard, carrying a laptop bag is a challenge,” she says.



Before the age of 20, Urquhart had to reassess how she would manage pain and began looking into alternative therapies. Cannabidiol (CBD) oil wasn’t as accessible as it is now, but for Urquhart, it was a life-saver. “And it didn’t have the negative side efects of normal medication, it was a sustainable expense,” she says. “The alternative healing world is very cowboy. There’s no regulation and while you can find people who are incredible healers, some are charlatans who are milking vulnerable people for money. When you’re in a horrible state of pain and you’re trying to find help, you’re willing to pay and do anything to find relief.”



At 25, Urquhart hit a financial blocker – taking out her own medical aid as she was too old to be on the family plan. She often had to fork out cash for therapy as she couldn’t aford weekly (sometimes twice-a-week) treatments. Added to that, she was working at an advertising agency, a high-stress job where taking time of or asking to work from home was seen as a weakness.



“You just want to be normal; you want to be considered competent and capable… it becomes tough to open up and share what you’re struggling with,” she says. In order to manage her pain, she’s had to learn a lot of maintenance techniques. While she can drive an automatic car, for example, the condition of South Africa’s roads afects how she lives her life. Hitting a pothole could not only damage her car, but severely impact her condition: “If we go on holiday and I have to go into a dirt road, I know I am going to feel it for a couple of days. I pack a neck pillow, muscle spasm relaxant, heat pad – and that’s just for leisure!”



“I have a lot of medical expenses around



this as my condition is technically considered a disability,” says Urquhart, who adds that one of her biggest expenses has been physiotherapy, finding someone who can help



manage her pain without hurting her. “Physios will also push you to try other techniques, like needling, and some of it has worked, some really hurt me, and others made no diference at all but it has been a massive expense in



my life – you pay, per hour!” After starting psychotherapy at 26, Urquhart found that dealing with emotional issues impacted how she lived with chronic pain. “Pain takes you to the extreme and your mind is a most powerful tool. Intense pain can be transformative but unfortunately, when you grow up with chronic pain, you don’t always develop the mental tools to deal with it,” she adds.



Living with chronic pain, Urquhart, now 34, works for herself and from home. There’s no tell-tale sign that something is wrong with her or that she has a physical anomaly.

I need medication to get rid of this flu

Chronicling Chronic Pain: ‘I Didn’t Know How I Would Cope With The Level Of Pain – Just Carrying A Handbag Is Hard, Carrying A Laptop Bag Is A Challenge

Alessandro Rosano’s contrarian playbook for the comfort-footwear company: no financing and minimal marketing. It worked so well he sold to Crocs for $2.5 billion.



Two years ago, Brown’s Shoe Fit Co.’s desperation to stock enough HeyDude shoes to meet the demand reached frenzied levels. The buyers for the 73-store Midwestern chain would get a status report in the morning and try to place a large order. “We would get one-fourth or one-half of what we put in for,” says Adam Smith, senior manager for Brown’s and a former store manager in Jacksonville, Illinois. “The whole nation was trying to get them.”



HeyDude founder Alessandro Rosano, an Italian entrepreneur living in Hong Kong, had tried his hand at other businesses before. But with HeyDude, which makes comfortable slip-on loafers with a so-ugly-they’re-cute look, he hit the jackpot. With minimal investment and almost no marketing, revenue took off, reaching $581 million in 2021, with net profit of $175 million. That December, Rosano agreed to sell the brand to Crocs, the $6.2 billion (market cap) firm whose own ugly-cute rubber clogs are a worldwide phenomenon, for $2.5 billion in cash and stock.



With that deal, Rosano became a billionaire, worth $1.4 billion by&nbsp;Forbes&nbsp;estimates. His business partner and American distributor Daniele Guidi also made a fortune, worth some $650 million after tax by&nbsp;Forbes&nbsp;estimates, after bringing in $787 million in cash from the deal, according to regulatory filings with the Securities and Exchange Commission.



Rosano declined to speak with Forbes, and Guidi didn’t respond to requests for comment. But what the two men were able to build, largely under the radar, is an unlikely success. It stands in stark contrast to many of the direct-to-consumer brands that received lavish amounts of funding and attention from social media during the boom years while failing to become viable businesses. Comfort shoe maker Allbirds, once the darling of Silicon Valley, for example, has seen its market cap collapse from a peak of more than $4 billion after its 2021 initial public offering to just $199 million today as annual sales failed to top $300 million and losses piled up.



Now Rosano, a strategic advisor to the brand under Crocs following the acquisition, has set up a family office to invest his money and work on philanthropy. Crocs is using the brand, which reached $1.1 billion in sales in the latest 12-month period, to add spice to its broader business.



Comfort shoes are having a moment. Crocs, with total sales of $3.6 billion in 2022, has said it hopes to reach $5 billion in sales for its flagship brand by 2026. HeyDude looks poised to help the company soar past that. In 2022, HeyDude was the single fastest growing brand at retail, according to consumer research firm Circana (formerly NPD).



“When we first bought it, we wanted to be clear to people that this was a scale business,” Crocs CEO Andrew Rees tells&nbsp;Forbes. “They hadn’t heard of it, and didn’t know what it was. We put out the $1 billion target, which we knew we could blow past, and we’ve gotten to that easily.”



Rosano, who is in his mid-50s, was a shoe dude long before he came up with HeyDude. He grew up in Tuscany, and studied at Commercio Estero, Pistoia, from 1982 to 1987, though he never received a university degree, according to his LinkedIn profile. Pistoia, a medieval Italian city that’s popular with tourists, is less than 30 miles from Florence, home to Ferragamo and Gucci, in a region known for luxury goods and footwear.



Rosano, who started designing shoes at age 18, had tried other businesses before HeyDude, and had a shoe distributor called Fratelli Diversi. On his LinkedIn profile, where he has just 164 connections, he describes his approach to that company as “acting in a fair and reasonable way, to the people and the environment. Charity acts are also a duty.”



Rosano cofounded a company with Guidi and a third person to make wooden watches called WeWood. Wooden watches are a tough business, and the company was subject to unfair competition litigation in 2011 from a now-defunct watchmaker called Vestal International. Rosano also came up with an idea for wooden clogs with springs in their heels that sold under the name Baldo. None of his early businesses found notable success.



<hr class="wp-block-separator has-alpha-channel-opacity"/>



<blockquote class="wp-block-quote">
“If you were to lay out the playbook that they followed and present it to a series of business executives, they would say there’s no way that this would succeed.”Crocs CEO Andrew Rees
</blockquote>



<hr class="wp-block-separator has-alpha-channel-opacity"/>



He’d been working in these various businesses for more than 20 years when he founded HeyDude in 2008. In a&nbsp;<a href="https://fotoshoemagazine.com/hey-dude-comfort-has-an-iconic-style/" target="_blank" rel="noreferrer noopener">2020 interview with Fotoshoe magazine</a>, an Italian industry publication, Rosano’s sister Elena De Martini, who was then CEO of Fratelli Diversi, described how Rosano returned from a trip to China and realized that a modern shoe that was as comfortable as a slipper didn’t exist — and decided to create one.



The shoes Rosano developed, starting with the Wally for men, were lightweight, with elastic laces that didn’t require fastening, and affordable, at around $60 a pair. “The result is perfectly constructed footwear, which is innovative, ultra-light and casual, but with style,” De Martini told&nbsp;Fotoshoe.&nbsp;The shoes were designed in Italy, but the business was headquartered in Hong Kong, where Rosano lives, with production at contract factories in China.



Rosano “is a student,” Crocs CEO Rees says. “He’s a serial entrepreneur. He had a number of entrepreneurial businesses before this that had not been successful. He was looking to improve his chances of success and he admired [Crocs’] focus on simplicity and comfort.”



Though many Italian shoemakers create beautiful shoes for Europeans, Rosano was going for something more mainstream. Not wanting to name the brand after himself as many Italian shoe entrepreneurs would, he came up with HeyDude for its laid-back California vibe, says Rick Blackshaw, who became president of the brand under Crocs. “But all his friends in Italy would call it ‘ey du-day,’” Blackshaw says.



In 2010, Guidi, who has a degree in aerospace engineering from the University of Pisa and runs a consulting and marketing firm called Lever Your Business, joined Rosano to open U.S. operations. The shoes took off, and HeyDude added a woman’s model known as the Wendy, a water shoe and a variety of eco-friendly designs. The shoes were prototypically American looking, easy to wear — and looked like nothing else on the market. Almost all the sales came from the U.S. market, rather than from Europe.



HeyDude sales soared from $20 million in 2018 to&nbsp;<a href="https://s22.q4cdn.com/133460125/files/doc_presentations/2022/01/10/ICR-Presentation-vF.pdf" target="_blank" rel="noreferrer noopener">$191 million in 2020,</a>&nbsp;according to financials that Crocs shared with investors at the 2022 ICR conference. During the pandemic, as consumers stayed home wearing yoga pants and comfort shoes, the brand fit right in. Its success came despite having no marketing to speak of other than paid search and a commission-based sales team. “It was built on a shoestring,” says Crocs’ Rees.



The brand took off by word of mouth. “In many senses, it’s a pretty remarkable story,” Rees says. “If you were to lay out the playbook that they followed and present it to a set of business executives, they would say there’s no way that this would succeed.”



<blockquote class="wp-block-quote">
With comfort shoes having a moment, the brand’s sales soared from $20 million in 2018 to $581 million in 2021.
</blockquote>



<hr class="wp-block-separator has-alpha-channel-opacity"/>



Footwear analysts and industry watchers were blindsided. “It kind of caught a lot of the industry players by surprise,” says Beth Goldstein, a footwear analyst at Circana. “This brand came up and was all of a sudden having these huge growth rates and buzz. It piqued everyone’s interest.”



Brown’s became one of the earliest larger retailers to stock it after its Muskogee, Oklahoma store manager learned about the brand at a 2012 trade show in Las Vegas. The Buckle, a Kearney, Nebraska-based retail chain with 440 stores, also began carrying HeyDude before the shoe company’s major expansion, in 2019.



“We were known as the top HeyDude retailer,” says Brown’s Smith. “In the pandemic, we didn’t know if we could get products, so we were ordering them by the pallet.” With customers sometimes buying five pairs at a time, however much Brown’s could get its hands on sold out fast. Facebook groups sprung up where people could compare notes, and buy, sell and trade their shoes.



“It was limited quantity and a lot of fun styles and colors, and the price was right,” Smith says. “The customer wanted them so bad it almost didn’t matter what the color was. It was crazy, that’s probably the best way to put it.”



Two days before Christmas 2021, Crocs agreed to buy HeyDude for $2.5 billion, most of it in cash and a smaller amount in stock. Wall Street was not impressed. The shoes that were selling out in the Midwest were scarce on the coasts, where many of the analysts and investors live, and the shoes lacked the cache of hot new sneaker brands like Hoka and On.



“To be honest, when they announced the acquisition, I had never heard of the brand,” says Tom Nikic, a Wedbush analyst, who follows Crocs and has been covering the footwear industry for more than a decade. “It was very much a shock to the system. I think those of us in the New York, Wall Street bubble, we didn’t realize what was happening with the brand.”



Rosano had clearly timed the market well, putting the brand up for sale as it was growing fast and demand for comfort shoes was at a high. Allbirds had gone public in November 2021 gaining a $4.1 billion valuation, making it worth 15 times its sales for that year despite being in the red. By contrast, HeyDude, which was already profitable on higher sales, seemed like a bargain. Crocs CEO Rees says that he’d been following HeyDude for a few years by the time he learned it was on the market and figured it wouldn’t be too difficult to turn it into a $1 billion brand under the Crocs umbrella.



“It was a tightly managed sale process,” Rees says. “They were trying to sell to private equity at that point. We got introduced to the founder and managed to get ourselves inserted into the sales process. At that point, we also started to learn about the compelling financials. It wasn’t completely obvious because they were private, and because they weren’t selling in the traditional channels it wasn’t showing up in the typical data sets.”



<hr class="wp-block-separator has-alpha-channel-opacity"/>



<blockquote class="wp-block-quote">
Rosano had a number of businesses before HeyDude, including a wooden watch startup and a brand of clogs with springs in their heels. None found notable success.
</blockquote>



<hr class="wp-block-separator has-alpha-channel-opacity"/>



With Covid restrictions in place, Rees and Rosano couldn’t meet in person. But Rees figured he didn’t need to meet the HeyDude management team since he planned to replace them. He saw similarities with Crocs: both were polarizing brands that a lot of consumers loved. “I think we got a pretty good deal,” he says. “We weren’t daunted by the large-dollar price tag.”



HeyDude’s strategy of focusing on one style of comfort shoe at a mass-market price was a playbook familiar to Crocs. “Alessandro was really clear that he had modeled a lot of his company on Crocs,” Rees says. “He had been studying Crocs and taking our strategies and incorporating them.”



Crocs also knew what Wall Street didn’t at first: Rosano, helped by Guidi’s U.S. distribution, had built a significant and profitable brand with minimal investment. Though those who know him say that Rosano had been strategic in how he’d built the brand, from the outside it appeared to have burst onto the scene almost by chance.



“We’ve become somewhat acclimated to these newer upstart brands being unprofitable and burning through cash,” analyst Nikic says. “This isn’t Allbirds. This isn’t a money-losing, cash-burning business. It’s actually a very highly profitable company.” Nikic compares the brand’s fast growth to Crocs itself, as well as to Ugg, which built its business on one style of comfort boots.



Since acquiring HeyDude, Crocs has hired Blackshaw, who previously ran Sperry and Keds, as its new brand president. It’s introduced new styles, including sneakers, and is setting up collaborations to give it more buzz. It’s also rejiggering its distribution, expanding to major retailers like Shoe Carnival, Famous Footwear and Academy Sports, and building a new distribution center in Las Vegas to handle its expansion.



The acquisition hasn’t been without a few snags. In the second quarter, HeyDude took a hit — with modest 3% growth as its wholesale revenue dropped 8% year-over-year — and Crocs cut its guidance for the brand for the year from mid-20% growth to between 14% and 18%. One problem: as Crocs cut smaller distributors set up by Rosano and Guidi before the acquisition, some dumped their inventory at lowball prices on Amazon. Wedbush analyst Nikic figures that the problems with gray-market goods should wind down in the coming months once the legacy distributors’ inventory is gone. In its earnings call, Crocs pointed to HeyDude’s 30% increase in direct-to-consumer revenues as a sign of the brand’s strength while it dealt with the “pipeline fill” issues in the wholesale channel. Crocs shares are down 19%, at a recent $100, since the deal was announced.



<hr class="wp-block-separator has-alpha-channel-opacity"/>



<blockquote class="wp-block-quote">
Crocs hopes to make HeyDude as ubiquitous as its original ugly-cute rubber clogs, helped by new distribution and marketing muscle.
</blockquote>



<hr class="wp-block-separator has-alpha-channel-opacity"/>



Marketing muscle and collaborations helped Crocs push its flagship brand, and it intends to do the same with HeyDude. Blackshaw says that the company will “overinvest,” noting it could spend up to 8% of total sales on marketing. Part of the plan: connect with consumers on TikTok and Meta, helped by partnerships with influencers and athletes. A collaboration with hunting brand Mossy Oak launched in June, another with YouTube sports and comedy group Dude Perfect (whose channel has 60 million subscribers) followed in August and a college licensing deal is in the works for this fall. The company has plans for more collaborations, including with&nbsp;Yellowstone,&nbsp;The Big Lebowski, a major beer brand and some toy brands. “It’s a lot of the same playbook that Crocs brought to bear,” Blackshaw says.



Whether the brand will take off on the coasts as it has in the middle of the country remains to be seen. Another risk for HeyDude as it expands is oversaturation. As analyst Goldstein notes, Crocs will need to strike the right balance between growth and introducing new styles that risk cannibalizing its core business. “They almost invented a category,” she says. As the brand expands into other types of shoes, “they need to make their proposition clear,” she says. “Why is a HeyDude sneaker better than anyone else’s casual sneaker?”



Meanwhile, Rosano has his fortune to invest and give away. While venture-backed startups stumble, HeyDude harkens back to an older way of building a company on a smart idea and a shoestring. Perhaps, like comfort shoes, it’s time for that to come back into style.

F4Ye2L5WIAAYHWb

How The HeyDude Guy Became A Billionaire Selling Ugly Shoes

<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



Cancer is on the rise among younger people and scientists don’t really know why, according to&nbsp;<a href="https://bmjoncology.bmj.com/lookup/doi/10.1136/bmjonc-2023-000049" target="_blank" rel="noreferrer noopener">research</a>&nbsp;published in&nbsp;BMJ Oncology&nbsp;on Tuesday, an unexplained trend that threatens to strain already stretched healthcare systems and upends much of what we thought we knew about the disease.



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



While cancer still tends to be more common among older people, the number of cancers among people younger than 50—when it is considered to be “early-onset cancer”—has risen over the past three decades, according to the peer reviewed analysis of health data.



Globally, there were 1.82 million new cancer diagnoses and 1.06 million deaths from cancer among under 50s in 2019, the researchers said, respectively a 79% and 28% increase from figures in 1990.



Early-onset cancers of the windpipe and prostate rose most steeply between 1990 and 2019, the researchers found, climbing an estimated 2.28% and 2.23% each year, respectively.



Breast cancer—the most&nbsp;<a href="https://www.who.int/news-room/fact-sheets/detail/cancer#:~:text=The%20most%20common%20cancers%20are,and%20lack%20of%20physical%20activity." target="_blank" rel="noreferrer noopener">common</a>&nbsp;type of cancer worldwide excluding non-melanoma skin cancer—was responsible for the largest number of cases and associated deaths among younger people, the researchers said, with rates of 13.7 cases and 3.5 deaths per 100,000 people.



Deaths increased most sharply among people with kidney or ovarian cancers and, following breast cancer, cancers of the windpipe, lung, stomach and bowel exacted the highest death toll.



The researchers noted that while rates of early-onset cancer were a concern globally, the rate of new cases in 2019 were highest in wealthy countries in North America, Western Europe and Australasia and lower income countries in Central Asia, Eastern Europe and Oceania suffered disproportionately high death rates.



<h2 class="wp-block-heading" id="h-what-to-watch-for">WHAT TO WATCH FOR</h2>



Given trends over the past three decades, the researchers predict new early-onset cancer cases and associated deaths will increase an additional 31% and 21%, respectively, by 2030. People in their 40s are likely to be the most at risk, the researchers said.



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<h2 class="wp-block-heading" id="h-crucial-quote">CRUCIAL QUOTE</h2>



Writing in a linked editorial, researchers from the Center for Public Health at Queen’s University Belfast said the findings “challenge perceptions of the type of cancer diagnosed in younger age groups” and “serves as a warning for future burden on healthcare systems” that are still recovering from the Covid-19 pandemic. Given the risks to people aged between 40 and 49, public healthcare systems should consider expanding screening programs, they said.



<h2 class="wp-block-heading" id="h-what-we-don-t-know">WHAT WE DON’T KNOW</h2>



It is still something of a mystery as to why cancer cases are on the rise among younger people. In essence, cancer is a disease of uncontrolled cell proliferation, with cells growing and spreading to other parts of the body. It happens when the genetic information in our cells responsible for keeping cell growth in check is damaged, which explains why it is more common in older people who have had more time to acquire these mutations. Many factors influence the risk of getting cancer, including genetic predispositions, exposure to certain viruses and environmental factors like pollutants, diet, exercise and the use of drugs like alcohol and tobacco and the researchers said there is no single explanation for the rise in early-onset cancers over the past three decades. Better detection through screening and medical system improvements, such as cervical cancer screening in the U.S., could explain part of the increase, the researchers said. Other factors like changing lifestyles, particularly increased rates of obesity and physical inactivity, as well as environmental pollution could also account for some of the increase, they said.



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



The researchers found that the rates of some early-onset cancers decreased over the three decades studied. New cases of early-onset liver cancer fell by an estimated 2.88% every year, the researchers said, the steepest decline of the cancers studied.



<h2 class="wp-block-heading" id="h-big-number">BIG NUMBER</h2>



10 million. That’s roughly how many people died of cancer in 2020,&nbsp;<a href="https://www.who.int/news-room/fact-sheets/detail/cancer" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to the World Health Organization. Collectively, cancers accounted for nearly one in every six deaths. The WHO said around one-third of these are due to preventable factors like tobacco use, high body mass index, alcohol consumption, a diet poor in fruit and vegetables and physical inactivity.



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<a href="https://www.forbes.com/sites/roberthart/2023/02/23/cancer-will-cost-us-53-trillion-by-2050-researchers-estimate/">Cancer Will Cost U.S. $5.3 Trillion By 2050, Researchers Estimate</a> (Forbes)<a href="https://www.forbes.com/sites/roberthart/"></a>

UCSF Cancer Center Uses Latest Technologies To Battle Cancer

Cancer Is On The Rise Among Younger People—But Scientists Don’t Know Why

Kenneth Odoemenam, the founder of KenChu&#8217;s Farm Services, is making an impact in Nigeria’s aquaculture industry by training others in catfish farming.



Kenneth Odoemenam, the founder of KenChu&#8217;s Farm Services, is among the 80% of fish farmers engaged in catfish farming in Nigeria, which is Africa&#8217;s third-largest fish producer, according to data from the World Bank.



With aquaculture production reaching 313,231 metric tons, Nigeria&#8217;s fisheries and aquaculture subsector plays a vital role in the country&#8217;s economy, contributing 5% to its Gross Domestic Product (GDP) and supporting the livelihoods of approximately 24 million people, as reported by the World Trade Organization (WTO).



Driven by the desire to challenge the notion that farming is exclusive to older individuals, Odoemenam embraced catfish farming and turned it into a thriving venture. With continuous learning and a passion for the craft, he steadily improved and scaled up his operations, establishing himself in the industry.



His journey began with an abandoned pond within his family&#8217;s compound in Port Harcourt, the capital and largest city of Rivers State, located in the southern region of Nigeria.



The catfish farmer tells FORBES AFRICA: &#8220;We had a pond constructed on our family compound by a family friend, initially intended for fish farming but left unused. Recognizing the opportunity, I decided to start my catfish farming journey using that very pond.


<div class="wp-block-image">
<figure class="alignleft size-large is-resized"><img decoding="async" loading="lazy" src="https://cms.forbesafrica.com/wp-content/uploads/2023/09/IMG-0898-768x1024.jpg" alt="" class="wp-image-59433" style="width:448px;height:597px" width="448" height="597" srcset="https://cms.forbesafrica.com/wp-content/uploads/2023/09/IMG-0898-768x1024.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2023/09/IMG-0898-225x300.jpg 225w, https://cms.forbesafrica.com/wp-content/uploads/2023/09/IMG-0898-1152x1536.jpg 1152w, https://cms.forbesafrica.com/wp-content/uploads/2023/09/IMG-0898-1536x2048.jpg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2023/09/IMG-0898-scaled.jpg 1920w" sizes="(max-width: 448px) 100vw, 448px" /><figcaption class="wp-element-caption">Image Supplied</figcaption></figure></div>


&#8220;After completing my first degree in Industrial Chemistry from Abia State University in 2017, I attended an enlightening agribusiness seminar that included specialized training in catfish farming. Eager to dive into this promising venture, I began with small-scale experiments, but initial results were not as I had hoped. Undeterred, I remained determined and committed to learning and seeking guidance from experienced individuals.&#8221;



During the early days, he encountered learning curve challenges in understanding the intricacies of proper management, water quality, feeding schedules, disease prevention, and other essential aspects. He overcame with dedication to learning and seeking guidance which has helped him improve the management of the farm and achieve better results.



He also confronted the capital challenge to scale up operations. &#8220;As a young farmer, securing the necessary finances to invest in infrastructure, equipment, and fish stock can be challenging. Although I have been exploring different avenues, such as applying for grants, to secure the required funding.&#8221;



Leveraging his background in data analysis and a master&#8217;s degree in Environmental Chemistry and Pollution Control, he found innovative ways to integrate technology and sustainable practices into his catfish farming enterprise.



&#8220;I began my catfish farming journey while working as a data analyst. As my catfish farming enterprise grew and flourished, I made the decision to transition into full-time catfish farming. I am now fully dedicated to running and managing my catfish farm. Moreover, leveraging my expertise and experience in the field, I have also taken on the role of training and consulting for other catfish farms, sharing my knowledge and insights to contribute to the success of fellow farmers in the industry,&#8221; says Odoemenam.



KenChu&#8217;s Farm Services focuses on providing comprehensive farm consultancy, training, and farm setup services; offerings which its founder notes are essential to support aspiring aquaculture entrepreneurs, existing fish farmers, and investors seeking to venture into the sector.



His three-year old YouTube channel, Catfish Farm Enterprise, has become a valuable platform for sharing his expertise and knowledge, and it has over 5,700 subscribers and 151 videos.



&#8220;YouTube offers the opportunity to collaborate with other young farmers across Africa, by showcasing the work and achievements of young people in the aquaculture sector. My channel acts as a powerful marketing tool for my catfish farming enterprise. As my channel gains subscribers and viewership, it helps build my brand&#8217;s reputation and recognition within the agriculture and aquaculture community. The exposure gained through YouTube has attracted customers interested in my products and services,&#8221; says Odoemenam.



Through KenChu&#8217;s Farm Services, he has achieved milestones, including training over 100 individuals in catfish farming and providing setup services for more than 20 catfish farms across the country, contributing to the growth of the aquaculture sector and generating employment opportunities.



His ebook, Guide to Successful Catfish Farming, and the development of an automated farm record sheet exemplify his dedication to promoting efficiency and sharing valuable insights with aspiring farmers.



Looking ahead, Odoemenam envisions a bright future for KenChu&#8217;s Farm Services and the aquaculture sector as a whole.



&#8220;The aquaculture sector holds immense promise, particularly in Nigeria, where there is vast untapped potential. At KenChu&#8217;s Farm Services, we will capitalize on this opportunity and make a significant impact in the industry,&#8221; says Odoemenam.



He plans to expand his consultancy and training services to support aspiring aquaculture entrepreneurs and existing fish farmers. By embracing technological advancements, promoting sustainable practices, and focusing on capacity building and research, he aims to play a vital role in driving the growth and development of the aquaculture industry in Nigeria.



Odoemenam remains a beacon of hope and inspiration for young farmers and entrepreneurs. With his unwavering passion and determination, he is proving that the agricultural sector holds immense promise, and young people can actively participate and excel in this rewarding field.

Kenneth Odoemenam; image supplied

The Nigerian Data Analyst-Turned-Catfish Farmer Empowering Entrepreneurs In Aquaculture  

<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



With a potential winter and fall surge of the flu, Covid and RSV, some experts recommend getting all three shots at the same time, while limited research shows doing so might cause rare side effects.=



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



It’s “acceptable” to get the new respiratory syncytial virus (RSV) vaccine co-administered with other vaccines, including the flu and Covid vaccines,&nbsp;<a href="https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2023-06-21-23/07-RSV-Adults-Britton-508.pdf" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to the Centers for Disease Control and Prevention.



For the first time, two RSV vaccines have been greenlit by the FDA to protect&nbsp;<a href="https://www.forbes.com/sites/mollybohannon/2023/05/03/fda-approves-first-ever-rsv-vaccine-after-brutal-2022-season/?sh=3dd0ac5910b2">older Americans</a>&nbsp;and&nbsp;<a href="https://www.forbes.com/sites/roberthart/2023/08/21/fda-approves-first-rsv-vaccine-for-kids-given-to-pregnant-moms-heres-what-to-know/?sh=75ffd2ab813e">infants</a>&nbsp;against the virus, which are expected to be available this fall, and the agency also approved an&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2023/08/03/first-rsv-vaccine-for-infants-approved-by-cdc-and-fda-other-top-vaccines-and-their-effectiveness/?sh=7a5031872040">antibody shot</a>&nbsp;for infants and toddlers in August.



New monovalent&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2023/08/21/new-covid-boosters-expected-this-fall-why-some-doctors-suggest-holding-off-on-getting-your-next-booster-until-then/?sh=18f37e73438b">Covid boosters</a>&nbsp;to protect against variants of the dominant XBB lineage are being developed by Moderna, Pfizer and Novavax at the request of a Food and Drug Administration panel and also are predicted to be available this fall.



As the fall and winter seasons approach, there are concerns another respiratory virus “tripledemic”—caused by a simultaneous rise in flu, Covid and RSV cases, causing hospitals to become overwhelmed—may happen again this year.



<h2 class="wp-block-heading" id="h-crucial-quote">CRUCIAL QUOTE</h2>



It’s “more probable that we&#8217;ll have a high viral season” this year with people getting Covid, the flu and RSV around the same time, so getting vaccinated is an important preventative step, Sharon Nachman, the chief of the division of pediatric infectious diseases at Stony Brook Children’s Hospital, told&nbsp;Forbes.



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<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



<a href="https://covid.cdc.gov/covid-data-tracker/#variant-proportions" target="_blank" rel="noreferrer noopener">Covid</a>&nbsp;hospitalizations in recent weeks ticked up, increasing by almost 19% between August 13 and August 19, while deaths increased almost 18% between July 8 and August 26, as EG.5, or the Eris variant, made up the majority of cases. Though national&nbsp;<a href="https://www.cdc.gov/surveillance/nrevss/images/trend_images/RSV14Num_Nat.htm" target="_blank" rel="noreferrer noopener">RSV cases</a>&nbsp;have increased slightly since June—they went from 149 cases in the week of June 17 to 423 cases the week of August 26—cases were over four times higher around this time last year.&nbsp;<a href="https://www.cdc.gov/flu/about/season/index.html" target="_blank" rel="noreferrer noopener">Flu cases</a>&nbsp;aren’t witnessing a spike just yet, as flu season is expected to begin in October, but updated vaccines are available for the upcoming season.



<h2 class="wp-block-heading" id="h-big-number">BIG NUMBER</h2>



50,000. That’s how many people in the U.S. died from Covid infection between November 2022 and March 2023,&nbsp;<a href="https://covid.cdc.gov/covid-data-tracker/#maps_deaths-total" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to the CDC. The&nbsp;<a href="https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm" target="_blank" rel="noreferrer noopener">flu</a>&nbsp;accounted for around 58,000 deaths during last year’s tripledemic and&nbsp;<a href="https://www.cdc.gov/rsv/research/rsv-net/dashboard.html" target="_blank" rel="noreferrer noopener">RSV</a>&nbsp;killed 10,000 people—mostly seniors—and caused twice as many hospitalizations than in prepandemic years.



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



A good number of patients last year were admitted into Nachman’s hospital with “more than one virus” at a time. So, she recommends those who are eligible to first get their doctors’ approval and then get all three shots in preparation for the upcoming seasons. Other than approving the co-administration of the RSV shot with other vaccines, the CDC also&nbsp;<a href="https://www.cdc.gov/flu/prevent/coadministration.htm" target="_blank" rel="noreferrer noopener">endorses</a>&nbsp;co-administration of the Covid and flu vaccines. Nachman said there’s a “better immune response” when more than one vaccine is administered at the same time. A&nbsp;<a href="https://www.sciencedirect.com/science/article/pii/S0264410X22015687" target="_blank" rel="noreferrer noopener">study</a>&nbsp;published in&nbsp;Elsevier&nbsp;found dual vaccination of Covid and the flu saw a reduced risk of infection than in unvaccinated people.



<h2 class="wp-block-heading" id="h-contra">CONTRA</h2>



Epidemiologist Richard Reithinger told&nbsp;Forbes, “People are a little bit more cautious” about getting the RSV vaccines at the same time as the other two because they were only recently approved by the FDA this year. There is limited evidence on whether the new RSV vaccines negatively interact with the Covid and flu vaccines. However, there were rare instances in a clinical trial where people developed severe side effects after getting the RSV and flu shots at the same time. Two 71-year-old participants developed acute disseminated encephalomyelitis (<a href="https://www.ninds.nih.gov/health-information/disorders/acute-disseminated-encephalomyelitis#:~:text=Acute%20disseminated%20encephalomyelitis%20(ADEM)%20is,helps%20with%20electrical%20nerve%20signaling." target="_blank" rel="noreferrer noopener">ADEM</a>), a neurological disorder that causes widespread swelling in the brain and spinal cord that damages the nerves’ protective coating, according to a&nbsp;<a href="https://www.cdc.gov/mmwr/volumes/72/wr/pdfs/mm7229a4-H.pdf" target="_blank" rel="noreferrer noopener">report</a>&nbsp;by a CDC advisory committee. One of these instances resulted in death. However, researchers aren’t sure if these cases were a result of the vaccines being administered together, or just a coincidence. The study also found that RSV and flu antibodies were slightly lower when administered together, though the “clinical significance is unknown.” If people are unsure about getting all three vaccines at once, it’s okay to “just take the flu vaccine [right now] and then wait for the Covid-19 and RSV” vaccines to be released later this year, according to Reithinger. Although he believes getting all three vaccines at the same time is safe, he ultimately recommends people consult with their doctors on timing.



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<a href="https://www.forbes.com/sites/ariannajohnson/2023/08/21/new-covid-boosters-expected-this-fall-why-some-doctors-suggest-holding-off-on-getting-your-next-booster-until-then/?sh=18f37e73438b">New Covid Boosters Expected This Fall: Why Some Doctors Suggest Holding Off On Getting Your Next Booster Until Then</a>&nbsp;(Forbes)



<a href="https://www.forbes.com/sites/ariannajohnson/2022/12/20/heres-why-there-is-a-shortage-for-childrens-tylenol-advill-and-motrin-and-what-to-do-about-it/?sh=3a6e33ce28f4">Here’s Why There Is A Shortage For Children&#8217;s Tylenol, Advil And Motrin—And What To Do About It</a>&nbsp;(Forbes)



<a href="https://www.forbes.com/sites/mollybohannon/2023/05/03/fda-approves-first-ever-rsv-vaccine-after-brutal-2022-season/?sh=3dd0ac5910b2">FDA Approves First-Ever RSV Vaccine After Brutal 2022 Season</a>&nbsp;(Forbes)



<a href="https://www.forbes.com/sites/roberthart/2023/08/21/fda-approves-first-rsv-vaccine-for-kids-given-to-pregnant-moms-heres-what-to-know/?sh=75ffd2ab813e">FDA Approves First RSV Vaccine For Kids—Given To Pregnant Moms—Here’s What To Know</a>&nbsp;(Forbes)



<a href="https://www.forbes.com/sites/ariannajohnson/2023/08/03/first-rsv-vaccine-for-infants-approved-by-cdc-and-fda-other-top-vaccines-and-their-effectiveness/?sh=7a5031872040">First RSV Shot For Infants Approved By CDC And FDA: Other Top Shots And Their Effectiveness</a> (Forbes)

Injection of the third dose of the covid 19 vaccine at a Covid-19 vaccination center in Dinan, Brittany

It’s Okay To Get Your Covid, Flu And RSV Shots At The Same Time, Experts Say

Opportunity abounds for retailers giving used clothing a second lease on life, but while some are reveling in the country’s current economic climate and contributing to the circular economy, the high-end designers are finding it difficult to compete and cope.



In an open-air market in Yaba, Lagos, Tobi Iddrisu, is getting ready to open her boutique and welcome the day’s first customers. She opened the store almost a decade ago with the goal of selling second-hand clothes from China.



Since that time, the store, as well as Iddrisu, have gone through several iterations. For the former, life began as a second-hand children clothing store before moving to incorporate toys and finally transitioning to focus on second-hand fast fashion goods for Gen Z and millennial women.



These days, her suppliers come from places like London, Germany and the United Arab Emirates (UAE) but China still leads the pack. Lately, her brother in Germany has begun sending her some electronic devices like old iPads, laptops and LED television sets which, according to Iddrisu, are beginning to sell rapidly.



For Iddrisu, the shift from her nine-to-five job as a customer service clerk at First Bank Nigeria to a second-hand market trader, has proven to be one of the best decisions of her life, for a number of reasons.



In those days, she took home a meager N250,000 ($330) and struggled to make that stretch to cover her monthly expenses, which included fending for her two boys.



Today, her sons are in one of the top private schools in Lagos and Iddrisu has also ventured into the real estate market with two rental units in her name. Moreover, she is now able to provide employment opportunities to five disadvantaged individuals who Iddrisu employs as sales assistants.



“Things were very good when we started but now there is a lot of competition. Those who supply quality second-hand goods are still thriving because the economy is very difficult,” says Iddrisu.



For her and many other second-hand merchants, business is booming. Cash-strapped Nigerians who cannot pay the prices in high-end retail outlets are flooding to markets in Yaba, Katangua and Asuwani to make their naira stretch as far as possible.



“We sell goods at least 200% or cheaper than those sold in boutiques on the island and for people who are already struggling to make ends meet, how can they buy brand-new items? This goes for all items like hair, cosmetics and electronics. It is simply not affordable buying these things brand new,” says Iddrisu.



The World Poverty Clock, a tool which provides up-to-the-minute poverty data across the world, puts Nigeria as the country with the second highest level of poor people at 71 million after India.



These are people who live below the poverty line of $2. The problem is further exacerbated when you consider the rate of inflation which, according to the Nigerian Bureau of Statistics (NBS), stood at an all-time high of 22.41% in May 2023.



This report also estimates that the Consumer Price Index (CPI), a measure of the monthly changes in the price of goods and services paid by Nigerians, rose to 24.82% in May. The NBS further cites that about 133 million Nigerians are living in multi-dimensional poverty.



From a lack of forex which has brought trade to almost a complete standstill since the beginning of the year, a devaluation of the naira coupled with challenges in swapping old naira notes for new ones, to the recent fuel subsidy crisis, the country’s economic woes seem far from over.



The report by the NBS shows that the inflationary rise was attributed to food and non-beverage products, electricity, gas and other fuel as well as clothing and footwear. Several initiatives that should have offered advantages to Africa’s largest economy, have also, unfortunately, been met with barriers to entry by Nigeria.



The African Continental Free Trade Area (AfCFTA), for example, was supposed to provide regional integration of goods and services between African countries. However, Nigeria’s food import substitution policy is not favorable with the goals of the AfCFTA, according to a report by the World Bank.



This was further buttressed when, in August 2019, Nigeria’s former president, Muhammadu Buhari, closed Nigeria’s borders, effectively blocking trade between the country and its neighbors for about a year. The move was an attempt to stop neighboring Benin from re-exporting rice to Nigeria for a significantly higher margin, thereby reducing dumping of the product.



That closure has also led to an increase in the prices of clothes in the second-hand market.



“We get some items from neighboring countries like Benin and Ghana, and when the government shut down the border, a lot of vendors who were relying on their supply from these countries were affected. The lack of supply has increased the cost of some items in the second-hand market and they keep rising even today,” says Iddrisu.



According to American news platform, CBS, the global second-hand market is estimated to hit $350 billion by 2025 and for personal shopper, Bobby Smith, the surge in demand for second-hand products is great for business.



“I usually deal with high-end clients who want exclusive designer wear at affordable prices. For example, most of my clients are interested in second-hand exclusive designer bags which tend to have amazing resale value. I have seen a trend in clients opting for quality, used designer items instead of those brand-new ones from stores because they want to be economical with their spending, given the current economic climate,” says Smith.



The current economic state has actually led to sales orders from individuals with a higher disposable income opting for fairly-used designer items than brand-new ones.



“I am a club promoter in Ikoyi and that means I have to look my best every night. Most of my business comes from meeting [with] new venues and offering my services to the owners, which includes bringing in a crowd that would patronize their goods and keep the club buzzing. My appearance is extremely important so I need to keep up with the trends. I shop second-hand designer wear because there is a lot of originality especially if you know the right stores, because most designers never repeat their styles so you get one-of-a-kind pieces,” says Tola T.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;



But not everyone is happy about the boom in second-hand clothing. For Lola Amusan, a fashion designer in Lagos, who makes her money designing customized, ready-to-wear clothes, it is a major issue.



“We actually create bespoke clothes for our customers and so the current state of the economy is having a big impact on our bottom line. You cannot comfortably cost how much an item is because every day you go to the market, fabric prices are changing. The unstable power supply means I am running my business on [a] generator 24/7, which means I am spending a lot of money on fuel,” she says.



About 25% of the Nigerian population are considered to be Gen Z and have an insatiable appetite for fashion pieces, according to Iddrisu.



“The young ladies of today want trendy items that no one has and they want items that are not too expensive so they can change them regularly without breaking the bank. Some of our tops sell for as low as N2,000 ($2) to N5,000 ($6),” she says.



Another contributing factor to the growth in the second-hand market relates to the volume of charitable clothing donations from the West. There are various news articles on how Africa has become fast fashion’s dumping ground, a trend which is leading to significant climate change issues for the continent.



As much as the second-hand market is great for cash-strapped Nigerians, there is also a detrimental effect on the local textile and garment industries.



“We simply cannot compete with the second-hand market and I feel the current state of the economy is going to drive a lot of designers, like myself, out of business. Something has to be done,” says Amusan.



One solution that has been suggested by experts is to perhaps transform the fashion economy into a circular one. A circular economy is one where waste is minimized by reusing and upcycling as well as leasing garments. Some have also advocated for an import ban of used clothing into Africa.



But the problem with that is it leaves millions of impoverished people in Africa’s most populous economy without the means to purchase affordable clothing. As it stands, Nigeria’s inflationary problems seem to have a long way to go before subsiding and the current President Bola Tinubu has his work cut out for him.



For people like Iddrisu, times are great and the boom in second-hand clothing is now birthing yet a new opportunity for her in the consumer electronics sector, in which she has opened a brand-new store in Ikeja, as well as provided employment to a further 10 individuals. It’s just another way that she has used the current economic climate to give herself and her employees a second chance at happiness and fulfilment.

Woman Goes Clothing Shopping

Less Is More: Nigeria’s Second-Hand Fashion Market Booms As Inflation Soars

<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



Officials in New York City this week&nbsp;<a href="https://www.dailymail.co.uk/health/article-12471305/NYC-Health-Department-tells-New-Yorkers-MASKING-Labor-Day-good-idea-new-Covid-variants-drive-infection-rates.html" target="_blank" rel="noreferrer noopener">reportedly</a>&nbsp;urged residents to wear masks in public as a new strain of Covid-19 continues to spread throughout the country, while some hospitals and schools have also reimplemented mask mandates, though medical experts say masking requirements might not last long, and might not be necessary for the entire population.



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



New York City Health Commissioner Dr. Ashwin Vasan this week warned the virulent Ba.2.86 variant is “likely to evade immunity that has developed from vaccination or prior infection,” while a city health official told the Daily Mail it would be a “good idea” to mask up in crowded indoor places over the holiday weekend.



In Atlanta, Morris Brown College—a historically Black university—implemented a&nbsp;<a href="https://www.fox5atlanta.com/news/morris-brown-college-implements-two-week-covid-19-mask-mandate-as-cases-climb" target="_blank" rel="noreferrer noopener">two-week mask mandate</a>&nbsp;for all students and faculty last week as students move back on campus, also re-imposing social distancing amid “reports of positive cases among students.”



California-based healthcare facility Kaiser Permanente&nbsp;<a href="https://www.pressdemocrat.com/article/news/kaiser-permanente-reinstates-covid-19-mask-mandate-amid-spike-in-cases-but/" target="_blank" rel="noreferrer noopener">reinstated</a>&nbsp;its mask mandate at its facilities in Santa Rosa, California last week “amid an uptick in patients testing positive,” while in New York, a group of hospitals also imposed mask mandates,&nbsp;<a href="https://www.fox4news.com/news/citing-rising-covid-cases-these-us-hospital-systems-have-now-reinstated-mask-mandates" target="_blank" rel="noreferrer noopener">including</a>&nbsp;United Health Services, Auburn Community Hospital and University Hospital in Syracuse, New York.



In Santa Monica, California, Hollywood studio&nbsp;Lionsgate&nbsp;also&nbsp;<a href="https://www.hollywoodreporter.com/movies/movie-news/hollywood-studio-covid-rates-mask-mandates-back-1235571466/" target="_blank" rel="noreferrer noopener">requested</a>&nbsp;employees wear masks in certain parts of its facilities in response to a rise in cases last month.



A mask mandate is also in effect in&nbsp;<a href="https://sf.gov/information/know-when-masks-are-needed#:~:text=There%20are%20no%20longer%20masking,or%20people%20living%20in%20jails." target="_blank" rel="noreferrer noopener">San Francisco</a>&nbsp;for healthcare workers when around patients, as well as for employees at jails.



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<h2 class="wp-block-heading" id="h-contra">CONTRA</h2>



Officials have been torn on mask mandate policies since the start of the pandemic, while studies have found mandates might not be a guaranteed safeguard from community-wide spread. George Washington University Dr. Leana Wen told&nbsp;<a href="https://www.cnn.com/2023/08/31/health/labor-day-coronavirus-increase-wellness/index.html" target="_blank" rel="noreferrer noopener">CNN</a>&nbsp;this week the decision to mask up also depends on an array of factors, including a person’s age and whether they’re at high risk of contracting the virus—she also said children in schools who are at low risk should not be required to mask up. When asked about Labor Day weekend precautions, Wen added people who didn’t cancel their plans last year probably don’t need to cancel them either, despite cases being on the rise.



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



Vaccine boosters from drugmakers Pfizer, Moderna and Novavax are&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2023/08/21/new-covid-boosters-expected-this-fall-why-some-doctors-suggest-holding-off-on-getting-your-next-booster-until-then/?sh=6d037a70438b">expected</a>&nbsp;to be ready for use later this month and widely available in October, though they are still pending Food and Drug Administration approval. Those boosters, unlike their predecessors, target newer coronavirus strains, including the Eris strain and other XBB subvariants, adding to Americans’ arsenal to combat Covid, though only 17% of Americans have received the current bivalent booster shot,&nbsp;<a href="https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-people-booster-percent-pop5" target="_blank" rel="noreferrer noopener">according to</a>&nbsp;the Centers for Disease Control and Prevention.



<h2 class="wp-block-heading" id="h-big-number">BIG NUMBER</h2>



15,067. That’s the number of Covid hospitalizations in the U.S. over the week ending August 19, an increase of 18.8% from the week before, according to&nbsp;<a href="https://covid.cdc.gov/covid-data-tracker/#maps_new-admissions-rate-county" target="_blank" rel="noreferrer noopener">CDC data</a>. More than 6.27 million people in the U.S. have been hospitalized since the outbreak of the pandemic more than three years ago.



<h2 class="wp-block-heading" id="h-chief-critic">CHIEF CRITIC</h2>



Despite the rise in cases, Republican lawmakers have slammed Covid mask mandates, with Mississippi Gov. Tate Reeves (R)&nbsp;<a href="https://mailchi.mp/5dd152f9c1de/governor-tate-reeves-mask-mandates?e=ae3824fee2" target="_blank" rel="noreferrer noopener">swearing off</a>&nbsp;potential mask orders, saying, “MIssissippians will not and should not submit to fear again.” In a&nbsp;<a href="https://truthsocial.com/@realDonaldTrump/posts/110979968873429026" target="_blank" rel="noreferrer noopener">video</a>&nbsp;posted on his social media platform Truth Social, former President Donald Trump argued mask mandates amounts to “fear mongering,” calling lawmakers “Covid tyrants,” and vowing: “We will not shut down our schools, we will not accept your lockdowns, we will not abide by your mask mandates and we will not tolerate your vaccine mandate.”



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<a href="https://www.forbes.com/sites/ariannajohnson/2023/08/21/new-covid-boosters-expected-this-fall-why-some-doctors-suggest-holding-off-on-getting-your-next-booster-until-then/?sh=6d037a70438b">New Covid Boosters Expected This Fall: Why Some Doctors Suggest Holding Off On Getting Your Next Booster Until Then</a>&nbsp;(Forbes)



<a href="https://www.forbes.com/sites/williamhaseltine/2023/08/25/wastewater-analysis-update-on-ba286-in-the-united-states-its-here-be-careful/?sh=6ab2e5353cc0">Wastewater Analysis Update On BA.2.86 In The United States: It’s Here, Be Careful</a> (Forbes)

Business owner setting up face mask required sign in cafe window

Will Covid Mask Mandates Return? Here’s Where They’re Making A Comeback

Johannesburg&#8217;s heartbreak deepens as a heritage building fire claims 74 lives, exposing the urban decay in the CBD. Amid tales of despair and resilience, the tragedy raises urgent questions about illegal building occupations and housing challenges in the city.



Yet another tragedy has struck Johannesburg&#8217;s Central Business District (CBD), revealing the dire state of decay in the area. A fire that broke out in a designated heritage building has turned into a mass casualty event, leaving at least 74 people dead, numerous others injured, and countless individuals homeless.



The fire ignited during the early hours of the morning yesterday and swiftly consumed the lower floors, as reported by residents. In their desperate bid to escape, many people had to leap from the upper floors to avoid the flames. Police forensics personnel at the scene, speaking to FORBES AFRICA, confirmed that some victims had succumbed to impact trauma, while others perished due to burns or smoke inhalation.



One resident, who preferred to remain anonymous, described the harrowing experience: &#8220;It started around midnight, sounding like gunshots. We lived on the ground floor and felt the intense heat. When we fled the building, we saw flames raging above.&#8221;



Firefighters, police, and emergency services swiftly arrived at the scene as the day began, and a crowd of onlookers had gathered to witness yet another tragedy in the inner city, more deadly than the recent gas explosion on Lilian Ngoyi street, also in the CBD.



Robert Mulaudzi, spokesperson for Johannesburg Emergency Services, stated, &#8220;The [victims] were treated for smoke inhalation and various injuries. The building was an informal settlement, heightening the risk of being trapped.&#8221;



As the death toll climbed, from 20 to 45, then 53, and now to 74, anguished cries could be heard from those who had lost loved ones. Dozens of people gathered on nearby streets, beyond the police cordon, carrying clothing, blankets, and essential supplies they had managed to salvage before the fire consumed the building.



A resident from the building across the road recounted, &#8220;Some people were jumping. Everyone was frantically trying to call 10111, the fire brigade, and the police, but it took them about an hour to arrive.&#8221;



The building, located at 80 Albert Street in Marshalltown, was originally the headquarters of Johannesburg&#8217;s Non-European Affairs Department when constructed in 1954. After the apartheid era, it served as Usindiso Ministries&#8217; women&#8217;s shelter and clinic. Later, it became one of the many &#8216;hijacked&#8217; buildings in the inner city, housing some of the most marginalized residents in cramped and unserviced quarters. Deeds office records indicate that the building remains in the possession of the City of Johannesburg.



FORBES AFRICA also visited two buildings across the street from the fire, housing both locals and foreign nationals, with no access to running water or electricity. Most rooms, the size of individual corporate offices, were crowded with three-four occupants, often including children. The situation of the 80 Albert Street building was no different.



The problem of &#8216;hijacking,&#8217; or illegal occupation of buildings for residence, has long plagued Johannesburg&#8217;s CBD. In 2018, then Mayor Herman Mashaba&#8217;s spokesperson reported over 432 hijacked buildings in the city, a number that has likely grown since. Residents of 80 Albert Street, many of whom were foreign nationals, disclosed monthly payments between R1,000 ($53.5) and R2,000 ($107) for their occupancy.



Continual migration to Johannesburg in search of employment, coupled with a housing backlog exceeding 500,000 as of last year, forces many residents and migrants into alternative, often illegal, housing.



One resident interviewed by FORBES AFRICA expressed disbelief, learning that her friend Amanda, just 21 years old, had perished: &#8220;She was a child, and now she&#8217;s gone.&#8221;



While the nationalities of the residents remain largely unknown, many appeared to be of foreign origin, a point that quickly became a focal issue. Operation Dudula attempted to stage a demonstration near the site but was turned away by the police.



Mulaudzi stated: &#8220;The people living there, I don&#8217;t have all the details. Some might be South African citizens, and some might be foreign nationals, but this information is yet to be confirmed. It&#8217;s a mix of residents in that area.&#8221;



In conversations with local residents, some South African nationals alleged that poor safety conditions and the ensuing fire were a result of illegal activities. &#8220;They are selling drugs,&#8221; claimed the same resident who was a friend of the deceased Amanda. &#8220;It&#8217;s everywhere here.&#8221;



Several politicians were present, including Johannesburg Mayor Kabelo Gwamanda and the City&#8217;s MMC for public safety, Dr Mgcini Tshwaku. They spoke out against the incident, framing it as a nationalistic issue, and addressed the problem of building-hijackings within the CBD.



&#8220;As they remove the bodies, it&#8217;s evident that people were trapped. The bodies piled up because people on the first floor tried to escape, but the gate was locked. People were trapped. We need to deal with this issue – buildings are being hijacked,&#8221; Tshwaku emphasized. &#8220;At this time, the city doesn&#8217;t have alternative housing solutions.&#8221;



The death toll is anticipated to rise as emergency services continue their operations. This incident ranks among the deadliest building fires worldwide, highlighting the pressing issues faced in Johannesburg&#8217;s inner city.

31 August 2023 Joburg Fire Forbes (1 of 1)

Johannesburg’s Deadly CBD Blaze: A Heartbreaking Mass Casualty Event Claims 74 Lives

<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



A new scientific study offers the first-ever estimates of how many polar bear cubs die because of greenhouse gas emissions—something experts hope will allow the federal government to use the Endangered Species Act to regulate individual projects for their greenhouse gas emissions.



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



The study by researchers with Polar Bears International, published Thursday in the academic journal&nbsp;Science,&nbsp;explains that polar bears’ survival is heavily dependent on sea ice concentration, because when that sea ice melts, polar bears are forced onto land, where food is less abundant and they are forced to fast for long periods of time.



Polar bears are normally able to fast for long periods of time and survive, but the study says sea ice melting is forcing them to fast for even longer than typical.



The longer they fast, the more weight they lose—nearly a kilogram of body mass each day—and this makes mother bears less able to care for and provide milk for their cubs, which makes cubs less likely to survive into adulthood.



As less cubs survive into adulthood, the species grows closer to extinction.



This study, researchers say, was able to quantify just how much each individual greenhouse-gas emitting project contributes to that sea ice melting and thus contributes to the extinction of polar bears—though the rate at which greenhouse gas emissions contribute to polar bear extinction varies by the region in which those polar bears live, as there are 12 distinct subpopulations of polar bears, each living in a different eco-region.



For example, the study found that 24.1 gigatons of carbon dioxide (a greenhouse gas) emissions will decrease the amount of polar bears that survive into adulthood by 2.7% in the Chukchi Sea subpopulation and by 0.6% in the West Hudson Bay subpopulation.



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



In 2008, after projections showed that two thirds of the world’s polar bears could die by the middle of the 21st century, polar bears became the first animal to be listed as a protected species under the Endangered Species Act as a result of human-caused climate change. Section Seven of the Endangered Species Act establishes a process with which the Department of the Interior must ensure projects they fund or authorize do not further jeopardize the survival of listed endangered species like polar bears. However, in October 2008, then Solicitor of the Department of the Interior David Bernhardt issued a legal opinion declaring Section Seven considerations wouldn’t be required unless one could differentiate the effects of greenhouse gas emissions of specific projects from the total greenhouse gas emissions created by humans since the start of the Industrial Revolution. This made it impossible for the Department of the Interior to evaluate projects based on how their greenhouse gas emissions would contribute to the death of endangered species, because the department previously had no way to establish one specific project’s impact separate from all the other greenhouse gas-emitting projects in the world. However, the researchers at nonprofit Polar Bears International believe this study has finally discovered how to do that. This study, the researchers argue, provides the scientific basis to rescind Bernhardt’s memo and begin including consideration of greenhouse gas emissions in reviews of all new projects.



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



The researchers behind this paper said that they focused on polar bears because Bernhardt’s memo was created in response to polar bears being listed under the Endangered Species Act. However, they said their findings can be extended to other endangered species. For example, they believe with more research, scientists would be able to establish a similar direct link between individual greenhouse-gas-emitting projects and the survival of marine turtles.



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<a href="http://www.science.org/doi/10.1126/science.adh2280?adobe_mc=MCMID%3D92211209542915049140651591500405688068%7CMCORGID%3D242B6472541199F70A4C98A6%2540AdobeOrg%7CTS%3D1693398899" target="_blank" rel="noreferrer noopener">Unlock the Endangered Species Act to address GHG emissions</a> (Nature)

A polar bear walks on the ice floe, a glacier in the background

New Study Makes First-Ever Direct Link Between Greenhouse Gases And Polar Bear Deaths

According to MedicineNet, at least 10% of the world’s population is affected by chronic pain. Eight out of those 10 patients are affected by depression, and lower back pain is the most common chronic condition, globally. It’s no wonder that pain clinics are popping up everywhere, some of them being called ‘pill mills’, one-stop shops for the medicine that specialists are becoming cautious of prescribing.



“Are they really clinics? My answer is no,” says Dr Marnin Romm, a specialist interdisciplinary pain management clinician and assistant and associate professor based in Boston, United States (US), but born in South Africa.



“A true pain clinic, by definition, is interdisciplinary.”



For Romm, one of the biggest problems with pain management is the commercial side of the business. “It’s ludicrous. Where’s the sustainability of the practitioner?” he asks. “Pain is more complex than just cracking your back, or going to a physiotherapist and feeling okay for a day or two until the pain comes back with a vengeance and you have to go back. That tells me you’re not managing the patient properly, you’re not doing the right treatment and if you keep doing the same thing day in and day out, where’s the ethics?”



Based on his training, clinical experience and work as an academic, Romm believes that pain management is about self-management.



His goal is to help his patients, many of whom have gone down the Dr Google rabbit hole, to stop relying on healthcare providers – including himself.



“It’s for the greater purpose of the good of the patient,” he explains. “I’m not here to fix them. I’m here to guide and navigate in terms of their self-management to different modalities, different tools, and a mixture of different tools, a mix of pharmacology.”



According to Romm, there has been a shift in terms of understanding the physiological and molecular mechanisms underlying chronic pain. Instead of understanding the pathophysiology underlying chronic pain, healthcare providers use pharmacological agents and invasive interventions.



<div class="wp-block-media-text is-stacked-on-mobile" style="grid-template-columns:33% auto"><figure class="wp-block-media-text__media"><img decoding="async" loading="lazy" width="681" height="1024" src="https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-681x1024.jpeg" alt="" class="wp-image-59398 size-full" srcset="https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-681x1024.jpeg 681w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-200x300.jpeg 200w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-768x1154.jpeg 768w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-1022x1536.jpeg 1022w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-1363x2048.jpeg 1363w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-scaled.jpeg 1703w" sizes="(max-width: 681px) 100vw, 681px" /></figure><div class="wp-block-media-text__content">
<blockquote class="wp-block-quote">
“IN MEDICAL SCHOOL, THE AVERAGE AMOUNT OF TIME SPENT TRAINING DOCTORS OR PHYSIOTHERAPISTS (OR ANYONE INVOLVED IN PAIN) OVER THE SPAN OF SEVEN YEARS IS FOUR HOURS… FOUR HOURS. FOR A PANDEMIC. SO, YOU’RE SAYING YOU CAN LEARN EVERYTHING YOU NEED TO KNOW ABOUT PAIN MECHANISM IN FOUR HOURS? THAT’S IMPOSSIBLE.”
<cite>—Dr Marnin Romm</cite></blockquote>
</div></div>



“And it’s not their fault. The reason for this is that in medical school, the average amount of time spent training doctors or physiotherapists (or anyone involved in pain) over the span of seven years is four hours,” he says. “Four hours. For a pandemic. So, you’re saying you can learn everything you need to know about pain mechanism in four hours? That’s impossible.”



Romm, who spent two years in London doing a master’s degree in pain neuroscience, says that the reason healthcare practitioners find it difficult to treat chronic pain is because they’re unable to identify what mechanisms are at play.



“In my assessments, I find out what is going on in the body and then target those mechanisms. Whether the treatment is pharmacological, more invasive, or psychological to reduce stress and anxiety or even exercise-based, but one of the biggest problems in pain management now is that’s still not the case,” adds Romm.



<h4 class="wp-block-heading has-text-align-center" id="h-making-money-off-pain">MAKING MONEY OFF PAIN</h4>



There’s no question that opioids are both oversupplied and overprescribed in high-income countries. Patrick Radden Keefe’s 2021 exposé about Purdue Pharma and the opioid epidemic, Empire of Pain, pinpointed the Sackler family’s marketing strategy to generate billions of dollars – which resulted in millions of addicts.



In sub-Saharan Africa, there has been a sharp increase in treatment admission trends for opioids and opioid-related disorders. A BBC investigative documentary called Sweet Sweet Codeine uncovered corruption at major pharmaceutical companies in Nigeria with staff running drug syndicates to meet the high demands of the black market. A few years after banning cough syrup containing codeine, the National Agency for Food and Drug Administration and Control (NAFDAC) reportedly shut down three pharmaceutical firms. Whether used to combat pain or recreationally, the United Nations (UN) put in a report that west, north and central Africa jointly account for 87% of all pharmaceutical opiates seized globally.



Another problem sub-Saharan Africa faces is the use of fake or substandard medications. Drugs are big business which means counterfeits and poorly-made medication benefits the pharmaceutical company that doesn’t know these products are infiltrating their supply chain and the street vendors who knowingly peddle these drugs.



A report from the UN Office on Drugs and Crime showed that 267,000 deaths in Sahel countries (Burkina Faso, Chad, Mali, Mauritania and the Niger) were linked to fake or below-par antimalarial medication. Just under 170,000 deaths have been linked to falsified antibiotics used to treat severe pneumonia in children. Sahel countries rely on imports of medical products due to their own pharmaceutical industries being in the earlier stages of development.



It is believed the counterfeit drugs are imported from pharmaceutical exporters (like Belgium, France, China and India), and diverted from the legal supply chain, or manufactured in neighboring countries.



An alternative to opioids is cannabidiol, or CBD. Different to tetrahydrocannabinol (THC) which also comes from cannabis plants, CBD is non-intoxicating in its pure form. While regulations around the world differ due to the insufficiency of solid evidence to establish its benefit versus the risks, there are many countries that have approved its use for pain. A Forbes Health survey found that 60% of the adults who use CBD in America do so for its pain relief effects. When it comes to cancer pain, Canada has given the thumbs up for CBD and so has the UK to treat the pain that comes with multiple sclerosis stiffness and spasms. In Lesotho, marijuana has become a cash crop as the small landlocked country grows and exports medical cannabis to Europe. In South African President Cyril Ramaphosa’s State of the Nation Address, he said that the legal hemp and cannabis sector has the potential to create over 130,000 new jobs in the country – the pharmaceutical market has been estimated at over R100 billion ($53 million) a year. 



<h3 class="wp-block-heading has-text-align-center" id="h-brain-training-and-tech-to-track-and-treat-pain">BRAIN TRAINING AND TECH TO TRACK AND TREAT PAIN</h3>



There’s more to the business of pain management than drugs, pharmaceuticals and otherwise. Exciting technology such as AI tools to monitor and track pain with big data to non-invasive devices that stimulate nerve fibers are being researched. Telemedicine has also become a big part of chronic pain care as some patients cannot travel to see specialists but still need to consult a doctor.



Another type of technology that’s up-and-coming in the pain space is virtual reality (VR) distraction therapy for pain relief. Dr David Binder, the director of innovation at Spaulding Rehabilitation Hospital in Boston, US, has been studying VR for a number of years. He explains that stimuli can distract the brain from receiving pain signals. In a paper for Harvard Health Publishing, he writes: “We already take advantage of this wiring all the time. For example, if you hit your elbow by accident, and it hurts, you rub the elbow and it feels better. You’re tricking the brain by producing the sensory reaction of touching the elbow, which cancels some pain signals.”



Dr Todd Maddox is part of AppliedVR, a company in Texas in the US that makes prescription VR-based therapeutics for chronic pain management. “One of the ways people learn to deal with chronic pain is with breathing mechanisms – this deals with a part of the brain that learns behavior and the goal is to engage those centers in the brain,” he explains.



Maddox explains chronic pain (and where technology fits in) as something that gets worse over time because the brain gets you into a habit that you cannot break out of. Chronic pain is not only about issues with the tissues as muscles, as one example, usually heal within six to 12 weeks, it’s how your brain processes information.


<div class="wp-block-image">
<figure class="aligncenter size-large"><img decoding="async" loading="lazy" width="1024" height="576" src="https://cms.forbesafrica.com/wp-content/uploads/2023/08/AppliedVR-1024x576.jpeg" alt="" class="wp-image-59396" srcset="https://cms.forbesafrica.com/wp-content/uploads/2023/08/AppliedVR-1024x576.jpeg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/AppliedVR-300x169.jpeg 300w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/AppliedVR-768x432.jpeg 768w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/AppliedVR-1536x864.jpeg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/AppliedVR-2048x1152.jpeg 2048w" sizes="(max-width: 1024px) 100vw, 1024px" /><figcaption class="wp-element-caption">AppliedVR makes prescription VR-based therapeutics for chronic pain management</figcaption></figure></div>


“So much of how we approach chronic pain is cognitive… but the behavior centers in the brain don’t listen to the cognitive centers very well,” says Maddox. This is why talking to someone and telling them what to do with chronic pain doesn’t always work – someone may do the exercises recommended by a physiotherapist but they also might not.



“Here’s what VR does: it broadly engages the brain. It engages your sensory and perception centers – the parts of the brain that say you’re there. It engages cognitive centers, emotional centers, you get motivated, excited and are poised for behavior change…” The research behind this non-pharmacologic form of chronic relief is exciting but it’s something that depends on good content which costs money to create. There’s also the fact that at this point, VR for pain isn’t covered by insurance unless you’re in a nursing home in America and on a CareWell plan. The alternative to what a company like AppliedVR offers is a patient buying their own VR headset and downloading a meditation app like TRIPP which combines tried- and-tested relaxation techniques with binaural audio – it just won’t be supervised by a specialist and the content won’t be specifically designed around pain relief.



Smartphones have given rise to numerous apps to track pain and others that take a more multidisciplinary approach, pairing users with a health coach who can create customized care plans. 



One piece of wearable tech that is making the rounds on social media is Healy, an expensive, palm-sized device which delivers mild electrical currents to the wearer. Robyn Gilbert, a mom of two, discovered Healy from a friend. “I have pain from an autoimmune condition and Healy can mitigate it almost completely,” she says. “It has also improved my sleep, my overall energy levels, and my general sense of emotional wellbeing.” While Gilbert doesn’t feel the current – in fact, it is recommended to keep the stimulation levels low so the user doesn’t feel it – she says she felt a mental shift straight away. “People experience profound changes in many different ways, from the cessation of pain to an overall sense of wellbeing on an emotional and mental level,” she adds. Healy was invented by Marcus Schmieke, founder of the Existential Consciousness Research Institute. It isn’t approved by the FDA but that hasn’t stopped over 300,000 people from buying a device.



<h3 class="wp-block-heading has-text-align-center">‘IT’S ALL IN YOUR… GUT?’</h3>



Chronic pain may be common but it’s complex and the idea that it’s all ‘in your head’ is something not every doctor agrees on.



Dr Sarette Zecharia is a clinical psychologist who works with alternative forms of pain management, including traditional Chinese medicine and Ayurveda, and is on the board of the Association for Comprehensive Energy Psychology. “Medication is a quick fix but the issue is that it’s foreign to the body and you end up taking more medication to cover up the side effects,” she says. “What I recently heard is that for each decade you’re in, you have to be on two medications and if 



you’re not, it’s mind-boggling. It’s no longer normal to not be on medication.”



<img decoding="async" loading="lazy" width="20" height="20" src="">Zecharia has seen incredible (and less expensive) results with her pain patients by simply managing diet, using food as fuel. “In modern science, it’s very easy to find the one thing that’s the cause of everything – and medicate. Pain is in every single system, the energetic system, the physical system, the mental system, the emotional system, the spiritual system, and it has to be dealt with on all of those levels,” she adds.



New research from the Massachusetts Institute of Technology has shown that there is a connection between the gut and chronic pain because the bacteria living



in our gut can influence some neurological diseases – when the microbiome is disrupted, the communication between the gut and brain is disrupted. There is also research in the Nature science journal which validates that an out-of-balance microbiome can lead to chronic inflammatory disease. “If you think about all these psychotropic medications that people are given, it disrupts the gut and the gut is where you make the majority of your neurotransmitters. That’s where your mood comes from and that’s why food is so important,” she adds.



“Food is not important to people whose mood is regulated, but the moment your mood isn’t regulated, you start to realize the importance of food.”



The connection between pain, food and diet culture is complicated and can be attributed to various factors, including societal pressure, media influence and individual experiences. Living a ‘healthy lifestyle’ comes at a cost and the diet industry globally is worth billions ($282.53 billion by 2028 per GlobeNewswire), profiting off those who struggle with their relationship with food and body image.



While Zecharia does believe food is fuel and has seen regenerative diets work for those in pain, she says making money off pain is easy because you can charge people a fortune and “keep giving them stuff that’s just knocking them more off their center line”.



Where does the spend stop and relief begin? For those dealing with pain, chronic or acute, finding a quick fix can take a dark turn but as the field expands and researchers across different disciplines collaborate, there is hope. Says Zecharia: “I’m not saying don’t take psychotropic medication if you need it. The problem is when someone gets medication from a healthcare provider who doesn’t really know what they have. And if it doesn’t work, you keep upping the dosage, messing up your gut biome…”

Closeup female hand neatly placing medicament at domestic first aid kit top view. Storage organization in transparent plastic box drug, pill, syringe, bandage. Fast health help safety emergency supply

The Business Of Pain Management: Expert-Speak From Africa

<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



Canada has updated its travel advisory to warn LGBTQ residents visiting the United States about local laws and policies that may &#8220;infringe on your human rights&#8221; amid a rise in legislation targeting gay and transgender people, adding Canada to a list of countries that warn visitors to America about gun laws, mass shooting events and hate crime regularity.



<h2 class="wp-block-heading">KEY FACTS</h2>



Spurred by what Deputy Prime Minister Chrystia Freeland&nbsp;<a href="https://abcnews.go.com/International/canada-issues-warning-lgbtq-travelers-united-states/story?id=102674189&amp;cid=social_twitter_abcnp" target="_blank" rel="noreferrer noopener">called</a>&nbsp;a need to prioritize the “interests and the safety of every single Canadian,” the country’s advisory page tells residents to check relevant state and local laws and&nbsp;<a href="https://travel.gc.ca/destinations/united-states#laws" target="_blank" rel="noreferrer noopener">now links</a>&nbsp;to several maps outlining where anti-LGBTQ+ laws are in place worldwide.



Mexico&nbsp;also&nbsp;<a href="https://portales-sre-gob-mx.translate.goog/guiadelviajero/index.php/103-ficha-de-paises/326-estados-unidos?_x_tr_sl=auto&amp;_x_tr_tl=en&amp;_x_tr_hl=en&amp;_x_tr_pto=wapp" target="_blank" rel="noreferrer noopener">warns</a>&nbsp;residents that the state of Florida has passed several laws “that could have an unfavorable impact” on LGBTQ+ people, specifically noting anti-trans bathroom bills, and&nbsp;New Zealand&nbsp;<a href="https://www.safetravel.govt.nz/united-states-america" target="_blank" rel="noreferrer noopener">warns</a>&nbsp;that LGBTQ+ people or those with “diverse ethnic, cultural and religious backgrounds” could be the targets of “violent crime.”



Venezuela, which is&nbsp;<a href="https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories/venezuela-travel-advisory.html" target="_blank" rel="noreferrer noopener">listed by&nbsp;</a>the United States as a do-not-travel country, warns travelers about “indiscriminate hate crimes,” as does&nbsp;Uruguay, which adds a warning about “racism and discrimination” to its travel advisory—the<a href="https://www.cnn.com/2019/08/06/americas/venezuela-uruguay-travel-warnings-us/index.html" target="_blank" rel="noreferrer noopener">&nbsp;South American warnings&nbsp;</a>came in 2019 after the U.S. saw two large-scale&nbsp;<a href="https://www.forbes.com/sites/rachelsandler/2019/08/04/2-mass-shootings-leave-at-least-29-dead-in-under-24-hours-suspects-identified/">mass shootings</a>&nbsp;kill 31 people within 24 hours.



Canada,&nbsp;Australia&nbsp;and the&nbsp;United Kingdom&nbsp;also warn about common mass shootings—typically defined as gun-related violence with four or more casualties or injuries—as the United States<a href="https://www.forbes.com/sites/brianbushard/2022/11/25/611-mass-shootings-recorded-so-far-in-2022-second-worst-year-for-gun-violence-in-almost-a-decade/">&nbsp;saw more&nbsp;</a>than 600 mass shootings in 2022 compared to 2 in the United Kingdom, 1 in Australia and 4 in Canada.



Germany&#8216;s Ministry of Foreign Affairs <a href="https://www.auswaertiges-amt.de/de/service/laender/usa-node/usavereinigtestaatensicherheit/201382#content_1" target="_blank" rel="noreferrer noopener">tells its residents</a> that Americans are “facing increases in violent crime” and easy access to guns leads to “occasional killing sprees.” Such travel warnings are not uncommon—the U.S., for example, warns travelers of increased terrorist threats in<a href="https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories/united-kingdom-travel-advisory.html" target="_blank" rel="noreferrer noopener"> the United Kingdom</a>, civil unrest <a href="https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories/spain-travel-advisory.html" target="_blank" rel="noreferrer noopener">in Spain</a> and crime <a href="https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories/brazil-travel-advisory.html" target="_blank" rel="noreferrer noopener">in Brazil</a>.



<h2 class="wp-block-heading">TANGENT</h2>



Canada also warns that the gender notation of X on a passport, indicating an unspecified gender, could cause entry problems in some countries (the U.S.&nbsp;<a href="https://travel.state.gov/content/travel/en/passports/need-passport/selecting-your-gender-marker.html#:~:text=At%20this%20time%2C%20you%20can,facility%20or%20renew%20by%20mail." target="_blank" rel="noreferrer noopener">allows</a>&nbsp;X as a gender marker for American passports).



<h2 class="wp-block-heading">KEY BACKGROUND</h2>



The Human Rights Campaign&nbsp;<a href="https://www.hrc.org/press-releases/roundup-of-anti-lgbtq-legislation-advancing-in-states-across-the-country" target="_blank" rel="noreferrer noopener">says</a>&nbsp;more than 530 anti-LGBTQ bills had been introduced in U.S. state legislatures by May of this year, with 220 specifically targeting transgender and nonbinary people. Of those, 70 had been enacted by the start of the summer. More than&nbsp;<a href="https://www.forbes.com/sites/tylerroush/2023/08/25/judge-temporarily-blocks-texas-ban-on-gender-affirming-care-here-are-all-the-states-with-similar-bans-or-restrictions/?sh=a15020222a8c">a dozen states</a>&nbsp;have placed restrictions on gender-affirming care for transgender people this year, including Missouri, Kentucky and Alabama, where it is now a felony to prescribe puberty blockers and hormones to transgender minors under 19 years old. Other bills have banned drag shows and censored school curriculum. The Department of Homeland Security&nbsp;<a href="https://www.hrc.org/press-releases/roundup-of-anti-lgbtq-legislation-advancing-in-states-across-the-country" target="_blank" rel="noreferrer noopener">warned in May</a>&nbsp;that threats against LGBTQ people were on the rise and FBI hate crime statistics said 20% of all hate crimes in 2021 were motivated by LGBTQ bias.



<h2 class="wp-block-heading">BIG NUMBER</h2>



356. That’s how many anti-LGBTQ hate crimes were documented by the Anti-Defamation League and GLAAD between June 2022 and April 2023.



<h2 class="wp-block-heading">SURPRISING FACT</h2>



Journalists Lyric and Asher Fergusson earlier this year published a report on the&nbsp;<a href="https://www.asherfergusson.com/lgbtq-travel-safety/" target="_blank" rel="noreferrer noopener">safest places</a>&nbsp;for LGBTQ people to travel in 2023. They used ten factors to rank countries and included things like whether people were protected from discrimination, if violence against LGBTQ people is illegal, if same-sex marriage is legal and transgender murder rates. The United States was ranked 25th on the list with an overall grade of B+ and the report noted that some states don&#8217;t offer protections against discrimination while others prohibit “advocacy of homosexuality” in schools. Canada was rated as the safest country, followed by Sweden, the Netherlands and Malta.



<h2 class="wp-block-heading">FURTHER READING</h2>



<a href="https://www.forbes.com/sites/laurabegleybloom/2023/06/27/new-lgbtq-safety-report-ranks-trans-friendly-travel-destinations/?sh=6ed4a8252930">New LGBTQ+ Safety Report Ranks Trans Friendly Travel Destinations</a>&nbsp;(Forbes)



<a href="https://www.forbes.com/sites/tylerroush/2023/08/25/judge-temporarily-blocks-texas-ban-on-gender-affirming-care-here-are-all-the-states-with-similar-bans-or-restrictions/?sh=a15020222a8c">Judge Temporarily Blocks Texas Ban On Gender-Affirming Care—Here Are The Other Trans Health Restrictions Facing Court Battles&nbsp;</a>(Forbes)



<a href="https://www.forbes.com/sites/mollybohannon/2023/08/07/florida-will-let-schools-teach-entirety-of-ap-psychology-reversing-course-after-dispute-over-lgbtq-topics/?sh=6f83ba152504">Florida Will Let Schools Teach ‘Entirety’ Of AP Psychology—Reversing Course After Dispute Over LGBTQ Topics </a>(Forbes)

Crowd raising and holding rainbow gay flags during a Gay Pride. Trans flags can be seen as well in the background. The rainbow flag is one of the symbols of the LGBTQ community

Here’s Why These Countries—Not Just Canada—Warn Citizens Visiting The U.S.

Nigeria, Algeria, and Egypt are anticipated to be the primary drivers of a gas supply surge, collectively contributing around 80% of the total African gas production. Experts respond to the development, highlighting both opportunities and obstacles on the horizon.



According to the State of African Energy report in August by the African Energy Chamber, Nigeria, Algeria and Egypt are anticipated to be the primary drivers of a gas supply surge, collectively contributing around 80% of the total African gas production.



The report forecasts short-term natural gas supply in Africa poised for growth, projecting an increase from this year&#8217;s supply levels of 25.5 Bcf/d to slightly over 27 Bcf/d in 2024, maintaining this level until 2027.



It indicates, &#8220;Algeria is expected to experience growth from 10 Bcf/d in 2023 to 11 Bcf/d by 2027. Egypt&#8217;s production is expected to remain steady at 6.25 Bcf/d. Nigeria&#8217;s output is expected to fluctuate marginally between 4.5 Bcf/d and 5.5 Bcf/d.&#8221;



Reacting to this development, Kelvin Emmanuel, an economist, highlights that one of the key challenges impacting the African gas landscape is the ongoing diplomatic impasse in the Sahel region.



Emmanuel explains to FORBES AFRICA: &#8220;The 4,128-km gas pipeline linking the AKK pipeline from Kano through Niger Republic to Algeria was intended to supply the trans-Mediterranean pipeline. The inability of the Economic Community of West African States (ECOWAS) and the African Union (AU) to find a diplomatic solution to the Sahel impasse jeopardizes this vital project, as well as the capacity of Nigeria, Algeria, and Egypt to surpass other producers like Tanzania and Mozambique.&#8221;



He further underscores Russia&#8217;s influence on gas dynamics, pointing out that the embargo on Russian gas and the inability to secure letters of credit (LC) for gas exports from Nord Stream I and II have led to a demand-supply gap in the African gas market.



Emmanuel elaborates that while the Nigeria Morocco Gas Pipeline and the Trans-Saharan Gas Pipeline were initially designed to address Europe&#8217;s energy needs, complex strategic considerations and the global competition for influence have complicated the situation.



&#8220;Understanding the geopolitical forces at play and the interplay of economic interests with the Sahel&#8217;s unfolding events is of utmost importance for achieving success,&#8221; says Emmanuel.



For Iheakanwah Felix Arinzeh, a financial expert and doctor of business administration, this &#8220;advantageous position&#8221; offers multiple benefits for the leading countries&#8217; economies and the broader African energy landscape.



Arinzeh shares with FORBES AFRICA that the countries&#8217; dominance &#8220;will streamline their ability to meet their domestic gas demand. In Nigeria, energy constitutes a significant production cost, particularly in the manufacturing sector. I anticipate that this cost component will experience a positive impact, potentially translating to more affordable products and services in Nigeria.&#8221;



He believes the increased prominence in the African gas market could lead to enhanced energy security.



&#8220;The countries will attain a more secure energy supply by relying less on imported gas. Consequently, their susceptibility to supply disruptions and price volatility will decrease. The increased use of gas will



contribute to reduced greenhouse gas emissions, given that gas burns cleaner than coal or oil. This will improve air quality and mitigate climate change,&#8221; says Arinzeh.



Arinzeh also identifies this development as a magnet for foreign investment that could further stimulate growth in their respective gas sectors, benefiting not only their economies but also their foreign exchange earnings.



However, he acknowledges potential challenges: &#8220;There are also potential challenges associated with these countries dominating Africa&#8217;s gas supply market. If not properly managed, these countries may become overly reliant on gas exports, rendering their economies vulnerable to fluctuations in the global gas market. To maximize benefits and minimize risks, I strongly recommend that each of these countries diligently manage these challenges.&#8221;

Tag: South Africa

FORBES AFRICA SOCIAL MEDIA