In a stretch of Louisiana with about 170 fossil fuel and petrochemical plants, premature death is a fact of life for people living nearby. The air is so polluted and the cancer rates so high it is known as Cancer Alley.

“Most adults in the area are attending two to three funerals per month,” said Gary C. Watson Jr., who was born and raised in St. John the Baptist Parish, a majority Black community in Cancer Alley about 30 miles outside of New Orleans. His father survived cancer, but in recent years, at least five relatives have died from it.

Cancer Alley is one of many patches of America — mostly minority and poor — that suffer higher levels of air pollution from fossil fuel facilities that emit tiny particles connected to higher death rates. When the federal government in 2009 targeted carbon dioxide and other greenhouse gases as a public health danger because of climate change, it led to tighter regulation of pollution and cleaner air in some communities. But this month, the Trump administration’s Environmental Protection Agency overturned that “endangerment finding.”

Public health experts say the change will likely mean more illness and death for Americans, with communities like Watson’s hit hardest. On Wednesday, a coalition of health and environmental groups sued the EPA over the revocation, calling it unlawful and harmful.

“Not having these protections, it’s only going to make things worse,” said Watson, with the environmental justice group Rise St. James Louisiana. He also worries that revoking the endangerment finding will increase emissions that will worsen the state’s hurricanes.

The Trump administration said the finding — a cornerstone for many regulations aimed at fighting climate change — hurts industry and the economy. President Donald Trump has called the idea “a scam” despite repeated studies showing the opposite.

Growing evidence shows that poor and Black, Latino and other racial and ethnic groups are typically more vulnerable than white people to pollution and climate-driven floods, hurricanes, extreme heat and more because they tend to have less resources to protect against and recover from them. The EPA, in a 2021 report no longer on its website, concluded the same.

The finding’s reversal will affect everyone, but “overburdened communities, which are typically communities of color, Indigenous communities and low-income communities, they will, again, suffer most from these actions,” said Matthew Tejada, senior vice president for environmental health at the Natural Resources Defense Council and a former deputy with the EPA’s office for environmental justice.

Hilda Berganza, climate program manager with the Hispanic Access Foundation, said: “Communities that are the front lines are going to feel it the most. And we can see that the Latino population is one of those communities that is going feel it even more than others because of where we live, where we work.”

A study published in November found more than 46 million people in the U.S. live within a mile of at least one type of energy supply infrastructure, such as an oil well, a power plant or an oil refinery. But the study found that “persistently marginalized” racial and ethnic groups were more likely to live near multiple such sites. Latinos had the highest exposure.

The EPA, in that 2021 report, estimated that with a 2-degree Celsius (3.6 Fahrenheit) rise in global warming, Black people were 40% more likely to live in places with the highest projected rise in deaths because of extreme heat. Latinos, who are overrepresented in outdoor industries such as agriculture and construction, were 43% more likely to live where labor hour losses were expected to be the highest because of heat.

Julia Silver, a senior research analyst at the University of California, Los Angeles’ Latino Policy and Politics Institute, found in her own research that California Latino communities had 23 more days of extreme heat annually than non-Latino white neighborhoods. Her team also found those areas have poor air quality at about double the rate, with twice as many asthma-related emergency room visits. Other research shows that Latino children are 40% more likely to die from asthma than white children in part because many lack consistent health care access.

“What we’re risking with a rollback like this at the federal level is really human health and well-being in these marginalized groups,” Silver said.

Armando Carpio, a longtime pastor in Los Angeles, has seen firsthand how vulnerable his mostly Latino parishioners are. Many are construction workers and gardeners who work outside, often in extreme heat. Others live and work near polluting freeways. He sees children with asthma and elders with dementia, both linked to exposure to air pollution.

“We’re regressing,” he said. “I don’t know how many years back, but all of this really affects us.”

It is difficult to quantify how much more communities of color could be impacted by the finding’s revocation, but experts who spoke with The Associated Press all said it would be significant.

“You will see statistically significant increases in excess morbidity and mortality when it comes to climate impacts and health impacts associated with co-pollutants” in communities of color, said Sacoby Wilson, a University of Maryland professor and executive director of the nonprofit Center for Engagement, Environmental Justice and Health INpowering Communities.

Beverly Wright, founding director of the Deep South Center for Environmental Justice in New Orleans, said at least four Black communities in Cancer Alley no longer exist because of the expansion of industrial facilities. The repeal will bring more pollution, higher cancer rates, more extreme weather and the disappearance of more historic communities, she said.

“It has us going in the wrong direction, and our communities are now at greater risk,” she said.

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The Associated Press receives support from the Walton Family Foundation for coverage of water and environmental policy. The AP is solely responsible for all content. For all of AP’s environmental coverage, visit https://apnews.com/hub/climate-and-environment

GOMA, Congo — In a maternity ward in eastern Congo, Irene Nabudeba rested her hands on her bulging midsection, worried about giving birth in a city under rebel control.

The conflict that flared this year has left many medical supplies stranded beyond the front line. Infrastructure like running water has collapsed, along with the economy in Goma, the region’s humanitarian and commercial hub.

And now the one glimmer of hope for mothers — a free maternity care program offered by Congo’s government — has ended after it was not renewed in June. It was not clear why, and Congolese officials did not respond to questions.

Nabudeba has five children and wonders whether the sixth will survive.

“At the hospital, they ask us for money that we don’t have. I’m pushing myself to come to the consultations, but for the delivery … I don’t know where I’ll find the money,” she said at the Afia Himbi health center.

Several women told The Associated Press they cannot afford maternal care after Congo’s program that was aimed at reducing some of the world’s highest maternal and neonatal death rates ended earlier this year. The program launched in 2023 offered free consultations and treatment for illnesses and at-risk pregnancies at selected health facilities across the country.

Congo ranked second in maternal deaths globally with 19,000 in 2023, behind Nigeria’s 75,000 deaths, according to U.N. statistics.

Health workers said more women in Goma are now giving birth at home without skilled help, sometimes in unsanitary conditions, leaving them vulnerable to hemorrhage, infection or death.

Clinics and hospitals were already struggling after the M23 rebels, backed by neighboring Rwanda, seized Goma in an escalation of fighting in January.

Although clashes subsided amid U.S.- and Qatar-led peace efforts, fighting escalated again in recent days and the conflict has collapsed public institutions, disrupted essential services and displaced more than 700,000 people, according to the U.N. humanitarian office.

In Goma, the armed rebels are seen everywhere, making a pregnant woman’s walk to clinics another source of anxiety.

Freddy Kaniki, deputy coordinator of M23, asserted to the AP that the free maternal care “was not renewed because it was a failure,” without elaborating. Congolese officials did not respond to questions.

Rwanda denies supporting the M23 despite U.N. experts saying they have evidence of it. Rwanda prides itself on health care and recently signed a five-year deal with the U.S. for investment of up to $158 million in its own health care sector.

The collapse of essential services in rebel-held areas, combined with mass displacement and insecurity, has left civilians struggling to access even basic care.

An International Committee of the Red Cross assessment in September found that at least 85% of health facilities were experiencing medicine shortages, and nearly 40% have seen an exodus of staff after the conflict surged in the provinces of North Kivu and South Kivu.

The ICRC in October said 200 health facilities in eastern Congo had run out of medicines because of looting and supply disruptions. Doctors Without Borders, or MSF, has reported hospitals attacked, ambulances blocked and medical staff threatened or killed.

Childbirth at a clinic in Goma now costs $5 to $10, out of reach for many families in a region where over 70% of the population lives on less than $2.15 a day, according to the World Bank.

Franck Ndachetere Kandonyi, chief nurse at the Afia Himbi health center, said the number of births there under the free program had jumped from around five a month to more than 20. But the program ended in June.

Facing a table of statistics in his office, Kandonyi said the number of births per month is now down to nine.

“When a parent cannot even pay 10,000 Congolese francs ($4.50) for their wife’s or child’s care, it’s a real problem,” the nurse said.

Meanwhile, banks have closed in Goma, prices have soared and the franc has depreciated.

Nabudeba’s husband, a driver, has been unemployed since January. She said her family is barely surviving.

“When the war broke out, we lost all our resources,” she said. “Lately, the situation has not been favorable, and we are suffering greatly.”

Across town at the Rehema Health Center, Ernestine Baleke waited for help with her ninth pregnancy, with concern on her face. She said she doesn’t know where she will get money for the delivery.

Her husband lost a factory job when the place was looted earlier in the conflict, she said. Then their house burned.

“I don’t even have 100 francs (45 cents) in my pocket,” Baleke said.

She walks more than half a mile to the hospital because she cannot afford transportation. Three months remain before her delivery.

“The authorities must restore free health care,” Baleke said. “We risk dying in our homes while giving birth.”

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For more on Africa and development: https://apnews.com/hub/africa-pulse

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The Associated Press receives financial support for global health and development coverage in Africa from the Gates Foundation. The AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.

GOMA, Congo — As a deadly new Ebola outbreak kills dozens in southern Congo, health authorities and organizations are sounding the alarm, warning they lack the funds and resources to mount an effective response to the crisis.

The World Health Organization said Wednesday that 57 cases and 35 deaths have been reported since the outbreak was announced by Congolese authorities on Sept. 4. The fatality rate is over 61%.

It is the first Ebola outbreak in 18 years in Kasai province, a remote part of Congo characterized by its poor road networks. It is located more than 1,000 kilometers (620 miles) from the nation’s capital of Kinshasa.

“We urgently need our partners and donors to step up and support this lifesaving response to ensure we can contain the outbreak quickly and protect the most vulnerable communities,” said Susan Nzisa Mbalu, head of communications for the International Federation of Red Cross and Red Crescent Societies Africa, IFRC.

Earlier this week, the IFRC said it is appealing for 20 million Swiss francs ($25 million) to help contain the outbreak and aiming to reach 965,000 people with urgent assistance. It warned that health facilities are overwhelmed and lack the resources to provide care, with clean water and protective equipment running critically low.

According to the IFRC, the only treatment centre in the Bulape health zone, where the epicenter of the outbreak has been declared and the majority of cases are concentrated, is already at 119% capacity.

Health officials are particularly concerned about the impact of U.S. funding cuts, especially since the U.S. has a history of supporting Congo’s past Ebola outbreaks, including a 2021 effort when the U.S. Agency for International Development, USAID, provided up to $11.5 million to support efforts across Africa.

IFRC’s Nzisa Mbalu said it is still early to fully assess the level of donor support for the Ebola response, adding that the organization has so far allocated 1.75 million swiss francs ($2.2 million) in emergency funds to respond to the outbreak.

Despite the absence of USAID, Mathias Mossoko, the Ebola Response Coordinator in Bulape, said that the U.S. government has provided “some small support,” though he could not provide specific details.

WHO spokesperson Tarik Jasarevic told the AP on Thursday that the organization’s only current funding for the outbreak response is a $2 million emergency fund and around $2.3 million from the United Kingdom, Germany, and the Gavi vaccine alliance.

That is far below the WHO’s projected cost of around $20 million to respond to the outbreak over the next three months.

“Without immediate support, gaps in operations will persist, jeopardizing efforts to contain the outbreak and protect vulnerable communities,” Jasarevic said.

The Congolese authorities’ current national response plan is estimated at $78 million.

Treating Ebola demands “enormous resources,” even for a single patient, said Jean Paul Mbantshi, the chief medical officer of the Bulape health zone. He said the zone desperately needs ambulances to transport patients from remote areas to the hospital before they become highly contagious. Health workers also require more protective equipment, medicine, and additional vaccines.

“All this costs money, we need more support,” Mbantshi said.

According to the WHO, just 1,740 people in three health zones of Kasai province — Bulape, Bulambae and Mweka — have been vaccinated as of Sept. 21. The Bulape zone alone has a population of more than 212,000, according to 2020 figures from the United Nations.

WHO said the vaccination campaign has not been implemented as fast as desired because of logistical challenges. A lack of storage infrastructure in Bulape, for instance, has forced officials to transport vaccines in small batches, causing delays.

Amitié Bukidi, chief medical officer of the Mweka health zone, said the response is still in the early stages, with the majority of cases occurring outside of health centers.

“We would like to expand our community outreach, especially by raising awareness among opinion leaders, to reach farmers who are hardest to reach,” Bukidi said, adding that his team needs motorcycles to reach remote, hard to access areas.

“The need is still very great,” he said. “If USAID were to be involved, that would be good.”

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Banchereau reported from Dakar, Senegal.

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The Associated Press receives financial support for global health and development coverage in Africa from the Gates Foundation. The AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.

Congo’s health ministry has announced a new Ebola outbreak, the 16th in the central African country, after a case was confirmed in the southern Kasai province

KINSHASA, Congo — Congo’s health ministry on Thursday announced a new Ebola outbreak, the 16th in the central African country, after a case was confirmed in the southern Kasai province.

“To date, the provisional report shows 28 suspected cases and 15 deaths, including 14 in Boulapé and 1 in Mweka, as well as four healthcare workers,” said Samuel-Roger Kamba, Congo’s health minister.

He added that the case fatality rate, estimated at 53.6%, showed the gravity of the situation.

He said that the figures were provisional and research was ongoing. The suspected cases and deaths presented symptoms such fever, vomiting, diarrhoea and haemorrhage. The Ebola virus is highly contagious and can be contracted through bodily fluids such as vomit, blood, or semen. The disease it causes is a rare but severe — and often fatal — illness in humans.

SANTA FE, N.M. — The governor of New Mexico declared a state of emergency Wednesday in response to violent crime and drug trafficking across a swath of northern New Mexico, including two Native American pueblo communities.

The emergency declaration by Gov. Michelle Lujan Grisham makes $750,000 available in response to calls by local governments and tribal officials in Rio Arriba County for reinforcements against violent crime as well as other crime and hardships associated with illicit drugs.

The vast area stretches from the city of Española, 25 miles (40 kilometers) north of Santa Fe, to the Colorado state line and has long been afflicted by opioid use and high drug-overdose death rates, with homeless encampments emerging in recent years in more populated areas.

“The surge in criminal activity has contributed to increased homelessness, family instability and fatal drug overdoses, placing extraordinary strain on local governments and police departments that have requested immediate state assistance,” Lujan Grisham said in a statement.

In April, Lujan Grisham declared a state of emergency in New Mexico’s largest city, Albuquerque, saying that a significant increase in crime in Albuquerque warrants the help of the New Mexico National Guard.

There were no immediate calls for troop deployments in Rio Arriba County, though the new emergency declaration allows for authorities to call up the National Guard.

The tribal governor of Santa Clara Pueblo on the edge of Española urged the state to address a growing public safety crisis stemming from the use and abuse of fentanyl and alcohol in the community at large.

“The pueblo has expended thousands of dollars trying to address this crisis … and to protect pueblo children who are directly and negatively affected by a parent’s or guardian’s addiction,” said Santa Clara Gov. James Naranjo in a July letter to Lujan Grisham. “But we are not an isolated community and the causes and effects of fentanyl/alcohol abuse, increased crime, and increased homelessness extend to the wider community.”

In 2020, President Donald Trump sent federal agents, including Homeland Security officers, to Albuquerque as part of an effort to contain violent crime.

LONDON — U.S. Health Secretary Robert F. Kennedy Jr. said the country is pulling its support from the vaccines alliance Gavi, saying the organization has “ignored the science” and “lost the public trust.”

A video of Kennedy’s speech was shown to participants at a Gavi meeting in Brussels on Wednesday, where the vaccines group was hoping to raise at least $9 billion for the next five years.

Gavi is a public-private partnership including WHO, UNICEF, the Gates Foundation and the World Bank. It has paid for more than 1 billion children to be vaccinated through routine immunization programs, saving an estimated 18 million lives. The United States has long been one of its biggest supporters; before Donald Trump’s re-election, the country had pledged $1 billion through 2030.

Kennedy called on Gavi “to re-earn the public trust and to justify the $8 billion America has provided in funding since 2001,” saying officials must “consider the best science available, even when that science contradicts established paradigms.” Kennedy said until that happens, the U.S. won’t contribute further to Gavi.

Kennedy, a longtime vaccine skeptic, said he and President Trump were concerned about how Gavi and the World Health Organization partnered together during the COVID-19 pandemic to work with social media companies “to silence dissenting views, to stifle free speech and legitimate questions” during a time when many people had questions about vaccine safety.

Kennedy said Gavi continues to make “questionable recommendations,” like advising pregnant women to get immunized against COVID-19 and funding the roll-out of a vaccine against diphtheria, tetanus and pertussis in poorer countries.

WHO and other health authorities have recommended pregnant women get vaccinated against COVID-19, saying they are at higher risk of severe disease.

Kennedy said he has seen research that concluded that young girls vaccinated against diphtheria, tetanus and pertussis were more likely to die from all other causes than children who weren’t immunized.

Some observational studies have shown that vaccinated girls do have a higher death rate compared to unvaccinated children, but there is no evidence the deaths are caused by the vaccine.

Gavi said in a statement Thursday that its “utmost concern is the health and safety of children.” The organization said any decision it makes on vaccines to buy is done in accordance with recommendations issued by WHO’s expert vaccine group.

“This ensures Gavi investments are grounded in the best available science and public health priorities,” it said. Gavi said scientists had reviewed all available data, including any studies that raised concerns, and that the diphtheria, tetanus and pertussis vaccine has “played a key role in helping halve childhood mortality.”

The British government said Wednesday it would give 1.25 billion pounds ($1.7 billion) between 2026 and 2030 to Gavi. It said the money would help Gavi protect up to 500 million children in some of the world’s poorest countries from diseases including meningitis, cholera and measles.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

JAKARTA, Indonesia — JAKARTA, Indonesia (AP) — Bill Gates was in Indonesia on Wednesday to discuss health and sustainable development initiatives with the leader of the world’s fourth most populous country.

Gates met President Prabowo Subianto at the colonial-style Merdeka palace in Jakarta to discuss global health, nutrition, financial inclusion and public digital infrastructure, Indonesia’s presidential office said in a statement ahead of the meeting.

The co-founder of Microsoft and Gates Foundation praised Indonesia’s adoption of vaccines like Rotavirus for diarrhea and Pneumococcus for pneumonia and the country’s efforts in reducing child mortality.

He said ten million children under the age of five worldwide died when his foundation launched in 2000, with 90% of the deaths due to diarrhea, pneumonia or malaria. That number has now been cut in half to below five million, Gates said.

“It’s been an amazing time period. And there’s many new tools coming,” he told the meeting, which was also attended by prominent Indonesian businesspeople and philanthropists.

Gates’ foundation is currently developing a tuberculosis vaccine that’s planned to be tested in Indonesia, Subianto said.

“This is crucial because TB is still a deadly disease in the country,” he said.

Gates said that because rich countries don’t have tuberculosis, “it just doesn’t get hardly any money for diagnostics or drugs or vaccines.”

Gates has granted more than $159 million to Indonesia since 2009. Much of it was allocated to the health sector, especially for vaccine procurement, Subianto said. Thanks to the funds, Subianto said Biofarma, a state-run pharmaceutical company, now can produce two billion doses of its polio vaccine every year, benefiting more than 900 million people in 42 countries.

The Gates Foundation is also planning to roll out a micronutrient supplement for pregnant women in Indonesia in coming months.

Subianto said that Gates will receive Indonesia’s highest honor in New York during the U.N. General Assembly in September for his services to the country.

During his first in-person visit to the Indonesian capital, Gates is also scheduled to visit a primary school in eastern Jakarta where more than 500 students were taking part of the program.

The United Nations Children’s Fund estimates that one in 12 Indonesian children younger than 5 suffers from low weight, while one in five is shorter than normal. Both conditions are caused by malnourishment.

Indonesia launched an ambitious project this year to fight malnutrition that aims to feed nearly 90 million children and pregnant women. The program is expected to cost 450 trillion rupiah ($28 billion) through 2029.

Critics question whether it is affordable. Investors and analysts have questioned the burden on state finances and the economy, and the project’s ties with the interests of industrial lobby groups.

NEW YORK — More U.S. women died around the time of childbirth last year, reversing two years of decline, according to provisional data posted Wednesday.

The Centers for Disease Control and Prevention said 688 people died last year during pregnancy or shortly after giving birth. That’s up from 669 deaths in 2023, but down from 2022 and 2021, when it was the highest level in more than 50 years.

The maternal mortality rate rose to 19 deaths per 100,000 live births, up from 18.6 the year before.

The CDC counts women who die while pregnant, during childbirth and up to 42 days after birth from conditions related to pregnancy. Excessive bleeding, blood vessel blockages and infections are leading causes.

Such deaths spiked during the COVID-19 pandemic, as the coronavirus was particularly dangerous to pregnant women. And, in the worst days of the pandemic, burned out physicians may have added to the risk by ignoring pregnant women’s worries, experts say.

The waning of COVID-19 is considered a major reason for the declines in maternal deaths in 2022 and 2023, experts say.

But those improvements are now being offset by other factors that may reduce access to medical care, experts say. They say the list includes the closure of rural hospitals and the U.S. Supreme Court decision that did away with the federally established right to abortion, which caused some doctors to feel constrained about providing care during pregnancy-related medical emergencies.

The U.S. has one of the highest maternal mortality rate among wealthy nations. Past research has found wide racial disparities in such deaths, with Black women dying at a far higher rate than white women.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

CAIRO — Mothers and children in the Sudanese region of South Darfur are experiencing one of the “worst” health emergencies in the world, humanitarian organization Doctors Without Borders said Tuesday, one of the consequences of the violence that has engulfed the country since April 2023.

Doctors Without Borders, also known as MSF, said in its latest report that 114 maternal deaths occurred during the period from January to mid-August 2024.

More than 50% of maternal deaths happened in medical settings, with sepsis being the most common cause of death in MSF-supported facilities. Between January and June, 48 newborns died from sepsis at two MSF-backed medical facilities, the organization said.

Malnutrition among children in South Darfur also exceeded emergency thresholds, the group said, adding that demands for medical attention “far exceed what MSF can respond to.”

Sudan has been engulfed by violence since April of last year, when tensions between leaders of the Sudanese military and the paramilitary Rapid Support Forces erupted into intense fighting and spread across the country, including to Darfur. The amount of critical aid reaching South Darfur rose slightly in June, when the U.N. World Food Program delivered life-saving food and nutrition to some families.

In August, 30,000 children under the age of two were screened for malnutrition, including nearly 33% who are acutely malnourished and 8.1% who are severely and acutely malnourished, MSF said Tuesday.

“This is a crisis unlike any other I have seen in my career — multiple health emergencies happening simultaneously with almost no international response from the UN and others,” said Dr. Gillian Burkhardt, MSF sexual and reproductive health activity manager, in Nyala, South Darfur. “Newborn babies, pregnant women, and new mothers are dying in shocking numbers. So many deaths are due to preventable conditions, as almost everything has broken down.”

The situation was particularly dire for women at Nyala Teaching Hospital and Kas Rural Hospital, where MSF reported 46 maternal deaths between January and August. In those two hospitals, 78% of maternal deaths happened within the first 24 hours after admission.

Women would often arrive at hospitals in critical condition due to high transportation costs and a shortage in functioning medical facilities, said MSF. The women were forced to give birth in unsterilized environments due to the lack of much-needed medical resources that could prevent infections.

“A pregnant patient from a rural area waited two days to collect the money needed to get care,” said Maria Fix, MSF medical team leader in South Darfur. “When she traveled to a health center, they had no drugs so she went back home. After three days, her condition deteriorated, but again she had to wait five hours for transportation. She was already in a coma when she reached us. She died from a preventable infection.”

Most humanitarian organizations haven’t returned to Nyala, the capital of South Darfur, since the war broke out, leaving MSF as one of the few international groups there on the ground.