The California Department of Public Health should have complete authority over packaging of marijuana and marijuana products. This authority should explicitly include, which the initiative does not, the option of requiring plain packaging. Plain packaging could contain graphic images of the specific health risks of marijuana use similar to those required for cigarettes in Australia and other countries, or could also be required to have a plain color, a standardized small and simple font for the brand name, and no graphics. Given the extensive research on the effectiveness of plain packaging, or packaging with graphic health warning labels to reduce and prevent tobacco use, it is unlikely that the warning labels under AUMA will protect the public by preventing underage initiation, over consumption in adults, or accidental ingestion. Although the AUMA and ReformCA initiatives share many of the same provisions for regulating retail marijuana in California, there are some important differences. Rather than granting existing public agencies jurisdiction over marijuana, ReformCA creates a new California Cannabis Commission as the single rulemaking body to develop marijuana regulations for health education programs, research, licensing, marketing and adverThising, products, packaging, and labeling standards. Five of the seven appointed members of the 13-member Commission are required to be from the marijuana industry and one from organized labor; public health is not represented . Such industry domination of the California Cannabis Commission would almost certainly prioritize business development over protecting public health.
The California Cannabis Commission would have authority over regulations for retail marijuana licensees, including time, place, and manner restrictions, grow lights for cannabis and over restrictions on the number and types of licensees. Given its membership, it is unlikely that it would establish strong product regulations or state of the art packaging and labeling requirements similar to tobacco products to discourage and prevent marijuana use. Indeed, there is nothing preventing the Commission from establishing regulations that would permit highly potent or products designed, like modern cigarettes, to maximize addictive potential. ReformCA does not include dedicated funds to any specific health program and, most important, there are no earmarked funds for marijuana prevention and control programs. It is unlikely that the Commission would create a robust, anti-marijuana campaign to counter marijuana company adverThisements and marketing on television, radio, and the internet. The ReformCA initiative allows marijuana consumption in most public places, including indoors in restaurants, bars, and marijuana retail stores. Although ReformCA permits local governments to adopt regulations on public consumption, and location and operating hours for marijuana retailers stronger than the state, local governments are preempted from other important aspects of regulating marijuana commercial activity. A local government would not be able to prohibit cultivation, production, testing, distribution, or retail licenses unless the action was approved by a majority of voters in an election. Requiring a direct popular vote creates a substantial economic and political barrier that will discourage local jurisdictions from quickly addressing new problems and issues with legal marijuana marketing, sales and use as they arise.
It also imposes substantial costs on local governments or citizens to hold an election and mount a campaign to assert local control, something that will almost certainly be opposed by moneyed marijuana interests. Malaria is a significant public health problem affecting predominantly vulnerable pregnant women and children in Africa. Interestingly, in Southeast Asia, there has been a change in malaria epidemiology where the adult male population has borne a greater burden of disease. Although there is a strong correlation between malaria and poverty , malaria is both a cause and a consequence of poverty. Malaria’s devastating effects have historically been observed in countries of the Greater Mekong Subregion . Since the inception of the World Health Organization’s Mekong Malaria Program a decade ago, the malaria situation in the GMS has been greatly improved, reflected by the continuous decline in annual malaria incidence and deaths. However, as all countries within the GMS are moving towards malaria elimination, significant challenges remain, particularly in Myanmar, where the regional malaria burden is the heaviest. Malaria epidemiology in this region has several characteristics, including being an epicenter of antimalarial drug resistance, high malaria transmission in the forested fringe areas and in the remote border region, and cross-border malaria introduction due to human movement. For example, over 90% of the imported falciparum malaria in China was introduced across the China-Myanmar border.
As the GMS countries aim at malaria elimination by 2030, it is crucial to examine the current situations of malaria epidemiology and vector biology in the high-risk border region so that optimal elimination strategies can be developed. Vector control has historically been the most effective method to reduce malaria transmission. It remains the most important tool available, but its effectiveness relies on a thorough understanding of vector biology and their interactions with the environment. Due to human population expansion and an increasing demand for food supply, deforestation has become a very serious problem in the China-Myanmar border area. Consequently, previously forested areas are often converted to lands for subsistence and cash crops. The changes in the environmental conditions in the area have been shown to alter malaria vector species composition and in turn, malaria transmission. Different vector species vary in their feeding behaviors and vector competence. However, the ecological mechanisms underlying malaria vector species succession are not well understood. The objective of the present study is to determine the effects of land use and land cover on the adult survivorship of major malaria vector species in the China-Myanmar border area using the life-table experiments. We found that mosquito survivorship was strongly influenced by the microclimatic conditions such as ambient temperature, which is directly affected by land use and land cover. This information is useful for predicting the impact of environmental and climate changes on vectorial capacity.No specific permits were required for the described field studies. For mosquito collection in banana fields, oral consent was obtained from field owners in each location. These locations were not protected land, and the field studies did not involve endangered or protected species. The use of mice in mosquito blood-feeding was performed in strict accordance with the recommendations in the Guide for the Care and Use of Laboratory Animals of the National Institutes of Health. All of the animals were handled according to approved institutional animal care and use committee protocols of University of California at Irvine.The study was conducted in the China-Myanmar border region . The study sites were located in Kachin State, Myanmar and Yingjiang County of Yunnan Province, China . The study area covered an area of about 100 km2 , including two villages in China and one site near the town of Laiza, Kachin State in Myanmar. The two sites in China differ in elevation with Nabang at 240 m and Daonong at 660 m above sea level. The site in Myanmar, Je Yang Hka, is about 5 km from Nabang with an elevation of ~200 m above sea level. The study area is a hilly area, indoor cannabis grow system with mountains being covered mainly by forest or maize/banana plantations after deforestation and the valley areas being covered by banana plantations. Rubber, black pepper, and banana farming are the predominant agricultural activities, and food crops of mostly maize are cultivated at a very small scale. The average annual rainfall in the past 30 years was 1,464 mm and average monthly ambient temperature was 19.3°C. The mosquito larvae habitats in the study area included ponds, puddles, swamps, and other sources of stagnant aquatic habitats.We examined three land cover scenarios: banana planation, forest, and indoor environment within typical local houses. The study was conducted from May to July in 2014, during the peak malaria transmission season in this area. The peak vector abundance was occurred from April to July each year. A forested area is defined as an area with >60% tree canopy coverage measured by ground shade area, and the vegetation was mainly subtropical evergreen broad-leaf rainforest with some deciduous trees in the canopy layer.
The banana plantation was an area of banana plants planted two years prior to this study, and the canopy coverage was about 40% measured by ground shade area. Typical local houses have mixed brick and wood/ bamboo structures, with brick/concrete walls on the ground floor and wood/bamboo walls on the elevated floor. Windows are usually not screened. Residents usually spend the night upstairs but may take naps downstairs during noon time. The major vector mosquito species are Anopheles minimus and Anopheles sinensis . Approximately 5,000 Anopheline mosquito larvae were collected from local habitats and reared to adults in an insectary located in Nabang. To avoid using mosquitoes from one single female, we collected no more than 50 third- to fourth-instar larvae per habitat and reared them to adults under the same conditions. Emerged adults were identified to species or species complex using published morphological keys of Dong . Species-specific polymerase chain reactions were used for confirmatory identification of the species for a subset of adult mosquitoes. Newly emerged adults were used for life-table studies. Briefly, 50 female and 50 male adult mosquitoes within 24 h post-emergence were placed in a cylindrical cage of 20 cm in diameter and 30 cm in height. The cage was covered with nylon mesh to prevent the escaping of mosquitoes. Four replicates were used for each of the three environments. In the forested environment and banana plantation, the cages were suspended under a tree or banana leaf, 2 m above the ground. In the indoor environment, mosquito cages were hung in the middle of the living room, also 2 m above the ground. A plastic cap filled with water was hung directly above the cages to prevent ants from entering the cages. Mosquitoes were provided with 10% sucrose and one mouse in each cage was used to blood feed mosquitoes for approximately 30 minutes every morning. The cages were examined daily for the numbers of surviving and dead mosquitoes, and dead mosquitoes were then removed. HOBO data loggers were placed inside the cages to record hourly temperature, relative humidity, and light intensity every min during the entire duration of the experiment. The HOBO data logger is a compact, battery-powered device equipped with an internal microprocessor, data storage, and one or more sensors, which can be used to track environmental temperature, relative humidity and light intensity. Life-table studies were conducted for An. sinensis and An. minimus, the two predominant malaria vector species in the study area.To further confirm the effects of microclimate conditions on mosquito survivorship, we conducted life-table studies in an indoor environment at two sites differing in elevation and inindoor air temperature. The study was conducted in Nabang and Daonong villages, from April to June in 2012. The same procedures described above were used for larval sample collection, mosquito rearing, cage placement conditions, and blood feeding to determine daily survivorship. Four replicates were used in each village. HOBO data loggers were placed inside the same houses to measure hourly indoor temperature, relative humidity, and light intensity at the two study sites for the entire duration of the experiment.Data were analyzed to address the following questions: 1) Do land use and land cover significantly affect mosquito survivorship? We addressed this question using Kaplan-Meier survival analysis to determine the variation in daily survivorship among mosquitoes placed in different land use and land cover types, or between two sites of different elevations. 2) Do land use and land cover significantly affect the microclimatic conditions of local niches where adult mosquitoes were tested for survivorship? Daily average, minimum, and maximum temperatures and relative humidity were calculated from the hourly record. Analysis of variance with repeated measures was used to determine the differences in these microclimatic variables across different land use and land cover types. The post hoc, Tukey’s honestly significant difference test was used to determine which groups significantly differed from each other. Tukey’s HSD procedure was developed specifically to account for multiple comparisons and maintains an experiment-wise error rate at the specified level. 3) Do mosquito species differ in their response to the microclimatic conditions in survivorship? Kaplan-Meier survival analysis was used to compare the two mosquito species under the same environmental conditions.