JOHN: TONIGHT ON PBS NEWS WEEKEND. NEW AIR STRIKES KILL DOZENS ACROSS GAZA AND THE WEST BANK TODAY, AS THE ISRAELI MILITARY'S SEARCH OF GAZA'S BIGGEST HOSPITAL FORCES HUNDREDS TO FLEE. THEN, AS U.S. FUNDING FOR UKRAINE STALLS ON CAPITOL HILL, THE HUMANITARIAN SITUATION IN THE WAR-TORN COUNTRY GETS WORSE. >> IT'S BECOME A DAILY REALITY FOR THIS GENERATION OF VIOLENCE, TRAUMA, DESTRUCTION AND DISPLACEMENT. JOHN: HOW NURSE PRACTITIONERS ARE FILLING A MUCH NEEDED HEALTHCARE GAP, AND THE PUSH TO ALLOW THEM TO PROVIDE CARE WITHOUT A PHYSCIAN'S OVERSIGHT. ♪ >> MAJOR FUNDING HAS BEEN PROVIDED BY. >> CONSUMER CELLULAR, THIS IS SAM, HOW MAY I HELP YOU? >> WITH CONSUMER CELLULAR YOU GET NATIONWIDE COVERAGE WITH NO CONTRACT. >> THAT'S KIND OF OUR THING. >> HAVE A NICE DAY. >> AND WITH THE ONGOING SUPPORT OF THESE INDIVIDUALS AND INSTITUTIONS. AND FRIENDS OF THE NEWSHOUR. THIS PROGRAM WAS MADE POSSIBLE BY THE CORPORATION FOR PUBLIC BROADCASTING AND CONTRIBUTIONS FROM VIEWERS LIKE YOU. THANK YOU. JOHN: GOOD EVENING. I'M JOHN YANG. IN GAZA TONIGHT, MORE PALESTINIANS ARE ON THE MOVE AS RESTORED COMMUNICATIONS HAVE ALLOWED THE UNITED NATIONS TO RESUME CRITICAL AID DELIVERIES. ISRAEL IS AGAIN URGING PALESTINIANS IN NORTHERN GAZA TO GO SOUTH AND PATIENTS, STAFF AND DISPLACED PEOPLE ARE LEAVING GAZA'S BIGGEST HOSPTIAL AMID CONFLICTING CLAIMS OF WHAT TRIGGERED THE DEPARTURE. ON GAZA'S MAIN ROAD SOUTH, PANIC AND CONFUSION. PALESTINIANS FLED AL-SHIFA HOSPITAL IN GAZA CITY, AFTER DOCTORS SAY ISRAEL ORDERED AN EVACUATION. AL-SHIFA PHYSICIAN RAMEZ RADWAN. >> IN THE LAST MOMENTS THE ISRAELI AUTHORITIES WARNED WHOEVER WAS INSIDE THE HOSPITAL HAD TO LEAVE, EXCEPT THE WOUNDED, THE SURGEON AND SOME OF THE MEDICAL AND NURSING STAFF.” JOHN: THE ISRAEL DEFENSE FORCES DENY THAT THEY ORDERED PEOPLE TO LEAVE. THEY SAY THE HOSPITAL ASKED THEM TO HELP THOSE WHO WANTED TO LEAVE VOLUNTARILY. THE PALESTINIAN HEALTH MINISTER SAID FIVE DOCTORS ARE STAYING TO CARE FOR THE REMAINING 120 OR SO PATIENTS, INCLUDING SOME IN INTENSIVE CARE AND SOME PREMATURE BABIES. THE MINISTER CALLED ON INTERNATIONAL AID ORGANIZATIONS' TO HELP TRANSPORT THE INFANTS TO EGYPT. >> THE ISRAELI FORCES ARE DAMAGING ALL WARDS OF THE HOSPITAL, AND THE HOSPITAL HAS BECOME A MILITARY BASE FOR THE OCCUPATION FORCES. JOHN: THE UNITED NATIONS SAID ISRAELI AIR STRIKES KILLED DOZENS OF PEOPLE AT A UN-RUN SCHOOL THAT HAD SERVED AS A SHELTER FOR THOUSANDS OF DISPLACED PALESTINIANS. THE IDF IS URGING CIVILIANS TO MOVE TO SOUTHERN GAZA, WHERE THERE IS LITTLE REFUGE FROM THE WAR. ISRAELI AIRSTRIKES HIT HUDA MUBASHER'S HOME, WHERE SHE LIVED WITH HER HUSBAND, DAUGHTER AND TWO CATS. >> SUDDENLY SOMETHING FELL ON US AND I FOUND STONES IN MY MOUTH, I COULDN'T BREATHE OR SPEAK. JOHN: IN THE WEST BANK CITY OF NABLUS, A FUNERAL PROCESSION FOR VICTIMS OF AN ISRAELI AIRSTRIKE, IN WHICH THE PALESTINIAN RED CRESCENT SAID FIVE PEOPLE WERE KILLED. THE IDF SAID IT WAS TARGETING A TERRORIST HIDEOUT INSIDE THE BALATA REFUGEE CAMP. 2000 MILES AWAY IN ABU DHABI, EIGHT INJURED GAZAN CHILDREN AND THEIR FAMILIES ARRIVED FOR MEDICAL TREATMENT. THE UNITED ARAB EMIRATES HAS PLEDGED TO CARE FOR ONE THOUSAND INJURED PALESTINIANS. SOMAYA TAHER IS PREGNANT AND LOST HER HUSBAND IN AN AIRSTRIKE. HER YOUNG SON WAS BADLY BURNED. >> THANK GOD WE ARE HERE. THE SITUATION WAS GETTING WORSE. IT'S DIFFICULT TO EXPLAIN. THERE'S NOTHING LIKE IT, EXPERIENCING THE DIFFICULTIES OF LIFE IN GAZA. JOHN: ELON MUSK'S SPACE-X GOT ITS BIGGEST ROCKET OFF THE GROUND IN A TEST LAUNCH TODAY, BUT A PAIR OF EXPLOSIONS JUST MINUTES INTO THE FLIGHT DESTROYED BOTH THE BOOSTER ROCKET AND THE SPACECRAFT. SPACE-X OFFICIALS SAY IT APPEARS THE CRAFT'S SELF-DESTRUCT SYSTEM BLEW IT UP OVER THE GULF OF MEXICO AFTER LIFT OFF FROM SOUTH TEXAS. THE FLIGHT LASTED ONLY ABOUT EIGHT MINUTES. TWICE AS LONG AS THE FIRST TEST IN APRIL, WHICH ALSO ENDED WITH AN EXPLOSION. ELON MUSK GOT MORE BAD NEWS TODAY AS COMCAST JOINED THE LIST OF ADVERTISERS STEPPING AWAY FROM HIS SOCIAL MEDIA PLATFORM "X." FORMERLY KNOWN AS TWITTER, OVER CONCERNS THAT THEIR ADS WERE SHOWING UP NEXT TO ANTI-SEMITIC CONTENT. OTHER COMPANIES PAUSING THEIR ADS ON "X" INCLUDE I-B-M, DISNEY AND PARAMOUNT GLOBAL. MUSK HAS BEEN ACCUSED OF TOLERATING AND EVEN ENCOURAGING ANTI-SEMITIC MESSAGES ON "X" AND DREW FIRE EARLIER THIS WEEK FOR AGREEING WITH A POST ACCUSING JEWS OF HATING WHITE PEOPLE. STILL TO COME ON "PBS NEWS WEEKEND", THE GROWING NEED FOR NURSE PRACTITIONERS AND THE FIGHT OVER HOW THEY PROVIDE CARE. THE SPREAD OF MOSQUITOES AND THE DISEASES THEY CARRY. >> THIS IS "PBS NEWS WEEKEND" FROM WETA STUDIOS IN WASHINGTON. JOHN: IN A "WASHINGTON POST" OPED TODAY, PRESIDENT BIDEN URGED SUPPORT FOR UKRAINE. HE'S ASKED CONGRESS FOR TENS OF BILLIONS OF DOLLARS TO SUPPORT THE NATION IN ITS WAR WITH RUSSIA. MOST OF IT WOULD BE MILITARY AID, BUT IT ALSO INCLUDES MONEY TO ADDRESS THE HUMANITARIAN SITUATION, WHICH, AS ALI ROGIN TELL US, GETS WORSE BY THE DAY. ALI: SOME 18 MILLION UKRAINIANS, SOME 40% OF THE POPULATION ARE IN NEED OF HUMANITARIAN AID. TRYING TO HELP THOSE CAUGHT IN THE CROSSFIRE. THOSE GROUPS ARE CONCERNED SUPPORT FOR THEIR MISSION IS FLAGGING. THE SENIOR DIRECTOR FOR THE UKRAINE CRISIS AT THE INTERNATIONAL RESCUE COMMITTEE, A HUMANITARIAN RESCUE ORGANIZATION. THANK YOU FOR JOINING US. COULD YOU TAKE US THROUGH THE MOST PRESSING HUMANITARIAN NEEDS? >> HEAVY FIGHTING CARRIES ON, PARTICULARLY IN THE SOUTHEAST OF THE COUNTRY. IT IS DAMAGING HOMES, HOSPITALS, SCHOOLS. DRIVING THE HUMANITARIAN NEED. THE NEED INSIDE OF FLORIDA IS RIDDLED, NEARLY TWO YEARS INTO A FULL-SCALE WAR. PEOPLE'S ABILITY TO COPE IS GETTING WEEKEND. WE HAVE ALARMING STATISTICS ABOUT THE MENTAL HEALTH IMPACTS OF THE WAR. FOUR POINT ONE MILLION CHILDREN NEED HUMANITARIAN AID. IT'S BECOMING A DAILY ATTITUDE FOR VIOLENCE, TORMENT, DISPLACEMENT, CHILDREN ARE BEING KILLED, WOUNDED, DEEPLY TRAUMATIZED BY VIOLENCE. IT HAS REALLY AFFECTED THE FUTURE. THERE HAS BEEN PROLONGED DISRUPTION WITH THE COVID-19 PANDEMIC. THIS IS FOUR YEARS OF EDUCATIONAL CHALLENGES. THEY HAVE BEEN DISPLAYING CLEAR SIGNS OF EXTENSIVE LEARNING. IT IS A SOCIAL SETBACK. REALLY DEPRIVE CHILDREN OF SAFE SPACES TO LEARN. WHEN THE INVASION STARTED TO THE HOME OF -- 3220 EIGHT EDUCATIONAL FACILITIES HAVE BEEN DAMAGED. 365 HAVE BEEN DESTROYED. ALI: YOU HAVE BEEN TRACKING THE IMPACT ON STUDENTS OUTSIDE OF UKRAINE. HOW ARE THEY FARING? >> THE REFUGEES IN POLAND, HALF OF THOSE REFUGEE CHILDREN ARE NOT INVOLVED. THEY PARTICIPATE IN DISTANCE LEARNING. THEY HAVE BEEN DAMAGED OR RESIDE. SOME BUT NOT ALL DISTANCE LEARNING INVOLVES ONLINE CLASSES. SOMETIMES THEY ARE SUBJECT TO THE OUTAGES. THAT DISRUPTS LEARNING AS WELL. A WE ARE ENTERING THE SECOND PERIODLI: OF THIS. HOW DO YOU EXPECT THAT TO IMPACT WAR ON THE CIVILIAN COMMUNITY? >> THE PREDICTION THIS YEAR IS UKRAINE WILL BE -- PREVIOUSLY HOMES AND POWER GRIDS HAVE NOT BEEN PREVIOUSLY REPAIRED. UKRAINE WILL SUFFER FROM INTENSE MISSILE STRIKES AND MORE WIDESPREAD DESTRUCTION. THE COMBINATION OF ONGOING CONFLICT DESTROYED THE INFRASTRUCTURE WILL MAKE LIFE INCREDIBLY TOUGH. ALI: ARE YOU CONCERNED INTERNATIONAL ATTENTION IS TURNING AWAY FROM UKRAINE? >> THE HUMANITARIAN RESPONSE IS ONLY FUNDED 46%. EVEN THOUGH THE UNITED STATES HAS DONATED $2.6 BILLION, WHICH HELPED UKRAINIANS THROUGH THE HARSH WINTER. THE NEED TO COME IS ESTIMATED AT 3.5 BILLION USD. THE FUNDING IS HALF OF WHAT WAS IN 2022. IT REMAINS HIGH BUT FUNDING SHORTAGES REALLY HAMPER HUMANITARIAN ABILITY ON PEOPLE. ALI: ZOE DANIELS, THANK YOU SO MUCH FOR YOUR TIME. >> THANK YOU. JOHN: ONE FOURTH OF ALL MEDICAL VISITS ARE PROVIDED BY NONPHYSICIANS. A LOT OF THAT IS DUE TO THE GROWING NUMBER OF NURSE PRACTITIONERS, NURSE PRACTITIONERS SAY THEIR WORK IS HAMPERED BY OUTDATED RESTRICTIONS ON THE ABILITY TO PROVIDE CARE WITHOUT PHYSICIAN SUPERVISION. WITH SUPPORT FROM THE PULITZER CENTER, STEPHANIE REPORTS FROM OHIO FOR OUR SERIES, CRITICAL CARE, THE FUTURE OF NURSING. >> I COULD FEEL IT ON THIS SIDE. STEPHANIE: LOIS PRUNTY, A FOOD SERVICE WORKER IN HER MID 30S, FIRST CAME TO THE TOTAL HEALTH & WELLNESS CLINIC AT OHIO STATE EAST HOSPITAL THREE YEARS AGOIT . IT WAS ONE OF THE FEW PROVIDERS IN THE AREA THAT TOOK HER MEDICAID PLAN. >> I THINK IT'S EXCELLENT CARE. STEPHANIE: THE CARE AT THIS FEDERALLY QUALIFIED HEALTH CENTER IS ALSO UNIQUE. IT'S LED ENTIRELY BY NURSE PRACTITIONERS OR “NPS.” THESE NURSES HAVE GRADUATE DEGREES AND ANYWHERE FROM 500 TO 3000 HOURS OF SUPERVISED CLINICAL TRAINING, BEYOND THE PREPARATION OF A STANDARD BEDSIDE NURSE. THEY CAN DIAGNOSE CONDITIONS, ORDER AND PERFORM TESTS, AND PRESCRIBE MEDICATION. CANDY RINEHART IS THE DIRECTOR OF THE CLINIC LOCATED IN COLUMBUS. >> FROM THE VERY BEGINNING WE HAD A PHARMACIST, A SOCIAL WORKER, A MENTAL HEALTH COUNSELOR, REGISTERED NURSES WHO DO CASE MANAGEMENT. THAT'S THE APPROACH WE TAKE IN NURSING IS WE'RE LOOKING AT THE WHOLE PERSON AND HOW THEY'RE BEING CARED FOR. STEPHANIE: TOTAL HEALTH AND WELLNESS CLINIC SEES PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, FILLING A CRITICAL GAP IN CARE. >> I DIDN'T HAVE A REGULAR DOCTOR IN YEARS. CERTAIN PLACES ONLY TAKE CERTAIN INSURANCES AND STUFF LIKE THAT. I KNOW I GOT TURNED AWAY FROM A DOCTOR I GOT RECOMMENDED TO BECAUSE THEY DIDN'T ACCEPT MY INSURANCE, SO I HAD TO GO BACK TO SQUARE ONE. STEPHANIE: THE NURSE PRACTITIONER ROLE WAS CREATED IN THE SIXTIES DUE TO A NEED TO INCREASE PATIENTS' ACCESS TO CARE. EVEN BEFORE THE COVID ERA, NEARLY TWO DOZEN STATES ALLOWED NPS TO PRACTICE ON THEIR OWN. WITHOUT PHYSICIAN SUPERVISION. NPS CALL THIS ‘FULL PRACTICE AUTHORITY.' AND THE MOVEMENT HAS PICKED UP STEAM SINCE THE PANDEMIC. WITH FOUR MORE STATES GRANTING FULL PRACTICE AUTHORITY TO NPS. NATIONAL PHYSICIAN GROUPS WARN THAT NURSE PRACTITIONERS ARE VEERING INTO THEIR LANE AND RISKING PATIENT SAFETY. THAT'S NOT TRUE, SAYS CANDY RINEHART. >> WE COLLABORATE CONSTANTLY WITH SPECIALISTS. IF A PERSON NEEDS TO BE SENT TO A NEPHROLOGIST, THEN YOU COLLABORATE WITH THAT NEPHROLOGIST. SO WE ALL STAY IN OUR LANE AS FAR AS WHAT WE WERE EDUCATED TO DO AND WORK TOGETHER. STEPHANIE: STILL, IN OHIO AND 22 OTHER STATES, NPS CAN'T PROVIDE CARE WITHOUT MANDATED PHYSICIAN OVERSIGHT. NPS MUST SECURE WHAT ARE KNOWN AS COLLABORATIVE PRACTICE AGREEMENTS, TYING NURSE PRACTITIONERS TO A PHYSICIAN IN THEIR SPECIALITY. JENNIFER GROSS IS AN NP AND ALSO A STATE LAWMAKER. REP. GROSS: HAVING BEEN A NURSE PRACTITIONER BOARD CERTIFIED SINCE 2005, I'VE CARRIED THAT AT EVERY TURN IN ORDER TO PRACTICE. SO IF WE PRACTICE WITHOUT ONE OF THOSE, WE WILL BE FINED AND OUR LICENSE CAN BE REMOVED. STEPHANIE: THE OHIO STATE MEDICAL ASSOCIATION, WHICH OPPOSES ANY CHANGE TO THE CURRENT ARRANGEMENT, WOULDN'T COMMENT FOR THIS STORY, BUT MARC PARNES WOULD. HE'S A RETIRED OB-GYN WHO STILL MANAGES A MEDICAL PRACTICE IN COLUMBUS. DR. PARNES: MY BIAS IS KNOWING HOW LOVELY THAT COORDINATED CARE OF A PHYSICIAN AND A NURSE PRACTITIONER CAN BE WORKING TOGETHER. STEPHANIE: HE SAYS THAT EVEN WITH THEIR EXPANDED TRAINING, NPS TYPICALLY HAVE FEWER HOURS OF CLINICAL PRACTICE, THAN PHYSICIANS DO. DR. PARNES: THERE'S AN ART TO MEDICINE. AND IT'S NOT THAT NURSE PRACTITIONERS CAN'T PRACTICE IT. THEY DEFINITELY CAN. THERE ARE DIFFERENT LEVELS OF DEVELOPING THAT ART AND DIFFERENT OPPORTUNITIES TO DEVELOP IT. STEPHANIE: HOW DO YOU DECIDE AT WHAT POINT YOU REALLY NEED TO SEE A PRIMARY CARE PHYSICIAN WITH ALL THOSE THOUSANDS OF HOURS OF RESIDENCY VERSUS BEING OKAY WITH SEEING AN ADVANCED PRACTITIONER? DR. PARNES: I THINK INITIALLY IT WOULD BE ACCESS. AND SO THAT IS ONE OF THE THINGS I LIKE ABOUT HAVING MORE AND MORE NURSE PRACTITIONERS IS IT INCREASES THE ACCESS. STEPHANIE: GROSS SAYS THE LAW MAKES IT HARDER FOR ORDINARY OHIOANS TO ACCESS HEALTH CARE. REP. GROSS: LET'S TALK ABOUT OUR ELDERLY. LET'S TALK ABOUT OUR MEDICAID. WE'RE A MEDICAID EXPANSION STATE. THOSE PATIENTS THAT ARE MEDICAID AND MEDICARE HAVE BETTER ACCESS TO CARE WHEN NURSE PRACTITIONERS ARE NOT REQUIRED TO HAVE COLLABORATIVE AGREEMENTS. STEPHANIE: NURSE PRACTITIONERS IN RURAL AREAS SAY THEY ARE ESPECIALLY IMPACTED BY LAWS MANDATING PHYSICIAN COLLABORATION. STUDIES SHOW THAT WHEN ALLOWED TO PRACTICE INDEPENDENTLY, NOT ONLY DOES ACCESS TO CARE IMPROVE, BUT PATIENT OUTCOMES ARE NO WORSE OFF AND IN SOME CASES, BETTER. OVER 2 MILLION OHIOANS, ROUGHLY 20%, LIVE IN AREAS THAT SUFFER A SHORTAGE OF PRIMARY CARE PROFESSIONALS. >> HEALTHCARE ACCESS BEFORE I STARTED MY PRACTICE HERE WAS PRETTY SCARCE AND FEW BETWEEN. STEPHANIE: THE QUAINT VILLAGE OF BYESVILLE IS IN RURAL SOUTHEASTERN OHIO. ELISHA CLARK GRADUATED FROM THE LOCAL HIGH SCHOOL, HAS BEEN A NURSE PRACTITIONER FOR 12 YEARS IN THE AREA, AND OPENED HER OWN PRACTICE IN JANUARY. >> THAT WAS MY MAIN GOAL IN LIFE, TO OPEN A FACILITY WHERE PATIENTS FEEL LIKE THEY'RE AN EXTENDED FAMILY. STEPHANIE: SHE CITES THE COLLABORATIVE AGREEMENT AS A MAJOR HURDLE. >> FIRST YOU HAVE TO FIND SOMEONE THAT YOU TRUST AND THAT TRUSTS YOU, AND THEN YOU HAVE TO TALK TO THEM ABOUT WHAT KIND OF DETAILS THEY REQUIRE IN ORDER TO SIGN A PHYSICIAN AGREEMENT WITH YOU. STEPHANIE: HOW LONG DID IT TAKE TO FIND THAT PERSON? >> A LITTLE OVER A YEAR. STEPHANIE: WHAT DOES THE COLLABORATION LOOK LIKE? IS THIS SOMEBODY THAT YOU CONSULT WITH REGULARLY? >> NO, THIS IS SOMEONE THAT HAS TO BE PRESENT IN SOME WAY, SHAPE, OR FORM FOR YOU TO CONTACT IF YOU HAVE A QUESTION ABOUT SOMETHING, AND THIS IS SOMEONE THAT YOU GENERALLY HAVE TO PAY. STEPHANIE: CLARK SAYS HER COLLABORATING PHYSICIAN IS IN HIS SEVENTIES, MAKING HER ABILITY TO PROVIDE CARE LONG-TERM UNCERTAIN. >> I HAVE A LITTLE OVER 1600 PATIENTS THAT ARE SEEING ME. SO IF HE, GOD FORBID, HAS SOME HEALTH ISSUE OR IF HE RETIRES, WE ARE IN A GREAT BIND HERE FOR THE HEALTHCARE OF GUERNSEY COUNTY. STEPHANIE: WHAT WOULD HAPPEN EXACTLY? >> I WOULD IMMEDIATELY HAVE TO WITHIN 30 DAYS FIND A DIFFERENT PHYSICIAN AGREEMENT PARTNER TO HAVE SIGN A CONTRACT WITH ME. STEPHANIE: SHE AND OTHER NP'S SAY THE REQUIREMENT IS ALSO A FINANCIAL BURDEN. REP GROSS: YOU HAVE TO ENTER INTO AN AGREEMENT WITH A PHYSICIAN THAT WOULD COST YOU ABOUT $500 TO ROUGHLY $5,000 A MONTH, SO YOU CAN SEE THAT THAT'S PRETTY COST PROHIBITIVE. THOSE COSTS ARE THEN PASSED ON TO THE PATIENT. STEPHANIE: 71-YEAR-OLD SUSIE KHUNE HAS BEEN SEEING CLARK FOR SEVERAL YEARS, MOVING WITH HER TO HER PRIVATE PRACTICE WHEN SHE OPENED UP IN BYESVILLE. >> THAT WAS ONE OF MY BIGGEST COMPLAINTS ABOUT SOME OF THE DOCTORS THAT I HAVE SEEN PREVIOUSLY, THAT THEY ASK YOU A QUESTION AND THEN THEY ANSWER IT BEFORE YOU GET A CHANCE TO, SHE LISTENS AND THEN SHE GOES THROUGH THE OPTIONS WITH YOU NOT SAYING DO THIS, DO THIS YOU SIDE TOGETHER WITH ALICIA. STEPHANIE: SHE AND HER ADULT CHILDREN ARE ALL PATIENTS OF CLARK FOR PRIMARY CARE. WHAT WOULD YOU GUYS DO IF THE PRACTICE WAS FORCED TO CLOSE? BECAUSE SHE COULDN'T FIND A PHYSICIAN TO COLLABORATE WITH HER? >> IT'S SCARY. I DIDN'T REALIZE IT UNTIL EARLIER, AND I CAN'T IMAGINE HAVING TO GO TO SOMEONE ELSE BESIDES ELISHA. STEPHANIE: SHE'S WORRIED ABOUT LOSING THAT LISTENING EAR, AND THAT CHOICE FOR HER OWN HEALTHCARE. FOR PBS NEWS WEEKEND, I'M STEPHANIE SY IN OHIO. JOHN: THAT ANNOYING BUZZ IN YOUR EAR, THE ITCHY BITE THAT LEADS TO FRENZIED SCRATCHING. FOR MANY OF US IN THE UNITED STATES, MOSQUITOES ARE MERELY A SUMMERTIME NUISANCE. BUT ALI ROGIN IS BACK TO TELL US THAT AROUND THE WORLD, MOSQUITOES ARE A GROWING PUBLIC HEALTH PROBLEM. ALI: THE TINY MOSQUITO IS RESPONSIBLE FOR MORE DEATHS THAN ANY OTHER ANIMAL, THEY KILLED MORE THAN 600,000 PEOPLE IN 2021. IN THAT SAME YEAR, ANOTHER 247 MILLION PEOPLE WERE INFECTED. NOW THESE DEADLY VECTORS OF DISEASE ARE EXPANDING REACH, SHOWING UP IN PARTS OF THE WORLD NEVER SEEN BEFORE. A NEW MULTIPART INVESTIGATION LOOKS AT THE GLOBAL FIGHT AGAINST MOSQUITO BORNE DISEASES AND HOW YEARS OF PROGRESS HAVE BEEN REVERSED. STEPHANIE NOLAN COVERS GLOBAL HEALTH FOR THE "NEW YORK TIMES." THANK YOU SO MUCH FOR JOINING US. AS WE MENTIONED, HUMANS WERE WINNING THE WAR AGAINST MALARIA, MOSQUITO BORNE DISEASES FOR SO LONG. NOW, MOSQUITOES ARE WINNING, WHAT CHANGED? >> MOSQUITOES ARE CRAFTY. THEY EVOLVE VERY QUICKLY, EVERY GENERATION OF MOSQUITO HAS GENERATIONS OF MUTATIONS. THEY ARE RESISTANT WITH THINGS WE COME UP WITH TO KILL THEM. MOSQUITOES AROUND THE GLOBE ARE RESISTANT TO INSECTICIDES. EVERY TIME WE COME UP WITH SOMETHING WE THINK WILL BE THE SILVER BULLET, MOSQUITOES GET AROUND IT. WHEREAS DESIGNING, TESTING, BRINGING TO MARKET, GENERALLY TAKES A MINIMUM OF 10 YEARS. ALI: IT SEEMS MOSQUITOES ARE GETTING IMPERVIOUS TO THESE EFFORTS. HAVE WE HIT A PERFECT STORM? STEPHANIE: I DON'T THINK SO. AFTER A YEAR OF LOOKING AT THIS, I'M REALLY HOPEFUL. YOU ARE RIGHT TO BE STRIK ING A BIT OF AN ALARM. WE SEE MOSQUITOES WITH VIRUSES TURNING UP PLACES LIKE FRANCE AND THE UNITED STATES THAT HAVE NEVER HAD THAT PROBLEM. THE MOSQUITO FROM ASIA THAT HAS THREATENED AFRICAN CITIES. MALARIA IS A RURAL PROBLEM IN AFRICA. IT PUTS HUNDREDS OF MILLIONS OF NEW PEOPLE AT RISK. PLACES THAT DON'T HAVE THE INFRASTRUCTURE TO RESPOND. YOU ARE SEEING DANGEROUS SPECIES ADAPTING TO LIVE IN ALL KINDS OF PLACES. I LOOK AT BIG PICTURE PRODUCTS -- PROJECTS. SO THEY WOULDN'T BE ABLE TO TRANSMIT DISEASE. THOSE STRATEGIES MIGHT WORK FOR MULTIPLE DISEASES AND MULTIPLE PLACES. THOSE ARE THE ONES I THINK KEEP ME FROM COMPLETELY PANICKING. ALI: YOU MENTIONED HOW SOME OF THESE DISEASES HAVE SHOWN UP IN THE UNITED STATES. THERE WERE NINE CASES OF MALARIA REPORTED. HOW IS IT AND WHY THAT THESE DISEASES MADE IT TO THE UNITED STATES? STEPHANIE: NINE CASES IS MAYBE NOT YET A CAUSE FOR PANIC. THOSE MALARIA OUTBREAKS ARE LIKE A TINY LITTLE YOU SHOULD BE PAYING ATTENTION TO THIS. DO I THINK THERE WILL BE TENS OF THOUSANDS OF MALARIA CASES? I DON'T. WHAT IS INTERESTING TO ME ABOUT U.S. MALARIA AND HOW IT REMINDED PEOPLE THERE ARE AN ISSUE, THINK ABOUT HOW DO WE GET RID OF MALARIA IN THE U.S.? ULTIMATELY, WHAT MADE A DIFFERENCE WAS WHERE PEOPLE LIVED. WE ARE LOCATING COMMUNITIES AND MAKING SURE PEOPLE HAVE ADEQUATE HOUSING TO SPEND MORE THAN 22 MILLION DOLLARS A YEAR FIGHTING MOSQUITOES. WE COULD CONTINUE TO POUR MONEY INTO THOSE THINGS, WE COULD TALK ABOUT WHAT KIND OF INVESTMENT IT WOULD TAKE TO GET THE PEOPLE WHO WERE CURRENTLY VULNERABLE INTO THE SAME KIND OF STANDARDS OF HOUSING. ALI: WHO ARE THE PEOPLE MOST VULNERABLE HERE? STEPHANIE: IT IS THE POOREST PEOPLE IN THE POOREST PLACES, TANZANIA HAS ONE OF THE HIGHEST MALARIA BURDENS IN THE WORLD. THEY TAKE PLACE IN THE PEOPLE THAT LIVE IN THE 10% LOWEST QUALITY OF HOUSING. FEVER AND VIRUSES I THINK ARE GOING TO BE INTERESTING TO WATCH. ZIKA, YELLOW FEVER. THE MOSQUITO THAT CARRIES THEM IS NOT BITING PEOPLE IN RURAL TANZANIA, IT LIVES HAPPY IN CITIES, ON THE BALCONY OF YOUR APARTMENT BUILDING IN MIAMI. IT WILL LIVE AROUND YOUR HOUSE, AND YOUR CLOSET. MANY OF US ARE EITHER NOW OR SOON TO BE VULNERABLE TO THESE MOSQUITOES. ALI: THANK YOU SO MUCH FOR YOUR TIME. STEPHANIE: IT'S A PLEASURE. ♪ JOHN: THAT IS PBS NEWS WEEKEND FOR THIS SATURDAY. FOR ALL OF MY COLLEAGUES, THANKS FOR JOINING US. SEE YOU TOMORROW. >> MAJOR FUNDING FOR PBS NEWS WEEKEND HAS BEEN PROVIDED BY. >> CONSUMER CELLULAR, THIS IS SAM, HOW MAY I HELP YOU? >> THIS IS A POCKET DIAL. >> WITH CONSUMER CELLULAR, YOU GET NATIONWIDE COVERAGE WITH NO CONTRACT. >> THAT'S OUR THING. HAVE A NICE DAY. >> AND WITH THE ONGOING SUPPORT OF THESE INDIVIDUALS AND INSTITUTIONS. THIS PROGRAM WAS MADE POSSIBLE BY THE CORPORATION FOR PUBLIC BROADCASTING AND CONTRIBUTIONS TO YOUR PBS STATION FROM VIEWERS LIKE YOU. THANK YOU. [CAPTIONING PERFORMED BY THE NATIONAL CAPTIONING INSTITUTE, WHICH IS RESPONSIBLE FOR ITS CAPTION CONTENT AND ACCURACY.]
