Pressure Mounts on Israel for Longer Gaza Pause

 Israeli Prime Minister Benjamin Netanyahu visits Gaza Strip, during a temporary truce between Hamas and Israel, in this handout obtained by Reuters on November 26, 2023.(Handout via Reuters)
Israeli Prime Minister Benjamin Netanyahu visits Gaza Strip, during a temporary truce between Hamas and Israel, in this handout obtained by Reuters on November 26, 2023.(Handout via Reuters)
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Pressure Mounts on Israel for Longer Gaza Pause

 Israeli Prime Minister Benjamin Netanyahu visits Gaza Strip, during a temporary truce between Hamas and Israel, in this handout obtained by Reuters on November 26, 2023.(Handout via Reuters)
Israeli Prime Minister Benjamin Netanyahu visits Gaza Strip, during a temporary truce between Hamas and Israel, in this handout obtained by Reuters on November 26, 2023.(Handout via Reuters)

Israel faces mounting pressure to extend a four-day pause in its war against Hamas, but military officials fear that a longer truce risks blunting its efforts to rout the movement.

After hours of delay and acrimony that underscored the fragility of the truce, a second tranche of 13 Israeli hostages was freed on Saturday by Hamas in exchange for 39 Palestinian prisoners -- the same number as the previous day.

A total of 15 foreigners have also been released during the ceasefire -- mediated for weeks by Qatar, the United States and Egypt -- that marks the first breakthrough after seven weeks of relentless war.

Under the deal, 50 of the roughly 240 hostages held by the militants will be freed over four days in exchange for 150 Palestinian prisoners, with a built-in extension mechanism to prolong the process as long as at least 10 Israeli captives are released each day.

That increases the number of hostages returned -- and there is strong domestic pressure within Israel to do so -- but gives Hamas a longer window in which to regroup, recover, re-arm and ultimately return to the fight, analysts say.

It also increases diplomatic pressure on Israel from the international community, which will become steadily less willing to countenance a return to the pounding of Gaza and the resulting humanitarian crisis.

"Time works against Israel as always and against the IDF," said Andreas Krieg, of King's College London, referring to the Israeli military.

"On one hand you want all the hostages out knowing that you can't get them out militarily and on the other you don't want to lose completely the momentum of this war," he told AFP.

And the longer a truce lasted, he said, the more the international community would lose patience with a continuation of the war, he added.

But the Israeli military is determined to pursue its objective of "crushing" Hamas.

Visiting Israeli troops in the war-battered Gaza Strip on Saturday, Defense Minister Yoav Gallant insisted the timeline for the truce was "short".

"It won't take weeks, it will take days, more or less," he said, flanked by heavily armed soldiers. "Any further negotiations will take place under fire."

'Dilemma'

The war began after Palestinian militants smashed through the highly militarized border on October 7, killing about 1,200 people, mostly civilians, according to Israeli officials, and triggering Israel's invasion of Gaza.

Israel has defied international criticism of its Gaza offensive, which its Hamas rulers say has killed more than 15,000 people, mostly civilians, and left an unprecedented trail of destruction in the Palestinian territory.

"The real pressure (to prolong the truce) comes from inside Israel -- from the families of the hostages," said Arik Rudnitzky, from Tel Aviv University's Moshe Dayan Center.

On Saturday, tens of thousands of demonstrators packed the streets of Tel Aviv in support of the remaining hostages, chanting "Now, now, now, all of them now!" and clutching banners that read "Get them out of hell".

An Israeli military official said the country was committed to freeing as many hostages as possible but expressed concern that the longer the truce lasts the more time Hamas has to "rebuild its capabilities and attack Israel again".

"It's a terrible dilemma," he told AFP, requesting anonymity.

'You cannot win this'

The lead mediator in the negotiations for the pause in the fighting has been Qatar, whose foreign ministry spokesman Majed Al-Ansari told AFP there was a need to "maintain the momentum" for a lasting ceasefire.

"That can only be done when you have political will not only from the Israelis and Palestinians but also with the other partners who are working with us."

US President Joe Biden, a staunch ally of Israel, on Friday said "the chances are real" for extending the truce, as he urged a broader effort to achieve a two-state solution with a viable Palestinian state existing alongside Israel.

With a presidential election next year, there was no stomach in Washington for a prolonged intensive operation "for months and months on end", said Krieg of King's College London. "So the Biden administration needs to find an off ramp as well".

"There isn't a military solution to the conflict, you cannot win this," he added.

Senior Hamas official Taher al-Nunu said the group was "ready to search seriously to reach new deals".

But Hamas on Saturday delayed the handover of the second group of hostages for hours, accusing Israel of breaching the terms of the agreement -- claims denied by Israel.

Hamas would "play the long game with the hostages to try to exhaust the card over the longest possible length of time and at the greatest price to Israel," former Israeli intelligence official Avi Melamed told AFP.

It was hoping support within Israel for the Gaza Strip incursion would dissipate, and ultimately "international and internal pressures levied on Israel's government will create the circumstance where Hamas can continue to exist, and rule Gaza even after this war ends."

Independent Middle East analyst Eva Koulouriotis agreed.

"For Hamas, any scenario for this war that does not lead to an end to its presence in the Gaza Strip will be considered a victory," she told AFP. "Regardless of its human and material losses, of the extent of the destruction in Gaza, and of the extent of civilian casualties".



New Mpox Strain Is Changing Fast; African Scientists Are ‘Working Blind’ to Respond 

Dr. Robert Musole, medical director of the Kavumu hospital (R) consults an infant suffering from a severe form of mpox at the Kavumu hospital, 30 km north of Bukavu in eastern Democratic Republic of Congo, August 24, 2024. (AFP)
Dr. Robert Musole, medical director of the Kavumu hospital (R) consults an infant suffering from a severe form of mpox at the Kavumu hospital, 30 km north of Bukavu in eastern Democratic Republic of Congo, August 24, 2024. (AFP)
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New Mpox Strain Is Changing Fast; African Scientists Are ‘Working Blind’ to Respond 

Dr. Robert Musole, medical director of the Kavumu hospital (R) consults an infant suffering from a severe form of mpox at the Kavumu hospital, 30 km north of Bukavu in eastern Democratic Republic of Congo, August 24, 2024. (AFP)
Dr. Robert Musole, medical director of the Kavumu hospital (R) consults an infant suffering from a severe form of mpox at the Kavumu hospital, 30 km north of Bukavu in eastern Democratic Republic of Congo, August 24, 2024. (AFP)

Scientists studying the new mpox strain that has spread out of Democratic Republic of Congo say the virus is changing faster than expected, and often in areas where experts lack the funding and equipment to properly track it.

That means there are numerous unknowns about the virus itself, its severity and how it is transmitting, complicating the response, half a dozen scientists in Africa, Europe and the United States told Reuters.

Mpox, formerly known as monkeypox, has been a public health problem in parts of Africa since 1970, but received little global attention until it surged internationally in 2022, prompting the World Health Organization to declare a global health emergency. That declaration ended 10 months later.

A new strain of the virus, known as clade Ib, has the world's attention again after the WHO declared a new health emergency.

The strain is a mutated version of clade I, a form of mpox spread by contact with infected animals that has been endemic in Congo for decades. Mpox typically causes flu-like symptoms and pus-filled lesions and can kill.

Congo has had more than 18,000 suspected clade I and clade Ib mpox cases and 615 deaths this year, according to the WHO. There have also been 222 confirmed clade Ib cases in four African countries in the last month, plus a case each in Sweden and Thailand in people with a travel history in Africa.

"I worry that in Africa, we are working blindly," said Dr. Dimie Ogoina, an infectious diseases expert at Niger Delta University Hospital in Nigeria who chairs the WHO's mpox emergency committee. He first raised the alarm about potential sexual transmission of mpox in 2017, now an accepted route of spread for the virus.

"We don’t understand our outbreak very well, and if we don't understand our outbreak very well, we will have difficulty addressing the problem in terms of transmission dynamics, the severity of the disease, risk factors of the disease," Ogoina said. "And I worry about the fact that the virus seems to be mutating and producing new strains."

He said it took clade IIb in Nigeria five years or more to evolve enough for sustained spread among humans, sparking the 2022 global outbreak. Clade Ib has done the same thing in less than a year.

MUTATING 'MORE RAPIDLY'

Mpox is an orthopoxvirus, from the family that causes smallpox. Population-wide protection from a global smallpox vaccine campaign 50 years ago has waned, as the vaccinating stopped when the disease was eradicated.

Genetic sequencing of clade Ib infections, which the WHO estimates emerged mid-September 2023, show they carry a mutation known as APOBEC3, a signature of adaptation in humans.

The virus that causes mpox has typically been fairly stable and slow to mutate, but APOBEC-driven mutations can accelerate viral evolution, said Dr. Miguel Paredes, who is studying the evolution of mpox and other viruses at Fred Hutchison Cancer Center in Seattle.

"All the human-to-human cases of mpox have this APOBEC signature of mutations, which means that it's mutating a little bit more rapidly than we would expect," he said.

Paredes and other scientists said a response was complicated by several mpox outbreaks happening at once.

In the past, mpox was predominantly acquired through human contact with infected animals. That is still driving a rise in Congo in clade I cases – also known as clade Ia - likely due in part to deforestation and increased consumption of bushmeat, scientists said.

The mutated versions, clade Ib and IIb, can now essentially be considered a sexually transmitted disease, said Dr. Salim Abdool Karim, a South African epidemiologist and chair of the Africa CDC’s mpox advisory committee. Most of the mutated clade Ib cases are among adults, driven at first by an epidemic among female sex workers in South Kivu, Congo.

The virus also can spread through close contact with an infected person, which is likely how clusters of children have been infected with clade Ib, particularly in Burundi and in eastern Congo’s displacement camps, where crowded living conditions may be contributing.

Children, pregnant women and people with weakened immune systems or other illnesses may be at greater risk of serious mpox disease and death, say the WHO and mpox scientists.

Clade I has typically caused more severe disease, with fatality rates of 4%-11%, compared to around 1% for clade II. Ogoina said data from Congo suggests few have died of the new Ib version, but he feared some data is being mixed up.

More research is urgently needed, but three teams tracking mpox outbreaks in Africa say they cannot even access chemicals needed for diagnostic tests. Clade Ib can also be missed by some diagnostic tests.

Planning a response, including vaccination strategies, without this is difficult, the scientists said.

Karim said around half of cases in eastern Congo, where Ib is particularly prevalent, are only being diagnosed by doctors, with no laboratory confirmation.

Getting samples to labs is difficult because the healthcare system is already under pressure, he said. And around 750,000 people have been displaced amid fighting between the M23 rebel group and the government.

Many African laboratories cannot get the supplies they need, said Dr. Emmanuel Nakoune, an mpox expert at the Institut Pasteur in Bangui, Central African Republic, which also has clade Ia cases.

"This is not a luxury," he said, but necessary to track deadly outbreaks.