August 19, 2019
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    A bomb has exploded in a wedding hall in the Afghan capital, Kabul, killing 63 people and wounding more than 180.Witnesses told the BBC a suicide bomber detonated explosives during a wedding ceremony.The explosion happened at around 22:40 local time (18.10 GMT) in an area in the west of the city mostly populated by Shia Muslims. The Taliban denied they were behind the attack. No other group has admitted carrying out the bombing. Sunni Muslim militants, including the Taliban and the Islamic State group, have repeatedly targeted Shia Hazara minorities in Afghanistan and Pakistan.
    The Afghan interior ministry confirmed the death toll hours after the bombing. Pictures on social media showed bodies strewn across the wedding hall amid overturned chairs and tables. Afghan weddings often include hundreds of guests who gather in large halls where the men are usually segregated from the women and children. Wedding guest Mohammad Farhag said he had been in the women's section when he heard a huge explosion in the men's area. "Everyone ran outside shouting and crying," he told AFP news agency. "For about 20 minutes the hall was full of smoke. Almost everyone in the men's section is either dead or wounded. Now, two hours after the blast, they are still taking bodies out of the hall."
    A waiter at the hall, Sayed Agha Shah, said "everybody was running" after the blast. "Several of our waiters were killed or wounded," he added. A Taliban spokesman said the group "strongly condemned" the attack."There is no justification for such deliberate and brutal killings and targeting of women and children," Zabiullah Mujaheed said in a text message to the media. The latest blast comes just 10 days after a huge bomb outside a Kabul police station killed at least 14 people and injured nearly 150. The Taliban said they carried out that attack.
    On Friday a brother of Taliban leader Hibatullah Akhundzada was killed by a bomb planted in a mosque near the Pakistani city of Quetta. No group has so far claimed that attack. A source in Afghan intelligence told the BBC that Hibatullah Akhundzada had been due to attend prayers at the mosque and was probably the intended target. Tensions in the country have been high even though the Taliban and the US, which has thousands of troops stationed in Afghanistan, are reportedly getting closer to announcing a peace deal.
    How are Afghan peace talks progressing? Taliban and US representatives have been holding peace talks in Qatar's capital, Doha, and both sides have reported progress. On Friday, US President Donald Trump tweeted that both sides were "looking to make a deal - if possible".Just completed a very good meeting on Afghanistan. Many on the opposite side of this 19 year war, and us, are looking to make a deal - if possible! The deal would include a phased US troop pullout in exchange for Taliban guarantees that Afghanistan will not be used by extremist groups to attack US targets.
    The Taliban would also begin negotiations with an Afghan delegation on a framework for peace including an eventual ceasefire. The militants have been refusing to negotiate with the Afghan government until a timetable for the US withdrawal is agreed upon. The Taliban now control more territory than at any point since they were forced from power in 2001.
    What could peace look like?
    The Taliban now control more territory in Afghanistan than at any point since 2001 For the first time in 18 years, the US government seems serious about withdrawing its forces from Afghanistan and winding up the longest war in its history. Since October, US officials and representatives of the Taliban have held seven rounds of direct talks - aimed at ensuring a safe exit for the US in return for the insurgents guaranteeing that Afghan territory is not used by foreign militants and won't pose a security threat to the rest of the world.
    A US-led military coalition drove the Taliban from power in 2001 for sheltering al-Qaeda, the militant group behind the 9/11 attacks. A rare consensus about resolving the conflict peacefully, both inside and outside Afghanistan, means peace has never been so close. During a visit to Afghanistan in late June, US Secretary of State Mike Pompeo said the Trump administration was aiming for "a peace deal before September 1st". But the US-Taliban talks in Qatar's capital, Doha - as well as intra-Afghan dialogue involving the insurgents and some Afghan officials - are only the first phase of a complicated process with an uncertain outcome - and there are many hurdles to overcome. Does there need to be a ceasefire? While the US has reversed its refusal to talk directly to the Taliban, intense fighting and unprecedented numbers of airstrikes by the US and Afghan militaries are still going on all over the country. And while the Taliban negotiate they now control and influence more territory than at any point since 2001.
    The war in Afghanistan is now the deadliest conflict in the world, causing more casualties than the fighting in Syria, Libya or Yemen. Patterns of violence have changed dramatically in recent years. The vast majority of those being killed and injured now are Afghans - civilians, police and soldiers, and Taliban fighters. In January, Afghan President Ashraf Ghani said more than 45,000 members of the country's security forces had been killed since he became leader in late 2014. Over the same period "the number of international casualties is less than 72", he said.
    In February, the UN said civilian deaths reached a record high in 2018. It said more than 32,000 civilians had in total been killed in the past decade. Taliban fighters are also regularly killed in large numbers in airstrikes, night raids and ground fighting. Given the continued stalemate with the insurgents, US President Donald Trump is keen to end the war, which, according to US officials, costs about $45bn (£34bn) annually. His indication to withdraw most or all of his 14,000 forces in the near future caught everyone by surprise, including the Taliban. There are also nearly 1,000 British troops in Afghanistan as part of Nato's mission to train and assist the Afghan security forces
    President Trump is considering withdrawing many of the US troops still in Afghanistan But even if the US and the Taliban resolve their major issues, the Afghans themselves will need to sort out a number of key internal issues - including a ceasefire, dialogue between the Taliban and the government, and most importantly, the formation of a new government and political system.Ideally, a ceasefire would precede presidential elections later this year and the Taliban would take part - but the latter seems unlikely. Without a full or even partial ceasefire, there are fears that poll irregularities and a possible protracted political turmoil over the results could undermine any peace process and may increase political instability.
    Can power be shared, and if so how? There are a number of options and scenarios.First of all, a decision will need to be taken by all major players on whether presidential elections, already postponed to late September, take place as planned. Can Taliban and Afghan leaders share peace? Who are the Taliban? The Afghan women determined not to lose out in Taliban talks Will negotiations lead to peace in Afghanistan?
    If they do, a new government in Kabul could negotiate terms with the Taliban, unless a peace deal had been reached before the vote. Whether that government served a full term or held power on an interim basis while intra-Afghan power-sharing options were discussed is unclear. But elections could also be further delayed or suspended - and the current government's term extended - while a mutually agreed mechanism to establish a new government, acceptable to all sides including the Taliban, is sought.
    Will the Taliban end up back in government? eating a temporary neutral government or a governing coalition, that could even include the Taliban, is another option being looked at in this scenario. A loya jirga - or grand assembly - of Afghans could also be called to choose an interim government which would hold elections once US troops have left and the Taliban has been reintegrated. An international conference similar to the one in Bonn, Germany, in 2001 is another suggestion to help chart a future course for the country.It would include Afghan players, major powers and neighbouring states - but this time also with the participation of the Taliban.Several Taliban leaders have told me they need time to enter mainstream Afghan society and prepare for elections.

    Would former enemies be able to work together?
    There will be very difficult issues to surmount after a conflict that has left hundreds of thousands of casualties on all sides, including government forces, insurgents and civilians.

    For example, the Taliban do not accept the current constitution and see the Afghan government as "a US-imposed puppet regime".

    So far President Ghani's administration has not been involved in direct talks with the insurgents who refuse to talk to a government they don't recognise.

    Image copyrightREUTERS
    Image caption
    The Taliban have dismissed the government of Ashraf Ghani as a puppet of the US
    Therefore, given the internal rivalries and diverse agendas of various local actors, the intra-Afghan phase of the peace process might prove more difficult than the US-Taliban talks.

    However, there are positive signs.

    Two rounds of intra-Afghan dialogue took place in Moscow earlier this year when Afghan politicians including ex-president Hamid Karzai, former commanders and civil society members, including women, met Taliban representatives to discuss ending the war.

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    A third such meeting took place in Doha in July, in which several officials currently serving in the Afghan government also participated, albeit in a "personal capacity". It is hoped that such meetings will eventually pave the way for formal peace talks between the Taliban and other Afghans, including the government.

    A number of Afghans fear that sharing power with the Taliban could see a return to the group's obscurantist interpretation of Islamic justice. They are concerned that various freedoms, notably certain women's rights, could be lost.

    The Taliban banned women from public life when they were in power in the 1990s, and their punishments included public stoning and amputations.

    What if talks don't lead to peace?
    Since the Soviet invasion of Afghanistan in 1979, there has been a long list of unfulfilled agreements and failed attempts aimed at ending the war in the country.


    Media captionAt least 45,000 Afghan police and soldiers have died over the past four years
    Several scenarios from the past could be repeated this time round.

    A US pullout, with or without a peace deal, might not automatically result in the sudden collapse of the government in Kabul.

    The war could continue and the government's survival would largely depend on financial and military assistance from foreign allies, especially the US, and the unity and commitment of the country's political elite.

    When Soviet forces withdrew in 1989, the Moscow-backed government in Kabul lasted for three years.

    Image copyrightGETTY IMAGES
    Image caption
    The Taliban are still openly active in about 70% of Afghanistan
    But its collapse in 1992 ushered in a bloody civil war, involving various Afghan factions supported by different regional powers.

    If issues are not handled with care now, there is a risk of a re-run of these two scenarios.

    The Taliban, who emerged out of the chaos of the civil war, captured Kabul in 1996 and ruled most of Afghanistan until the US-led invasion removed them from power in 2001.

    They could try to capture the state again if a deal is not reached this time round, or one fails.

    What would chaos look like?
    The current peace efforts could see the Taliban participating in a new set-up in Afghanistan.

    This would mean the end of fighting and the formation of an inclusive Afghan government - a win-win for Afghans, the US and regional players.

    But the alternative is dire - a probable intensification of conflict and instability in a country strategically located in a region with a cluster of major powers including China, Russia, India, Iran and Pakistan.

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    How Qatar came to host the Taliban
    Another round of chaos could well result in the emergence of new violent extremist groups.

    Afghans and the rest of the world would have to deal with a possible security vacuum in which militant groups such as al-Qaeda and Islamic State found fertile ground.

    Increased production of drugs and the overflow of refugees would pose serious challenges not only to Afghanistan but also to the whole region and the rest of the world.

    How could it be avoided?
    History shows that starting negotiations and signing deals does not guarantee that conflicts will be peacefully resolved.

    These steps are only the beginning of a complicated and challenging process - implementation of what's on paper is even more important.

    The biggest challenge for Afghanistan would be the creation of verifiable enforcement mechanisms in any post-deal scenario.

    Image copyrightGETTY IMAGES
    Image caption
    The Taliban have had a political office in Doha since 2013
    Given the history of conflict in the country, the current opportunity could be easily squandered if the process is taken in the wrong direction by one or more of the local or foreign actors.

    Therefore, international guarantors and a framework involving the region and the key international players are needed to co-ordinate efforts for peace and deter and prevent spoilers from sabotaging the process.

    There's a rare opportunity to resolve four decades of war - handle it with care, or risk facing the consequences.

    Who is representing the Taliban?
    Image copyright US DEFENSE DEPARTMENT
    Image caption
    The "Guantanamo Five" were released by the US without being charged with any terror-related crime
    The 14-member Taliban negotiating team also features the "Guantanamo Five" - former high-ranking officials captured after the fall of the regime and held for nearly 13 years in the controversial US detention camp.

    They were sent to Qatar in a 2014 prisoner exchange involving Bowe Bergdahl, the US soldier captured by insurgents in 2009.

    Freed Taliban five to choose war or peace
    They are (clockwise from top left in photo above):

    Mohammad Fazl - the Taliban's deputy defence minister during the US military campaign in 2001
    Mohammad Nabi Omari - said to have close links to the Haqqani militant network
    Mullah Norullah Noori - a senior Taliban military commander and a former provincial governor
    Khairullah Khairkhwa - served as a Taliban interior minister and governor of Herat, Afghanistan's third largest city
    Abdul Haq Wasiq - the Taliban's deputy head of intelligence
    Sher Mohammad Abbas Stanikzai, a senior Taliban political figure and former head of its political office in Qatar, is leading the group's negotiating team.

    In an interview with the BBC in February, he said a ceasefire would not be agreed until all foreign forces were withdrawn from Afghanistan.

    Also present in Qatar is Mullah Abdul Ghani Baradar, the Taliban's deputy head for political affairs and one of the group's co-founders, who was released from prison in Pakistan last October after spending nearly nine years in captivity.



    Are we close to solving the puzzle of consciousness?
    By David Robson

    We know that they have the same sensors – called nociceptors – that cause us to flinch or cry when we are hurt. And they certainly behave like they are sensing something unpleasant. When a chef places them in boiling water, for instance, they twitch their tails as if they are in agony. But are they actually “aware” of the sensation? Or is that response merely a reflex?
    When you or I perform an action, our minds are filled with a complex conscious experience. We can’t just assume that this is also true for other animals, however – particularly ones with such different brains from our own. It’s perfectly feasible – some scientists would even argue that it’s likely – that a creature like a lobster lacks any kind of internal experience, compared to the rich world inside our head.
    “With a dog, who behaves quite a lot like us, who is in a body which is not too different from ours, and who has a brain that is not too different from ours, it’s much more plausible that it sees things and hears things very much like we do, than to say that it is completely ‘dark inside’, so to speak,” says Giulio Tononi, a neuroscientist at the University of Wisconsin-Madison. “But when it comes down to a lobster, all bets are off.”

    The question of whether other brains – quite alien to our own – are capable of awareness, is just one of the many conundrums that arise when scientists start thinking about consciousness. When does an awareness of our own being first emerge in the brain? Why does it feel the way it does? And will computers ever be able to achieve the same internal life?

    Tononi may have a solution to these puzzles. His "integrated information theory" is one of the most exciting theories of consciousness to have emerged over the last few years, and although it is not yet proven, it provides some testable hypotheses that may soon give a definitive answer.

    Knowing what consciousness is, and how it came about, is crucial to understanding our place in the universe and what we do with our lives – Giulio Tononi

    Tononi says his fascination arose as a teenager with a “typically adolescent” preoccupation with ethics and philosophy. “I realised that knowing what consciousness is and how it came about is crucial to understanding our place in the universe and what we do with our lives,” he says.

    At that age, he did not know the best path to follow to pursue those questions – Would it be mathematics? Or philosophy? – but he eventually settled on medicine. And the clinical experience helped to fertilise his young mind. “There is really something special about having a direct exposure to neurological cases and psychotic cases,” he says. “It really forces you to face directly what happens to patients when they lose consciousness or lose the components of consciousness in ways that are really difficult to imagine if you didn’t see that it actually happens.”

    In his published research, however, he built his reputation with some pioneering work on sleep – a less controversial field. “At that time you couldn’t even talk about consciousness,” he says. But he kept on mulling over the question, and in 2004, he published his first description of his theory, which he has subsequently expanded and developed.

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    It begins with a set of axioms that define what consciousness actually is. Tononi proposes that any conscious experience needs to be structured, for instance – if you look at the space around you, you can distinguish the position of objects relative to each other. It’s also specific and "differentiated" – each experience will be different depending on the particular circumstances, meaning there are a huge number of possible experiences. And it is integrated. If you look at a red book on a table, its shape and colour and location – although initially processed separately in the brain – are all held together at once in a single conscious experience. We even combine information from many different senses – what Virginia Woolf described as the “incessant shower of innumerable atoms” – into a single sense of the here and now.

    According to Tononi’s theory, the more information that is shared and processed between many different components then the higher the level of consciousness

    From these axioms, Tononi proposes that we can identify a person’s (or an animal’s, or even a computer’s) consciousness from the level of “information integration” that is possible in the brain (or CPU). According to his theory, the more information that is shared and processed between many different components to contribute to that single experience, then the higher the level of consciousness.

    Perhaps the best way to understand what this means in practice is to compare the brain’s visual system to a digital camera. A camera captures the light hitting each pixel of the image sensor – which is clearly a huge amount of total information. But the pixels are not “talking” to each other or sharing information: each one is independently recording a tiny part of the scene. And without that integration, it can’t have a rich conscious experience.

    Like the digital camera, the human retina contains many sensors that initially capture small elements of the scene. But that data is then shared and processed across many different brain regions. Some areas will be working on the colours, adapting the raw data to make sense of the light levels so that we can still recognise colours even in very different conditions. Others examine the contours, which might involve guessing the parts of an object are obscured – if a coffee cup is in front of part of the book, for instance – so you still get a sense of the overall shape. Those regions will then share that information, passing it further up the hierarchy to combine the different elements – and out pops the conscious experience of all that is in front of us.

    The same goes for our memories. Unlike a digital camera’s library of photos, we don’t store each experience separately. They are combined and cross-linked to form a meaningful narrative. Every time we experience something new, it is integrated with that previous information. It is the reason that the taste of a single madeleine can trigger a memory from our distant childhood – and it is all part of our conscious experience.

    At least, that’s the theory – and it’s compatible with many observations and experiments across medicine.

    By altering the levels of important neurotransmitters, anaesthesia appears to break down the brain’s information integration

    One study, published in 2015, examined the brains of participants under various forms of anaesthesia – including propofol and xenon. To get an idea of the brain’s capacity to integrate information, the team applied a magnetic field above the scalp to stimulate a small area of the cortex underneath – a standard non-invasive technique known as Transcranial Magnetic Stimulation (TMS). When awake, you would observe a complex ripple of activity as the brain responds to the TMS, with many different regions responding, which Tononi takes to be a sign of information integration between the different groups of neurons.

    But the brains of the people under propofol and xenon did not show that response – the brainwaves generated were much simpler in form compared to the hubbub of activity in the awake brain. By altering the levels of important neurotransmitters, the drugs appeared to have “broken down” the brain’s information integration – and this corresponded to the participants’ complete lack of awareness during the experiment. Their inner experience had faded to black.

    Drug-induced fantasies

    As a further comparison, the team also looked at participants under ketamine. Although the drug renders you unresponsive to the outside world – meaning that it is also used as an anaesthetic – the patients frequently report wild dreams, as opposed to the pure “blank” experienced under propofol or xenon. Sure enough, Tononi’s team found that the responses to the TMS were far more complex than those under the other anaesthetics, reflecting their altered state of consciousness. They were disconnected from the outside world, but their minds were still very much turned on during their drug-induced fantasies.

    Tononi has found similar results when examining different sleep stages. During non-REM sleep – in which dreams are rarer – the responses to TMS were less complex; but during REM sleep, which frequently coincides with dream consciousness, the information integration appeared to be higher.

    He emphasises that this isn’t “proof” that his theory is correct, but it shows that he could be working on the right lines. “Let’s say that if we had obtained the opposite result, we would have been in trouble.”

    Some people lack a cerebellum - containing half the neurons in the whole brain - yet they are still capable of conscious perception

    Tononi’s theory also chimes with the experiences of people with various forms of brain damage. The cerebellum, for instance, is the walnut-shaped, pinkish-grey mass at the base of the brain and its prime responsibility is coordinating our movements. It contains four times as many neurons as the cortex, the bark-like outer layer of the brain – around half the total number of neurons in the whole brain. Yet some people lack a cerebellum (either because they were born without it, or they lost it through brain damage) and they are still capable of conscious perception, leading a relatively long and “normal” life without any loss of awareness.

    These cases wouldn’t make sense if you just consider the sheer number of neurons to be important for the creation of conscious experience. In line with Tononi’s theory, however, the cerebellum’s processing mostly happens locally rather than exchanging and integrating signals, meaning it would have a minimum role in awareness.

    Measures of the brain’s responses to the TMS also seem to predict the consciousness of patients in a non-communicative and vegetative state – a finding with potentially profound clinical applications.

    Great claims require great evidence, of course – and few scientific questions are more profound than the mystery of consciousness.

    Tononi’s methods so far only offer a very crude “proxy” of the brain’s information integration – and to really prove his theory’s worth, more sophisticated tools will be required that can precisely measure processing in any kind of brain.

    Daniel Toker, a neuroscientist at the University of California Berkeley, says the idea that information integration is necessary for consciousness is very “intuitive” to other scientists, but much more evidence is required. “The broader perspective in the field is that it is an interesting idea, but pretty much completely untested,” he says.

    It all comes down to mathematics. Using previous techniques, the time taken to measure information integration across a network increases “super exponentially” with the number of nodes you are considering – meaning that, even with the best technology, the computation could last longer than the lifespan of the universe. But Toker has recently proposed an ingenious shortcut for these calculations that may bring that down to a couple of minutes, which he has tested with measurements from a couple of macaques. This could be one first step to putting the theory on a much firmer experimental footing. “We’re really in the early stages of all this,” says Toker.

    Only then can we begin to answer the really big questions – such as comparing the consciousness of different types of brain. Even if Tononi’s theory doesn’t prove to be true, however, Toker thinks it’s helped to push other neuroscientists to think more mathematically about the question of consciousness – which could inspire future theories.

    If integrated information theory is correct, computers could behave exactly like you and me, and yet there would literally be nobody there – Giulio Tononi

    And should information integration theory be right, it would be truly game changing – with implications far beyond neuroscience and medicine. Proof of consciousness in a creature, such as a lobster, could transform the fight for animal rights, for instance.

    It would also answer some long-standing questions about artificial intelligence. Tononi argues that the basic architecture of the computers we have today – made from networks of transistors – preclude the necessary level of information integration that is necessary for consciousness. So even if they can be programmed to behave like a human, they would never have our rich internal life.

    “There is a sense, according to some, that sooner rather than later computers may be cognitively as good as we are – not just in some tasks, such as playing Go, chess, or recognising faces, or driving cars, but in everything,” says Tononi. “But if integrated information theory is correct, computers could behave exactly like you and me – indeed you might [even] be able to have a conversation with them that is as rewarding, or more rewarding, than with you or me – and yet there would literally be nobody there.” Again, it comes down to that question of whether intelligent behaviour has to arise from consciousness – and Tononi’s theory would suggest it’s not.

    Although the concept of group consciousness may seem like a stretch, Tononi’s theory might help us to understand how large bodies of people sometimes begin to think, feel, remember, decide, and react as one entity

    He emphasises this is not just a question of computational power, or the kind of software that is used. “The physical architecture is always more or less the same, and that is always not at all conducive to consciousness.” So thankfully, the kind of moral dilemmas seen in series like Humans and Westworld may never become a reality.

    It could even help us understand the ways we interact with each other. Thomas Malone, director of the Massachusetts Institute of Technology's Center for Collective Intelligence and author of the book Superminds, has recently applied the theory to teams of people – in the laboratory, and in real-world, including the editors of Wikipedia entries. He has shown that the estimates of the integrated information shared by the team members could predict group performance on the various tasks. Although the concept of “group consciousness” may seem like a stretch, he thinks that Tononi’s theory might help us to understand how large bodies of people sometimes begin to think, feel, remember, decide, and react as one entity.

    He cautions this is still very much speculation: we first need to be sure that integrated information is a sign of consciousness in the individual. “But I do think it’s very intriguing to consider what this might mean for the possibility of groups to be conscious.”

    For now, we still can’t be certain if a lobster, computer or even a society is conscious or not, but in the future, Tononi’s theory may help us to understand ‘minds’ that are very alien to our own

    Humans didn’t start out being able to digest animal milk – but now many populations do. Why has evolution favoured tolerating dairy?

    By Michael Marshall

    Dairy milk has competition. Alternative “milks” made from plants like soya or almonds are increasingly popular. These alternatives are often vegan-friendly and can be suitable for people who are allergic to milk, or intolerant of it. The runner-up in the 2018 series of The Apprentice (UK) ran a flavoured nut milk business.

    But the rise of alternative milks is just the latest twist in the saga of humanity’s relationship with animal milk. This relationship dates back thousands of years, and it has had a lot of ups and downs.

    When you think about it, milk is a weird thing to drink. It’s a liquid made by a cow or other animal to feed its young; we have to squirt it out of the cow’s udders to obtain it.

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    In many cultures it is almost unheard of. Back in 2000, China launched a nationwide campaign to encourage people to consume more milk and dairy products for health reasons – a campaign that had to overcome the deep suspicions of many older Chinese people. Cheese, which is essentially milk that has been allowed to go off, can still make many Chinese people feel sick.

    Set against the 300,000-year history of our species, drinking milk is quite a new habit. Before about 10,000 years ago or so, hardly anybody drank milk, and then only on rare occasions. The first people to drink milk regularly were early farmers and pastoralists in western Europe – some of the first humans to live with domesticated animals, including cows. Today, drinking milk is common practice in northern Europe, North America, and a patchwork of other places.

    Baby food

    There is a biological reason why drinking animal milk is odd.

    Milk contains a type of sugar called lactose, which is distinct from the sugars found in fruit and other sweet foods. When we are babies, our bodies make a special enzyme called lactase that allows us to digest the lactose in our mother’s milk. But after we are weaned in early childhood, for many people this stops. Without lactase, we cannot properly digest the lactose in milk. As a result, if an adult drinks a lot of milk they may experience flatulence, painful cramps and even diarrhoea. (It’s worth noting that in other mammals, there aren’t any lactase-persistent adults – adult cows don’t have active lactase, and neither do cats or dogs, for example).

    So the first Europeans who drank milk probably farted a lot as a result. But then evolution kicked in: some people began to keep their lactase enzymes active into adulthood. This “lactase persistence” allowed them to drink milk without side effects. It is the result of mutations in a section of DNA that controls the activity of the lactase gene.

    “The first time that we see the lactase persistence allele in Europe arising is around 5,000 years BP [before present] in southern Europe, and then it starts to kick in in central Europe around 3,000 years ago,” says assistant professor Laure Ségurel at the Museum of Humankind in Paris, who co-authored a 2017 review of the science of lactase persistence.

    The lactase persistence trait was favoured by evolution and today it is extremely common in some populations. In northern Europe, more than 90% of people are lactase persistent. The same is true in a few populations in Africa and the Middle East.

    But there are also many populations where lactase persistence is much rarer: many Africans do not have the trait and it is uncommon in Asia and South America.

    It is hard to make sense of this pattern because we don’t know precisely why drinking milk, and therefore lactase persistence, was a good thing, says Ségurel: “Why was it so strongly advantageous in itself?”

    The obvious answer is that drinking milk gave people a new source of nutrients, reducing the risk of starvation. But on closer inspection this doesn’t hold up.

    “There’s a lot of different sources of food, so it’s surprising that one source of food is so important, so different from other sorts of food,” says Ségurel.

    People who are lactase-non-persistent can still eat a certain amount of lactose without ill effects, so drinking a small amount of milk is fine. There is also the option of processing milk into butter, yoghurt, cream or cheese – all of which reduce the amount of lactose. Hard cheeses like cheddar have less than 10% as much lactose as milk, and butter is similarly low. (Read more about parmigiano, a cheese with so little lactose it can be eaten by the lactose-intolerant). “Heavy cream and butter have the lowest lactose,” says Ségurel.

    Accordingly, people seem to have invented cheese rather quickly. In September 2018, archaeologists reporting finding fragments of pottery in what is now Croatia. They carried fatty acids, suggesting that the pottery had been used to separate curds from whey: a crucial step in making cheese. If that is correct (and the interpretation has been questioned), people were making cheese in southern Europe 7,200 years ago. Similar evidence from slightly more recent times, but still more than 6,000 years ago, has been found elsewhere in Europe. This is well before lactase persistence became common in Europeans.

    That said, there is clearly a pattern behind which populations evolved high levels of lactase persistence and which didn’t, says genetics professor Dallas Swallow of University College London. Those with the trait are pastoralists: people who raise livestock. Hunter-gatherers, who do not keep animals, did not acquire the mutations. Neither did “forest gardeners” who cultivated plants, but not livestock.

    It makes sense that people who did not have access to animal milk were not under great evolutionary pressure to adapt to drinking it.

    The question is, why did some pastoralist people acquire the trait and not others?

    Ségurel points to east Asian herding peoples, such as those in Mongolia, who have some of the lowest rates of lactase persistence even though they rely heavily on milk from their animals for food. The mutations were common in nearby populations in Europe and western Asia, so it would have been possible for them to spread into these east Asian groups, but they didn’t. “That’s the big puzzle,” says Ségurel.

    Dairy benefits

    Drinking milk might have other advantages besides its nutritional value

    She speculates that drinking milk might have other advantages besides its nutritional value. People who keep livestock are exposed to their diseases, which can include anthrax and cryptosporidiosis. It may be that drinking cow’s milk provides antibodies against some of these infections. Indeed, milk's protective effect is thought to be one of the benefits of breastfeeding children.

    But some of the mysterious absences of lactase-persistence could be down to sheer chance: whether anyone in a group of pastoralists happened to get the right mutation. Until fairly recently there were a lot fewer people on Earth and local populations were smaller, so some groups would miss out by plain bad luck.

    “I think the most coherent part of the picture is that there’s a correlation with the way of life, with pastoralism,” says Swallow. “But you have to have the mutation first.” Only then could natural selection go to work.

    In the case of Mongolian herders, Swallow points out that they typically drink fermented milk, which again has a lower lactose content. Arguably, the ease with which milk can be processed to be more edible makes the rise of lactase persistence even more puzzling. “Because we were so good at adapting culturally to processing and fermenting the milk, I’m struggling with why we ever adapted genetically,” says Swallow’s PhD student Catherine Walker.

    There may have been several factors promoting lactase persistence, not just one. Swallow suspects that the key may have been milk’s nutritional benefits, such as that it is rich in fat, protein, sugar and micronutrients like calcium and vitamin D.

    It is also a source of clean water. Depending on where your community lived, you may have evolved to tolerate it for one reason over another.

    It’s unclear whether lactase persistence is still being actively favoured by evolution, and thus whether it will become more widespread, says Swallow. In 2018 she co-authored a study of a group of pastoralists in the Coquimbo region of Chile, who acquired the lactase-persistence mutation when their ancestors interbred with newly-arrived Europeans 500 years ago. The trait is now spreading through the population: it is being favoured by evolution, as it was in northern Europeans 5,000 years ago.

    But this is a special case because the Coquimbo people are heavily reliant on milk. Globally, the picture is very different. “I would think it’s stabilised myself, except in countries where they have milk dependence and there is a shortage [of other food],” says Swallow. “In the West, where we have such good diets, the selective pressures are not really likely to be there.”

    Dairy decline?

    If anything, the news over the last few years offers the opposite impression: that people are abandoning milk. In November 2018, the Guardian published a story headlined “How we fell out of love with milk”, describing the meteoric rise of the companies selling oat and nut milks, and suggesting that traditional milk is facing a major battle.

    But the statistics tell a different story. According to the 2018 report of the IFCN Dairy Research Network, global milk production has increased every year since 1998 in response to growing demand. In 2017, 864 million tonnes of milk were produced worldwide. This shows no sign of slowing down: the IFCN expects milk demand to rise 35% by 2030 to 1,168 million tonnes. (Read more about how milk became a staple food in industrialised societies).

    Still, this masks some more localised trends. A 2010 study of food consumption found that in the US milk consumption has fallen over the last few decades – although it was replaced with fizzy drinks, not almond milk. This fall was balanced by growing demand in developing countries, especially in Asia – something the IFCN has also noted. Meanwhile, a 2015 study of people’s drinking habits in 187 countries found that milk drinking was more common in older people, which does suggest that it is less popular with the young – although this says nothing about young people’s consumption of milk products like yoghurt.

    Still, it seems unlikely that alternative milks will make much of a dent in the world’s growing appetite for milk, at least over the next decade.

    Walker adds that alternative milks are “not a like-for-like substitution” for animal milk. In particular, many don’t have the same micronutrients. She says they are most useful for vegans and for people allergic to milk – the latter being a reaction to milk protein, and nothing to do with lactose.

    It’s particularly striking that so much of the growth in milk demand is in Asia, where most people are non-lactase-persistent. Whatever advantages the people there see in milk, they outweigh the potential digestive issues or the need to process the milk.

    In fact, the United Nations Food and Agriculture Organisation has pushed for people in developing countries to keep more non-traditional dairy animals, such as llamas, so that they can obtain the benefits of milk even if cow’s milk is unavailable or too expensive.

    What’s more, a major study published in January described a “planetary health diet” that is designed to both maximise health and minimise our impact on the environment. While it entails drastically cutting down on red meat and other animal products, it nevertheless includes the equivalent of one glass of milk a day.

    Milk, it seems, is not down and out. If anything it’s still on the up – even if our bodies have mostly stopped evolving in response to it

    Cervical cancer is the third most common type of cancer among women in Sri Lanka. It is a significant reproductive health problem, and estimates for 2018 alone shows that around 1,136 new cases of cervical cancer are diagnosed annually in Sri Lanka. Human papillomavirus (HPV) is the primary cause of cervical cancer, which is a highly contagious infection that is transmitted through sexual activity.This is one of the conditions screened for at the Well Woman Clinics in Sri Lanka, which includes screening for hypertension, nutritional status, diabetes, breast abnormalities, cervical abnormalities, family planning status, menstrual disorders, reproductive tract infections and perimenopausal or menopausal problems.

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