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Why it’s so hard to get better drugs for neglected diseases

2026-05-07T11:00:00+00:00

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Hello from Nairobi.

The weekend brought in a bit of natural chaos: rains torrential enough to bring down trees near my home, and marauding Sykes’ monkeys in numbers sufficient to convince me I may never eat the soursops growing in my back yard. (I have long since given up on the mangoes.)

This week we’ve got a proper hodgepodge. A story on why it’s still so hard to get better drugs to people with neglected diseases, even after real medical advances. A damning investigation into an AI-driven health insurance system. Updates on both the widening health toll of conflicts in the Middle East, and the stall in a global pandemic treaty, and, finally, a rare virus trapped on a quarantined cruise ship.

My name is William Herkewitz, and I’m a journalist based in Nairobi, Kenya. This is the Global Health Checkup, where I highlight some of the week’s most important stories on outbreaks, medicine, science, and survival from around the world.

With that, as we say in Swahili: karibu katika habari — welcome to the news.

The neglected disease trap for better drugs

We’ll start with a story out in Nature that cleanly captures the maddening challenge to treat and cure some of the world’s most neglected diseases.

Enter our hero: moxidectin.

It’s a drug that’s both safe and proven since 2018 as a dramatic improvement for preventing and treating two widespread parasitic diseases (river blindness and elephantiasis).

The problem for moxidectin? The uptake has been an uphill battle.

Disease breakdown: River blindness, also known as onchocerciasis, is a parasitic disease that’s spread by biting blackflies, which breed in rapidly flowing rivers. The nightmarish parasites grow in the skin and eyes, which cause intense itching, scarring, and lesions that can lead to permanent blindness. There are an estimated 20 million cases of this disease, almost entirely on the African continent, and 250 million people require preventive treatment.
Disease breakdown: Elephantiasis is another terrifying parasitic disease, this one spread by mosquitoes. It can cause extreme swelling in limbs or other tissues (commonly in the breasts and genitals) and skin thickening. Hence the name, which is Greek-derived for “elephant-like disease.” There are an estimated 51 million cases of this disease across the equatorial world, and over 650 million people require preventive treatment.

To be clear, moxidectin’s efficacy is not in question.

For river blindness, clinical trials have shown that it lasts longer in the body and appears to clear parasites “86%” more effectively than the current treatment, an anti-parasite drug called ivermectin. The same is true for elephantiasis. In one small trial referenced in the article, the drug cleared parasites in about 95% of patients, compared with 32% for existing treatments.

The drug itself also has a unique backstory. It was invented in the ‘80s for livestock use, but it wasn’t until last decade that it jumped the expensive hoops for human clinical trials.

Those decades of lag is largely because there’s not a lot of commercial incentive for pharmaceutical companies to invest in something like moxidectin. (Even if the World Health Organization says nearly 900 million total people can use it!) After all, its target market is mostly the very poorest people in the world. And for both diseases, other treatments already exist, even if moxidectin appears to work better.

Instead, it took the altruistic efforts of an organization called Medicines Development for Global Health, a non-profit pharmaceutical company that focuses on neglected diseases, to run the trial gauntlet. And they made history doing so.

As the article outlines, this “development, regulatory approval, and [rollout] without involvement of a commercial pharmaceutical partner…” was “a first-of-its-kind achievement for a non-profit company.”

Where are we now?

While moxidectin was finally approved for river blindness in 2018, its first real-world rollout is only now underway in Ghana, “where around 120,000 people received the new treatment last year.”

Part of the delay is pure regulatory bureaucracy. Countries and the WHO still have to review the data and issue guidance. Part of it is also logistical. After all, someone has to manufacture, buy, and distribute the stuff.

But the cruelest delay is, again, financial: Ivermectin, the older and weaker drug, is donated for free by the pharma company Merck. Moxidectin’s nonprofit maker can offer it at a reduced cost, but not for free. So, as you might imagine, competing with a free pill… makes for a hard sell, especially in an era of tightening budgets.

What’s my takeaway? I said this at the top, but this is a maddening story. The layers of systems built around neglected diseases, even in the face of medical advancements, still seem almost designed to make success as hard as possible.

Still, if there is a silver lining, it’s that there are organizations like Medicines Development for Global Health nevertheless trying to exploit the various cracks in that broken system to get better drugs, slowly, into people’s hands.

Stalled pandemic negotiations, part 2

A month ago, we covered the stalled global pandemic treaty, and noted the sticking point to progress: “one final, unresolved section known as Pathogen Access and Benefit Sharing. Basically an agreement on how countries will share bacteria/virus samples of the next pandemic, and how medicines and tests developed from those samples will be distributed.”

The issue basically being that: Poorer countries are being asked to quickly share samples, but they want guarantees that they won’t be last in line for the vaccines, tests, and treatments made from them… like, uh, they were last time.

Well, Reuters is reporting that WHO member states have now even further extended talks on this same unresolved section, “casting doubt on when a pandemic treaty adopted last year can ‌come into effect.”

To be clear, until these final negotiations finish, there is no active treaty (even though the unfinished treaty was technically signed in 2025).

It’s a terrible limbo of inaction. If another pandemic were to emerge tomorrow, we’d still be at the same place we were in early 2020: no settled rulebook on how we work together as a global community, and (assuredly) plenty of consternation to go around.

What’s to be done? I came across a useful essay by three global health law experts, published almost exactly one year ago. And their argument, today, is all the more salient: This final, unresolved section is buckling because it’s trying to solve two extremely hard problems at once.

“Pathogen and data sharing [and] pharmaceutical supply and distribution… both are vital activities that would be more effectively addressed separately,” they write. But, (and here’s my favorite quote from the essay) “exactly why member states think they can resolve the most contentious issues of the preceding three years simply because it is in a separate annex… is rather baffling.”

Ultimately, their sharper point is that these negotiations are being asked to do too much political work. Because the fight isn’t really about technical details anymore, it’s about trust.

The world needs countries to share dangerous pathogens quickly. And poorer countries need some assurance that they won’t once again help create lifesaving tools they can’t access. But both of these issues may be easier to solve if they are not forced into the same all-or-nothing negotiation.

The takeaway? Break up the negotiations!

Counting global conflict’s health toll

There are two data-heavy stories worth your time this week on the widening fallout from conflicts in the Middle East.

First up, Reuters reports that attacks on health care workers and health facilities are rising globally, with the recent Middle East conflicts driving a clear jump.

By the numbers: Before the outbreak of fighting in Iran and Lebanon, the WHO said “attacks globally on such facilities and staff averaged about 3.7 per day.” But that has now risen to an average of 4.3 attacks per day.

“This is clearly showing that health care is the target,” Altaf Musani, the WHO’s director of emergency health, told Reuters

And that’s not even the bleakest figure in the story!

Here are several more: Since March, Lebanon alone has seen 149 attacks on health care, according to the WHO. Gaza is down to just one fully functioning hospital. In Sudan, only half of hospitals are fully operational. As Musani put it, where “health care is needed most, it is being attacked.”

Meanwhile, The Guardian has a figure-filled story on how the blockade in the Strait of Hormuz has disrupted the global supply chain for humanitarian aid.

To be clear, only part of the issue is food and medicine that’s directly stuck in the strait. For example, how the International Rescue Committee told The Guardian that $130,000 worth of supplies for 20,000 people in Sudan is still stranded in Dubai.

Rather, the big killer is fuel shortages and rising prices, which are in full swing. Like in Nigeria and Ethiopia, where “government oil rations meant the emergency relief body [the International Rescue Committee] was having to limit generator use in its health clinics.”

Save the Children also estimates that every $5 increase in the price of a barrel of oil is costing the charity an additional “$340,000 a month” in shipping, fuel, food, and medical supplies. And if oil stays around $100 a barrel through 2026, that could mean an extra $27 million in costs this year.

In response, humanitarian leaders are calling for a humanitarian corridor through the Strait of Hormuz to freely move food and medical supplies, alongside fuel to address these humanitarian crises. (Which is, let’s be real, an extremely unlikely resolution.)

This is clearly an ongoing story, and one we’ll keep watching.

HealthInsuranceGPT

Sorry, but it’s dealer’s choice for this next one. (When a global health story lands in Nairobi, I’m going to cover it!) The Guardian just published a damning investigation on Kenya’s new national health insurance program.

In short: That program is based on an “AI system used to predict how much Kenyans can afford to pay for access to health care,” but which has “systemically driven up costs for the poor.”

(If you’re tempted to skip this because you’re not especially invested in one country’s health insurance system, fair enough. But you can read this as a broader, cautionary tale about handing off messy human decisions to opaque artificial intelligence systems.)

According to the report, the 2-year-old AI system has been, from the start, “systematically overcharging the poorest Kenyans … while undercharging the wealthiest by underestimating their incomes.”

The core issue is that the “system is structured on a decades-old World Bank bugbear: proxy means testing,” which is “a way of estimating the incomes of the poor based on their possessions and other life circumstances, such as how many children they have or whether they live alone.”

In practice, “this has meant deploying government volunteers … across the country to register their roofing materials, livestock, and children – and feeding those details into an opaque algorithm to decide how much they earn and how much they must pay.”

The end result, according to the reporting, is a widespread mess of misclassification: with “critically ill people who cannot get treatment,” and families “facing a sum of between 10% and 20% of meager incomes.”

“People are dying, people are suffering,” said one of the officials registering families under the system in Nairobi.

Ultimately, The Guardian reports that there is “not a single reason” for these inaccuracies. “Poverty is a fluid category – and using factors such as an iron roof or a pit toilet to estimate a family’s wealth is an intrinsically imprecise undertaking.”

There is one last point worth noting: As development economist Stephen Kidd told The Guardian, failures like this don’t just get numbers wrong and cost lives, they also reduce public faith in government services. “It feels like a lottery,” he said. “The lottery is not a great way of building trust.”

The Hantavirus cruise

I’ll leave you with a story I initially dismissed as too small, but which I’ve come across enough times in enough outlets that I just have to flag.

The BBC reports that a Dutch-operated cruise ship (the MV Hondius) was moored off Cape Verde after a suspected hantavirus outbreak killed three people and left another passenger seriously ill. The ship was sailing from Argentina to the Canary Islands.

In port, two more cases were confirmed. On Wednesday, the ship departed Cape Verde was heading to Spain’s Canary Islands with nearly 150 people on board, the Associated Press reported.

Disease breakdown: Hantavirus is a family of rare viruses usually carried by rodents. People typically get infected by breathing in particles from infected rodent urine, droppings, or saliva. It can cause severe respiratory illness, with symptoms appearing one to eight weeks after exposure. (A lag that can allow cases to silently accumulate.) Human-to-human spread is rare, but has been documented with the Andes virus in South America. There is no specific treatment or vaccine, so care is mostly supportive.

One source at the WHO told the BBC that in this case, some person-to-person spread may have happened among close contacts sharing cabins, but the first infection could also have come from rodents before the ship left Argentina, or during one of its stops.

Still, there’s more questions than answers as of yet.

(Only modestly related here, but this news reminds me of a story I wrote about 12 years ago for Popular Mechanics. I was helping at my father’s automotive shop and we found rats living in a Porsche’s cabin air filter. A Centers for Disease Control and Prevention ecologist told me that was “an ideal way to spread an airborne virus,” since the car’s vents were blowing particles from rodent droppings or urine straight into an unlucky customer’s face.)

Anyhow… a rare virus, a stranded cruise ship, several deaths, and no clear answer yet on where the outbreak began?

Fine. It gets the closing slot!

I’ll see you next week,

William

William Herkewitz is a reporter covering global public health for Healthbeat. He is based in Nairobi. Contact William at wherkewitz@healthbeat.org.

Researchers warn of threats – to humans and native plants – from little-known ant

2026-05-01T18:32:46+00:00

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Researchers in the South want people to know about an invasive ant species whose painful sting can cause fatal anaphylaxis in some people – and disrupt local ecologies as well.

Asian needle ants are not widely known and often meander outdoors individually, so it’s easy to miss them and get stung. As temperatures grow warmer in the spring, the ants become more active and people spend more time outside.

Dan Suiter, an entomologist with the University of Georgia’s extension service, received calls from three people in 2024 reporting being stung by Asian needle ants and requiring hospitalization for anaphylaxis, an allergic reaction that can be fatal.

Suiter said he wants to make sure people know about the Asian needle ant so they can avoid stings. Since he began putting out press alerts over the past few years, he’s received many more reports from people who were stung and needed serious medical treatment.

@healthbeatnews
Researchers in the South want people to know about an invasive ant species whose painful sting can cause fatal anaphylaxis in some people – and disrupt local ecologies as well. #AsianNeedleAnts are not widely known and often meander outdoors individually, so it’s easy to miss them and get stung. As temperatures grow warmer in the spring, the ants become more active and people spend more time outside. Learn more about the Asian needle ant and how to minimize risk at healthbeat.org. #ants #insects #georgia #south
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The species, discovered in Decatur, Georgia about a century ago, likely arrived in the United States through international trade.

The ant has been reported in more than 20 states east of the Mississippi River, from Florida to Wisconsin, according to data from the Global Ant Biodiversity Informatics project at the University of Hong Kong.

One study published last year found the ants thriving in a community mulch pile in Watkinsville, Georgia. Gardeners taking mulch from the pile could be contributing to the ant’s local spread, the authors wrote.

The species has a 100-year head start on researchers, and they lack good historical data as to how the ant has spread in the United States, said Christopher Hayes, an entomologist at North Carolina State University.

How invasive ants can affect the environment

As with other invasive species – like kudzu – it’s too embedded in the environment to successfully remove it, Hayes said.

In the Southeast, fire ants and Joro spiders are well-known invasive species.

Scientists are seeking to better understand the Asian needle ant: where it is, its habitat, and its environmental impact. That’s important, Hayes said, because the ant can harm ecological systems.

“On a daily basis, you have these multiple species that they’re always competing with one another,” Suiter said. Asian needle ants “out-compete” other ant species for food, driving those species to “local extinction.”

That’s a problem because those species are often responsible for seed dispersal that allows native plant species to reproduce, he said.

Hayes said he would like to figure out how to preserve native species and mitigate the Asian needle ant’s environmental impact.

Painful sting can prompt anaphylaxis, phantom pain

Allergic reactions to stings by honeybees, wasps, and ants account for up to 43% of anaphylaxis cases and about 20% anaphylaxis-related fatalities. That makes them an important, if sometimes underrecognized, public health issue, according to a 2022 study.

Suiter said people who are allergic to bees and wasps and those who carry EpiPens should know what the Asian needle ant looks like so they can avoid a potentially serious allergic reaction.

Asian needle ants crawl along decaying wood and leaves.

As temperatures warm and summers grow longer, Hayes said, the Asian needle ant will have longer active seasons. While the ants typically “hunker down” over the winter, they become more active in warmer weather, meaning people will have more chances of being exposed to them.

The ants don’t come indoors, instead preferring moist environments, like downed logs, Suiter said.

The ants, whose scientific name is Brachyponera chinensis, are brownish, measure 3/16-inch long, and often live in logs and leaf litter and under rocks and stones.

“One of the ways to minimize the numbers of needle ants in your yard would be simply to clean up all that,” Suiter said.

Asian needle ants are less aggressive than fire ants, Hayes said. They are “stealthier” and more likely to be hidden in piles of wood than the fire ant mounds that Southerners are used to seeing.

And while fire ants are more likely to come pouring out of a mound and bite people multiple times, Asian needle ants will “meander around on your arms” or other body parts until they get squeezed, such as in a gardener’s glove, prompting them to bite, Hayes said.

In contrast to most other ant species that form long trails, Asian needle ants tend to go it alone.

“When you see them in your yard or on the concrete, they’re just kind of meandering around as a single ant, and they don’t really garner your attention” the way ants in long trails might, Suiter said.

“With the Asian needle ant, their rate of triggering anaphylaxis from a single sting is much higher than the rate of a fire ant individual sting triggering anaphylaxis,” Hayes said. “The sting of an Asian needle ant is more dangerous on the individual ant level.”

(Colloquially most people say they were “bitten” by an ant, Hayes said. In reality, most ants first bite people and then either sting with venom or spray an acid.)

The sting looks different than a fire ant sting, which looks like a small zit with a white pustule, Suiter said. Asian needle ant stings have small red dot surrounded by swelling, similar to a yellow jacket sting.

People who are allergic to other insects like bees and wasps are most at risk of anaphylaxis, Hayes said, because the venom is similar.

But there are reports of people with no history of allergies or anaphylaxis also having severe reactions to the Asian needle ant, Hayes and Suiter said.

If you do think you’ve been stung, keep an eye on the site and mark any swelling or redness with a marker on your skin so you can tell if it spreads. If it does spread, or you have difficulty breathing, seek medical advice right away, Hayes said.

He has been stung before – “for science” – and said the sting felt like fiberglass underneath his skin, different from how a fire ant’s sting feels. He keeps an EpiPen and Benadryl on hand to help manage allergic reactions.

The Asian needle ant has an unusual feature: It can cause pain hours after the initial sting, even up to 24 or 48 hours later.

Hayes said his young son was stung last summer and woke up hours later screaming in pain.

Suiter also reported the pain returning hours later after a sting. “It’s got kind of a bizarre response,” he said.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Scientists find clue to cause of noma, an illness that disfigures children across Africa

2026-04-30T11:00:00+00:00

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Hello from Nairobi.

This week we’re following some remarkable medical advances: a potential breakthrough in a long-neglected disease, and new treatments and tests for the world’s deadliest parasite. We also have an update to last week’s story on American HIV aid, and, at the end, a sci-fi-meets-Ken-Kesey story that combines psychedelic toad-licking, ayahuasca, tobacco, and genetically engineered bacteria.

With that, as we say in Swahili: karibu katika habari — welcome to the news.

‘Astonishing discovery’ for a little-studied, disfiguring disease

Scientists believe they may have finally found the root cause of noma, a disfiguring illness in the sad bucket of “neglected tropical diseases,” The Guardian reports.

Disease breakdown: Noma is a rare but rapidly progressing disease of the mouth and face. It’s largely a children’s disease of poverty, with no single, proven cause, but an estimated 30,000 to 140,000 cases a year. Most cases are in children under 6 years old, across a belt of African countries from Mauritania to Nigeria to Ethiopia. Untreated, it kills 90% of those affected, and even with treatment the heartbreaking disease often leaves lifelong facial deformities and scars.

The new discovery was a bit serendipitous. Researchers at the Liverpool School of Tropical Medicine set out to map the bacteria living in the mouths of 19 children with noma across Nigeria. In the process, they uncovered a previously unknown species of bacteria, now called Treponema A.

The obvious question followed: Could this be the cause of the illness? To make sure it wasn’t a fluke, the researchers went back to “reanalyze older samples from other noma patients” and found the same bacteria there, too.

As The Guardian reports, this “astonishing discovery” doesn’t necessarily prove that the new bacteria cause the disease, but it certainly gives scientists something concrete to chase. As one researcher put it, “we don’t know if [Treponema A] can colonize a noma wound, because of the architecture and the environment, or if it causes the noma wound.”

Still, it’s an incredible starting point.

I reached out to Stuart Ainsworth, an infection biology and microbiome expert at the University of Liverpool, and part of the team behind the discovery. We discussed what this finding means and what it shows about the value of researching neglected diseases.

I started by asking Ainsworth how a disease this severe could still have such basic unanswered questions, and how a lead like this could have gone unnoticed for so long. Ainsworth was frank: “There has hardly been any research on noma at all,” he said.

He pointed to a 2021 review of the history of noma research, which found that there have only been 147 studies done on the disease since the year 1850. “In comparison, there were around 650 papers on rabies in 2021 alone,” he told me.

The core issue is that noma, Ainsworth says, “is the quintessential neglected disease. It only affects the very poorest in society and typically occurs in remote rural regions.” And because those who aren’t killed by the disease are often “left debilitated and scarred and generally hidden from society,” he said, “there is little impetus globally to invest in research.”

It’s a brutal dynamic, and one that cuts to the core purpose of medical research. “The goal with all diseases is to eradicate them, or at least control them to the point where they are no longer an issue.” And yet, “all of these things are impossible if you do not have at least a very basic understanding of what is the cause of the disease,” he said.

But that bleak starting point is also what gives this kind of scientific work such an incredible upside. “We know so very little” about noma that even “simple targeted research could potentially have a huge impact,” he said.

Looking forward, Ainsworth says further research could help move beyond the current treatment for noma, which is a shotgun approach of broad antibiotics, and that “we hope that these types of studies will eventually enable us to develop the targeted prevention, diagnostic, and treatment options to eradicate or prevent noma.”

A stalling fight against HIV, part 2

Last week we covered new data that showed U.S.-funded HIV treatment holding steady on paper, but testing, prevention, and case detection dropped sharply, raising fears about a surge in new infections.

Well, there are a few follow-on stories that are worth your time.

(First, we’re owed a correction. I flagged the State Department’s claim that “20.6 million people” are on HIV treatment, but it appears that the official figures don’t actually match the underlying data, which puts the number closer to 20.3 million.)

Second, the person in charge of the science behind that data just left. Mike Reid, the HIV program’s chief science officer, stepped down. He blames a system where American HIV aid is being “entangled with access to critical minerals or geopolitical positioning,” to the detriment of the work, Reuters reports.

Reid posted a full essay on Substack upon his departure, and there are a few sections worth pulling out to understand why he walked.

Reid starts with the core shift:

“When life-saving health assistance, often beyond the immediate capacity of partner countries, is conditioned on unrelated commercial or strategic objectives, something essential is lost … That is not a marginal adjustment. It is a different model. And I do not believe that model is consistent with the purpose of global health. I do not believe it serves patients, or countries, or ultimately even the long-term interests of the United States.”

He follows with a strikingly blunt assessment, which directly contradicts the State Department’s framing, and echoes what many HIV experts have been warning about.

“We have asked partner governments to take on substantial new responsibilities despite constrained fiscal space, high levels of sovereign debt, and growing demographic pressures, all while programs themselves have been weakened by recent U.S. funding cuts. In places like Zambia, which I care about deeply, the consequences of stepping away too abruptly could be devastating, and avoidable. I have to take that possibility seriously.”

Ultimately, Reid casts his resignation as a break with the core idea of the field itself. “I’ve believed that global health — at its best — is a form of solidarity. Not charity. Not strategy.” And now, that very belief “is why I am resigning my post as chief science officer at PEPFAR in the U.S. State Department.”

A malaria drug for newborns

For the first time, there’s a malaria drug for newborns, Deutsche Welle reports.

Disease breakdown: Malaria is the world’s deadliest parasitic disease. The parasite spreads almost entirely through mosquito bites, then moves into the blood and causes cycles of fever, chills, and severe anemia. Young children are hit hardest because they have little natural immunity. The disease is preventable and treatable. Vaccines exist, but they reduce risk rather than eliminate the threat altogether.

The treatment was just approved by the World Health Organization for “babies weighing less than 5 kilograms (11 pounds).” Its development closes what was previously a “medical care gap for 30 million babies born each year in malaria-endemic areas" across Africa, which is by far the hardest-hit continent.

Technically, it’s a new formulation of two existing treatments: artemether and lumefantrine, which were developed thanks to a secret Chinese military project in the ’60s and ’70s to aid the North during the Vietnam war. (Really!)

Together, the drugs hijack the malaria parasite’s eating process, so that the blood molecules (hemoglobin) that should feed it actually end up destroying it.

You may be asking: If this is the first ever treatment, how have sick infants been treated until now? Well, routinely “infants have been treated with drugs developed for older children,” an imperfect workaround, as these drugs can “expose newborns to risks of dosing errors and toxicity.”

My takeaway: It’s encouraging that medical science keeps providing tools to fight and treat this disease. Earlier this month, the WHO also approved three new rapid tests for “malaria parasites [that] have evolved to become harder to detect,” as they stopped producing the molecule that older tests relied on.

Very timely! In some countries in the Horn of Africa (like Ethiopia, Djibouti, and Somalia), those tests started missing “up to 80% of cases.”

India’s largest pharma deal

India’s largest drugmaker, Sun Pharmaceutical Industries, has just made the country’s “largest pharma deal,” Reuters reports.

The company has agreed to buy the U.S.-based Organon & Co. It’s an $11.75 billion all-cash deal, the most expensive overseas acquisition ever by an Indian company.

Why does this matter?

Let me pepper in a bit of context: As we’ve written before, India, the “pharmacy of the world,” is where a fifth of all generic drugs and well over half of all vaccines are manufactured. And Sun Pharma is India’s biggest drugmaker by revenue, churning out over a thousand separate medicines and drug ingredients. A true generics giant, those drugs include everything from diabetes treatments and psychiatric drugs to cancer therapies and dermatology medicines.

Meanwhile, Organon (which started as an insulin producer over 100 years ago) makes specialty medicines: contraceptives and drugs for pregnancy and menopause, along with a variety of other hormone-based therapies. Although it’s a minnow in the American market, it produces “70 women’s health and general medicines sold across about 140 countries.”

If you scan through the link you’ll see that the Reuters story is a business one, full of debt figures and deal details. What’s more interesting is what this deal reflects about India’s pharma sector more broadly.

The big takeaway is this: India’s pharmaceutical sector is enormous, and only growing. Many projections have the entire sector doubling in value from 2025 to just 2030. Much of that growth is expected to come from a shift out of cheap generics into specialty medicines, and so this is exactly the kind of deal that will help make that shift real.

Whatever you do, don’t smoke this

Let’s end on a fairly wild story from New Scientist: A research group based at the Weizmann Institute of Science in Israel has "engineered tobacco plants to produce five powerful psychedelic compounds,” all in a single plant.

As the authors argue, this could offer a more sustainable way to produce psychedelic drugs, “which are increasingly in demand for research and medical uses.”

What I find particularly interesting about this story isn’t just the tie dye-inducing tobacco plant. It’s the fascinating technique the scientists used, which lands just shy of permanent gene-editing.

Here’s the explainer from the story:

“[The scientists] modified Nicotiana benthamiana plants using a technique called agroinfiltration, which involves using a bacterium to introduce genes from other organisms into a plant. The modified plant then makes the proteins encoded by those genes, but the DNA isn’t incorporated into the plant’s genome, so the effect is short-lived.”

Ultimately, those bacteria induced the tobacco plants to produce psilocin and psilocybin, two compounds found in “magic mushrooms”; DMT, which is found in the psychoactive drink ayahuasca; and bufotenin and 5-methoxy-DMT, which are secreted by Colorado river toads.

The researchers argue that their method is a much easier way to produce these molecules for medical testing than, say, raising cages full of toads. And it’s doing it across biological kingdoms, creating compounds from fungi, plants, and animals in a single organism.

The takeaway: As the article outlines, “the idea of growing drugs through pharmaceutical farming, or ‘pharming,’ certainly isn’t new.” As far back as 2002, we’ve had corn engineered to produce trypsin, a digestive enzyme. But doing it temporarily, without forever altering the plant’s genome, limits the risk of these traits escaping or persisting in the wild.

And heck, it makes the infamous “Simpsons” “tomacco” plant look as everyday as a steamed ham.

Until next week,

William

William Herkewitz is a reporter covering global public health for Healthbeat. He is based in Nairobi. Contact William at wherkewitz@healthbeat.org.

Psychedelics offer exciting promise for mental health – if rolled out right

2026-04-29T11:00:00+00:00

Public health, explained: Sign up to receive Dr. Jay K. Varma’s reports in your inbox a day early.

Hello and welcome to Healthbeat’s weekly report on stories shaping public health in the United States.

I am Dr. Jay K. Varma, a physician, epidemiologist, and public health expert currently serving as chief medical officer at Fedcap, a global nonprofit that promotes economic mobility and well-being for vulnerable communities. Views expressed here are my own.

This week I am reminded how little we know about the brain and how that lack of understanding impairs our ability to address two of the most serious public health problems in America: severe mental illness and dementia.

A White House event was either a historic turning point for mental health or a dangerous workaround of the Food and Drug Administration’s safety regulations; and a new report found that Alzheimer’s drugs have almost no benefit.

We also saw updates to two important stories involving the Centers for Disease Control and Prevention and a chance to highlight one of the most important, but least well known, programs it runs.

Psychedelics and mental health: promising, but let’s do this right

In the past decade, there have been several positive developments in mental health, including a growing willingness of prominent people — athletes, elected officials, musicians — to talk about their struggles and reduce stigma. Unfortunately, there has not been an equivalent increase in access to services, and most treatment approaches have limited effectiveness or durability.

That is why there has been so much excitement recently around a new approach to serious mental illness: psychedelic-assisted therapy. We saw a remarkable event at the White House last week. President Donald Trump, flanked by Health and Human Services Secretary Robert F. Kennedy Jr. and podcaster Joe Rogan, signed an executive order directing federal agencies to accelerate research into psychedelic medicines and expand access to them for treating serious mental illness.

Psychedelics are a group of compounds either derived from naturally occurring organisms, such as psilocybin from “magic mushrooms” and ibogaine from a shrub found in Gabon, or synthesized in laboratories, such as LSD and MDMA. While chemically distinct, psychedelics have in common the ability to profoundly alter perception, cognition, and consciousness.

In mental health therapy, psychedelics work very differently from conventional pharmacology. Antidepressants and other approved psychiatric medications primarily seek to alleviate symptoms. Patients must take them daily, and symptoms recur when they stop.

In contrast, psychedelic therapy involves one structured session or a few sessions in which the person takes the psychedelic and undergoes talk therapy before, during, and after. Rather than suppressing emotions or thoughts as with traditional psychiatric medications, these compounds create a window of openness in which patients can access deeply buried feelings, e.g., grief, shame, trauma, and help to rewire the way people feel and think about problems.

As a JAMA editorial put it, the approach “addresses the cause of symptoms rather than merely suppressing them.”

Psychedelic therapy is primarily being evaluated for severe depression, post-traumatic stress disorder, obsessive-compulsive disorder, and substance-use disorders — conditions for which existing treatments often produce only modest, short-lived benefit.

The executive order commits $50 million to ibogaine research and directs the FDA to prioritize review of psychedelics holding the agency’s Breakthrough Therapy designation, reserved for drugs showing early evidence of substantial improvement over existing treatments.

I am genuinely excited about this research. And I am also concerned that the way it’s being rolled out could undermine its promise. While the early data are impressive, making therapy available at scale requires the government to ensure safety and efficacy the way we do for other medications.

The executive order expands access through the Right to Try Act, a pathway designed for terminally ill patients to obtain experimental treatments outside clinical trials. This administration has shown a fondness, unfortunately, for treating unproven compounds as standard consumer goods rather than medications.

For example, Kennedy has used a similar approach to peptides, arguing that individual freedom matters more than safety and efficacy. While there is substantial real-world data on the safety of most psychedelics, we need high-quality research to demonstrate the effectiveness of different dosages and treatment protocols. I believe this study on MDMA-assisted psychotherapy for PTSD, although somewhat controversial, shows what can and should be done to advance the field.

What I want is something modeled after the work of HIV/AIDS activists, such as Treatment Action Group. They believed — correctly — that access and evidence do not have to compete with each other. You can modernize trial designs to accelerate data collection and mobilize staffing to accelerate regulatory review, so that you can have safety, efficacy, and access.

Another more recent example was Operation Warp Speed for Covid vaccines. The result was faster access to medical interventions that actually worked. That is what I want for psychedelics.

Alzheimer’s drugs: when statistical significance isn’t enough

For decades, the leading hypothesis for Alzheimer’s disease has been that dementia is caused by the buildup of a protein called amyloid-beta in the brain, forming plaques that disrupt neurons and cause progressive cognitive decline. This “amyloid hypothesis” has driven billions of dollars in drug development.

The Cochrane Collaboration, an international network that systematically reviews the best available evidence, published an analysis this month of seven monoclonal antibody drugs developed to clear amyloid from the brain. The review examined 17 randomized controlled trials involving more than 20,000 patients and concluded that the clinical benefit of these drugs is, at best, trivial.

Cognitive function, dementia severity, and ability to manage daily activities showed little to no meaningful change after 18 months of treatment. The drugs can also increase the risk of brain swelling and bleeding, though in most patients these side effects cause no symptoms.

Some Alzheimer’s experts argue that the Cochrane review improperly lumps failed drugs together with the two most recently approved treatments. One critic compared it to mixing rotten ingredients with fresh food and declaring the meal inedible. While that is a legitimate methodological concern, even the trial results for those two recently approved drugs showed only modest slowing of cognitive decline, i.e., patients got worse, but just not as quickly as they would have without treatment.

Whether patients or their families can perceive that difference is genuinely unclear. As one Cochrane author put it, the benefit was “far below the minimal effect that’s needed to be noticeable at all for patients and caregivers.”

This points to one of the most underappreciated problems in pharmaceutical regulation: the gap between statistical significance and clinical significance. A drug can clear an approval threshold based on an effect large enough to be measurable, but too small to matter to anyone living with the disease.

One of the successes of public health is longevity: People are living longer across the world. But our ability to prevent and manage conditions of aging is not advancing fast enough. This latest study shows that even the best available pharmacological therapies are not worth using.

CDC: one step backward, one step forward, and one cause for celebration

Two weeks ago, I wrote about how the CDC had been blocked from publishing a study showing that Covid vaccines reduced hospitalizations by about 55% during the past winter season. An HHS spokesman confirmed last week it will not be published, citing methodological concerns, even though a flu vaccine study using the exact same methods was published in the Morbidity and Mortality Weekly Report just one week before the Covid study was blocked.

Unfortunately, this confirms what I have been worried about all along. Even with widespread uproar in the media that a methodologically sound study was being blocked, the current administration will continue to hide data that demonstrate the harms of the Covid virus and the benefits of Covid vaccines.

On a more hopeful note, the White House nominated Dr. Erica Schwartz, a former deputy surgeon general and retired Coast Guard officer, to serve as the permanent CDC director. Dr. Jennifer Shuford, Texas state health commissioner, was announced as incoming CDC chief medical officer. I think the public health community needs to see this as a minor victory in the ongoing battle to protect the CDC from further damage.

I have heard from many current and former CDC colleagues that they have concerns about Schwartz’s actions when she was deputy surgeon general, but they are absolutely elated by the choice of Shuford as chief medical officer.

Many people who have worked with Shuford in the past, including during the large Texas measles outbreak in 2024, have praised her knowledge, skills, and temperament and are holding out hope that she can serve as an effective counterbalance to some of the anti-science positions that HHS leadership continues to push.

Finally, I want to highlight the 75th anniversary of one of the most important and least known public health programs in the country: The CDC’s Epidemic Intelligence Service. I entered the program after completing my medical residency, and EIS taught me skills I could not have learned anywhere else.

I learned to design epidemiologic studies by investigating real outbreaks, received hands-on mentorship in policy development and public communication, and worked with government agencies at every level, domestically and globally over two years.

Since 1951, EIS has trained more than 4,300 people — including physicians, veterinarians, nurses, pharmacists, lawyers — who have investigated nearly every major public health crisis of the past seven decades: smallpox, HIV/AIDS, Ebola, influenza pandemics, the 2001 anthrax attacks, and Covid-19.

Today, 1 in 3 state epidemiologists in the United States is an EIS alumnus, and 4 of the 12 CDC directors in history completed the program. At a moment when the CDC’s institutional capacity is under serious strain, it is worth recognizing what 75 years of investment in training has built and what would be lost if that were allowed to erode.

While many lay people hear about the limits of science and turn away to other approaches, I think we should see those limits as a reason to demand more. We need more trials, more rigorous review of data, and more protection of the institutions, like EIS, that have spent 75 years turning science into health promotion and disease prevention.

Until next week,

Jay

Dr. Jay K. Varma, who is recognized globally for his leadership in the prevention and control of infectious disease, writes about public health for Healthbeat. He has guided epidemic responses, developed policies, and implemented programs that have saved lives across Asia, Africa, and the United States. He is based in New York. Contact Jay at jvarma@healthbeat.org.

How politics and AI are making it harder to ‘follow the science’

2026-04-15T11:00:00+00:00

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Hello and welcome to Healthbeat’s weekly report on stories shaping public health in the United States.

I am Dr. Jay K. Varma, a physician, epidemiologist, and public health expert currently serving as chief medical officer at Fedcap, a global nonprofit focused on economic mobility and well-being for vulnerable communities. Views expressed here are my own.

During the peak of the Covid pandemic, the phrase “follow the science” became a popular refrain, used first by those advocating stronger infection control policies and later by those opposed to them. Today I am discussing how, in the past few weeks, scientific evidence has been selectively chosen to meet a specific political or economic end, and how artificial intelligence is making it harder than ever to know which scientific studies we can trust.

Politics of Covid vaccines and origins continue to cause trouble

The Washington Post broke a story last week that acting Centers for Disease Control and Prevention Director Jay Bhattacharya has been preventing CDC career scientists from publishing a study about the benefit of Covid vaccines during the recent winter respiratory virus season.

The report, which had cleared the agency’s full scientific review process and was scheduled for publication in the CDC’s flagship journal, the Morbidity and Mortality Weekly Report, on March 19, found that, between September and December 2025, healthy adults who received a Covid vaccine reduced their likelihood of emergency department and urgent care visits by 50% and the likelihood of Covid-associated hospitalizations by 55%.

According to the story, Bhattacharya, a health economist, thinks that the methodology used by CDC scientists is flawed. He is arguing that the CDC should only be publishing randomized control trials, a position completely at odds with the overwhelming consensus of vaccine scientists and epidemiologists who work in academia, government, and industry.

Randomized controlled trials are used to answer the question: “Does this vaccine prevent an infectious disease when used as intended in a selected population?” In contrast, the methods used in the suppressed Covid study are used to answer a different question: “Does this vaccine prevent an infectious disease when used in a real-world population under real-world conditions?”

The Food and Drug Administration and industry consider this "real world evidence," and the CDC has been using the exact same method for decades to estimate the effectiveness of the seasonal flu vaccine after each flu season has ended.

A report about flu vaccine effectiveness this past winter, using the exact same methods, was published in the MMWR just a week before Bhattacharya blocked the Covid study. (I covered the flu study last week). Why did his concerns about scientific methods apply to the Covid vaccine study and not the flu vaccine study?

I fear that the real reason Bhattacharya has squashed this study is that he does not want the CDC publishing any data about the benefit of Covid vaccines. Despite his repeated podcasting and writing about the importance of scientific debate, he rose to prominence as a Covid contrarian and is using his positions as National Institutes of Health and CDC director to promote his views and squash opposing scientific views.

On March 20, in his role as NIH director, Bhattacharya hosted the inaugural lecture of a series he is calling “NIH Scientific Freedom.” That talk featured a science writer from the UK named Matt Ridley about the “search for the origin of Covid-19.” Ridley argues that Covid was engineered in a lab and released accidentally. His talk completely disregarded the extensive evidence that points to an opposing hypothesis: The virus spilled over from animals into humans and amplified into an outbreak at a live animal market in Wuhan, China.

Thankfully, a diverse team of experts recently pushed back. Twenty-three of the 27 original members of the World Health Organization’s Scientific Advisory Group for the Origins of Novel Pathogens recently published a careful, detailed review concluding that most peer-reviewed scientific evidence supports that SARS-CoV-2 spilled over from an animal into humans. They found no conclusive evidence for a lab leak, and noted that government and intelligence reports favoring a lab leak rely on political, rather than scientific, arguments. Virologist Angela Rasmussen has written a considerably more caustic assessment of the Ridley lecture that is also worth reading.

In studies about the origins of a virus, we can rarely say anything is 100% certain. While a lab leak is certainly possible, the evidence strongly and consistently points elsewhere.

Politics of raw milk products causes trouble at FDA

Science remains a point of contention in an ongoing outbreak of E. coli O157 infections that CDC and FDA investigators have linked to cheddar cheese sold by a company known as RAW FARM.

Identifying the source of a food-borne disease outbreak is straightforward when people are exposed to the contaminated food at a single event — what’s known as a “point source” outbreak. When the exposure occurs over a wide geographic area and a long period — such as a food product sold around the country over weeks — the investigation is far more challenging.

Epidemiologists need to interview every patient about any foods they may have eaten before they became sick, relying on human memory and electronic records, neither of which are completely reliable.

Microbiologists need to obtain specimens from patients and link them together using genomic analyses. Ideally, they are also able to obtain specimens from food, but this is often difficult because the contamination may have been intermittent or limited to a batch that has already been sold and discarded.

Because it is so difficult to find a “smoking gun,” public health officials need to use a preponderance of scientific evidence to decide what to do, similar to the debates about how much evidence we need to decide Covid originated in nature or that vaccines work in the real world.

In this outbreak, the epidemiological case against RAW FARM is substantial. As of early April, nine people had been infected with the outbreak strain of E. coli across three states. Eight of these nine people were interviewed, and all reported eating raw dairy products. Of the seven who remembered the brand, all named RAW FARM. Genomic sequencing confirmed all the infections were genetically identical, meaning everyone probably got sick from the same source.

And yet RAW FARM twice refused FDA requests to voluntarily recall its cheese, posting on social media that the outbreak was not connected to its products and resharing testimonials from customers who continued to buy and feed the cheese to their children. When the company finally issued a recall on April 2, it did so “under protest,” continuing to deny the investigation’s findings.

Unfortunately, this not just a problem of one defiant cheese maker. The FDA took weeks longer than it would have previously to compel action, and the company’s defiance was likely emboldened by the current political moment, in which the head of the federal department overseeing food safety has celebrated raw dairy as a health food and framed food safety regulations as an assault on consumer freedom.

When leading government officials signal that food safety standards have changed, some producers are going to test that proposition and sicken us in the process.

AI is causing trouble with the scientific literature

An article published last week in Nature illustrates a different and perhaps more insidious threat: how AI can corrupt scientific communication and literature.

A medical researcher at the University of Gothenburg, Almira Osmanovic Thunström, invented a fake skin condition called “bixonimania,” a name she chose specifically because it sounded absurd, a psychiatric term attached to an eye condition.

She uploaded two obviously fake preprints about the condition to an academic website in early 2024, complete with a fictional author, a made-up university, and acknowledgements thanking “Professor Sideshow Bob” and “the Galactic Triad” for funding support. One of the papers stated explicitly that it was “made up.” Her goal was to test whether AI systems would pick up and repeat fabricated medical information.

The experiment worked faster and more thoroughly than she had anticipated. Within weeks, major AI chatbots were telling users that bixonimania was a real condition, describing its prevalence, and advising them to see an ophthalmologist.

Even more troubling, the fake papers were then cited in actual peer-reviewed medical literature, suggesting that some researchers were using AI-generated references without reading the underlying papers. One such paper, published in a Springer Nature journal, was retracted only after Nature’s reporters contacted the journal to ask about it.

As recently as March, some versions of major AI chatbots were still describing bixonimania as an “emerging condition” or a “proposed new subtype” of a real disorder. Millions of people now use AI chatbots as a first stop for health information. If the scientific literature that feeds those systems can be poisoned by fake papers, bad actors could potentially manufacture medical “evidence” to sell products, cast doubt on real treatments, and distort public understanding of disease.

Who controls what counts as evidence?

Who controls what counts as evidence, and what happens when that control is abused? In the past week, we saw examples of this problem from government agencies and the private sector. Scientific reasoning requires understanding what a particular study can and cannot tell you, what the weight of evidence across multiple studies suggests, and where genuine uncertainty remains. That kind of reasoning is hard to do, easy to distort, and, as this week makes clear, under assault from multiple directions at once.

Until next week,

Jay

How a medical student is helping the CDC alert doctors to heat’s effects on medications

2026-04-14T22:25:40+00:00

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Medical student Riya Goel’s life has been shaped by climate change. She spent part of her childhood in Bangalore, India, where she experienced frequent asthma attacks, often requiring hospitalization, due to poor air quality.

Other stints living in California and Colorado exposed her to wildfire smoke. She learned firsthand about Atlanta’s extreme heat when she started medical school at Emory University, where she will graduate in May.

Those experiences sparked an interest in understanding the interaction between climate change and health. Goel has developed a resource for the Centers for Disease Control and Prevention that helps clinicians understand how heat could affect patients on commonly prescribed medications, from aspirin to antidepressants.

Many drugs can reduce patients’ ability to withstand higher temperatures. Some drugs increase sun sensitivity, and high heat can reduce the efficacy of some drugs.

Providers need to be aware of the heat risks of drugs so they can educate patients and help offset those, Goel said.

The resource provides information for clinicians about how heat impacts the body along with tips for educating patients. It then provides a list of more than 20 commonly prescribed drug classes and indicates how high heat can impact them.

For example, some common selective serotonin reuptake inhibitors, often prescribed for anxiety and depression, can increase sweating. Aspirin can make it harder for the body to release heat.

Diuretics, which are commonly prescribed for conditions like heart failure and high blood pressure, can cause dehydration, increasing the risk for falls in extreme heat. But the drugs are designed to remove fluid from the body, so increasing water intake isn’t necessarily a good solution. Ideally, people on diuretics would have access to cool environments, Goel said.

“We can be conferring risk even just by very basic prescriptions that we write for our patients,” Goel said.

She’d like to see more medications added to the CDC list, and she wants more clinicians to be aware of the potential interactions.

“A lot of current efforts, including CDC guidance, are focused on building that awareness,” she said.

The tool recommends that clinicians make a plan with their patients for days when the HeatRisk is orange, red, or magenta. HeatRisk is a National Weather Service tool that measures temperature, humidity, and other factors for locations across the United States to help people plan for high heat.

Goel created the medication list working with Dr. Laura Seeff at the CDC. The CDC provided Goel with an initial list of medications to research, and she started with a literature review before diving deeper into how heat can impact each drug.

“I remember just spending hours every day, researching and adding things to the Excel doc,” Goel said. She identified additional medications for the list through her research.

Despite her long interest in climate change and medicine, Goel said her research for the project revealed some facts she hadn’t known before. For example, inhalers like the one she uses for asthma can lose their potency if stored in high heat. They should be kept at room temperature.

Dr. Randall Tackett, a professor at the University of Georgia’s College of Pharmacy, said that kind of information is important for patients. He pointed out that many people get their prescriptions delivered by mail, and sitting outside on a porch or a driveway in hot weather could degrade some medications.

The CDC tool Goel created can be used anywhere but will be especially relevant in cities like Atlanta that have many high-temperature days.

“During the summers [in Atlanta], it’s extreme heat every single day, and there’s so many people on antihypertensives, anti-epileptics, anti-depressants, and they all kind of alter our physiology in ways that are really important to recognize,” Goel said.

The city experiences about two more weeks of high heat days than it did in 1970, Dr. Kristina Dahl, vice president for science at nonprofit Climate Central, told Healthbeat last year.

The effects can vary widely, depending on where people live in the city and their access to cooling. For example, citywide about 96% of homes have central air conditioning, but in some westside neighborhoods, that drops to 80%, a 2023 analysis by Georgia Tech Professor Brian Stone found.

Along with people who lack air conditioning, there are many other vulnerable groups, Goel said. They include:

Children
Elderly people
Unhoused people
People who work outdoors
People with certain mental illnesses or cognitive deficits
People who are immunocompromised
Pregnant people

Goel is especially passionate about that last group because she will start her OB-GYN residency at the University of California in Los Angeles in June.

Pregnant people have “decreased sweating abilities, because there’s just more fluid that’s needed to make sure the circulation is adequate, and they tend to put more fluid towards their extremities,” Goel said. “The way that they expel heat or absorb it is also different.”

Older people are also especially vulnerable, Tackett said, because age impacts the body’s ability to regulate heat. That can increase the risk of people fainting or falling, he said.

“There is always the chance of someone getting out into hot weather and developing heat prostration or fainting,” Tackett said.

Pharmacists want to counsel their patients about the medications they are dispensing, Tackett said, but often people are in a hurry and decline counseling. Patients who start taking a medication during the winter may not be aware that a medication could increase heat sensitivity, he said.

He encouraged patients to take the time to check in with their pharmacist or clinician to learn more about how their medications are impacted by heat.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

AI could help save lives by easing delivery of treatments that we know work

2026-04-10T11:00:00+00:00

This is a guest essay for Healthbeat. Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

According to tech leaders, artificial intelligence will be transformative for our health. AI could give us “the next 50-100 years of biological progress in 5-10 years,” declared Dario Amodei, CEO of Anthropic. “Maybe with 10 gigawatts of compute, AI can figure out how to cure cancer,” enthused Sam Altman, CEO of OpenAI.

Back in the clinic, our enthusiasm is more guarded. Part of it is the checkered history of health technology, too often extracting humanism in medicine for the pursuit of profits. Another hesitation is because so often, in the real world, the problem is not discovery but delivery. Cures that don’t reach the patients most in need; prevention that never makes it into practice. But what if AI could actually help us change that?

Take one of my longtime patients, whom I recently saw on his 45th birthday. We commiserated about the travails of middle age (I’m also turning 45 this year), and celebrated some progress he had made with his mental health in the last few months. And — with colon cancer affecting more young patients — I recommended a colonoscopy.

He acquiesced to a stool test, which screened positive, but declined the follow-up colonoscopy that might save his life. When I reached him to understand why, I learned that he had lost his job and his health coverage, and felt he had bigger fish to fry. “I’m feeling fine, doc” he said to me. His reassurance just reinforced my own powerlessness to reassure him.

My patient is far from alone: Roughly half of Americans with a positive stool test don’t complete follow-up within six months, despite the proven benefits of early detection and treatment.

This yawning gap repeats itself across American medicine. Less than half of patients with high blood pressure are on an effective regimen for it. Only about a third of patients who qualify for the medicines that could cure them of hepatitis C receive them. Fewer than 1 in 5 patients who would benefit from therapies like buprenorphine for opioid addiction get treated.

Even as we discover more effective treatments, we fail to deliver them to those most in need.

AI can help patients get through complex process to care

The discovery-delivery gap is not new. Three decades ago, health care pioneer Don Berwick highlighted “the gap between what we know and what we do.” But we now have a realistic opportunity to fix this failure, by thoughtfully harnessing AI to save lives.

Take my patient’s positive screen for colon cancer. Several steps are required after the stool test: notifying the patient, arranging scheduling, ensuring coverage, explaining the bowel prep. Sometimes the prep isn’t adequate, and we send patients back to square one.

The complexity of this process explains why many health systems employ patient navigators, and why people with greater means seek out concierge care to cut through the thicket. Artificial intelligence could help scale this kind of personalized, persistent engagement. Imagine a system that calls my patient in his native language, helps schedule his colonoscopy, and answers questions about the bowel prep. Nurses and social workers can focus their precious time on more complicated cases, like helping my patient enroll in Medicaid.

A test for AI apps is whether they enrich the human relationships at the heart of exceptional care. Too often, health technology has eroded relationships: reducing eye contact, depersonalizing interactions, making medicine transactional. Patients become less inclined to trust recommendations. In this environment, trusted intermediaries like community health workers become more important, not less, and technology must work for them.

Human relationships have always been a key to bridging innovations, like vaccines and cures, with implementation. The United States tamed tuberculosis, for example, through painstaking efforts to find and monitor cases in the community and provide subsequent support for completing treatment regimens.

AI can help cures reach patients who need them

Today we have a chance to eliminate modern scourges like hepatitis C, thanks to new therapies like curative antivirals. Hepatitis C is an insidious disease: Tens of thousands of Americans each year progress toward cirrhosis, their eyes yellowing and toxins clouding their minds as the liver fails. Yet a simple 8- to 12-week course of pills can eliminate the virus from the body. AI could help ensure that such breakthroughs actually reach patients.

Casefinding is especially important when people can transmit infection without knowing they are infected. Yet our tools for identifying these “silent carriers” are often blunt. Today, the national recommendation for hepatitis C is to screen every American between 18 and 79 at least once with a blood test. By contrast, a machine-learning algorithm tested in Israel was 100 times more efficient: yielding one diagnosis for every 10 tests instead of one for every thousand.

A similar opportunity exists for HIV prevention. As powerful new tools like the long-acting injection lenacapavir emerge, AI could help ensure that protection reaches those at highest risk.

Eliminating diseases like HIV and hepatitis C, just as we did for smallpox and polio, is within our reach — though it will take more than just technology.

What AI can’t do is solve our all too human problems, like the fact that high prices preclude broad access to some of our most consequential breakthroughs, from antivirals for hepatitis C, to the $28,000-a-year lenacapavir, to the new GLP-1 medications for diabetes and obesity. For this, we will have to work through our messy human systems to forge a better path.

Mere mortals have done it before. In Louisiana, a so-called “Netflix model” facilitated expanded access to hepatitis C medicines for a flat subscription fee. And the Congressional Budget Office estimated that a national subscription model for hepatitis C would save the federal government approximately $6.6 billion over 10 years, in part due to costs averted from hospitalizations and intensive care that would otherwise be borne by Medicare. We can save lives and money.

My patient ended up completing his colonoscopy after our social worker helped find health coverage he could afford. They found a small polyp that was precancerous, and he and I both breathed sighs of relief. But he’s due for another colonoscopy in five years. I hope we can make a century of medical progress by then. At the least, we can make it easier for patients like him to receive the care we already know saves lives.

Dr. Dave A. Chokshi is a physician at Bellevue Hospital and Sternberg Family Professor at the City College of New York. Previously, he served as health commissioner of New York City.

U.S. scientists sequence 1,000 genomes from measles, a disease long eliminated with vaccines

2026-04-02T19:08:46+00:00

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This week, the Centers for Disease Control and Prevention posted online its first large tranche of advanced genetic data from measles viruses spreading last year. Scientists with knowledge of the operation expect the agency to post heaps more in weeks to come, revealing whether the United States has lost its hard-won measles elimination status.

The CDC withheld the data for months as a team hit hard by mass layoffs and resignations sorted through the information. But now that scientists at the agency have posted their first batch of whole measles genomes — the genetic blueprint of the viruses — the rest should “start flowing more smoothly at a more rapid cadence,” said Kristian Andersen, an evolutionary virologist at the Scripps Research Institute who isn’t involved with the CDC’s effort but is following it.

The CDC did not answer queries from KFF Health News on its timeline for publishing measles data or analyses. However, once all the data is public, researchers can run quick initial analyses that will signal whether outbreaks across the United States last year resulted from the continuous spread of the disease between states, rather than separate introductions from abroad.

If there was continuous transmission for a year, that means the United States has lost its status as a country that has eliminated measles. That status, which the United States has held since 2000, reflects a country’s vaccination rates: Two doses of the measles-mumps-rubella vaccine prevent most infections and so stop outbreaks from growing.

More careful analyses take weeks.

“We should see a report in April,” Andersen said, “assuming no political interference.”

This is the first time that the United States has applied sophisticated genomic techniques to measles, which largely disappeared from the country a quarter-century ago because of broad vaccine uptake.

Declining vaccination rates, misinformation, and the Trump administration’s budget cuts and lagging response to outbreaks have fueled a resurgence of the disease. With at least 2,285 cases in 44 states, 2025 was the worst year for measles in more than three decades. This year is on track to surpass that, with 1,575 cases as of late March.

While welcoming the science, researchers say the government’s top priority should be to stop the virus from spreading.

“I think it’s incredibly important to do whole genome sequencing for outbreaks,” Andersen said, “but we shouldn’t need to do this for measles in the first place, because we have an extremely effective and safe vaccine.”

How the South Carolina measles outbreak grew from 5 to 997 cases

“That we’re even talking about this is nuts,” he added.

Health and Human Services Secretary Robert F. Kennedy Jr. and other government officials should sound an alarm about measles’ comeback and launch nationwide vaccine campaigns, said Rekha Lakshmanan, executive director of The Immunization Partnership, a nonprofit in Houston that advocates for vaccine access.

“I applaud the science,” she said, “but the more urgent need is to get measles under control as quickly as possible.”

Top officials have instead downplayed the seriousness of the disease, and false notions about vaccines have been granted new life in Kennedy’s CDC. This includes abrupt changes to vaccine information on CDC websites that medical associations say aren’t based on evidence and endanger lives.

Kennedy continues to promote unproven remedies that could mislead parents into believing that they can avoid vaccines without consequence. On the Joe Rogan Experience podcast in late February, Kennedy spoke at length about measures to improve America’s health but didn’t mention vaccines. He said preventive measures could entail “holistic medicine, or take vitamins, or take vitamin D, which is, as you know, it’s kind of miraculous.”

“The risk of measles remains low for most of the United States,” HHS spokesperson Emily Hilliard wrote. “CDC has made $8.5 million available to address measles response activities in seven jurisdictions experiencing outbreaks,” she wrote. “The CDC, HHS principles, and the secretary have been vocal that the MMR vaccine is the best way to protect yourself against measles.”

Genomic data hold clues to outbreak spread

In December, the CDC enlisted the help of one of the country’s leading centers for virus sequencing, the Broad Institute in Cambridge, Massachusetts. Major outbreaks in Texas, Utah, and South Carolina had been fueled by the same type of measles virus, labeled D8-9171. But since that type also circulates in Canada and Mexico, researchers need more data to discern whether it spread among states or entered the United States multiple times.

Whole genome sequencing provides that information because viruses evolve over time. The measles virus acquires a mutation every two to four transmissions between people, said Bronwyn MacInnis, director of pathogen surveillance at the Broad.

“There is enough signal in this data to tease apart questions at hand,” MacInnis said, “the main one being sustained transmission within this country.”

MacInnis’ team worked overtime to sequence the entire genomes of inactivated measles viruses that had been collected from states in 2025 and 2026.

“We’ve done about 1,000 samples and delivered the genome data back to the CDC,” sending it on a rolling basis since December, MacInnis said. “This is the CDC’s data to publish.”

The CDC didn’t post a single one of those genomes until late March, when eight appeared on a public database hosted by the National Center for Biotechnology Information. By Wednesday, an additional 154 had gone online.

“It should be on NCBI within a couple of weeks of being produced,” Andersen said, “and certainly not take longer than a month when you have an active outbreak.”

Dora Nabatanzi, a molecular biologist at the Broad Institute in Cambridge, Massachusetts, prepares chemicals needed to sequence the genomes of measles viruses.

Genomic data hold clues about how outbreaks start and spread. It allows researchers to develop tests, treatments, and vaccines — and detect variants that might evade them.

Such data was critical in the Covid pandemic. Chinese and Australian scientists posted the first SARS-CoV-2 genome online on Jan. 10, 2020, within a week of sequencing it. “It definitely shouldn’t take the CDC months,” said Eddie Holmes, the Australian virologist who helped publish the first coronavirus sequence.

One reason for the delay is that the CDC’s measles lab has been sorely understaffed amid mass layoffs and other turmoil at the agency over the past year, a CDC scientist told KFF Health News. Another reason, the researcher added, is a learning curve: The CDC and health departments haven’t needed to sequence hundreds of whole measles genomes before now. (KFF Health News agreed not to identify the scientist, who feared retaliation.)

In contrast with the CDC, the Utah Public Health Lab has shared measles genomes rapidly. Most of some 970 measles genomes posted online since Jan. 1, 2025, were sequenced by the state, hailing from Utah, Arizona, South Carolina, and other states willing to share them.

“We’ve only got a handful of samples from Texas that were collected kind of in the middle of their outbreak,” said Kelly Oakeson, a genomics researcher at the Utah Department of Health and Human Services. The genomes of the Texas and Utah measles viruses are similar but distinct, Oakeson said, meaning that intermediate versions of the virus are missing.

If the genetic code of viruses collected late in the Texas outbreak are a closer match to those from Utah’s, that will suggest that spread was continuous and the country has lost its measles-free status. The hundreds of genome sequences still sitting at the CDC probably hold the answer.

Evaluation of U.S. measles status delayed till November

The CDC expected to finish its analysis before April, said Daniel Salas, executive manager of the immunization program at the Pan American Health Organization, which works with the World Health Organization. That’s when PAHO was slated to evaluate the United States’ measles status.

He said PAHO delayed its evaluation until the organization’s annual meeting in November, partly because the CDC needed more time to do the genomic analysis and partly because the measles status of Mexico, Bolivia, and other countries is also under review, and holding staggered meetings for each country is inefficient.

The United States is the only country using whole genome sequencing to answer the elimination question, Salas said. Typically, countries classify measles viruses according to a tiny snippet of genes, then assume that large outbreaks caused by the same type are linked. Whole genomes provide a more accurate view.

CDC outbreak models warn about underreporting in S.C. measles outbreak

“If the U.S. can fill in the blanks with genomic data, that’s a sort of breakthrough,” Salas said. “That doesn’t mean other countries are going to be able to pull off this kind of analysis,” he added. “It takes a lot of specialized knowledge and resources.”

Equipment to sequence and analyze genomes costs upward of $100,000, and the cost to process each sample, including paying the researchers involved, typically ranges from $100 to $500 per sequence.

“I’m pro-science, but we shouldn’t have to do this,” said Theresa McCarthy Flynn, president of the North Carolina Pediatrics Society. “We don’t have to have a measles epidemic.”

Flynn said she regularly fields questions from parents concerned by misinformation spread by Kennedy and anti-vaccine groups, including the one he founded before joining the Trump administration. Parents have also pointed to changes in the CDC’s recommendations and to its websites that are at odds with the scientific consensus.

Before Kennedy took the helm, a CDC website said “Vaccines do not cause autism” in prominent type, and listed several large studies in premier scientific journals that refuted a link between vaccines and developmental disorders.

Last year, the website shifted to saying, “Studies supporting a link have been ignored by health authorities.” The high-quality studies were replaced with a report from a single investigator who has ties to anti-vaccine groups.

In an email to KFF Health News, Hilliard echoed the altered website’s claims about vaccines, disregarding extensive studies on the topic.

Flynn, of the pediatrics association, said, “The CDC itself is spreading misinformation about vaccines. I cannot overstate the seriousness of this.”

Although the acting director of the CDC, Jay Bhattacharya, says vaccines are the best way to prevent measles, he too has undermined vaccine policy. He said the controversial January decision to reduce the number of vaccines recommended to children was based on “gold standard science.” Hilliard wrote that the updated schedule was “aligning U.S. guidance with international norms.”

In fact, the new schedule makes the United States an outlier among peer nations.

A federal court temporarily invalidated the change last month in a lawsuit brought by the American Academy of Pediatrics and other groups.

Bhattacharya hasn’t held briefings with the public or the press on the surge of measles this year or activated the CDC’s emergency capabilities.

“Normally, we’d have a big push to get vaccination rates up in areas where it’s low. We’d do a big social media push, put out ads on getting vaccinated,” said another CDC scientist whom KFF Health News agreed not to identify, because of fears of retaliation. “People at the CDC want to do this, but political leadership at the agency has not allowed the CDC to do it.”

Further, the Trump administration’s cuts and delays to public health funds have made it hard for local health officials to protect communities. Philip Huang, director at Dallas County Health and Human Services in Texas, said the department lost over $4 million when the administration clawed back about $11 billion from health departments early last year as a measles outbreak surged in the state.

“We lost 27 staff and had to cancel over 20 of our community vaccination efforts, including to schools identified as having low vaccination rates,” he said. “There are simultaneous attacks on immunizations that are making our jobs harder.”

This story has been updated to include comments from Department of Health and Human Services spokesperson Emily Hilliard.

Amy Maxmen is a Healthbeat national reporter through a partnership with KFF Health News.

‘Maximum disruption, minimal clarity’: How ‘America First’ aid deals are playing out in Africa

2026-03-05T12:00:00+00:00

Public health, explained: Sign up to receive Healthbeat’s Global Checkup in your inbox a day early.

Hello from Nairobi.

We’ve begun the long rainy season here (we get two each year), which means three months of brisk mornings and muddy shoes. Unfortunately, an influx of mosquitoes will soon follow. But this city sits at a higher elevation than Denver, Colorado, so the malaria risk is extremely low. (It’s too cool for the parasite to reliably develop inside mosquitoes!)

Today we’ve got a hodgepodge of news: from the fragile state of America’s new health deals in Africa, to a one-pill breakthrough, and the latest chapter in the story of the woman whose cells changed medicine. We’ll close with a story whose comedic headline left me no choice but to include it.

My name is William Herkewitz, and I’m a journalist based in Nairobi, Kenya. This is the Global Health Checkup, where I highlight some of the week’s most important stories on outbreaks, medicine, science, and survival from around the world.

With that, as we say in Swahili: karibu katika habari — welcome to the news.

America’s health pivot, finally coming into focus

First up: The United States and the Democratic Republic of the Congo “signed a $1.2 billion health partnership” on Feb. 26, the Associated Press reports.

While the full text of the agreement is not public, it’s noteworthy because this is the 19th one-on-one health agreement the United States has signed directly with an African government since dismantling the U.S. Agency for International Development last year.

It also follows news from last week, with Zimbabwe and Zambia backing away from similar deals.

Some background: Generally speaking, these country-by-country agreements are meant to move U.S. health funding away from non-profit aid organizations and United Nations agencies, and into an “America First” framework of direct partnerships with national governments. While these deals represent a dramatic cut in funding from previous years (at least 25%, but potentially more, depending on how many countries end up without deals), the United States nevertheless remains the largest global health donor on paper.

I covered the first of these deals with Kenya back in December (which is still mired in a legal dispute about the data-sharing demands imposed by Washington). But I’ve largely held off on covering the rest.

Why? Because it’s so early and the implementation has been so chaotic that even my sources inside the State Department struggle to explain how these agreements will (or are) functioning in practice.

Thankfully, I was able to speak with Dr. Paul Spiegel, who directs Johns Hopkins’ Center for Humanitarian Health for some much needed context. Few people have a clearer view of how global health systems are actually working in today’s crisis settings, and we discussed what he’s seeing and how to make sense of these deals so far.

I started by asking Spiegel frankly: Are these 19 deals a sign of stabilization from the chaos of 2025? While he acknowledged some upsides (which we’ll get to) his overall assessment of the deals, and the year ahead of us, was grim. “No. I think things are going to get a lot worse before they get better,” he said.

Spiegel described “maximum disruption right now with minimal clarity,” and that reality on the ground for lifesaving aid programs is still chaotic, with supply chains disrupted and local partners unsure whether funding will continue month to month. He blames the rushed transition “from the old architecture to something so new, so quickly,” he said. “In the meantime, so many people are going to die and suffer.”

We also zeroed in on what worries us both most. The new U.S. strategy is publicly built around channeling major funding directly to governments that (at best!) lack robust oversight and, in some cases, rank among the worst globally on corruption. And the admittedly cumbersome bureaucracy that once helped curb fraud, waste, and abuse has been functionally stripped of many of its guardrails. (That said, let me acknowledge that it’s difficult to judge the concrete risks, because so few of the agreements’ terms have been made public.)

Spiegel also warned about turning health aid into what is openly described by Washington as a transactional exchange. Beyond the moral argument that “humanitarian assistance should follow need and evidence,” Spiegel said there is a hard practical reality. These programs take years to build, and when funding becomes contingent on unrelated political demands or can be withdrawn overnight, systems unravel quickly. As we’re seeing now, the human cost is immediate, and rebuilding takes years.

What are the upsides? Spiegel acknowledged a “kernel of truth” behind the new strategy, which requires both parties to pony up funds. For years, he said, donors failed to ensure governments built the capacity to manage their own systems. Requiring countries to put in more of their own money is “hugely necessary.”

This is (no longer) spinal tap

Europe has approved a new and simple oral medicine that may finally help win the fight against sleeping sickness, the AP reports.

Disease breakdown: Human “trypanosomiasis” is a highly fatal parasitic disease that’s spread by blood-sucking tsetse flies. Symptoms start flu-like, but as the parasites multiply and attack the nervous system, victims often find their sleep-wake cycle flipped (hence the illness’ common name). Without medicines, coma and death usually follow. Thankfully, treatments developed in the early 2000s slashed infections from many tens of thousands a year to today, where fewer than 600 cases are reported annually.

The new, single-dose pill is called acoziborole. To understand why it could be a game changer, it helps to understand two things: Why we don’t just have a vaccine, and the limits of the treatments we’ve relied on for two decades.

First, the worm-like sleeping sickness parasite has long evaded vaccine efforts thanks to its tricky and unique ability to alter the makeup of its “skin” (technically, its outer protein layer). This shapeshifting both helps the parasite stay ahead of immune defenses, and creates a frustrating, moving target for a hypothetical vaccine.

Second, current treatments for the illness are burdensome. They “can take 10 days,” and “require difficult trips to hospitals from remote villages,” with many patients needing to “undergo spinal taps to help doctors understand the stage of infections,” and which drugs to treat them with.

Keep in mind, many of the people affected by this illness live in incredibly rural or remote areas in equatorial Africa. So, when your nearest hospital is a 10-hour drive away, and may not even have the diagnostics you need … you can see the issue.

The new pill (technically three medicines compounded together) obviates spinal taps, and is highly effective against the disease at a range of stages. The most recent study found that “95% of treated patients were considered cured 18 months later.”

Granted, one powerful drug is not enough on its own to meet the WHO’s elimination goal for the disease of 2030. Ending sleeping sickness also means continuing to find new cases quickly, reducing the number of infected tsetse flies, and stopping the disease from spreading again through animals.

Still, the pill may be the breakthrough needed to make that deadline.

The immortal settlement(s) of Henrietta Lacks

In 1951, doctors at Johns Hopkins Hospital took cancer cells from Henrietta Lacks, a young Black woman in Baltimore, Maryland. They were taken without her knowledge or consent, and she would die months later.

Those cells, dubbed HeLa (for her name), became the first human cells to be grown indefinitely in a lab. It is a fascinating story, one detailed in Rebecca Skloot’s best-selling book The Immortal Life of Henrietta Lacks. Which, if you have not read it yet, this is your reminder.

Lacks’ cells helped unlock the polio vaccine, advance cancer therapies, and grounded decades of other biomedical research. (There’s an obvious benefit to having a standard set of cells you can use to compare or replicate work in various labs worldwide.) And they are still used today: I actually have a personal friend in the UK whose cancer research right now is entirely underpinned by this woman’s cells.

Why is this relevant today? Some 75 years later, Novartis, the Swiss multinational pharmaceutical company, has settled a lawsuit brought by her estate over the use of those cells, the AP reports.

The terms of the settlement were not disclosed. But the case is part of a broader reckoning over who profits from the scientific discoveries that followed Lacks’ death. While “Johns Hopkins said it never sold or profited from the cell lines … many companies have patented ways of using them,” including Novartis.

The settlement follows another “in 2023, [when] Lacks’ estate reached an undisclosed settlement with the biotechnology company Thermo Fisher Scientific Inc.” And the AP reports that “there are other pending lawsuits by the Lacks estate.”

The flu vaccine’s own annual booster

Every year, the World Health Organization convenes a panel of flu experts to make a high-stakes prediction: which versions of the virus are most likely to dominate next winter. Once the experts make their call, vaccine makers lock in that recipe and get to work.

But … it’s a strange ritual when you think about it. We do not rewrite most vaccines annually.

That’s because unlike most viruses, flu evolves gradually *and* abruptly. Flu doesn’t just slowly accumulate small mutations as it spreads. It can also trade whole chunks of its genetic material when two different strains infect the same person, creating entirely new combinations almost overnight.

That brings us to the news: Last week, the expert panel updated the recipe for the Northern Hemisphere’s 2026 to 2027 flu shots, Health Policy Watch reports. And it’s a fuller reset than usual. (Although like last year, the panel is recommending three different flu variants targeted in each shot.)

The biggest shift is in one of the three targets from last year, the H3N2 strain, where a newer genetic branch has taken over globally. As I’ve covered previously, in these strains, the “H and N numbers refer to the shape of two important proteins on the outside of the virus.” Hemagglutinin, or “H,” helps the virus latch onto cells. Neuraminidase, or “N,” helps it break free and spread.

It’s news worth noting for two reasons. One, “there are around a billion cases of seasonal influenza annually,” so hitting or missing the mark on the vaccine, while a (let’s be honest) boring bureaucratic process, could prevent millions of cases or fail to address tens of thousands of deaths. That is not small stakes.

Second, it’s a reminder of something important. No matter where you live, the flu will touch you, your family, or your workplace this year. And experts are clear: Vaccination remains a safe and effective way to blunt the damage.

I applaud you, headline writers

Ok, ok. Please allow me to end on a story whose incredible headline alone forced its way into this report.

It is: “Chimp urine test study bolsters ‘drunken monkey’ theory,” Reuters reports.

(Right? How could I not include it!?)

What’s the story? Actually, something rather fascinating. Researchers studying wild chimpanzees in Uganda’s Kibale National Park have found evidence supporting the so-called “drunken monkey” hypothesis: the idea that primates, including early human ancestors, may have evolved a taste for alcohol because it helped them find calorie-rich ripe fruit.

In tests of 20 urine samples from chimps, collected from puddles on the forest floor, nearly all contained a metabolic marker of ethanol. This is a compound that both chimps and humans produce after drinking alcohol. Some of the ethanol levels were roughly equivalent to having thrown back a few beers, or a single cocktail.

Narrowly, the findings suggest that at least some chimps, our closest primate relatives, regularly consume naturally fermented fruit and metabolize the alcohol in it. More broadly, the study adds support to the speculation that our attraction to booze may precede the human inventions of beer, wine, cider, or spirits.

What’s my takeaway? Ultimately, this story is not just about tipsy chimps. It is about why we are drawn to alcohol in the first place, and how deep that relationship runs in our evolutionary wiring. I brew and adore craft beer (and have no plans on stopping), but we know that alcohol use and abuse today drives millions of deaths annually, from liver disease to injuries to cancer. Understanding whether our attraction is cultural, biological, or both is not just trivia.

But also… tipsy chimps!

I’ll see you next week.

William

William Herkewitz is a reporter covering global public health for Healthbeat. He is based in Nairobi. Contact William at wherkewitz@healthbeat.org.

AI can be a transformative health tool. It can also cause harm.

2026-02-25T12:00:00+00:00

Public health, explained: Sign up to receive Dr. Jay K. Varma’s reports in your inbox a day early.

Hello and welcome to Healthbeat’s weekly report on stories shaping public health in the United States.

I am Dr. Jay K. Varma, a physician, epidemiologist, and public health expert currently serving as chief medical officer at Fedcap, a national nonprofit focused on economic mobility and well-being for vulnerable communities. Views expressed here are my own.

This week, I’m focusing on a question that sounds like science fiction but is increasingly being asked in serious policy circles: Will artificial intelligence kill us all?

AI can help health agencies avert illness and death

Let’s start with my bias. I believe that AI is a transformative tool that can help public health agencies avert illness and death in their communities if used responsibly and ethically. It can help epidemiologists process, analyze, and interpret surveillance data. It can assist health officials in tailoring communications, particularly in emergencies, and improving programs for immunizations, sexually transmitted infections, tuberculosis, and maternal child health.

As AI systems grow more capable, many experts are wondering, however, whether the risks could outweigh the benefits. Some of those risks are distant but catastrophic. Others are happening right now at a smaller scale.

An AI safety leader warns the ‘world is in peril’

Earlier this month, a senior safeguards researcher at the AI company Anthropic resigned, warning that the “world is in peril.” In his resignation letter, he cited concerns about AI, bioweapons, and interconnected global crises.

Anthropic has positioned itself as a safety-oriented firm in the race to build increasingly powerful generative AI systems. The New Yorker just published an in-depth investigation into Anthropic and the inherent tensions people in the company feel trying to build advanced AI systems while safeguarding against risks to humanity. Curiously, the U.S. Defense Department just took the view that Anthropic may be a risk to the U.S. government, because it’s too focused on ethics and protecting human health.

(Full disclosure: I’m a big fan of Claude Code, one of Anthropic’s premier products. Read an excellent review of that product by widely respected AI expert Ethan Mollick here.)

The departing Anthropic researcher had led work on reducing risks from AI-assisted bioterrorism and on understanding how AI assistants could distort human judgment. His concerns are shared by others in the field.

As AI models become more proficient in synthesizing scientific literature and solving technical problems, they may lower the barrier to designing or modifying pathogens. Biology is already digitized. Genome sequences are publicly available. Laboratory protocols are published in journals and databases.

Recent research has tested advanced AI models on graduate-level virology problems, demonstrating that they can perform at or near expert level on tasks involving viral genetics and pathogenesis. While such capabilities can help humanity by improving vaccine design or antiviral discovery, they could also be misused to enhance the infectiousness or immune evasion of pathogens.

Having led outbreak responses in Asia, Africa, and the United States, I still believe that we need to worry most about nature — “spillover” of viruses from animals into humans — when trying to prevent the next pandemic. Nevertheless, the pace of AI development is extraordinary, which means my risk assessment is changing daily as well. An intentionally engineered pathogen designed for maximum spread could have far greater consequences than even the Covid pandemic.

Proposals to reduce biosecurity risks

Researchers and policymakers have outlined approaches to mitigate risk.

One proposal is to secure closed-source biological AI models, restricting access and subjecting users to rigorous vetting and monitoring. Companies can conduct exercises in which they deliberately probe their own systems for vulnerabilities before malicious actors do.

A second approach is to protect high-risk biological datasets from being used to fine-tune open-source models. If detailed genomic data on high-consequence pathogens or advanced laboratory protocols are easily accessible for model training, they can amplify the capabilities of otherwise general-purpose systems. Tighter access controls and clearer publication norms could reduce misuse.

A third area is to restrict AI agents that interface with biological tools. As AI systems move beyond generating text to interacting with laboratory equipment or ordering synthetic DNA, systems need to be in pace to ensure there is a human that is screening DNA synthesis orders and auditing AI-designed workflows.

In the AI era, biosecurity will require multiple layers of defense that protect humanity at the level of algorithms, data, and laboratory infrastructure.

The near-term mental health risks

While headlines often focus on existential threats, I am most concerned at the moment about a more immediate hazard: AI’s impact on mental health and suicide.

Millions of people now interact daily with AI “companion” chatbots designed to simulate friendship, empathy, or therapeutic dialogue. Some users, including minors, disclose suicidal thoughts to these systems. In multiple lawsuits, there are allegations that AI chatbot interactions led to people committing suicide.

In response, California enacted Senate Bill 243 in 2025, the first law in the nation regulating AI companion chatbots. The law requires clear disclosure when a user is interacting with AI rather than a human, mandates protocols for responding to suicidal ideation, and imposes additional rules for known minors, including periodic reminders that the chatbot is not human, and restrictions on sexually explicit content. It also creates a private right of action, allowing civil lawsuits for violations.

California’s law is an important milestone. It acknowledges that emotionally realistic AI systems can foster attachment and dependence, particularly among adolescents. It also recognizes that AI systems need regulation to ensure they do not severely harm mental health and promote suicidal thinking.

We do not know if these regulations, however, will even work. Disclosure that a system is “not human” may not counteract emotional realism. Protocol requirements do not guarantee effectiveness. Operators may avoid collecting information about users’ ages, limiting their obligations to minors.

From a public health perspective, these debates remind me of the challenges with social media platforms. Almost 16 years after Instagram was released, we are now seeing possible the company be held legally liable for its impact on mental health.

Last week, Mark Zuckerberg, CEO of Meta, had to testify in court about whether Instagram (which Meta owns) was designed to addict and harm teenagers. Social media technologies optimized for engagement have amplified loneliness, misinformation, and depression, and AI systems could likely do the same at an ever larger scale.

Evaluating the uncertainty

So back to the original question: Will AI kill us all? I believe the probability of an extinction-level event is low today, but low is not zero, and the consequences would be catastrophic. At the same time, the mental health risks of emotionally persuasive AI systems have already appeared and need to be addressed.

Public health agencies must always prepare for rare catastrophic events while addressing everyday harms. Now, with AI, we must do both simultaneously as well.

Until next week,

Jay

AI therapy can help in countries with scarce care, but experts urge regulation

2026-02-19T12:00:00+00:00

Public health, explained: Sign up to receive Healthbeat’s Global Checkup in your inbox a day early.

Hello from Nairobi.

This week we’ve got interesting news about AI therapy, new gene-editing medicines, and other topics … but before that, I have to mention that TIME magazine just published its 100 most influential people in global health. It’s great for a laugh!

The list includes Chris Hemsworth, for being exceptionally good looking while talking about Alzheimer’s, and some very stilted wordsmithing around Robert F. Kennedy Jr., who is labeled a “Titan of Health.” Conspicuously absent are any of the heroes who responded to last year’s Ebola outbreak. But hey, there’s always next year.

With that, as we say in Swahili: karibu katika habari — welcome to the news.

Your therapist, ChatGPT

The Guardian just published a fascinating article on the global use of artificial intelligence chatbots as therapy tools, featuring vignettes from Nigeria.

As the story states, “AI platforms offering first-line mental health support have proliferated over the past year.” And for Nigeria in particular, there is an obvious appeal in easing access to mental health care in a country with just “262 psychiatrists for 240 million people” (!).

The article starts with a very compelling story about a woman named Joy Adeboye in the capital, Abuja, who turns to an AI chatbot out of desperation and need. The result? “For the first time in months, Adeboye says, she felt less alone.”

Still, in most countries regulation on this use of AI is basically nonexistent, and that makes several basic, open questions all the more pertinent: Do these tools actually work as therapy, are they safe, and should they be trusted with vulnerable people?

I reached out to Briana Vecchione, a researcher who studies this topic at the Data & Society Research Institute, a nonprofit focused on social implications of automation and AI. Vecchione provided some striking insight on both the history of chatbots for therapy (which, surprisingly, dates back to the 1960s), and how to think about the tension between potential harm and help.

We covered much more than I can fit here, but luckily for you, she’s moderating a talk on this very topic on Feb. 26.

On how or if these tools actually work: Vecchione was careful to balance where the research stands (outside of a few narrow contexts, “I don’t believe chatbots are as effective as talk therapy,” she said) with what many users report their lived experience to be. “We have definitely seen that people feel some sort of relief after using these systems,” she said.

“But you need to really be careful about what forms of other care you’re displacing,” and ultimately, she says, “I do not think it’s a replacement for therapy."

When it comes to potential harms, she points to the incentive structures of many of the companies making these AI systems. “These [tools] are typically optimized for engagement. They’re not typically optimized for helping you close the loop and step away, which is actually bad for the companies. They want you to come back,” she said. In Vecchione’s research, she hears users frequently say they “feel unsure when to stop,” or at worse, “feel overly dependent on these systems,” and feel significant shame about that dependence.

Another potential harm is privacy, which I acknowledged to Vecchione I’ve always thought of as an abstract or general concern. But Vecchione points out that the risk here is extremely acute. “These things have no fiduciary duty in the same way that therapists do. They are not protected by HIPAA,” the U.S. Health Insurance Portability and Accountability Act, which protects a patient’s sensitive information, or patient confidentiality, she said. This means that in many countries (the United States included) there is nothing stopping an AI therapy tool from immediately selling your data to a prospective health insurer.

Still, with the prospect of AI therapy filling what would otherwise be an incredible void in many developing countries, Vecchione is clear that “these kinds of supplements to care can be useful,” she said. “Is it better than nothing? Maybe, if it’s being used responsibly.”

What’s the takeaway? At least in the United States, Vecchione and her colleagues have authored a detailed public comment to the U.S. Food and Drug Administration on their recommendations for the future of these technologies. They argue that relevant AI systems should fall within the FDA’s “medical-device” definition for mental health, should be treated as such, and regulated as such.

Diet, exercise, and… gene editing?

We cover a lot of tropical diseases on the Checkup. But zoom out to the global picture, and the biggest threat to health is far less exotic. Heart disease remains the top killer.

As a disease, it’s a bit of a catch-all. A range of factors like high blood pressure, diet, and smoking can damage the heart in different ways. But all told, the major risk for heart disease lies in high LDL cholesterol, which is made by your liver. With too much of this waxy fat, it can build up in blood vessels and block blood flow.

But in what feels like a glimpse of science fiction, clinicians are increasingly experimenting with new gene-editing techniques to reduce LDL cholesterol production, the AP reports. These trials are early, but are showing shocking improvements in patients who did not respond to regular medicines.

How does it work? Basically, a patient is injected with an IV of microscopic fat bubbles, which the liver naturally absorbs from the bloodstream. The trick is that these bubbles are carrying a clever DNA-cutting protein (part of the gene-editing tool CRISPR) along with a short RNA “instruction” that tells it exactly what piece of DNA to cut out.

The clinicians are specifically targeting a gene called ANGPTL3 to edit away, and only in specific cases. In some people this gene goes haywire, and causes an overproduction of “LDL cholesterol and another bad fat, triglycerides.”

It’s a one-time therapy, because when the edited liver cells reproduce … the deleted gene can’t carry onward. These are of course early trials, and the article does a great job couching the caveats.

There are major safety questions to be answered, cautioned Dr. Joseph Wu of Stanford University, who wasn’t involved in either study. CRISPR-based therapies for any disease haven’t been used enough to know long-term safety — and the particles carrying the gene-editing tool can irritate or inflame the liver, he said. Another unknown is whether gene-editing hits only the intended target. That’s why for now, studies largely target people at very high risk.

The who’s who of the next WHO

The World Health Organization director-general’s term does not expire until August 2027, but the race to succeed Tedros Ghebreyesus is already heating up. Nominations formally open in April, and Health Policy Watch is tracking the top contenders circulating in the “rumor mill.”

These include would-bes from the reform-minded Budi Gunadi Sadikin, Indonesia’s minister of health, all the way to Sania Nishtar, the CEO of Gavi.

I’ll be honest, seeing this much speculation so early is a little funny. (The article has some strong “The Bachelor” season premiere vibes.) Still, this is a five-year term that often turns into 10, and is the most important job in global health. So, if we’re being fair, the early speculation is more a la papal conclave than reality TV.

Jokes aside, the job earnestly matters more now than ever. Even beyond the global funding shortfall, the article paints a rough picture of the current state of affairs inside the WHO:

“Internally, the organization is struggling with a 25% cut in staff following the loss of United States support, leading to a low in staff morale. The layoffs, a lack of transparency, sexual abuse scandals, and a fear of retaliation among staff who have raised claims of harassment and damaged trust in the organization’s leadership.”

The real question is, who can right the ship? We will see.

(One last note on the incumbent: It’s too early to assess Ghebreyesus’ tenure. He will be remembered for steering the WHO through Covid and the 2025 wave of austerity. How well did he do? Hard to say. Still, credit where it is due. This week he publicly condemned a controversial U.S.-funded hepatitis drug trial involving newborns in Guinea-Bissau. It is hard to imagine a similar trial within the United States surviving legal/ethical challenges.)

A new polio vaccine

The WHO has cleared a new polio vaccine for global use, Reuters reports.

Disease breakdown: Polio, or poliomyelitis, is a gut virus that spreads largely through feces. While most infections pass without symptoms, the worst cases can wither limbs or invade the spinal cord to cause paralysis or death. Importantly, the disease can’t hide in animals, and vaccines stop it cold. Although polio is ancient enough to have been carved into Egyptian hieroglyphs, two strains of the virus were eliminated in 1999 and 2020, and only two more remain.

We covered this back in October. Despite a 30% cut to the effort, humanity is on the verge of eliminating this disease altogether. (That would make it only the second disease eradication, after smallpox in 1980.)

As I wrote then, “the last wild strain of the virus (still hanging on in Afghanistan and Pakistan) is now expected to be stopped by 2027,” and a second “strain of the virus that bubbled up from earlier vaccine drives, and which is largely pocketed across the African continent,” is on track for elimination by 2029.

What’s the focus of this new, oral drug? It targets that second variant, the vaccine-derived strain behind the African outbreaks. The key upgrade here is that this new vaccine is far more stable, so it’s less likely to mutate and accidentally seed new outbreaks while we work to stop existing ones.

And it can’t come fast enough.

Last week, Malawi launched a new campaign with about 1.7 million doses of the older oral vaccine, after the second variant showed up in sewage in the country’s second largest city, Blantyre, ABC News reports. (You have to love sewage sampling for both its grossness … and its effectiveness at monitoring hundreds of thousands of people to catch diseases early.)

I’ll see you next week.

William

William Herkewitz is a reporter covering global public health for Healthbeat. He is based in Nairobi. Contact William at wherkewitz@healthbeat.org.

How my own medical mystery led to a career in scientific research

2026-01-05T17:26:17+00:00

This story was part of Healthbeat’s live storytelling event, “Aha Moments in Public Health,” held Nov. 3 at Manuel’s Tavern in Atlanta. Watch the full show here. Sign up to receive Healthbeat’s free Atlanta newsletter here.

Days after my 18th birthday, I had a seizure in a lecture hall of 300 people. My introduction to Clemson University and collegiate life involved an ER trip and a big unanswered question: What caused the seizure?

Afterward, my health began to decline. My heart was constantly racing out of control, and I would get dizzy and start sweating profusely, occasionally passing out. I was severely fatigued, and my body ached all over.

I bounced between specialists, had every test you can think of, and left each appointment with more questions than answers.

Then one night while scrolling through Twitter (as one does when they’re desperate for distraction), I came across a lab at the Medical University of South Carolina researching the mechanisms of hypermobile Ehlers-Danlos syndrome, also known as hEDS, a genetic connective tissue disorder.

The collection of symptoms I was reading about sounded suspiciously like what I was living through. Not only was the team in Charleston conducting research, but they were looking for interns — interns who had hEDS.

Most primary care physicians are unfamiliar with hEDS. The average delay between symptom onset and diagnosis is over 10 years. On top of that, hEDS is the only subtype of Ehlers-Danlos syndrome that does not have testing available for known causal genes. That means it is both an “invisible disability” and an unsolved puzzle for the medical community.

I had no diagnosis at the time, but I reached out anyway. I asked if I could still apply, even though my condition had not been confirmed. After I interviewed, it took them just seven minutes to offer me the position.

That summer, I moved to Charleston. I spent my days doing research and learning about hEDS, and through the incredible mentors I met there, I finally got my diagnosis confirmed.

At the end of the summer, my mentor and the team sat me down for a meeting — not to discuss the data I was working with, but to persuade me to pursue a PhD. To consider research as a career.

After a whole year with no direction, no thoughts of anything past the day in front of me, I was suddenly imagining a future in science. I had previously intended to pursue genetic counseling, but the proximity of research to groundbreaking developments in the field drew me in.

Back at Clemson, I switched my focus to research. I joined a canine genetics lab comparing disease etiology in dogs to what was known in humans. I started my own independent project on Miniature American Shepherds, fell in love with Eloise, and she is now my greatest joy.

When I applied to graduate schools, I was advised against disclosing my disability until after I received offers. It might be seen as a hindrance toward my degree progress and ability to produce research for a university. I decided to write about it anyway in my admissions essays because I didn’t want to attend a program with a culture that would not support disabled students.

I leaned into my story. I talked about my diagnosis, my lived experience, and my passion for accessible research. I wasn’t trying to hide my disability — I was reframing it as a strength. And it worked. I received offers of both admissions and fellowships, and I got to share my experience as a patient-scientist.

I think the programs that accepted me recognized that, having experienced the patient side of genetics, I can provide a valuable perspective and enhanced motivation to clinical research and patient care. Patients are an often overlooked resource for important scientific questions, and patient outreach can lay the groundwork for developing treatments and interventions that target the most troubling issues.

MUSC’s hEDS research program and the internship I participated in have led to the first candidate gene discovery, with almost every initiative driven by a patient-scientist.

We need more disabled representation in both genetics and biomedicine to provide an empathetic lens to our research and connect our goals back to those we hope to serve. By including patients and disabled researchers in the research that benefits them, we ensure the impact of our work and learn from the perspectives of those it supports.

Diverse perspectives in research broaden our minds, enhance our critical thinking, and keep moving us forward. Because inclusive science means better science — for everyone.

Katherine Grace Singleton is a genetics and molecular biology PhD candidate at Emory University. She is from Sumter, South Carolina, and did her undergraduate degree and research at Clemson University. After completion of a PhD, Katherine hopes to complete an ACMG-accredited Laboratory Genetics and Genomics fellowship program to continue research in a clinical setting.

This HIV expert quit the CDC: ‘Erasing people from the story harms actual people’

2025-12-10T12:00:00+00:00

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John Weiser, a doctor and researcher, has treated people with HIV since the beginning of the AIDS epidemic in the 1980s. He joined the CDC’s HIV prevention team in 2011 to help lead its Medical Monitoring Project, the only in-depth survey of HIV across the United States. The project has shaped the country’s response to the epidemic over two decades, but the Trump administration censored last year’s findings and stopped funding it.

Weiser spoke with KFF Health News on the evening before World AIDS Day, which the U.S. government didn’t acknowledge for the first time since 1988. That was only the latest blow to efforts to combat HIV. The Trump administration has cut funds to provide lifesaving HIV care abroad, withheld money to prevent and treat HIV in the United States, and fired HIV experts at the Centers for Disease Control and Prevention.

Weiser was fired from the CDC during mass layoffs in April, rehired in June, and then resigned. He continues to treat patients at Grady Memorial Hospital in Atlanta. In November, he published an article that warns against complying with presidential orders to censor data about transgender people.

The following conversation has been condensed and edited for clarity.

In the first weeks of his presidency, Donald Trump issued several executive orders with implications for HIV programs. One directed federal employees to exclude gender identities that didn’t correspond to a person’s biological sex assigned at birth.

On how this played out at the CDC:

We were told to scrub any mention of gender or transgender people from dozens of research papers and surveillance reports that had already been published or were going to be published, and to stop collecting information from participants about their gender identity. For example, we had to recalculate our numbers on HIV among men who have sex with men, or MSM, a category that the CDC changed to “males who have sex with males.”

The CDC had no director at the time. The order came from on high. And there was no discussion about whether we wanted to comply with the directive.

On how this directive has affected his research:

Using data from the Medical Monitoring Project, we found that people with HIV who misused opioids were more likely to engage in behaviors that could pass on HIV to another person — through unprotected sex or shared injection. And we found that very few people who misused opioids were receiving treatments for substance misuse. This information could have been useful to change clinical practice and boost funding to treat people with HIV who misuse opioids.

We were getting ready to publish this study, but when I put the paper through CDC’s clearance process, I was told to remove data about the prevalence of opioid misuse among transgender people.

I thought carefully about that, and I decided not to do that because it’s bad science to suppress data for ideologic reasons, and because erasing people from the story harms actual people. I thought about my transgender patients and how I would face them, and what I would say to them while I’m sitting with them in the exam room, knowing that I had erased their existence from CDC.

I withdrew the paper. It remains unpublished.

On how removing data harms people:

Purging data about transgender people has the effect of erasing them from the real world, pretending that they don’t exist. This group of people is heavily affected by HIV, and this type of information informs improvements in treatment. My transgender patients struggle with poverty, with unstable housing, with food insecurity, with mental health disorders, with substance misuse, and face a huge amount of stigma and discrimination in their daily lives.

My transgender patients are trying to get by, day by day. They’re trying to survive. I think it’s important to realize that somebody who is transgender needs to feel comfortable in their own body to be healthy — and denying them recognition compounds their challenges.

After the executive order came down, one of my patients said she felt even more afraid of being in public and not passing, and so she was considering having additional surgical treatment to feel safer. Her concern was not about politics. It was about survival.

On why the CDC went along with orders to remove transgender data:

I think the hope was that by complying with the directive, other work at the CDC would be spared. And unfortunately, that hasn’t proved to be the case. Funding for the Medical Monitoring Project was terminated after 20 years, and the concern within CDC is that the president will eliminate all HIV prevention and surveillance funding.

One of my concerns while there was that if it’s OK to comply with a directive to remove information about gender, what if the next demand is that we don’t report about people who emigrated from other countries, or on people who are experiencing homelessness? What if there’s a directive to suppress data about a particular racial or ethnic group that’s unpopular? How far would we go?

Some HIV clinics and organizations have considered curtailing their work with transgender people and undocumented immigrants, or on equity initiatives, because they fear the loss of federal funds.

His advice on these decisions:

People making these decisions are in a really tough spot. They want to do what’s best for their programs. They want to do what’s best for their employees. They want to do what’s best for the people they’re charged with taking care of. Those are careful decisions that need to be made weighing all of the considerations. What I want these leaders to do is also consider how a decision to essentially throw one group of people under the bus undermines scientific integrity, and harms everyone.

And I think that it’s also necessary for the rise of autocracy to go along, to compromise, to acquiesce. While all of this was going on, I heard an interview with Masha Gessen, who is a Russian American journalist who writes about the rise of autocracy. Gessen explained that decisions to go along are not made because people are unethical or heartless. They’re rational choices. They’re made in order to protect something that’s important — institutions, families, jobs — even if it means sacrificing principles. Gessen’s point is that this gradual process of compromising ultimately is what solidifies an autocrat’s power.

On why he resigned from the CDC:

As a physician working at the CDC, numbers have always described individual people, people whose suffering I witness. When you know somebody, they’re no longer just a concept that you make a judgment about.

I realized that I could do more good by spending more time with my patients than I could working for the CDC under this administration.

Amy Maxmen is a Healthbeat national reporter through a partnership with KFF Health News.

Emory researcher explains how ‘frugal’ AI could reshape global public health

2025-12-04T21:20:09+00:00

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As the U.S. public health system weighs how to integrate artificial intelligence, an Emory University lab is patenting new ideas for precision medicine that its leader says could bring AI research into practical use – quickly and with nuance.

Professor Anant Madabhushi’s work covers AI options for detecting and treating a dizzying range of diseases, from cancer to HIV to cardiovascular disease, in countries from China to Tanzania to Brazil.

The bioengineer’s upbringing in Mumbai, India, and work with researchers around the world has driven his focus on finding uses for AI to save money, time, and resources in public health and health care.

Madabhushi holds more than 225 issued or pending patents and has headed the Empathetic AI for Health Institute at Emory since 2023. He’s also co-founded several companies focused on AI in health.

The U.S. Department of Health and Human Services announced Thursday an intention to incorporate AI into public health.

Artificial intelligence could have major public health benefits across the world, including the rural United States, Madabhushi said. But he’s concerned the United States is falling behind in the large-cohort studies needed to fuel AI’s promise.

“The necessity of these technologies, frugal and opportunistic, have implications not just in the Global South, but also in rural America,” he said. “We really owe it to Americans to be able to do whatever we can, particularly in this time of health care costs and some of the challenges with access.”

Here are seven takeaways from a recent conversation with Madabhushi.

Artificial intelligence will not replace clinicians.

“In reality, the real value lies in augmenting clinical decision-making, reducing variability, and expanding access — especially where clinical expertise is limited,” Madabhushi said. That includes parts of the world with limited resources, whether that’s his native India or rural Georgia.

Artificial intelligence has the power to transform lives and health systems, but the breakthroughs aren’t “plug-and-play.”

“In truth, they require careful validation, bias mitigation, regulatory oversight, and thoughtful deployment to ensure they actually help patients rather than introduce new inequities,” Madabhushi said.

He pointed to the example of a cancer center in India that sees about 1 million patients a year.

“Whatever technology you bring into play not only has to be able to deliver accurate insights, it also has to be done in a way that doesn’t add time to the system” Madabhushi said. “You can’t add more complexity. You can’t add more seconds to the diagnosis, to the clinical workflow.”

With 1 million patients a year, just one second added to the workflow means “suddenly you’re talking about some serious amount of time.”

Eyes are diagnostic windows to health, Madabhushi said.

Using AI, eyes can predict heart failure among patients with chronic kidney disease, as well as early forms of blood cancers.

“It turns out that even the simple fundus image [of the eye] has so much information, which, with the opportunistic use of AI, could start to tell us about a whole bunch of systemic conditions and systemic diseases,” Madabhushi said. That, in turn, could catch diseases very early and allow people to make lifestyle changes to mitigate their risks.

A “frugality constraint” could be “a game changer.”

Madabhushi and his team studied 10 diseases commonly seen in emergency rooms and found that AI could help reduce the costs of diagnosis while preserving accuracy. The point is to reduce the number of tests – and costs – required to get to a correct diagnosis.

“When you have this frugality constraint encoded into the AI algorithm, then we only require something like 10% or 11% of the total tests that were ordered for that particular patient to get to that diagnosis right,” Madabhushi said. That could dramatically reduce system and individual costs in a variety of settings.

Madabhushi’s longtime obsession with imaging has driven his commitment to saving money on the front end of diagnosis. AI can save “some very, very serious money” on pathology slides. Pathologists often need multiple stains of slides to diagnose disease. Those costs can add up quickly, with the burden falling on patients in countries like India. AI could obviate that by producing the multiple stains all at once.

In places like India, “You don’t have the luxury of these additional [pathology] stains, and if we could learn all of these various stains and parameters from a single HD [high definition] image with the power of AI, now that becomes a game changer,” Madabhushi said.

AI can reduce human suffering.

A paper Madabhushi published this week highlights this. The paper reports that AI could distinguish which types of prostate cancer would benefit from a particular type of chemotherapy drug (docetaxel) without the need for additional biopsies. The ability to distinguish which types of prostate cancer would benefit from the strong drug could prevent people from needlessly suffering serious side effects, which can include neurotoxicity and, very rarely, death.

AI research should reflect diverse populations.

“We want to make sure that we have diversity in these data sets for training the models. We want to make sure these tools that we’re developing truly are going to work across a plurality of populations,” Madabhushi said.

He pointed to a paper published this summer that found differences in endometrial cancer in Black and white patients.

“When we explicitly incorporated those differences in creating more population-tailored models for Black women, those AI models work much, much better compared to a what is called a population-agnostic one,” Madabhushi said.

The United States is losing its edge in AI health research.

“Maybe there was a time where we had a bit of an edge, but I think we’ve really given up that edge,” Madabhushi said, noting China is “quite significantly ahead” in the health care and AI space. Chinese researchers are more easily able to access and share large datasets about patients, which are key to validating AI algorithms.

“The Chinese have been able to figure this out at speed compared to us,” Madabhushi said, in part through robust data-sharing arrangements.

He also pointed to India, saying the country’s entrepreneurial spirit of doing more with less has driven innovative technologies that are now being deployed in the United States.

Madabhushi gave the example of Mumbai-founded Qure.AI, a company with AI products that can help detect lung cancer and tuberculosis. The company’s technology has been deployed in over 100 countries, according to its website, including the United States and across Europe.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Low-income Georgia women can get free cancer screenings. Many don’t. A new study asks why.

2025-11-12T21:12:01+00:00

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Low-income women in Georgia and across the country can get screenings for breast and cervical cancer for free – but not all of them do.

A new project at Morehouse School of Medicine aims to learn what barriers Black and Latina women in Georgia face in accessing those services. Researchers are launching a two-year, $800,000 project to find out, funded by the Black Women’s Health Imperative, a national nonprofit and advocacy group.

The study aims to understand why people may not be taking advantage of what Morehouse School of Medicine associate professor Desiree Rivers calls “an incredible resource”: the Georgia Breast and Cervical Cancer program, which provides free screenings for low-income, under- or uninsured women.

The Georgia initiative is part of a national program overseen and funded by the Centers for Disease Control and Prevention since 1991.

While President Donald Trump’s budget proposal for fiscal 2026 would have eliminated the screening program, the latest version of the Senate budget includes funding to continue it, and the House budget would increase funding, said Molly Guthrie, vice president of policy and advocacy at the Susan G. Komen breast cancer nonprofit.

Close to half a million, or 14%, of Georgia women between ages 18 and 64 were uninsured in 2023, according to the U.S. Census. About 12.7% of Black women in that age group are uninsured, and the rate is especially high for Latina women: 34.2%.

Atlanta study finds relationship between childhood trauma and heart health in Black women

The Georgia screening program screened only 11,919 women for breast and cervical cancer in fiscal 2024, according to data from the Georgia Department of Public Health. The screenings and other related services are available at local public health departments, the Grady Health System, and some other locations.

Many women know they should get regular mammograms and cervical cancer screenings, said Dr. Christopher Ervin, director for community-based initiatives at the Department of Family Medicine at the Morehouse School of Medicine. But that doesn’t mean it’s easy for them to do so, even if the tests are free. That’s the impetus for the new study.

“What we think will be important is if we had some way of understanding why aren’t people taking advantage of those services,” said Rivers, the study’s principal investigator.

Some of the reasons could be a lack of knowledge, a lack of transportation, caregiving responsibilities, and difficulty taking time off work, especially for hourly employees, Rivers and Ervin said.

There could be psychological reasons, as well, said Jenny Spencer, an assistant professor of population health at the University of Texas at Austin’s Dell Medical School who is not involved in the study. People may be scared of a positive result or feel like they won’t have the resources to get needed care if diagnosed with cancer.

“When you look at ‘what I should be doing to be healthy’ versus ‘what I can do to be healthy’ in many of these communities,’ that’s a big gap to cross,” Ervin said. “The point of this study is, how do we help our community members better utilize the screenings that are available to them?”

That’s particularly important for Black and Latina women, said Amirah Burton, a postdoctoral fellow at Morehouse School of Medicine.

When compared to white women, fewer Black women are diagnosed, Burton said.

Black women who are diagnosed “tend to have worse survival rates. They die sooner. They have worse outcomes in terms of their health when compared to white women,” Burton said, meaning that increasing early screening for breast and cervical cancer can make a difference.

Mortality is higher in non-Hispanic Black women than in non-Hispanic white women for breast and cervical cancer, Spencer said. Black women also have higher incidence of cervical cancer.

“Historical racism in the United States has led to differences in clinical care by race that persist,” Spencer said. “We know that women with otherwise similar characteristics do have different outcomes.”

The researchers in Atlanta want to recruit 120 participants for their study. They will use surveys and interviews to better understand what barriers the women face in getting the screenings. They will also use community health workers to help women better access services and track how well that works. They will incorporate those workers’ and medical providers’ perspectives into their research, as well. The screenings will be conducted at Grady.

Conducting the research in DeKalb and Fulton, counties with large Black populations, and under the auspices of a historically black college and university is important, Burton said.

“We’re not just doing it just because we’re doing it [but] because we care about you all in the population that we are serving,” Burton said. “We can help those in the community, help them to not only understand the importance, but to help them also understand the work we’re doing.”

People interested in participating in the study or learning more can email Professor Desiree Rivers at drivers@msm.edu.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Monkey escape is latest safety breach involving Tulane research facility

2025-10-31T17:45:51+00:00

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The crash of a truckload of research monkeys this week in Mississippi is the latest safety breach involving a national primate research center run by Tulane University.

The Tulane National Biomedical Research Center in Covington, La., drew national media attention in 2015 when a deadly foreign-strain of bacteria – that poses a significant public health threat in other countries – escaped one of the center’s high-containment laboratories.

That incident, which I reported on at the time for USA Today and further investigated for a recent book on the risks posed by lab accidents, is one of several biosafety lapses that have occurred over the years at the research facility. Until it was renamed this month, the center was called the Tulane National Primate Research Center.

A Tulane spokesperson said the center’s safety history has nothing to do with Tuesday’s truck crash that resulted in the escape of some of the 21 rhesus macaques that were being transported from the university’s facility to an undisclosed destination.

“This incident is completely unrelated to the other issues you mention,” Tulane spokesman Mike Strecker said Friday in a text message to Healthbeat, noting the animals were not owned or transported by the center. “The primates in this week’s tragic accident were not carrying any diseases and had received recent checkups confirming that they were pathogen-free.”

Here are four things to know about some of the Tulane research center’s past biosafety breaches, which are detailed in a full chapter about the facility in my book, “Pandora’s Gamble: Lab Leaks, Pandemics, and a World at Risk.”

Deadly bacteria escaped Tulane center’s lab in 2014

In late 2014, two rhesus macaques – part of the Tulane center’s massive monkey breeding operation that involved about 4,000 animals kept in outdoor cages – became ill. Tests ultimately revealed they were infected with a lab-strain of a dangerous bacterium called Burkholderia pseudomallei.

The monkeys, as breeding stock, had never been used in any experiments. Their outdoor cages were on the other side of the center’s 500-acre compound, far from the secure and federally regulated biosafety level 3 lab where scientists had been using this specific strain of bacteria.

The strain, called 1026b, was not one that could be found naturally in the United States. It had been isolated from a rice farmer in Thailand who became infected in 1993.

Burkholderia pseudomallei causes a disease called melioidosis that can be fatal in people and animals. The disease, which is spread through contact with bacteria-contaminated water or soil, as well as by breathing contaminated dust or water droplets, is difficult to diagnose. The bacteria is often studied because of its potential to be used as a biological weapon and the need to develop treatments against the disease.

The bacterium is rarely found in the United States, but poses a significant public health risk in parts of the world with tropical climates where it is common, especially Southeast Asia and northern Australia.

The bacteria’s release from the center’s secure lab worried local, state, and federal officials because Burkholderia pseudomallei bacteria, which can cause fatal infections in people, lives and grows in warm, moist soil.

These conditions were present in the dirt and grass floored cages where the sick monkeys had been living – raising concerns about the potential for contamination of the wider environment in that part of Louisiana.

CDC investigators blamed sloppy lab practices for bacteria release

Lab regulators from the Centers for Disease Control and Prevention announced in March 2015 that the federal investigation concluded the most likely cause of the bacteria getting out of Tulane’s secure lab involved the organism hitching a ride to the monkeys on contaminated worker clothing.

Federal inspectors determined that workers routinely entered the secure lab without wearing appropriate personal protective gear, increasing the risk of unknowingly carrying bacteria out of the lab or becoming infected. The monkeys, the CDC said, may have become infected either in their outdoor cages or in an on-site veterinary clinic where they went for routine care and treatments.

“CDC has found no evidence to date to suggest the organism was released into the surrounding environment, and therefore it’s unlikely there is any threat to the general population,” the agency told the public.

USDA investigators privately warned of risk to Louisiana’s environment

Investigators for another federal agency, however, saw the situation differently.

According to a copy of a 58-page risk assessment, obtained for “Pandora’s Gamble” through public records requests, investigators from the U.S. Department of Agriculture saw several plausible ways the bacteria could have escaped the facility’s labs.

They concluded, however, that contaminated laboratory wastewater was the most likely way the bacteria escaped the lab and infected monkeys in the outdoor breeding colony. The USDA report found evidence that Tulane was lax in its decontamination of potentially infectious wastewater going back years – a particularly significant issue for a bacteria that lives in water and soil.

The serious biosafety breaches cited in the USDA risk assessment included the way lab workers at the Tulane center failed to decontaminate – with bleach or heat – the blood and body fluids from animals used in experiments with Burkholderia pseudomallei.

Instead, the report said, infected monkeys were “exsanguinated” – draining the blood from their bodies – “directly into the sink during the course of euthanasia and that fluids were not retained for any contact period with disinfectant before entering the drain.”

These fluids from infected monkeys then flowed into the primate center’s on-site wastewater settling ponds, the report said, noting the ponds were near the outdoor breeding colony. The USDA team noted that the nearby Bogue Falaya River, where the center’s wastewater was discharged, “is within the optimal temperature range for B. pseudomallei April through October.”

CDC inspectors privately also had concerns about the facility’s workers not properly disinfecting blood and tissue waste from infected monkeys before sending the potentially infectious materials down the drain.

“This observation raises serious concerns regarding environmental contamination due to improper decontamination of infectious fluids,” they wrote in a March 2015 inspection report marked “Sensitive But Unclassified” that I obtained for the book under the Freedom of Information Act.

In the wake of the monkey infections and regulatory concerns, Tulane officials have said that hundreds of tests have been done of the environment, wildlife, monkeys, and lab workers and that none have detected the presence of Burkholderia pseudomallei.

In response to the 2015 monkey infection incident, Tulane told me for the book that the center had “improved our biosafety program which is widely regarded as a model program for other institutions throughout the country.”

More lab wastewater safety lapses occurred in 2017

Records show that in October 2017, the USDA notified the Tulane center it could face up to $600,000 in fines for multiple violations of the Agricultural Bioterrorism Protection Act of 2002 for issues related to its release of Burkholderia pseudomallei.

The department eventually let Tulane settle the violations by paying about $39,000.

Despite safety concerns about the potential of the facility’s wastewater to release pathogens into the environment, records show that in November 2017 built-up sewage sludge was pulled out of the facility’s wastewater treatment plant that serves laboratories, then spread across the ground in an area on the primate center’s property where the debris from monkey cages was routinely dumped.

Tulane’s safety officials didn’t learn about the sludge spreading until a month after it happened, and they didn’t notify state environmental regulators until October 2018, records show.

During that gap, Tulane hired an outside expert to test soil at the dump site for the presence of Burkholderia pseudomallei and also the bacteria that cause anthrax. Both had been studied in the center’s labs, and both had the potential to contaminate the environment if they were present.

The tests did not detect the presence of these pathogens, and in correspondence with Louisiana environmental regulators, Tulane officials said they “believe that the land application of the sludge did not have an adverse effect on the environment, did not pose a threat to public health, and did not cause an emergency condition.”

In 2021, Tulane officials sought funding from the National Institutes of Health to improve systems at the research facility, including installing a system to sterilize biohazardous liquid lab waste.

“Effluent decontamination capabilities are desperately needed and will be realized through installation of the proposed effluent decontamination system,” Tulane wrote in its application, which was funded.

A spokesperson for the university told me for the book that the request involved equipment needed for future growth into new research areas and that the center’s existing programs were in compliance with waste treatment rules.

Questions remain about monkeys that escaped in Mississippi this week

In the wake of Tuesday’s truck crash on Interstate 59 in Mississippi, which resulted in some monkeys escaping and others being killed, Tulane officials have released little information about why the animals were being moved or where they were going.

The Jasper County, Mississippi, sheriff’s department initially announced on Facebook that the monkeys were aggressive, carried “hepatitis C, herpes, and COVID,” and that handling them required the use of personal protective equipment, based on what the department said the truck’s driver told local law enforcement.

The sheriff’s department later posted a short statement from Tulane, which said that the research center provides primates to other research organizations, and the monkeys involved in the crash “belong to another entity and are not infectious.” But that organization was not identified.

In text messages to Healthbeat on Friday, Tulane spokesman Strecker said it is the university’s understanding that 13 of the monkeys recovered from the crash site remain in the possession of their owner and have arrived at their original destination.

Local law enforcement has acknowledged that some of the 21 rhesus macaques monkeys that were being transported were killed by officers after the crash. Three monkeys were still on the loose as of midday Friday, according to the Mississippi Department of Wildlife, Fisheries, and Parks, whose officers are involved in the search.

Strecker said that the transport of research animals is common and usually involves contracts that prevent the disclosure of information “both for the safety of the animals and to protect the parties’ proprietary information.”

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

What the Apple Watch teaches public health about monitoring disease

2025-10-15T16:53:55+00:00

Dr. Jay K. Varma is a special contributor to Healthbeat. Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

When the Food and Drug Administration cleared the Apple Watch Hypertension Notification Feature this year, it approved a medical device that, curiously enough, does not actually measure blood pressure. Instead of displaying systolic or diastolic readings, it aggregates data from its light sensor and, after 30 days of monitoring, uses a mathematical algorithm to decide whether to alert a user that their blood pressure may be high and could benefit from being checked.

While the Apple Watch identifies only about 40% of people with hypertension, the FDA cleared it because the device’s specificity is high. That is, most alerts indicate high blood pressure, and, for a person who already owns an Apple Watch, there is no additional cost.

When I heard the FDA announcement, I was struck by how it represents a larger shift that has been occurring in both personal and public health. As more health-related data become available, duration can sometimes be more important than accuracy. That is, the longer and more continuously we can monitor patterns, whether in a person’s physiology or a community’s wastewater, the better able we are able to assess health, even if each individual measurement is imperfect.

How technology is changing how we test people for diseases

For most of modern medicine, we designed tests for two different purposes and used them in sequence. We first use tests with high sensitivity — ones that rarely miss disease — to screen a large population. If someone tests positive on this test, we then use a second test with high specificity — one that rarely gives a false positive — to definitively diagnose them with a disease and offer them treatment.

For example, when I was working in Southeast Asia, I helped develop a screening test that could identify people with HIV who were likely to have tuberculosis, the leading cause of death in that population. The purpose of that screening test was to identify patients who would benefit from further testing, such as chest X-rays and microbiologic analysis of their sputum, and, if diagnosed, anti-TB treatment.

The Apple Watch has an optical light sensor that detects changes in light absorption due to pulsatile blood flow. When combined with motion and heart rate data, the watch’s software detects patterns that suggest sustained high blood pressure.

As wearable sensors become more available, many of us are concerned that these devices are too sensitive. They will trigger false alarms, leading to unnecessary visits, anxiety, and wasted clinical resources. Apple took a smart approach by adding an additional dimension: What happens if we continuously apply an imperfect test to a person, then aggregate the results of that imperfect test over time before delivering a result?

In some ways, Apple shifted to a “specificity-first” approach for hypertension: missing some cases temporarily is acceptable, because confirmatory testing is cheap (a blood pressure cuff), the condition develops slowly, a delay in diagnosis is rarely deadly, and the monitoring runs constantly in the background. It also helps prevent monitoring fatigue, i.e., people ignoring alerts because the device is constantly indicating something is wrong.

In the studies Apple conducted to get approval, participants wore the device for at least 15 days within a 30-day window. The algorithm correctly identified high blood pressure in about 40% of adults who truly had the condition, while falsely indicating high blood pressure in 8% of adults who did not have the condition. Among people with Stage 2 hypertension, over 50% were correctly identified.

While this means that half of people with high blood pressure will not be detected, the algorithm was deliberately designed to minimize false positives while ensuring that the highest-risk users were the most likely to receive alerts. In this model, the objective is to identify people at highest risk and push them toward having a definitive test. Moreover, it is assumed that people with hypertension who are missed during one screening period might be detected at a future date if they continue wearing the watch. Continuous monitoring helps compensate for imperfect snapshots.

While clinical medicine has used continuous monitoring to measure abnormal heart rhythms and changes in blood sugar, Apple and other companies are creating devices that are worn for non-health purposes by millions of people already while also collecting health data passively and unobtrusively.

How continuous monitoring has benefited public health practice

What Apple is doing for individual health has been something that public health has been gradually shifting toward as well. For most of modern public health, our disease surveillance systems have relied on discrete moments, such as laboratory tests or household surveys. Two big infectious disease events changed that.

After the bioterrorism-related anthrax attacks in 2001, public health agencies began implementing syndromic surveillance systems. Instead of tracking laboratory or physician reports of disease, public health agencies began monitoring health-related events, such as 911 calls, emergency department visits, and over-the-counter medication sales. These data were messy and nonspecific, but the fact that they were collected continuously over years made them powerful. In late February and early March 2020, this data indicated a rise in “influenza-like illness” visits to emergency departments after peak influenza season. This was a trigger — just like an Apple Watch hypertension alert — to test for other pathogens, such as Covid, which had not yet been detected broadly in the community.

Here’s how artificial intelligence could improve public health

The Covid pandemic led to another shift in continuous monitoring: wastewater surveillance. Wastewater contains genetic fragments of viruses and other pathogens excreted by infected persons, including those who have not yet been diagnosed. Microbiologists are able to test wastewater specimens to detect and follow trends for infectious diseases that may be circulating in the community. Any one test performed on a sewage specimen is unlikely to be useful, because it contains the waste of many humans and animals, but continuous tracking from multiple sites in cities has helped improve detection of Covid before standard surveillance did.

Opportunities for continuous monitoring to improve public health in the future

The same principle now extends to other domains where continuous monitoring can help turn “noisy” data into important health signals.

Efforts are ongoing to expand wastewater surveillance to monitor a broader range of pathogens beyond Covid, such as mpox and measles, and for opiates and other illicit drugs.

New devices can listen for cough and collect data continuously to help monitor for an increase in respiratory infections, including seasonal viruses and TB.

Public health agencies primarily rely on periodic surveys of children and of school entrance records to monitor vaccination uptake. With anti-vaccine sentiment rising, these episodic measurements may miss early trends in vaccine hesitancy or refusal that might be detected earlier by aggregating electronic health record data.

We still need highly accurate laboratory tests

Continuous monitoring needs to complement, rather than replace, traditional public health surveillance, such as laboratory-reports of confirmed cases. The first tells us that something may be happening; the second tells us what is definitively happening and how to respond.

This is particularly important for high-consequence infectious diseases — like novel influenza strains, measles, botulism, or Ebola — in which public health officials and clinicians need tests with both high sensitivity and high specificity. In these settings, a single false positive can lead to unnecessary interventions and public concern, while a false negative can delay opportunities to limit transmission.

Challenges for monitoring health continuously

Constant monitoring of individuals and populations creates new ethical and equity challenges. Wearable devices generate massive streams of physiological data. Questions remain about ownership, consent, and potential misuse by employers or insurers. Algorithmic bias also threatens fairness. Apple says it invested in large, diverse clinical studies to validate performance across skin tones and demographics, but we know that devices may not work the same in all populations. Portable oxygen monitoring (“pulse oximetry”) was used for 40 years before a large study showed definitively that it produced inaccurate results in people with dark skin tones.

Continuous observation is transforming how we understand both individual and population health. Wearables like Apple’s hypertension feature for individual health and wastewater surveillance for public health share a common principle: While a single data point may be “noise,” a pattern across thousands of data points may be a “signal” for action. The future of public health surveillance will ideally include a combination of both more accurate individual tests and broader sources of data to detect patterns that might otherwise be missed.

Dr. Jay K. Varma is a physician and epidemiologist. An expert in the prevention and control of infectious diseases, he has led epidemic responses, developed global and national policies, and implemented large-scale programs that saved hundreds of thousands of lives in Asia, Africa, and the United States.

Emory University contract cut in Trump administration’s mRNA vaccine research ‘wind-down’

2025-08-08T19:16:28+00:00

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A research project at Emory University is among the 22 grants and contracts that are being cancelled as the U.S. Department of Health and Human Services begins a “coordinated wind-down” of research studying mRNA vaccine technology.

The grants, which were being developed under the Biomedical Advanced Research and Development Authority, amounted to nearly $500 million in funding to research projects. According to the agency website, researchers at Emory received $750,000 to develop an inhalable dry powder that could be used to immunize patients against influenza and SARS-CoV-2, the virus that causes Covid-19. Emory University did not respond to a request for comment.

Vaccines using mRNA were first developed by Pfizer-BioNTech and Moderna in response to the Covid-19 pandemic, and won a Nobel Prize in Physiology or Medicine in 2023. While traditional vaccines can take years to develop, mRNA vaccines can be developed much faster, and can be more quickly adapted in response to virus mutations.

However, U.S. Health Secretary Robert F. Kennedy Jr. — who has repeatedly questioned the safety and efficacy of vaccines and promoted widely debunked claims about vaccine harm — claimed that the Trump administration was terminating the grants because mRNA vaccines “fail to protect effectively against upper respiratory infections like Covid and flu.”

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“We’re shifting that funding toward safer, broader vaccine platforms that remain effective even as viruses mutate,” he said in a Tuesday announcement. Research contracts with companies like Luminary Labs, ModeX Therapeutics, and CSL Seqirus are also being cancelled.

The most recent round of grant terminations comes on the heels of a nearly $600 million contract with Moderna aimed at developing a vaccine against bird flu that was cancelled by the Trump administration in May.

Public health experts, including state Rep. Michelle Au, a Johns Creek Democrat, condemned the decision to terminate the grants.

“Many preventable diseases will not, in fact, be prevented,” she said. “We will see the result of many chronic health conditions resulting from preventable disease, and those effects are going to last decades. This is a generational change in how we approach vaccine support and funding, not just in this country, but worldwide.”

Georgia’s current childhood vaccine rates are also far below the 95% rate needed to ensure herd immunity from measles, mumps and rubella, according to data from the Centers for Disease Control and Prevention. Only 88.4% of kindergarten students in Georgia received the MMR vaccine during the 2023-24 school year.

Au, who works as an anesthesiologist, also warned of the harm that could await future patients due to vaccine research cuts.

“We’re only starting to scratch the surface of the damage that we’re going to see,” she said. “When you stop research in its tracks like this, even if you say, ‘oh, maybe we’ll restore the cuts in the future,’ these are harms that will carry through even beyond what the immediate funding cuts generate.”

This story was originally published at Georgia Recorder.

How AI can help public health agencies improve screening, prevention, and treatment of diseases

2025-08-05T13:33:05+00:00

This is a guest essay for Healthbeat. Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

While public health agencies focus primarily on assessment, policy development, and assurance of services, they are also frequently tasked with the primary prevention and control of high-priority infectious and chronic diseases and with supporting maternal-child health.

Artificial intelligence can improve disease control by improving patient communication, supporting clinical decision-making, and managing resources and data more effectively.

AI can improve immunization logistics and uptake

Public health agencies often manage the ordering, distribution, and monitoring of recommended childhood vaccines and some adult vaccines, such as influenza. The Covid-19 pandemic exposed important weaknesses in these systems, including patient registration and eligibility assessments, recall reminders, and inventory management.

Many immunization information systems also have gaps in their ability to integrate with electronic health records, and, in some states, legal barriers restrict the completeness of recording and reporting. AI can help clean and standardize these records, filling in missing data and identifying children who have missed routine vaccines.

Several examples of using AI for immunization systems have been documented outside the United States. In DataKind’s collaboration with Gavi, an AI-supported system used natural language processing to scan paper-based health records and extract vaccine histories, helping outreach workers locate unvaccinated children. It also used machine learning to predict where vaccine stocks would run low and which areas were likely to have higher dropout rates.

These insights help immunization programs pre-position supplies, organize mobile clinics, and target community education campaigns. They also help prevent waste and shortages of vaccines.

AI can strengthen HIV, STI, and TB prevention and treatment

Public health departments operate some of the longest-running, most comprehensive programs to screen and treat tuberculosis, sexually transmitted infections, and HIV. Despite tremendous advances in biomedicine — from rapid testing systems to improved prevention and treatment regimens for all three conditions — many health departments still rely on antiquated systems for other aspects of disease control. Registering, tracing, and tracking patients and exposed persons often requires the use of paper forms, faxed results, and manual data entry.

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Digital chatbots, already tested in HIV and STI programs in South Africa, can improve outreach by answering common questions, booking appointments, and conducting eligibility screening. AI can also analyze surveillance data to identify geographic clusters of new cases or detect unusual patterns that might indicate a gap in prevention services.

For TB, computer vision algorithms can now interpret chest X-rays more accurately than non-specialist clinicians. While these tools do not replace clinicians or case managers, they could be used to triage patients faster, support decision-making, and flag anomalies in real time.

That, in turn, allows skilled public health workers to focus on activities that require human interaction, empathy, and judgment, such as interviewing patients about highly sensitive topics, counseling them on treatment options and social services, and supporting them emotionally.

AI can strengthen services to pregnant patients and infants

Public health systems have long prioritized linking people to care as soon as they become pregnant and supporting them through pregnancy and the first weeks of a baby’s life. Delays in accessing care, poor follow-up, and low-quality care can lead to complications, disability, or death, as demonstrated by persistently high infant mortality rates and a growing epidemic of congenital syphilis.

Digital assistants powered by AI can help frontline health workers deliver timely information to pregnant people and new parents, including personalized messages about antenatal visits, warning signs, and infant feeding. When integrated with electronic health records, these systems can alert providers when patients miss appointments or when risk factors suggest the need for more frequent monitoring.

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In Rwanda, an AI algorithm used data from routine prenatal visits to predict which pregnancies were most likely to result in adverse outcomes. When applied, this could help nurses and midwives prioritize specific patients for follow-up care, reducing their workload and improving outcomes. Similarly, AI-supported triage tools can help differentiate normal from high-risk deliveries, ensuring that women are routed to the most appropriate facility for their pregnancy.

Postnatal care may offer the most immediate opportunity to improve outcomes. Many deaths among mothers and newborns occur in the weeks immediately after birth. AI-powered mobile apps or voice-based tools can help monitor symptoms, guide self-care, and prompt clinic visits when needed.

AI can help expand reach and reduce inequity in chronic disease care

While screening for hypertension, diabetes, and cancer is primarily carried out by clinics and hospitals, public health agencies often organize mass screening events, promulgate guidelines, and work to connect underserved populations to care. AI can help improve the efficiency and equity of these efforts.

Algorithms can analyze electronic health records and insurance claims to identify people who are overdue for screening. AI tools can also support mobile screening units by rapidly interpreting test results and flagging high-risk individuals for follow-up. In India, researchers developed a smartphone-based retinal scanner paired with an AI system that screens for diabetic retinopathy, allowing trained technicians, not ophthalmologists, to provide service in rural areas.

For cancer screening, AI can support interpretation of mammograms, Pap smears, or stool-based tests. Chatbots, phone-based reminders, and predictive risk models can help ensure that people complete initial testing and follow through with diagnostic evaluation and treatment.

AI implementation requires funding, leadership, and oversight

One of the most critical unanswered questions is whether AI applications will improve services and disease control in populations who distrust health institutions or face barriers to care. AI evangelists argue that AI can help health care workers personalize their outreach messages, identify the highest priority persons or populations for intervention, and offload some routine tasks to increase the amount of direct human contact with persons in need of services.

The risks, however, remain substantial. AI in public health raises concerns about data privacy, surveillance, bias, and accountability. Systems trained on incomplete or biased data can reinforce inequities. Tools designed without community input may be rejected by those they aim to serve. And commercial AI systems may be unaffordable for public agencies unless open-source models or shared infrastructure are developed.

Realizing the benefits of AI, while limiting the harms, will require public health agencies to have a combination of funding to modernize data systems, leadership willing to take chances, and ongoing technical, ethical, legal review about patient rights and equitable application.

Atlanta researchers develop wearable sensor to help outdoor workers stay safe in heat

2025-07-17T13:35:42+00:00

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Growing up as the daughter of immigrants from El Salvador, Roxana Chicas heard horror stories about what the heat could do to construction workers like her stepfather.

Stories of a worker who got dizzy and fell off a roof, a farmworker who fainted in the field and was run over by a tractor trailer, and the daily challenges of working outdoors under a “blazing sun” inspired Chicas to devote her career to researching the impacts of heat on the body.

“I remember those stories and carry them with me in everything that I do now,” said Chicas, an assistant professor of nursing at Emory University in Atlanta. She and a team of researchers from Georgia Tech have developed a new device to help outdoor workers monitor how heat is affecting their bodies and collect data to better understand the effects.

People who do intense physical labor in high temperatures and become dehydrated are at risk of kidney damage. The new device, a two-inch patch worn on the chest, measures those indicators and alerts wearers to take a break and rehydrate. The sensor, which connects to the wearer’s phone via Bluetooth, tracks physical activity, oxygenation rate, respiration rate, heart rate, and skin temperature.

Summer heat is felt unevenly across metro Atlanta. Experts say more data is needed to address the public health threat.

The project, funded by a five-year, $2.46 million grant from the National Institutes of Health, developed from Chicas’ research with farmworker groups in Florida.

“Many farmworkers work in rural communities. They are often unseen, but they are often at the front lines of climate change,” Chicas said. “Oftentimes workers will push themselves to continue working … they just feel like they have to power through.”

But that could seriously damage their bodies or lead to heatstroke, she said. Chicas and other scientists have identified associations among outdoor work, dehydration, and physically intense labor and acute kidney injury, although they don’t fully understand the physiological mechanisms behind that. Repeated multiple times, acute kidney injury can cause chronic kidney injury, she said.

Dr. Roxana Chicas, an assistant professor of nursing at Emory University in Atlanta, worked with a team of researchers from Georgia Tech to develop a device to help outdoor workers monitor how heat is affecting their bodies.

Heat is a public health problem, with farmworkers 35 times more likely than others to die from heat-related causes, according to a 2016 study in the American Journal of Industrial Medicine. A 2018 study in Lancet Planet Health found that 15% of people who worked under heat stress experienced kidney disease or acute kidney injury.

Earlier this year, the Medical Society Consortium on Climate and Health and 86 other organizations sent a letter to the Occupational Safety and Health Administration urging it to finalize heat protections for workers.

Besides kidney damage, heat can cause respiratory problems, and it’s been associated with higher rates of preterm births and low birthweight.

The idea for the sensor came from Chicas’ community-based research with a mostly Spanish-speaking farmworker population in Florida and Georgia. Georgia had about 44,000 farmworkers in 2022, according to the U.S. Department of Agriculture’s Census of Agriculture.

Chicas and her team asked the workers to name their top concern, expecting the answer to be pesticides. The workers said it was heat.

“They started talking about how hot it is, how they feel like it gets hotter every year … They just don’t know how to consider exactly what’s happening, but they feel different,” Chicas said.

The heat monitoring patch is designed to be worn on the chest.

That response launched her team down a path of multiple smaller studies to better understand what was going on. One study found farmworkers’ core body temperatures after work reached 38 degrees Celsius (100.4 degrees Fahrenheit) and higher, which significantly increases the risk of heatstroke, Chicas said.

They found that a cooling bandana around the neck can provide better relief than a cooling vest, and that workers who drank 5 liters of water with electrolytes did not get dehydrated, while workers who drank the same amount of plain water did.

Chicas said the heat sensor project will use machine learning to mine and analyze data from the sensors. Most workers have smartphones, she said, and are eager to try new things.

Community groups that work with farm laborers in Florida recruited a group of 18 volunteers to try out the sensor in July 2021. In exchange, the study organizers provided the workers with detailed health data, including cholesterol, blood sugar, kidney function, and other indicators.

“They have said to us that that’s the number one reason why they participate, because they want to know about their health, because many of them do not have access to health care,” Chicas said.

Cristian Estrada, South Georgia organizer for the Latino Community Fund of Georgia, said the farmworkers he works with aren’t guaranteed breaks. Their working hours have shifted earlier and earlier, so they can finish before the heat of midday, which can reach an average of 95 degrees in July, according to the National Weather Service.

Estrada said he likes the idea of a sensor to help workers and highlight the problems faced by farmworkers.

“It’s a great way to just find out more about a community that’s underlooked,” Estrada said.

Chicas and her team want to see the product on the market – at an affordable price – within the next year or two.

“This is a population that really is the backbone of the food industry and really requires some attention from us to help them stay healthy so that they can continue being the backbone of the food industry,” Chicas said.

She said she wants to see greater federal and state protections for outdoor workers.

“We’ve all agreed we don’t want people dying in the fields,” she said.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

How AI can make infectious disease surveillance smarter, faster, and more useful

2025-07-01T11:00:00+00:00

This is a guest essay for Healthbeat. Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

Public health agencies are under pressure to move faster, detect threats earlier, and make better decisions, even as their funding is cut and their authority reduced. While most public health agencies will have to do less with less, artificial intelligence systems provide an opportunity to maintain and possibly improve performance in one critical area: infectious disease surveillance.

When I led infectious disease programs for the New York City Health Department, I saw how even the best-resourced health departments rely on inefficient, error-prone systems. Disease surveillance often requires personnel to manually review lab reports, call health care providers, and write and revise code to clean, analyze, and visualize data.

AI has improved performance in industries where data are abundant and decisions need to be fast and accurate, such as finance and logistics. Public health surveillance systems are essentially large repositories of data about a community’s health. The same tools that improve performance in other fields can help health agencies save time, improve accuracy, and act faster.

What is disease surveillance and why does it matter?

Surveillance is how governments monitor the incidence and overall burden of disease in a population over time, detect outbreaks, inform policies, and assess whether prevention and control programs are working. Each state maintains a list of “notifiable” diseases that health care providers and laboratories are legally mandated to report.

With infectious diseases, most reporting occurs through laboratory-based surveillance. The system is supposed to work like this: A patient has symptoms and visits a health care provider, the provider collects a specimen from the patient and sends it to a clinical laboratory, the laboratory performs tests to identify a potential pathogen, then the laboratory reports that data to a state or local health agency. This is how health agencies collect data about everything from salmonella to HIV to Covid-19.

Monitoring laboratory-confirmed cases, in this way, gives public health agencies the confidence that they are investigating cases of public health importance, not just people with symptoms of a disease that is less relevant to public health.

Here’s how artificial intelligence could improve public health

Health agencies ideally receive these reports electronically through systems that use standardized digital formatting and vocabulary. But many reports still come by fax or phone. More importantly, regardless of whether data are transmitted digitally or analog, duplicate records must be adjudicated, errors corrected, and missing information (often about patient demographics and exposures) filled in.

AI can improve how data get collected and reported

Labs generate huge volumes of data. While some lab instruments automatically generate data in a format that can be readily reported to health agencies, technicians often must interpret and record results in another electronic system, and labs or health departments must process that data into a standardized format to merge them with disease surveillance databases.

AI-powered natural language processing can scan free-text lab reports and extract useful data: which pathogen was detected, which test was used, when it was done, what the result was, and what identifiable and reportable information is there about the patient (e.g., name, date of birth, home address, gender, race, ethnicity). That information can be automatically formatted to meet public health reporting requirements.

AI can also monitor data flowing from laboratory instruments and detect when a reportable disease appears. It can then automate the steps needed to report that infection without requiring a person to notice it, look it up, and enter data into a system manually.

Another major problem is compliance with reporting. Staff turnover, new software, or new instruments can result in cases not being reported. Health departments often discover these problems only after reviewing trends (e.g., why has this lab not reported any diseases in the past quarter?), then staff spend time reviewing data, contacting labs, and sometimes issuing official warnings. AI “agents” operated by health departments could continuously monitor reporting trends by facility, flag unusual drops in reporting, issue reminder emails, and even conduct calls to the laboratory facility – with a human supervising the system, but not necessarily conducting the activities.

AI can help clean and connect the data

At a health agency, epidemiologists must merge surveillance data from many different sources, e.g., labs, hospitals, outpatient offices, and other facilities. AI algorithms help accelerate and improve identification and resolution of duplicates. Two reports might refer to the same patient but have different names or dates. Or one patient might have multiple test results for the same infection. AI can learn to match and consolidate these records, improving the accuracy of matching over time.

Most lab reports contain just a few pieces of information: name, age, sex, address, and the name of the doctor and facility that ordered the test. But to understand disease burden and identify outbreaks, public health investigators need much more: When did symptoms start? What was the patient exposed to? Did they travel? Were they hospitalized?

To get these details, epidemiologists must call patients or providers and search other agency databases. That takes time, staff, and effort. AI tools and agents can help by automating some of these processes. AI agents could send links to patients’ mobile phones or email for online surveys or chatbot interviews and, as they evolve, even interview patients by voice. If legally permitted in a state, AI agents can connect to hospital records, immunization registries, or death certificates to fill in missing demographic and outcome data.

AI can make sense of the data faster

One of the most promising uses of AI is to improve the analysis, visualization, and communication of surveillance data.

In well-resourced health agencies, epidemiologists run models to “nowcast” and “forecast” diseases. Most county health departments in the United States, however, lack epidemiologists with these skills. AI tools can be built to automate these processes, including merging surveillance data with other locally available databases, such as from emergency rooms, 911 calls, and/or pharmacy sales to estimate current and future incidence, depending on different interventions.

AI can also write custom summaries of the data for different audiences. Most surveillance reports are dense and difficult to read, written by epidemiologists for a broad audience that covers experts and lay persons. Generative AI tools can create summaries that are tailored for different technical levels and perspectives, such as policymakers, journalists, health care providers, or the public.

Privacy and security still matter

While surveillance data is generally exempt from federal health privacy laws like HIPAA, it is still governed by strict state and local laws.

AI tools used for public health surveillance must be designed to operate within these legal frameworks. They should not store or use identifiable information for training purposes. They must limit access to authorized personnel. And they should be run in secure, closed electronic environments.

AI may also help allow more data transparency while preserving confidentiality. One reason health agencies hesitate to release detailed surveillance data is the risk that individuals could be identified. AI tools could help automatically de-identify records and test whether patients can be re-identified once datasets are made public.

What’s next

For AI to have an immediate impact, public health agencies need tools that are validated for data processing and analysis and can be easily adapted to the needs of epidemiologists. Partnerships between public health experts, AI developers, and policymakers will be essential to ensure these systems are incorporated and improve the speed, quality, and usability of public health surveillance systems, while maintaining robust security and privacy controls.

Dr. Jay K. Varmais a physician and epidemiologist. An expert in the prevention and control of infectious diseases, he has led epidemic responses, developed global and national policies, and implemented large-scale programs that saved hundreds of thousands of lives in Asia, Africa, and the United States.

‘We dissent’: NIH workers protest Trump policies that ‘harm the health of Americans’

2025-06-09T14:49:17+00:00

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Hundreds of workers at the National Institutes of Health on Monday openly protested the Trump administration’s cuts to the agency and consequences for human lives, writing in a sharply worded letter that its actions are causing “a dramatic reduction in life-saving research.”

In a Monday letter to NIH Director Jay Bhattacharya, NIH workers said they felt “compelled to speak up when our leadership prioritizes political momentum over human safety and faithful stewardship of public resources.”

“For staff across the National Institutes of Health (NIH), we dissent to Administration policies that undermine the NIH mission, waste public resources, and harm the health of Americans and people across the globe,” they said.

The letter is an extraordinary rebuke of the Trump administration’s actions against the NIH, which include: terminating hundreds of grants funding scientific and biomedical research; firing more than 1,000 employees this year; and moving to end billions in funds to partner institutions overseas, a move current and former NIH workers say will harm research on rare cancers and infectious diseases, as well as research that aims to minimize tobacco use and related chronic illnesses, among other areas.

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Some NIH workers signed their names publicly, openly daring to challenge a president who has sought to purge the government of employees he views as disloyal to him. Others signed anonymously.

“It’s about the harm that these policies are having on research participants and American public health, and global public health,” said Jenna Norton, who works at the National Institute of Diabetes and Digestive and Kidney Diseases, one of NIH’s 27 institutes. “There are research participants who generously decide to donate their time and literal pieces of their body, with the understanding that that service is going to help advance research for diseases that they are living with and help the next person who comes along with that disease.”

“These policies are preventing us from delivering on the promise we made to them and honoring the commitment that they made, and putting them at risk,” she said.

Letter cites vows to priortize ‘academic freedom’

The workers wrote that they hope Bhattacharya welcomes their criticisms given his vows to prioritize “academic freedom” and to respect dissenting views as leader of the NIH, which is based in Bethesda, Maryland. Its authors called it the “Bethesda Declaration” — a play on the controversial “Great Barrington Declaration” that Bhattacharya co-authored during the covid-19 pandemic.

Bhattacharya’s declaration advocated against lockdown measures and proposed that widespread immunity against covid could be achieved by allowing healthy people to get infected with the virus and instituting protective measures only for medically vulnerable people. It was criticized at the time by Francis Collins, then-director of the NIH, who called Bhattacharya and his co-authors “fringe epidemiologists,” according to emails the American Institute for Economic Research obtained through a Freedom of Information Act request.

In their letter, NIH workers demanded that Bhattacharya restore grants that were “delayed or terminated for political reasons.” Those grants funded a range of projects, including those addressing Alzheimer’s disease, ways to boost vaccination rates, and efforts to combat health disparities or health misinformation.

“Academic freedom should not be applied selectively based on political ideology. To achieve political aims, NIH has targeted multiple universities with indiscriminate grant terminations, payment freezes for ongoing research, and blanket holds on awards regardless of the quality, progress, or impact of the science,” the NIH workers wrote.

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The funding terminations, they said, “throw away years of hard work and millions of dollars,” “risk participant health,” and “damage hard-earned public trust, counter to your stated goal to improve trust in NIH.”

In an emailed comment, Bhattacharya said, “The Bethesda Declaration has some fundamental misconceptions about the policy directions the NIH has taken in recent months, including the continuing support of the NIH for international collaboration. Nevertheless, respectful dissent in science is productive. We all want the NIH to succeed.”

The NIH’s nearly $48 billion budget makes it the world’s largest public funder of scientific research. Its work has led to countless scientific discoveries that have helped improve health and save lives around the globe. But it hasn’t been without controversies, including instances of research misconduct and not effectively monitoring grant awards and the related research.

Jay Bhattacharya, director of the National Institutes of Health, speaks during his confirmation hearing before the Senate Health, Education, Labor and Pensions Committee.

Researchers and some states have sued NIH and HHS over the grant cuts. An April 3 deposition by NIH official Michelle Bulls said Rachel Riley, a senior adviser at HHS who is part of the Department of Government Efficiency created by executive order, provided NIH officials lists of grants to terminate and language for termination notices. Elon Musk, the world’s richest person, led DOGE through May.

Norton has worked at the NIH as a federal employee or contractor for about a decade. She said the current administration’s policies are “definitely unethical and very likely illegal,” listing a string of developments in recent months. They include terminating studies early and putting participating patients at risk because they have had to abruptly stop taking medications, and holding up research that would predominantly or exclusively recruit participants from minority races and ethnicities, who have historically been underrepresented in medical research.

“They’re saying that doing studies exclusively on Black Americans to try to develop interventions that work for that population, or interventions that are culturally tailored to Hispanic-Latino populations — that that kind of research can’t go forward is extremely problematic,” Norton said. “And, as a matter of fact, studies that over-recruit from white people have been allowed to go forward.”

Letter demands reinstatement of fired workers

The NIH workers also demanded that Bhattacharya reinstate workers who were dismissed under recent mass firings and allow research that is done in partnership with institutions in foreign countries “to continue without disruption.” The NIH works with organizations around the globe to combat major public health issues, including types of cancer, tobacco-related illnesses, and HIV.

In addition to the firing of probationary workers, NIH fired 1,200 civil servants as part of a rapid “reduction in force” at federal health agencies. During a May 19 town hall meeting with NIH staff, a recording of which was obtained by KFF Health News, Bhattacharya said the decisions about RIFs “happened before I got here. I actually don’t have any transparency into how those decisions were made.”

He started at NIH on April 1, the day many workers at NIH and other agencies were told they were fired. Other workers have been fired since Bhattacharya took the helm — nearly all the National Cancer Institute’s communications staff were fired in early May, three former employees told KFF Health News.

The letter is the latest salvo in a growing movement by scientists and others against the Trump administration’s actions. In addition to in-person protests outside HHS headquarters and elsewhere, some former employees are organizing patients to get involved.

Peter Garrett, who led the National Cancer Institute’s communications work, has created an advocacy nonprofit called Patient Action for Cancer Research. The aim is to engage patients “in the conversation and federal funding and science policymaking,” he said in an interview.

Public health labs are being defunded. Here’s what that means for disease surveillance.

His group aims to get patients and their relatives to speak out about how federal cancer research affects them directly, he said — a “guerrilla lobbying” effort to put the issue squarely before members of Congress. Garrett said he retired early from the cancer institute because of concerns about political interference.

Career officials routinely work under both Republican and Democratic presidents. It is par for the course for their priorities and assignments to evolve when a new president, Cabinet secretaries, and other political appointees take over. Usually, those changes occur without much protest.

This time, workers said the upheaval and harm done to the NIH is so extensive that they felt they had no choice but to protest.

In 11 years at NIH, Norton said, “I’ve never seen anything that comes anywhere near this.”

In the June 9 letter, the workers said, “Many have raised these concerns to NIH leadership, yet we remain pressured to implement harmful measures.”

“It’s not about our jobs,” said one NIH worker who signed the letter anonymously. “It is about humanity. It is about the future.”

Senior KFF Health News correspondent Arthur Allen contributed to this report, which was originally published at KFF Health News, Healthbeat’s national reporting partner.

Here’s how artificial intelligence could improve public health

2025-06-09T11:00:00+00:00

This is a guest essay for Healthbeat. Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

Public health experts agree that five interventions saved the most lives in the past century: clean water, sanitation, nutrition, vaccines, and antibiotics. Will artificial intelligence join that list in the 21st century, helping to avert illness and extend life expectancy?

Having led public health programs around the world for the past two decades, I believe that AI represents the single biggest opportunity to improve public health in my lifetime. As new diseases emerge more rapidly, and climate change increases other threats to health, officials may be able to use AI to practice public health with greater speed, precision, and effectiveness.

AI revolution in health amplifies intelligence

In his 2024 book “The Coming Wave,” Mustafa Suleyman describes how humans came to dominate the Earth through their intelligence — the ability to develop, transmit, and implement ideas — and the application of that intelligence to develop energy, cultivate food, improve shelter, and enhance health. AI is, of course, the culmination of that process. We have created technology that amplifies our intelligence far beyond our biological capacity, allowing us to build things we never could have built before.

Generative AI tools like ChatGPT, Claude, Gemini, and Microsoft Co-Pilot have demonstrated how AI dramatically improves the speed and productivity of “cognitive labor,” particularly writing text for humans, code for computers, or analyses of data in written or numeric format. This is why some also prefer to call it “augmented intelligence.”

The next waves of AI will go beyond ingesting and producing text to augment other functions of the human brain, such as vision, hearing, and speech.

How will AI improve health care delivery and R&D?

Billions of dollars are being invested around the world to design and implement AI for health-related purposes. The health sector can broadly be classified into three areas: research and development; health care delivery; and public health. Much of the money is flowing into the first two areas of the health sector.

Investments in health research are particularly promising, because practical uses of AI are emerging at the exact same time as another transformative technology is also emerging: synthetic biology.

Decades of research into biology has given scientists tools to decode the genes behind all forms of life and, most important, write that genetic code to create new biological entities that treat disease, kill pathogens, break down waste, and make new materials. Developing new products for human health — drugs, diagnostics, vaccines, and devices — requires years of intensive work across multiple disciplines. In drug development, this includes optimizing the formulation, dosing, and delivery in animals and then humans, and, most important, to demonstrating safety and efficacy in large, diverse populations using rigorous protocols. Much of this work is repetitive, cognitive, and rule-based, the kind of pattern-heavy work AI is built to do.

Public health labs are being defunded. Here’s what that means for disease surveillance.

Especially in the United States, where health care accounts for over 20% of the economy, there is tremendous investment into AI to improve how health care services are delivered to individual patients. Entire medical journals, and sections of prestigious medical journals, are now devoted to the burgeoning field of digital health. AI has already moved from the developer’s screen to the clinic with chatbots, scheduling, decision support, diagnostic support, and care management. At my clinic, we are testing “ambient AI” technology in which a system listens in the background while I perform a history and physical examination on a patient, then serves as a digital, autonomous medical scribe, preparing notes and orders for me to review and approve.

Many believe that it is not long in the future until the first interaction a person has with a doctor is an AI physician. Multiple studies have shown that AI can already out-perform clinicians on screening, diagnosis, and treatment in different clinical settings and patient populations.

Public health practice needs AI investment

Where does that leave public health, the third part of the health sector?

In its most broad sense, public health means everything a society does to prevent disease and promote the health of humans. Public health practice refers to the work of people in public health, including: monitoring the health of a population, developing and implementing policies and programs to improve health, generating evidence to guide health policies, and responding to outbreaks and other emergencies. Most of this work is done by people working for government, because most countries recognize that public health is a form of public safety, like police and defense, and that private markets alone cannot meet its demands.

With sufficient resources and political will, current generative AI tools could be used right now to improve:

Ingesting, cleaning, and analyzing surveillance and other health-related data, including nowcasting and forecasting for different scenarios
Aggregating evidence and local data from diverse real-world sources to aid decision-making during routine health operations and emergencies
Tailoring reports, written communications, and graphical media to different audiences, including elected officials, media, and general public
Improving health care service delivery for immunizations, sexually transmitted infections, tuberculosis, and maternal child health programs through chatbots, medical decision support, and patient engagement before and after services
Preparing applications and reports for grants and other outside funders

Four critical challenges for public health and AI

While I am optimistic about the future of AI for improving health, I do worry that public health practice could still fall behind or, worse, be harmed by AI. Here are my top four concerns.

The public health workforce

Much of the work in public health agencies can broadly be considered cognitive manual labor. I previously hoped that AI could be used for task shifting. For example, a public health program that currently requires 10 epidemiologists could use AI to shift at least half of them away from desks to working directly with communities on disease prevention, diagnosis, treatment, and emergency response — a shift that could address one of the ways public health struggled during COVID-19.

How the Trump administration aims to slash health care spending

In 2025, however, there have been widespread efforts to dismantle public health domestically and globally, with agencies gutted, funding slashed, and legal authorities reduced at the state and federal level. The Department of Government Efficiency initiative includes efforts to fire federal workers and replace them with AI, rather than shift those workers to other services. Will a new public health agency that relies on AI be able to maintain essential public health services? What happens in an emergency when public health workers who would normally be reassigned from routine work to emergency response are no longer available?

The investment gap in public health

AI investment chases profit, which means AI funding will inevitably flow to financial markets, business and consumer applications, and entertainment. For the health sector, AI funding will flow to the areas where there is the most money to be made: developing new drugs and caring for sick people.

The private sector rarely invests in technology to support public health practice. As chronically underfunded government entities, public health agencies cannot pay the same rates for software and equipment that the private sector can, and the tools that public health agencies need are often highly specialized and have limited utility for business or other private sector customers.

The best hope then is that AI applications developed for other sectors — health care delivery, biotechnology, defense, academia, public relations — can be adapted for public health. That is, public health becomes a secondary adopter of AI, rather than the primary developer or customer. Will AI technologies for research, health care delivery, and other sectors meet the needs of public health agencies? Will the cost of adapting them be affordable, and will there be sufficient interest from companies to invest in adapting them for public health uses? Will tools like generative AI chatbots evolve enough to improve public health practice?

Leadership and innovation

Public health agencies tend to lag behind other sectors on adopting new technologies. They operate under a scarcity mindset and worry, appropriately, that their budgets will be cut if they try to innovate and that innovation fails. Because they are entrusted with highly sensitive personal data — identifying information about a patient and their diagnosis of syphilis, HIV, or other disease — they also hesitate to adopt any technology that might risk exposing a patient’s identity to the public. Where will agencies find the bold leadership to design and develop AI systems amid these longstanding challenges and a future landscape of less authority, staffing, funding, and credibility?

Ethical implementation

AI ethical risks include data privacy, bias, and inequality. AI systems gather and analyze large amounts of data, potentially allowing the confidential health history of a patient to be accessible to staff who should not have access in the first place and, far worse, to expose that data to the public through an inadvertent data breach. AI systems are also trained on data collected by humans, so are embedded with the same biases of individuals and human-created systems. Similarly, the benefit of AI is likely to be highly asymmetric, with well-resourced countries and localities reaping an exponential benefit and exacerbating health inequalities. What protections will be built in to protect privacy and ensure the ethical application and distribution of AI for public health? Who will be held accountable if they fail?

More debate needed about AI in public health

It is abundantly clear that AI is a general use technology — like the printing press or electricity — that will completely transform society, but I have been surprised at how little public discourse there has been about how AI can be applied now to improve public health practice and disease control. We need more open discussion and debate about how AI can strengthen, and not replace, public health workers.

Trump cuts off budding CUNY scientists from mentorship and aid

2025-05-14T15:08:55+00:00

This story was originally published by THE CITY. Sign up to get the latest New York City news delivered to you each morning. Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

The Trump administration has cut off support that has sustained a teaching model that for decades has been instrumental in catapulting students into careers as scientists.

Funded by the National Institutes of Health, the Undergraduate Research Training Initiative for Student Enhancement supports the pursuit of advanced degrees by students in the biomedical field, who are offered tuition assistance, mentorship, registration to professional conferences and, crucially, lab experience.

Now, however, the NIH has abruptly severed that pipeline, stating that the program fails to align with the White House’s priorities.

NIH canceled all U-RISE funding at City College, Queens College, Brooklyn College, Lehman College and Medgar Evers College. According to the NIH reporter, which tracks the institute’s grants and projects, the agency ceased funding for several other institutions nationwide, including historically Black colleges and universities.

Professors who work with students in the program say the federal defunding will likely doom the program, and with it vital opportunities to conduct research while attending a public college — putting them on track for further academic research.

NIH cuts halted CUNY research on Covid-19 vaccination and mental health. Here’s what that means for the unfinished project.

“A student, no matter how driven or brilliant or capable they are, if they are not given some kind of exposure to a lab or research environment, they’re not gonna get admitted to a PhD program, period,” Dr. Maral Tarjerian, director of the Queens College U-RISE program, told THE CITY. “We need to have something that’s gonna facilitate access to research at the undergraduate level, or else we’re really not training these students adequately.”

Among the research students tackled were projects on molecular pharmacology, neuroplasticity, and chemistry.

One student, who declined to provide their name citing fear of retaliation from the Trump administration, told THE CITY that they likely would not have considered enrolling in any graduate program before signing up for U-RISE.

“For it to happen out of the blue, it’s been surreal,” they said about the abrupt cancellation. “I’m grateful for the training that I’ve been given, regardless, and it sucks that I won’t be able to continue as it stands right now.”

U-RISE gave smaller institutions a boost

All five CUNY institutions were two years into what were supposed to be five-year grants that are terminated as of March 31. The schools had already received between $133,661 and $402,643 to support about eight students on each campus.

The 2-year-old U-RISE program, administered by the NIH, had been an extension of two, decades-old nationwide programs, known as Maximizing Access to Research Careers and Research Initiative for Scientific Enhancement. U-RISE has been intended to give smaller institutions similar support to programs that did the same for top research universities.

The U-RISE cuts are among 61 research-related CUNY projects that received stop-work orders from the NIH, according to an email sent to staffers in late April by Chancellor Felix Matos Rodriguez. The agency also shut down a project spearheaded by researchers at the CUNY School of Public Health studying vaccine misinformation.

The defunding of U-RISE comes as part of a larger effort by President Donald Trump and Health and Human Services Secretary Robert F. Kennedy Jr. to slash the NIH budget by 40% as part of the secretary’s “Make America Healthy Again” agenda.

On Tuesday, Sen. Bernie Sanders, a Vermont independent, released a report calculating that $2.7 billion in NIH funding had been eliminated through March, including funding for research in infectious disease, mental health, cancer and aging.

Samples stored at the Queens College Stress in Pregnancy lab.

Program directors at all five colleges said they learned about the funding termination via email and have filed an appeal through NIH seeking to reverse it.

Dr. Donna McGregor, U-RISE program director at Lehman, said she had been expecting another payment on March 31.

“We found out like four days before that, that there would be no more money because we had a stop work order,” she told THE CITY.

Cuts part of Trump’s cancellation of DEI initiatives

In an email sent to City College and Lehman, the NIH sought to justify canceling the funding.

“Research programs based primarily on artificial and non-scientific categories, including amorphous equity objectives, are antithetical to the scientific inquiry, do nothing to expand our knowledge of living systems, provide low returns on investment, and ultimately do not enhance health, lengthen life, or reduce illness,” the email read.

“Worse,” the email continued, “so-called diversity, equity, and inclusion (‘DEI’) studies are often used to support unlawful discrimination on the basis of race and other protected characteristics, which harms the health of Americans. Therefore, no additional funding will be awarded for this project, and all future years have been removed.”

Not all colleges got a formal termination letter though. Directors at City College and Brooklyn College only learned that their programs had been axed when they received their notice of award notifying them of the defunding.

NIH did not respond to a request for comment from THE CITY.

CUNY’s U-RISE programs are open to students studying science, biomedical engineering or psychology who intend to pursue further research, and the programs targeted students with backgrounds underrepresented nationally in scientific research.

Facing federal turmoil, this New York City Council member wants to ‘Trump proof’ public health

Professors say that the defunding, in line with Trump’s war on diversity, equity and inclusion initiatives, targets CUNY students simply for being who they are, in the communities they live in.

“We are a minority-serving institute organically. It’s not that we choose to only serve minorities. We’re just being representative of our neighborhood,” said Queens College U-RISE Program Director Maral Tajerian. The college is located in Flushing, a community with a large Asian American population.

“They think for some reason it’s being taken away from someone else. That’s not the case,” she said. “This is our community, and we’re serving our community. It just happens that our community is diverse.”

CUNY overall “remains deeply concerned about the potential impact of federal cuts,” a university spokesperson said in a written statement.

“University leadership is working to support everyone in our community and will pursue every avenue available to sustain CUNY as a preeminent research institution,” wrote Noah Gardy.

City College director: ‘This is a big hole’

Labiba Aziz, who turns 22 on Saturday, is a U-RISE grantee at Queens College who is graduating with a degree in neuroscience this month and will next be studying molecular cellular pharmacology at Stony Brook University. She had received a $12,000 stipend each month that helped cover living expenses, and was able to obtain valuable lab experience studying the impacts of stress during pregnancy.

“Being part of this program really allowed me to pursue research and see it as a possible career choice,” Aziz told THE CITY in a phone interview, noting that she “definitely” would not have been able to enroll in graduate school without U-RISE.

Through the program, Aziz was able to leave her job as a medical assistant at a fertility clinic to work with researchers on a study that tracked hundreds of mothers to see how stress experienced during pregnancy affected child and fetal development.

Students walk by the Benjamin Rosenthal Library at Queens College.

Aziz lamented that her peers who have not graduated yet will not have the support she received. “They’re also pretty upset. And I totally get it. They had a whole year. They were promised funding. It was almost abruptly cut off,” she said. “I don’t really know what to tell them because I think, not to be pessimistic, but I am not sure for the next four years if they’re going to have such opportunities again, and what they can really do to help themselves apply.”

According to the program directors, City College and Lehman are filling in the financial gap through the remainder of the academic year, while Queens College and Brooklyn College gave financial support for the month of April.

Students at Medgars Evers College in Brooklyn, a predominantly Black institution, have not received any additional financial aid amid the NIH cuts.

“We haven’t approached it that way, given the budget situation,” Dr. Moshin Patwary, director of the U-RISE program at Medgar Evers, told THE CITY.

“We made sure that every student got their full second year of support. And if some of the grant was terminated before all of them had gotten that full second year, the college is covering that,” said Dr. Jonathan Levitt, director of the U-RISE program at City College. “There’s no soft-coating it. This is a big hole.”

McGregor said that Lehman College provided $3,000 to each of the eight students in the program to help cover expenses for April and May.

Since the U-RISE program is only 2 years old, most trainees have not graduated yet. One student at Lehman College and Aziz are set to graduate in the coming weeks. Levitt noted that 35 of 57 students enrolled in the MARC program at City College, which preceded U-RISE, earned a postgraduate degree over the last two decades while the others completed their undergraduate degrees.

McGregor, who helmed the RISE program at Lehman for five years before that was replaced by U-RISE in 2023, said that 14 of 15 students matriculated in biochemical graduate programs. Six students in this year’s cohort were on track to graduate next year before the NIH terminated its support.

Patwary directed the RISE program at Medgar Evers from 2014 to 2021, where 22 of 42 students enrolled in biomedicine graduate programs while the remainder obtained employment in healthcare or pursued medical, dental, or pharmacy degrees. After a three-year application process, NIH granted a U-RISE program at Medgar Evers in 2024.

Brooklyn College U-RISE director Dr. Mariana Torrente told THE CITY that MARC graduated 90 students over more than three decades. About 75% of those graduates earned advanced degrees or are currently pursuing them, she said.

“These programs have a strong return on investment,” said Torrente, who noted that three of Brooklyn College’s 10 U-RISE trainees are set to finish their degree next semester and are in the process of applying to graduate programs.

Of the 57 students who graduated through the MARC program at Queens College, which was established in 2004 and preceded U-RISE, 45 obtained or are pursuing advanced degrees.

“Everyone who applies gets in somewhere, and everyone who got in finished or is still there doing fine,” said Levitt, who has directed the U-RISE and MARC programs at City College for more than 20 years. “That’s what all these programs are supposed to do: Make them competitive and prepared.”

Aziz says the NIH cuts cripple CUNY’s mission to increase students’ socioeconomic mobility.

“CUNY has always been historically this place of access and mobility. I’ve had a lot of my siblings attend other CUNY schools, so I’ve seen how CUNY has always uplifted communities such as mine,” she said.

“But, you know, cutting these programs really undermines their mission of access and mobility.”

Jonathan Custodio is THE CITY’s Bronx reporter, where he covers the latest news out of the city’s northernmost borough.

Emory survey of Georgia parents finds most believe childhood vaccines are safe

2025-05-06T11:00:00+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

In an Emory University survey of nearly 1,000 Georgia parents released Tuesday, 86% said they believe childhood vaccines are very or somewhat safe.

The purpose of the survey – which its organizers hope will become an annual report that helps track changes over time – was to find out what parents think about the well-being of their children.

The Emory professors worked with polling company Ipsos to conduct an online poll between late January and early March that represented the population of Georgia parents and analyzed the results.

Overall, nearly 86% of parents were confident vaccines are safe.

“Generally, parents trust the information they get,” said pediatrician Dr. Stephen Patrick, a professor at Emory’s Rollins School of Public Health who helped organize the survey.

Vaccination rates for deadly childhood diseases like measles are on the decline in Georgia, falling to 88% for young children, as measles cases surge across the country and newly appointed public health leaders like U.S. Health and Human Services Secretary Robert F. Kennedy Jr. promote misinformation about vaccines.

The survey, which also captured parents’ top concerns and unmet needs for their children’s health, broke down results by racial group, as well as geography. That analysis showed that a lower percentage of Black parents, 81.7%, thought routine childhood vaccines are very or somewhat safe; 91.7% of Hispanic parents thought the same.

Nearly three-quarters of respondents said they trust their child’s doctor to provide accurate information about vaccines. Other trusted sources include the Centers for Disease Control and Prevention, the Georgia Department of Public Health, county health departments, and the U.S. Food and Drug Administration.

Measles misinformation is on the rise — and Americans are hearing it, survey finds

Parents in rural and urban areas said they trust their child’s doctor at about equal levels, but rural parents placed greater levels of trust in the DPH and their county health department for vaccine information than urban parents did.

Doctors and others can be key “trusted messengers” to provide vaccine information to parents, Patrick said.

“Everything is local, especially in rural communities. That connection is paramount,” he said.

The survey also asked parents what they thought about school vaccine requirements.

Most parents – 55% – said childhood vaccines should be required, with many saying exemptions should be allowed for medical or religious reasons.

Georgia requires children to be vaccinated to attend school, including preschool, but parents can obtain religious or medical exemptions. Georgia’s vaccination rates are below the community or “herd” immunity rate needed to prevent widespread transmission of measles.

State public health workers contained an outbreak of three cases in one family earlier this year.

Education, bullying, violence among other concerns

The survey also asked parents to rank their top concerns for their children. These were the top five:

1. Education and school quality: 39%

2. Social media use: 34%

3. Bullying, including cyberbullying: 32%

4. Gun violence: 27%

5. Mental health and suicide: 25%

The results varied by ethnicity, the report said. Hispanic and Black parents were most concerned about gun violence, while white parents were most concerned about social media use. Hispanic and Black parents were also concerned about racism, while white parents were not.

Rural parents listed drug and alcohol use as one of their top concerns, while urban parents ranked gun violence in the top five.

Even though bullying or social media may not be traditional public health issues, they are important to children’s health.

“All of these things are intertwined,” Patrick said. “You can’t neatly piece them apart.”

The study also asked parents about their concerns about alcohol and drug use.

Overall, about one-third of parents believed unused prescription opioid pills were the main cause of adolescent overdose deaths. Another third thought counterfeit pills that contained fentanyl or other dangerous drugs were the main cause.

Patrick said the leading cause of overdose deaths among adolescents is counterfeit pills that contain fentanyl.

“Talk to your kids about counterfeit pills and their dangers,” Patrick said. While prescription pills can be a risk, parents need to talk about counterfeit pills to their children.

Nearly two-thirds of the parents surveyed said they thought schools are less safe than they were 10 years ago.

Nearly half of parents reported keeping firearms in their home or garage. While the American Academy of Pediatrics recommends counseling families on firearm safety, only about a quarter of the parents in the survey said their pediatrician had asked about safe gun storage.

Unmet needs include mental health services, food

The study also found that 3 of 5 children in Georgia, or 63%, have been diagnosed with mental or behavioral conditions but are not receiving mental health services.

“There are incredible challenges to getting access to mental health services in the entire U.S.,” Patrick said.

Federal data show that more than one-third of Georgia households with children are food insecure. More than half of parents in the survey reported changing their food spending habits in the past year, including by stopping or reducing eating out, changing the types of food they eat, and changing where they buy groceries. Nearly a quarter, or 23%, of parents reported skipping meals.

Ninety-one percent of the parents polled supported free breakfast and lunch for all children in Georgia public schools.

It’s important to ensure Georgia children have the services they need, said Mindy Binderman, executive director of the Georgia Early Education Alliance for Ready Students.

“Children’s most rapid and consequential brain growth happens in early childhood — at a rate of 1 million new neural connections formed every second. … I, too, worry about kids’ mental health, access to care, and education quality,” Binderman said.

GEEARS is pushing to preserve programs like Medicaid, which provides health insurance to low-income children, and Head Start, which provides early childhood education, in Georgia.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Measles misinformation is on the rise — and Americans are hearing it, survey finds

2025-04-23T15:24:05+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

While the most serious measles epidemic in a decade has led to the deaths of two children and spread to 27 states with no signs of letting up, beliefs about the safety of the measles vaccine and the threat of the disease are sharply polarized, fed by the anti-vaccine views of the country’s most senior health official.

About two-thirds of Republican-leaning parents are unaware of an uptick in measles cases this year, while about two-thirds of Democratic ones knew about it, according to a KFF survey released Wednesday.

Republicans are far more skeptical of vaccines and twice as likely (1 in 5) as Democrats (1 in 10) to believe the measles shot is worse than the disease, according to the survey of 1,380 U.S. adults.

Some 35% of Republicans answering the survey, which was conducted April 8-15 online and by telephone, said the discredited theory linking the measles, mumps, and rubella vaccine to autism was definitely or probably true — compared with just 10% of Democrats.

The trends are roughly the same as KFF reported in a June 2023 survey. But in the new poll, 3 in 10 parents erroneously believed that vitamin A can prevent measles infections, a theory Health and Human Services Secretary Robert F. Kennedy Jr. has brought into play since taking office during the measles outbreak.

About 900 cases have been reported in 27 U.S. states, mostly in a West Texas-centered outbreak.

Georgia contained a measles outbreak. But low vaccination rates keep the state vulnerable.

“The most alarming thing about the survey is that we’re seeing an uptick in the share of people who have heard these claims,” said co-author Ashley Kirzinger, associate director of KFF’s Public Opinion and Survey Research Program. KFF is a health information nonprofit that includes KFF Health News.

“It’s not that more people are believing the autism theory, but more and more people are hearing about it,” Kirzinger said. Since doubts about vaccine safety directly reduce parents’ vaccination of their children, “that shows how important it is for actual information to be part of the media landscape,” she said.

“This is what one would expect when people are confused by conflicting messages coming from people in positions of authority,” said Kelly Moore, president and CEO of Immunize.org, a vaccination advocacy group.

Numerous scientific studies have established no link between any vaccine and autism. But Kennedy has ordered HHS to undertake an investigation of possible environmental contributors to autism, promising to have “some of the answers” behind an increase in the incidence of the condition by September.

The deepening Republican skepticism toward vaccines makes it hard for accurate information to break through in many parts of the nation, said Rekha Lakshmanan, chief strategy officer at The Immunization Partnership, in Houston.

Lakshmanan on Wednesday was to present a paper on countering anti-vaccine activism to the World Vaccine Congress in Washington. It was based on a survey that found that in the Texas, Louisiana, Arkansas, and Oklahoma state assemblies, lawmakers with medical professions were among those least likely to support public health measures.

“There is a political layer that influences these lawmakers,” she said. When lawmakers invite vaccine opponents to testify at legislative hearings, for example, it feeds a deluge of misinformation that is difficult to counter, she said.

Eric Ball, a pediatrician in Ladera Ranch, California, which was hit by a 2014-15 measles outbreak that started in Disneyland, said fear of measles and tighter California state restrictions on vaccine exemptions had staved off new infections in his Orange County community.

“The biggest downside of measles vaccines is that they work really well. Everyone gets vaccinated, no one gets measles, everyone forgets about measles,” he said. “But when it comes back, they realize there are kids getting really sick and potentially dying in my community, and everyone says, ‘Holy crap; we better vaccinate!’”

Ball treated three very sick children with measles in 2015. Afterward his practice stopped seeing unvaccinated patients. “We had had babies exposed in our waiting room,” he said. “We had disease spreading in our office, which was not cool.”

Although two otherwise healthy young girls died of measles during the Texas outbreak, “people still aren’t scared of the disease,” said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, which has seen a few cases.

But the deaths “have created more angst, based on the number of calls I’m getting from parents trying to vaccinate their 4-month-old and 6-month-old babies,” Offit said. Children generally get their first measles shot at age 1, because it tends not to produce full immunity if given at a younger age.

Arthur Allen is a reporter for KFF Health News, Healthbeat’s national reporting partner.

NIH cuts halted CUNY research on Covid-19 vaccination and mental health. Here’s what that means for the unfinished project.

2025-04-18T16:44:04+00:00

Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

As the Covid-19 pandemic spread through New York City in March 2020, researchers affiliated with the City University of New York launched a nationwide research project tracking the disease, its financial and mental health impacts, and eventually, vaccine uptake.

Over time, they became particularly interested in understanding the barriers to Covid-19 vaccination for people with anxiety and depression. That led to a research project funded by about $3 million from the National Institutes of Health, exploring what prevents people with anxiety and depression from getting vaccinated, and testing out possible interventions.

But last month, the project’s grant was terminated, part of a wave of deep cuts to NIH funding that has impacted research institutions throughout New York and the United States. The team of about 15 people working on the project had completed collecting data, but still had significant analysis and writing to do, said Dr. Denis Nash, a distinguished professor of epidemiology at the CUNY School of Public Health and one of the project’s principal investigators, alongside Dr. Angela Parcesepe, an associate professor at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill.

Dr. Denis Nash is a distinguished professor of epidemiology at the CUNY School of Public Health and the executive director of the CUNY Institute for Implementation Science in Population Health in New York.

It was a “devastating” development for research that took root at the start of the pandemic, Nash, who is also the executive director of the CUNY Institute for Implementation Science in Population Health, told Healthbeat.

Last spring, CUNY researchers had recruited about 1,500 people from their CHASING COVID Cohort Study who had received a primary series Covid-19 vaccination but were not up to date on their vaccines. As part of the study, participants were texted or emailed a questionnaire that included a link to one of three videos showing an interaction between a doctor and patient. One video used cognitive behavioral therapy techniques to encourage vaccination, another countered vaccine misinformation, and a third presented standard public health messaging on the benefits of vaccination. Researchers returned to the participants after four weeks and again at six months to record their vaccination status.

In this interview, edited for length and clarity, Nash describes what his team’s research involved, and what it means to have their grant terminated.

Where did this research emerge from?

[The CHASING COVID Cohort Study] measured mental health and depression and anxiety pretty frequently over the course of the four or five years that we followed the cohort. When things started to subside with the pandemic, we were realizing that the next set of problems is: How do we contribute to an understanding of improving vaccination outcomes?

Amid fears of deeper federal cuts, New York health leaders affirm commitment to health equity

When we started this latest study, maybe 21% of adults around the U.S. had received the latest Covid vaccine, which is not nearly as high as it needs to be. Angela and I decided to do something we hadn’t done with the cohort before, which was to develop some kind of intervention that we could deploy to see if we could improve outcomes. Before that, we were just observing people and gathering information about them. It was useful and important, but we had not tried to see if there were things that we could do to influence their health behaviors and outcomes.

We had another researcher on the team who had done some intervention work around inoculation theory, around misinformation and disinformation. It’s this idea that if you prepare people in advance that they might be exposed to inaccurate information, or deliberately deceptive information, when they are confronted with those messages later on, they’re better prepared to deal with it and not be manipulated by it.

Based on our research, we learned that people with common mental disorders in our cohort were more likely to endorse misinformation and disinformation. In other words, they were more likely to cite that as reasons for not being vaccinated. And they also reported barriers that especially the mental health experts on our team thought could be overcome, with cognitive behavioral therapy-type interventions.

So we designed these three brief videos, and we wanted to see if we randomized people to get one of these three videos, did it have an effect on people’s decision to get vaccinated over the subsequent four weeks? Did it change their likelihood of making an appointment, or deciding to make an appointment, and then actually going to get vaccinated?

What did your research find?

We didn’t, unfortunately, see an impact of the intervention on outcomes. But it was important for us to do the study to assess whether there was a theory-informed low-touch strategy that could be used here. There have been other studies in the literature, for example, where pharmacies would send text outreach reminders to people, and [differences in vaccine uptake] tended to be pretty small, like a 1% increase. That’s in line with what we saw. But we were taking a different approach, in that we were trying to get people to engage in a way of thinking about what might be delaying them or getting in the way of something they want or feel that they need.

Did the research suggest interventions that could work better?

The things that are getting in the way among people who have been vaccinated before, but are not up to date, are bigger than a brief one-minute video could potentially overcome. It doesn’t mean that an approach like this couldn’t work; it may need to be a little more intensive in some ways.

How did you find out your funding was terminated?

I was at an HIV conference in San Francisco at the time, and I heard from a reporter at Science that a reputable source at NIH leaked a list of canceled grants. Mine was on it; did I care to comment?

Local health projects across New York in limbo after abrupt HHS cuts

We had heard in the days before that there were going to be a bunch of vaccine-related grants canceled. We were bracing ourselves, but the messaging was such that everyone whose grant was canceled had been told the night before. So part of me was thinking, maybe we dodged a bullet. But the fact was, they hadn’t told everyone yet. A few hours after that interaction with the reporter, we got the official notice from NIH.

It was devastating. It was a horrible time. The feeling at this conference was kind of like a funeral. I was running into so many people with cancelled grants. The Columbia cancellations had just happened, and my colleagues from Columbia were there. It was a horrible week.

Where does this leave your research?

The devastating thing is that we still had a lot of analysis and writing to do, and it was all abruptly halted when the grant was canceled. So we have the paper with the four-week outcomes that was already submitted to a journal. We are busily revising that, but there are many other papers that we want to write to contribute to this knowledge, that we’re not going to be able to do, or it’s going to happen way more slowly.

We have faculty and staff, and many of the staff are PhD and master’s students that we pay to work on these research projects, and they learn how to do research in the process. [Now] they’re not allowed to work on it because we don’t have funding to support it. They can volunteer their time to do that, but that’s not the same as paying someone 40 hours a week to do data cleaning, to help us do literature searches, and analyze data in support of preparing a manuscript. It’s really a team effort. Without paid staff, it’s going to move much more slowly.

What did it mean for you to have NIH supporting this research?

We launched the [CHASING COVID Cohort] of our own accord, with very limited institutional funds, but we thought it was important to start. At the same time, we wrote a grant to NIH to support it going forward, including the blood specimens we needed to collect from all participants over time. And we did get emergency funds from NIH to do the cohort.

So the investment in this work goes way back, to March of 2020, on the part of NIH. If you want to think about efficiency, in this particular grant, they paid for all the data collection. And participants have volunteered their time and contributions to the work, only to have the most important part — the contributions to knowledge, to science, to the field — be abruptly curtailed. It is a huge loss, and definitely not part of the mission of NIH and [the U.S. Department of Health and Human Services]. They’re all about trying to contribute to scientific knowledge and improving public health outcomes. It’s a very untimely termination.

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

Beyond Ivy League, RFK Jr.’s NIH slashed science funding across states that backed Trump

2025-04-17T13:54:38+00:00

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The National Institutes of Health’s sweeping cuts of grants that fund scientific research are inflicting pain almost universally across the United States, including in most states that backed President Donald Trump in the 2024 election.

A KFF Health News analysis underscores that the terminations are sparing no part of the country, politically or geographically. About 40% of organizations whose grants the NIH cut in its first month of slashing, which started Feb. 28, are in states Trump won in November.

The Trump administration has singled out Ivy League universities including Columbia and Harvard for broad federal funding cuts. But the spending reductions at the NIH, the nation’s foremost source of funding for biomedical research, go much further: Of about 220 organizations that had grants terminated, at least 94 were public universities, including flagship state schools in places such as Florida, Georgia, Ohio, Nebraska, and Texas.

The Trump administration has canceled hundreds of grants supporting research on topics such as vaccination; diversity, equity, and inclusion; and the health of LGBTQ+ populations. Some of the terminations are a result of Trump’s executive orders to abandon federal work on diversity and equity issues. Others followed the Senate confirmation of anti-vaccine activist Robert F. Kennedy Jr. to lead the Department of Health and Human Services, which oversees the NIH. Many mirror the ambitions laid out in Project 2025’s “Mandate for Leadership,” the conservative playbook for Trump’s second term.

Affected researchers say Trump administration officials are taking a cudgel to efforts to improve the lives of people who often experience worse health outcomes — ignoring a scientific reality that diseases and other conditions do not affect all Americans equally.

KFF Health News found that the NIH terminated about 780 grants or parts of grants between Feb. 28 and March 28, based on documents published by the Department of Health and Human Services and a list maintained by academic researchers. Some grants were canceled in full, while in other cases, only supplements — extra funding related to the main grant, usually for a shorter-term, related project — were terminated.

Among U.S. recipients, 96 of the institutions that lost grants in the first month are in politically conservative states including Florida, Ohio, and Indiana, where Republicans control the state government or voters reliably support the GOP in presidential campaigns, or in purple states such as North Carolina, Michigan, and Pennsylvania that were presidential battleground states. An additional 124 institutions are in blue states.

Sybil Hosek, a research professor at the University of Illinois-Chicago, helps run a network that focuses on improving care for people 13 to 24 years old who are living with or at risk for HIV. The NIH awarded Florida State University $73 million to lead the HIV project.

“We never thought they would destroy an entire network dedicated to young Americans,” said Hosek, one of the principal investigators of the Adolescent Medicine Trials Network for HIV/AIDS Interventions. The termination “doesn’t make sense to us.”

NIH official Michelle Bulls is director of the Office of Policy for Extramural Research Administration, which oversees grants policy and compliance across NIH institutes. In terminating the grant March 21, Bulls wrote that research “based primarily on artificial and nonscientific categories, including amorphous equity objectives, are antithetical to the scientific inquiry, do nothing to expand our knowledge of living systems, provide low returns on investment, and ultimately do not enhance health, lengthen life, or reduce illness.”

The U.S. was on track to end the HIV epidemic. Budget cuts threaten that progress.

Adolescents and young adults ages 13 to 24 accounted for 1 in 5 new HIV infections in the United States in 2022, according to the Centers for Disease Control and Prevention.

“It’s science in its highest form,” said Lisa Hightow-Weidman, a professor at Florida State University who co-leads the network. “I don’t think we can make America healthy again if we leave youth behind.”

HHS spokesperson Emily Hilliard said in an emailed statement that “NIH is taking action to terminate research funding that is not aligned with NIH and HHS priorities.” The NIH and the White House didn’t respond to requests for comment.

“As we begin to Make America Healthy Again, it’s important to prioritize research that directly affects the health of Americans. We will leave no stone unturned in identifying the root causes of the chronic disease epidemic as part of our mission to Make America Healthy Again,” Hilliard said.

Cuts bring harm to HIV, vaccine studies

The NIH, with its nearly $48 billion annual budget, is the largest public funder of biomedical research in the world, awarding nearly 59,000 grants in the 2023 fiscal year. The Trump administration has upended funding for projects that were underway, stymied money for new applications, and sought to reduce how much recipients can spend on overhead expenses.

Those changes — plus the firing of 1,200 agency employees as part of mass layoffs across the government — are alarming scientists and NIH workers, who warn that they will undermine progress in combating diseases and other threats to the nation’s public health. On April 2, the American Public Health Association, Ibis Reproductive Health, and affected researchers, among others, filed a lawsuit in federal court against the NIH and HHS to halt the grant cancellations.

Two National Cancer Institute employees, who were granted anonymity because they were not authorized to speak to the press and feared retaliation, said its staff receives batches of grants to terminate almost daily. On Feb. 27, the cancer institute had more than 10,800 active projects, the highest share of the NIH’s roughly two dozen institutes and centers, according to the NIH’s website. At least 47 grants that NCI awarded were terminated in the first month.

Local health projects across New York in limbo after abrupt HHS cuts

Kennedy has said the NIH should take a years-long pause from funding infectious disease research. In November 2023, he told an anti-vaccine group, “I’m gonna say to NIH scientists, ‘God bless you all. Thank you for public service. We’re going to give infectious disease a break for about eight years,’” according to NBC News.

For years, Kennedy has peddled falsehoods about vaccines — including that “no vaccine” is “safe and effective,” and that “there are other studies out there” showing a connection between vaccines and autism, a link that has repeatedly been debunked — and claimed falsely that HIV is not the only cause of AIDS.

KFF Health News found that grants in blue states were disproportionately affected, making up roughly two-thirds of terminated grants, many of them at Columbia University. The university had more grants terminated than all organizations in politically red states combined. On April 4, Democratic attorneys general in 16 states sued HHS and the NIH to block the agency from canceling funds.

Researchers whose funding was stripped said they stopped clinical trials and other work on improving care for people with HIV, reducing vaping and smoking rates among LGBTQ+ teens and young adults, and increasing vaccination rates for young children. NIH grants routinely span several years.

For example, Hosek said that when the youth HIV/AIDS network’s funding was terminated, she and her colleagues were preparing to launch a clinical trial examining whether a particular antibiotic that is effective for men to prevent sexually transmitted infections would also work for women.

“This is a critically important health initiative focused on young women in the United States,” she said. “Without that study, women don’t have access to something that men have.”

Other scientists said they were testing how to improve health outcomes among newborns in rural areas with genetic abnormalities, or researching how to improve flu vaccination rates among Black children, who are more likely to be hospitalized and die from the virus than non-Hispanic white children.

“It’s important for people to know that — if, you know, they are wondering if this is just a waste of time and money. No, no. It was a beautiful and rare thing that we did,” said Joshua Williams, a pediatric primary care doctor at Denver Health in Colorado who was researching whether sharing stories about harm experienced due to vaccine-preventable diseases — from missed birthdays to hospitalizations and job loss — might inspire caregivers to get their children vaccinated against the flu.

He and his colleagues had recruited 200 families, assembled a community advisory board to understand which vaccinations were top priorities, created short videos with people who had experienced vaccine-preventable illness, and texted those videos to half of the caregivers participating in the study.

They were just about to crack open the medical records and see if it had worked: Were the group who received the videos more likely to follow through on vaccinations for their children? That’s when he got the notice from the NIH.

“It is the policy of NIH not to prioritize research activities that focuses gaining scientific knowledge on why individuals are hesitant to be vaccinated and/or explore ways to improve vaccine interest and commitment,” the notice read.

Williams said the work was already having an impact as other institutions were using the idea to start projects related to cancer and dialysis.

Grant terminations hit work to improve rural health care

Congress previously tried to ensure that NIH grants also went to states that historically have had less success obtaining biomedical research funding from the government. Now those places aren’t immune to the NIH’s terminations.

Sophia Newcomer, an associate professor of public health at the University of Montana, said she had 18 months of work left on a study examining undervaccination among infants, which means they were late in receiving recommended childhood vaccines or didn’t receive the vaccines at all. Newcomer had been analyzing 10 years of CDC data about children’s vaccinations and had already found that most U.S. infants from 0 to 19 months old were not adequately vaccinated.

Her grant was terminated March 10, with the NIH letter stating the project “no longer effectuates agency priorities,” a phrase replicated in other termination letters KFF Health News has reviewed.

CDC cuts hit HIV prevention program, jeopardizing decades of progress on reducing infant transmission rates

“States like Montana don’t get a lot of funding for health research, and health researchers in rural areas of the country are working on solutions to improve rural health care,” Newcomer said. “And so cuts like this really have an impact on the work we’re able to do.”

Montana is one of 23 states, along with Puerto Rico, that are eligible for the NIH’s Institutional Development Award program, meant to bolster NIH funding in states that historically have received less investment. Congress established the program in 1993.

The NIH’s grant terminations hit institutions in 15 of those states, more than half that qualify, plus Puerto Rico.

Researchers can’t ‘just do it again later’

The NIH’s research funds are deeply entrenched in the U.S. health care system and academia. Rarely does an awarded grant stay within the four walls of a university that received it. One grant’s money is divvied up among other universities, hospitals, community nonprofits, and other government agencies, researchers said.

Erin Kahle, an infectious disease epidemiologist at the University of Michigan, said she was working with Emory University in Georgia and the CDC as part of her study. She was researching the impact of intimate partner violence on HIV treatment among men living with the virus. “They are relying on our funds, too,” she said.

Kahle said her top priority was to ethically and safely wind down her nationwide study, which included 418 people, half of whom were still participating when her grant was terminated in late March. Kahle said that includes providing resources to participants for whom sharing experiences of intimate partner violence may cause trauma or mental health distress.

Rachel Hess, the co-director of the Clinical & Translational Science Institute at the University of Utah, said the University of Nevada-Reno and Intermountain Health, one of the largest hospital systems in the West, had received funds from a $38 million grant that was awarded to the University of Utah and was terminated March 12.

The institute, which aims to make scientific research more efficient to speed up the availability of treatments for patients, supported over 5,000 projects last year, including 550 clinical trials with 7,000 participants. Hess said that, for example, the institute was helping design a multisite study involving people who have had heart attacks to figure out the ideal mix of medications “to keep them alive” before they get to the hospital, a challenge that’s more acute in rural communities.

After pushback from the university — the institute’s projects included work to reduce health care disparities between rural and urban areas — the NIH restored its grant March 29.

Among the people the Utah center thanked in its announcement about the reversal were the state’s congressional delegation, which consists entirely of Republican lawmakers. “We are grateful to University of Utah leadership, the University of Utah Board of Trustees, our legislative delegation, and the Utah community for their support,” it said.

Hilliard, of HHS, said that “some grants have been reinstated following the appeals process, and the agency will continue to carry out the remaining appeals as planned to determine their alignment.” She declined to say how many had been reinstated, or why the University of Utah grant was among them.

Other researchers haven’t had the same luck. Kahle, in Michigan, said projects like hers can take a dozen years from start to finish — applying for and receiving NIH funds, conducting the research, and completing follow-up work.

“Even if there are changes in the next administration, we’re looking at at least a decade of setting back the research,” Kahle said. “It’s not as easy as like, ‘OK, we’ll just do it again later.’ It doesn’t really work that way.”

KFF Health News is Healthbeat’s national reporting partner.

NIH cuts disrupt Alzheimer’s research at Emory, training for scientists at UGA

2025-04-03T16:41:29+00:00

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Alzheimer’s prevention research and training for future scientists are among the Georgia programs canceled by federal funding cuts implemented abruptly by the new Trump administration.

The sudden termination of a grant from the National Institutes of Health forced Emory University professor Whitney Wharton to take down websites and cancel appointments for people at risk for Alzheimer’s disease contributing to her study. At the University of Georgia, professors are searching for funds to help their students finish out the academic year after NIH support for their training was canceled.

The nation’s main health research agency, the NIH, has canceled hundreds of grants totaling more than $1 billion because they study racial minorities and LGBTQ people and help promote diversity in science. The cancellations follow executive orders from President Donald Trump calling on federal agencies to end diversity, equity, and inclusion programs, to recognize just two sexes, and remove references to transgender people and “gender ideology.”

That includes more than a dozen awards to Georgia universities, according to a list of canceled grants from the U.S. Department of Health and Human Services, the NIH parent agency. The cuts come amid a hiring freeze at Emory; layoffs of about 2,400 employees at the Centers for Disease Control and Prevention, many in Atlanta; cuts to Georgia public and mental health agencies; and a sweeping reorganization of HHS.

Wharton, a professor at Emory’s School of Nursing, testified about the impact of the cuts during a March 26 forum in Washington hosted by two Democrats, Sen. Tammy Baldwin of Wisconsin and Sen. Peter Welch of Vermont.

Two of Wharton’s research grants into Alzheimer’s prevention have been canceled over the past month, leaving salary worries and unpaid bills.

Wharton said she — and the American taxpayers — made a promise to the patients participating in her study to see the work supported by the $2.2 million, four-year grant to completion.

The study, focused on Alzheimer’s prevention in LGBTQ+ adults, was canceled on Feb. 28. Wharton said she had about six months and about $500,000 left to spend, budgeted for staff salaries and other costs. Wharton has appealed the cancellation.

She and her team developed a registry of more than 1,000 LGBTQ+ patients willing to participate in research studies on Alzheimer’s prevention. Wharton wants to ensure the registry continues, perhaps by finding private funding.

“Building and retaining a group of patients and participants who donate their time, their energy, and quite literally, their body fluids, particularly when they have or are at risk for a terminal illness, is a gift,” Wharton testified to the congressional forum.

Wharton removed an online directory of resources for aging LGBTQ+ adults in all 50 states to keep it from being used as a “roadmap” to organizations that might be targeted for more cuts.

She said she won’t be able to pay honorariums to the members of the advisory board who helped her ensure her research reflects the needs of the community, and she and her staff may have to cancel their planned attendance at events.

A second grant on which Wharton is a co-principal investigator based at the University of Nevada, Las Vegas was also cancelled, causing further funding worries since the projects share resources.

Wharton said the abrupt cancellations surprised her, though she anticipated cuts to research about LGBTQ+ people.

“It is not scientifically or ethically appropriate to terminate these projects in the way that they are being terminated …. The participants … signed up for a project and they signed up for a project that was going to be seen through completion,” Wharton said.

‘Maximally cruel’: UGA pipeline for health researchers canceled midyear

University of Georgia professors Kimberly Klonowski and Erin Dolan are worried about the pipeline of future scientists after an NIH program devoted to providing underrepresented groups with a “research intensive, one-year experience” was canceled.

In its 11th year, the UGA Post-Baccalaureate Research Education Program was canceled on March 12. The professors found out two days later from a UGA staffer, they told Healthbeat this week.

The abrupt cancellation has left the two professors scrambling to find funding from other sources so the six students, who typically complete the program in May or June, can finish the year.

“It was maximally cruel by cutting funding without warning, without notification, in the middle of the year,” Dolan said.

Scholars spend a year working in UGA labs, providing them with research experience many could not access as undergraduates, often because they studied at a small college without a research infrastructure.

The program helps students navigate the graduate school application process and “allows them to hit the ground running and be successful in a PhD program,” keeping up with students who graduated from elite universities, Dolan said.

The program is designed to help underrepresented students but is not limited to racial and ethnic minorities, Dolan said. Other eligible groups include those who have disabilities, grew up in low-income families, or come from rural or inner-city environments.

The UGA program was one of many at universities across the country, Dolan said. At least four of those have been canceled, according to a list of canceled grants posted on the HHS website Friday.

NIH awards to Spelman College, Morehouse School of Medicine, and Georgia State University have also been canceled.

Organizations led by the American Public Health Association and the UAW, which represents about 120,000 higher education workers, filed a lawsuit this week against the NIH and HHS in U.S. District Court for Massachusetts over the funding cuts.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Mass layoffs at CDC hit public health, economy in Atlanta

2025-04-01T22:16:26+00:00

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Thousands were laid off Tuesday from the Atlanta-based CDC, dealing a blow to the city’s public health workforce, local, national and global research on illness prevention, and likely the city’s economy.

The CDC’s parent agency, the U.S. Department of Health and Human Services, last week announced a sweeping reorganization that would result in about 2,400 “reductions in force” at the CDC.

Kevin Caron, a health scientist in the CDC’s Office of Smoking and Health, received notice via email early Tuesday that he had been terminated. He spoke to Healthbeat as he drove to the agency’s Chamblee campus to retrieve his belongings, including awards for his work.

Caron was instructed not to come in, but then received notice about 10:30 a.m. that his access to the office could be cut off by noon. He is on administrative leave until June 2 and was told to hold onto his work laptop for now.

Caron said the majority of the staff at the Office of Smoking and Health – over 90 people – was laid off. He was worried about the work they will leave undone. The office is “essentially not functional anymore,” Caron said.

The team’s research saved lives, he said, recalling their discovery in 2019 that a chemical was causing serious lung injuries and deaths in teenagers who vaped.

“Smoking is the number one, the leading cause, of preventable death in the U.S.”, and Caron’s entire office was working on it.

“Children will be vulnerable because they’re the ones who are most frequently targeted by the industry and most susceptible to becoming addicted to the use of tobacco products,” Caron said.

Kevin Caron, a health scientist in the Centers for Disease Control and Prevention's Office of Smoking and Health, was laid off from the agency on Tuesday. He and his wife, Priyanka Bhatt, a human rights attorney, are expecting a baby this month.

On the home front, Caron and his wife are expecting their first child on April 12, and his wife’s maternity leave has started.

“I’m very worried about what kind of world she’s going to come into, and worried about my own … financial security,” Caron said of the impending birth. “But I’m also worried about the bigger picture.”

Specimens put into deep freeze as cuts disrupt labs

Kevin Pettus also lost his job Tuesday after more than three decades at the CDC. Pettus worked as a clinical microbiologist and in syphilis serology as a unit lead at the Laboratory Reference and Research Branch of the Division of Sexually Transmitted Disease Prevention.

He was able to retrieve his belongings from the agency’s campus on Clifton Road but said he’s worried about the future of the lab — and the work that it did.

“We were just told to place whatever specimens that we are working on into our long-term freezer …. with the hopes that somehow this will all be recanted, and they will ask us to come back and continue our research,” Pettus said.

Lab instruments would become unusable without daily maintenance, he said.

Kevin Pettus, a clinical microbiologist who worked in syphilis serology at the Laboratory Reference and Research Branch of the Division of Sexually Transmitted Disease Prevention at the Centers for Disease Control and Prevention, poses for a photo with his wife and four daughters.

“I don’t see how this is saving the taxpayers money. [It] is going to cost them so much more in either repairing or even discarding some of these materials and supplies,” Pettus said.

The CDC lab provided important testing services to state and local health departments, Pettus said.

The changes will “dramatically impact healthcare and the testing process in the very near future,” Pettus said. “I’m not sure what these institutions and public health labs … are going to do moving forward.”

CDC job losses could impact Atlanta economy

HHS Secretary Robert F. Kennedy Jr. has said the CDC layoffs were in line with President Donald Trump’s executive order calling for “large-scale” terminations.

The reorganization will involve moving two CDC centers – the Agency for Toxic Substance and Disease Research and the National Institute for Occupational Safety and Health – to a newly created branch of HHS, the Administration for a Healthy America. Meanwhile, 1,000 employees at the Administration for Strategic Preparedness and Response will move to the CDC.

Supporters of workers at the Centers for Disease Control and Prevention rally outside the agency's Atlanta headquarters on Friday.

Lists circulating among CDC employees and retirees on Monday suggested that many parts of the agency had been impacted by the layoffs, including the divisions of violence and injury prevention, the Office of Health Equity, the asthma and air quality branch, the global division of HIV and tuberculosis, the division of reproductive health in the National Center for Chronic Disease Prevention and Health Promotion.

“There’s a growing sense of uncertainty and not feeling whole in this nation,” said Atlanta Mayor Andre Dickens on Friday of the impending reductions. “Cuts at the CDC impact health, national security, community wellness, jobs in Atlanta, and faith in our day to day.”

The CDC employed about 13,000 people, with 10,000 in Georgia, spokesperson Jason McDonald said in November.

“It has a specifically devastating impact on jobs in this area, and these are thousands of jobs,” said Barb Marston, who leads an informal group of CDC retirees who have been organizing and rallying each week to support the agency’s workers.

“Ordinarily, if somebody had something that was going to create thousands of jobs, they’d celebrate that as good for Georgia’s economy. Here we have a situation where we’re losing thousands of jobs. That’s obviously going to be bad for the economy,” Marston said.

The impact of the job losses will include the loss of employees’ spending on items like health care, housing, going out to eat and entertainment, said Peter Bluestone, of the Center for State and Local Finance at Georgia State University.

“Firms will be reluctant to make investments with an unpredictable future going forward, and job seekers may be reluctant to apply to the CDC again, with its future potentially uncertain,” Bluestone said.

Councilmember Jason Dozier last month sponsored an Atlanta City Council resolution calling on local and state governments to hire employees laid off by the CDC and other federal agencies. The resolution was adopted unanimously.

He said Tuesday he’s especially worried about the HIV epidemic in Atlanta.

“Atlanta is especially vulnerable to these cuts as our city has been and will continue to be on the frontline of combating the spread of HIV. But we need the CDC’s help in that fight. Black and LGBTQ+ communities in Atlanta are disproportionately affected by HIV and the CDC funds programs specifically designed to address these disparities,” Dozier said.

Georgia health dept. to lose $334.4M in federal funds

HHS last week cancelled billions in grants to state and local health departments, including funding initially provided for Covid relief and funds for mental health services.

The Georgia Department of Public Health said late Tuesday the cuts would result in a loss of at least $334.4 million in federal funds.

“There will be minimal impacts to essential core public health services,” DPH spokesperson Nancy Nydam said. The canceled grants were set to expire between May 2025 and July 2027.

Covid services will be reduced or continued, including testing kiosks, mobile vaccine deployments, community-based vaccine services, and vaccine and testing registration systems, Nydam said.

DPH also laid off about 170 Covid contract tracers on Thursday, Nydam said, as well as 10 other staffers.

“The impact on district-level staff is still being analyzed, with each district conducting its own review to determine local effects,” Nydam said.

The cuts could result in a $467,000 cut to the Cobb and Douglas county public health budget, leaders said last week.

This story has been updated to include a second interview with a CDC staffer and figures from the Georgia Department of Public Health on federal funding reductions released late Tuesday.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Looming cuts to NIH funding have Atlanta startup founders on edge

2025-03-18T15:21:31+00:00

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Disruptions to funding streams from the National Institutes of Health aren’t just rattling university researchers. Atlanta startups that help move scientific innovations to market – creating jobs and furthering industry and academic collaboration – are also on edge.

These are small businesses that use a tiny portion of the NIH’s budget to bridge the gap between research and consumers. They make tape to improve nerve repair, devices that reduce pain without opioids, and digital tools to help people with cognitive challenges navigate daily life, among other innovations.

The NIH awarded $700 million to Georgia universities in fiscal 2024, according to estimates from an agency reporting tool. In contrast, small businesses in the state received less than $27 million for 45 projects at 29 companies in 2024, according to the tool.

Technology transfer from labs to small businesses creates a host of economic benefits, said Stephen Susalka, CEO of AUTM, which represents technology managers who help commercialize discoveries.

“It’s a Swiss Army knife in terms of impact,” Susalka said, creating new products, new companies, and new jobs. “That just leads to economic development, right? So now you have a new tax base. You have new facilities that are purchased. Those people are buying lunch every day.”

Emory University plans to curb spending, staffing as fed research cuts loom

The federal funding “can really lead to strong industry and academic collaboration,” said Maria Thacker Goethe, president and CEO of Georgia Life Sciences, a nonprofit industry group. Many startups in Atlanta have “spun off” from local universities, and they play a key role in the state’s innovation economy.

The new Trump administration has frozen some NIH funding, then restarted some of it, amid threats of further cuts to come. Healthbeat Atlanta spoke to the leaders of several startups about how the uncertainty at the NIH is affecting their work. Here are four of their stories.

MapHabit: Tech for people with dementia, autism

NIH funding that flows through the Small Business Innovation Research program has been crucial to MapHabit’s success, co-founder Matt Golden said. The tablet-based platform helps people with conditions like dementia or autism complete daily activities. It placed first in a National Institute of Aging innovation competition in 2019.

MapHabit is part of the health tech portfolio at the Advanced Technology Development Center, the state’s technology incubator at Georgia Tech. The company, which has received four NIH awards, employs 15 full-time and 15 part-time workers, many in Atlanta, Golden said.

Golden’s funds were frozen in February and then restored 24 hours later, he said. Still, proposed changes at NIH like cuts to payments for overhead costs have him worried.

“The shotgun approach is going to reverse decades of progress, unfortunately,” Golden said. “These grants have been given to us so that we can spend the time to publish… to generate the data that proves this work, and that’s essential in health care.”

Cuts could mean products like his get stuck on the shelf, Golden said, before they can reach those who need them.

“They’ll just basically be halfway complete,” Golden said. “That’s going to put America at a big disadvantage.”

Friendi.fi: AI technology for relationships

An abrupt loss of access to NIH funding in February sent small business founder Chantal Kerssens scrambling.

Her startup, Friendi.fi, which she runs remotely from Atlanta, receives money from the national health agency to develop and test its technology, which uses artificial intelligence to connect people with an AI friend and coach. It’s also designed to help insurers gather information about the needs of their patients. At 6 months old, the company needs the NIH awards, even when it has other sources of funding.

“We need to know what we’re up against,” Kerssens said. She called a meeting of the company’s leaders to discuss how they would cover NIH-supported salaries using funds for other expenses.

Kerssens was unable to access the company’s NIH grant funds through a federal portal for nearly two weeks, even amid reports that the funds had been restored. That lack of clear information added to her anxiety.

And she’s worried about the future of the program.

Dr. Amy Baxter: Drug-free pain relief

Dr. Amy Baxter is a pediatric emergency room doctor who left private practice to develop Buzzy, a device to reduce the pain of getting a shot that won a 2020 Tibbetts Award for SBIR achievement.

She lost access to her NIH funds for eight days in February. This week, operations were back on track.

Baxter is working to develop tools to reduce pain without opioids, including VibraCool, a device that reduces pain with vibrations, heat, and cold, and a product to address low-back pain, the DuoTherm, as part of a federal initiative to end opioid addiction.

She is also using NIH funding to develop a tool to more accurately capture data about people’s opioid use, much of which comes from unused pills from prior prescriptions, Baxter said. This will help researchers better track whether their new inventions truly reduce opioid use.

Vivo: Testing a virtual strength program for seniors

Eric Levitan is using an SBIR award to evaluate the efficacy of a virtual strength program for older adults, Vivo.

He said receiving notice in February that NIH funding was paused was “devastating.” Though the money was unfrozen soon after, “the damage was done,” he said, and it caused his team to “rethink everything.”

Vivo, founded in 2020, weaves together workouts and community building and helps reach older adults where they are, including at senior centers, a key customer, Levitan said. Vivo employs four full-time and 35 part-time workers, 10 of whom are in Atlanta.

The company has raised over $4.1 million from angel investors, respected investors like AARP’s AgeTech Collaborative, and Techstars – and a three-year, $2.3 million award from the NIH.

Levitan teamed with Kathryn Starr, an associate professor at Duke University School of Medicine, to apply for a small business “fast track” grant to conduct a randomized control trial to see whether the Vivo program reduces blood sugar in people with prediabetes.

“Once we realized that all NIH funding may be at risk, it caused a ripple effect across our team and our research partners. …Will it change how we’re looking at R&D, how we manage funds, or [our] approach to growth?” Levitan said. “It forced us to go into contingency mode.”

A proposed NIH policy that would cut how much it pays for the “indirect” costs of research like maintaining a facility and routine bills would amount to a 25% reduction in expected payments, Levitan said.

That would likely force him to stop the randomized trial, he said, though the money has been budgeted, and results are expected later this year.

What’s next for the SBIR program?

The proposed NIH policy to cut research funding is on hold due to an injunction from a federal judge, while lawsuits filed by universities and other organizations are pending.

It’s not yet clear if the policy – if implemented — would apply to existing SBIR grantees, said Mark Skinner, CEO of SSTI, a national nonprofit focused on bolstering innovation.

The application process for the NIH’s small business grants is rigorous, with the applications reviewed in a two-step process that includes evaluation by industry professionals and academic scientists. In fiscal 2023, just 19% of all applications were funded, according to data from the agency.

Meanwhile, Congress must this year reauthorize the SBIR program by Sept. 30, a step it typically takes every three years. That could provide an opportunity for Congress to introduce changes.

Earlier this month, U.S. Senate Small Business and Entrepreneurship Committee Chairwoman Sen. Joni Ernst, an Iowa Republican, proposed a wide-ranging reauthorization bill that would address criticisms of the program.

Concerns include so-called SBIR “mills” that repeatedly apply for grants without much commercial success and security concerns over Chinese involvement in American research and business.

That may not be the final version, Skinner said, with other proposals likely to come from the House and Senate.

Ernst’s bill would prevent the SBIR program from providing supplemental funds “based on the race, gender, or ethnicity of the principal investigator, founder, or key personnel of a small business concern.‘’

If enacted, that could be a problem for Golden of MapHabit, who has used an NIH program designed to promote diversity among entrepreneurs to hire two Black scientists to lead clinical trials and ensure his studies enroll diverse participants.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

How the FDA opens the door to risky chemicals in America’s food supply

2025-03-13T18:30:00+00:00

Joseph Shea, who sells athletic wear in Myrtle Beach, South Carolina, wonders and worries about the food he eats.

The chemical ingredients with mystifying names. The references on product labels to unspecified natural or artificial flavors. The junk food that fits his budget but feels addictive and makes him feel unwell.

Shea, one of 1,310 people who responded to a poll the health policy research group KFF conducted on health care priorities, said he assumes the FDA is making sure the ingredients are safe.

In many cases, it is not.

The FDA’s restraints on food ingredients are limited and relatively feeble, especially compared with those in Europe, a KFF Health News examination found. There are at least 950 substances in our food that are not permitted in Europe, according to one expert’s estimate, and chemicals linked to health concerns show up in hundreds of products that line the shelves of American supermarkets.

Robert F. Kennedy Jr., the new head of the Department of Health and Human Services, has railed about the risks of food additives for years and has said he wants to end “the mass poisoning of American children.” At a March 6 confirmation hearing, Marty Makary, President Donald Trump’s nominee to head the FDA, expressed concern about foods “with a lot of molecules that do not appear in nature.”

“These are chemicals that the industry insists are safe, a subset of which are concerning,” he said.

But the Trump administration’s initial moves to reduce staff at the FDA led the director of its food safety unit, Jim Jones, to resign last month and raised fears among food safety specialists that the administration could weaken oversight.

To a great extent, the FDA leaves it to food companies to determine whether their ingredients and additives are safe. Companies don’t have to tell the FDA about those decisions, and they don’t have to list all ingredients on their product labels.

Though pharmaceutical companies are required to share research on humans with the FDA, the agency is largely blind to what food-makers know about their products.

“The food industry does massive amounts of research that we have no access to,” Robert Califf told a Senate committee in December on his way out as FDA commissioner.

As a result: The FDA’s oversight of food additives is much weaker than its oversight of prescription drugs.

“There is good reason to be concerned about the chemicals that are routinely included in much of our food,” Califf testified.

Food is a big business. American consumers spend almost $1.7 trillion annually on food and beverages, according to Circana, a research and advisory firm.

Yet American food companies keep secret much of what they put in their products.

KFF Health News asked nine of the largest food manufacturers — The Coca-Cola Co., Conagra Brands, General Mills, Kellanova (successor to Kellogg), The Kraft Heinz Co., Mondelēz International, Nestlé, PepsiCo, and Unilever — for the number of ingredients, if any, that go unnamed on their product labels and the names of those ingredients deemed safe without involvement by the FDA, and substances used in their products in the United States but not in Europe, and vice versa.

None provided answers to those questions.

“We focus on the quality of the ingredients that we use, and all comply with applicable regulatory requirements,” Nestlé spokesperson Dana Stambaugh said.

Chemicals such as titanium dioxide and potassium bromate, whose safety has been debated, are allowed in foods in the United States but not in Europe.

Corporations may turn a blind eye to potential dangers, a July 2024 FDA-funded report warned.

Potentially harmful ingredients “are not necessarily required to be named on a product label,” the Reagan-Udall Foundation for the FDA, an adjunct to the agency, said in the report, which was based largely on interviews with representatives of companies across the food supply chain.

“Companies may choose not to track the presence of these ingredients/compounds due to concern about future litigation,” the report said.

Some additives can remain hidden from the public behind such catchall terms as “spices” and “artificial flavors,” as the Center for Science in the Public Interest has reported, or shrouded by other exemptions from disclosure requirements.

And some ingredients that should have been listed on product labels — potential allergens such as milk, wheat, eggs, and dyes — have at times gone undisclosed, according to a series of food recalls. Gaps in oversight have alarmed political leaders on both sides of the aisle, the U.S. Government Accountability Office, watchdog groups such as the CSPI, and academic researchers.

Adding to the concern: the profusion of ultra-processed foods, which use a wide array of chemicals to add flavor and color, extend shelf life, reduce cost, control texture or consistency, and generally tempt people to eat more. Ultra-processed foods now make up 73% of the U.S. food supply, researchers have estimated. Sen. Bernie Sanders of Vermont, the ranking member of the Senate Health, Education, Labor and Pensions Committee, has said there’s growing evidence they are “deliberately designed to be addictive,” contributing to an epidemic of obesity — a rare point of agreement between him and Kennedy.

At his confirmation hearing, Makary said some ingredients cause a chronic, low-grade inflammatory reaction in the gastrointestinal tract. “And what are we doing? We are drugging our nation’s children at scale,” he said.

The KFF poll found that 58% of respondents want the Trump administration to prioritize setting stricter limits on chemicals in the U.S. food supply.

The Consumer Brands Association, which represents many of the largest food-makers, defends the regulatory system as “rigorous,” “evidence-based,” and “proven.” The system enables companies “to innovate to meet consumer demand,” Sarah Gallo, the association’s senior vice president of product policy, said in a statement to KFF Health News.

“Food manufacturers attest to the safety of an ingredient through the development of extensive scientific evidence and third-party expert review,” Gallo added.

More than a decade ago, Pew Charitable Trusts estimated that there were about 10,000 additives allowed in food in the United States — and that the FDA had not reviewed the safety of about 3,000 of them.

“The system is fundamentally broken,” said Thomas Neltner, one of the authors of the Pew study. “It’s so bad, nobody knows — not even FDA knows — what’s in our food.”

Banned Abroad

The FDA allows titanium dioxide to be used to enhance the appearance of foods, among other purposes. According to an Environmental Working Group database, it’s listed as an ingredient in more than 1,900 products, including many candies.

The European Union takes a more cautious approach. In 2021, an EU regulatory panel concluded that titanium dioxide “can no longer be considered as safe when used as a food additive.” The panel said it couldn’t rule out the possibility that titanium dioxide could damage chromosomes.

The FDA allows potassium bromate to be used in baking, and, according to the EWG database, it’s listed as an ingredient in more than 200 products, including bread, buns, and bagels.

Potassium bromate has been banned from food in many countries, including those of the European Union, Canada, India, and Peru. In 2023, California banned it from food effective in 2027. The United Kingdom prohibited it in 1990. The International Agency for Research on Cancer identified it as possibly carcinogenicmore than 25 years ago. A joint committee of the United Nations and the World Health Organization identified it as a “genotoxic carcinogen” in 1992.

On its website, the FDA says it has worked with industry to minimize potassium bromate levels and is reviewing the chemical, among others.

The EWG says that it created the database to help consumers make healthier choices and that the raw data on product labels is supplied by Label Insight — which is owned by NielsenIQ, a major provider of data to industry. The EWG has called for tighter regulation of foods.

Based on a review of FDA and European Commission databases, it appears that at least 950 more additives are used in foods in the United States than are allowed in the European Union, said Erik Millstone, an emeritus professor at the University of Sussex in England who has been studying food safety policy since the 1970s.

Direct comparisons are difficult because the two regulatory systems and the way they keep their records differ greatly.

A definitive count is elusive because the FDA doesn’t require industry to inform it of everything used in foods in the United States.

“That kind of casual neglect totally would be unacceptable in Europe,” Millstone said.

‘Several Decades Behind Europeans’

When the FDA formally approves substances for use in food, it can let decades pass without reassessing them — even when subsequent research raises doubts about their safety.

In January, when the FDA banned Red Dye No. 3 from foods, it cited research published in 1987. (The FDA said it had no evidence the dye puts people at risk; invoking one of the stricter consumer protections, it said a law from 1960prohibits the use of additives found to induce cancer in animals.)

In the European Union, substances used in foods must pass regulatory approval before being introduced. The EU has also required that its regulators reassess all additives that were on the market before Jan. 20, 2009, a process that is ongoing.

“In the FDA, although we have authorization to do post-market reviews, there’s no statutory mandate to do them,” Jones, the former deputy commissioner of the FDA’s Human Foods Program, told a Senate committee in December. “We are several decades behind Europeans and our Canadian counterparts because they have legal mandates to reevaluate chemicals that have been authorized at some point in the past.”

The FDA website lists 19 post-market determinations since 2010 that substances were not “generally recognized as safe.” Four involve chemical constituents of one mushroom and the mushroom itself. Others include an anabolic steroid, caffeinated alcoholic beverages, cannabidiol (CBD), Ginkgo biloba, melatonin, and partially hydrogenated oils.

Meanwhile, trichloroethylene, banned by the Environmental Protection Agency in December as “an extremely toxic chemical known to cause liver cancer, kidney cancer, and non-Hodgkin’s lymphoma,” is still allowed under FDA rules for use as a solvent in the production of foods.

FDA spokesperson Enrico Dinges said the agency will work with new leadership at HHS “to safeguard the food supply through pre-market and post-market safety evaluations of chemicals in the food supply.”

‘The Loophole Swallowed the Law’

The biggest gap in the FDA’s oversight of foods goes back generations.

In 1958, Congress mandated that, before additives could be used in foods, manufacturers had to prove they were safe and get FDA approval. However, Congress carved out an exception for substances “generally recognized as safe,” which came to be known simply as GRAS.

As conceived, GRAS promised regulatory relief for standard ingredients like salt, sugar, vinegar, and baking powder — along with many chemicals.

Over time, “the loophole swallowed the law,” said a 2014 report by Neltner and Maricel Maffini for the Natural Resources Defense Council.

Companies can unilaterally decide their ingredients are already recognized as safe and use them without asking the FDA for permission or even informing the agency.

A better translation of GRAS would be “Generally Recognized as SECRET,” the Natural Resources Defense Council report said.

A federal watchdog reached a similar conclusion. “GRAS substances can be marketed without FDA’s approval or even its knowledge,” the Government Accountability Office warned in 2010.

That spared the FDA from spending time reviewing countless substances.

For advice on whether ingredients are GRAS, companies may convene panels of specialists. The FDA has noted that panel members could be paid by the companies commissioning the review, but, in guidance to industry, it says “such compensation is not itself an unacceptable conflict.”

About 3,000 flavoring ingredients have been deemed GRAS by a panel of scientists working for an industry group, the Flavor and Extract Manufacturers Association of the United States, known as FEMA, said George Southworth, the organization’s executive director.

The scientists on the FEMA panel “adhere to stringent conflict-of-interest policies,” and their GRAS determinations are submitted to the FDA, which includes them in an online database, Southworth said.

Southworth described the panel as independent, and the FEMA website says panel members have never been employees of companies in the food industry.

Asked how many times FEMA’s panel found that a flavoring didn’t meet the test, Southworth wouldn’t say. He indicated that some reviews are called off before a conclusion is reached.

“Publicly reporting these numbers without full context could lead to misinterpretations about the safety of substances,” he added.

Another Way

Food companies have another option: They can voluntarily notify the FDA that they believe their product is GRAS for its intended use and lay out their reasons — giving the FDA a heads up and essentially seeking its blessing.

If they take that route, they don’t have to wait for an answer from the FDA to begin marketing the product, the agency has said.

And they don’t risk much. If the FDA spots weaknesses in a company’s argument or reasons to worry about a chemical’s safety, it routinely calls off its review instead of declaring the substance unsafe.

FDA records posted on the agency’s website show that the FDA often coaches companies to ask the agency to cease its evaluation. That, too, leaves the company free to sell the product, food watchdogs said.

For companies that voluntarily run their products past the FDA, victory is a letter saying the agency has no questions.

But if companies market products as “generally recognized as safe” without firm grounds, they run the risk that the FDA could one day take enforcement action, such as issuing a warning or stopping sales. That’s if the FDA notices.

Psyched Out

On March 8, 2022, a Canadian company, Psyched Wellness, issued a news releasesaying it had a green light to market products in the United States.

An “independent review panel of scientific experts” concluded that an extract the company developed, AME-1, was “Generally Recognized As Safe,” paving the way for it to be sold in bulk and used as an ingredient, the company said.

The company described the panel’s judgment as a successful “certification” and “a key milestone.” The extract was derived from a hallucinogenic mushroom, Amanita muscaria, which the company said “has incredible healing and medicinal powers.” As the company later put it in a news release, it had obtained “self-Gras status.”

In June 2024, the company announced that it would soon release Amanita muscaria watermelon gummies.

However, the FDA later took issue with the company and its product.

In a memo dated Sept. 9, 2024, an FDA toxicologist said Psyched Wellness’ claim of GRAS certification was false. The firm failed to show that its extract was generally recognized as safe, the FDA memo said.

Speaking of the mushroom, its extracts, and its known “pharmacologically active constituents,” the FDA memo posted on the agency’s website said they have “potential for serious harm and adverse effects on the central nervous system.”

The FDA was focusing on the mushroom against the backdrop of a spate of medical problems linked to another company’s “Diamond Shruumz” brand chocolate bars, gummies, and infused cones. When it recalled those products in June 2024, that other company announced that a chemical found in Amanitamushrooms was a possible cause of symptoms, including seizures and loss of consciousness.

The FDA memo discussed that recall and said one death and 30 hospitalizations might have been related.

The memo did not connect Psyched Wellness to the outbreak or the Diamond Shruumz products.

The chief executive of Psyched Wellness, Jeffrey Stevens, did not respond to an interview request or written questions.

As recently as Feb. 1, Psyched Wellness said in a securities filing that it will “continue to market its products in the U.S. using the Self-GRAS designation.”

‘Probably Poisoning Us’

If food ingredients cause acute reactions — sending people to emergency rooms, for example — the potential dangers may be relatively easy to identify, and regulatory action might naturally follow. Some critics of the system say they worry more about health effects that could take years or decades to develop.

Then, when it’s too late, it could be hard to trace the harm to any particular ingredient.

All that leaves Joseph Shea of Myrtle Beach in a tough spot.

For a while, Shea tried shopping at a market that has a lot of organic offerings, he said in an interview. That proved too expensive.

Shea said the entire picture is “incredibly frustrating.”

“They’re probably poisoning us, and we don’t know,” he said. “We’ll figure it out 30 years down the road when we get sick.”

This story originally published at KFF Health News, Healthbeat’s national reporting partner.

Political climate linked with Georgia women’s mental health outcomes, Emory study finds

2025-03-13T11:00:00+00:00

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While politicians can make decisions that have direct effects on keeping the public healthy, new research from Emory University highlights how policymakers may also have indirect impacts on their constituents’ wellbeing.

A study published in Social Science and Medicine in January examined some of the potential mental health effects related to the current political climate. Previous research has suggested that politicians’ actions and media outlets’ coverage of the events can have a chronic stress effect on those who watch national political news.

From fall 2023 to spring 2024, the paper’s authors — comprised of researchers at Emory, University at Albany, and Northern Arizona University — surveyed 148 Georgia women between 18 and 40 years old. They asked the participants a series of questions to estimate how much political events caused them stress, in addition to measuring how much anxiety, depression, and overall stress they experience.

Ultimately, the authors found an association between increased stress from politics and symptoms of the three mental health measures. Stephanie Eick, an assistant professor at Emory’s Rollins School of Public Health and the paper’s senior author, said the paper is consistent with other research that found these symptoms often persist beyond the results of a presidential election.

“Even when it’s not election season, I do think that it’s important to think about the political climate as a source of stress,” she said.

The study participants were just surveyed once, so the authors could not determine what caused the negative health impacts. Additionally, most of the participants have earned college degrees, identify as liberal, and live in the metro Atlanta region — making it difficult to know whether these trends hold true among all Georgia women.

One national issue Eick and her coauthors noted could be an especially stressful event for the mental health of women was the U.S. Supreme Court’s decision to rescind national abortion protections. That ruling, paired with Georgia’s six-week abortion ban, is cited by the authors as a reason why the mental health of women in the state is important to be monitored.

“As somebody who’s a woman of reproductive age living here, it seems that a lot of the restrictions related to abortion access are salient here,” she said.

Asked to comment on the study, Frank Sloan, a health policy and management professor emeritus at the Duke Global Health Institute, said in an email that the relatively small number of women studied who identified as politically conservative or had not received a college degree make it difficult to determine how different groups’ mental health are affected by following politics.

Sloan added that it would have been helpful if the authors had examined whether the mental health outcomes changed before and after the 2024 presidential election.

Eick said these limitations are important to be addressed in future studies, and she would like to see her group or others pursue a study that tracks women’s health with political engagement over time. But she said the results seem consistent with other researchers’ observations on the topic.

Because the measures of general stress, anxiety, and depression can be screened for by primary care doctors, Eick said this study could be a call for clinicians to be on the lookout for attending these symptoms among women of reproductive age.

And as federal lawmakers proceed with actions that may further distress some Georgia residents, such as a plan to cut hundreds of billions of dollars from government health care services, Eick said it’s important for people to be proactive about seeking mental health treatment when available.

“Even if we can’t mitigate some of the political stressors … maybe we could mitigate some of the mental health outcomes through existing resources.”

Allen Siegler is a reporter covering public health in Atlanta for Healthbeat. Contact Allen at asiegler@healthbeat.org.

Atlanta study finds relationship between childhood trauma and heart health in Black women

2025-03-12T11:00:00+00:00

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While there’s a growing body of evidence addressing the relationship of childhood trauma to heart health, Telisa Spikes wanted to take “a deeper dive’’ into the experiences of Black adults.

To do so, the assistant professor at Emory University’s Nell Hodgson Woodruff School of Nursing used a unique dataset about healthy Black adults in Atlanta.

The study found an association for Black women between childhood trauma and greater arterial stiffening. Black men did not show that association, suggesting women might experience trauma and stress differently, Spikes said — with implications for their heart health.

The findings, published in the Journal of the American Heart Association, have deep roots in Atlanta. Spikes, the lead author of the study, started her career as a cardiovascular nurse at Emory Saint Joseph’s Hospital, where she often saw relatively young Black women with heart failure.

That experience inspired her to study stress and heart health among Black women.

Spikes and a team from Emory and Morehouse School of Medicine looked at data from just over 400 Black Atlantans who participated in the Morehouse-Emory Cardiovascular Center for Health Equity, or MECA.

The MECA study, which collected data between 2014 and 2019, focused on “the determinants of resilience” among Black adults. People with a history of serious cardiovascular disease or other conditions were excluded from the study, meaning participants were in relatively good health.

Telisa Spikes is a professor at the Nell Hodgson Woodruff School of Nursing at Emory University.

MECA used a standard, 27-item questionnaire that asked participants to self-report on childhood trauma, including physical, emotional, and sexual abuse. It also measured markers of vascular health among participants.

Black women showed an association between experiences of childhood trauma and higher measures on two of the three vascular markers related to the stiffness of arteries, or the hardening of their walls. That can hinder blood flow and cause the heart to work harder as a pump. Over time this can lead to heart failure and stroke.

The Black men in the MECA study, on the other hand, did not demonstrate an association between childhood trauma and those markers.

Stiff arteries contribute to high blood pressure, a leading risk factor for heart attack and stroke. Black Americans tend to develop cardiovascular disease earlier in life than other racial or ethnic groups, Spikes said.

Black women face unique chronic stressors “due to that intersectional identity of being not only Black but also being female,” Spikes said. Those include the wage gap, caregiving responsibilities and a greater likelihood of being single heads of household.

Spikes added that Black women who experienced childhood trauma could have worse arterial health due to factors like lack of physical activity and unhealthy diet.

Or women could have a different physiological stress response than men, she said, adding that prolonged stress can damage cardiovascular health.

The stronger association between childhood trauma and stiff artery markers “raises important questions about possible biological and social differences in how stress affects the body,” Paula Rodriguez-Miguelez, an associate professor at Virginia Commonwealth University, said in an email. She agreed to comment on the study and was not part of the research.

She explained that all people experience stress in everyday life but chronic stress like “years of bullying at school or growing up in a challenging environment” can cause the body to “continuously release stress hormones like cortisol.”

Both Rodriguez-Miguelez and Spikes said that the damage caused by chronic stress and inflammation is “silent” and does not cause symptoms but contributes to high blood pressure and, often, heart disease and stroke.

Like Spikes, Rodriguez-Miguelez said the increased arterial stiffening among women with childhood trauma could also be due to behavioral factors like unhealthy diet, lack of exercise, and smoking.

“Individuals who experience childhood adversity may be more likely to develop unhealthy coping mechanisms,” Rodriguez-Miguelez said.

On the clinical front, Spikes suggested integrating a childhood trauma measure into primary care screenings.

Atlanta is a good place to look at Black heart health, Spikes said, because of its large Black population and high concentration of health researchers.

“Given the health challenges and health disparities of Black populations as well as the increase in health researchers of color [in Atlanta], there is a greater interest to develop strategies and interventions that will mitigate these disparities,” Spikes said.

She is now recruiting participants for a National Institutes of Health-funded study that looks at chronic stressors in Black women 35 to 44 years old. She’s expecting results next year.

Spikes is concerned about potential cuts to NIH funding and wants the results from her research about heart disease in marginalized communities to be shared “to highlight why funding this type of work matters.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

How uncertainty over federal health funding and data is affecting Georgia researchers

2025-02-12T17:35:14+00:00

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Georgia’s statewide public health conference has been canceled, and researchers are navigating disruptions in federal data accessibility and funding, with Emory University President Gregory Fenves in Washington this week to meet with lawmakers.

Georgia received over $780 million in National Institutes of Health research grants in fiscal 2024. About $488 million of that went to Emory. Other top Georgia recipients include the University of Georgia, Augusta University, Georgia Tech, Georgia State University and Morehouse School of Medicine.

A new NIH policy ordered by the Trump administration would reduce the amount grants pay to universities to help with the costs of conducting research – items like facilities and administrative support.

That reduction would cost Emory about $140 million a year, according to a Saturday email to faculty and staff from Ravi Thadhani, executive vice president for health affairs, and Lanny Liebeskind, interim provost and vice president for academic affairs.

A federal judge on Monday temporarily blocked the guidance from taking effect in response to lawsuits, including one filed by the American Council on Education and a group of research universities and other national organizations.

A separate lawsuit filed by 22 attorneys general succeeded in getting the guidance temporarily blocked in those states. Georgia is not among them.

Still, Emory leaders are worried.

“The university depends on federal funding to power many important initiatives …. Now, elements of that partnership are evolving, and it will be challenging for the entire university,” Fenves wrote Tuesday in a note to “the Emory community.”

Fenves was in Washington, D.C., on Tuesday to meet with elected officials.

“It is our responsibility to make a compelling case for the value of Emory’s research and scholarship as part of a national research enterprise that has propelled economic growth, health and well-being, workforce development, and international competitiveness in the United States,” he said in the statement.

Threat of funding cuts brings uncertainty at Georgia State

NIH projects in Georgia encompass a wide range of basic and applied research, including new treatments for lung cancer, stroke rehabilitation, alcohol and substance use disorders, and many other fields.

The threat of federal funding cuts has created a “context of profound uncertainty” for faculty and students at Georgia State University, said Harry Heiman, a professor of public health.

Students have also lost access to key datasets, interrupting research, Heiman said.

For example, HIV data on the U.S. Centers for Disease Control and Prevention website had been removed.

“They’re not sure what to do all of a sudden,” Heiman said. “The data that they’ve been using to try to better understand and help solve critical public health problems … that work is put on hold as is their training, which they’ve invested significant time, energy and dollars in getting.”

New Emory survey finds Americans agree on public health priorities: affordable care, food and water safety, chronic diseases

The data removals started after Jan. 20 executive orders from President Donald Trump banning Diversity, Equity, and Inclusion initiatives, allowing the recognition of only two genders, and banning federal funding for “gender ideology.”

A federal judge issued a temporary restraining order Tuesday ordering the agencies to restore the missing data after nonprofit group Doctors for America sued over the removals.

The nation’s largest public health surveillance system, the Youth Risk Behavior Survey, was taken offline. It was restored, but some data were still missing Wednesday, including a data explorer tool.

Its website, like many others at the CDC, displays a banner saying the “CDC’s website is being modified to comply with President Trump’s Executive Orders.”

Emory Professor Nadine Kaslow said the survey “provides without a doubt the best information we have in our country” about high school students’ mental and behavioral health.

It includes data on a wide range of social identities, behaviors such as social media interactions, and even protective factors that can help young people cope with adversity.

Kaslow said states do and should collect data, but the national view from the survey is important for federal policymaking.

“It also allows us to learn from other states who implement programs,” she said.

The Georgia Department of Public Health and the Department of Behavioral Health and Developmental Disabilities use the survey data to track youth behavior and guide policy, Kaslow said.

“I am extremely concerned that having less access to existing data … will reduce our ability to understand young people in this country,” she said.

Georgia Public Health Association conference canceled

Meanwhile, a pause on non-essential travel at the state DPH has prompted the state public health association to cancel its annual conference.

Scheduled for April 30 to May 2 on Jekyll Island, the event has been canceled due to “the current pause in federal funding and due to directives received from the Georgia Department of Public Health,” according to a Friday email from Valerie Melson, an executive assistant at the District 4 public health district in LaGrange.

DPH’s travel freeze would have prevented most of the over 600 expected attendees from coming, GPHA President Dr. Jimmie Smith said. Most of the attendees work for county, district, and state public health programs.

“It wasn’t a decision we made lightly, but [we] had to look at all the factors that surrounded it,” Smith said of the cancellation.

The conference gives frontline public health workers, researchers, and board of health members from across the state a chance to get together and learn from each other, said Jack Bernard, a longtime attendee who is chairperson of the Fayette County Board of Health.

County health board members like Bernard are usually not trained public health professionals, he said. The conference is a way for them to learn “what our local and state health problems are and the most cost-effective ways of addressing them.”

About half of DPH’s budget comes from the federal government.

The agency paused non-essential travel, defined as non-emergency and non-regulatory travel, as of Feb. 3, spokesperson Nancy Nydam said.

“The travel deferment is not in response to any specific order or direction,” Nydam said. “Because of the continuing uncertainties around federal funding, DPH is being judicious with its discretionary spending to ensure the Department remains on solid financial footing.”

Nydam said funding is currently operating normally and the agency has not experienced delays with reimbursements.

“All routine public health services are continuing as normal,” she said. “At this time personnel are not affected, and it would be premature to speculate about potential changes.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

New Emory survey finds Americans agree on public health priorities: affordable care, food and water safety, chronic diseases

2025-02-07T21:33:25+00:00

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Here’s a few public health priorities that Americans can agree on: making health care more accessible and affordable, ensuring the safety of food and water, and fighting chronic diseases.

Those were named as the top priorities in survey results released this week by Emory University in Atlanta and Gallup.

“We wanted to make sure we had essentially a pulse check for where Americans wanted us to go,” said Dr. Stephen Patrick, an Emory professor who helped design the survey of 2,121 adults 18 and older.

The survey was conducted in December after President Donald Trump’s election.

“How can we, early on in a new administration, highlight what Americans really want out of public health in the next four years?” Patrick said of the impetus for the survey.

Responses were weighted to match national demographics by gender, age, race/ethnicity and other factors.

“There’s a fair amount of agreement across political parties, across demographics” in the findings, Patrick said.

Most respondents named these priorities in their Top 3:

Improving health care access and affordability (52%)
Ensuring safe water and food (37%)
Reducing chronic diseases (32%)

Patrick said he wasn’t surprised that those issues ranked high. He hears concerns from parents of patients in his neonatology practice about finding and paying for care.

Food and water safety are highly local issues, Patrick said. “It’s the local public health department that makes sure the restaurant up the street meets safety codes.”

Some believe U.S. has ‘lost ground’ on opioids, mental health

The survey asked people about progress on 10 health issues, Patrick said. The results showed many see a lack of progress on opioids and mental health.

Fifty-four percent of respondents thought America had lost ground on the opioid epidemic, and 50% said the country had lost ground on mental health.

Republicans and Republican-leaning respondents were more likely than other groups to say the United States has lost ground on mental health (59%) and opioid (69%) issues.

“We still treat mental health and substance use as pretty darn separate,” Patrick said. “Perhaps that’s an area where we can focus the next couple of years to be really comprehensive in the way we approach the opioid conversation and really have a broader conversation about mental health.”

It’s an issue that affects his practice, too.

“As a neonatologist, infants are the fastest-growing group in foster care today, most due to parental substance use,” Patrick said. “You just see the trickle effects of some of these problems that Americans are highlighting that really could take all of us to begin to address.”

Republicans and Democrats agree that the federal government plays a key role in health care, Patrick said.

For example, many said the federal government was better equipped than state governments to address a wide range of health issues, including ensuring safe water and food and addressing health effects from weather and climate change.

For other issues, like loneliness and rural health, many more people said state governments are better equipped.

Democrats and Republicans trust the CDC

The survey found some agreement about trusted sources of public health information, with some differences by age, education and party affiliation.

In general, the country’s Top 3 trusted public health sources – chosen from a list of 15 -- were:

Doctor, nurse or health care provider
Scientific research and studies
The Centers for Disease Control and Prevention

Democrats (60%) and Republicans (17%) ranked the CDC among their Top 5 sources for trusted information.

Other top trusted sources include medical websites and state health departments.

When it comes to social platforms, 9% of respondents ranked social media as a Top 3 trusted source, and 6% of respondents chose YouTube and other influencers.

That is more pronounced among young people. Sixteen percent of young people between ages 18 and 29 said social media is a Top 3 trusted source, the survey found.

“That’s one area where perhaps we need to be more effective” in public health messaging, Patrick said.

“I do think it’s incumbent upon social media companies to do a better job of ensuring that what we have on social media is more accurate,” Patrick said. “As a pediatrician and as a parent of adolescents, I have profound worries about what social media continues to do to our youth.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Little tracking, wide variability permeate the teams tasked with stopping school shootings

2025-02-03T16:39:51+00:00

This story originally appeared in KFF Health News and is republished here with permission.

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Max Schachter wanted to be close to his son Alex on his birthday, July 9, so he watched old videos of him.

“It put a smile on my face to see him so happy,” Schachter said.

Alex would have turned 21 that day, six years after he and 16 other children and staff at Marjory Stoneman Douglas High School in Parkland, Florida, were shot and killed by a former student in 2018. In the years before the shooting, that former student had displayed concerning behavior that elicited dozens of calls to 911 and at least two tips to the FBI.

“Alex should still be here today. It’s not fair,” Schachter said.

After two weeks of grieving Alex’s death, Schachter, propelled by anger and pain, began advocating for school safety. In part, he wanted to ensure his three other children would never be harmed in the same way. He joined the newly formed Marjory Stoneman Douglas High School Public Safety Commission to improve the safety and security of Florida’s students. And he launched a nonprofit bearing Alex’s name, which advocates for school safety.

Doing that work, he learned about threat assessment teams, groups of law enforcement and school officials who try to identify potentially dangerous or distressed kids, intervene, and prevent the next school shooting. Florida is one of about 18 states that require schools to have threat assessment and intervention teams; a national survey estimates 85% of public schools have a team assigned to the task.

The teams, whose mission and operational strategies often are based on research from the FBI and the Secret Service’s National Threat Assessment Center have become more common as the number of school shootings has increased. Despite their prevalence for almost 25 years, some of the teams have developed systemic problems that put them at risk of unfairly labeling and vilifying children.

States vary widely in their requirements of threat assessment teams, and there isn’t a nationwide archetype. Few school districts and states collect data about the teams, little is known about their operations, and research on their effectiveness at thwarting mass shootings and other threats is limited. But a 2021 analysis by the NTAC of 67 plots against K-12 schools found that people “contemplating violence often exhibit observable behaviors, and when community members report these behaviors, the next tragedy can be averted.”

“School shooters have a long thought process. They don’t just snap. They have concerning behavior over time. If we can identify them early, we can intervene,” said Karie Gibson, chief of the FBI’s Behavioral Analysis Unit.

Yet, Dewey Cornell, a forensic clinical psychologist who in 2001 developed one of the first sets of guidelines for school threat assessment teams, said there have been problems. In many cases, he said, threats have been deemed not serious “but parents and teachers are so alarmed that it is difficult to assuage their fears. The school community gets in an uproar, and the school administrators feel pressured to expel the student.”

And in other cases, a school doesn’t do a threat assessment and assumes a student is dangerous when somebody else reports them as a threat, and they may take a zero tolerance approach and remove them from the school, said Cornell, the Virgil S. Ward professor of education at the University of Virginia.

Secret Service: Most student threats aren’t credible

A task force convened by the American Psychological Association found little evidence that zero tolerance policies have improved school climate or school safety and said they may create negative mental health outcomes for students. The task force cited examples of students who were expelled for incidents or school rule violations as minor as having a knife in their lunch box for cutting an apple.

Marisa Randazzo, a research psychologist and the director of threat assessment for Georgetown University, said she has also seen “hyperreactions,” especially among school communities that have experienced a mass killing.

“It’s understandable. People who have been close to an event like this are on higher alert than other people,” said Randazzo, who previously worked for the Secret Service and co-founded Sigma Threat Management Associates.

Threat assessments are supposed to be a graduated process calibrated to the seriousness of a problem, since the majority of student threats are not credible and can be resolved through supportive interventions, according to research from the Secret Service.

Stephanie Crawford-Goetz, a school psychologist and the director of mental health for student support services in the Douglas County School District in Colorado, where a shooting occurred at a charter school in 2019, said her district’s threat assessment process emphasizes a proactive, rehabilitative approach to managing potential threats, as the NTAC suggests.

Crawford-Goetz said her district interviews students before convening the team to assess whether a threat is a misguided expression of anger or frustration and if the student has a plan and means to carry out violence.

Students whose threats are deemed transient receive support, such as help with coping skills, and they may meet with a mental health provider.

If the threat is credible, a student may be temporarily removed from the classroom or school.

Randazzo said the vast majority of kids who make threats are suicidal or despondent: “The process is designed primarily to figure out if someone is in crisis and how we can help. It is not designed to be punitive.”

Crawford-Goetz tells parents about her district’s threat assessment team at the beginning of the school year. Some districts report keeping their teams a secret from parents, which is not how they were designed to operate, said Lina Alathari, chief of the NTAC. Her team encourages schools to educate the whole community about the threat assessment process.

Disability may be considered in threat assessment

Some advocacy groups contend that threat assessment teams have perpetuated inequities. There has also been widespread concern that children with disabilities can easily get swept into a threat assessment.

In a 2022 report, the National Disability Rights Network, a nonprofit based in Washington, D.C., said some threat assessment teams have become “judge, jury, and executioner,” going beyond assessing risk of serious, imminent harm to determining guilt and punishment.

Expanding their scope allows threat assessment teams to get around civil rights protections, the report says.

Cornell disputed the disability rights group’s conclusion. “This has not been corroborated by scientific studies and is speculative,” he said.

Some states, such as Florida, mandate that threat assessment teams determine whether a student’s disability played a role in their behavior and recommend they include special education teachers and other professionals in their evaluation.

In Texas, which has mandated threat assessment teams, a third of students subjected to threat assessments in the Dallas Independent School District receive special education services.

Yet, the district doesn’t have a special education staff representative on its threat assessment team, according to a March 2023 report by Texas Appleseed, a nonprofit public interest justice center.

Many school districts are developing their own models in the absence of national standards for threat assessments.

Florida revamped its threat assessment system in January 2024 to improve response times, provide consistent data collection, and build in more checks and balances and oversight, said Pinellas County Sheriff Bob Gualtieri, who is also chair of the Marjory Stoneman Douglas High School Public Safety Commission.

The new model requires the teams to work quickly and file uniform, electronic summary reports of threat assessment findings. Those results follow students throughout their school years.

The adjustments are intended to eliminate the risk of not knowing about a student’s past troubling behavior if they change schools, as occurred with the Parkland shooter and a student who shot and killed classmates at a high school near Winder, Georgia, in September, Gualtieri said.

“As parents, you never stop worrying about your kids,” Schachter said.

Virginia mandates that all public schools and higher education institutions, including colleges, have threat assessment teams. In Florida, where one of Schachter’s daughters attends college, threat assessment teams are mandated in all public schools, including charter schools.

“There’s more work to be done,” Schachter said.

This story was originally published by KFF Health News, Healthbeat’s national reporting partner. Cheryl Platzman Weinstock’s reporting is supported by a grant from the National Institute for Health Care Management Foundation.

New York City aims to increase life expectancy by targeting chronic diseases

2025-01-28T22:43:36+00:00

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New York City officials on Tuesday released a comprehensive plan to address chronic and diet-related diseases, which are among city residents’ leading causes of death.

The city’s plan, laid out in a new report, Addressing Unacceptable Inequities: A Chronic Disease Strategy for New York City, details a cross-agency approach to confront heart disease, diabetes, and screenable cancers through 19 proposals. The strategy aims to address existing diseases and their root causes, including by providing direct assistance, promoting healthy lifestyles, and tackling the commercial systems that drive chronic disease.

“Chronic diseases are the number one killer of New Yorkers, and as city government, we have a responsibility to really address it,” Dr. Michelle Morse, acting commissioner of the Department of Health and Mental Hygiene, said in an interview.

‘Equity and stability’: An interview with Dr. Michelle Morse, NYC’s acting health commissioner

In New York, chronic and diet-related diseases — which include heart disease, stroke, diabetes, and some cancers — are leading causes of death across all racial and ethnic groups, but disproportionately impact Black New Yorkers, according to the Health Department. The other drivers of premature death in the city include drug overdose, suicide, homicide, and Covid-19.

By 2030, the city aims to reduce deaths due to screenable cancers by 20%, and those due to cardiovascular and diabetes-related disease by 5%. Those goals are part of HealthyNYC, a campaign to extend New Yorkers’ lives that launched in 2022, following a sharp decline in life expectancy due to the Covid-19 pandemic. In one year, New Yorkers’ life expectancy fell to 78 years in 2020, from 82.6 years in 2019. By 2022, life expectancy had climbed back up to 81.5 years. The city aims to exceed 83 years of life expectancy by 2030.

Most chronic diseases are caused by just a few risk factors, including tobacco consumption, poor nutrition, physical inactivity, and excessive alcohol use, according to the U.S. Centers for Disease Control and Prevention. The city’s report, citing the Health Department’s 2022 and 2023 community health surveys, said only 6% of adult New Yorkers eat the recommended five servings of fruit and vegetables each day, 8% smoke, 26% binge drink alcohol, and about 30% get no physical activity.

The city’s plan includes a broad array of proposals that aim to chip away at persistent chronic and diet-related disease mortality. One proposed program, “More Veggies,” would provide 250 patients from a federally qualified health center in the Bronx with debit cards for monthly purchases of produce. The participants — Medicaid recipients who are food insecure and with poorly controlled type 2 diabetes — would also receive case management assistance.

Another proposal would explore limiting the promotion of sugary drinks on Metropolitan Transportation Authority property, as part of the city’s work to reduce the consumption of harmful products including tobacco, alcohol, and sugary food and beverages.

New York City also aims to promote healthy lifestyles, including by investing in public spaces, encouraging participation in activities at city parks, and expanding the presence of community health workers at public housing developments.

Some of the city’s proposals draw on existing funding, while others would depend on securing additional resources. Amid uncertainty about the impact of the Trump administration’s dramatic changes to the federal government on states and municipalities, Morse said that she collaborates closely with the state health department and will advocate for the city’s chronic disease initiatives to receive necessary resources.

This work is personal, Morse said: Her father had a below-the-knee amputation from diabetes at the age of 59.

“I hope that no New Yorker has to suffer from that in the future,” she said. “It’s completely preventable.”

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org .

Analysis finds growing inequality in life expectancy among Americans

2025-01-22T10:00:00+00:00

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The life expectancy among Native Americans in the western United States has dropped below 64 years, close to life expectancies in the Democratic Republic of the Congo and Haiti. For many Asian Americans, it’s around 84 — on par with life expectancies in Japan and Switzerland.

Americans’ health has long been unequal, but a new study shows that the disparity between the life expectancies of different populations has nearly doubled since 2000. “This is like comparing very different countries,” said Tom Bollyky, director of the global health program at the Council on Foreign Relations and an author of the study.

Called “Ten Americas,” the analysis published late last year in The Lancet found that “one’s life expectancy varies dramatically depending on where one lives, the economic conditions in that location, and one’s racial and ethnic identity.” The worsening health of specific populations is a key reason the country’s overall life expectancy — at 75 years for men and 80 for women — is the shortest among wealthy nations.

To deliver on pledges from the new Trump administration to make America healthy again, policymakers will need to fix problems undermining life expectancy across all populations.

“As long as we have these really severe disparities, we’re going to have this very low life expectancy,” said Kathleen Harris, a sociologist at the University of North Carolina. “It should not be that way for a country as rich as the U.S.”

Since 2000, the average life expectancy of many American Indians and Alaska Natives has been steadily shrinking. The same has been true since 2014 for Black people in low-income counties in the southeastern United States.

“Some groups in the United States are facing a health crisis,” Bollyky said, “and we need to respond to that because it’s worsening.”

Heart disease, car fatalities, diabetes, Covid-19, and other common causes of death are directly to blame. But research shows that the conditions of people’s lives and their environments heavily influence why some populations are at higher risk than others.

Native Americans in the West — defined in the “Ten Americas” study as more than a dozen states excluding California, Washington, and Oregon — were among the poorest in the analysis, living in counties where a person’s annual income averages below about $20,000. Economists have shown that people with low incomes generally live shorter lives.

Studies have also linked the stress of poverty, trauma, and discrimination to detrimental coping behaviors like smoking and substance use disorders. And reservations often lack grocery stores and clean, piped water, which makes it hard to buy and cook healthy food.

About 1 in 5 Native Americans in the Southwest don’t have health insurance, according to a KFF report. Although the Indian Health Service provides coverage, the report says the program is weak due to chronic underfunding. This means people may delay or skip treatments for chronic illnesses. Postponed medical care contributed to the outsize toll of Covid among Native Americans: About 1 of every 188 Navajo people died of the disease at the peak of the pandemic.

“The combination of limited access to health care and higher health risks has been devastating,” Bollyky said.

At the other end of the spectrum, the study’s category of Asian Americans maintained the longest life expectancies since 2000. As of 2021, it was 84 years.

Education may partly underlie the reasons certain groups live longer. “People with more education are more likely to seek out and adhere to health advice,” said Ali Mokdad, an epidemiologist at the Institute for Health Metrics and Evaluation at the University of Washington, and an author of the paper. Education also offers more opportunities for full-time jobs with health benefits. “Money allows you to take steps to take care of yourself,” Mokdad said.

The group with the highest incomes in most years of the analysis was predominantly composed of white people, followed by the mainly Asian group. The latter, however, maintained the highest rates of college graduation, by far. About half finished college, compared with fewer than a third of other populations.

The study suggests that education partly accounts for differences among white people living in low-income counties, where the individual income averaged less than $32,363. Since 2000, white people in low-income counties in southeastern states — defined as those in Appalachia and the Lower Mississippi Valley — had far lower life expectancies than those in upper midwestern states including Montana, Nebraska, and Iowa. (The authors provide details on how the groups were defined and delineated in their report.)

Opioid use and HIV rates didn’t account for the disparity between these white, low-income groups, Bollyky said. But since 2010, more than 90% of white people in the northern group were high school graduates, compared with around 80% in the southeastern United States.

The education effect didn’t hold true for Latino groups compared with others. Latinos saw lower rates of high school graduation than white people but lived longer on average. This longstanding trend recently changed among Latinos in the Southwest because of Covid. Hispanic or Latino and Black people were nearly twice as likely to die from the disease.

On average, Black people in the United States have long experienced worse health than other races and ethnicities in the United States, except for Native Americans. But this analysis reveals a steady improvement in Black people’s life expectancy from 2000 to about 2012. During this period, the gap between Black and white life expectancies shrank.

This is true for all three groups of Black people in the analysis: Those in low-income counties in southeastern states like Mississippi, Louisiana, and Alabama; those in highly segregated and metropolitan counties, such as Queens, New York, and Wayne, Michigan, where many neighborhoods are almost entirely Black or entirely white; and Black people everywhere else.

Better drugs to treat high blood pressure and HIV help account for the improvements for many Americans between 2000 to 2010. And Black people, in particular, saw steep rises in high school graduation and gains in college education in that period.

However, progress stagnated for Black populations by 2016. Disparities in wealth grew. By 2021, Asian and many white Americans had the highest incomes in the study, living in counties with per capita incomes around $50,000. All three groups of Black people in the analysis remained below $30,000.

A wealth gap between Black and white people has historical roots, stretching back to the days of slavery, the Jim Crow laws, and policies that prevented Black people from owning property in neighborhoods that are better served by public schools and other services. For Native Americans, a historical wealth gap can be traced to a near annihilation of the population and mass displacement in the 19th and 20th centuries.

Inequality has continued to rise for several reasons, such as a widening pay gap between predominantly white corporate leaders and low-wage workers, who are disproportionately people of color. And reporting from KFF Health News shows that decisions not to expand Medicaid have jeopardized the health of hundreds of thousands of people living in poverty.

Researchers have studied the potential health benefits of reparation payments to address historical injustices that led to racial wealth gaps. One new study estimates that such payments could reduce premature death among Black Americans by 29%.

Less controversial are interventions tailored to communities. Obesity often begins in childhood, for example, so policymakers could invest in after-school programs that give children a place to socialize, be active, and eat healthy food, Harris said. Such programs would need to be free for children whose parents can’t afford them and provide transportation.

But without policy changes that boost low wages, decrease medical costs, put safe housing and strong public education within reach, and ensure access to reproductive health care, including abortion, Harris said, the country’s overall life expectancy may grow worse.

“If the federal government is really interested in America’s health,” she said, “they could grade states on their health metrics and give them incentives to improve.”

Amy Maxmen is Healthbeat’s national reporter through its partnership with KFF Health News.

Many schools used Covid aid on long-term needs like curriculum and buildings, new report says

2025-01-16T17:21:04+00:00

This story originally published at Chalkbeat, Healthbeat’s sister site. Sign up for Chalkbeat’s free weekly newsletter to keep up with how education is changing across the United States. Sign up for Healthbeat’s national newsletter here.

When schools were handed an unprecedented $129 billion in federal pandemic aid, it wasn’t surprising that Covid-related equipment topped the shopping list as schools rushed to snap up hotspots, laptops, desk dividers, and air filters.

But another widespread pattern is emerging as federal officials tally up the spending: Many districts also used their one-time funding to take care of longstanding needs, like replacing aging infrastructure and outdated textbooks, that schools previously wanted to tackle but could not afford.

Around 1 in 3 school districts and charter operators nationwide, or some 5,200, used Covid relief during the 2022-23 school year to adopt new curriculum or learning materials, a report released Wednesday by the U.S. Department of Education found. That made it the most common strategy to address learning loss, which schools spent $11 billion on that year.

Schools spent some $6 billion in federal pandemic aid that same year to upgrade and maintain their facilities. That meant 1 out of every 10 Covid relief dollars spent during the 2022-23 school year went toward a school building. It was six times more than states spent on tutoring.

And half of all Covid relief dollars schools spent that year, or just under $25 billion, were spent on staff salaries and benefits. A good chunk of that went toward paying new social workers and school nurses, which schools added to their ranks in droves with the aid.

Now that the Covid aid is mostly gone — schools have until the end of this month to spend it, unless they seek an extension — schools are confronting big questions about how they will cover curriculum overhauls and critical building repairs going forward, as well as how many of those additional staffers will lose their jobs. Many school districts, especially those with declining enrollments, are considering closing schools or cutting programs to balance their budgets.

The report looks at how the nation’s roughly 16,000 school districts and charter operators spent just over $49 billion in Covid relief dollars during the 2022-23 school year. Nearly all of the first two Covid relief packages had been exhausted, and schools were halfway through spending their last and largest aid package by the end of the 2022-23 school year. Schools had spent some $117 billion in pandemic aid by that point.

Investing in long-term projects encouraged

Investing in people and projects with the potential for long-term payoffs made sense, federal officials say, and the Biden administration encouraged this type of spending.

Federal officials also believe provisions in the Covid aid laws that required states to maintain their own school funding will help schools return to more usual levels of funding more easily than they did following the Great Recession. When stimulus packages enacted in the wake of that financial crisis expired, many states slashed education funding and schools cut hundreds of thousands of jobs, dramatically shrinking the size of the K-12 education workforce.

“There are certainly difficult decisions that are going to get made after $130 billion is fully invested,” said Adam Schott, the principal deputy assistant secretary in the Education Department’s Office of Elementary and Secondary Education. “We are just not seeing the type of fiscal cliff that we saw 10, 12, 15 years ago.”

Part of the reason for that, Schott said, is that the Biden administration urged schools to spend the pandemic aid on immediate needs, but also long-term academic goals.

To the administration, investing in school buildings — and getting rid of issues like asbestos, mold, and lead — was also crucial.

“For decades, we’ve known that a classroom that’s 90 degrees in May or in September is an impediment to in-person learning,” Schott said. “We saw this as really core to academic recovery.”

Pennsylvania's New Kensington-Arnold School District, like many across the U.S., used COVID aid to make long-term improvements to school buildings.

Many schools spent on curriculum amid worrying test scores

The new data about spending on curriculum and classroom materials comes as many states and districts overhaul their approach to teaching reading and math, opting for materials that better align with the science of how children learn.

That spending also coincides with several years of national and international test score data showing that American children are academically stagnant or falling behind their earlier counterparts. That was true even before the pandemic. But the trend is especially stark for kids who score the lowest on math and reading tests.

And while recent state test scores have shown some students are rebounding to pre-pandemic levels, “We are clearly not where we ought to be,” Schott said.

Federal COVID relief dollars improved student test scores, two new studies find

Now that the federal Covid aid is gone, “states have to be ready to grab the baton,” he added, whether that’s finding new ways to spend existing federal funding, or adding money to state education budgets. “We’re going to keep beating that drum with every minute we’ve got left.”

The new federal report also comes as President-elect Donald Trump prepares to start his second term in a few days. It’s unclear how or if top education officials in his administration will push schools to continue pandemic-era programs.

On the campaign trail, Trump and his supporters said they wanted to get rid of the federal education department or shrink its powers and give more responsibility to state officials — who already largely control what and how kids learn.

By the 2022-23 school year, most students were back to learning in person for a second school year. The Covid-19 global health emergency was declared officially over halfway through the school year. But many students were struggling to follow the routines of school. Student absenteeism rates were still abnormally high.

Expanded summer programming was a very common investment — though it’s unclear if some of these programs helped kids improve academically. About 2 in 5 school districts or charter school operators used Covid aid on summer programs that school year, reaching around 4.5 million students.

A smaller number of districts and charter operators — around 1 in 10 nationally, or around 2,100 — used pandemic money to add instructional time. Researchers were a fan of that strategy, but educators often found it was difficult to pull off.

Money went to tutoring and staffing

Meanwhile, states spent $1 billion on tutoring that school year, and districts ran intensive tutoring programs that reached some 3 million kids, or around 6% of public school students. Of those students, around half were from low-income families, while 13% were students with disabilities and 14% were learning English as a new language — suggesting that many students from historically disadvantaged backgrounds did not receive tutoring.

Earlier estimates have suggested less than 10% of students were getting tutoring thanks to Covid aid — a figure researchers have said was likely much smaller than the share of kids who needed extra academic help after the pandemic’s disruptions to learning.

The report points out that Covid aid helped to put “more people working in America’s schools than at any time in the last decade.” As of October 2024, the report notes, schools had added some 643,000 jobs since 2021, with a 43% increase in social workers and a 23% increase in school nurses.

Some school finance experts have criticized schools for adding many new staffers or programs that they couldn’t afford to keep after the Covid aid ran out. They’ve said the hiring and firing is destabilizing, especially for schools that had more staff turnover prior to the pandemic.

Still, Schott defended that use of the money. He pointed out that some of the added spending helped to raise low teacher pay or invest in gummed-up educator pipelines. Other spending got “more caring eyes on kids” at a chaotic time.

“You couldn’t maintain consistency for kids, you couldn’t deliver instruction, you couldn’t get core nutrition services flowing without people,” he said.

Kalyn Belsha is a senior national education reporter based in Chicago. Contact her at kbelsha@chalkbeat.org.

Most New Yorkers had Covid symptoms for more than a month, Health Dept. survey finds

2025-01-16T15:10:48+00:00

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Most New Yorkers infected with Covid experienced symptoms for a month or longer, the New York City Department of Health and Mental Hygiene found in a survey.

Of more than 2,000 adults infected with Covid who were surveyed by the Health Department in late 2022, 80% reported at least one post-acute symptom — a symptom lasting for a month or longer. The most commonly reported symptoms were fatigue and decreased exercise tolerance, according to the survey, which was released in late December.

The findings suggest that Covid symptoms frequently extend beyond one or two weeks, which is often referenced as the recovery period for mild or moderate cases. While 21% of surveyed adults reported no post-acute symptoms, 30% reported at least one mild symptom, 29% reported at least one moderate symptom, and 21% reported at least one severe symptom, according to the survey.

“It’s very common for people to experience some symptoms that last up to a month, and potentially longer than a month,” said Sam Packard, the senior project manager for Long Covid surveillance at the Health Department, who co-authored the report on the survey.

Some people with post-acute symptoms may go on to develop Long Covid, a chronic condition characterized by symptoms of more than three months, which can be severe or disabling. The Health Department survey did not assess the prevalence of Long Covid, but the agency has several ongoing data collection initiatives focused on the condition, Packard said.

It’s not unusual to have a “long tail” of recovery following a Covid infection, said David Putrino, the Nash Family Director of the Cohen Center for Recovery from Complex Chronic Illnesses at Mount Sinai Health System. The Health Department’s findings are consistent with larger epidemiological studies, as well as with his own clinical experience, he said.

“A majority of people do not quickly recover from an acute SARS-CoV-2 infection,” said Putrino, who is also a professor in the Department of Rehabilitation and Human Performance at the Icahn School of Medicine at Mount Sinai.

In the Health Department survey, New Yorkers reported a wide range of post-acute symptoms, from anxiety and difficulty concentrating to coughs and muscle aches. Decreased exercise tolerance and fatigue were each reported by about half of all surveyed adults.

Of New Yorkers with at least one severe post-acute symptom, most reported activity limitations, and 1 in 3 had probable depression, according to the survey. People with at least one severe post-acute symptom also reported 10 days of reduced ability, or an inability, to complete typical activities or work, compared with six days for those with moderate symptoms and three days for those with mild symptoms.

Putrino, who treats Long Covid patients at the Cohen Center, noted that fatigue and post-exertional malaise — the worsening of symptoms after physical or mental activity — can be “quite disabling.” A Covid infection is a significant event, he emphasized.

“It’s not necessarily an easy and simple recovery from SARS-CoV-2, even if your acute illness is mild,” he said.

The Health Department’s survey found a similar prevalence of mild symptoms across socio-economic groups. But moderate symptoms were more prevalent among Latino and Asian/Pacific Islander adults than among white adults, and severe symptoms were more prevalent among Latino and Black adults than among white adults. Moderate and severe symptoms were also more prevalent in higher-poverty neighborhoods than in lower-poverty neighborhoods.

Packard noted that those findings reflect many of the structural determinants of health that produced unequal outcomes in Covid cases, hospitalizations, and deaths during the height of the pandemic.

“Those same structural determinants of health are at play when it comes to who’s experiencing severe illness, prolonged illness, post-acute symptoms, potentially even going on to develop Long Covid,” he said.

While the survey did not assess the prevalence of Long Covid, it found uncertainty among New Yorkers about the condition. Many people said they were unsure whether they had Long Covid. More than half of New Yorkers with post-acute symptoms said they had sought out a health care provider for their symptoms, and many reported receiving help. But the vast majority — even those with severe symptoms — said their provider had not talked to them about Long Covid.

Those findings highlight the need for better Long Covid education for the public, health care providers and policy makers, Packard said.

At the Cohen Center, which Putrino directs, the demand for Long Covid care has been overwhelming, he said. The clinic uses a precision medicine approach, performing comprehensive assessments on patients and treating specific deficits.

Long Covid remains a challenging condition to treat. Putrino said that for the majority of patients, the clinic can help improve symptom burden and the ability to function, but a small percentage of patients do not seem to recover.

“We can’t possibly manage the amount of Long Covid cases that are beating down our doors,” he said. “So we see the only way forward is to educate others on how to identify and then how to manage Long Covid and other infection-associated chronic conditions. That has largely become our mission.”

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org .

DeKalb health needs: Better access to providers and healthy food, report finds

2024-11-22T02:01:32+00:00

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DeKalb County residents want more options for physical activity and healthy food and better access to health care providers, according to the latest Community Health Needs Assessment.

DeKalb Public Health CEO Dr. Sandra Valenciano presented the findings at a quarterly meeting of DeKalb Public Health’s board Thursday.

Lack of access to those services impact Black, lower-income and South DeKalb residents in particular, according to the assessment. Published in June, it was conducted for DeKalb Public Health by OMNI Institute and incorporated results from a survey of 122 residents and focus groups, along with quantitative data.

Race and location are important in understanding people’s access to health, Valenciano said. In DeKalb, 55% of the population is Black, 7% is Asian, and 9% is Hispanic. Sixteen percent of residents are foreign born, and 19% speak a language other than English at home.

“When we examine the landscape of DeKalb, it’s important to incorporate factors that aren’t necessarily medical factors that can still impact health, and these factors are called the social determinants of health,” Valenciano said.

The county public health agency is focusing on improving trust and information-sharing with the help of a U.S. National Institutes of Health grant.

Staff turnover at the public health agency is also a problem.

DeKalb residents voice need for access to healthy food

Eleven percent of DeKalb residents were food insecure in 2020, according to the report, and 9% of low-income residents had limited access to healthy foods.

Meanwhile, 25% of residents did not have access to large grocery stores.

Four in five residents in a community survey of 122 said the county should focus on improving food access. Some listed nutrition among their top five priorities.

Respondents urged the county to expand access to farmers’ markets and food pantries, promote community gardens, engage with the faith community, and use DeKalb Public Health’s mobile units as farmers’ markets.

The DeKalb Public Health board presented a report assessing the community's health needs on Thursday in Decatur.

While more adults in DeKalb reported adequate access to exercise opportunities than most Georgians, about a quarter reported no leisure-time activity, at about the same rate as all Georgians.

Meanwhile, nearly 70% reported it is very important for the county to focus on improving opportunities for physical activity. They suggested adding and improving sidewalks and paths for running and walking and making gym memberships and other wellness services more affordable.

More South DeKalb residents asked for more sidewalks, bike paths, recreation centers and parks than those who live in other areas.

Access to health care better in DeKalb, but still low

The ratio of health care providers to the population is better in DeKalb than in the rest of the state, including primary care physicians, mental health providers, and dentists, the report said.

Still, almost a quarter of residents had not seen a doctor in the past 12 months, the report found. Data from 2017 indicated cost and a lack of health insurance as obstacles.

“Among community survey respondents, over 80% of respondents said it is very important for DeKalb County to improve the availability and accessibility of health care providers, to focus on more primary care options, and to provide more support and education on health insurance enrollment and benefits,” Valenciano said.

“One in three respondents reported that there was a time in the past 12 months when they or a loved one who did medical care but could not get it, and, of these individuals, over a third stated that they could not get medical care, due to the lack of insurance,” she added.

Valenciano did not directly address steps the agency plans to take to address the needs identified in the report. Spokesperson Eric Nickens said the findings will be used to develop a Community Health Improvement Plan.

But she said she plans to have the needs assessment done every year, instead of every five years as was the practice before Covid arrived.

Improving information, fighting disinformation are priorities

A lack of information about public health services, and more broadly, health misinformation, are major challenges for DeKalb public health.

Over a third of respondents identified health care providers as the source of most of their health information, and another 20% said they got most health information online.

Some people, including physicians, don’t realize all the services the Department of Public Health offers, Valenciano said. She gave the example of taking her child to the pediatrician and that doctor not realizing the public health department offers flu shots.

“Our providers don’t know where can their patients seek services or things that we’re providing at low cost or no cost,” she said.

On the flip side, some residents who access WIC, the Women Infant and Children supplemental nutrition program, via DeKalb Public Health are also surprised to learn about the many other health services the agency offers, Valenciano said.

Misinformation is also a problem. DeKalb Public Health is one of three pilot sites (the other two are in Mississippi and North Carolina) participating in the second phase of a pilot project to address health disinformation.

Sponsored by the NIH, the Knowledge Monitoring and Response System seeks to leverage community organizations to address health misinformation.

The plan is to use weekly surveys to inform health information and to leverage “trusted messengers.”

The public health department will work with a wide range of community health groups, from the Hispanic Health Coalition of Georgia to New Birth Missionary Baptist Church.

Health department sees high turnover in workforce

About two-thirds of the agency’s roughly $50 million budget goes to personnel costs, said finance manager Phuong Le.

DeKalb Public Health has budgeted for 436 full- and part-time jobs, of which 349 are filled, Nickens said.

Between Aug. 1 and Oct. 31, DeKalb Public Health hired 25 new employees but lost 24 employees. Sixteen resigned, six left because of the ending of seasonal assignments, and two left due to terminations, Valenciano said.

“Our turnover … obviously impacts our ability to carry [out] initiatives,” Valenciano said.

This story has been updated with additional information about staffing and DeKalb Public Health’s plans for addressing community needs.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Report on Georgia Latinos: Legal status and language among barriers to health

2024-11-20T01:19:25+00:00

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Latinos, who make up at least 11% of the state’s population, face serious barriers to health care, especially mental health services, according to the State of the Latino Community in Georgia report released Tuesday.

“Immigration is a social determinant of health,” according to the report, which cited immigration status, transportation, and language among the challenges in gaining access to care.

In 2022, 58% of the about 1 million Latinos in Georgia were born in the United States, and that share is increasing.

Community leaders discussed the report at the 10th annual Latino Summit in Norcross. The report was sponsored by a group of community organizations led by the Latino Community Foundation of Georgia and Ser Familia, a nonprofit organization that provides social services.

The report combines quantitative data from the U.S. Census Bureau and the Georgia Department of Public Health with individual stories and insights from Latinos in the state. Data in the report is limited with a lack of statistics disaggregated by race and the difficulty of counting undocumented immigrants.

The report covers a host of issues, from economic development to the arts. Here are five takeaways related to public health.

1. Immigration fears affect access to health system

About 350,000 of Georgia’s 1 million Latinos are undocumented immigrants, according to the report, but concerns about immigration status and deportation are widespread, said Belisa Urbina, CEO of Ser Familia.

Latinos often live in “mixed status” families or are otherwise fearful of being tracked. That prevents them from applying for government services, said Nikolai Elneser, the community impact officer at nonprofit Neighborhood Nexus.

Close to 15% of Latino children lack health insurance, more than double the 7% of Georgia children across all groups.

At Tuesday’s summit, Gilda Pedraza, executive director of the Latino Community Fund of Georgia, called on the state government to expand Medicaid to include all people, even if they are undocumented.

Not having a driver’s license makes it harder for some to get to and from doctor’s appointments in Atlanta, which has limited public transit.

2. Mental health system lacks Spanish-speaking providers

Intentional self-harm is the seventh leading cause of death among Latinos in Georgia. Latinos are the only group for which self-harm is in the top 10 causes of death, according to the report.

“We see about 1,500 minors a year in services, group and individual therapy, and two-thirds of them present [with] suicidal ideation. … This is very alarming,” Urbina said at the summit.

Some Latinos are reluctant to turn to psychiatric medications for cultural reasons, according to the report, but may trust a provider who takes the time to thoroughly discuss medication.

Parents are especially eager to get services for their children, but have trouble finding Spanish-speaking providers and getting appointments when they are not working, Elneser said.

“We have a tremendous disparity between the people that need the services and the available services that are linguistically relevant,” Urbina said.

Georgia’s certification requirements for foreign health professionals, including mental health workers, are too cumbersome, she said.

She estimates there are 100 fully licensed mental health providers who speak Spanish in the state and maybe only one Spanish-speaking psychiatrist. Her organization will soon hire a Spanish-speaking psychiatric nurse practitioner.

While many Latinos are proficient in English, people want to access services in their own languages, Urbina said. It’s especially important when discussing traumatic or sensitive topics.

Children face particular stresses, including the need to serve as interpreters for their family while dealing with weighty issues. And Latinos in general feel a great deal of anxiety about immigration, leaders said during Tuesday’s summit.

3. Latinas getting inadequate maternal health care

Pregnant Latinas get adequate maternal care at lower rates than the general population in Georgia.

About 22% of the state’s live births are born to Latina mothers who had inadequate prenatal care, higher than the 16% rate for non-Latina mothers.

The inability to get insurance and pay for services is one major barrier, said Roxana Chicas, a professor of nursing at Emory University. They also may have difficulty taking time off work to get care during the day and not be able to get rides to clinics.

“We know that more and more Latinos are moving out into Gwinnett, Cobb and further out, and [there’s] no transportation,” Chicas said.

Women who need to change their diets – because of gestational diabetes, for example – may not get culturally competent guidance about what to eat, Elneser said.

“The healthcare system is lacking cultural competency, and sometimes it’s not a warm environment for some women,” Chicas said.

4. Heat is a public health issue

The report calls on the governments and businesses to expand protections for workers exposed to heat.

Latinos are over-represented in hazardous occupations like construction, hospitality, and farmwork, according to the report, and heat is a particular problem.

Farmworkers are far more likely to die from heatstroke than other types of workers, according to one study cited in the report. The report notes that most H-2A (temporary agricultural visa) workers in Georgia are Latino.

“Many of these workers are workers of color … that don’t have the option of not working outdoors,” said Chicas, who specializes in studying the impact of heat on worker health.

“We have a responsibility to protect these workers while they’re building our homes, while they are harvesting our foods, so that they don’t die on the job from heat stroke, which is preventable,” she said.

It’s hard to know exactly how many people have died due to heat in Georgia because no surveillance system exists, although national numbers can help indicate local trends, Chicas said. It’s hard to identify when heat causes a death. She gave the example of someone who falls due to heat stroke – that death would be counted as death due to a fall and not heat.

Protecting workers from heat is not only the right thing to do, it’s also good business, the report said.

“Safe working conditions (including heat protections) benefit both workers (less injuries and illness) and employers (less absenteeism, lower turnover rates, and disruptions of operations),” the report said.

Six states have enacted worker heat protections, according to the Natural Resources Defense Council.

Pedraza called on U.S. Sen. Jon Ossoff to support legislation providing federal heat protections.

5. Trust is key to Latino public health

Leaders emphasized that trusted health workers are key to helping Latino Georgians access health services.

While more Spanish-speaking providers are needed, that’s not the only solution. Urbina would like to see more funding for community health workers.

Her organization has one who works within the Wellstar Health System to help people access and navigate services.

Ser Familia provides group therapy, and there are other evidence-backed, culturally competent programs that social service groups can provide that require a trained, but not necessarily professionally certified, health worker.

“There’s fear of being tracked as a mixed-status family,” Elneser said. “Latino communities have a very strong preference to engage with community organizations,” rather than governmental social services.

The personal touch is key for a community skittish about accessing help, said Dianne Román. As the coordinator of the Latino Community Fund’s Ventanillas de Salud program, she helps Latinos find free, Spanish-language services.

Román makes it clear that the events she organizes are “a safe space” to try to lessen people’s concerns about being deported over their immigration status.

And she serves as a constant point of contact for people in need of help.

“It [is] something more personal, and that’s how I like to work with the community: They know who is providing the services. They can trust you,” Román said.

This story has been updated to correct Roxana Chica’s first name.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Emory researchers find clues to Covid severity in nasal swabs

2024-11-19T14:42:05+00:00

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Heading into the fifth U.S. winter of Covid-19, an Emory University lab has found the presence — or absence — of a particular antibody in the nose of patients can predict how severe their illness would be.

The presence of the antibody, called anti-interferon alpha, indicated the infection would likely be limited to mild symptoms like coughing or sore throats, according to a study published earlier this month in Science Translational Medicine. Those without the antibodies in their nostrils often experienced shortness of breath, indicative of a more severe case of Covid.

Emory and University of California San Francisco researchers developed diagnostic technology to test for the antibodies in nasal swabs for the disease, like those found in over-the-counter tests. Eliver Ghosn, an Emory Vaccine Center researcher and the study’s senior author, said if clinicians could use a commercialized version of this technology with the standard tubular tests, they may be able to determine which patients need more care.

“You have a lot of biological waste,” he said. “Because those tubes that we collect [and] the nasal swab, they go as biological waste. Our proposal is, why not collect that waste?”

Previous research suggested the presence of anti-interferon alpha antibodies could have the opposite effect, predicting that someone’s Covid infection symptoms would be severe or fatal. But those studies examined the biomarkers in blood samples — not mucus samples like Ghosn and his colleagues tested.

To Ghosn, the study results resolve a contradiction of what scientists know these antibodies can do and how they interact with Covid.

“We never looked at the nose,” he said. “And the nose was the key, right? That’s where the virus goes first.”

The antibodies keep the virus from flourishing in petri-dish tests, Ghosn said. But his team doesn’t claim the association between the nasal antibodies and quick infection recovery is causal, and he said more research is needed to better determine that relationship.

If in the next two to three months his lab finds a pharmaceutical company that could develop a commercial product using this technology, Ghosn said clinicians might be able to use such tests by this winter. But it has not yet signed an agreement to bring a product to market.

Georgia public health board: Respiratory viruses are low

Dr. Greg Martin, Emory’s director of pulmonary and critical care medicine, said the technology Ghosn’s lab developed and their research could bring clinicians insights beyond general risk factors as to what someone’s Covid-19 infection will be like. With that knowledge, health care workers can make better decisions as to who should be prescribed treatments like Paxlovid and how quickly they should be connected to care.

“This you could easily see as an important next step for particularly all these people in the gray zone, where you’re not sure the likelihood of them having a more severe course of disease,” he said.

Although the virus’ death rate has decreased significantly since 2020, it has contributed to the death of about 43,000 Americans and over 1,200 Georgians in 2024. That’s why Martin said innovations like those developed in Ghosn’s lab and new over-the-counter tests that can detect both flu and Covid-19 are important for keeping families healthy.

Last week at the Georgia Department of Public Health’s board meeting, the state’s epidemiologist said she expected the risk of Covid-19 death to be lower this winter than previous seasons. But that risk could be exacerbated if hundreds of thousands of uninsured Georgians don’t have access to updated vaccines.

Martin noted that recent seasonal data from the Southern Hemisphere can help scientists estimate what the U.S. flu season will be like. Because countries in South America and Oceania had mild respiratory disease winters, that may indicate Georgia could expect a similar situation.

But that could change if people let their guard down and forgo testing and vaccination, especially as families gather for the winter holidays.

“Which is why we still advocate for people to be attentive,” Martin said.

Allen Siegler is a reporter covering public health in Atlanta for Healthbeat. Contact Allen at asiegler@healthbeat.org.

Black Americans still suffer worse health. Here’s why there’s so little progress.

2024-10-28T15:50:21+00:00

One morning in late April, a small brick health clinic along the Thurgood Marshall Highway bustled with patients.

There was Joshua McCray, 69, a public bus driver who, four years after catching Covid-19, still is too weak to drive.

Louvenia McKinney, 77, arrived complaining about shortness of breath.

Ponzella McClary brought her 83-year-old mother-in-law, Lula, who has memory issues and had recently taken a fall.

Morris Brown, the family practice physician who owns the clinic, rotated through Black patients nearly every 20 minutes. Some struggled to walk. Others pulled oxygen tanks. And most carried three pill bottles or more for various chronic ailments.

But Brown called them “lucky,” with enough health insurance or money to see a doctor. The clinic serves patients along the infamous “Corridor of Shame,” a rural stretch of South Carolina with some of the worst health outcomes in the nation.

“There is a lot of hopelessness here,” Brown said. “I was trained to keep people healthy, but like 80% of the people don’t come see the doctor, because they can’t afford it. They’re just dying off.”

About 50 miles from the sandy beaches and golf courses along the coastline of this racially divided state, Morris’ independent practice serves the predominantly Black town of roughly 3,200 people. The area has stark health care provider shortages and high rates of chronic disease, such as diabetes, high blood pressure, and heart disease.

But South Carolina remains one of the few states where lawmakers refuse to expand Medicaid, despite research that shows it would provide medical insurance to hundreds of thousands of people and create thousands of health care jobs across the state.

The decision means there will be more preventable deaths in the 17 poverty-stricken counties along Interstate 95 that constitute the Corridor of Shame, Brown said.

“There is a disconnect between policymakers and real people,” he said. The African Americans who make up most of the town’s population “are not the people in power.”

The U.S. health care system, “by its very design, delivers different outcomes for different populations,” said a June report from the National Academies of Sciences, Engineering, and Medicine. Those racial and ethnic inequities “also contribute to millions of premature deaths, resulting in loss of years of life and economic productivity.”

Over a recent two-decade span, mounting research shows, the United States has made almost no progress in eliminating racial disparities in key health indicators, even as political and public health leaders vowed to do so.

And that’s not an accident, according to academic researchers, doctors, politicians, community leaders, and dozens of other people KFF Health News interviewed.

Federal, state, and local governments, they said, have put systems in place that maintain the status quo and leave the well-being of Black people at the mercy of powerful business and political interests.

Across the nation, authorities have permitted nearly 80% of all municipal solid waste incinerators — linked to lung cancer, high blood pressure, higher risk of miscarriages and stillbirths, and non-Hodgkin lymphoma — to be built in Black, Latinx, and low-income communities, according to a complaint filed with the federal government against the state of Florida.

Federal lawmakers slowed investing in public housing as people of color moved in, leaving homes with mold, vermin, and other health hazards.

And Louisiana and other states passed laws allowing the carrying of concealed firearms without a permit even though gun violence is now the No. 1 killer of kids and teens. Research shows Black youth ages 1 to 17 are 18 times as likely to suffer a gun homicide as their white counterparts.

“People are literally dying because of policy decisions in the South,” said Bakari Sellers, a Democratic former state representative in South Carolina.

KFF Health News undertook a yearlong examination of how government decisions undermine Black health — reviewing court and inspection records and government reports, and interviewing dozens of academic researchers, doctors, politicians, community leaders, grieving moms, and patients.

From the cradle to the grave, Black Americans suffer worse health outcomes than white people. They endure greater exposure to toxic industrial pollution, dangerously dilapidated housing, gun violence, and other social conditions linked to higher incidence of cancer, asthma, chronic stress, maternal and infant mortality, and myriad other health problems. They die at younger ages, and Covid shortened lives even more.

Disparities in American health care mean Black people have less access to quality medical care, researchers say. They are less likely to have health insurance and, when they seek medical attention, they report widespread incidents of discrimination by health care providers, a KFF survey shows. Even tools meant to help detect health problems may systematically fail people of color.

All signs point to systems rooted in the nation’s painful racist history, which even today affects all facets of American life.

“So much of what we see is the long tail of slavery and Jim Crow,” said Andrea Ducas, vice president of health policy at the Center for American Progress, a nonprofit think tank.

Put simply, said Jameta Nicole Barlow, a community health psychologist and professor at George Washington University, government actions send a clear message to Black people: “Who are you to ask for health care?”

Racial health care disparities weren’t tracked till 1980s

The end of slavery gave way to laws that denied Black people in the United State basic rights, enforced racial segregation, and subjected them to horrific violence.

“I can take facts from 100 years ago about segregation and lynchings for a county and I can predict the poverty rate and life expectancy with extraordinary precision,” said Luke Shaefer, a professor of social justice and public policy at the University of Michigan.

Starting in the 1930s, the federal government sorted neighborhoods in 239 cities and deemed redlined areas — typically home to Black people, Jews, immigrants, and poor white people — unfit for mortgage lending. That process concentrated Black people in neighborhoods prone to discrimination.

Local governments steered power plants, oil refineries, and other industrial facilities to Black neighborhoods, even as research linked them to increased risks of cardiovascular and respiratory diseases, cancer, and preterm births.

The federal government did not even begin to track racial disparities in health care until the 1980s, and at that time disparities in heart disease, infant mortality, cancer, and other major categories accounted for about 60,000 excess deaths among Black people each year. Elevated rates of six diseases, including cancer, addiction, and diabetes, accounted for more than 80% of the excess mortality for Black and other minority populations, according to “The Heckler Report,” released in 1985. During the past two decades there have been 1.63 million excess deaths among Black Americans relative to white Americans. That represents a loss of more than 80 million years of life, according to a 2023 JAMA study.

Recent efforts to address health disparities have run headlong into racist policies still entrenched in health systems. The design of the U.S. health care system and structural barriers have led to persistent health inequities that cost more than a million lives and billions of dollars, according to the national academies report.

“When Covid was first hitting, it was just sort of immediately clear who was going to suffer the most,” Ducas said, “not just because of differential access to care, but who was in a living environment that’s multigenerational or crowded, who is more likely to be in a job where they are an essential worker, who is going to be more reliant on public transportation.”

For example, in spring 2020, the North Carolina health department, led by current Centers for Disease Control and Prevention Director Mandy Cohen, failed to get Covid testing to vulnerable Black communities where people were getting sick and dying from Covid-related causes at far higher rates than white people.

And Black Americans were far more likely to hold jobs — in areas such as transportation, health care, law enforcement, and food preparation — that the government deemed essential to the economy and functioning of society, making them more susceptible to Covid, according to research.

Joshua McCray, of Kingstree, South Carolina, retired as a public bus driver after he caught Covid-19 and nearly died. Black Americans were more likely to hold jobs — in fields such as transportation, health care, law enforcement, and food preparation — that the government deemed essential to the functioning of society, making them more susceptible to the virus.

Until McCray, the bus driver in Kingstree, South Carolina, got Covid in his mid-60s, he was strong enough to hold two jobs. He ended up on a feeding tube and a ventilator after he contracted Covid in 2020 while taking other essential workers from this predominantly Black area to jobs in a whiter, wealthier tourist town.

Now he cannot work and at times has difficulty walking.

“I can tell you the truth now: It was only the good Lord that saved him,” said Brown, the rural physician who treated McCray and many patients like him.

Federal and state governments have spent billions of dollars to implement the Affordable Care Act, the Children’s Health Insurance Program, and other measures to increase access to health care. Yet, experts said, many of the problems identified in “The Heckler Report” persist.

When Lakeisha Preston in Mississippi was diagnosed with walking pneumonia in 2019, she ended up with a $4,500 medical bill she couldn’t pay. Preston works at Maximus, which has a $6.6 billion contract with the federal government to help people sign up for Medicare and Affordable Care Act health plans.

She is convinced that being a Black woman made her challenges more likely.

“Think about how many centuries the same thing has been happening,” said Preston, noting how her mother worked two jobs her entire life without a vacation and suffered from health conditions including diabetes, cataracts, and carpal tunnel syndrome. Today Preston can’t afford to put her 8-year-old son on her health plan, so he’s covered by Medicaid.

“We consistently offer healthcare plans that are on par, if not better, than those available to most Americans through state and federal exchanges,” said Eileen Cassidy Rivera, a Maximus spokesperson.

In email exchanges with the Biden administration, spokespeople insisted that it is making progress in closing the racial health gap. They said officials have taken steps to address food insecurity, housing instability, pollution, and other social determinants of health that help fuel disparities.

President Joe Biden issued an executive order on his first full day in office in 2021 that said “the Covid-19 pandemic has exposed and exacerbated severe and pervasive health and social inequities in America.” Later that year, the White House issued another executive order focused on improving racial equity and acknowledged that long-standing racial disparities in health care and other areas have been “at times facilitated by the federal government.”

“The Biden-Harris Administration is laser focused on addressing the health needs of Black Americans by dismantling persistent structural inequities,” said Renata Miller, a spokesperson for the administration.

The CDC, along with some state and local governments, declared racism a serious public health threat.

U.S. Rep. Alma Adams, a North Carolina Democrat, pushed for “Momnibus” legislation to reduce maternal mortality. Yet federal lawmakers left money for Black maternal health out of the historic Inflation Reduction Act in 2022.

“I come to this space as an elected official, knowing what it is like to be poor, knowing what it is like to not have insurance and having to get up at 3, 4 in the morning with my mom to take my sister to the emergency room,” Adams said.

In the 1960s in North Carolina, Adams and her family would take her sister Linda, who had sickle cell anemia, to the emergency room because they had no doctor and could not afford health insurance. Linda died at the age of 26 in 1971.

“You have to have some sensitivity for this work,” Adams said. “And a lot of folks that I’ve worked with don’t have it.”

Medicaid expansion would provide insurance, bring jobs

The website for Kingstree depicts idyllic images of small-town life, with white people sitting on a porch swing, kayaking on a river, eating ice cream, and strolling with their dogs. Two children wearing masks and a food vendor are the only Black people in the video, even though Black people make up 70% of the town’s population.

But life in Kingstree and surrounding communities is marked by poverty, a lack of access to health care, and other socioeconomic disadvantages that have given South Carolina poor rankings in key health indicators such as rates of death and obesity among children and teens.

Some 23% of residents in Williamsburg County, which contains Kingstree, live below the poverty line, about twice the national average, according to federal data.

There is one primary care physician for every 5,080 residents in Williamsburg County. That’s far less than in more urbanized and wealthier counties in the state such as Richland, Greenville, and Beaufort.

Edward Simmer, the state’s interim public health director, said that if “you are African American in a rural zone, it is like having two strikes against you.”

Asked if South Carolina should expand Medicaid, Simmer said the challenges South Carolina and other states confront are worsened by health care provider shortages and structural inequities too large and complicated for Medicaid expansion alone to solve.

“It is not a panacea,” he said.

But for Brown and others, the reason South Carolina remains one of the few states that have not expanded Medicaid — one step that could help narrow disparities with little cost to the state — is clear.

“Every year we look at the data, we see the health disparities and we don’t have a plan to improve,” Brown said. “It has become institutionalized. I call it institutional racism.”

A July report from George Washington University found that Medicaid expansion would provide insurance to 360,000 people and add 18,000 jobs in the health care sector in South Carolina.

“Racism is the reason we don’t have Medicaid expansion. Full stop,” said Janice Probst, a former director of the Rural and Minority Health Research Center in South Carolina. “These are not accidents. There is an idea that you can stay in power by using racism.”

South Carolina’s Republican governor, Henry McMaster, in July vetoed legislation that would have created a committee to consider Medicaid expansion, saying he did not believe it would be “fiscally responsible.”

Expanding Medicaid in the state could result in $4 billion in additional economic output from an influx of federal funds in 2026, according to the July report.

Beyond health care coverage and provider shortages, Black people “have never been given the conditions needed to thrive,” said Barlow, the George Washington University professor. “And this is because of white supremacy.”

Fred Clasen-Kelly and Renuka Rayasam are reporters with KFF Health News, Healthbeat’s national reporting partner. Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

Blood test for prostate cancer aims to improve odds for Black men

2024-09-16T12:55:55+00:00

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Leanne Woods-Burnham is a top prostate cancer researcher.

But being a top researcher doesn’t guarantee your relatives get the best care.

Burnham’s husband struggled to persuade a doctor to run a common prostate cancer screening test, even though he was over 40, Black, and had several relatives who had been diagnosed with advanced cancer.

“It was like pulling teeth,” Burnham said. It was especially concerning because Black men have a much higher rate of death from prostate cancer than white men. When caught early, prostate cancer is curable.

Burnham, an assistant professor at the Morehouse School of Medicine, has long thought that standard clinical guidelines don’t match the needs of Black men, as her father was diagnosed with prostate cancer at age 50.

Now she’s accumulating the evidence to prove it. And she has persuaded Grady Health System, the largest public hospital–based system in the Southeast, to revise its prostate cancer screening guidelines in an effort to boost health equity by identifying the disease early among Black men.

One study Burnham conducted found that among 500 Black men, over half had never discussed prostate cancer testing with their primary care physician.

It may come as a surprise to many that there’s a simple blood screening test, the prostate-specific antigen. Detecting high levels of the antigen doesn’t necessarily mean a person has prostate cancer, but it does indicate that further screening is needed. The test is an appealing initial screening option for men who want to avoid a rectal exam.

Dr. Leanne Woods-Burnham, an assistant professor at the Morehouse School of Medicine, researches prostate cancer. She believes the clinical guidelines for screening do not meet the needs of Black men, who die of prostate cancer at a higher rate.

Less aggressive testing is the norm

There are three major authorities on prostate cancer screening guidelines, said Dr. Yolanda Wimberly, Grady’s chief health equity officer. The American Urological Association, the National Comprehensive Cancer Network, and the European Association of Urology recommend screening for Black men between ages 40 and 45.

But the U.S. Preventive Services Task Force, an influential federal body that evaluates evidence and writes clinical guidelines, has not adopted that guideline, instead recommending that men between 55 and 69 years old consider getting the test.

That less aggressive testing recommendation is driven by concerns about overdiagnosis and treatment, according to the task force’s website.

The task force guidelines are adopted by health systems, typically becoming part of electronic workflows that shape how primary care providers interact with patients.

The task force acknowledged the need for more aggressive screening for some Black men with its Grade C recommendation for earlier testing for some patients (“recommendation depends on a patient’s situation”) in 2018.

But, Burnham pointed out, that recommendation is not necessarily integrated into busy providers’ electronic systems.

To meet the needs of Black men in Atlanta, and to try to reduce the prostate cancer mortality rate in the state, Burnham asked Grady Health System to revamp its screening guidelines.

That strategy worked. Grady now screens for prostate cancer in men over 40, Wimberly said, meaning an additional 2,000 men have been added to the list of people who will be tested.

“It’s really a bold move to step outside of what the U.S. Preventive Service Task Force is saying for the general population and realizing that Grady’s population is that high-risk population,” Burnham said. “They’re setting the example.”

Dr. Anuj Desai, a urologist at Georgia Urology who is not affiliated with Grady or Morehouse School of Medicine, said there are stories in everyone’s practice in prostate cancer of a disproportionate risk to the Black population.

“What Grady’s doing is very important. I think it will be impactful, and I think that it will save lives,” he said.

Desai emphasized that men who have higher levels of PSA detected in the screening test don’t necessarily have aggressive cancer.

“It really just gives us information so that we can follow them to prevent complications that otherwise we would have not even had on our radar,” Desai said.

System neglects Black men, at high risk

“African American men die at a higher rate than men from any other race or ethnic group, which was of great concern at Grady,” Wimberly said of prostate cancer. “Through provider and community outreach, Grady can close the disparity gap and achieve health equity.”

In 2021, the latest year for which data is available, over 3,500 new cases of prostate cancer were diagnosed in Black men. In 2022, 411 Black men died from prostate cancer, according to the U.S. Centers for Disease and Prevention.

Black men are twice as likely to die from prostate cancer as white men, Desai said.

Burnham believes Grady is the first major health system to adopt the more aggressive guidelines, and she hopes other hospitals will follow, even if the U.S. Preventive Services Task Force does not.

Grady has also developed a cheeky media campaign to go along with the effort to get more men screened, playing on reluctance to have a physical exam.

“No gowns, no gloves,” is the slogan. “Prostate screening, it’s just a blood test.”

The digital and social media ads are specifically targeted to men over 40 in Fulton and DeKalb County Zip codes with higher rates of prostate cancer, as well as to women who can influence men to get tested, Grady spokesperson Danielle Hackett said. The health system’s campaign also includes a video encouraging screening from Black prostate cancer survivors.

Burnham and her Morehouse School of Medicine team also run a robust community screening program, providing free tests for men at local events. The Prostate Cancer Precision Prevention Program is on track to screen 2,000 men over the next two years.

Earlier this year, the team screened around 100 men at an event at The King Center. Dexter Scott King, son of the Rev. Martin Luther King Jr., died earlier this year of prostate cancer at age 62.

Burnham shares her father’s experience to help encourage screening, and she sees her role as a changemaker in a public health system that has been shaped by systemic racism. Many experiments do not include specimens from diverse patients.

“Then from the science, we go to clinical trials,” which may not be designed to recruit diverse patients, Burnham said. Recommendations like those for prostate cancer screening are not tailored to diverse populations.

“There has been a systemic neglect of diverse populations in medicine and science,” Burnham said.

She is an advocate for a federal law that would require require insurers to provide free PSA tests for high-risk patients at no cost, as many women have no co-pays for mammograms. Several states, including New York and Illinois, have adopted a similar measure.

“We’re part of the population that has been marginalized, but now we get to sit at the decision-making tables,” Burnham said. “We’ve lived it with our families, but now we have our degrees, we have our MDs, we have our PhDs and we’re saying, we don’t like what we’ve seen, and we want to change it.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.