Category: 8. Health

A real-world study showed that taking lanadelumab for 3 years reduced the rate of hereditary angioedema (HAE) attacks per month.¹ The proportion of patients with an attack each month dropped from 54% before lanadelumab initiation to 9.8%.

“Prior to starting lanadelumab, patients who were on a previous [long-term prophylaxis] had better outcomes before starting lanadelumab treatment than those who were not,” wrote investigators, led by William R. Lumry, MD, from Allergy and Asthma Research Associates in Dallas, Texas. “Regardless of prior [long-term prophylaxis], patients saw incremental improvement in outcomes over time while receiving lanadelumab.”

The US Food and Drug Administration (FDA) approved lanadelumab, the first monoclonal antibody for the treatment of types 1 and II hereditary angioedema in patients aged ≥ 12 years, on August 23, 2018.² A 26-week randomized, double-blind, placebo-controlled, parallel-group trial evaluated this plasma kallikrein inhibitor. Participants were divided into 3 dosing arms: 50 mg or 300 mg every 4 weeks, 300 mg every 2 weeks, or placebo. Compared with placebo, a significantly greater proportion of patients were attack-free throughout the 26 weeks.

The FDA may have approved lanadelumab to treat HAE 7 years ago, but there remains a lack of real-world data surrounding the outcome of patients receiving long-term lanadelumab. Investigators sought to describe the real-world outcomes of patients with HAE on lanadelumab for ≥ 3 years consecutively.¹

The team collected data from the Adelphi Wave II Disease Specific Programme, a real-world, cross-sectional survey of US physicians and their patients with HAE, between 2023 – 2024. Physicians had reported HAE attack frequency, attack severity, and quality of life before lanadelumab initiation, at 12, 24, and 36 months after initiation, and at the time of the survey for 51 patients.

Before lanadelumab, physicians reported mild and severe HAE attack severity in 49% and 8.2% of patients, respectively. At 36 months, physicians reported 62.5% of patients with mild attacks and none with severe attacks.

Fewer patients experienced ≥ 1 attack per month after lanadelumab, dropping from a mean proportion of 54% patients before lanadelumab initiation to 9.8% at the time of the survey. Investigators also observed numerically lower rates of hospitalization after lanadelumab initiation.

Quality of life also improved; the proportion of patients with good or excellent quality of life increased from 68.6% before lanadelumab to 88.2% at the time of the survey. The reductions in attacks and severity may have also reduced patients’ anxiety about future attacks, improving their quality of life.

“However, the fact that 7.8% of patients were reported to have poor or very poor QoL post 36 months at the time of the survey, while none during years 1 to 3, is unexpected,” investigators noted. “The reasons for this are not clear, and fluctuations in long-term QoL warrant further investigation, however this might be partly attributable to recall or recency bias.”

The team also addressed the limitations of only using physician-reported data. Physicians may not fully capture the patient when it comes to HAE attack frequency or quality of life. Investigators wrote that future research should collect data from the Angioedema Quality of Life questionnaire.

“Long-term real-world research in patients with HAE receiving lanadelumab, along with comparison of the results with those for other [long-term prophylaxis] treatments, will further aid treatment decisions and improve outcomes in patients.

References

1. Lumry WR, Davis-Lorton M, Soteres D, et al. Long-term Real-world Outcomes in Patients with Hereditary Angioedema Receiving Lanadelumab for 3 or More Years. Int Arch Allergy Immunol. Published online July 17, 2025. doi:10.1159/000546987

2. FDA Approves Lanadelumab for Hereditary Angioedema. HCPLive. August 23, 2018. https://www.hcplive.com/view/fda-approves-lanadelumab-for-hereditary-angioedema. Accessed July 22, 2025.

A growing number of products and routines – such as red light masks and de-puffing regimens – claim to fight the signs of inflammation. Many nutritional methods have proven to help chronic inflammation, too – such as eating a vegetable-heavy Mediterranean diet or more whole grains and omega-3-rich fish.

But cost and access issues can get in the way of these solutions. Plus, they may not address a major root cause, as increasing evidence says chronic stress can induce chronic inflammation.

To prevent and manage chronic stress, more health professionals are offering “social prescriptions”, or referrals to non-medical, community-based, de-stressing activities. Often, these activities are free or the costs are covered by another party, like an insurer or local non-profit.

Dr Alan Siegel, executive director of non-profit Social Prescribing USA and a family physician at Kaiser Permanente in Oakland, has prescribed community walks, painting classes and museum visits to his patients for over two decades. “Whether somebody walks into my office with type 2 diabetes or depression, I’ve seen how social prescriptions can help patients truly heal and adopt healthier lifestyles in the long-term.”

More than 30 countries and a dozen US states have social prescribing programs, which have led to improved health and reduced pressure on healthcare.

But even without a doctor’s note or a thick wallet, anyone can engage in these scientifically backed anti-inflammatory activities.

What is inflammation?

Inflammation – the body’s evolutionary response to infection, injury, or other threats – has been a trending topic in the health world. Some scientists have even called inflammation “the cause of all diseases”. But what actually causes inflammation, and what fights it?

In some contexts, inflammation is good. When the body faces an acute threat – say, an ear infection or a sprained ankle – it responds with acute inflammation, an immune system process marked by fever, swelling and pain in the affected area.

But in the face of chronic threats – say, from trauma or job stress – acute inflammation can also become chronic, and the immune, stress and cardiometabolic responses can become dysregulated. Research links chronic inflammation with low mood, cognitive impairment, cardiovascular risks and a range of mental health conditions including depression and dementia.

Spend time in nature

Forest-bathing – engaging in natural environments with all five senses – is a known wellbeing booster. But according to Dr Qing Li, professor of clinical medicine at Nippon Medical school in Tokyo, forest bathing can also help support healthy functioning of the Hypothalamic-Pituitary-Adrenal (HPA) axis, a key player in controlling the stress and inflammation response.

“Forest environments can promote relaxation and activate the parasympathetic nervous system, which is responsible for the ‘rest and digest’ functions,” says Dr Li. It can also reduce activity in the sympathetic nervous system, which is responsible for the “fight or flight” responses. By helping to prevent and manage stress, forest bathing can also help prevent and manage chronic inflammation.

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A series of Li’s studies show that forest bathing can reduce the stress hormones cortisol, adrenaline and noradrenaline. Other research similarly finds time in nature can reduce physiological markers of stress, like cortisol, and the perception of stress. One study found just 20 minutes of nature per day can make a difference in stress levels.

Engage with art and music

Art can also promote relief from chronic stress. In one study, healthy adults who participated in a 45-minute art-making session saw significantly lower levels of cortisol afterward.

Feelings of stress are related to a loss of control, says Dr Girija Kaimal, professor of creative arts therapies at Drexel University, who co-authored the study. Creating art helps us feel like “there’s something we have a sense of agency over” and “lets us take charge of the distress”.

The study’s participants self-reported that they found art-making relaxing, enjoyable, “freeing from constraints”, and conducive to flow and self-discovery. “Distraction is a great initial coping mechanism to help us calm down after a stressful event, but art can help us dig deeper – it helps us pay attention to what distressed us, and it’ll help the next time something similar sets us off,” says Kaimal.

It’s important to create “the kind of art that speaks to you,” says Kaimal – whether it’s writing, dancing, or drawing – and skill level doesn’t matter. “You want to get into a judgment-free zone where you can play and have fun without consequences.”

A growing body of research suggests experiencing art, not just creating it, can also promote inflammation reduction. Some research has found listening to music, for instance, can reduce blood pressure and cortisol. Researchers at the University of Florida have been documenting the health benefits of engaging with the arts, with some studies suggesting just one to three hours of related activity per week can reduce risk of depression and cognitive decline.

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Move your body

Beyond reducing stress, exercise is linked to a number of other anti-inflammatory benefits. This makes sense from an evolutionary perspective because bodily movement was often linked with fighting a predator or fighting for our lives, says Dr Michael Gleeson, emeritus professor of exercise biochemistry at Loughborough University. “The body puts its survival first,” and temporarily inhibits the inflammatory response so it can use energy more efficiently, he says.

In his co-authored research, Gleeson suggests exercise not only induces an anti-inflammatory environment in the short-term, but may also reduce visceral fat mass in the long-term. The accumulation of visceral fat can drive and worsen chronic inflammation by promoting development of insulin resistance, atherosclerosis and other diseases linked to physical inactivity.

Other research finds that exercise can significantly reduce production of pro-inflammatory proteins, such as CRP and IL-6, and increase anti-inflammatory proteins, such as IL-10.

To reap these and other benefits, the World Health Organization recommends adults spend at least 150 minutes each week on moderate aerobic activity, such as brisk walking and cycling, or 75 minutes on vigorous activity, such as running, Zumba or sports. A longitudinal study finds sports involving social interaction – such as tennis, badminton and soccer – are best at promoting health and longevity.

Support other people

Because cooperation with others has historically been essential for survival, our bodies have evolved to respond to the absence of social connections. The late neuroscientist Dr John Cacioppo compares this evolutionary response to hunger. Just as hunger signals the absence of energy and nutrients and cues the body to find food, loneliness signals the absence of social connections, and cues us to seek out or repair relationships.

That’s why multiple studies link feelings of loneliness and social isolation to a range of stress responses, including increased pro-inflammatory proteins and dysregulated cortisol function.

Conversely, studies link high levels of social support to lower cortisol, and link social activities like volunteering and giving social support to lower pro-inflammatory proteins.

Experience ‘awe’

Within all of these activities, the experience of awe – a feeling of being in the presence of something vast that transcends our current understanding of the world – can also reduce inflammation.

Dr Jennifer Stellar, a professor of psychology at University of Toronto, co-authored a study that links awe to greater positive affect and lower inflammatory proteins.

Further research is underway but Stellar suggests “that positive emotions can undo the effects of negative emotions, and negative emotions are associated with inflammation”. Another reason is that “awe makes us feel connected to others, and social connection has been documented to act as a buffer against inflammatory responses.”

So how can you encounter awe? Her co-author, Dr Dacher Keltner, a professor of psychology at University of Berkeley California and renowned awe expert, says that it can result from engagement with the “eight wonders of life”: the moral beauty of others, nature, collective movement, music, visual design, spirituality and religion, big ideas, and the cycle of life and death.

Aging-related diseases, including cancer, cardiovascular disorders and type 2 diabetes, are associated with defects in protein synthesis and folding.

Previous studies have shown that protein misfolding occurs in insulin-producing β-cells of patients with type 2 diabetes. These cells are found in pancreatic islets.

The resulting stress was believed to mainly occur within the endoplasmic reticulum, which is responsible for producing and distributing proteins to the cell.

Ultimately, the stress results in cell death.

In a study published in Nature Metabolism, researchers at the University of Michigan found that mitochondria also accumulate misfolded proteins, which kills β-cells.

Reversing this process could help treat type 2 diabetes.

Previously, scientists had observed that two proteins-insulin and amylin-were frequently misfolded in patients with type 2 diabetes.

Both are produced by the β-cells in the pancreas.

Amylin promotes the feeling of fullness after a meal, while insulin helps lower blood glucose levels by helping cells bring in sugar. 

Amylin can form amyloid aggregates in diabetic β-cells that are similar to the amyloid plaques found in the brain in Alzheimer’s disease.

These two proteins were the sole focus in diabetic islet cells. We wanted to take an unbiased approach and find all the misfolded proteins in these cells.”

Scott Soleimanpour, M.D., Larry Soderquist Professor of Diabetes Research and director of the Michigan Diabetes Research Center

The team compared islet cells from donors with type 2 diabetes to healthy donor cells and found that misfolded proteins build up in the mitochondria at higher levels than elsewhere in the islet cells.

The group had previously discovered that mitochondrial damage affects β-cells, but the underlying mechanisms were unclear.

By sequencing the genes and proteins in healthy and diabetic β-cells, the researchers found that the defense systems that respond to misfolded mitochondrial proteins do not turn on during type 2 diabetes.

Specifically, LONP1, a protein responsible for getting rid of damaged or misfolded proteins, was lower in cells from donors with diabetes.

“Although LONP1 has some associations with rare mitochondrial diseases, this is the first study to show that it has a role in type 2 diabetes,” Soleimanpour said.

The team confirmed their findings by comparing mice that had the LONP1 system with those that did not.

Mice lacking LONP1 had higher glucose levels and fewer β-cells.

These defects were reversed when LONP1 was reintroduced into the mice, suggesting that targeting this system could be a new avenue for therapy.

“It is clear that people with type 2 diabetes have problems with eliminating misfolded proteins,” Soleimanpour said.

“The next step is to find drugs that can help refold or eliminate these proteins.”

The group is also interested in understanding the timeline of how type 2 diabetes develops.

The condition is often found in adults and Soleimanpour hypothesizes that the misfolded proteins might accumulate over time and eventually overwhelm the β-cells, leading to disease.

Early intervention, therefore, could be key.

Living near green spaces before and during pregnancy as well as in early childhood is associated with a reduced risk of neurodevelopmental disorders, according to Rutgers Health researchers.

Published in Environment International, the study examined how exposure to green spaces during critical periods of early childhood development influences the risk of neurodevelopmental conditions, including attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and other developmental delays.

The researchers said the impact of exposure to these natural environments on neurodevelopment, particularly among socioeconomically disadvantaged populations, is understudied. This new research sought to address this gap and explore how green space might help reduce disparities in neurodevelopmental outcomes among vulnerable groups.

Our findings suggest that enhancing green space access in urban environments may support early childhood neurodevelopment and help reduce the burden of neurodevelopmental delays.”

Stefania Papatheodorou, associate professor at the Rutgers School of Public Health and senior author of the study

Researchers analyzed demographic and neurodevelopmental diagnoses data from the Medicaid Analytic Extract between 2001 and 2014. Green space exposure was measured via satellite imaging to assess vegetation levels near mothers’ residential ZIP codes during the preconception, pregnancy and early childhood periods.

The dataset consisted of more than 1.8 million racially and socioeconomically diverse mother–child pairs enrolled in Medicaid in multiple states. Their analysis found that higher levels of green space exposure were associated with a lower risk of neurodevelopmental disorders in children.

“The observed associations persisted after adjusting for individual and area-level confounders, and the results were robust to multiple sensitivity analyses,” Papatheodorou said.

The researchers also suggested that the impact of green space exposure on neurodevelopmental outcomes varied depending on the timing of exposure.

“We observed protective associations between residential green space and several neurodevelopmental outcomes across distinct exposure windows – preconception, prenatal and early childhood – suggesting the involvement of different underlying biological mechanisms,” said Papatheodorou.

Prenatal exposure was linked to a lower risk of autism spectrum disorder, while preconception exposure was inversely associated with intellectual disability. Early childhood exposure to green space was protective against learning difficulties. Additionally, researchers found the protective associations were strongest among children living in urban areas and among Black and Hispanic children.

“Associations were more pronounced among children living in urban areas, suggesting a potentially greater benefit of green space where it is limited,” Papatheodorou said. “Our findings suggest that enhancing green space access in urban environments may support early childhood neurodevelopment and help reduce the burden of neurodevelopmental delays.”

The study’s results point to a need for public health policies that expand access to green spaces for pregnant individuals and young children living in vulnerable areas.

“These findings suggest that increasing green space access could be a potentially modifiable environmental strategy to reduce the risk of neurodevelopmental disorders among children, especially in vulnerable, low-income populations,” Papatheodorou said. “It also suggests that urban planning strategies that enhance residential greenness may have long-term developmental benefits for children.”

The researchers said future research will explore the biological and environmental mechanisms that may explain the association between green space and neurodevelopment and will examine long-term cognitive and behavioral health outcomes into adolescence. Another area of study is how exposure to different types of green spaces, like parks, walking trails, and recreational fields, may be linked to neurodevelopment.

More than 14 million children missed out on lifesaving vaccines against diphtheria, tetanus and whooping cough last year, putting global goals off track, new UN data shows.

Despite an overall record number of child vaccinations in low- and middle-income countries, these countries accounted for more than two-thirds of the so-called “zero-dose” children, according to analysis.

In 2024, about 115 million children — 89 per cent of infants globally — received at least one dose of the diphtheria, tetanus and pertussis (DTP)-containing vaccine, and roughly 109 million — 85 per cent — completed all three doses, according to figures released today (15 July) by the WHO and UNICEF. This represents a modest gain from the previous year.

However, almost 20 million infants missed at least one dose of DTP-containing vaccine, including 14.3 million zero-dose children who didn’t receive a single dose of any vaccine, the agencies said.

The figure, a key indicator of global vaccine coverage, marks an increase of 1.4 million from 2019 and is 4 million over the 2024 target needed to stay on track to meet global goals on immunisation by 2030, they noted.

Kate O’Brien, director of the WHO’s department of immunization, vaccines and biologicals, said the latest estimates presented “a really worrying trajectory”.

“The world is currently off track for the goal to halve zero-dose children and achieve at least 90 per cent global immunisation coverage,” O’Brien said during a virtual press conference Monday (14 July).

“We have hit this stubborn glass ceiling and breaking through that glass ceiling to protect more children against vaccine preventable diseases is becoming more difficult,” she added.

Conflict and cuts

With support from Gavi, the Vaccine Alliance, lower-income countries protected more than 72 million children against a range of infectious diseases in 2024, more than any previous year on record, according to the new data, which tracks national immunisation coverage for 16 diseases across 195 countries.

Vaccination rates have been steadily rising since the declines seen during the COVID-19 pandemic.

However, population growth, fragility, and conflict still present major barriers to achieving true equity, leaving millions of the most vulnerable — and the world — at risk, the UN agencies warn.

Sweeping cuts to aid by the US, including funding for global immunisation programmes, also cast a shadow over the progress made.

WHO director-general Tedros Adhanom Ghebreyesus said: “Drastic cuts in aid, coupled with misinformation about the safety of vaccines, threaten to unwind decades of progress.”

He said the WHO was working with partners to develop local solutions and increase domestic investment to reach all children with vaccines.

“Continued commitment from governments and partners will be critical to saving lives and protecting the world from infectious disease threats,” said Sania Nishtar, CEO of Gavi.

Geographic disparities

Due to population growth, countries are having to reach more children each year to maintain coverage levels, according to Gavi. In 2024, there were 2.5 million (three per cent) more births in the 57 lower-income countries the alliance supports compared to 2019.

Despite a decline of half a million, there are still 10.2 million zero-dose children in lower-income countries who have received no doses of the DTP vaccine, Gavi notes. It says coverage with the first dose of the DTP vaccine is an important measure of how many children still don’t have access to life-saving vaccines.

Nearly half (4.9 million) of these live in five populous countries — Nigeria, DR Congo, India, Pakistan and Ethiopia. Nearly 30 per cent (2.9 million) live in fragile and conflict-affected settings.

Coverage rates of children for all three doses of the vaccine remained stable at 61 per cent in the 12 countries Gavi classifies as experiencing fragility and conflict.

However, there were large declines in Sudan (down 12 percentage points) and Yemen (down 4 percentage points), counteracting improvements in countries such as Mali, Syria and Haiti, the alliance said.

There were half a million fewer zero-dose children in lower-income countries in 2024, mainly as a result of the targeted efforts in populous countries like India, DR Congo and Ethiopia, according to Gavi’s analysis.

Targeted efforts to reach missed children are yielding improvements, but face challenges, Nishtar noted.

HPV, measles gains

Meanwhile, more girls in lower-income countries were vaccinated in 2024 with the HPV vaccine than in the whole of the previous decade. The vaccine protects against cervical cancer, one of the leading killers of women and girls in lower-income countries.

HPV vaccine coverage in lower-income countries reached 25 per cent in 2024, up from just three per cent in 2019.

Coverage with the first dose of measles vaccine reached 80 per cent in 2024, up two percentage points from the previous year.

Ephrem T Lemango, associate director for health, and global chief of immunisation at UNICEF, said there were encouraging signs of recovery.

“The growing immunity gaps between different countries are fueling outbreaks,” he said.

“Despite this, an additional 1.7 million children have been reached with measles vaccine and this represents progress in the right direction.”

Somalia and Djibouti are showing that, even in complex and challenging environments, it is possible to build systems that protect public health and foster trust. The two countries have made major strides by introducing national pharmacovigilance systems — tools that help monitor and ensure the safety of medicines.

Pharmacovigilance is the process and science of monitoring the safety of medicines as they are used by patients. It helps health workers and regulatory authorities detect adverse drug reactions, and substandard or falsified products, and respond effectively to emerging safety concerns.

For many countries in Africa, where most medicines are imported and health systems are often under strain, having a robust pharmacovigilance system is crucial to ensuring the safety of medicines and maintaining public trust. Without such systems, harmful drug reactions or substandard medicines can go unnoticed.

A single batch of low-quality medicines or a new vaccine with unexpected side effects can cause serious harm and reduce public trust. Pharmacovigilance acts as an early warning system, helping ensure that treatments remain safe and effective.

In recent years, Somalia and Djibouti have seen a welcome increase in the availability of vaccines and medicines. However, with greater access comes greater risk. Until recently, neither country had a formal mechanism to report or investigate problems related to medicine safety.

That is now changing. With support from the Africa Centres for Disease Control and Prevention (Africa CDC), the World Health Organization (WHO), and other partners, both countries have taken major steps to build national pharmacovigilance systems. Health workers have been trained, new reporting tools introduced, and reports are now being submitted to VigiBase, the WHO’s global platform for safety reports on adverse reactions to medicines and vaccines.

In doing so, Somalia and Djibouti are contributing medicine safety data to global networks, helping flag concerns more quickly and learning from the experiences of other countries.

“The progress made by Somalia and Djibouti marks a turning point in strengthening pharmacovigilance in the region,” said Dr Alemayehu Duga, Head of the Pharmacovigilance Unit at Africa CDC. “By establishing the systems, tools and capacities needed to monitor medicine and vaccine safety, both countries are not only protecting patients today but also building the foundation for a safer, more accountable health system tomorrow.”

The COVID-19 pandemic highlighted the critical need for robust pharmacovigilance systems. Countries with strong systems addressed vaccine side effects swiftly and reassured the public, while others struggled with misinformation, fear, and delays in vaccine uptake. This experience underscored the importance of ensuring medicine safety, particularly in regions that rely heavily on imports.

Africa imports over 70% of its medicines, many passing through complex supply chains that increase risks such as damage, expiration, or counterfeiting. As new treatments and vaccines are introduced for diseases like malaria, tuberculosis, and non-communicable conditions, monitoring their real-world safety is essential.

Yet pharmacovigilance in Africa faces significant challenges. Estimates suggest that over 10% of medicines are substandard or falsified. Moreover, the continent contributes less than 1% of global safety reports to VigiBase, a critical under-reporting issue that hinders effective monitoring.

Nevertheless, progress is being made. Eight African countries — Egypt, Ghana, Nigeria, Rwanda, Senegal, South Africa, Tanzania, and Zimbabwe — have attained the WHO’s Maturity Level 3 (ML3) status, indicating strong regulatory systems capable of ensuring the safety, efficacy, and quality of medical products. ML3 status helps reduce the use of substandard medicines and boosts public trust, although it remains a rare achievement.

The advances made in Somalia and Djibouti are part of a broader effort supported by the Saving Lives and Livelihoods (SLL) programme, funded by the Mastercard Foundation. This initiative aims to boost COVID-19 vaccine uptake while strengthening public health systems across Africa. A key component is helping all African Union Member States to establish or improve pharmacovigilance systems.

Akros Research, a key regional partner, has supported this work by building local capacity, deploying tools, and promoting sustainable systems for monitoring medicine and vaccine safety.

“Across the continent, many countries still lack the essential systems needed to detect and respond to medicine and vaccine safety concerns,  especially during public health emergencies when rapid action is critical. Without these safeguards, lives are at risk and public trust in health interventions can quickly erode,” said Dr Mosoka Fallah, Acting Head of Science and Innovation at Africa CDC.

“The progress made in Somalia and Djibouti shows what’s possible with focused support and national commitment.”

While much has been achieved, the work continues. More training, better digital tools, and stronger coordination between health workers, clinics, and government agencies will be required to keep these systems running smoothly.

With Africa CDC at the forefront, the continent is working to gain greater control over the production of the vaccines and medicines it needs. The African Union (AU) has set an ambitious goal: for Africa to produce 60% of its vaccines locally by 2040, up from the current rate of less than 5%.

This push is driven by hard lessons learned during the COVID-19 pandemic, when African countries were pushed to the back of the global vaccine supply chain. The result was delayed access to life-saving doses, leaving millions unprotected while wealthier nations secured their supplies first. Reducing this dependence through local manufacturing is now seen as essential for health sovereignty and pandemic preparedness.

“Now is the time to better support African manufacturers by encouraging technology transfer agreements that will rapidly expand the capacity of our local industries, and by providing tailored financing solutions that overcome the barriers to market entry,” said Africa CDC Director General Dr Jean Kaseya.

This momentum is already yielding measurable results. Twenty-three manufacturers now produce vaccines across various countries, with three set to supply eight antigens for Africa within five years. As vaccine production ramps up, pharmacovigilance ensures safety. Somalia and Djibouti are demonstrating that progress is possible even under the most challenging conditions.

Moreover, what began as foundational support is now evolving into sustained national action. Building on this momentum, Africa CDC is working to strengthen long-term capacity by supporting countries to implement robust safety surveillance systems for vaccines and therapeutics used during public health emergencies.

In Somalia, efforts are underway to embed pharmacovigilance into the health system through nationwide training, broader adoption of digital tools, and the rollout of standardised reporting forms, all aimed at significantly boosting reports of adverse events by the end of 2025.

In Djibouti, the SLL programme aims to strengthen the national pharmacovigilance infrastructure by establishing a dedicated unit, implementing digital reporting platforms, and enhancing supervision.

All these forward-looking investments are not just about systems and forms, they signal a shift in mindset, where medical safety becomes a shared responsibility and a core part of national health priorities.

A permanent halt in funding from the biggest contributor to the HIV/AIDS effort could set back decades of progress and put millions of lives at risk, despite efforts by many low- and middle-income countries to plug the gap, the UN agency said in its annual report.

It comes after the US permanently closed its international development agency USAID and halted funding to the President’s Emergency Plan for AIDS Relief (PEPFAR), which had committed US$4.3 billion in bilateral support across more than 50 countries in 2025.

According to the 2025 UNAIDS report, 1.3 million people were newly infected with HIV globally in 2024. A permanent withdrawal of US funding could lead to an additional 6 million new infections and 4 million HIV related deaths by 2029, the report warns.

“This is not just a funding gap — it’s a ticking time bomb,” said UNAIDS executive director Winnie Byanyima during the launch of the report in Johannesburg today (Thursday).

“If the world doesn’t plug this hole, we are going to see an unnecessary, preventable surge in new infections and deaths,” Byanyima cautioned.

She said UNAIDS had seen HIV services “vanish overnight” after the US suddenly changed its strategy on foreign aid in January.

“Health workers have been sent home. And people — especially children and key populations — are being pushed out of care,” she added.

Funding cuts have hit prevention more than treatment, according to the report, which calls all countries to step up with domestic funding.

Byanyima urged global solidarity with affected communities in low- and middle-income countries. “Communities are showing what works … Developing countries are putting their foot forward,” she said.

“Rich countries must also maintain support to end the global disease.”

Research at risk

The launch comes ahead of IAS 2025, the 13th IAS Conference on HIV Science, taking place in Kigali, Rwanda, next week (13-18 July).

IAS president Beatriz Grinsztejn says the conference is taking place at a paradoxical moment for all who have dedicated their careers to ending the HIV pandemic.

“We’re witnessing extraordinary scientific breakthroughs that could transform prevention and treatment and even bring us closer to a cure,” Grinsztejn told an online press briefing on Tuesday (8 July).

“On the other hand, these very advances are under threat from massive funding cuts that risk stalling clinical trials, slowing our progress, and jeopardising the progress we’ve fought so hard to achieve.”

According to Grinsztejn, the sweeping US cuts threaten to undermine systems supporting HIV research, prevention and care, at the very moment when the scientific tools and knowledge are becoming available to end the HIV pandemic.

IAS president-elect Kenneth Ngure said: “The sudden cuts to US funding have been deeply felt across the African continent by the millions of people who rely on HIV prevention, testing and treatment services, and by the researchers and health workers striving to end the pandemic.”

In 2024, 630,000 people died from AIDS-related causes, 61 per cent of them in Sub-Saharan Africa. Over 210,000 adolescent girls and young women aged 15—24 acquired HIV in 2024 — an average of 570 new infections every day according to the 2025 UNAIDS report.

Ngure noted that studies to be presented at IAS 2025 offer real-world insights into the impacts of these actions on vulnerable populations now and in the future.

An online survey of 40 community-based HIV organisations in Latin America and the Caribbean earlier this year found that the majority (21 out of 24) had had US funding suspended.

Meg Stevenson, a senior research data analyst at Johns Hopkins Bloomberg School of Public Health in the US, noted that the losses represented an average of nearly half the annual budget of the organisations surveyed.

“In some cases, it was 100 per cent of their budgets,” she said during the IAS event.

“Funding cuts affected programmes that were providing HIV prevention and treatment, as well as ancillary services, to adults and children.

“These 21 organisations alone reported that over 150,000 beneficiaries will lose access to HIV treatment and prevention services,” she added.

Terminated programmes included sexual health programmes such as condoms and contraceptives, HIV testing services, psychosocial support, and care services.

Zackie Achmat, founder of the Treatment Action Campaign, a South African activist organization, and a member of the Global HIV Treatment Coalition, a UN initiative, called for urgent need for debt refinancing to protect the HIV response in low- and middle-income countries.

“The convergence of crushing debt and funding cuts threatens everything we’ve built,” said Achmat, who has long campaigned for action on the disease that he is afflicted with.

“We need urgent debt restructuring so African countries can invest in saving lives instead of servicing debt.”

A new study, led by experts at the University of Nottingham, has found that the Covid-19 pandemic may have accelerated people’s brain health, even if they were never infected with the virus.

What does it mean to grow older, not just in years, but in terms of brain health? Can stress, isolation, and global disruption leave their mark on people’s minds?

The findings of this new study, which are published in Nature Communications, showed that people who lived through the Covid-19 pandemic showed signs of faster brain aging over time than those scanned entirely before it. The changes were most noticeable in older individuals, in men, and in people from more disadvantaged backgrounds. 

Only participants who were infected by Covid-19 between their scans showed a drop in certain cognitive abilities, such as mental flexibility and processing speed. This may suggest that the pandemic’s brain aging effect, on its own (without infection) may not cause symptoms. Also, the authors highlight that the observed brain aging may be reversible.

The study was led by a team of experts from the University’s School of Medicine and was supported by the National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre and the Medical Research Council (MRC) DEMISTIFI programme. 

Dr. Ali-Reza Mohammadi-Nejad led the study, he said: “What surprised me most was that even people who hadn’t had Covid showed significant increases in brain aging rates. It really shows how much the experience of the pandemic itself, everything from isolation to uncertainty, may have affected our brain health.”

The research team looked at longitudinal brain scans from nearly 1,000 healthy adults, taken as part of the UK Biobank study. Some participants had scans before and after the pandemic; others, only before. Using advanced imaging and machine learning, the researchers estimated each person’s “brain age”-how old their brain appeared to be compared to their actual age. 

The brain age model was developed using brain scans from over 15,000 healthy individuals, without comorbidities, allowing the researchers to build an accurate model for estimating brain age.

This study reminds us that brain health is shaped not only by illness, but by our everyday environment. The pandemic put a strain on people’s lives, especially those already facing disadvantage. We can’t yet test whether the changes we saw will reverse, but it’s certainly possible, and that’s an encouraging thought.”

Dorothee Auer, Professor of Neuroimaging and senior author on the study

Stamatios Sotiropoulos, Professor of Computational Neuroimaging, and co-lead author added: “The longitudinal MRI data acquired before and after the pandemic from the UK Biobank gave us a rare window to observe how major life events can affect the brain.”

In a recently published retrospective cohort study, patients with aquaporin-4-antibody-positive (AQP4) neuromyelitis optica spectrum disorder (NMOSD) had higher 14-3-3 protein levels in cerebrospinal fluid relative to those with multiple sclerosis (MS) and myelin oligodendrocyte glycoprotein disorder (MOGAD). These findings highlight the potential of CSF 14-3-3 protein levels as a biomarker of neuroaxonal damage in AQP4-NMOSD, supported by their correlation with disease severity and their ability to predict poor clinical recovery.¹

Published in Neurology, the multicentric study comprised 29 patients with AQP4-NMOSD, 43 with MOGAD, and 62 with MS, each of whom had 14-3-3 protein levels quantified using ELISA assays. When comparing the groups, CSF levels of 14-3-3 protein were higher in those with AQP4-NMOSD (median interquartile range [IQR], 4471 [3323-12,303] AU/mL) compared with those with MS (3170 [IQR, 2523-3749; P-adjusted = 0.001) and MOGAD (3112 [IQR, 2358-3875]; P-adjusted = 0.004). Notably, there were no significant differences between those with MOGAD and MS (P-adjusted = 0.989).

The study, led by a number of notable authors including Manuel Comabella, MD, PhD, head of the Neuroimmunology Laboratory at the Fundació Institut de Recerca del HUVH, spanned across 5 European Centers. Coming into the trial, patients with AQP4-NMOSD were older at sampling (P <.001), presented more frequently with myelitis (P = .002), and displayed a higher Expanded Disability Status Scale (EDSS) during attacks (P <.001).

In the study, 14-3-3 protein levels were found to be associated with attack severity and predict final disability in patients with AQP4-NMOSD with myelitis. In this group, those who reached a final EDSS of 6 or greater (n = 11) had higher baseline levels than those with a final EDSS score less than 6 (n = 18; median, 12,303.35 [IQR, 6067.55-21,932.24] vs 3391.44 [IQR, 2829.43-4226.36], respectively; P-adjusted = 0.003). Similar results were found when selecting patients with AQP4-NMOSD with sampling at the first attack (EDSS ≥6.0 [n = 7]; EDSS <6.0 [n = 8]; P-adjusted = 0.022).

“While serum GFAP is a well-established astroglial biomarker for diagnosing and predicting relapses in AQP4-NMOSD, with the advantage of noninvasive sampling, CSF 14-3-3 may provide complementary diagnostic and prognostic value,” Comabella et al wrote. “However, its moderate sensitivity (60%) for disease discrimination and lack of association with relapse risk limit its stand-alone clinical utility, reinforcing the need for a multibiomarker approach.”

READ MORE: International Case Series Reveals Meningitis as a Potential Underrecognized Feature of MOGAD

The study authors continued, “Clinically, serum GFAP could facilitate early AQP4-NMOSD diagnosis and relapse prediction, optimizing maintenance therapy decisions. Meanwhile, CSF 14-3-3, because of its high specificity, may aid in differential diagnosis in ambiguous cases, particularly in myelitis. Furthermore, its association with long-term disability suggests that it could help identify patients at higher risk of poor recovery after a myelitis attack, supporting the need for more intensive acute treatment or adjustments in long-term therapy. This combined approach could enhance diagnostic accuracy and support personalized treatment strategies.”

In the study, patients with AQP4-NMOSD who presented with myelitis (n = 15) demonstrated higher CSF levels of 14-3-3 protein compared with optic neuritis (ON; n = 9; 12,303 [IQR, 4795-17,202] vs 3357 [IQR, 2893-3834], respectively; P <.001). This was considered notable, as there was no differences between the 3 conditions for those with ON presentations. In a subgroup analysis focused on myelitis attacks, higher CSF levels of 14-3-3 protein were observed in those with AQP4-NMOSD relative to the MOGAD and MS groups (P <.001).

In univariate analysis, CSF 14-3-3 levels predicted final EDSS ≥ 6.0 (OR, 10.41 [CI, 2.63-81.12]; P <.001), but this association lost significance after adjusting for age, EDSS at sampling, and post-sampling relapses. However, in patients with myelitis, 14-3-3 levels remained a significant predictor of this outcome after adjusting for chronic treatment (OR, 9.48 [CI, 1.69-194.34; P = .041), while no association was found with annualized relapse rate (ß = –0.02; CI, –0.57 to 0.53; P = .932).

“14-3-3 levels were comparable between MS and MOGAD, likely because of a similar degree of neuroaxonal damage, limiting its utility for distinguishing these conditions. Alternative biomarkers directly related to disease-specific pathophysiology, such as complement factors and cytokines, may offer better diagnostic precision as recently reported,” the study authors wrote. “Future studies including diverse myelitis etiologies could further elucidate the specificity of 14-3-3 protein. Other limitations of the study include its retrospective design and the lack of longitudinal assessment because of the intrinsic difficulties in accessing CSF samples.”

REFERENCE
1. Villacieros-Alvarez J, Sepulveda M, Valls-Carbo A, et al. Cerebrospinal 14-3-3 Protein Levels as a Neuroaxonal Biomarker in Aquaporin-4 Antibody–Positive Neuromyelitis Optica Spectrum Disorder. Neurology. 2025;12(5). doi:10.1212/NXI.0000000000200432