Category: 8. Health

Researchers at the Federal University of São Carlos (UFSCar) in the state of São Paulo, Brazil, are developing a panel of biomarkers for the early detection of Alzheimer’s disease and for distinguishing it from other types of dementia using blood tests. The research project is supported by FAPESP and is based on the genotype analysis of 500 volunteers with and without the disease.

One of the most recent findings by the research group, published in the journal Neurobiology of Aging, was the identification of a rare genetic alteration related to Alzheimer’s disease that is also associated with high levels of the ADAM10 protein. The study examined 85 individuals with cognitive impairment and the genetic condition, all of whom had high levels of the protein in their blood.

The protein is known among scientists for its role in cleaving, or breaking down, the beta-amyloid precursor protein. This prevents the formation of plaques in the brain, which is a hallmark of Alzheimer’s disease.

ADAM10 is an old candidate biomarker for Alzheimer’s disease that in recent years has gained prominence due to advances in ultrasensitive equipment that allows these molecules to be detected at very low concentrations in the blood plasma.”

Márcia Regina Cominetti, from the Biology of Ageing Laboratory (LABEN-UFSCar) and one of the project’s coordinators

The study found that the genetic condition involving alterations in the E4 allele of the APOE gene could result in an increase in inactive ADAM10 molecules in the blood. Consequently, the amount of active molecules would decrease, reducing their ability to inhibit the formation of beta-amyloid plaques in the brain.

Complex disease

Alzheimer’s disease is the leading cause of dementia worldwide, affecting over 35.6 million people. Not only is there no cure, but diagnosis remains a major challenge for medicine. The earlier it is identified, the greater the chance of delaying the onset of symptoms. This is because, until now, reversing the neurodegenerative process has only been possible in the early stage of the disease, known as mild neurocognitive impairment. This stage is characterized by cognitive decline without significantly affecting the individual’s functionality.

In this context, UFSCar researchers are developing prognostic blood tests based on ADAM10 that can identify individuals with mild cognitive impairment who are at a higher risk of developing Alzheimer’s disease.

“Our studies indicate that not only in the case of this rare condition but also in other causes of Alzheimer’s disease ADAM10 acts in a pathway prior to the formation of beta-amyloid plaques. With this, it’s possible, if everything goes as our hypothesis predicts, that it could be a prognostic marker, indicating, before the formation of these pathological milestones, whether or not the person has a chance of developing the disease,” says the researcher.

Cominetti points out that, currently, the detection of beta-amyloid plaques in the brain and hyperphosphorylated tau protein (another hallmark of Alzheimer’s disease) is highly accurate for diagnosis. “However, differentiating one dementia from another is still a major challenge. In this sense, a combination of biomarkers could, for example, make broader population screening possible through blood tests,” he says.

In partnership with the Chemistry and Gerontology departments at UFSCar, the researchers have developed a sensor that uses ADAM10 levels in the blood to distinguish between healthy older adults and those with Alzheimer’s disease. The test is currently being validated through studies with 500 volunteers.

“We’re moving towards finding prognostic markers for the disease. Many people wonder why they’re looking for a diagnosis if there’s no cure for Alzheimer’s yet. The fact is that we’re working in the long term. At some point, a cure may appear and then it’ll be extremely important to have a diagnostic method like the one we’re proposing to develop,” he says.

Another important aspect of the project, Cominetti notes, is the construction of a genetically diverse database that also considers risk factors for Alzheimer’s, such as education level, income, and quality of life. “We’ve completed the genetic sequencing of the 500 volunteers, creating a database without equal in the world. As well as reflecting Brazil’s genetic variability, the database is the result of a population that has distinct characteristics from the Global North, where most research is conducted. This is important because it’s known that the relevance of risk factors for Alzheimer’s can vary between rich and poor regions,” explains Cominetti.

Despite a steady decline in reported cases following a large outbreak in 2022, diphtheria is still being reported in Europe, with the number of cases higher than before 2020. An ECDC Rapid Risk Assessment issued today highlights how ongoing circulation of diphtheria caused by Corynebacterium diphtheriae (C. diphtheriae) may affect some populations who are more vulnerable to infection and recommends tailored public health response measures to protect those most at risk.

A total of 234 cases of diphtheria have been reported across the European Union/European Economic Area (EU/EEA) since January 2023. A significant proportion of these cases has been among people more vulnerable to diphtheria, such as people experiencing homelessness, people residing, working or volunteering in transitional housing centres, migrants, and people who use and inject drugs.

The fact that we see diphtheria infections acquired by vulnerable populations in the EU/EEA indicates ongoing unnoticed transmission in the community. This is a cause for concern, and calls for more intense efforts to address barriers to vaccination among these vulnerable groups. Effective vaccination programmes have helped to almost eliminate diphtheria, but this also means that healthcare workers may be less likely to recognise the symptoms. Increasing awareness of symptoms, quick diagnosis and prompt public health action are essential.”

Bruno Ciancio, Head of ECDC’s Unit for Directly-Transmitted and Vaccine-Preventable Diseases

Before 2020, the EU/EEA averaged 21 cases of diphtheria each year. In 2022, 320 cases were reported, many among recently arrived migrants who had been exposed to diphtheria on their journey. Most cases were associated with three sequence types: ST377, ST384 and ST574.

Since the end of 2022, six European countries (Austria, Czechia, Germany, Norway, Poland and Switzerland) have diagnosed 82 diphtheria cases caused by one of the diphtheria sequence types identified during the 2022 outbreak. At least 25 of these cases affected people experiencing homelessness, people who use or inject drugs, people who had not been vaccinated against diphtheria and older adults.

Although ECDC assesses the risk to the general population as very low, thanks to high vaccination coverage against diphtheria in most EU/EEA countries, this risk increases to moderate for groups who are more vulnerable to infection.

If infected, people who have not been vaccinated against diphtheria may present with skin infections or respiratory diphtheria. Respiratory diphtheria can be fatal in 5−10% of cases. In highly-vaccinated populations, most infections are asymptomatic or mild. It is very rare for diphtheria to occur in fully vaccinated individuals and vaccination against diphtheria is part of routine national immunisation programmes in Europe.

The rarity of diphtheria infection and the many ways in which it can manifest mean that clinicians may struggle to identify and diagnose infections. It is essential to increase awareness of diphtheria among clinicians and those working with vulnerable populations to ensure that diphtheria is properly diagnosed and treated, and that cases are notified to public health authorities.

ECDC is issuing the following recommendations to reduce the risk of severe infection in the most vulnerable individuals and to stop the circulation of C. diphtheriae in the community:

• Increase awareness among healthcare workers and people working with vulnerable populations of the various clinical presentations of the illness.
• Apply health promotion activities tailored to populations more likely to be exposed to diphtheria and promote engagement with these groups.
• Ensure equitable access to vaccination including by offering vaccinations to members of groups more vulnerable to infection.
• Regularly assess the availability of diphtheria antitoxin (DAT) for treatment locally/nationally.
• Improve surveillance to promptly detect cases and understand transmission patterns.

A new study from the USC Leonard Davis School of Gerontology reveals that just 30 days of guided mindfulness meditation can significantly enhance key aspects of attentional control – especially how quickly and accurately people direct their focus – regardless of age.

The study is among the first to use eye tracking, a powerful and objective measure of attention, to test the effects of mindfulness training on young, middle-aged, and older adults. The findings demonstrate that even short-term meditation can lead to measurable cognitive improvements, said USC Leonard Davis School postdoctoral researcher Andy Jeesu Kim, the study’s first author.

This study shows that mindfulness isn’t just about feeling more relaxed-it can literally change the way your brain handles attention. And that’s incredibly important for maintaining cognitive health as we age.”

Andy Jeesu Kim, study’s first author

Why attention matters in aging

As people age, they often experience slower reaction times and increased difficulty tuning out distractions. These changes are tied to a brain system called the locus coeruleus–noradrenaline (LC-NA) system, which plays a critical role in attention, arousal, and memory. Prior research, including work led by USC Leonard Davis Professor and study senior author Mara Mather, links age-related decline in this system to early Alzheimer’s disease changes.

Previous investigation has also shown that mindfulness meditation can enhance brain areas involved in attention and may increase activity in the LC-NA system. However, this is the first study to examine how mindfulness training affects attention using precise eye-tracking methods and whether the benefits differ across age groups, Kim explained.

The study: Mindfulness vs. audiobook

The USC study enrolled 69 adults split into three age groups: young (18–30), middle-aged (50–65), and older adults (65–80). Participants were randomly assigned to practice one of two options:

• Mindfulness meditation using the Headspace app, 10–15 minutes per day for 30 days
• An audiobook control, listening to chapters from a novel for the same duration

All participants completed three in-person lab visits and performed two eye-tracking visual search tasks that measured their speed and accuracy in focusing attention and ignoring distractions.

Key findings: Faster focus, stronger control

After the mindfulness training, participants showed improvements in several core aspects of attention:

• Faster reaction times: Participants were quicker to move their eyes toward target shapes, showing more efficient visual processing.
• Improved goal-directed focus: They made more direct saccades (eye movements) toward relevant targets and were better able to resist being pulled off course by distracting objects.
• Reduced distractibility: In some tasks, participants were less likely to fixate on irrelevant but visually “loud” items.

Interestingly, the benefits were not limited to one age group.

“We expected older adults to benefit the most, but we found that mindfulness improved attention similarly across young, middle-aged, and older adults,” Kim said. “This suggests mindfulness can be a useful tool at any stage of life.”

However, these improvements were not reflected in self-reported mindfulness scores from questionnaires, underscoring the value of objective eye-tracking measures.

A powerful tool for everyday attention

Although mindfulness has been widely embraced for stress relief and emotional wellness, this study provides compelling evidence for its cognitive benefits, too. The improvement was particularly apparent in attention control, a mental ability that is crucial for everything from driving to reading to social interactions.

Importantly, the study also compared the effects of the mindfulness intervention to an audiobook control. While both groups showed some improvement in attention, mindfulness participants improved more quickly and more significantly in certain areas, particularly reaction speed.

What’s next

The researchers note that while the study demonstrates promising short-term benefits, future studies should explore whether longer or more intensive mindfulness training could produce even greater effects, especially for older adults facing age-related cognitive decline.

“We’re excited about the potential of digital mindfulness interventions to help people support their brain health,” Kim said. “It’s simple, low-cost, and widely accessible. The key is consistency.”-

“The effects of mindfulness meditation on mechanisms of attentional control in young and older adults: A preregistered eye tracking study,” appeared in eNeuro on July 7, 2025. The study was funded by the National Institute on Aging (F32-AG076288) and the USC Center for Mindfulness Science. Along with Kim and Mather, coauthors included Keran Chen and Ying Tian of the USC Leonard Davis School.

BBC

‘Really nasty’

The South Western Ambulance Service says it is ready for a significant rise in demand during the school summer holidays.

Every year, the region welcomes about 23 million visitors according to the South Western Ambulance Service NHS Foundation Trust (SWASFT) – that is on top of the 5.5 million people it already serves.

In the region more than one million emergency 999 calls are made each year.

Dr John Martin, chief executive of SWASFT, said: “We know the summer will be a busy period for us, so we want to make sure that we’re there for everyone that needs us in a medical emergency.”

SWASFT is encouraging residents and tourists to plan ahead to ensure a safe and healthy summer by:

• Knowing how to describe your exact location in a remote or rural area by using What3Words – a free app which converts your location into a unique three-word address, so the emergency services can find you.

• Making use of community pharmacies, which can advise on minor illnesses and provide medications.

• Being considerate when parking to make sure there is enough room for emergency service vehicles to pass through.

Dr Martin said: “We need your support to help us, help you, by asking you to choose the right care so we have crews available for patients with the most life-threatening conditions.

“999 is for when someone is seriously injured or ill and their life may be at risk. For example, if someone is unconscious, not breathing or is bleeding heavily.”

The trust said it was leading the country in treating patients at home, which avoided unnecessary hospital visits.

Nearly a third (30.5%) of all patients in May were assessed and treated by paramedics at the scene without needing to be taken to hospital, it said.

The Trust’s Emergency Operations Centres in Bristol and Exeter use a triage system to assess and prioritise calls.

Bosses said, in many cases, patients could be helped over the phone through the service’s Hear and Treat initiative.

In May, 13,309 patients – about 14.5% of all callers – were treated remotely or directed to more appropriate NHS services without needing an ambulance on scene, the trust said.

Megan Barker, deputy head of clinical operations and safety, said: “If we can send our ambulances to patients who need them most, that’s our ultimate goal.”

Announcing a new article publication for BIO Integration journal. The pyrimidine analog 5-flurouracil (5-FU) is effective against solid tumors. However, the half-life of intravenously administered 5-FU is less than 20 minutes, and the compound is quickly eliminated and shows systemic toxicity.

This study was aimed at developing a nanohydrogel of 5-FU to improve anticancer drug delivery for skin cancer treatment. 5-FU Chitin nanoparticles (5-FCHNPs) were prepared through the ionic gelation technique, and 3²-factorial design approach was used to optimize the 5-FCHNPs and nanohydrogel formulations. Subsequently, 5-FCHNP particle size, zeta potential, and entrapment efficiency were evaluated.

The optimized nanohydrogel formulation was assessed for pH, spreadability, consistency, morphology, and transmission electron microscopy (TEM), scanning electron microscopy (SEM), and in vitro cytotoxicity analyses were conducted. The developed nanohydrogel formulation (5-FNH9) showed 68.40% entrapment efficiency, 72.88% drug release, and 1.418% skin penetration. The IC₅₀ value of 5-FU was greater than that of 5-FNH9. The developed 5-FNH exhibited enhanced skin penetration and pH-responsive controlled drug release and therefore has potential in skin cancer treatment.

 

Have you ever said “for all intensive purposes” instead of “for all intents and purposes”? What about “biting your time” or calling someone an “escape goat”? If so, you’re not alone. These commonly misunderstood phrases are called eggcorns.

What is an eggcorn?

Merriam-Webster defines an eggcorn as “a word or phrase that sounds like and is mistakenly used in a seemingly logical or plausible way for another word or phrase either on its own or as part of a set expression.”

The term was coined in 2004 after a University of Pennsylvania linguistics professor saw the term “eggcorn”  instead of “acorn” in a letter from 1844.

Want to learn more? Check out NPR’s “Here Are 100 ‘Eggcorns’ That We Say Pass Mustard”

Are eggcorns caused by hearing loss?

Not necessarily. Hearing specialists regularly hear patients using incorrect words during a hearing exam, and not just those with hearing difficulties.

“It’s not uncommon for patients to misinterpret or closely approximate words during a hearing exam, particularly with words that sound similar or have similar syllable structures,” said Dr. Jason Wigand, AuD, CCC-A, chief audiologist at Beach Audiology Hearing & Balance Center. “This phenomenon can occur in people with both normal hearing and those with hearing loss.”  

Dr. Wigand explains that even in people with normal hearing, these errors can happen for several reasons—including reduced attention, cognitive difficulties, or simply because the test uses words that sound very similar.

For those with hearing loss, these mix-ups may happen more often, but for both groups it’s important to consider the context and how familiar a person is with the words being tested when evaluating results.

When mishearing words can be a sign of hearing loss

Hearing loss comes on gradually and symptoms are subtle at first. When it comes to misunderstandings, the more frequent they are the more likely it is that something hearing-related is going on.

“Occasional misunderstandings are typical, especially in noisy environments,” said Dr. Wigand. “However, consistent difficulty understanding speech—particularly when it happens frequently in quiet settings, during group conversations, or over the phone may indicate a hearing problem.”

He goes on to mention that other signs of hearing loss may include:

• needing others to repeat themselves often,
• turning up the TV louder than others prefer
• or withdrawing from conversations due to frustration.  

How hearing loss impacts speech sounds

The most common type of hearing loss is sensorineural hearing loss (SNHL). This is the type that happens with aging or exposure to loud noise, among other causes. Because this type of loss affects higher frequencies first, one of the earliest signs of SNHL is struggling to hear speech sounds, particularly consonants.

“This type of loss can damage the hair cells in the cochlea responsible for processing subtle sound details, making it difficult to distinguish similar consonants like “s,” “f,” “sh,” “th,” or “b” and “d,” said Dr. Wigand. “As a result, even when speech is loud enough, it may still sound like someone is mumbling or unclear.” 

These difficulties can make everything from following along in work meetings to dinner out with family and friends more frustrating and less enjoyable. 

When to get your hearing tested

If you are experiencing frequent miscommunications or other signs of hearing loss listed above, make an appointment for a hearing test. 

When you visit a hearing care professional, you’ll likely start with a pure tone audiometry test—the one with the familiar series of beeps. This test is a standard way to measure how softly you can hear sounds at different pitches.

But when it comes to understanding how well you can follow speech, especially in real-world settings, other tests may provide even more useful insights.

Why speech-in-noise testing matters

“Word recognition testing (sometimes called speech discrimination testing) is essential for evaluating how well someone can understand speech at a comfortable loudness level,” explained Dr. Wigand.

“However, more importantly, speech-in-noise testing—like the QuickSIN or the HINT test—can reveal how well a person understands speech in challenging listening environments. These tests help audiologists determine the degree of hearing loss and how well the brain processes speech. It’s not just about the beeps!”

Hearing aids help speech sound clearer

Though sensorineural hearing loss is permanent, treatments such as hearing aids can make a meaningful difference in your ability to understand what’s being said. 

Today’s hearing aids are designed to help you hear speech more clearly, especially in environments where background noise can make conversations difficult. They can:

• Amplify the speech frequencies you have trouble hearing
• Reduce background noise to make voices clearer
• Use directional microphones to focus on the person speaking
• Stream calls, TV, or other audio directly to your ears

Concerned your loved one has trouble hearing?

Have you noticed a parent or your spouse missing more words or asking you to repeat yourself? Not only can this be frustrating for both parties, but it’s also a sign that it may be time to have a conversation with them about getting their hearing checked.

Dr. Wigand urged empathy and concern, rather than frustration when broaching this topic. He suggested something along the lines of:

“I’ve noticed it’s getting harder for us to understand each other, especially when we’re out or watching TV. And you’re not engaging as much during conversations. I’m worried it might be your hearing. I want you to check it—it could help both of us.”

Read more: How to support someone with hearing loss

Find a hearing provider near you

Whether you or someone you care about is showing signs of hearing loss, seeing a hearing care specialist can make a big difference. It’s a simple step that can improve communication and strengthen your connection.

Not sure where to start? Use our hearing directory to find a provider near you.

Published on
09/07/2025 – 7:00 GMT+2

One of the world’s most common viruses appears to significantly raise the risk of cancer, according to a new study from the World Health Organization’s (WHO) cancer research agency.

Most people around the world have been infected with Epstein-Barr virus (EBV) at some point in their lives. It spreads easily through saliva and other bodily fluids and does not usually cause symptoms, but it can lead to mononucleosis, also known as “mono” or “the kissing disease”.

Scientists already knew that EBV, which stays in the body forever, can cause certain cancers, such as lymphomas and a rare form of throat cancer. But until now, there has been little data on the broader health risks.

The new study, which was published in the journal Nature Communications, found that the virus puts people at higher risk for additional cancers, years before they are diagnosed.

Researchers tracked nearly 74,000 people in southern China for eight to 10 years, identifying 1,990 cancer cases. They also tested whether people had EBV antibodies, which are proteins that fight off infections and are stored in the body, serving as a sign that someone has had the virus.

People with EBV antibodies were about five times as likely to develop cancer compared with people who did not have them, according to the study from the WHO’s International Agency for Research on Cancer (IARC) and research centres in China.

The higher the level of antibodies, the higher the cancer risk.

The findings will help scientists “understand the link between [EBV infection] and the risk of various cancer types,” said Dr Zisis Kozlakidis, one of the study’s co-authors and head of IARC’s laboratory support, biobanking, and services unit.

The risks were highest for nasopharyngeal cancer, which is a rare cancer that affects the part of the throat that connects the back of the nose to the back of the mouth. People who had EBV were 26 times as likely to develop this form of cancer than those who were not infected.

Meanwhile, EBV antibodies were also tied to an elevated risk of developing lung cancer, liver cancer, and lymphomas, which are a group of blood cancers.

The study had some limitations. The results may not translate directly to different demographic groups, for example, and other risk factors, such as smoking rates, could have affected the findings.

Even so, researchers said the findings shed new light on cancer-causing viruses such as EBV. They called for more investigation into how exactly the virus causes cancer.

Most people who have had mono will not develop cancer because of EBV, but the virus can cause genetic changes in cells that make them more likely to become cancerous.

Health experts say that if people know their risks, they can watch out for signs of cancers that may be linked to the virus.

The herpes simplex virus type 1 (HSV-1), which affects almost two-thirds of the world’s population and is generally associated with oral herpes, may cause painful cold sores or fever blisters around the mouth. 

Yet, when genetically engineered to fight cancer, the virus may also play an important role in treating advanced melanoma, skin cancer that has spread to other parts of the body, according to phase 1-2 clinical trial results published in the Journal of Clinical Oncology and recently presented by Keck Medicine of USC at the 2025 American Society of Clinical Oncology annual meeting. 

The study involved 140 patients from the IGNYTE clinical trial, which included Keck Medicine and other sites worldwide. These patients had advanced melanoma that did not respond or stopped responding to immunotherapy, which uses the body’s own immune system to fight cancer. 

Patients were treated with a genetically modified HSV-1 in combination with an immunotherapy (nivolumab). By the end of the clinical trial, one-third of the participants had their tumors shrink by at least 30%, and nearly one out of six patients had tumors completely disappear. 

These findings are very encouraging because melanoma is the fifth most common cancer for adults, and about half of all advanced melanoma cases cannot be managed with currently available immunotherapy treatments.”

Gino Kim In, MD, medical oncologist with Keck Medicine and principal investigator at the Keck Medicine clinical trial site

Dr. In is also a member of the IGNYTE trial steering committee and one of the lead investigators on the trial. “The survival rate of untreatable advanced melanoma is only a few years, so this new therapy offers hope to patients who may have run out of options to fight the cancer.” 

A novel class of drugs to fight cancer 

The genetically modified HSV-1 evaluated in the study, RP1, is one of a relatively new, innovative class of cancer immunotherapy drugs known as oncolytic viruses that are designed to target and destroy cancer tumors while generating an anti-tumor immune response throughout the entire body. RP1 does not cause herpes. 

In January 2025, the U.S. Food and Drug Administration granted priority review to RP1 with nivolumab for patients with advanced melanoma whose cancer had not responded to prior immunotherapy. 

When injected into a tumor, RP1 replicates, killing off the cancer cells while leaving healthy cells unharmed. Additionally, RP1 stimulates the body’s white blood cells to seek out and destroy any other cancer cells in the body. 

The second cancer drug used in the study, nivolumab, is a standard immunotherapy treatment in fighting advanced melanoma and other cancers that have spread through the body. Researchers theorized that nivolumab, which works by using the body’s own immune system to fight and destroy cancer cells, would enhance the potential effect of RP1. 

How the treatment was administered 

Patients admitted into the study had already been treated with minimal success by one or more immunotherapy therapies and had to have more than one tumor that could be injected with RP1. Some tumors were considered “superficial” – meaning visible on the skin, or just below the skin’s surface – and some were located deeper in the body, such as in the liver or lungs. Researchers injected both superficial and deep tumors with RP1. 

Encouraging findings 

During the clinical trial, patients were given a combined therapy of RP1 and nivolumab every two weeks for up to eight cycles. If patients responded to the treatment, they continued on nivolumab alone every four weeks for up to 30 cycles (or two years). 

Researchers measured both treated tumors and untreated tumors. They discovered that not only did injected tumor size shrink in one third of the patients by 30%, but that patients’ uninjected tumors also shrank or even disappeared, just as frequently and as deeply. 

“This result suggests that RPI is effective in targeting cancer throughout the entire body and not just the injected tumor, which expands the potential effectiveness of the drug because some tumors may be more difficult or impossible to reach,” said Dr. In, who is also a member of USC Norris Comprehensive Cancer Center, part of Keck Medicine of USC. 

The study also found that RP1 was well-tolerated and had a favorable safety outcome. 

While it is too soon to tell if the positive outcomes remain permanent, Dr. In is optimistic about the future of RP1 therapy. “I believe that oncolytic viruses will open up an important new approach to fighting cancer in some patients in the near future,” he said. 

Other clinical trial researchers include Phillip M. Cheng, MD and Ali Rastegarpour, MD, diagnostic radiologists with Keck Medicine. 

Phase 3 clinical trial now open 

Phase 1-2 of the IGNYTE clinical trial examined the safety, side effects, best dosing and effectiveness of administering RP1 along with nivolumab on a limited patient population. Dr. In and his fellow researchers have launched the phase 3 trial, known as IGNYTE-3, to confirm their findings in a global population of more than 400 participants. 

Keck Medicine will again be one of the sites of the clinical trial, with Dr. In heading up the site. Patients interested in participating can contact Sandy Tran at [email protected]. 

Replimune, a manufacturer of RP1 and other oncolytic immunotherapies, is the sponsor of the IGNYTE clinical trial. 

Following numerous executive actions since January that have fundamentally changed U.S. foreign assistance, KFF, a partner organization of the Genetic Literacy Project, has released a collection of fact sheets documenting the impact on U.S. global health programs. These actions include the initiation of a foreign aid review, the dissolution of U.S. Agency for International Development (USAID) (including the reduction of most staff members and contractors) and the cancellation of most global health assistance awards. KFF will expand the fact sheet collection and update existing fact sheets as new details emerge.

Background on U.S. Global Tuberculosis (TB) Efforts

• The U.S. government has been involved in global TB activities for decades and began ramping up its efforts in the late 1990s when a global TB program was created at USAID.
• TB, an infectious disease caused by bacteria, causes more deaths than any other infectious agent worldwide, including 25 million people who died in 2023, and is among the 10 leading causes of death worldwide. TB is the leading cause of death among people with HIV.
• U.S. government efforts have contributed significantly to improving TB health outcomes, including helping to save the lives of more than 58 million since 2000 and contributing to a 9% decline in TB-related mortality between 2019 and 2023 in USAID TB priority countries.
• The FY 2025 Continuing Resolution that passed in March included level funding for bilateral TB activities at USAID and CDC of $406 million (as well as level funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria). The U.S. has been the top donor government to TB efforts, through its bilateral funding and contributions to the Global Fund. The administration’s FY 2026 budget request includes $178 million for TB, a decrease of $228 million (final appropriation levels are determined by Congress).
• USAID has served as the lead implementing agency for U.S. TB efforts, focusing on 24 priority countries – with activities in 50 (including at least 20 of the 30 high burden countries) – to support prevention, detection, and treatment of TB, including drug-resistant TB. The Centers for Disease Control and Prevention (CDC) also carries out global TB efforts and the State Department’s Bureau of Global Health Security and Diplomacy (GHSD), which oversees PEPFAR, leads U.S. efforts to address TB-HIV co-infection.

Current Status of U.S. Global TB Efforts

The following administration actions have had a significant impact on TB program operations:

• Funding freeze/stop-work order: The stop-work order initially froze all bilateral TB programming and services, halting existing work in the field. Because it halted payments, many implementers had to let go of thousands of staff and end some services.
• Limited waiver: Some TB activities were included in a limited waiver issued by the State Department on February 4 allowing “life-saving services” to continue, which are defined as “Essential screening, testing, and treatment for tuberculosis (TB) and drug resistant TB (DR-TB) including provision and monitoring of laboratory services, drug susceptibility testing, clinical visits, dispensing of essential medicines to avert near-term mortality and spread of infection.” HIV/TB activities were also allowed under PEPFAR’s limited waiver. Even with the waivers, services remain disrupted and implementers have faced challenges in getting permission to resume programming and difficulties in getting paid.
• Dissolution of USAID: As the main government implementer of TB efforts, the dissolution of USAID and loss of most staff have significantly affected TB program implementation capacity and operations. In addition, recent announcements of reductions at CDC could further affect global TB efforts.
• Canceled awards: It was recently reported that the administration has canceled 86% of all USAID awards. KFF analysis finds that of the 770 global health awards identified, 162 included TB activities, 79% of which were terminated.
• Legal actions: In response to two lawsuits filed against the administration’s actions, a federal judge issued a preliminary injunction ordering the government to pay for work completed by February 13, 2025, although not all payments have been made and the court has not stopped the government from canceling awards.
• Reorganization: The administration notified Congress on March 28, 2025 of its intent to permanently dissolve USAID and that any remaining USAID operations would be absorbed by the State Department with remaining global health activities to be integrated into its Bureau of Global Health Security and Diplomacy (GHSD) which oversees PEPFAR. On May 29, 2025, the State Department further notified Congress of its proposed reorganization plan.

Impact on Global TB Services and Outcomes

• An internal USAID memo reported that the cessation of USAID’s TB control programs would increase global TB incidence by 28-32% and have a similar effect on new cases of multi-drug-resistant TB.
• According to WHO, the 30 highest TB-burden countries have already reported that U.S. funding withdrawals are affecting services, including the loss of thousands of health workers, and disruptions of the drug supply chain and laboratory services.
• A recent rapid assessment survey of 108 WHO country offices found that approximately 40% reported moderate or severe disruptions to TB services, including for medicines and health products, due to the U.S. foreign aid freeze and other shortages.
• Analysis of the impact in South Africa estimated that the loss of TB funding could result in 580,000 fewer people being tested for TB and 35,000 fewer people receiving TB treatment in 2025.
• A recent modeling study found that U.S. TB program cuts could result in as many as 10.7 million new TB cases and 2.2 million additional TB deaths in 26 high-burden countries by 2030. Researchers concluded that the “loss of U.S. funding endangers global TB control.”
• Another modeling study found that cessation of U.S. TB funding could result in almost 69 million additional TB cases and 2.2 million additional TB deaths by 2040.

What to Watch

Funding/Budget Request: The administration’s FY 2026 budget request includes significant reductions in funding for global health, including a $228 million reduction for TB. The administration also submitted its first rescission package to Congress, including proposed rescissions of more than $1 billion in prior year funds for global health (little information on specific funding lines to be eliminated has been provided). Final appropriation amounts and rescission decisions are determined by Congress.

Foreign aid review results: The administration could soon release results of its 90-day foreign aid review, including for TB. It is unknown whether it will recommend any changes to TB efforts, including further reductions, and how or if Congress will respond to its recommendations.

Reorganization. The proposed permanent dissolution of USAID and integration of any remaining USAID global health activities, including for TB, into GHSD, raises several questions, including whether additional capacities will be provided to allow for the management and implementation of TB and these other health programs at the State Department.

A version of this article was originally posted at Kaiser Family Foundation and has been reposted here with permission. Any reposting should credit the original author and provide links to both the GLP and the original article. Find Kaiser Family Foundation on X @KFF