Conquering Alzheimer’s: a look at the therapies of the future

Researchers are looking to drug combinations, vaccines and gene therapy as they forge the next generation of treatments for the condition.

Alison Abbott

Nature | April 04, 2023

A brain scan reveals the extent of damage caused by Alzheimer’s disease. Credit: Zephyr/Science Photo Library


When neurologist Reisa Sperling stepped up to receive her lifetime achievement award at an international Alzheimer’s conference last December, she was more excited about the future than about celebrating the past.

What thrilled Sperling, who won the award for her work on clinical trials of Alzheimer’s treatments, was a sense of hope, which has been conspicuously missing from research into the disease for many years. Most other attendees felt the same.

Just a few months before the meeting, researchers had announced that an antibody drug called lecanemab clearly lowered the amount of amyloid protein plaques — a tell-tale sign of the disease — in the brains of participants in a clinical trial, and slowed their cognitive decline.

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Industries can harm health in many ways: Here are 3 that aren’t so obvious

Some products and practices are directly linked to avoidable ill health, planetary damage and social and health inequity, especially by large transnational corporations

Sameera Mahomedy

Down To Earth | March 30, 2023

Research confirms the adverse effects of social media on mental health. Photo: Shutterstock Research confirms the adverse effects of social media on mental health. Photo: Shutterstock

A recent ground-breaking series of reports in the science journal The Lancet unpacks what commercial determinants of health are, and how they affect public health. It uses a new, broader definition of the determinants:

the systems, practices and pathways through which commercial actors drive health and equity.

Some commercial entities contribute positively to health and society. However, research shows that some commercial products and practices are directly linked to avoidable ill health, planetary damage, and social and health inequity. Large transnational corporations are especially to blame.

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The effects of racism, social exclusion, and discrimination on achieving universal safe water and sanitation in high-income countries

Joe Brown, PhD 

Charisma S Acey, PhD

Carmen Anthonj, PhD

Dani J Barrington, PhD

Cara D Beal, PhD

Drew Capone, PhD

Oliver Cumming, MSc

Kristi Pullen Fedinick, PhD

Jacqueline MacDonald Gibson, PhD

Brittany Hicks, BS

Michal Kozubik, PhD

Nikoleta Lakatosova, MA

Karl G Linden, PhD

Nancy G Love, PhD

Kaitlin J Mattos, PhD

Heather M Murphy, PhD

Inga T Winkler, PhD

The Lancet | Open Access | Published: April, 2023 | DOI:https://doi.org/10.1016/S2214-109X(23)00006-2

Summary

Drinking water and sanitation services in high-income countries typically bring widespread health and other benefits to their populations. Yet gaps in this essential public health infrastructure persist, driven by structural inequalities, racism, poverty, housing instability, migration, climate change, insufficient continued investment, and poor planning. Although the burden of disease attributable to these gaps is mostly uncharacterised in high-income settings, case studies from marginalised communities and data from targeted studies of microbial and chemical contaminants underscore the need for continued investment to realise the human rights to water and sanitation. Delivering on these rights requires: applying a systems approach to the problems; accessible, disaggregated data; new approaches to service provision that centre communities and groups without consistent access; and actionable policies that recognise safe water and sanitation provision as an obligation of government, regardless of factors such as race, ethnicity, gender, ability to pay, citizenship status, disability, land tenure, or property rights.

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At World Health Organization, the future of health care is being decided, and contested

Peoples Dispatch | February 27, 2023

Jyotsna Singh of the People’s Health Movement talks about the recent Executive Board meeting of the World Health Organization. She talks about what happens during such meetings and the major issues on the table at the WHO. This is a key moment for the future of global health care as amendments to the International Health Regulations and the Pandemic Treaty are being discussed. Jyotsna describes the concerns raised by countries of the Global South and the ways in which the pandemic has influenced these discussions.

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Impact of malnutrition on early outcomes after cancer surgery: an international, multicentre, prospective cohort study

GlobalSurg Collaborative and NIHR Global Health Unit on Global Surgery | Open Access | Published: March, 2023 | DOI:https://doi.org/10.1016/S2214-109X(22)00550-2

Summary

Background

Malnutrition represents a key priority for global health policy, yet the impact of nutritional state on cancer surgery worldwide remains poorly described. We aimed to analyse the effect of malnutrition on early postoperative outcomes following elective surgery for colorectal or gastric cancer.

Methods

We did an international, multicentre, prospective cohort study of patients undergoing elective surgery for colorectal or gastric cancer between April 1, 2018, and Jan 31, 2019. Patients were excluded if the primary pathology was benign, they presented with cancer recurrence, or if they underwent emergency surgery (within 72 h of hospital admission). Malnutrition was defined with the Global Leadership Initiative on Malnutrition criteria. The primary outcome was death or a major complication within 30 days of surgery. Multilevel logistic regression and a three-way mediation analysis were done to establish the relationship between country income group, nutritional status, and 30-day postoperative outcomes.

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The use of imagery in global health: an analysis of infectious disease documents and a framework to guide practice

Esmita Charani, PhD †
Sameed Shariq, BSc †
Alexandra M Cardoso Pinto, BSc
Raabia Farooqi, BSc
Winnie Nambatya, MPharm
Oluchi Mbamalu, PhD
Seye Abimbola, PhD
Marc Mendelson, PhD

The Lancet | Open Access | Published: December 01, 2022 | DOI:https://doi.org/10.1016/S2214-109X(22)00465-X

Summary


We report an empirical analysis of the use of imagery by the key actors in global health who set policy and strategy, and we provide a comprehensive overview, particularly related to images used in reports on vaccination and antimicrobial resistance. The narrative currently depicted in imagery is one of power imbalances, depicting women and children from low-income and middle-income countries (LMICs) with less dignity, respect, and power than those from high-income countries. The absence of any evidence of consent for using intrusive and out-of-context images, particularly of children in LMICs, is concerning. The framework we have developed provides a platform for global health actors to redefine their intentions and recommission appropriate images that are relevant to the topic, respect the integrity of all individuals depicted, are accompanied by evidence of consent, and are equitable in representation. Adhering to these standards will help to avoid inherent biases that lead to insensitive content and misrepresentation, stigmatisation, and racial stereotyping.

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How the World Bank weakens health systems

Health researchers Natalie Rhodes and Remco van de Pas discuss about the nature and limitations of the World Bank Pandemic Prevention, Preparedness and Response fund.

Peoples Dispatch | October 31, 2022

Natalie Rhodes, PhD candidate at University of Leeds, and People’s Health Movement, along with Remco van de Pas, researcher at the Centre for Planetary Health Policy, and People’s Health Movement discuss in detail about the implications of the newly established World Bank fund for Pandemic Prevention, Preparedness and Response and the Bank’s other policies pertaining to public health.

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The health status of Indonesia’s provinces: the double burden of diseases and inequality gap

Vicka Oktaria and Yodi Mahendradhata

The Lancet | Open Access | Published: November, 2022 | DOI:https://doi.org/10.1016/S2214-109X(22)00405-3

In The Lancet Global Health, the Global Burden of Disease Study (GBD) 2019 Indonesia Collaborators report on 30 years of disease burden and risk factors in Indonesia, expanding their analysis to a more granular subnational level.

1

 Given the ongoing challenges of obtaining comparable subnational data, the GBD data provides enlightening evidence for decision makers at the subnational level for future programmatic planning and policy strategies specific to their local health issues. These findings will ultimately help narrow down the inequality gaps at regional levels. This paper is perfectly timed to captured and illustrate the health status in Indonesia before and after the launch of the universal health coverage (UHC) programme Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS) in 2014. The BPJS has now covered more than 75% of the Indonesian population.

2

Although excellent programmatic interventions and policies have significantly reduced the disease burden in the past three decades, communicable diseases remain the main source of disability-adjusted life-years (DALYs) in Indonesia, along with the rising burden of non-communicable diseases (NCDs) such as diabetes. Diabetes has become one of the main priorities of the national government as programmatic research and efforts towards prevention, early detection, and treatment of diabetes are increasing. Apart from poor quality of life, health-care costs related to diabetes complications are high, with diabetic retinopathy accounting for nearly 2% of the total national state budget, and are estimated to triple by 2025.

3

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Drug-resistant typhoid ‘spreading out of South Asia’

Sanjeet Bagcchi

SciDevNet | June 29, 2022

[NEW DELHI] Antibiotic-resistant strains of Salmonella Typhi, the typhoid bacteria, have spread from South Asia to other countries nearly 200 times since 1990, new research suggests.

Every year, an estimated 11 to 20 million people suffer from typhoid and 128,000 to 161,000 victims die from the diseasesays the World Health Organization (WHO). Typhoid spreads through water contaminated by an infected person’s faeces. Its symptoms include prolonged fever, nausea, rashes, headache and diarrhoea or constipation.

S. Typhi can only infect humans, and by studying how closely related bacteria found in different places are, we discovered that typhoid had spread from South Asia, the home of typhoid, to many parts of the world many times,” says Gagandeep Kang, co-author of the study and professor at the Wellcome Trust Research Laboratory in the Division of Gastrointestinal Sciences at the Christian Medical College, Vellore, India.

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Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019

GBD 2019 Adolescent Transport and Unintentional Injuries Collaborators

The Lancet | Open Access | Published: June 29, 2022 | DOI: https://doi.org/10.1016/S2468-2667(22)00134-7

Summary
Background
Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10–24 years during the past three decades.

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