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Although SARS-CoV-2 caused more than 775 million reported cases of Covid-19 and killed over 15 million people, the health of humanity continues to improve; life expectancy at birth increased globally from 46 years in 1950 to 70 years in 2010 and estimated 73 in 2019, than down to 71.3 after the Covid pandemic.. There have been four pandemics within the last ten years: chikungunya, Zika, H1N1 influenza, and SARS-CoV-2 (COVID-19), and multiple epidemics including SARS (2003), MERS-CoV-2 (2012), and Ebola (2014 and 2018, 2022). Dangerous mutations of the corona virus continue around the world, requiring new vaccination programs. The Covid pandemic has prompted the world to better prepare to address future pandemics. The G20 agreed to establish the Global Pandemic Preparedness Fund at the World Bank to close critical gaps in preparedness and prevention. Without early warning and improved emergency response plans, increasing urbanization, travel, viral mutations and climate change makes future pandemics inevitable. WHO claims that climate change is the single biggest health threat facing humanity and estimates the world will be short 10 million health care workers by 2030.

As the world continues to warm, animals will migrate coming into contact with other species and humans, causing new diseases; hence, there are likely to be more and different pandemics in the future than in the past. WHO has opened a global pandemic intelligence center in Germany and the G-7 has called for decentralization of vaccine production on all continents. Poorer regions do not have sufficient tests, treatments, vaccines, and the ability to isolate to slow the spread of disease. The Covid vaccine using mRNA instead of weakened virus might speed the development of future vaccines. Meanwhile, WHO has declared that drug resistance (antimicrobial resistance) is increasingly a top threat to humanity with over 700,000 dying per year now, but could grow to 10 million by 2050. Although antibiotic-resistant microbes and new "superbugs" are increasing, development of new antibiotics are not keeping up. However, artificial intelligence is helping to create a new class of antibiotics to address such resistance. It is also making it easier to make bioweapons which are less expensive than nuclear weapons.

Meanwhile, indigenous measles and rubella have been eliminated from the Americas, and maternal and neonatal tetanus have been eliminated in Southeast Asia. ​ WHO has approved a second malaria vaccine for children. Yet, TB (the leading infectious cause of death) is increasingly drug-resistant. Outbreaks of cholera, Ebola, dengue, mpox, and Covid still occur in many developing countries. Confirmed new measles cases increased from 171,153 in 2022 to 321,582 in 2023. Only 10% of Africa has been vaccinated for Covid. BioNTech (Pfizer partner) is building an mRNA vaccine manufacturing plant in Rwanda, Senegal and South Africa while Moderna is building in Kenya.

Artificial intelligence is helping to reduce the time it takes to invent new drugs and that information is shared worldwide instantaneously. Covid-19 vaccines were created in a year and now over 5.5 billion people, almost 70% of humanity, have been vaccinated, the fastest campaign in the history. Artificial intelligence is also making " digital twins" of patients to test and improve treatments. The new treatment for Ebola and new vaccine was approved in 2019 in Europe. A new malaria vaccine was shown to be 77% effective for 450 children in Burkina Faso in 2021. Most of the 400,000 who die from Malaria are children under five.

Over 88 million people have been infected with HIV, of whom 43 million have died. About 40 million people were living with AIDS in 2023; 630,000 died in 2023, and 1.3 million were newly infected with HIV in 2023 down from 2.8 million in 1998. In 2023, 77% [61-89%] of people living with HIV were receiving antiretroviral therapy. The number of infections are falling around the world, except for increases in Eastern Europe, Central Asia, Middle East and North Africa. Today 75% (28.7 million) of the 38.4 million people living with HIV receive treatment. Compromised immune systems of those with AIDS and those being treated for Covid are vulnerable to deadly fungal infections. In addition to bacteria and viruses, 300 of the 5 million fungal species cause human disease and kill 1.6 million people every year. Although in development now, there are no vaccines against fungal infections.

Embryo gene editing has begun and could eventually eliminate inherited disease tendencies, including preventing infectious diseases like HIV; e.g., genes in two embryos were edited in China to prevent HIV. However, such editing for human enhancement is quite controversial, and a U.S. National Academy of Sciences panel has recommended against such research at this time. Regenerative medicine holds the potential to create living, functional cells and tissues extending life, and DNA repair and other longevity research continue.

But investment and development of new antibiotics have not kept pace with current and potential antibiotic resistance around the world. Without new advances, antimicrobial resistance could lead to 10 million deaths per year by 2050. No new classes of antibiotics have come on the market for more than 25 years. A superbug (with mcr-1 gene) resistant to antibiotics now exists on several continents. Making antibiotics much stronger is being explored to prevent drug residence by reducing the time needed to be cured. A universal vaccine to boost the immune system could become an alternative to slow the process of making new vaccines for new versions of diseases. Genomic vaccines are being tested to inject DNA or RNA into cells to produce a desired protein to help train the immune system to eliminate a selected pathogen. But how should we prioritize funds for infectious diseases? Should it be number of currently infected people or economic impact versus potential for spread of infection versus mortality rates? As the aging populations of richer countries are expected to exhaust medical budgets, will China, India, and other growing economies pick up to burden?

Global health spending increased dramatically as a result of the COVID-19 pandemic, and is projected to increase 17.1% by 2030. Investments into tele-medicine and tele-health software, robotics, AI, and the Internet-of-Things are increasing. This should accelerate our understanding of human biology, disease, treatment, and promote global health. Global health care spending rose to $9.8 trillion during 2021 which is 10.3% of the global economy. However, about 11% of the world's population lived in countries that spent less than $50 per person per year compared to $4,000 in high-income countries.

Support the development of a WHO legally binding pandemic accord.

As there are military exercises for defense even with a low probability of war, so too should public health hold exercises for pandemics which have a higher probability of occurring.

Create and update alternative pandemic scenarios to inform planning.

Implement Barcelona Institute for Global Health multinational Delphi consensus to end the COVID-19 public health threat.

Implement WHO Global Vaccine Action Plan.

Increase support to anticipate and counter drug resistance.

Improve global plans and resiliency training to address future major epidemics.

Create and implement strategies to counter the barriers to developing new classes of antibiotics and bringing them to market.

Complete mortality records worldwide to improve database for research; only half of all deaths have recorded causes.

Increase global health funding to its previous annual increase of about 10%.

Focus on early detection, accurate reporting, prompt isolation, and transparent information and communications infrastructure.

Increase tele-medicine and AI diagnostics as the shortage of health workers continues to worsen in poorer regions of the world.

Increase investment in clean drinking water, sanitation, and hand washing.

Optimize the use of current health technologies (drugs, devices, biological products, medical and surgical procedures, support systems, and organizational systems) with corporate/NGO partnering for holistic approaches to health care. Encourage telemedicine, including online self-diagnosis and AI, expert software.

Increase investments in monitoring of health risks due to climate change and other global environmental changes.

Require screening synthetic DNA online orders to counteract bioterrorist efforts to obtain and weaponize strains of dangerous material.

Africa: Cameroon is the first country to add malaria vaccine (RTS,S) to its regular vaccine program. About 580,000 Africans died of malaria in 2023 of whom 80% were children under 5 years old. With 17% of the world's population, Africa has 25% of the world's disease burden, 3% of its health workers, and 1% of its health expenditures. It has the world's highest prevalence of communicable diseases. Fortunately, new vaccine production facilities are being established in Algeria, Egypt, Kenya, Morocco, Rwanda, Senegal, South Africa. Africa CDC plans to manufacture 60% of its vaccine needs locally by 2040. Twelve African countries will be allocated 18 million doses of malaria vaccine (RTS,S) between 2023 and 2025. A newer vaccine R21, with three initial doses and a booster a year later reduced symptomatic malarial cases by 75% and has overall efficacy of 66%. Annual global demand for malaria vaccines is estimated at 40-60 million doses by 2026 alone, growing to 80-100 million doses each year by 2030. Ebola is now preventable and curable, but outbreaks continue. Sleeping sickness has been eliminated in Togo, Côte d'Ivoire, Benin, Uganda, and Rwanda. Deaths from Covid, AIDS, malaria, measles, polio, and tetanus are falling; however, Covid reduced the rates of these improvements. Egypt once had the highest rate of hepatitis C; it is now eliminated in Egypt via a one-year program of screening, free treatment, and re-testing. Africa is short 1.5 million health workers and if trends continue, WHO forecasts that Africa will be short 6.1 million health care professionals by 2030. More nurses leave South Africa than are trained there annually. Higher salaries in richer countries lure African health care workers to leave, but many eventually return with better skills improving health care. Improved tele-health care and decentralized medical facilities will be required.
PEPFAR (USA HIV/AIDS program) invested nearly$1.2 billion during 2022 to support 325,000 health workers across Africa and nearly 19 million people receive antiretroviral treatment. Although beginning to decline, there are still about 11 million AIDS orphans who lost one or both of their parents to AIDS in Sub-Sharan Africa. Africa's population is expected to grow from 1.5 billion to 2.5 billion by 2050 with all the health problems and increased health care requirements of rapid urbanization. Its life expectancy for both sexes increased from 55 years in 2010 to 62 years in 2020. The Africa Centers for Disease Control and Prevention (Africa CDC) and World Health Organization launched a Joint Emergency Preparedness and Response Action Plan (JEAP). This pioneering five-year strategic collaboration will boost emergency preparedness and response efforts throughout Africa and thus ensure disease outbreaks during humanitarian crises and otherwise are managed efficiently.

Asia and Oceania: Asia and the Pacific regions have made the most progress in health in the last two decades. Nevertheless, they remain an epicenter of emerging epidemics and there are concerns about data collection and assessment in many countries. Most statistics are based on only 30 countries in the region. Infant mortality rates in Asia and the Pacific fell from 6.4% in 1990 to 3.1% in 2012 and 1.1% by 2020. However, this is not close to the SDG goals for child health, although dramatic reductions have taken place in the incidence of postpartum maternal death. From 2000 to 2020, the maternal mortality rate (the number of women who die during pregnancy and childbirth per 100,000 live births) fell in East Asia and Pacific by 38% - from 121 deaths to 74 deaths per 100,000 live births and fell in South Asia by 66% - from 417 deaths to 138 deaths per 100,000 live births, rates of reduction faster than the global average of 34%.

In 2022, there was a 14% decrease in new HIV infections and 51% decrease in AIDS-related deaths since 2010 in Asia and Pacific region. Presently, some 6.5 million people are living with HIV in this region. Almost one quarter (23%) of new HIV infections were in Asia and the Pacific where new infections are rising alarmingly in some countries. The HIV epidemic in the region disproportionately affects people from key populations, especially young people (aged 15-24 years). In Cambodia, Indonesia, the Lao People's Democratic Republic, Myanmar, the Philippines and Thailand, nearly half of new HIV infections occurred among young people. The reported incidence of HIV/AIDS in China fell from around 0.048% in 2005 to around 0.02% in 2019. In some countries, the incidence rate of AIDS was reduced by more than half since 2005, including India (a 49% reduction) and Papua New Guinea (a 21% reduction). Treatment coverage varies substantially across the region. The percentage of adults and children living with HIV and receiving ART ranges from 5% in Afghanistan to 67% in Cambodia.

TB (tuberculosis) mortality rates were high in Nepal and Papua New Guinea with over 50 deaths of people without HIV per 100 000 population. South-East Asia accounted for 43% of the estimated TB cases globally in 2020, more than any other WHO region. India (26.0% of TB cases globally), China (8.5%), Indonesia (8.4%), the Philippines (6.0%), Pakistan (5.8%), and Bangladesh (3.6%) were amongst the most affected countries and territories in 2020 - keeping in mind that these countries and territories also had important reductions in the reporting of cases due to the COVID-19 pandemic - (WHO, 2021). High-quality TB services have expanded, and many cases are treated, reaching the treatment success rate for new TB cases of more than 85% in many Asia-Pacific countries and territories in 2019. Nevertheless, Fiji reports a low treatment success rate at 30%. In countries and territories where TB predominantly affects older people, such as Japan and Hong Kong (China), treatment success rate were lower than 75%.

About 2.31 billion people are at high risk of malaria in the Asia-Pacific region. Deaths from malaria decreased in the region by 88% over the past 20 years; however, it increased between 2021 and 2022 by 29% mostly due to Papua New Guinea. Pacific island developing countries had by far the highest malaria rates among subregions in Asia and the Pacific, with rates more than 40 times higher than the regional average. India, Indonesia, Myanmar, Pakistan, and Papua New Guinea account for 89% of all malaria cases in the region. Nevertheless, only 2% of deaths from malaria globally occurred inside the Asia-Pacific region. The number of estimated cases per 1000 population at risk showed a decline in all reporting Asia-Pacific countries and territories from 2010 to 2020, except for Papua New Guinea. After nearly four years of maintaining zero indigenous cases, Sri Lanka was certified by WHO as malaria-free in September 2016. The number of malaria cases not treated increased to around three out of ten in Papua New Guinea and the Philippines, whereas it decreased significantly to less than one in six in Nepal and Bangladesh from 2000 to 2020.

Hong Kong, Macau, Japan and Singapore have the longest life expectancies in Asia: 85.83, 85.51, 84.95, and 84.27 respectively. By 2023, the Chinese government had approved 2,700 internet hospitals, reaching 363 million people.

If Asian poultry farmers received incentives to replace their live-market businesses - the source of many viruses - with frozen-products markets, the annual loss of life and economic impacts worldwide could be reduced. In March 2023 Japan culled 330,00 chickens in Aomori Prefecture due to an outbreak of avian flu. Environmental health is getting greater attention due to the alarming air and water quality in China. Switching from coal to natural gas and increased use of electric vehicles has improved Beijing's air quality over the past 15 years, although still below national air quality standards. Iraq, Pakistan, Bangladesh, India, Nepal, and Iran have worse air quality than China.

In terms of NTDs (neglected tropical diseases), unprecedented progress has been made in the elimination of visceral leishmaniasis in the Indian subcontinent. Cases have plummeted 98% in the past 14 years. 44,533 people were diagnosed with visceral leishmaniasis in 2007, but in 2022, only 834 cases were reported. Bangladesh has become the first country globally to be validated for elimination of visceral leishmaniasis or kala azar on 31 October 2023. Only Indonesia has populations that require preventive chemotherapy for schistosomiasis; the implementation of MDA led to a significant decrease in schistosomiasis prevalence among humans, reducing it to 0.1% in 2019. However, in 2021 and 2022, prevalence rates started to rise, reaching 1.45%. This increase was attributed to the shift in public health resources and focus towards the COVID-19 pandemic.

Europe: Although the aging population of Europe and increasing migration are stressing government medical services, under-five mortality has fallen 50% since 1990 and maternal mortality has dropped 25%. The EC's EU4Health 2024 work program is investing €752.4 million with special attention to resilience planning. WHO Europe (Health 2020) is changing its focus toward prevention amid a funding crisis due to the global recession. Hospital-borne infections affect 3 million Europeans per year. TB deaths continue to increase in Europe after a 40-year decline. Ukraine has the highest prevalence of HIV in Europe, but this has been decreasing since 2006. New treatment for Ebola and a new vaccine were approved in Europe. In Russia, drug tests are obligatory in schools and universities. Russia's health care system is declining; it reduced health care spending to 5-6% of GDP, while the global average is about 10%. Antimicrobial resistance is estimated to be responsible for 25,000 deaths per year in the EU and might cause more deaths than cancer by 2050.

Latin America: Over 4.5 million dengue cases were reported in 2023 and 3.5 million in first quarter of 2024 with 1,000 deaths in the region. The majority of the dengue infections are in Brazil, but is spreading to other countries in LAC. The region has the highest life expectancy among developing regions and the highest rates of antiretroviral treatment for HIV/AIDS of any WHO region. Vaccination coverage is also among the highest in the developing world. El Salvador, Argentina, and Paraguay are now malaria free. While Haiti's HIV rate has fallen from 6% to 2.2% over the last 10 years, the earthquake in 2010 devastated medical systems and brought on a cholera outbreak of a half-million cases and perhaps 250,000 more, as the cholera strain is evolving, spreading to Cuba and the Dominican Republic, and may become endemic. Some 100,000 Haitians are expected to be vaccinated against cholera this year. The HIV/ AIDS epidemic remains stable throughout Latin America. Brazil has shown that free ART has since 1996 dramatically cut AIDS mortality, extended survival time, saved $2 billion in hospital costs, and keeps prevalence to 0.6%. Neglected tropical diseases affect 200 million people in Latin America (intestinal worms, chagas, schistosomiasis, trachoma, dengue fever, leishmaniasis, lymphatic filariasis, and onchocerciasis), mostly in Brazil. Canine rabies and human rabies transmitted by dogs have been eliminated in many countries in Latin America. Traffic accidents are the second leading cause of death in Mexico for people from 5 to 29 years of age.

North America: Virtually the entire U.S. population has had Covid at least once, which stimulated increased attention to biosecurity threats and deterrence. The future health threats from climate change such as extreme weather conditions and changing diseases carriers are expected to worsen for the foreseeable future. The current urgent threats in the U.S., according to CDC, are carbapenem-resistant Enterobacteriaceae, drug-resistant gonorrhea, and clostridium difficile (a serious diarrheal infection causing 250,000 hospitalizations and 14,000 deaths annually that is usually associated with antibiotic use). The U.S. has created National Biodefense Strategy and Implementation Plan. Although the U.S. spends almost 20% of its GDP on its health care, results have not been satisfactory and there are too many uninsured, resulting in the new U.S. health care legislation. Some 21 states have chosen not to take advantage of the expanded Medicaid part of the law, leaving many of the poorest without maximum benefit. In the meantime, with a slowed economy, hospitals are increasingly merging to form insurance-like systems; insurance companies are buying and/or making deals with health care providers. The U.S. is upgrading its electronic health records and other forms of health information technology with $29 billion from the HITECH Act. The FDA approved two long-acting injectable drugs to treat and prevent HIV. The U.S. had 1.2 million people with HIV by 2023; 13% did not know that they were infected. CDC reports that roughly half of new HIV infections in the U.S. originate from the 20% of people living with the virus who are unaware of their infection. As of 2024 Canada has 68,000 people with HIV and averages about 1,800 new infections per year.

About 33% of children in the U.S. are overweight or obese, and one survey found that children aged 8-18 spent on average 7.5 hours a day with entertainment media. The Americas has been declared the first region to eliminate rubella, following 15 years of vaccination campaigns. The Bill and Melinda Gates Foundation has committed nearly $2 billion in malaria grants and more than $1.4 billion to the Global Fund to Fight AIDS, Tuberculosis, and Malaria. According to a Gallop Poll, over half of the Americans who participated in the poll wanted a single payer federal healthcare program.

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Global Challenge 8 - The Millennium Project

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"Global Challenge 8 is to explore the evolving landscape of global health amid pandemics, climate change, and technological advancements.

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What is the Immune system & what are diseases? This website gives you a brief overview of what the immune system does and how it defends itself against infectious diseases.

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Many Colonizing Microorganisms Seem to Prefer Certain Tissue Sites over Others

The specificity of the association of particular bacteria with various host tissues was suggested by ecological studies of the indigenous (normal flora) and pathogenic bacteria colonizing oral mucosal surfaces and the various niches of dental tissue. For example, the actinomycete bacteria Streptococcus mutans and S. mitis, both of which promote tooth decay, were found in large numbers in dental plaque but sparsely on the surface of tongue epithelial cells. The reverse was true for S. salivarius, an organism normally found in abundance on the tongue but not at all on the teeth.

The contrast between two common pathogenic bacteria reinforces the concept of specificity. Escherichia coli, the most frequent cause of urinary tract infections, is abundant in periurethral tissues, but is seldom found in the upper respiratory tract. In contrast, group A streptococci, which are virtually limited to colonization of the upper respiratory tract and skin, are seldom associated with urinary tract infections. The specificity of bacterial adherence and colonization is further supported by the observation that certain bacterial infections are limited to one animal species.

The Chemical Nature of Some Bacterial Adhesins and Their Corresponding Receptors on Host Tissues Is Known

A large number of studies performed during the past decade have established that many bacteria have surface structures that bind to specific macromolecules on host cells in a lock-and-key (or induced-fit) fashion analogous to the combination of an enzyme with its substrate or an antibody with its antigen. The terms adhesin and receptor describe the corresponding molecules on the surfaces of the bacteria and the animal cells, respectively. In general, the bacterial adhesins are composed of proteins in the form of fimbriae or pili (hairlike fibers), whereas the recognized pan of the receptor is composed of carbohydrates. Because of their specific interactions with carbohydrate residues, most of the bacterial adhesins can be considered lectins, and like plant lectins, many of them agglutinate red blood cells.

Bacterial agglutinins (or lectins) were first reported in 1908, following the observation that cells of E. coli agglutinate erythrocytes. Only recently, however, was it established that carbohydrate-lectin interactions constitute the molecular means by which most bacteria adhere to animal cells. These interactions occur in three ways.

1. Bacterial surface lectins can bind to the carbohydrates on the surface of animal cells. Since the 1950s it has been known that mannose and methyl-α-D-mannoside specifically inhibit the adherence of many gram-negative bacteria to eukaryotic cells. In 1977, bacteria were suggested to have surface lectins, which serve as adhesins that bind the organisms to mannose residues on human cells. Since then, both gram-positive and gram-negative bacteria have been found to express specific lectins on their surfaces. Several different sugars that may serve as sites for attachment for these lectins are characteristic constituents of cell-surface glycolipids or glycoproteins.

The lectins are organized on bacterial surfaces in either fimbrial or nonfimbrial structures. Fimbriae, long tubelike projections, are assembled as hollow fibers by the polymerization of the monomeric subunits composed entirely of protein. On the basis of their sugar specificity, several types of fimbrial lectins have been distinguished.

Some bacterial strains are genotypically able to turn on and off the expression of fimbriae. The phenotypic expression of these organelles seems to be under the control of an on-off switch in the DNA itself and is minimally affected by environmental influences. This switching results in a relatively constant shift from fimbriate to nonfimbriate (or vice versa) at a frequency of one per thousand bacteria per generation, which is about 10,000 times as frequent as a true mutational event. The ability to undergo such rapid phenotypic variation in vivo is probably a key determinant of the survival of bacteria on mucosal surfaces and of their pathogenicity once they invade deeper tissues. Evidence for such rapid phase shifts has been reported for Proteus mirabilis (responsible for induced urinary tract infections).

2. Extracellular lectin molecules can form bridges between carbohydrates present on the surface of the bacteria and their host. The bridging type of carbohydrate-lectin interaction was first noticed in the interaction of the plant bacterium Rhizobium trifolii with the root hairs of clover. Clover roots secrete a carbohydrate-binding protein, trifolin A, which recognizes carbohydrate structures on the surfaces that are shared by the bacteria and the root hairs and ligates them by forming a bridge between their common sugar residues.

Recent data suggest that a mechanism of adherence similar to that of R. trifolii may occur between bacterial and animal cells. The bridging lectin may have endogenous (produced by the host) or exogenous (acquired mostly from food) origins. For example, the intestinal secretions of guinea pigs is characterized by lectin activity specific for glucose and fucose. This lectin agglutinates Shigella flexneri and may mediate its attachment to mucosal surfaces of the gut.

Since lectins are abundant in food, the possibility was examined that these exogenously acquired lectins may become associated with mucosal cells as a cell-coat component and thus function as receptors for bacterial adherence. Indeed, buccal epithelial cells scraped from persons shortly after they eat raw wheat germ contain high amounts of wheat germ agglutinin on their surfaces. Because wheat germ agglutinin is an N-acetylglucosamine-specific lectin, the coated cells bind an increased number of Streptococcus sanguis organisms, which contain N-acetylglucosamine residues on their surface. Certain dietary lectins may also reach the alimentary tract in a functional form and thus may potentially mediate bacterial adherence.

3. Bacterial surface carbohydrates can bind to a lectin contained within the animal cell membrane. Evidence accumulated during the past 10 years indicates that animal cells exhibit lectins on their surfaces. Such lectins have been found on many cell types. Liver-cell lectins have been found to serve as receptors for serum asialoglycoproteins, asialoerythrocytes, and various glycoproteins, and are thus responsible for the clearance of these tissue elements from the blood. Similarly, when bacteria were injected into the blood streams of animals, they become lodged in the liver in less than an hour. Recent studies demonstrated that bacteria were trapped in the liver by hepatic receptors (lectins), which recognize corresponding sugar residues on the bacterial surfaces.

Sugars Are Not the Only Determinants of Recognition Between Bacteria and Epithelial Cells

Studies have been aimed at clarifying the molecular basis of the host-cell attachment of streptococci. These organisms inhabit the skin, the mouth, and the throat and may cause a variety of infections and postinfectious complications, such as acute rheumatic fever or acute glomerulonephritis. Transmission electron microscopy of streptococci attached to buccal epithelial cells has revealed the presence of fibrillar structures extending from the bacteria to the surface of the epithelial cells. These fibrillar structures are composed of proteins complexed with lipoteichoic acid, an ampiphathic polymer produced by the bacteria: It consists of repeating units of glycerol phosphate capped at one end with a glycolipid moiety. The latter moiety is responsible for the binding of the streptococci to specific receptors on oral epithelial cells. Indeed, isolated lipoteichoic acid binds to receptors on a wide variety of mammalian cells. Moreover, the purified polymer blocked the adherence of epithelial cells of streptococci, but not of other bacteria, such as E. coli.

Since the fatty acid of lipoteichoic acid mediates the epithelial cell attachment of streptococci, a protein or glycoprotein with fatty-acid binding sites may serve as the receptor. The receptor now seems to be fibronectin, a ubiquitous glycoprotein present on the surface of many host cells-including oral epithelial cells. Binding of lipoteichoic acid to fibronectin occurs at a site on the glycoprotein that specifically binds fatty acid residues with a binding affinity two orders of magnitude higher than the binding of lipotichoic acid to fatty-acid binding sites of serum albumin. These results indicate that in addition to lectin-carbohydrate interactions, protein-lipid interactions are centrally involved in the specific attachment of certain bacteria to host cells.

Flagellates, which are unicellular eukaryotes, invade host cells by the specific interaction of parasite and host molecules. Malaria parasites invade erythrocytes by interacting with specific ligands on the red cell membrane. The ligand involved in invasion by Plasmodium vivax, a human malaria, and P. knowlesi, a simian malaria, is the Duffy blood group antigen; this identification explains the resistance to P. vivax of West Africans who lack the Duffy antigen on their red blood cells. The comparable molecule for P. falciparum, the major human malarial parasite, is sialic acid on glycophorin. The parasite receptors that bind these ligands are now being identified. The value of these receptor molecules as vaccine targets will depend on their variability in the parasite population and the presence of alternative pathways for invasion.

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The Immune System and Infectious Diseases

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The immune system orchestrates a potent defense that consists of the production of specific antibody molecules and lymphocytes capable of reacting with and inactivating foreign agents, either directly or indirectly through the involvement of molecular and cellular inflammatory processes.

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A cure is a treatment that completely eliminates a disease or health problem, and it is not expected to return.

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What is a cure?

"Cure" may be one of the most important - and most easily misunderstood - words in medicine. At face value, cure means something simple. A cure is a remedy. Being cured of a disease means it's gone and won't come back.

For many people, "cure" means something more. It means having the peace of mind of not feeling sick or having to stick to a treatment plan or attend regular doctor visits. The stakes are higher with terminal illnesses, like Alzheimer's disease, Parkinson disease and advanced forms of heart disease and cancer. Hope for a cure can mean living without fear of death or the burden of rearranging your life because of a diagnosis you can't control.

This is where "cure" can become confusing. It's not the single magic bullet that provides good health and the peace of mind that goes along with it. For example, many people with incurable diseases, like some forms of cancer, live full lives - free of symptoms.

Understanding what a cure is (and what it isn't) can help you plan for the future if you're diagnosed with an incurable condition.

The difference between a cure and a treatment

Treatments include medicines, procedures and therapies to improve your health and well-being. A cure is one potential treatment outcome that can lead to these improvements. Other treatment outcomes may also keep you healthy and allow you to live the life you want.

Treatment outcomes include:

Cure: Gets rid of your disease or illness for good. For example, antibiotics can clear a bacterial infection. Antibiotics can't prevent future infections if you're exposed to new bacteria. But they can eliminate the particular bacteria causing your current infection.

Disease prevention: Keeps you from getting a disease or condition. For example, getting an HPV vaccine can shield you from getting infected with particular strains of the human papillomavirus (HPV) that cause cancer, including cancers of your anus, cervix, penis and throat.

Disease management: Lessens disease severity and improves your general condition. For example, taking insulin helps regulate your blood sugar levels if you have Type 1 diabetes. Diabetes is still an incurable condition, but it's one you can live with if you take your medicine as prescribed and check your levels regularly.

Palliative care: Improves your quality of life as someone living with a disease or disability by relieving your symptoms and treatment side effects. For example, having a healthcare provider reposition you in bed if you can't move on your own can prevent bedsores and provide the comfort of another person's touch. Palliative care won't cure your condition or lessen disease severity. Still, it makes your life better than it would be without it.

The difference between a cure and recovery

Many people use "cure" and "recovery" interchangeably because they're both hopeful words that involve getting better. But you can recover from a disease without being cured of it. For example, people living with substance use disorder may be in recovery. Recovery means your health is improving and you're not abusing substances, like recreational drugs or alcohol. But recovery doesn't mean you'll never have the desire to use these substances again. Instead, it involves choosing daily to commit to a life without substance use.

The difference between a cure and remission

Doctors who treat cancer, or oncologists, often measure treatment success based on whether cancer is in remission. While a cure means that a disease has gone for good, remission doesn't come with that guarantee.

Remission can be complete or partial:

Complete remission: Your oncologist can't find a trace of cancer, and you no longer have any symptoms. You may still have cancer cells hidden in tissue that neither tests nor imaging can detect. It's equally possible that you're 100% cancer-free.

Partial remission: You still have cancer cells in your body but less than you did before. You may have tumors that have gotten smaller or fewer cancer cells in your bloodstream.

Remission can be confusing because it doesn't have a set time limit. Your cancer may be in remission for your entire life. When you eventually die, you may pass for reasons unrelated to cancer. Or you may be in remission for weeks, months or even years until your oncologist detects signs of cancer. When this happens, your cancer has returned (recurred). Recurrent cancer may require new treatments that may send your cancer into remission again.

Learning you're in remission is good news. It can also be frustrating when you want a guarantee that your cancer is gone forever.

Can cancer be cured?

The short answer is no. Cancer can't be cured, at least not yet. The longer answer is much more complicated. Cancer isn't curable, but treatments for some types of cancer can likely eliminate it from your body completely. This is the answer most people care about.

Think of it this way. The word "cancer" makes it seem like a single disease, but it isn't. There are over 100 types of cancer. These cancers affect your body differently, vary in severity, require different treatments and respond to these treatments differently. Cancer treatments are successful partly because researchers have studied specific cancers and tailored treatments to them. As a result, people survive cancers that would've been deadly a few decades ago. Some of these cancers go into complete remission following treatment and never return.

These treatment successes have led more oncologists to refer to select cancers treated at select times (usually in the early stages before cancer has spread) as curable. "Curable" in these instances means that your oncologist can get rid of the cancer if you receive the proper treatment early enough.

Other oncologists never use words like "cure" or "curable" when referring to cancer treatment outcomes. Even when it's unlikely that the cancer will return, there's never 100% certainty that a cancer cell that's undetectable at one moment doesn't cause a future recurrence.

What cancers have the highest survival ("cure") rates?

Some oncologists may describe your cancer as "cured" if you're in remission for five or more years. They're more likely to use words like "cure" if you have a cancer associated with a high five-year cancer survival rate.

What are cancer survival rates?

Cancer survival rates communicate the percentage of people with a specific cancer diagnosis who are alive after a period (usually five years). The five-year mark is an important milestone because most cancers that return do so within five years. Depending on your cancer type, if your cancer hasn't returned by then, there's a good chance it won't.

One of the most important numbers oncologists use to predict your treatment outcomes is the five-year relative survival rate. It communicates how many people with a particular cancer diagnosis are alive five years following diagnosis compared to people who don't have the diagnosis. These numbers can't predict your unique experience, but they can provide a general idea of what to expect based on others' experiences.

Many cancers diagnosed and treated early have five-year relative survival rates higher than 90%. This means that 90 out of 100 people are alive in five years, compared to people without the same cancer diagnosis. Many people with these cancers who receive treatment live long lives, often without signs of cancer.

Breast cancer

Breast cancer forms in one (most common) or both breasts.

Five-year relative survival rate: Approximately 99% of people with breast cancer that hasn't spread beyond the breast tissue are alive five years later. Almost all people with pre-invasive or Stage 0 breast cancer, called ductal carcinoma in situ, are alive five years later. The outlook isn't as good for cancer that's spread.

Why is the outlook good? Breast cancer screenings can help detect cancer early so treatment begins immediately, increasing the chances of being cancer-free. Thanks to cancer research, scientists have developed treatments tailored to target and eliminate specific types of breast cancer.

Cervical cancer

Cervical cancer forms in your cervix, the canal that connects your vagina and uterus.

Five-year relative survival rate: Approximately 92% of people with cervical cancer that hasn't spread beyond their cervix or uterus are alive five years later. Survival rates are also high following treatment for cervical dysplasia, abnormal cell growth that can progress to cervical cancer. Cervical cancer that's spread to lymph nodes or other body parts is much harder to treat.

Why is the outlook good? Cervical cancer progresses slowly. Getting regular Pap smears can detect cancer in the early stages when treatments are most effective.

Hodgkin lymphoma

Hodgkin lymphoma is a group of cancers that form in white blood cells called lymphocytes.

Five-year relative survival rate: Approximately 92% of people with Hodgkin lymphoma that hasn't spread to major organs, bone marrow or lymph nodes above and below their diaphragm are alive five years later.

Why is the outlook good? Hodgkin lymphoma responds well to cancer treatments, like radiation therapy and chemotherapy.

Melanoma

Melanoma is a type of skin cancer.

Five-year relative survival rate: Approximately 99% of people with melanoma that hasn't spread beyond the skin's surface are alive five years later. The outlook is worse if the cancer has spread to layers underneath.

Why is the outlook good? Skin changes are easy to spot and catch early. Surgery often gets rid of melanomas growing on the top layer of skin. New advances in treatments like targeted therapy and immunotherapy have increased the likelihood of being cancer-free compared to 10 years ago.

Prostate cancer

Prostate cancer develops in your prostate gland.

Five-year relative survival rate: Approximately 99% of people diagnosed with prostate cancer that hasn't spread outside their gland are alive five years after diagnosis.

Why is the outlook good? Prostate cancer grows slowly and usually gets diagnosed and treated early - before it's spread. It's much harder to eliminate prostate cancer that's spread (metastasized).

Testicular cancer

Testicular cancer develops in one (most common) or both testicles.

Five-year relative survival rate: Approximately 99% of people diagnosed with testicular cancer that hasn't spread outside their testicles are alive five years after diagnosis. Testicular cancer treatments are highly effective, and many people with metastasized cancer (73%) are alive five years later.

Why is the outlook good? Surgery to remove the testicle with cancer often eliminates it. This cancer is also highly responsive to chemotherapy treatments.

Thyroid cancer

Thyroid cancer develops in your thyroid, a butterfly-shaped gland at the base of your neck.

Five-year relative survival rate: Almost all people with thyroid cancer that hasn't spread beyond their thyroid gland are alive five years later. A rare form of thyroid cancer called anaplastic thyroid cancer has a worse outlook.

Why is the outlook good? This form of cancer grows slowly. Surgery to remove the thyroid gland often gets rid of the cancer.

Ask your healthcare provider for more information when they use words like "cure," "treatment outcomes," "survival rates" or "remission." These words all communicate important information that can help you better understand your diagnosis and plan for your future. It's essential that you and your healthcare provider are on the same page when it comes to your treatment goals.
A note from Cleveland Clinic
Struggling with the ins and outs of language is the last thing most people want to do when trying to understand what a diagnosis means for their lives. Unfortunately, words like "cure" are complex, especially regarding diagnoses like cancer. If you have cancer, your provider may hesitate to use the word "cure" - even if you're free of cancer and it's unlikely to return.

Don't automatically assume the worst if you learn that your condition is incurable. Instead, ask questions based on your priorities. You might ask: Can you recommend treatments that can eliminate signs and symptoms of my disease? Can treatment help me return to my routine? Are there habits I can put in place to feel better? Get the answers you need for your own peace of mind.

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Being cured of a disease means it's completely gone and isn't coming back. For many people, cures represent the ultimate treatment goal.

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Antibiotics are a class of powerful medicines used to treat infections caused by bacteria. They work by either killing the bacteria directly (bactericidal) or preventing them from growing and multiplying (bacteriostatic).

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What are antibiotics?

Antibiotics are medicines that fight bacterial infections in people and animals. They work by killing the bacteria or by making it hard for the bacteria to grow and multiply.

Antibiotics can be taken in different ways:

Orally (by mouth). This could be pills, capsules, or liquids.

Topically. This might be a cream, spray, or ointment that you put on your skin. It could also be eye ointment, eye drops, or ear drops.

Through an injection or intravenously (IV). This is usually for more serious infections.

What do antibiotics treat?

Antibiotics only treat certain bacterial infections, such as strep throat, urinary tract infections, and E. coli.

You may not need to take antibiotics for some bacterial infections. For example, you might not need them for many sinus infections or some ear infections. Taking antibiotics when they're not needed won't help you, and they can have side effects. Your health care provider can decide the best treatment for you when you're sick. Don't ask your provider to prescribe an antibiotic for you.

Do antibiotics treat viral infections?

Antibiotics do not work on viral infections. For example, you shouldn't take antibiotics for:

What are the side effects of antibiotics?

The side effects of antibiotics range from minor to very severe. Some of the common side effects include:

More serious side effects can include:

Call your health care provider if you develop any side effects while taking your antibiotic.

Why is it important to take antibiotics only when they're needed?

You should only take antibiotics when they are needed because they can cause side effects and can contribute to antibiotic resistance. Antibiotic resistance happens when the bacteria change and become able to resist the effects of an antibiotic. This means that the bacteria continue to grow.

How do I use antibiotics correctly?

When you take antibiotics, it is important that you take them responsibly:

Always follow the directions carefully. Finish your medicine even if you feel better. If you stop taking them too soon, some bacteria may survive and re-infect you.

Don't save your antibiotics for later.

Don't share your antibiotic with others.

Don't take antibiotics prescribed for someone else. This may delay the best treatment for you, make you even sicker, or cause side effects.

Centers for Disease Control and Prevention

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Used properly, antibiotics can save lives by fighting bacterial infections. Read about how to use antibiotics and about when not to use antibiotics.

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Vaccines are medical products that stimulate a person's immune system to produce immunity to a specific disease, protecting the person from that disease.

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Immunization is a global health and development success story, saving millions of lives every year. Vaccines reduce risks of getting a disease by working with your body's natural defences to build protection. When you get a vaccine, your immune system responds.

We now have vaccines to prevent more than 20 life-threatening diseases, helping people of all ages live longer, healthier lives. Immunization currently prevents 3.5-5 million deaths every year from diseases like diphtheria, tetanus, pertussis, influenza and measles.

Immunization is a key component of primary health care and an indisputable human right. It's also one of the best health investments money can buy. Vaccines are also critical to the prevention and control of infectious disease outbreaks. They underpin global health security and will be a vital tool in the battle against antimicrobial resistance.

The Covid-19 pandemic, associated disruptions, and Covid-19 vaccination efforts strained health systems in 2020 and 2021, resulting in dramatic setbacks. However, from a global perspective recovery is on the horizon - in 2022 diphtheria-pertussis-tetanus (DTP) immunization coverage, albeit unevenly between countries, has almost recovered to 2019 levels.

Measles, because of its high transmissibility, acts as a "canary in the coalmine", quickly exposing any immunity gaps in the population. Still, 22 million children missed their routine first dose of measles vaccine in 2022, compared to 19 million in 2019.

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Vaccination is a simple, safe, and effective way of protecting people against harmful diseases, before they come into contact with them. It uses your body's natural defences to build resistance to specific infections and makes your immune system stronger.

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What makes these 3 stand out from the rest, is that these are things that help prevent diseases. For example, antibiotics can help prevent bacteria that makes you ill.

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The COVID-19 pandemic was a global outbreak of the infectious disease caused by the SARS-CoV-2 virus, which severely disrupted societies, healthcare systems, and the global economy from 2020 onward.

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The coronavirus disease 2019 (COVID-19) pandemic is a global outbreak of coronavirus - an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Cases of novel coronavirus (nCoV) were first detected in China in December 2019, with the virus spreading rapidly to other countries across the world. This led WHO to declare a Public Health Emergency of International Concern (PHEIC) on 30 January 2020 and to characterize the outbreak as a pandemic on 11 March 2020.

On 5 May 2023, more than three years into the pandemic, the WHO Emergency Committee on COVID-19 recommended to the Director-General, who accepted the recommendation, that given the disease was by now well established and ongoing, it no longer fit the definition of a PHEIC. This does not mean the pandemic itself is over, but the global emergency it caused is - for now. A review committee will be established to develop long-term, standing recommendations for countries on how to manage COVID-19 on an ongoing basis.

Since the COVID-19 pandemic started, over 2 million people in the European Region have died from the disease.

On 25 October 2023 WHO/Europe made several changes to its respiratory virus surveillance and data reporting systems. The COVID-19 Situation Dashboard played a pivotal role in providing essential information during the early stages of the pandemic. However, the landscape has now shifted, and so have data needs.

A new WHO/Europe COVID-19 Information Hub is replacing the previous COVID-19 Situation Dashboard to serve as a comprehensive resource, providing links to the most current health information, datasets and products concerning COVID-19.

Within the Hub, WHO/Europe and the European Centre for Disease Prevention and Control (ECDC)'s weekly European Respiratory Virus Surveillance Summary (ERVISS) displays integrated surveillance data for influenza, COVID-19, and respiratory syncytial virus (RSV) in the WHO European Region, including the European Union (EU)/European Economic Area (EEA).

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The coronavirus disease 2019 (COVID-19) pandemic is a global outbreak of coronavirus - an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Cases of novel coronavirus (nCoV) were first detected in China in December 2019, with the virus spreading rapidly to other countries across the world.

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Healthcare technology is advancing rapidly, driven by innovations in computing, connectivity, and data analysis. These technologies are improving patient care, streamlining hospital operations, and making health services more accessible.

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Recent Advancements in Emerging Technologies for Healthcare Management Systems: A Survey

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In recent times, the growth of the Internet of Things (IoT), artificial intelligence (AI), and Blockchain technologies have quickly gained pace as a new study niche in numerous collegiate and industrial sectors, notably in the healthcare sector.…

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The global healthcare system is experiencing a severe and ongoing shortage of qualified workers across nearly all roles and specialties. This crisis, which was dramatically worsened by the COVID-19 pandemic.

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The National Center for Health Workforce Analysis (NCHWA) helps public and private organizations understand how changes in population will affect future workforce demands.

What are the most recent projections data available?

In November 2024, NCHWA released projections for 2022-2037. This page provides summary information on those projections. All projections are available in the Workforce Projections Dashboard.

NCHWA also published these projections briefs in November 2024:

How does this data help?

By estimating supply, demand, and distribution of health care workers, we inform public policy to help prevent shortages and surpluses.

How do we make our projections?

We project the national supply of and demand for health professions by discipline. We use HRSA's Health Workforce Simulation Model to do this.

What are the projections for health workforce practitioners?

Allied health

The allied health workforce provides specialized care in a variety of disciplines.

NCHWA projects shortages in 2037 for many key allied health occupations, including:

36,820 dispensing opticians

6,480 respiratory therapists

9,140 physical therapists

17,030 pharmacists

4,430 podiatrists

8,190 chiropractors

Note: All data are expressed in full-time equivalents (FTEs).

Additional workforce projections for the allied health workforce can be found in the Workforce Projections Dashboard.

HRSA programs that support allied health include the National Health Service Corps and Community Health Worker Training Program. Expanding these programs would help address these future shortages.

Behavioral health

The increase in demand for behavioral health, mental health, and substance use disorder services in the United States is well-documented.

NCHWA projects shortages in 2037 for many key behavioral health occupations, including:

113,930 addiction counselors

87,840 mental health counselors

79,160 psychologists

50,440 psychiatrists

34,170 marriage and family therapists

39,710 school counselors

Note: All data are expressed in full-time equivalents (FTEs).

These estimates are based on current use of behavioral health services in the United States. They do not address the large amount of unmet need that exists for these same services. Including estimates of this unmet need results in even higher shortages.

For example, an additional 113,830 psychologists would be required by 2037 to meet all unmet need for psychologists. By contrast, 79,160 psychologists are required to address only current use.

Additional workforce projections for the behavioral health workforce can be found in the Workforce Projections Dashboard.

HRSA programs that support the behavioral health workforce include:

Expanding these programs would help to address these future shortages.

Long-term services and support

In 2030, all Baby Boomers will be age 65 or older, accounting for 1 out of every 5 Americans. This group will be an increasingly large part of the U.S. population in the future. They will need a robust, well-trained long-term services and support (LTSS) workforce to meet their needs.

Workforce projections for the LTSS workforce can be found in the Workforce Projections Dashboard.

HRSA programs that support the LTSS workforce include the Geriatrics Workforce Enhancement Program (GWEP) and a Health Workforce Research Center (HWRC) devoted to long-term care.

Nursing

NCHWA projects nationwide nursing shortages, including:

207,980 registered nurses (RNs)

302,440 licensed practical nurses (LPNs)

Note: All positions are full-time equivalents (FTEs).

Additionally, larger shortages of nurses are forecast in nonmetropolitan areas. In 2037, there is a projected shortage of 13% for RNs in nonmetropolitan areas while there is a projected shortage of 5% for RNs in metropolitan areas.

Additional workforce projections for the nursing workforce can be found in the Workforce Projections Dashboard.

Several HRSA programs support nursing. The Nurse Corps Scholarship Program pays education costs in return for a commitment to serve in a Critical Shortage Facility (CSF). The Nurse Corps Loan Repayment Program reimburses a portion of unpaid educational debt in return for serving in a CSF or as nurse faculty in an eligible nursing school. HRSA also supports over 20 nursing grant programs.

Oral health

Oral health plays an important role in the well-being of all Americans.

NCHWA projects shortages in 2037 in key oral health occupations, including:

29,740 dental hygienists

11,860 general dentists

Note: All positions are full-time equivalents (FTEs).

Those outside of metro areas face difficulties in accessing dental care, and these shortages will increase. In 2037, there is a projected shortage of 46% for dentists in nonmetro areas.

Additional workforce projections for the oral health workforce can be found in the Workforce Projections Dashboard.

Several HRSA programs support oral health. The National Health Service Corps offers scholarships and loan repayments to qualified dental clinicians. HRSA also supports oral care grant programs. Expanding these programs would help to address these future shortages.

Physicians

A well-trained, culturally competent physician workforce is vital for keeping Americans healthy. Since it can take over a decade of education and residency to prepare a physician, the United States should take steps now to address future physician shortages. NCHWA projects an overall shortage of 187,130 physicians in 2037.

This shortage includes many physician specialties, such as:

87,150 primary care physicians

8,650 cardiology physicians

9,890 OB-GYNs

8,450 anesthesiology physicians

4,050 nephrology physicians

Note: All data are expressed in full-time equivalents (FTEs).

NCHWA projects shortages across almost all specialties; 31 out of the 35 physician specialties modeled are projected to experience shortages in 2037. Residents of nonmetro areas will face the brunt of these shortages. In 2037, nonmetro areas will experience a 60% shortage of physicians; by comparison, metro areas will experience a 10% shortage.

Additional workforce projections for the physician workforce can be found in the Workforce Projections Dashboard.

HRSA programs that support physicians include:

Expanding these programs would help to address these future shortages.

Primary care

Primary care physicians are often the first contact point for a patient. NCHWA projects a shortage of 87,150 primary care physicians in 2037.

This shortage includes several types of primary care clinicians, including:

43,220 family medicine physicians

28,890 general internal medicine physicians

12,930 pediatricians

2,110 geriatricians

Note: All data are expressed in full-time equivalents (FTEs).

In 2037, nonmetro areas will experience a projected 42% shortage of primary care physicians. This shortage will make it especially difficult for Americans in nonmetro areas to find the care they deserve.

Additional workforce projections for the primary care workforce can be found in the Workforce Projections Dashboard.

HRSA programs that support primary care include:

Expanding these programs would help to address these future shortages.

Women's health

NCHWA projects a shortage of 9,890 full-time equivalent (FTE) OB-GYNs in 2037.

Shortages of OB-GYNs will be more severe in nonmetro areas. NCHWA projects a 49% shortage of OB-GYNs in nonmetro areas in 2037.

Additional workforce projections for the women's health workforce can be found in the Workforce Projections Dashboard.

HRSA programs that support women's health include:

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HRSA makes projections on the national supply of and demand for health professions by discipline to inform public policy to help prevent shortages and surpluses.

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Most of these slides relate to each other, because healthcare shortages began after the COVID19 pandemic. This is also when advances in healthcare technology started rising.

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Major measles outbreaks in the United Kingdom

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Major measles outbreaks in the United Kingdom

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After being nearly eliminated, measles has re-emerged, with England seeing significant clusters of cases in 2024 due to declining vaccination rates.

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Confirmed cases of measles in England by month, age, region and upper-tier local authority: 2025

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This report describes measles epidemiology in England from 1 January 2025.

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Re-Emerging Covid Cases in the US & Europe

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Re-Emerging Covid Cases in the US & Europe

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Research from institutions like the National Institutes of Health (NIH) and reports from the BMJ are documenting the ongoing impact of Long COVID, which causes chronic inflammation and other issues.

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Past coronavirus epidemics have also shown long-term effects. Research highlights the need for better rehabilitation and post-infection care, especially in low- and middle-income countries.

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About Middle East Respiratory Syndrome (MERS)

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Middle East Respiratory Syndrome (MERS) is a viral respiratory illness that can spread from camels t

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Climate Change in Brazil causing new diseases

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Climate Change in Brazil causing new diseases

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"With climate change, more frequent and intense rains will impact many diseases here, including schistosomiasis," said Roseli Tuan, a senior researcher at the São Paulo Secretariat of Health.

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Forecasting climate's impact on a debilitating disease

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In Brazil, climate and other human-made environmental changes threaten decades-long efforts to fight schistosomiasis, a widespread and debilitating parasitic disease. Now, researchers have developed models that can predict how the disease risk will shift in response to environmental changes.

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This article explores how dysregulation of the gut microbiome following an infection may contribute to the development of chronic conditions like Long COVID and chronic fatigue syndrome.

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These slides all relate to eachother because they are different factors in different parts around the world that have caused diseases. For example, climate change that caused new diseases to form or the MERS outbreak in the Middle East.

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Inequalities in healthcare systems in Latin America

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Inequalities in healthcare systems in Latin America

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A study in The Lancet highlighted significant fragmentation and inequality in health systems across Latin American countries, particularly affecting access to mental and preventive healthcare.

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High Costs Management of Healthcare in Italy

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High Costs Management of Healthcare in Italy

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Italy has implemented outcome-based payment models for advanced therapies to manage costs and ensure access, reflecting a different approach to reimbursement compared to the U.S.

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The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Affiliations

¹ HTA and Pharmaceutical Economics Department, Italian Medicines Agency, Via del Tritone 181, 00187, Rome, Italy. p.rivettidivalcervo@aifa.gov.it.

² HTA and Pharmaceutical Economics Department, Italian Medicines Agency, Via del Tritone 181, 00187, Rome, Italy.

Affiliations

¹ HTA and Pharmaceutical Economics Department, Italian Medicines Agency, Via del Tritone 181, 00187, Rome, Italy. p.rivettidivalcervo@aifa.gov.it.

² HTA and Pharmaceutical Economics Department, Italian Medicines Agency, Via del Tritone 181, 00187, Rome, Italy.

Abstract

Background: Advanced therapy medicinal products (ATMPs) are an innovative output of biomedical research, characterized by a high level of uncertainty on long-term efficacy and safety, elevated price tags and often complex administration. All these elements compounded make their European authorization, national price negotiation for reimbursement and subsequent dispensation and administration to the patient less straightforward and often less successful than for less innovative drugs. To assess if these hurdles have affected patient access and how are ATMPs used in Italy, we have analysed availability, access and expenditure of ATMPs in the period spanning from 2016 to 2023.

Methods: We have analysed real world data on the duration of ATMP regulatory evaluations for authorisation and reimbursement, time to first patient access and expenditure for ATMPs through the Italian National Health System (INHS) expenditure data flow, as well as information on patient mobility and availability of health facilities specialized in administering ATMPs.

Findings: Of the 18 ATMPs currently authorized in Europe, 9 are reimbursed by the INHS, but only 6 were actually used, generating a cumulative expenditure of roughly 300 Mln€ from 2016 to 2023, largely owing to CAR-T therapies. Time to patient access reaches an average of 340.6 days from the day publication in the official Gazette of the reimbursement decision to first patient treatment in one of the 107 health facilities authorized for ATMP administration, after an even longer evaluation time by regulatory agencies.

Conclusion: Since the first reimbursement decision for an ATMP in Italy, back in 2016, these innovative drugs became progressively more and more available, both in terms of numbers and in terms of coverage across the country. Almost all Italian regions have at least one centre for ATMP administration and has performed a treatment in 2023. Notwithstanding their high per-treatment prices, ATMPs currently have a rather contained expenditure, however it is bound to keep growing in the next few years.

PubMed Disclaimer

Conflict of interest statement

None declared.

F.T. and P.R.d.V.C.: study design, data interpretation, writing; P.R.d.V.C., A.E., M.L. and A.L.G. data collection, analysis and interpretation; P.R.d.V.C., M.L. and A.E.: manuscript drafting; F.T.: team supervision and manuscript editing. All authors read and approved the final manuscript and declare no conflicts of interest. The views expressed in this article are the personal views of the authors and may not be understood or quoted as being made on behalf of or reflecting the position of their institutional affiliation.

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Comparison of regulatory pathways for the approval of advanced therapies in the European Union and the United States.

Iglesias-Lopez C, Obach M, Vallano A, Agustí A. Iglesias-Lopez C, et al. Cytotherapy. 2021 Mar;23(3):261-274. doi: 10.1016/j.jcyt.2020.11.008. Epub 2021 Jan 19. Cytotherapy. 2021. PMID: 33483292

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health expenditures* / statistics & numerical data

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national center for biotechnology information

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Advanced Therapy Medicinal Products: Availability, Access and Expenditure in Italy - PubMed

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Since the first reimbursement decision for an ATMP in Italy, back in 2016, these innovative drugs became progressively more and more available, both in terms of numbers and in terms of coverage across the country. Almost all Italian regions have at least one centre for ATMP administration and has pe ...

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These two slides relate to each other because they have to do with Inequalities in healthcare systems whether it's here in America or Europe. These inequalities have to do with high healthcare costs. For example, someone might not be able to afford the high Costs of healthcare in Italy.

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A group of scientists in Japan have discovered that fermented stevia, a plant commonly used as a calorie-free sweetener, may hold intriguing anti cancer properties.

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From sweetener to cancer fighter? Fermented stevia shows promise in pancreatic cancer study

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Fermented stevia may kill pancreatic cancer cells while leaving healthy cells unharmed.

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''During 2024, about 85% of infants worldwide (109 million) received 3 doses of diphtheria-tetanus-pertussis (DTP3) vaccine, protecting them against infectious diseases that can cause serious illness and disability or be fatal. However, these global figures hide significant disparity among countries of different income strata, with low-income countries lagging behind.''

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Fact sheet from WHO on immunization coverage: provides key facts and information about recommended vaccines, key challenges and WHO response.

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Verifying you are human. This may take a few seconds.

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"Hepatitis B is still a major worldwide public health problem. Globally, 296 million people are estimated to be chronic carriers of hepatitis B virus (HBV), with approximately 820,000 deaths per year."

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Hepatitis B Vaccination: A Historical Overview with a Focus on the Italian Achievements

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Vaccination is the most effective way to control and prevent acute and chronic hepatitis B, including cirrhosis and HCC, on a global scale. According to WHO recommendations, 190 countries in the world have introduced hepatitis B vaccination into…

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Find out more about the COVID-19 pandemic, COVID-19 tests, COVID-19 treatments, mRNA research and COVID-19 vaccines.

2019

A new coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is found in China. The SARS-CoV-2 virus causes coronavirus disease 2019 (COVID-19). WHO will declare the COVID-19 outbreak a pandemic in 2020. WHO and CDC issue recommendations for preventing and treating COVID-19. By January 2021, COVID-19 will cause about 2.5 million deaths worldwide.

2020

Many COVID-19 vaccine clinical trials are in process. Researchers take what was previously learned from vaccine studies of SARS-CoV, MERS-CoV and other viruses to develop vaccines that prevent COVID-19. Researchers also study COVID-19 symptoms, long-term effects, diagnostic tests, antibody tests, treatments and drugs.

Mayo Clinic researchers study and develop a COVID-19 diagnostic test, an antibody test, monoclonal antibody medications, convalescent plasma therapy and vaccines.

COVID-19 vaccines

The FDA gives emergency use authorization to two mRNA COVID-19 vaccines, the Pfizer-BioNTech and the Moderna COVID-19 vaccines. Because there is an urgent need for COVID-19 vaccines and the FDA's vaccine approval process can take months to years, the FDA first gave emergency use authorization to COVID-19 vaccines based on less data than is normally required. The data must show that the vaccines are safe and effective before the FDA can give emergency use authorization or approval. Vaccines have gone through - and continue to go through - extensive safety monitoring. Millions of COVID-19 vaccines have been given since December 2020.

Researchers at Mayo Clinic and other medical centers continue to study more vaccines that prevent COVID-19.

2021

The FDA gives emergency use authorization to the Janssen/Johnson & Johnson COVID-19 vaccine. The FDA approves the Pfizer-BioNTech COVID-19 vaccine, now called Comirnaty, to prevent COVID-19 in people age 16 and older. The FDA also authorizes the Pfizer-BioNTech vaccine for children ages 5 through 15. Researchers continue to study and develop several other COVID-19 vaccines. Many COVID-19 vaccines are in clinical trials.

Learn more about COVID-19 updates during the COVID-19 pandemic

Learn more about COVID-19 vaccines

Learn more about COVID-19 vaccines and kids

Learn more about COVID-19 treatment

Learn more about COVID-19 tests

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History of COVID-19: Outbreaks and Vaccine Timeline

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Learn about the COVID-19 pandemic as well as mRNA research, COVID-19 tests and treatments, and COVID-19 vaccine development and approval.

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These slides most directly relate to each other. Whether it has to do with vaccines or the pandemic. For example, we found a vaccine for covid-19

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Why is there a shortage of healthcare workers in the United States?

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What are some new or re-emerging diseases (and if re-emerging why are they re-emerging?)

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There are many rising issues in healthcare, whether its healthcare staff shortages to emerging diseases. Some of the benefits to issues is healthcare technology advances. For example, telemedicine or EHRs(Electronic Health Records). Some downsides are healthcare affordability or patient care.