Hepatitis C virus. The hepatitis B virus has significant differences compared to the C virus, including differences in the protein envelope and DNA versus hep C’s RNA genome. Credit: Scientific Animations CC4.0
In an editorial published in the New England Journal of Medicine, University of Michigan Health hepatologist Anna S. Lok, MD, hails newly announced results of the B-Well clinical trials as “a major step toward a functional cure for hepatitis B virus infection.”
The results, published concurrently in NEJM, report that 20% and 19% of patients in two duplicate clinical trials achieved a functional cure for their chronic hepatitis B infections following 24 weeks of bepirovirsen (versus 0% of the placebo groups).
The lead and corresponding author of the trial results is Jinlin Hou, M.D., Chairman and Professor of the Hepatology Unit and Department of Infectious Diseases, Southern Medical University in Guangzhou, China.
The University of Michigan Health did not participate in these clinical trials.
The most common treatment for chronic hepatitis B infection, nucleoside or nucleotide analogue (NA) therapy, can successfully suppress hepatitis B virus replication – reducing the risk of cirrhosis and cancer – but is rarely curative, and most patients will relapse if treatment is discontinued before hepatitis B surface antigen loss.
In 2016, Lok led the first meeting among the US Food and Drug Administration, European Medicine Agency, American Association for the Study of Liver Diseases, European Association for the Study of the Liver, and experts in academia and industry to discuss definition and paths towards a cure for hepatitis B.
This group of experts recommended that functional cure of hepatitis B should be defined as undetectable hepatitis B surface antigen and hepatitis B virus DNA at least 24 weeks after completing a finite course of treatment. During the past 10 years, many clinical trials testing different combinations of antiviral and immunomodulatory agents have been evaluated but only one phase 3 trial has been completed so far.
In these latest phase 3 clinical trials, 24% of the patients taking bepirovirsen were able to discontinue NA therapy, compared to zero patients in the placebo groups, and none of the patients who discontinued NA therapy including a few who failed to achieve functional cure had clinical relapse.
Although these trials were conducted in highly selected patients and the results may not be generalizable to other patients with chronic hepatitis B — and side effects were more common among the patients who received bepirovirsen — they are encouraging and represent a major step towards a cure for hepatitis B. Lok hopes the results of these trials will encourage testing of other combinations that are safe and can lead to higher rates of functional cure in broader patient populations.
A renowned researcher into the natural history and treatment of hepatitis B, Lok co-authored every edition of the American Association for the Study of the Liver Diseases Guidelines on hepatitis B since 2001 and the first World Health Organization guideline on the condition in 2015.
Earlier this month, she was the senior author on a review of the current state of global hepatitis B virus prevention and treatment, published in JAMA.
The study, published in Jama Open Network, found naloxone administration during resuscitation by emergency medical service (EMS) personnel was associated with improved outcomes in patients with suspected OA-OHCA.
“This study provides important real-world evidence that naloxone may offer benefit even after cardiac arrest has occurred.”
David Dillon, study author
What the data shows
For this retrospective cohort study (looking back at existing patient records), researchers collected data from the California Resuscitation Outcomes Consortium between 2021 and 2022. In total, 3811 patients with suspected OHCA were treated by EMS.
Researchers found that people who received naloxone, a medication better known for reversing opioid overdoses, had higher rates of survival from the time they were treated by EMS to the time they were discharged from the hospital. The patients also benefitted from return of spontaneous circulation (ROSC) and favourable neurological outcomes compared to those who did not receive the drug.
The key findings included:
Survival to hospital discharge was higher among those receiving naloxone (8.1%) compared to those who did not (4.4%).
Naloxone use was associated with a 2.8% absolute increase in survival, after accounting for patient and clinical factors.
People treated with naloxone had improved neurologic outcomes (+3.2%) and ROSC (+3.3%).
Benefits were even greater among those with EMS-suspected drug-related cardiac arrest, with survival improvements approaching 8–9%.
The study also found that the association between naloxone and improved outcomes was weakened in certain situations – particularly among patients who required epinephrine during resuscitation. This suggests that timing, patient condition or resuscitation complexity may influence effectiveness.
Addressing a critical gap
Opioid overdose deaths in the United States have surged over the past two decades, contributing to a growing number of cardiac arrests outside the hospital. While naloxone is widely used to reverse opioid overdoses, its role during cardiac arrest has remained unclear and is identified by the American Heart Association as a key evidence gap.
“This study provides important real-world evidence that naloxone may offer benefit even after cardiac arrest has occurred,” said David Dillon, assistant professor of emergency medicine at UC Davis Health and one of the study’s authors. “While these findings are promising, randomised controlled trials are needed to determine whether naloxone directly improves survival in opioid-associated cardiac arrest.”
3D structure of a melanoma cell derived by ion abrasion scanning electron microscopy. Credit: Sriram Subramaniam/ National Cancer Institute
The combination of a vaccine and a drug, which both harness the immune system to attack cancer cells, has proven successful in cutting the risk of skin cancer recurrence by 49% , a new study shows. This reduction, which was calculated five years after patients had their tumours surgically removed, remains unchanged.
Led by researchers at NYU Langone Health and its Perlmutter Cancer Center, the study tested the vaccine, called intismeran, in combination with the mainstay immunotherapy pembrolizumab (Keytruda) in 107 patients who had been randomly chosen after melanoma surgery to determine whether the combination therapy prevented their cancer from recurring. Intismeran is a personalized immunotherapy strategy that is developed with information from a patient’s individual tumour. These results were compared with those from a randomly selected group of 50 melanoma patients who had only received pembrolizumab postoperatively, a current standard of care.
Results of the phase 2b trial, known formally as KEYNOTE-942, are being presented at the 2026 annual meeting of the American Society of Clinical Oncology on June 1 in Chicago and simultaneously published in the society’s Journal of Clinical Oncology.
After five years of follow-up, 68.8% of patients who took the combination therapy remained cancer-free, while 49.1% of the patients in the pembrolizumab-alone group had no signs of cancer. This means that adding intismeran to pembrolizumab reduced the risk for recurrence or death by 49%. The combination therapy also reduced the risk of distant metastasis by 59%. Overall survival, meaning no death from cancer or any other cause, was 92.2%for the vaccine with immunotherapy group, while for the immunotherapy-alone group it was 71.3%.
“Our study offers strong evidence to melanoma patients that intismeran vaccine therapy, when used in combination with immunotherapy, can demonstrably reduce their risk of having their cancer return and improve clinical outcomes,” said study senior investigator Janice Mehnert, MD, a professor in the Department of Medicine at NYU Grossman School of Medicine.
“Our findings also serve as encouragement to cancer researchers globally that mRNA vaccines like intismeran could work well in combination with immunotherapy for other cancers whose high rates of mutations have proven difficult to target,” said Dr Mehnert, who also serves as director of the melanoma medical oncology program and associate director of clinical research at Perlmutter Cancer Center.
The study results highlight the role of T cells, which are capable of attacking viruses as well as cancers. To spare normal cells, the immune system uses checkpoint molecules on T cell surfaces to “turn off” their attack against viruses when they clear the infection. The body may recognide tumours as abnormal, but cancer cells hijack checkpoints to turn off and evade immune responses. Immunotherapies like pembrolizumab seek to block checkpoints, specifically the PD-1 protein receptor, making cancer cells more “visible” and vulnerable again to immune cells.
Immunotherapies, including PD-1 inhibitors like pembrolizumab, have become the mainstay for treating melanoma, although they do not work for all patients, because melanoma cells, known for their ability to evade the immune system, can become resistant to immunotherapy. For this reason, researchers have looked at adding vaccines.
The vaccine intismeran is based on messenger RNA, a chemical cousin of DNA that provides cells with instructions for making proteins. Intismeran and other mRNA cancer vaccines are meant to teach the immune system to recognize cancer cells as different from normal cells. In designing a vaccine against melanoma, researchers attempted to trigger an immune response to specific abnormal proteins, called neoantigens, made by cancer cells.
Because the study volunteers all had their tumours removed, researchers were able to analyse their cells for 34 neoantigens that were specific to each melanoma and create a personalised vaccine for each patient. As a result, T cells specific to the neoantigen proteins encoded by the mRNA were produced. Those T cells could then attack any melanoma cells trying to grow or spread.
Dr. Mehnert said that a phase 3, multicenter trial is already underway to determine if intismeran helps as a first-line therapy in combination with pembrolizumab for melanoma. Already, the vaccine is being tested to see if it also works to prevent recurrence of lung and other cancers.
For the KEYNOTE-942 trial, patients were enrolled at cancer centers in Australia and the United States from 2019 to 2021. All were men and women who had had surgery to remove their melanoma tumors. Seven patients in each treatment group died during follow-up, most from cancer. Side effects were considered manageable and included fatigue, pain at injection sites, and chills.
Eating foods that contain common preservative food additives may increase the risks of high blood pressure and cardiovascular disease, according to research published in the European Heart Journal.
The research was led by Dr Mathilde Touvier, a research director at INSERM (the French National Institute for Health and Medical Research), and Anaïs Hasenböhler, PhD student, both from the Nutritional Epidemiology Research Team at the Université Sorbonne Paris Nord and Université Paris Cité, France.
Ms Hasenböhler said: “Food preservatives are used in hundreds of thousands of industrially processed foods. Experimental studies suggest that some preservative food additives may be harmful to cardiovascular health, but we have not had enough evidence on the impact of these ingredients in humans. As far as we know, this is the first study of its kind to investigate the links between a wide range of preservatives and cardiovascular health.”
The research is part of a larger study, called NutriNet-Santé, and included 112 395 volunteers from across France. Every six months, the volunteers told researchers everything they ate and drank over a period of three days.
Researchers carried out detailed analyses of the ingredients of all the food and drink, including any preservatives. They also tracked the volunteers’ health for an average of seven to eight years to see if they developed high blood pressure or any cardiovascular disease.
Researchers found that 99.5% of the volunteers had consumed at least one food preservative within the first two years of taking part.
Overall, they found that people who ate the largest amounts of ‘non-antioxidant’ preservatives had a 29% higher risk of hypertension, compared to those who ate the least, and a 16% higher risk of cardiovascular disease, including heart attack, stroke and angina. People who ate the most antioxidant preservatives had a 22% higher risk of hypertension. Non-antioxidant preservatives are designed to stop harmful microbes, such as mould and bacteria, from growing, whereas antioxidant preservatives are designed to stop oxidation, which means the food will not turn brown or become rancid.
Researchers also looked at 17 of the most commonly eaten preservatives and found that eight of these were specifically linked to high blood pressure. These were: potassium sorbate (E202), potassium metabisulphite (E224), sodium nitrite (E250), ascorbic acid (E300), sodium ascorbate (E301), sodium erythorbate (E316), citric acid (E330) and extracts of rosemary (E392). Ascorbic acid (E300) was also specifically linked to cardiovascular disease.
Dr Touvier added: “This study has some limitations inherent to its observational design. However, the findings are based on highly detailed data, and we have taken account of other factors that can increase or lower the risk of cardiovascular disease. Experimental research in the literature consistently suggested that preservatives may cause oxidative stress in the body or affect the way the pancreas works.
These results suggest we need a re-evaluation of the risks and benefits of these food additives by the authorities in charge, such as the EFSA in Europe and the FDA in the USA, for better consumer protection. In the meantime, these findings support existing recommendations to favour non-processed and minimally processed foods, and avoid unnecessary additives. Doctors and other healthcare professionals play a key role in explaining these recommendations to the public.”
The researchers are now looking at how food additives and ultra-processed foods may affect signs of inflammation, oxidative stress, metabolic profile in the blood and the composition of the gut microbiota. This may help them to understand why additives may increase the risks of disease.
Study finds postpartum psychosis is strongly influenced by genetics and reveals links to cholesterol metabolism, immune biology, and psychiatric disorders
Researchers at the Icahn School of Medicine at Mount Sinai have uncovered a substantial genetic component to postpartum psychosis, a rare but severe psychiatric illness that occurs in the days to weeks after childbirth. The findings, published May 14 in Molecular Psychiatry, provide new evidence that the condition has a substantial biological and genetic basis and may help guide future research into prediction, prevention, and treatment.
The study, which combined whole genome sequencing with population-level family data, identified rare damaging mutations in the gene HMGCR as associated with increased risk for postpartum psychosis. The researchers also found significant genetic overlap between postpartum psychosis and bipolar disorder, schizophrenia, and several autoimmune diseases, including rheumatoid arthritis, Sjögren’s syndrome, myasthenia gravis, and Crohn’s disease.
Postpartum psychosis affects approximately 1 in 1000 mothers and is considered a psychiatric emergency because of the elevated risk of suicide and infanticide. Symptoms can include delusions, hallucinations, severe mood changes, confusion, and disorganised behaviour.
“Our findings show that postpartum psychosis is a biological illness with a substantial genetic basis,” said Behrang Mahjani, PhD, Assistant Professor in the Departments of Psychiatry, Genetics and Genomic Sciences and Artificial Intelligence and Human Health at the Icahn School of Medicine and senior author of the paper. “It is not a parenting failure or a personal weakness, and women affected by it deserve the same medical seriousness afforded to other severe illnesses.”
This condition has historically been understudied, particularly at the genetic level, and we hope these results help move the field toward a more mechanistic understanding of why some women become vulnerable during the postpartum period.”
The study estimated that approximately 55 percent of risk for postpartum psychosis is attributable to inherited genetic factors based on family data, while whole genome sequencing analyses estimated heritability from common genetic variants at approximately 46 percent.
Researchers were particularly surprised by the identification of HMGCR, which encodes the rate-limiting enzyme in cholesterol biosynthesis. The study also revealed broader-than-expected overlap between postpartum psychosis and immune-related conditions. Researchers say the findings are consistent with longstanding clinical observations that autoimmune disease activity often changes during the postpartum period and suggest that immune biology may play a role in the illness.
“Cholesterol biosynthesis was not a pathway we had anticipated, but once HMGCR emerged, the biology became highly coherent in light of the changing dynamics of cholesterol during and after pregnancy, because cholesterol serves as the precursor for steroid hormone synthesis and prior reports linking low serum cholesterol to first episode psychosis and suicidal behaviour,” said Dr Mahjani. “The postpartum period is marked by dramatic hormonal and metabolic shifts, and this gene sits directly within pathways affected during that transition.”
The research, with analyses performed by Seulgi Jung, PhD, a postdoctoral fellow in the Mahjani Lab at Mount Sinai, is the first study to apply whole genome sequencing to postpartum psychosis, allowing investigators to examine rare damaging mutations across the genome rather than focusing solely on common genetic risk variants. The team combined data from Swedish national health registers with genomic information from the National Institutes of Health’s All of Us Research Program, enabling researchers to study one of psychiatry’s rarest and least understood conditions at an unprecedented scale.
“It is important to understand that multiple genes are involved in postpartum psychosis and that HMGCR can be used as a research tool for further scientific discovery,” said Veerle Bergink, MD, PhD, Director of the Women’s Mental Health Research Center at Mount Sinai and an author of the paper.
Future work will focus on expanding sample sizes and improving ancestral diversity. The team is now pursuing functional studies of HMGCR and other candidate genes in neuronal and immune cell models relevant to pregnancy and the postpartum period. Researchers also plan to integrate genetic findings with hormonal and immunological changes associated with childbirth to better understand why the illness emerges during such a tightly defined window.
“In the long term, our goal is to understand postpartum psychosis well enough to predict it, prevent it where possible, and develop treatments that target the underlying biology rather than symptoms alone,” said Dr Bergink.
The investigators also emphasized the importance of large-scale collaborative research infrastructure in enabling discoveries for rare conditions.
“This work would not have been possible without the NIH’s All of Us Research Program and the participants who contributed their data,” said Dr. Mahjani. “For rare and historically neglected illnesses such as postpartum psychosis, equitable access to large genomic datasets is essential for scientific progress.”
A plant long used in traditional medicine is now at the centre of research that could shape future cancer treatment options in South Africa and beyond.
Researchers at the North-West University(NWU) are investigating the anti-cancer potential of Lessertia frutescens, commonly known as cancer bush, after laboratory studies showed activity against several forms of cancer, including drug-resistant small cell lung cancer and colorectal cancer.
According to Prof Chrisna Gouws, a research professor in the Centre of Excellence for Pharmaceutical Sciences in the Faculty of Health Sciences, the research team tested extracts from the indigenous plant on cultured human cancer cells and more advanced laboratory-grown “mini-tumours” known as spheroids.
“Lessertia frutescens has shown significant anticancer activity against several different cancer types in our research,” she says.
Targeting cancers considered incurable
She says the findings became more important when the team observed activity in cancers that no longer respond to conventional treatment.
“What is very interesting and exciting is the apparent activity in drug-resistant cancers such as resistant small cell lung cancer where known chemotherapies have limited to no activity,” Prof. Gouws says.
“This provides us with new avenues to investigate for treatment options to treat cancers currently considered incurable.”
The research team said another factor attracting attention is the plant’s longstanding use in traditional medicine and its safety profile.
“An important consideration is that this plant has a long history of use and is considered non-toxic and safe for use,” Prof. Gouws says.
“It’s anticancer activity comes without the significant side-effects known to occur with most standard chemotherapies.”
Other systems in the body may benefit
Researchers also found that the plant may support other systems in the body during treatment.
“Lessertia has known boosting effects for the digestive and immune systems, and it can have mood-enhancing activities as well,” she says.
“It may therefore not only target the cancer but positively impact the patient as a whole at the same time.”
The team is now studying the plant’s phytochemicals to identify the molecules responsible for the anticancer activity and understand how they work.
“Although many molecules have been identified and shown to contribute to the anticancer activity of the plant, the mechanism of action remains mostly unclear,” says Prof. Gouws.
“We are therefore delving deeper now to try and understand how and why this plant works.”
The next phase of the study will include animal model testing later this year to confirm safety and efficacy before future clinical trials can be considered.
At the same time, the researchers are developing a complementary medicine product that may be available in pharmacies by 2027.
Prof. Gouws says the project could also create economic opportunities.
“Chemotherapy can be very expensive and inaccessible in rural areas. A new plant-based treatment will be much more cost-effective and may be more accessible because it can be manufactured locally,” she says. “An increase in demand for the plant material will also create economic opportunities through farming.”
More about Prof Chrisna Gouws
Prof Gouws leads the strategic project for Human-Based New Approach Methodologies for Biomedical Research. She holds a PhD in biochemistry and has more than 15 years’ experience in utilising cell culture-based models for human health and disease research, including developing new complex in vitro models for applications in drug research, including traditional medicinal remedies and plant materials for cancer treatment.
She is the founder and executive committee chair for the Society for Advanced Cell Culture Modelling for Africa, a board member of International Microphysiological Systems Society, and co-editor of the NAM Journal.
Patients with vitamin D deficiency may benefit from supplements before operations
Photo by Tima Miroshnichenko on Pexels
Vitamin D deficiency is associated with more moderate to severe pain following breast cancer surgery and an increased consumption of opioid drugs, finds research published online in the journal Regional Anesthesia & Pain Medicine. Breast cancer patients with low levels of vitamin D (below 30nmol/L) may benefit from taking supplements before undergoing a radical mastectomy, suggest researchers.
There is emerging evidence suggesting that vitamin D helps control how pain is felt and processed by the body. This is likely due to its anti-inflammatory effects and action on the immune system. Vitamin D deficiency is also commonly reported among patients with breast cancer. A team of researchers set out to examine the relationship between vitamin D deficiency and postoperative pain in patients undergoing breast cancer surgery.
Their prospective observational study, carried out at Fayoum University Hospital in Egypt between September 2024 and April 2025, included 184 breast cancer patients who were scheduled to undergo surgical removal of one entire breast.
Half of the patients were classified as vitamin D deficient (below 30 nmol/L) and half were classified as vitamin D sufficient (above 30nmol/L). Both groups had similar characteristics with an average age of 44 in the vitamin D deficient group and 42 in the vitamin D sufficient group.
Patients were managed according to the hospital’s routine protocol both during and after surgery. Clinical staff involved in their care were unaware of the patients’ vitamin D levels.
The opioid fentanyl was administered during the operation to manage acute pain. Following surgery, all patients were given paracetamol through a drip every 8 hours. In addition, patients could control how much tramadol (another opioid analgesic) they were given by directly pressing a button.
Patients reported their pain levels at zero, 6 hours, 12 hours, 18 hours and 24 hours after surgery. Nausea and vomiting, sedation score and days in hospital following surgery were also recorded.
Patients with vitamin D deficiency were three times more likely to report moderate to severe postoperative pain at any time point during the first 24 hours than those with sufficient vitamin D levels, the study found.
The researchers noted, however, that no patient in either group reported severe pain (7 or over on a scale of 0 to 10) so the difference was due entirely to a reduction in moderate pain (4-6 on the pain scale).
Vitamin D deficient patients received, on average, 8 μg more fentanyl during surgery, which the researchers described as a modest difference.
However, the study found those in the vitamin D deficient group used substantially more tramadol (112mg) after surgery than those who had sufficient vitamin D levels. This strong opioid was controlled directly by the patient up to a maximum dose of 50mg per hour.
Opioid drugs can cause a number of side effects including nausea, vomiting, drowsiness and confusion, while also carrying risks of dependency and addiction.
Postoperative nausea was more common in the vitamin D deficient group, and vomiting occurred only in that group, although the difference in vomiting was small and not statistically significant.
The study had some limitations. It was observational and conducted at a single centre, so no firm conclusion can be drawn about cause and effect. The researchers also did not assess inflammatory markers so could not explore the mechanisms underlying the relationship between vitamin D and pain. Data was also not collected on anxiety, depression, cancer stage, treatment or sleep disturbance before the surgery was carried out.
Nevertheless, the researchers conclude, “Vitamin D deficiency is associated with a higher occurrence of moderate to severe postoperative pain and increased opioid consumption in patients undergoing unilateral modified radical mastectomy.”
They suggest, “Preoperative vitamin D supplementation in breast cancer patients with vitamin D levels below 30 nmol/L may have a role in modulating postoperative pain.”
Johannesburg, 1 June 2026 – As the world prepares to commemorate World Blood Donor Day on 14 June, the South African National Blood Service (SANBS) is honouring the thousands of South Africans whose selfless blood donations continue to save lives every day.
Recognising June as a globally significant month for blood donor awareness, SANBS is proud to launch its bold new campaign, “Be The Lifeline – Give Blood. Give A Tomorrow.” The campaign forms part of this year’s World Blood Donor Day observance. It marks a dual milestone: celebrating 25 years of SANBS as a trusted lifeline for the nation, while paying tribute to the ordinary South Africans who have become extraordinary lifelines for patients and families across the country.
For SANBS, the campaign is a powerful reminder that behind every unit of blood donated is a future still unfolding.
From mothers safely holding their newborn babies for the first time, to accident victims receiving urgent emergency care, cancer patients continuing treatment, and children overcoming life-threatening illnesses, blood donors are the unseen force helping to protect countless tomorrows.
A tomorrow where a young adult learns to drive and experiences independence for the first time.
A tomorrow where a small business owner opens the doors to their first coffee shop.
A tomorrow where a child nervously walks into their first day of school.
Each moment made possible because someone chose to give blood.
According to SANBS CEO, Ravi Reddy, World Blood Donor Day serves as a powerful reminder of the impact of every donation.
“For 25 years, South Africans have consistently shown extraordinary generosity through blood donation. Every donor who walks through our doors becomes part of someone else’s tomorrow,” says Reddy. SANBS Reputation and Communication Manager, Sifiso Khoza, echoed this sentiment, highlighting the life-saving power of a single donation.
“World Blood Donor Day reminds us that behind every successful transfusion is a donor who chose to help someone they may never meet,” says Khoza. “Blood donation is one of the most powerful acts of humanity because a single donation can save multiple lives.”
This year’s campaign places a strong emphasis on trust, gratitude and recognition, honouring long-standing donors who have supported SANBS over the years, while encouraging more South Africans – particularly younger generations – to become regular blood donors.
Through the “Be The Lifeline” campaign, SANBS will spotlight real stories of donors, recipients, and healthcare workers whose lives have been transformed through blood donation, reinforcing the deeply human impact behind every unit collected.
Reddy says the organisation’s 25-year milestone extends beyond reflection, serving as a tribute to the millions of South Africans who have contributed to sustaining a reliable national blood supply. “We are deeply grateful to every donor who continues to choose compassion, kindness, and community through blood donation. Their contributions have helped SANBS remain a trusted lifeline for South Africans for the past 25 years,” he says.
As part of World Blood Donor Day, SANBS is calling on all eligible South Africans to join this life-saving legacy by donating blood and helping secure millions of tomorrows for patients in need.
“Blood cannot be manufactured. It can only come from people willing to give a part of themselves to save another life,” adds Khoza. “This World Blood Donor Day, we encourage South Africans to continue being the lifeline that so many patients depend on every day.”
As the news spread about the outbreak of Ebola in mid-May 2026, the World Health Organization (WHO) released a report about pandemics. The title was: A World on the Edge: Priorities for a Pandemic-Resilient Future.
The document was prepared by the WHO’s Global Preparedness Monitoring Board. It sets out why the world isn’t better prepared for pandemics a decade after Ebola exposed dangerous gaps. And six years after COVID-19 turned those gaps into a global catastrophe.
It adds that investment in pandemic preparedness has not kept pace with the rising risk of pandemics.
The Global Preparedness Monitoring Board is an independent monitoring and accountability body established in 2018 by the WHO and the World Bank. The aim was to strengthen preparedness for global health crises. It is composed of political leaders, agency principals and world-class experts. Its task is to provide assessments of global progress in building and sustaining the capacity to prevent, detect and respond to health emergencies.
The report was released during another Ebola epidemic. This time starting in the Democratic Republic of Congo. On 17 May the WHO declared the outbreak a public health emergency of international concern. This means that it is a risk to many countries through international spread and hence requires global coordinated efforts.
As a virologist and former global health administrator, I believe the monitoring board’s diagnosis and recommendations are vitally important for managing pandemics.
My first observation about the report is that its recommendations remain largely unimplemented by many countries. This is particularly true in Africa, where pandemics thrive and disease epidemics rage and ravage.
Africa needs to specially build trust in its own ability to prepare for and prevent disease outbreaks, and control them when they do occur.
To achieve this, and in line with the recommendations, Africa must sustain:
independent pandemic risk monitoring
health workforce capability and retention
equitable access to countermeasures such as vaccines
financing
political attention.
Independent pandemic risk monitoring
Using local resources and financing, African countries must own the solution to health through establishing data systems that uphold health sovereignty.
They must also ensure that data derived from surveillance, research and pathogen processing are securely managed and accountable to African institutions rather than foreign entities. Recent agreements with the US have brought this issue to the fore. Some were asking African countries to sign away their health data or prodigally release their precious pathogens in a barter exchange for donor funding.
But health data are an invaluable asset for public health, clinical management and research. They help countries identify diseases and develop vaccines and treatments.
What African countries should be doing instead is mobilising locally sourced counterpart funds. These should be used to create the local environment to support and enhance the capacity of indigenous scientists and researchers to develop innovations from national/natural pathogens for global benefits.
Two African health institutions should be at the centre of these endeavours: the WHO-Africa Region and the Africa Centers for Disease Control, an agency of the African Union. They must not compete, but collaborate and spearhead these efforts through centralised disease control and tracking scorecards.
Health workers
Fostering the well-being of health workforce results in growth, higher productivity, national pride and loyalty.
It also helps in long-term retention of health workers.
African countries need to prioritise capacity retention over capacity building. They must build and sustain a conducive work environment which involves physical workspace and psychological safety.
Availability of adequate resources is needed to function effectively and productively. This includes materials, laboratory facilities, supplies, reagents and consumables for a trained African health workforce and researchers.
Under such enabling conditions, the health workforce can focus on relevant and local health issues and find appropriate solutions to them.
Equitable access to countermeasures
Africa must not compromise on the ratification of international health pacts that guarantee fair technology transfer, intellectual property waivers, and robust regional manufacturing.
Countries must equally expand local production of laboratory diagnostic kits, vaccines and medical supplies as well as non-medical products. Such include gloves, personal protective equipment and masks.
This will reduce reliance on external donation and supply chains in and out of global crises.
Sustainable financing
The greater challenge for many African countries is the waste of available resources and spending on misplaced priorities.
To address this, governments must commit to sustained domestic investment in healthcare. At the same time they must use blended financing (involving both the public and private sectors) to close remaining gaps. Initiatives such as the African Epidemic Fund offer a practical model for building financial reserves for rapid, locally led responses. The fund, launched in 2025, is designed to mobilise funding to support preparedness and response efforts to combat public health threats on the continent. The African Epidemic Fund, though relatively new, must operate at the highest level of accountability. It must provide regular updates on contributions, projects supported and their impact on disease preparedness, prevention and control in Africa.
Sustained political attention
African leaders must keep pandemic preparedness high on the political agenda to ensure continuous resource allocation and accountability. The advocacy for preparedness must go beyond political campaign slogans. It must be driven by regional bodies like the African Union. Countries must then translate commitments into tangible national policies.
There can be no recess or holiday from pandemic preparedness.
African political leaders and elites, at the continental, national and sub-national levels, have crucial roles to play in achieving trusted community engagement and involvement for successful and reliable pandemic preparedness. Above all, there must be active community engagement and involvement.
Killer T cells surround a cancer cell. Credit: Alex Ritter, Jennifer Lippincott Schwartz and Gillian Griffiths, National Institutes of Health (CC BY 2.0).
Like fireflies and many deep-sea creatures, certain fungi can naturally emit light through bioluminescence pathways in which specialised enzymes convert chemical energy into visible light. Medical researchers have used fungal light-producing enzymes in the Fungal Bioluminescence Pathway (FBP) to visually track processes like tumour progression and inflammatory responses. New research published in The FEBS Journal provides insights that may help improve and expand such bioluminescence-based tools and applications.
One of the products of the FBP is oxyluciferin, which in fungi is subsequently degraded and recycled back into the pathway, sustaining the bioluminescent process. Previous studies have suggested a role for the caffeylpyruvate hydrolase (CPH), the last of four enzymes involved in the FBP, in breaking down oxyluciferin, but results have been inconclusive. In this latest study, investigators characterised CPH from one of the largest and brightest bioluminescent fungal species described to date, confirming that the enzyme converts oxyluciferin into caffeic and pyruvic acids. Caffeic acid can re-enter the pathway to sustain light emission, while pyruvic acid may be redirected into central metabolism to help generate cellular energy, potentially reducing the energetic cost of bioluminescence. The scientists also developed a new method to monitor CPH activity, thereby providing a useful resource for further studies on bioluminescence.
The findings could be used to develop self-sustained light-emitting systems in other organisms, with potential applications across medicine, agriculture, environmental monitoring, and biotechnology.
“After eight years of work, we were finally able to demonstrate that the breakdown of fungal oxyluciferin by CPH produces caffeic acid and pyruvic acid. This finding helps explain how fungi sustain bioluminescence through metabolite recycling while potentially recovering part of the energy invested in light emission,” said co–corresponding author Cassius V. Stevani, PhD, of the University of São Paulo, in Brazil. “It also provides important insights for the design of engineered cells capable of emitting brighter light in a more efficient and sustainable way.”
