Author: Peter Van Dyk

Categories : Expert Opinion Healthcare Politics and RegulationsTags :

The Global Fund to Fight AIDS, Tuberculosis and Malaria Should Step up Efforts

On By Peter Van Dyk
Photo by Towfiqu barbhuiya on Unsplash

The international community must protect global responses to HIV, tuberculosis (TB), and malaria to serve humanity’s collective interests, according to an opinion article published May 14, 2025, in the open-access journal PLOS Global Public Health by Gorik Ooms from the Institute of Tropical Medicine, Belgium, and colleagues.

Within days of starting his second term as President, Donald Trump ended most United States (US) contributions to global health. Global responses to HIV, TB and malaria are not the only programs affected but were particularly dependent on US support. The US withdrawal from global health could result in 3 million additional HIV deaths and 10 million additional HIV infections, 107 000 additional malaria deaths and 15 million additional malaria infections, and 2 million additional TB deaths, all in 2025.

HIV, TB and malaria are global health security threats that require international collective action. The Global Fund to fight AIDS, TB and Malaria (Global Fund) entered its replenishment cycle for 2027–2029, with a target of $18 billion. A failure of this replenishment would make it impossible for many countries to compensate for decreasing US funding and decreasing Global Fund support.

The abrupt end of most US funding for global health comes at a crucial moment for the fight against the three epidemics. For HIV, funding cuts are disrupting treatment and prevention, and increasing morbidity, mortality and infections especially among marginalised groups. The transmission of TB remains high due to insufficient access to treatment, urbanisation and undernutrition. Control of malaria remains elusive due to emerging resistance to treatments, and insecticides, gaps in prevention, and limited access to healthcare.

According to the authors, the reduction of US bilateral aid calls for re-prioritisation and enhanced coordination of the global fights against HIV, TB and malaria. Currently, the Global Fund is uniquely positioned to undertake this endeavour, as it financially supports HIV, TB and malaria programs in most, if not all, countries affected by US spending cuts. This requires a successful replenishment, which seems improbable given uncertainty about the US position and considering the aid spending cuts announced by other high-income countries. Low- and middle-income countries need to step in, which necessitates an overhaul of the Global Fund governance.

The authors outline four action points. First, all countries, regardless of income level, should support the current replenishment of the Global Fund. Second, the replenishment mechanism should move toward agreed and fair assessed contributions, such as 0.01% of the annual gross domestic product of all countries. Third, the Global Fund should commit to overhauling its governance structures to promote equal representation among geographical constituencies. Fourth, the Global Fund should commit to adhere to the Lusaka Agenda, which captures consensus around five key shifts for the long-term evolution of global health initiatives and the wider health ecosystem.

As noted by the authors, these four actions would save essential elements of the global responses to HIV, TB and malaria and set a central and collaborative mechanism for global health security on a path toward the principles of global public investment.

Dr Gorik Ooms adds: “Richer countries still view global health cooperation primarily as aid, from them to poorer countries. They do not seem to realise how this cooperation also protects their own interests. We must not only find enough funding to sustain it; but also rethink how we work together. Through genuine international cooperation between equal partners.”

Co-author Dr Raffaella Ravinetto concludes: “It is not only a matter of keeping life-saving programs alive. It is also a matter of building and maintaining a solid ecosystem, encompassing health infrastructure, policies and human resources, to make quality health care feasible everywhere. Through solidarity we can serve common interests.”

Provided by PLOS

Freely available article: https://plos.io/4djaJ2H

In your coverage please use this URL to provide access to the freely available article in PLOS Global Public Health: https://plos.io/4djaJ2H

Contact: Anna Dams, adams@itg.be, Ph.: +32 477 45 88 38; Gorik Ooms, gooms@itg.be, Ph./WhatsApp: +32 465 829 858   

Image Caption: A person holds medications. Limited access to diagnostics and medicines will worsen treatment quality, inducing resistance to antiretrovirals and medicines for infections.

Image Credit: Institute of Tropical Medicine (ITM), Antwerp, CC-BY 4.0 (https://creativecommons.org/licenses/by/4.0/)

Categories : Expert OpinionTags :

Foreign Cuts Force South Africa to Rethink Healthcare with Local Solutions

On By Peter Van Dyk
Operations Executive Lucelle Iyer

Johannesburg, 15 May 2025 – South Africa’s healthcare sector faces mounting pressure as international funding withdrawals threaten critical research and services.

Without the financial support, medical advancements are being jeopardised and access to care for vulnerable communities is limited.

With leading universities bracing for losses exceeding R800 million annually, experts warn of setbacks in disease treatment and public health initiatives. As foreign aid recedes, South Africa must look inward for sustainable solutions to safeguard its healthcare future.

At Adcock Ingram Critical Care (AICC), newly appointed Operations Executive Lucelle Iyer is part of a new wave of industry leaders focused on local solutions. Rather than relying on global models, she is driving efforts to strengthen domestic production and innovation. As public health programmes face uncertainty, the role of private-sector initiatives in sustaining healthcare access is becoming increasingly critical.

South Africa’s ability to bridge healthcare gaps and extend services to underserved communities increasingly depends on local innovation and resourcefulness. As AICC expands its investment in modernising plants and developing local talent through 2025, its initiatives could serve as a model for sustainable pharmaceutical manufacturing in South Africa and potentially across the continent. By focusing on innovation and homegrown expertise, the company is contributing to the broader effort to strengthen self-sufficiency in African healthcare.

The push towards localisation addresses the country’s significant dependence on imported pharmaceutical products and active pharmaceutical ingredients (APIs). In 2024, pharmaceutical imports to South Africa were valued at approximately $2.42 billion USD.1 Even though more than 60% of pharmaceutical products sold in South Africa are formulated locally, approximately 98% of APIs2 used in local formulation are imported.

This reliance exposes the healthcare system to risks like exchange rate fluctuations and supply chain disruptions, highlighting the need for increased local production. “We’ve seen the impact of the fragility of local supply chains on our hospitals, especially in rural and under-resourced areas,” says Iyer. “South Africa needs a manufacturing base that is resilient, scalable, and locally relevant.”

Iyer’s leadership is shaped by a philosophy of resilience, innovation, and strategic execution. As the first woman to lead operations at AICC and one of the youngest professionals to hold such a pivotal role, she has broken barriers in a traditionally male-dominated industry. Her success is driven by a solutions-focused mindset, tackling challenges with a commitment to progress and impact.

Building a future-proof pharma ecosystem

The shift to a local-first strategy is part of a broader sector-wide call for policy support and investment into the domestic pharmaceutical value chain. Experts argue that localisation is not only a health security imperative, but an economic opportunity — capable of generating skilled jobs and retaining healthcare spending within national borders.

“Pharma manufacturing has long been seen as too complex or too costly for the local context,” says Iyer. “But technology has changed that. Smart factories, digital quality control, and automation can make local production competitive.”

AICC’s comprehensive strategy includes:

  • Digitisation of production and regulatory compliance systems
  • Building local expertise in pharmacy, engineering, and biotechnology
  • Collaboration with stakeholders to streamline regulatory frameworks
  • Incorporating sustainability and circular economy principles into packaging and plastics manufacturing

Leveraging compliance for competitive advantage

AICC also challenges the common perception that regulatory compliance limits innovation. Instead, the company integrates compliance strategically into its digital transformation, embedding quality assurance and regulatory preparedness from the outset.

“When systems are designed with compliance in mind from the beginning, it greatly reduces rework and crisis management, turning quality into a driver of efficiency,” says Iyer, who brings extensive experience in regulatory affairs, quality management, and pharmaco-economics to her role.

A pivotal moment for the industry

South Africa’s pharmaceutical sector stands at a crossroads, with the potential to become a regional hub for essential medicines, medical devices, and biosimilars. Realising this ambition, however, hinges on coordinated efforts across public, private, and academic sectors to drive innovation, expand capacity, and ensure long-term sustainability.

“Our goal isn’t to replicate models from Europe or the US,” says Iyer. “It’s about creating a pharmaceutical ecosystem designed specifically for our unique needs – efficient, ethical, and sustainable.”

References:

1. Trading Economics. South Africa Imports of Pharmaceutical Products. April 2025. Available from: https://tradingeconomics.com/south-africa/imports/pharmaceutical-products

2. The Department of Trade Industry and Competition. API Development and Manufacturing https://www.thedtic.gov.za/wp-content/uploads/Opinion-Piece-API-Development-and-Manufacturing.pdf

Categories : Diet and Nutrition OphthalmologyTags :

Vitamin Supplements Slow Down the Progression of Glaucoma

On By Peter Van Dyk
Photo by Ksenia Chernaya

A vitamin supplement that improves metabolism in the eye appears to slow down damage to the optic nerve in glaucoma. Promising results have been published in the journal Cell Reports Medicine. The researchers behind the study have now started a clinical trial on patients.

In glaucoma, the optic nerve is gradually damaged, leading to vision loss and, in the worst cases, blindness. High pressure in the eye drives the disease, and eye drops, laser treatment or surgery are therefore used – with varying effect – to lower the pressure in the eye and thus slow down the disease.

Glaucoma researchers have long theorised that the substance homocysteine is somehow relevant to understanding the disease. Now, researchers at Karolinska Institutet have investigated the role of homocysteine in several ways. In the current study, the researchers discovered that when rats with glaucoma were given elevated levels of homocysteine, their disease did not worsen. 

Investigated metabolic pathways

The researchers also found that high levels of homocysteine in the blood of people with glaucoma did not correlate with how quickly the disease progressed, and that glaucoma was not more common in people with a genetic susceptibility to forming high levels of homocysteine. Based on these findings, the researchers concluded that homocysteine does not drive the disease but is a consequence of it.

Since homocysteine is a natural part of the body’s metabolism, the researchers wanted to investigate metabolic pathways involving homocysteine in both rodents and humans with glaucoma. They then saw several abnormalities, the most important of which were metabolic changes linked to the retina’s ability to use certain vitamins. This change meant that metabolism was slowed down locally in the retina – and this played a role in the development of the disease. 

“Our conclusion is that homocysteine is a bystander in the disease process, not a player. Altered homocysteine levels may reveal that the retina has lost its ability to use certain vitamins that are necessary to maintain healthy metabolism. That’s why we wanted to investigate whether supplements of these vitamins could protect the retina”, says co-lead on the paper James Tribble, researcher and assistant professor at the Department of Clinical Neuroscience at Karolinska Institutet.

Promising results lead to clinical trial

In experiments on mice and rats with glaucoma, the researchers gave supplements of the B vitamins B6, B9 and B12, as well as choline. This had a positive effect. In mice that had a slower developing glaucoma, the damage to the optic nerve was completely halted. In rats, which had a more aggressive form of the disease with faster progression, the disease was slowed down. 

In these experiments, eye pressure was left untreated, which the researchers highlight as particularly interesting – it suggests that the vitamin mix affects the disease in a different way than lowering eye pressure does. 

“The results are so promising that we have started a clinical trial, with patients already being recruited at S:t Eriks Eye Hospital in Stockholm”, says James Tribble. 

Both patients with primary open-angle glaucoma (slower progression) and pseudoexfoliation glaucoma (faster progression) are included. 

Read more about the clinical trial here. 

Source: Karolinska Institutet

Categories : CancerTags :

A Downside of Taurine: It Drives Leukaemia Growth

On By Peter Van Dyk
SAG Leukaemia. Credit: Scientific Animations CC0

A new scientific study identified taurine, which is made naturally in the body and consumed through some foods, as a key regulator of myeloid cancers such as leukaemia, according to a paper published in the journal Nature.

The preclinical research shows that scientists are a step closer to finding new ways to target leukaemia, which is one of the most aggressive blood cancers. The Wilmot Cancer Institute investigators at the University of Rochester were able to block the growth of leukaemia in mouse models and in human leukaemia cell samples by using genetic tools to prevent taurine from entering cancer cells.

Led by Jeevisha Bajaj, PhD, the research team discovered that taurine is produced by a subset of normal cells in the bone marrow microenvironment, the tissue inside bones where myeloid cancers begin and expand. Leukaemia cells are unable to make taurine themselves, so they rely on a taurine transporter (encoded by the SLC6A6 gene) to grab taurine from the bone marrow environment and deliver it to the cancer cells.

The discovery occurred as scientists were mapping what happens within the bone marrow and its ecosystem—a longtime focus among Wilmot researchers, who have advanced the science around the microenvironment with the goal of improving blood cancer treatments.

“We are very excited about these studies because they demonstrate that targeting uptake by myeloid leukaemia cells may be a possible new avenue for treatment of these aggressive diseases,” said Bajaj, an assistant professor in the Department of Biomedical Genetics and a member of Wilmot’s Cancer Microenvironment research program.

Researchers also discovered that as leukaemia cells drink up taurine, it promotes glycolysis (a breakdown of glucose to produce energy) to feed cancer growth. Prior to this, the authors said, it was not known that taurine might have a cancer-promoting role.

Leukaemia has several subtypes and survival rates vary. This study finds that taurine transporter expression is essential for the growth of multiple subtypes including acute myeloid leukaemia (AML), chronic myeloid leukaemia (CML), and myelodysplastic syndromes (MDS), which all originate from blood stem cells in the bone marrow. Future studies will investigate signals from the microenvironment that promote the transition of MDS, a precursor to leukaemia, to acute leukaemia.

Source: University of Rochester Medical Center

Categories : Cardiovascular DiseaseTags :

Elevated Risk of Death or Complications from Broken Heart Syndrome

On By Peter Van Dyk
Credit: American Heart Association

Takotsubo cardiomyopathy, also known as broken heart syndrome, is associated with a high rate of death and complications, and those rates were unchanged between 2016 and 2020, according to new research published in the Journal of the American Heart Association, an open-access, peer-reviewed journal of the American Heart Association.

Takotsubo cardiomyopathy is a stress-related heart condition in which part of the heart temporarily enlarges and doesn’t pump well. It is thought to be a reaction to a surge of stress hormones that can be caused by an emotionally or physically stressful event, such as the death of a loved one or a divorce. It can lead to severe, short-term failure of the heart muscle and can be fatal. Takotsubo cardiomyopathy may be misdiagnosed as a heart attack because the symptoms and test results are similar.

This study is one of the largest to assess in-hospital death rates and complications of the condition, as well as differences by sex, age and race over five years.

“We were surprised to find that the death rate from Takotsubo cardiomyopathy was relatively high without significant changes over the five-year study, and the rate of in-hospital complications also was elevated,” said study author M. Reza Movahed, MD, PhD, an interventional cardiologist and clinical professor of medicine at the University of Arizona’s Sarver Heart Center in Tucson, Arizona. “The continued high death rate is alarming, suggesting that more research be done for better treatment and finding new therapeutic approaches to this condition.”

Researchers reviewed health records in the Nationwide Inpatient Sample database to identify people diagnosed with Takotsubo cardiomyopathy from 2016 to 2020.

The analysis found:

  • The death rate was considered high at 6.5%, with no improvement over period.
  • Deaths were more than double in men at 11.2% compared to the rate of 5.5% among women.
  • Major complications included congestive heart failure (35.9%), atrial fibrillation (20.7%), cardiogenic shock (6.6%), stroke (5.3%) and cardiac arrest (3.4%).
  • People older than age 61 had the highest incidence rates of Takotsubo cardiomyopathy. However, there was a 2.6 to 3.25 times higher incidence of this condition among adults ages 46-60 compared to those ages 31-45 during the study period.
  • White adults had the highest rate of Takotsubo cardiomyopathy (0.16%), followed by Native American adults (0.13%) and Black adults (0.07%).
  • In addition, socioeconomic factors, including median household income, hospital size and health insurance status, varied significantly.

“Takotsubo cardiomyopathy is a serious condition with a substantial risk of death and severe complications,” Movahed said. “The health care team needs to carefully review coronary angiograms that show no significant coronary disease with classic appearance of left ventricular motion, suggesting any subtypes of stress-induced cardiomyopathy. These patients should be monitored for serious complications and treated promptly. Some complications, such as embolic stroke, may be preventable with an early initiation of anti-clotting medications in patients with a substantially weakened heart muscle or with an irregular heart rhythm called atrial fibrillation that increases the risk of stroke.”

He also noted that age-related findings could serve as a useful diagnostic tool in discriminating between heart attack/chest pain and Takotsubo cardiomyopathy, which may prompt earlier diagnosis of the condition and could also remove assumptions that Takotsubo cardiomyopathy only occurs in the elderly.

Among the study’s limitations is that it relied on data from hospital codes, which could have errors or overcount patients hospitalized more than once or transferred to another hospital. In addition, there was no information on outpatient data, different types of Takotsubo cardiomyopathy or other conditions that may have contributed to patients’ deaths.

Movahed said further research is needed about the management of patients with Takotsubo cardiomyopathy and the reason behind differences in death rates between men and women.

Source: American Heart Association