Skin cell (keratinocyte)
This normal human skin cell was treated with a growth factor that triggered the formation of specialised protein structures that enable the cell to move. We depend on cell movement for such basic functions as wound healing and launching an immune response. Credit: Torsten Wittmann, University of California, San Francisco
In a study published in Nature, researchers at Karolinska Institutet and SciLifeLab, among others, have identified a new mechanism for how cells deal with stress. This could have implications for treating certain hereditary, neurodegenerative diseases, but may also be relevant for future cancer treatment.
When cells are exposed to stress, such as lack of nutrients or oxygen, a process called the integrated stress response (ISR) is activated. This process helps cells adapt and survive, for example by affecting the production of different proteins.
Researchers have now discovered an alternative stress response, called s-ISR (split ISR), which results in changes in the expression of certain genes that are important for the cell’s energy balance. One of these genes, PCK2, affects the conversion of oxaloacetate to phosphoenolpyruvate, a substance important in the body’s metabolism of sugars and the production of amino acids such as serine and glycine. These amino acids are the building blocks of proteins that are essential for many functions in the body.
“Our discovery challenges the previous understanding of how cells handle stress and opens up new possibilities for understanding and treating diseases where the cells’ stress response is affected,” says Ola Larsson, researcher at the Department of Oncology-Pathology, Karolinska Institutet and the Science for Life Laboratory (SciLifeLab).
May affect cancer cells
One such group of diseases is leukodystrophies – inherited disorders in which the white matter of the brain, the myelin, breaks down. One of these diseases is called VWMD (vanishing white matter disease) and is caused by mutations in a protein involved in the cells’ stress response. Researchers have shown that cells with these mutations activate s-ISR, which can affect their survival under stress.
“Another disease characterised by high stress levels is cancer, and s-ISR may therefore be important for the survival of cancer cells,” says Ola Larsson.
By Kelly Widdop, Consumer Health Cluster Division Head for Bayer Sub-Saharan Africa
Healthcare innovation in Sub-Saharan Africa is rapidly evolving, driven by the need to address critical healthcare challenges such as limited access to healthcare services, high rates of infectious diseases, and growing non-communicable diseases (NCDs). With a population of over 1.1 billion people, many of whom live in rural and underserved areas, innovations are crucial to improving healthcare delivery, accessibility, and affordability.
What innovation in healthcare looks like
Healthcare innovation means more than introducing new medicines or medical devices; it involves creating integrated solutions that address both immediate health needs and systemic barriers to care. Globally, healthcare innovation is being driven by advances in digital technologies, personalised medicine, and artificial intelligence (AI) diagnostic tools. In developed regions, this includes the development of digital health, which provides remote consultation, diagnostic services, and treatment monitoring, helping to overcome geographical barriers for patients in underserved areas. In Sub-Saharan Africa, healthcare innovation is focused on overcoming infrastructure challenges and expanding access to self-care and wellness education. Both globally and locally, and in Sub-Saharan Africa, innovation is reshaping healthcare systems, making them more resilient, accessible, and responsive to the evolving needs of populations.
A decade of transformation – where we are as Sub-Saharan Africa
Sub-Saharan Africa presents a unique set of healthcare challenges, including limited infrastructure, a shortage of resources, and barriers related to affordability and access. Although not showing all at once, many changes are being achieved within the healthcare sector.
Kelly Widdop, Consumer Health Cluster Division Head for Bayer Sub-Saharan Africa
Over the past decade, the consumer health sector has undergone transformative growth, driven by a shift towards personalised wellness and a global demand for accessible and preventative care. Innovations in digital tools such as telemedicine and health-tracking apps, have empowered individuals to take charge of their health in real time, fostering a proactive approach to wellness. Alongside this, there has been a surge in personalised health products from targeted vitamins and mineral supplements, dry-to-sensitive skincare solutions, eco-friendly packaging and natural-based ingredients, which is gaining importance as consumers increasingly seek brands that align with their values. These changes have reshaped consumer health, making it more responsive, inclusive and environmentally conscious.
In the realm of nutritional vitamins and minerals, due to the rise in health awareness and lifestyle health management, many consumer health companies have tailored supplements to address common nutrient deficiencies such as bleeding gums, fatigue, joint pain, and delayed wound healing which are usually linked to, for example, a lack of calcium, vitamin b, vitamin c, vitamin d, and zinc. Consumer healthcare products, particularly vitamins and supplements, have empowered individuals to manage everyday health needs independently. With the availability of essential nutrients that support immunity, energy, mental clarity, and general well-being, consumers can now address minor ailments and manage everyday minor issues without needing to visit a doctor all the time, which can get expensive, especially for the low-income consumer. Instead of relying on medical help from a doctor for minor problems, consumers can now find over-the-counter solutions, saving both time and money.
The past decade has brought many changes in the dermatology space within the Sub-Saharan African market. With a focus on unique skin issues in the region, like sun damage and risks from unregulated skin-lightening products, there have been several public campaigns promoting safer skincare. Plus, with the expansion of telemedicine and digital health platforms, more and more people have access to dermatological consultations than ever before, without worrying about distance. The growing popularity of the use of natural ingredients has become super popular as consumers prefer these safer skincare options. In addition to the easily accessible dermatological products, there has been a significant increase in dermatological education and training across the region to build dermatological expertise in the region. Overall, these investments in both new product innovation and community engagement continuously empower consumers to manage their skin health.
In Sub-Saharan Africa, there have been some great advancements in allergy care, making it easier for people to find over-the-counter solutions for their allergy issues. With more people living in cities and changes in lifestyle and the environment, allergies like rhinitis, food allergies, and seasonal allergies are on the rise. To help with this, healthcare providers and companies have made antihistamines more accessible, allowing people to manage their symptoms without always needing to see a specialist. Plus, there is now a lot of useful information available on how to recognize, prevent, and treat allergic reactions, which helps consumers handle their allergies more effectively without frequent medical visits.
Capacitybuilding – a crucial aspect of the transformation
Capacity building has been a crucial aspect of this transformation. Investments in healthcare infrastructure, training programs, and community health initiatives have strengthened the overall healthcare system. For instance, healthcare providers have been trained to use digital health tools effectively, ensuring that they can offer remote consultations and monitor patients’ health from a distance. Community health workers have been equipped with the knowledge and resources to educate people about self-care practices, preventive measures, and the importance of regular health check-ups. These efforts have not only improved healthcare delivery but also empowered individuals to take control of their health.
Access to self-care has also expanded significantly. With the availability of over-the-counter products, individuals can now manage minor health issues on their own and educational campaigns have raised awareness about the importance of self-care, encouraging people to adopt healthier lifestyles and seek medical advice when necessary. This shift towards self-care has reduced the burden on healthcare facilities and allowed individuals to take a more active role in managing their health, and these changes have reshaped consumer health in Sub-Saharan Africa, making it more responsive, inclusive, and environmentally conscious.
What Sub-Saharan Africa can continuously adopt to succeed
Global relations and intercontinental trade have uniquely provided Sub-Saharan Africa an advantage in bringing successful healthcare innovations to the region.
The adoption of digital health platforms has the potential to change healthcare delivery in rural and underserved areas. Remote monitoring systems can help close the gap in access to health services, making it easier and more convenient for people to get care—just like what has been done successfully in places such as India and Latin America. Personalised health solutions, such as vitamin supplements and skincare products, can cater to local needs and encourage people to take charge of their health and health education initiatives delivered through social media and schools can empower individuals with health literacy, creating a culture of preventive self-care and informed consumer choices.
Additionally, telemedicine and remote care technologies can also be expanded across Africa to keep track of consumers’ health, ensuring they get continuous care even when healthcare facilities are hard to reach. Healthcare in Sub-Saharan Africa should go beyond just offering new products; it should be about creating lasting solutions that truly empower people, patients, and communities. Innovations that fit local needs can make a real difference and improve lives across the continent.
Artist’s representation of an approach for moulding biological structures in the lab using a metal called gallium. The image shows a metallic branching structure (gallium) and then empty vessels running through a block of organic tissue. Credit: Donny Bliss/NIH
The ability to engineer complex biological tissues, such alveoli or blood vessels, has vast potential to help us unlock fundamental biological insights, test new therapeutics, and one day even build fully functional replacement tissues or whole organs. But researchers have found it challenging to use current technologies such as 3D printing to produce living tissues using natural biological materials that include larger organ structures accurately constructed down to the tiny, cellular level. It has been too complex to recreate the many different tissue architectures of the human body in the lab.
A recent, NIH-supported study reported in Nature suggests a clever solution. The key is taking advantage of the natural properties of a silvery metal known as gallium, which is notable for melting at about 30°C, below body temperature, meaning it can be melted by body temperature. The new study demonstrated the metal’s use as a moulding material for generating soft biological structures complete with hollowed-out internal forms in the wide range of intricate shapes and sizes that would be needed to support the growth of larger, lifelike tissues from cells.
The team behind the new approach called ESCAPE (engineered sacrificial capillary pumps for evacuation), is led by Christopher Chen at Boston University and the Wyss Institute at Harvard University in Boston. The research team realised they needed a single process that could handle fragile biological materials while also building well at both large and extremely tiny scales.
How does ESCAPE achieve this? The strategy is much like traditional metal-casting, which has long been used to make intricate jewelry or sculptures from metals, but in reverse. In this process, a template is made from wax inside a rigid material. When the wax is melted away by molten metal, the desired form is left behind.
The researchers realized that gallium was an ideal material to work with for fashioning scaffolds for use in tissue engineering. Gallium is easy to handle and cast into desired shapes. Its low melting point and biocompatibility also made it especially appealing. In the ESCAPE approach, the researchers start by coming up with a desired shape. They then make a solid metal cast of the shape out of gallium. Next, they form a soft biomaterial around the gallium cast. When the temperature is raised, the gallium can be melted and cleanly removed, leaving behind a perfect scaffold. This works well because gallium also has a high surface tension state, which means that it can be made to readily pump itself out of a confined space. Finally, the researchers add cells to the biomaterial scaffold and grow them to form the desired tissue structure.
To demonstrate the potential of ESCAPE, the researchers chose to create blood vessel networks, including lengths at many different scales. They showed they could make complex, cell-laden vascular networks out of collagen, modelling healthy blood vessel structures, as well as some with dead ends found in disease states such as vascular malformations. The structures included 300 micrometre arterioles, as well as microvasculature ten times smaller than that. For context, the diameter of a human hair is around 75 micrometres.
The team went on to show they could produce distinct and interwoven tissue networks like those in the circulatory system. They also built cavities packed with cardiac cells lined with the blood vessels needed to feed them.
While it’s still early, the researchers say that the ESCAPE moulding approach could pave the way for producing a wide range of tissue architectures that had been previously impossible to make in the lab. They’re continuing to explore the approach with various cell types and shapes found in different organs throughout the body. The hope is that these fabricated tissues could help researchers in numerous ways, including for drug testing, the development of new treatments, and potentially one day with organ replacement.
Cuts to United States spending on aid and medical research have caused widespread havoc and anxiety in the last month. Professor Tulio de Oliveira sat down with Spotlight’s Biénne Huisman to talk through what it might mean for health research in South Africa.
As the Trump administration moves to freeze foreign aid, halting vital humanitarian health programmes and medical research trials worldwide – leaving patients cut off from lifesaving medicines and scientists in a bind – Professor Tulio de Oliveira argues that the United States stand to lose far more from this move than its 1% government investment in foreign aid.
The non-partisan Pew Research Center recently released figures showing that of the American government’s total 2023 budget, 1.2% or about $71.9 billion was spent on foreign aid. Of this foreign aid budget, 14.7% or about $10.6 billion was earmarked for the “ongoing battle against HIV/AIDS” and 2% or about $1.5 billion for “combatting pandemic influenza and other emerging public health threats”.
Speaking to Spotlight in a boardroom at the Centre for Epidemic Response and Innovation (CERI) at Stellenbosch University, De Oliveira says: “Spending on biosecurity is an investment in the future – I think the United States benefits much more from our research and our work than what we cost them.” Biosecurity refers to measures designed to protect populations against harmful biological or biochemical substances.
During the height of the COVID-19 pandemic, De Oliveira, a professor in bioinformatics, shot to global attention for leading the South African team credited with discovering the Beta and Omicron variants of SARS-CoV-2. Now, in the face of a new global health upheaval, he insists that cross-border scientific collaboration is critical for combating the global spread of disease.
“Pathogens don’t need passports, they don’t care about nationality,” he says, referencing former World Health Organisation Director-General, Dr Margaret Chan, who first used the phrase at the 2007 World Health Assembly.
Professor Tulio de Oliveira. (Photo: Supplied)
De Oliveira is a native Brazilian who speaks accented English. During his interview with Spotlight, his demeanour is calm and his speech unrushed as he expands: “It’s of great interest to America to keep investing – not as a kind of donation, or because we’re entitled to it – but because of how it helps them. We just came out of a pandemic and America actually had much bigger waves of infection than many of the poor countries.”
He lists recent global population health threats: “Like with Covid, now we have influenza; and the virus is mutating, transmitting through multiple animals. We just had an outbreak of Marburg in Rwanda and another one in Kenya. We had an emergence of mpox in central Africa. We had an emergence in Sudan of a strain of Ebola. In Uganda, a growing rate of malaria drug resistance.
“And in the last year, the US saw the biggest number of TB cases ever. So it’s of critical interest that these pathogens get quickly identified, are quickly controlled, that you treat people so that it doesn’t spread to other countries. In the end, it’s the health of the global population, it doesn’t matter which country we live in or how wealthy people are.”
Major funding cuts
Scores of South African research groups (many who provide affiliated public healthcare services) have in the past received funding from United States government entities – including the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), USAID, and the President’s Emergency Plan for Aids Relief (PEPFAR).
Many of these funding flows have been paused in recent weeks by the Trump administration. As a result, several important clinical trials have been stopped. The impacts are far-reaching – around 28% of the South African Medical Research Council’s (SAMRC) 2025/2026 budget was set to be funded by US government entities. Professor Ntobeko Ntusi, President of the SAMRC, told Spotlight that it would be catastrophic if the funding is cut.
Adding further uncertainty, prominent vaccine sceptic Robert F. Kennedy has been confirmed as the US’s health secretary under the Trump administration. Kennedy has argued that the NIH should reduce its focus on infectious diseases and dedicate more resources to non-communicable diseases like diabetes. The US government has until now been by far the biggest funder of both HIV and TB research.
De Oliveira appears unflustered. At CERI, of which he is the founding director, he says only 7% of funding is from the NIH – “and we have reason to believe that the current NIH grants that we have will not be discontinued”. One such grant was for R40 million over five years awarded in 2023 to CERI’s Professor Frank Tanser for designing HIV prevention strategies.
In fact, De Oliveira says CERI and the KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP) which he also heads, are expanding. Both centres use state-of-the-art genomics – the study of the DNA of organisms – to identify new variants of pathogens and to prevent disease.
“Yes, the opposite, we’re in an expansion phase,” says De Oliveira.
“Just last week, we advertised five post-doctoral fellowship positions. We hope that we can even absorb some of the great talent that may be lost from groups that were unfortunately more reliant on American funding.”
He stresses the importance of having a diversified funding portfolio, saying the work of CERI and KRISP is funded through 46 active grants with another 9 in the offing. “We have multiple grants from multiple funders from multiple countries. So again, I know it’s easily said, but I think it’s something that we should learn going forward, not to grow too reliant on one funder.”
Filling the gap
If the United States pulls back permanently from its leadership role in providing global aid – and medical research funding in particular – who might fill the gap?
The New Yorker quotes Clemence Landers, vice-president of the think tank Centre for Global Development, suggesting that China might come forward.
In response, De Oliveira says: “China could fill the gap. But people don’t realise the biggest foundation in the world at the moment is called the Novo Nordisk Foundation in Denmark which is linked to the company that had the massive breakthrough with Ozempic. They could easily fill the gap if they wanted. There are others as well. I would not be surprised if a completely unexpected foundation came forward to fill the gap.”
Reflecting further, he expresses hope that “people with noble causes step up”.
In 2022, TIME Magazine named De Oliveira one of the world’s 100 most influential people, and in 2024 he cracked the magazine’s top 100 health list. Has this public recognition made it easier for him to attract funding? He shrugs this off.
“We’re really committed to having a global impact that saves lives. And that commitment is not centralised in the director, but in our vision shared across principal investigators. And this is really important for the sustainability of organisations. I get offered good jobs every couple of weeks, and I mean even though I don’t intend on going anywhere, anything could happen. For example, two weeks ago I was skateboarding and cracked my ribs.”
In a moment of levity, he elaborates: “And this is the fifth time I cracked my ribs. Once was while skateboarding, another while snowboarding, surfing, once while mountain biking and another time falling from a children’s tractor.”
De Oliveira moved to South Africa in 1997, as the AIDS crisis was heading toward its peak. He says he feels “eternally grateful” for the boost PEPFAR brought to South Africa’s HIV-programme, adding that today the country might be in a “better position to absorb the loss of the funding than say five, ten years ago”.
He notes that 17% of South Africa’s HIV/AIDS spending was from PEPFAR, but that this does not include the procurement of antiretrovirals. “So yes, I think as South Africans we might be in a position to come up with solutions, as the programme is very well run.”
De Oliveira’s concern is for more vulnerable African countries – he singles out Mozambique – which are reliant on foreign aid for the procurement of medicines like antiretrovirals.
Needless to say, these recent events are a setback in the quest to develop an HIV vaccine. “When you decrease investment in research and science, you keep further away from developing the solutions,” he says. “But in terms of HIV/AIDS, luckily there are antiretroviral therapies that are very efficient.”
As we wrap up the interview, De Oliveira zooms out to the bigger picture: “Unfortunately, we are destroying the environment, there’s increased globalisation and crazy urbanisation, and this is making it easier for infectious diseases to spread.
“This is a challenging time for scientific and medical research. A time to develop solutions.”
A bundle of extremely fine electrode fibres in the brain (microscope image). (Image: Yasar TB et al. Nature Communications 2024, modified)
Researchers at ETH Zurich have developed ultra-flexible brain probes that accurately record brain activity without causing tissue damage. This technology, described in Nature Communications, opens up new avenues for the treatment of a range of neurological and neuropsychiatric disorders.
Neurostimulators, also known as brain pacemakers, send electrical impulses to specific areas of the brain via special electrodes. It is estimated that some 200 000 people worldwide are now benefiting from this technology, including those who suffer from Parkinson’s disease or from pathological muscle spasms. According to Mehmet Fatih Yanik, Professor of Neurotechnology at ETH Zurich, further research will greatly expand the potential applications: instead of using them exclusively to stimulate the brain, the electrodes can also be used to precisely record brain activity and analyse it for anomalies associated with neurological or psychiatric disorders. In a second step, it would be conceivable in future to treat these anomalies and disorders using electrical impulses.
To this end, Yanik and his team have now developed a new type of electrode that enables more detailed and more precise recordings of brain activity over an extended period of time. These electrodes are made of bundles of extremely fine and flexible fibres of electrically conductive gold encapsulated in a polymer. Thanks to a process developed by the ETH Zurich researchers, these bundles can be inserted into the brain very slowly, which is why they do not cause any detectable damage to brain tissue.
This sets the new electrodes apart from rival technologies. Of these, perhaps the best known in the public sphere is the one from Neuralink, an Elon Musk company. In all such systems, including Neuralink’s, the electrodes are considerably wider. “The wider the probe, even if it is flexible, the greater the risk of damage to brain tissue,” Yanik explains. “Our electrodes are so fine that they can be threaded past the long processes that extend from the nerve cells in the brain. They are only around as thick as the nerve-cell processes themselves.”
The tentacle electrodes (right) shown alongside three current technologies using thicker electrodes or an electrode mesh. (Yasar TB et al. Nature Communications 2024, modified)
The research team tested the new electrodes on the brains of rats using four bundles, each made up of 64 fibres. In principle, as Yanik explains, up to several hundred electrode fibres could be used to investigate the activity of an even greater number of brain cells. In the study, the electrodes were connected to a small recording device attached to the head of each rat, thereby enabling them to move freely.
No influence on brain activity
In the experiments, the research team was able to confirm that the probes are biocompatible and that they do not influence brain function. Because the electrodes are very close to the nerve cells, the signal quality is very good compared to other methods.
At the same time, the probes are suitable for long-term monitoring activities, with researchers recording signals from the same cells in the brains of animals for the entire duration of a ten-month experiment. Examinations showed that no brain-tissue damage occurred during this time. A further advantage is that the bundles can branch out in different directions, meaning that they can reach multiple brain areas.
Human testing to begin soon
In the study, the researcher used the new electrodes to track and analyse nerve-cell activity in various areas of the brains of rats over a period of several months. They were able to determine that nerve cells in different regions were “co-activated”. Scientists believe that this large-scale, synchronous interaction of brain cells plays a key role in the processing of complex information and memory formation. “The technology is of high interest for basic research that investigates these functions and their impairments in neurological and psychiatric disorders,” Yanik explains.
The group has teamed up with fellow researchers at the University College London in order to test diagnostic use of the new electrodes in the human brain. Specifically, the project involves epilepsy sufferers who do not respond to drug therapy. In such cases, neurosurgeons may remove a small part of the brain where the seizures originate. The idea is to use the group’s method to precisely localise the affected area of the brain prior to tissue removal.
Brain-machine interfaces
There are also plans to use the new electrodes to stimulate brain cells in humans. “This could aid the development of more effective therapies for people with neurological and psychiatric disorders”, says Yanik. In disorders such as depression, schizophrenia or OCD, there is often impairments in specific regions of the brain, which leads to problems in evaluation of information and decision making. Using the new electrodes, it might be possible to detect the pathological signals generated by the neural networks in the brain in advance, and then stimulate the brain in a way that would alleviate such disorders. Yanik also thinks that this technology may give rise to brain-machine interfaces for people with brain injuries. In such cases, the electrodes might be used to read their intentions and thereby, for example, to control prosthetics or a voice-output system.
AI image made with Gencraft using Quicknews’ prompts.
Quicknews takes a look at some of the big events and concerns that defined healthcare 2024, and looks into its crystal ball identify to new trends and emerging opportunities from various news and opinion pieces. There’s a lot going on right now: the battle to make universal healthcare a reality for South Africans, growing noncommunicable diseases and new technologies and treatments – plus some hope in the fight against HIV and certain other diseases.
1. The uncertainty over NHI will continue
For South Africa, the biggest event in healthcare was the signing into law of the National Health Insurance (NHI) by President Ramaphosa in May 2024, right before the elections. This occurred in the face of stiff opposition from many healthcare associations. It has since been bogged down in legal battles, with a section governing the Certificate of Need to practice recently struck down by the High Court as it infringed on at least six constitutional rights.
Much uncertainty around the NHI has been expressed by various organisation such as the Health Funders Association (HFA). Potential pitfalls and also benefits and opportunities have been highlighted. But the biggest obstacle of all is the sheer cost of the project, estimated at some R1.3 trillion. This would need massive tax increases to fund it – an unworkable solution which would see an extra R37 000 in payroll tax. Modest economic growth of around 1.5% is expected for South Africa in 2025, but is nowhere near creating enough surplus wealth to match the national healthcare of a country like Japan. And yet, amidst all the uncertainty, the healthcare sector is expected to do well in 2025.
Whether the Government of National Unity (GNU) will be able to hammer out a workable path forward for NHI remains an open question, with various parties at loggerheads over its implementation. Public–private partnerships are preferred by the DA and groups such as Solidarity, but whether the fragile GNU will last long enough for a compromise remains anybody’s guess.
It is reported that latest NHI proposal from the ANC includes forcing medical aid schemes to lower their prices by competing with government – although Health Minister Aaron Motsoaledi has dismissed these reports. In any case, medical aid schemes are already increasing their rates as healthcare costs continue to rise in what is an inexorable global trend – fuelled in large part by ageing populations and increases in noncommunicable diseases.
Further on the horizon, there are a host of experimental drugs undergoing testing for obesity treatment, according to a review published in Nature. While GLP-1 remains a target for many new drugs, others focus on gut hormones involved in appetite: GIP-1, glucagon, PYY and amylin. There are 5 new drugs in Phase 3 trials, expected variously to finish between 2025 and 2027, 10 drugs in Phase 2 clinical trials and 18 in Phase 1. Some are also finding applications beside obesity. The GLP-1 agonist survodutide, for example have received FDA approval not for obesity but for liver fibrosis.
With steadily increasing rates of overweight/obesity and disorders associated with them, this will continue to be a prominent research area. In the US, where the health costs of poor diet match what consumers spend on groceries, ‘food as medicine’ has become a major buzzword as companies strive to deliver healthy nutritional solutions. Retailers are providing much of the push, and South Africa is no exception. Medical aid scheme benefits are giving way to initiatives such as Pick n Pay’s Live Well Club, which simply offers triple Smart Shopper points to members who sign up.
Another promising approach to the obesity fight is precision medicine, which factors in many data about the patient to identify the best interventions. This could include detailed study of energy balance regulation, helping to select the right antiobesity medication based on actionable behavioural and phsyiologic traits. Genotyping, multi-omics, and big data analysis are growing fields that might also uncover additional signatures or phenotypes better responsive to certain interventions.
3. AI tools become the norm
Wearable health monitoring technology has gone from the lab to commonly available consumer products. Continued innovation in this field will lead to cheaper, more accurate devices with greater functionality. Smart rings, microneedle patches and even health monitoring using Bluetooth earphones such as Apple’s Airpods show how these devices are becoming smaller and more discrete. But health insurance schemes remain unconvinced as to their benefits.
After making a huge splash in 2024 as it rapidly evolved, AI technology is now maturing and entering a consolidation phase. Already, its use has become commonplace in many areas: the image at the top of the article is AI-generated, although it took a few attempts with the doctors exhibiting polydactyly and AI choosing to write “20215” instead of “2025”. An emerging area is to use AI in patient phenotyping (classifying patients based on biological, behavioural, or genetic attributes) and digital twins (virtual simulations of individual patients), enabling precision medicine. Digital twins for example, can serve as a “placebo” in a trial of a new treatment, as is being investigated in ALS research.
Rather than replacing human doctors, it is likely that AI’s key application is reducing lowering workforce costs, a major component of healthcare costs. Chatbots, for example, could engage with patients and help them navigate the healthcare system. Other AI application include tools to speed up and improve diagnosis, eg in radiology, and aiding communication within the healthcare system by helping come up with and structure notes.
4. Emerging solutions to labour shortages
Given the long lead times to recruit and train healthcare workers, 2025 will not likely see any change to the massive shortages of all positions from nurses to specialists.
At the same time, public healthcare has seen freezes on hiring resulting in the paradoxical situation of unemployed junior doctors in a country desperately in need of more doctors – 800 at the start of 2024 were without posts. The DA has tabled a Bill to amend the Health Professions Act at would allow private healthcare to recruit interns and those doing community service. Critics have pointed out that it would exacerbate the existing public–private healthcare gap.
But there are some welcome developments: thanks to a five-year plan from the Department of Health, family physicians in SA are finally going to get their chance to shine and address many problems in healthcare delivery. These ‘super generalists’ are equipped with a four-year specialisation and are set to take up roles as clinical managers, leading multi-disciplinary district hospital teams.
Less obvious is where the country will be able to secure enough nurses to meet its needs. The main challenge is that nurses, especially specialist nurses, are ageing – and it’s not clear where their replacements are coming from. In the next 15 years, some 48% of the country’s nurses are set to retire. Coupled with that is the general consensus that the new nursing training curriculum is a flop: the old one, from 1987 to 2020, produced nurses with well-rounded skills, says Simon Hlungwani, president of the Democratic Nursing Organisation of South Africa (Denosa). There’s also a skills bottleneck: institutions like Baragwanath used to cater for 300 students at a time, now they are only approved to handle 80. The drive for recruitment will also have to be accompanied by some serious educational reform to get back on track.
5. Progress against many diseases
Sub-Saharan Africa continues to drive declines in new HIV infections. Lifetime odds of getting HIV have fallen by 60% since the 1995 peak. It also saw the largest decrease in population without a suppressed level of HIV (PUV), from 19.7 million people in 2003 to 11.3 million people in 2021. While there is a slowing in the increase of population living with HIV, it is predicted to peak by 2039 at 44.4 million people globally. But the UNAIDS HIV targets for 2030 are unlikely to be met.
As human papillomavirus (HPV) vaccination programmes continue, cervical cancer deaths in young women are plummeting, a trend which is certain to continue.
A ‘new’ respiratory virus currently circulating in China will fortunately not be the next COVID. Unlike SARS-CoV-2, human metapneumovirus (HMPV) has been around for decades, and only causes a few days of mild illness, with bed rest and fluids as the primary treatment. The virus has limited pandemic potential, according to experts.
Biological entities called obelisks have been hiding – in large numbers – inside the human mouth and gut. These microscopic entities, which were recently discovered by a team at Stanford University, are circular bits of genetic material that contain one or two genes and self-organise into a rod-like shape.
Although the study is still in preprint form, meaning that it has not been peer-reviewed, it has already been extensively written about, including in two heavyweight journals: Nature and Science.
Let’s delve deeper into the strange world of very tiny “lifeforms”.
In biology, as in physics, things can get weirder and the rules fuzzier as we move through smaller and smaller scales.
Viruses, being unable to replicate without the help of a host, can most generously be considered to be on the edge of what constitutes life. Yet the estimated 10 nonillion (one followed by 31 zeroes) individual viruses on the planet can be found in every conceivable habitat and, through infecting and manipulating their hosts, have probably affected the evolutionary trajectories of all life.
Peering even further down into the world of minuscule biological entities, are the viroids – tiny scraps of genetic material (DNA-like molecules known as RNA) that cannot make proteins and, unlike viruses, don’t have a protective shell to encase their genome.
Viroids are examples of ribozymes: RNA molecules that may be a distant echo of the very first self-replicating genetic elements from which cellular life emerged.
Viroids can self-cleave (chop up) and re-ligate (stick back together) their genome as part of the replication cycle. And, despite their simplicity, they can cause serious disease in flowering plants.
Between a virus and a viroid – perhaps
The new preprint describes “viroid-like colonists of human microbiomes”. If “viroid-like” sounds non-committal, that is entirely deliberate. The newly discovered biological entity falls somewhere between viruses and viroids.
In fact, the name obelisks was proposed not only because of their shape, but also to provide wiggle room in case they turn out to be more like RNA plasmids (a different type of genetic element that resides inside bacteria) than either viruses or viroids.
Like viroids, obelisks have a circular single-stranded RNA genome and no protein coat but, like viruses, their genomes contain genes that are predicted to code for proteins.
All obelisks so far described encode a single major protein known as obulin, and many encode a second, smaller obulin.
Obulins bear no evolutionary resemblance, or “homology”, to any other protein found, and there are few clues as to their function.
By analysing existing datasets taken from the gut and mouth of humans as well as other diverse sources, the Stanford team found almost 30,000 distinct obelisk types.
These obelisk genomes have been previously overlooked because they are so dissimilar to anything described previously. The Stanford team found them using a clever bespoke method for searching databases for single-stranded circular RNA molecules to fish out any viroid-like elements.
It is clear from their results that obelisks are not rare. The researchers found them in datasets spanning the globe and in diverse niches.
These elements were detected in around 7% of microbiome datasets from the human gut and 50% of datasets from the mouth. However, whether these datasets provide a true representation of the prevalence and distribution of obelisks is unclear.
Different obelisk types were found in different body sites and in different donors. Long-term data revealed that people can harbour a single obelisk type for around a year.
Obelisks probably rely on microbial host cells to replicate, including those that live inside humans to replicate. Bacteria or fungi are likely hosts, but it is not known which exact species harbour these elements.
However, the researchers provide a critical lead through the analysis by providing strong evidence that a common bacterial component of dental plaque, Streptococcus sanguinis, plays host to a specific obelisk type.
We might have to rethink the gut microbiome. Credit Darryl Leja National Human Genome Research Institute National Institutes Of Health
Friend or foe?
As S sanguinis is easy to grow and experiment on in the laboratory, this will provide a valuable model for understanding the fundamentals of obelisk biology.
This is critical, as nothing is known about the broader evolutionary and ecological significance of obelisks. They may be parasitic and harm host cells, or they may be beneficial.
Hosts may have evolved elaborate defence mechanisms against obelisks, or else actively recruit them to gain some unsuspected advantage. If obelisks change or upset the human microbiome, this may in turn have implications for human health – they may even have therapeutic potential.
Alternatively, obelisks may cause neither harm nor benefit to their microbial host, or to humans. Instead, they may simply exist as stealthy evolutionary passengers, silently and endlessly replicating, like the original “selfish gene”.
As described in research published in the Biotechnology Journal, investigators have developed a novel patch that can help liver tissue regenerate. The patch is a combination of decellularised liver matrix, a liver growth factor, and an anticoagulant. In lab tests with liver cells, the patch helped liver cells regain function after exposure to a toxin.
In rats, patches attached to the liver and gut promoted recovery from liver fibrosis, with notable decreases in scarring and inflammation.
“The decellularised liver matrix–based hepatic patch has demonstrated the ability to restore liver function and inhibit inflammation in fibrotic livers,” said corresponding author Yung-Te Hou, PhD, of National Taiwan University. “This approach shows great potential for treating various liver-related diseases, ranging from mild conditions such as fatty liver to severe conditions like liver cirrhosis.”
Photo by Towfiqu barbhuiya: https://www.pexels.com/photo/a-toothbrush-with-toothpaste-on-a-white-surface-12065623/
Step aside, tropical rainforests and coral reefs, the latest hotspot to offer awe-inspiring biodiversity is in your bathroom. In a new study published in Frontiers in Microbiomes, microbiologists found that showerheads and toothbrushes are teeming with an extremely diverse collection of viruses – most of which have never been seen before.
Although this might sound ominous, the good news is these viruses don’t target people. They target bacteria.
The microorganisms collected in the study are bacteriophage, or “phage,” a type of virus that infects and replicates inside of bacteria. Although researchers know little about them, phage recently have garnered attention for their potential use in treating antibiotic-resistant bacterial infections. And the previously unknown viruses lurking in our bathrooms could become a treasure trove of materials for exploring those applications.
“The number of viruses that we found is absolutely wild,” said Northwestern’s Erica M. Hartmann, who led the study, which was published in the journal Frontiers in Microbiomes. “We found many viruses that we know very little about and many others that we have never seen before. It’s amazing how much untapped biodiversity is all around us. And you don’t even have to go far to find it; it’s right under our noses.”
The new study is an offshoot of previous research, in which Hartmann and her colleagues at University of Colorado at Boulder characterized bacteria living on toothbrushes and showerheads. For the previous studies, the researchers asked people to submit used toothbrushes and swabs with samples collected from their showerheads.
Inspired by concerns that a flushing toilet might generate a cloud of aerosol particles, Hartmann affectionately called the toothbrush study, “Operation Pottymouth.”
“This project started as a curiosity,” Hartmann said. “We wanted to know what microbes are living in our homes. If you think about indoor environments, surfaces like tables and walls are really difficult for microbes to live on. Microbes prefer environments with water. And where is there water? Inside our showerheads and on our toothbrushes.”
What they found: An ‘incredible diversity of viruses’
After characterizing bacteria, Hartmann then used DNA sequencing to examine the viruses living on those same samples. She was immediately blown away. Altogether, the samples comprised more than 600 different viruses — and no two samples were alike.
“We saw basically no overlap in virus types between showerheads and toothbrushes,” Hartmann said. “We also saw very little overlap between any two samples at all. Each showerhead and each toothbrush is like its own little island. It just underscores the incredible diversity of viruses out there.”
A potential pathogen fighter
While they found few patterns among all the samples, Hartmann and her team did notice more mycobacteriophage than other types of phage. Mycobacteriophage infect mycobacteria, a pathogenic species that causes diseases like leprosy, tuberculosis and chronic lung infections. Hartmann imagines that, someday, researchers could harness mycobacteriophage to treat these infections and others.
“We could envision taking these mycobacteriophage and using them as a way to clean pathogens out of your plumbing system,” she said. “We want to look at all the functions these viruses might have and figure out how we can use them.”
Avoid overreacting: Most microbes ‘will not make us sick’
But, in the meantime, Hartmann cautions people not to fret about the invisible wildlife living within our bathrooms. Instead of grabbing for bleach, people can soak their showerheads in vinegar to remove calcium buildup or simply wash them with plain soap and water. And people should regularly replace toothbrush heads, Hartmann says. Hartmann also is not a fan of antimicrobial toothbrushes, which she said can lead to antibiotic-resistant bugs.
“Microbes are everywhere, and the vast majority of them will not make us sick,” she said. “The more you attack them with disinfectants, the more they are likely to develop resistance or become more difficult to treat. We should all just embrace them.”
A team of scientists in Singapore and the US uncovered how a protein that controls our biological clock modifies its own function, offering new ways for treating jet lag and seasonal adjustments
Scientists from Duke-NUS Medical School and the University of California, Santa Cruz, have discovered the secret to regulating our internal clock. They identified that this regulator sits right at the tail end of Casein Kinase 1 delta (CK1δ), a protein which acts as a pace setter for our internal biological clock or the natural 24-hour cycles that control sleep-wake patterns and other daily functions, known as circadian rhythm.
Published in the journal PNAS, their findings could lead to new treatments for circadian rhythm disorders.
CK1δ regulates circadian rhythms by tagging other proteins involved in circadian rhythm to fine-tune the timing of these rhythms. In addition to modifying other proteins, CK1δ itself can be tagged, thereby altering its own ability to regulate the proteins involved in running the body’s internal clock.
Previous research identified two distinct versions of CK1δ, known as isoforms δ1 and δ2, which vary by just 16 building blocks or amino acids right at the end of the protein in a part called the C-terminal tail. Yet these small differences significantly impact CK1δ’s function. While it was known that when these proteins are tagged, their ability to regulate the body clock decreases, no one knew exactly how this happened.
Using advanced spectroscopy and spectrometry techniques to zoom in on the tails, the researchers found that how the proteins are tagged is determined by their distinct tail sequences.
Professor Carrie Partch at the University of California, Santa Cruzand corresponding author of the study explained:
“Our findings pinpoint to three specific sites on CK1δ’s tail where phosphate groups can attach, and these sites are crucial for controlling the protein’s activity. When these spots get tagged with a phosphate group, CK1δ becomes less active, which means it doesn’t influence our circadian rhythms as effectively. Using high-resolution analysis, we were able to pinpoint the exact sites involved—and that’s really exciting.”
Having first studied this protein more than 30 years ago while investigating its role in cell division, Professor David Virshup, the director of the Cancer and Stem Cell Biology Programme at Duke-NUS and co-corresponding author of the study, elaborated:
“With the technology we have available now, we were finally able to get to the bottom of a question that has gone unanswered for more than 25 years. We found that the δ1 tail interacts more extensively with the main part of the protein, leading to greater self-inhibition compared to δ2. This means that δ1 is more tightly regulated by its tail than δ2. When these sites are mutated or removed, δ1 becomes more active, which leads to changes in circadian rhythms. In contrast, δ2 does not have the same regulatory effect from its tail region.”
This discovery highlights how a small part of CK1δ can greatly influence its overall activity. This self-regulation is vital for keeping CK1δ activity balanced, which, in turn, helps regulate our circadian rhythms.
The study also addressed the wider implications of these findings. CK1δ plays a role in several important processes beyond circadian rhythms, including cell division, cancer development, and certain neurodegenerative diseases. By better understanding how CK1δ’s activity is regulated, scientists could open new avenues for treating not just circadian rhythm disorders but also a range of conditions.
The researchers plan to further investigate how real-world factors, such as diet and environmental changes, affect the tagging sites on CK1δ. This could provide insights into how these factors affect circadian rhythms and might lead to practical solutions for managing disruptions.
