Tag: 23/5/25

Categories : Expert Opinion HIVTags : Leave a comment

OPEN LETTER | Minister of Health Aaron Motsoaledi, Please Explain the HIV Numbers

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Minister of Health Dr Aaron Motsoaledi. Source: GCIS

By Anna Grimsrud and Sibongile Tshabalala-Madhlala

Minister of Health Dr Aaron Motsoaledi’s recent claim that over half a million people have been newly started on HIV treatment in less than six months has raised eyebrows in health circles. In this open letter, Anna Grimsrud and Sibongile Tshabalala-Madhlala, associated with CHANGE – South Africa, ask the Minister to explain numbers that, on the face of it, seem contradictory.

Dear Minister Motsoaledi,

We write to you in response to your 15 May 2025 press statement and subsequent remarks in Parliament on the current status of the national HIV, AIDS, and TB campaign. 

You stated that since the launch of the Close the Gap campaign, 520 700 people have been initiated on HIV treatment, reaching “more than 50% of the target”. You also stated that 5.9 million people are currently on antiretroviral therapy (ART). However, at the campaign’s launch on 25 February 2025, you reported the same number on HIV treatment — 5.9 million. This raises a critical question: if over half a million people have started or restarted treatment, why has the total number of people on treatment not increased?

If both figures are accurate, this would mean that approximately 520 000 people have been lost from care over the past few months — a deeply concerning and unprecedented level of attrition. We respectfully request that you provide the underlying data and clarify the current total number of people remaining on HIV treatment.

There are several reasons why we are concerned:

  1. Static treatment numbers: As noted, the number on treatment was reported as 5.9 million in both February and May 2025. If 520 700 people have been initiated or re-initiated during this period, the same number must have exited care — a scenario that requires urgent explanation.
  2. Slow growth in the number of people on treatment: According to official statements, the total number of people on HIV treatment increased by only 100 000 between March and December 2023 — from over 5.7 million to 5.8 million. The claim that the cohort has now grown by over 500 000 in a matter of months contradicts recent trends.
  3. Declining lab numbers: National Health Laboratory Service data reported by the Daily Maverick and Reuters, show notable declines in viral load testing and early infant diagnosis in March and April 2025 compared to the same months in 2024. These indicators should increase alongside meaningful growth in treatment uptake — not decrease.

In light of these concerns, we believe it is essential that you provide a transparent accounting of the current number of people on treatment and the metrics being used to assess progress under the Close the Gap campaign. Specifically, we request data demonstrating that the programme is on track to meet its stated goal: increasing the number of people on treatment from 5.9 million to 7 million.

We share your commitment to a strong and effective HIV response, especially in this period of financial and operational strain. Like you, we believe it is vital that accurate and complete information is shared with the public and Parliament at this critical moment.

*Anna Grimsrud is an epidemiologist with a PhD in Public Health and writes in her personal capacity. Sibongile Tshabalala-Madhlala is openly living with HIV and currently serves as the National Chairperson of the Treatment Action Campaign (TAC).” CHANGE is a coalition of more than 1 500 people from civil society organizations in South Africa and around the work — people living with HIV, activists, community health workers, researchers, programme members, epidemiologists, clinicians, economists, and others. CHANGE stands for Community Health & HIV Advocate Navigating Global Emergencies.

Published by Spotlight and GroundUp.

Note: Spotlight aims to deepen public understanding of important health issues by publishing a variety of views on its opinion pages. The views expressed in this article are not necessarily shared by the Spotlight editors.

Republished from Spotlight under a Creative Commons licence. Views expressed in the original article are not necessarily shared by Quicknews.

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Categories : Mental HealthTags : Leave a comment

Social Connection is Still Underappreciated as a Medically Relevant Health Factor

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Photo by Kindel Media on Pexels

Research confirms that social isolation and loneliness significantly impact health and mortality, even if not listed on death certificates. Brigham Young University psychology and neuroscience professor, Julianne Holt-Lunstad, has published extensively on the topic, including a landmark 2010 meta-analysis and a 2023 framework on assessment and treatment. She also served as lead scientist on the 2023 Surgeon General Advisory and is advising the World Health Organization on an upcoming report that addresses the pressing health threat of loneliness and isolation and a global agenda on social connection.

Social connection is now a legitimate health factor, but Holt-Lunstad and doctoral student, Andrew Proctor, recently published two studies showing that most of us (the general population and medical providers) still don’t think social connection affects physical health. And even the professionals who recognise the importance report that they don’t have time or tools to help patients address social concerns.

Proctor, who authored a study recently published in Springer Nature, explained that before the study, they had been watching how the pandemic was influencing internet searches around the topics of isolation and loneliness.

“I have a marketing background, so I thought that maybe the public perception had changed since COVID. Social distancing, isolation and loneliness were huge buzzwords on the internet as seen through Google Trends and BuzzSumo (an online trend analyzer). Everything around these search terms was super viral during that time, and so we wondered if perceptions about social connection had changed,” said Proctor.

With loneliness and isolation trending on the internet, the researchers set up a study. In a nationally representative sample of US adults, as well as samples from the UK and Australia, they surveyed 2,392 people about their perceptions of health risks associated with isolation and loneliness. The data showed that, despite the pandemic and other campaigns, people still underestimate the importance of social connection for physical health. And the underestimation exists equally among the lonely and the socially connected.

“The study identified blind spots in medical care,” said Proctor. “Social connection is like a vital sign. What if we didn’t care about high blood pressure? Or what if we never knew smoking was bad for us? Social connection is like a key vital sign. We just don’t tend to recognize it.”

In a closely connected study, Holt-Lunstad and Proctor, along with coauthors from top research medical centers, surveyed 681 healthcare providers (primarily doctors) about perceptions of health risks associated with poor social connection. Similar to the general population from the first study, healthcare providers underestimated social connection as a medically relevant health factor.

The researchers gleaned some unexpected insights due to an unintentional time lag in data collection in the second study.

“We completed the data collection at two different time points because we were waiting for institutional approvals. Our first cohort was healthcare providers through the University of Utah Health System. Slightly later, we had a second major cohort of University of California San Francisco (UCSF) physicians,” said Holt-Lunstad. “What was interesting is that the perceived importance of social factors was a bit higher among the UCSF group.”

Source: Brigham Young University

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Beyond Hormones: Researchers Define X and Y Chromosome Contributions to Height

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A Geisinger study provides new insight into height differences between adult men and women, demonstrating that Y chromosome genes contribute more to height than their X chromosome counterparts, independent of male sex determination. The results were published this week in the Proceedings of the National Academy of Sciences.

Typical females have two X chromosomes, while typical males have one X and one Y chromosome. The differences between the X and Y chromosomes cause hormonal differences between males and females, but these differences have been insufficient to explain the average 13cm height difference between the sexes.

“Because height shows a large and reproducible difference between sexes and is widely measured, it serves as a valuable model for investigating the genomic factors underlying sex differences,” said Matthew Oetjens, Ph.D., assistant professor in Geisinger’s Department of Developmental Medicine and one of the study leads.

The Geisinger research team sought to determine the effects of sex-related factors on human height by examining height in people with an abnormal number of X or Y chromosomes, a genetic condition known as sex chromosome aneuploidy.

The team analysed genetic and clinical data on nearly one million participants enrolled in Geisinger’s MyCode Community Health Initiative, the National Institutes of Health’s All of Us cohort and the UK Biobank. Of these participants, 1225 had a sex chromosome aneuploidy. By incorporating people with more or fewer than two sex chromosomes into a model of height, they found that exchanging an X for a Y chromosome increased height by 3.1cm, independent of other sex-related factors, including hormonal differences. This result suggests that an estimated 23% of the average difference in height between men and women is explained by increased expression of shared genes on the Y chromosome relative to the X chromosome.

“Beyond its implications for understanding human height, this study provides broader insights into how sex chromosome aneuploidy research can uncover the mechanisms behind observed sex differences in various medical conditions,” said Alexander Berry, PhD, bioinformatics scientist and study co-lead.

SHOX, a gene found on both the X and Y chromosomes, is a known contributor to human height, but because two copies are found in both men and women, it has not been considered a likely contributor to the sex difference in height. However, recent studies have shown that SHOX is partially silenced on the second X chromosome in individuals with two or more X chromosomes. The Geisinger study’s results are consistent with the hypothesis that reduced SHOX expression in females results in a net difference in height between the sexes.

Source: Geisinger Health System

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New Study Reveals Why Common Leukaemia Treatments Fail in Some Patients

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Genetic mutations and cell maturity as key factors in acute myeloid leukaemia drug resistance

Photo by Tima Miroshnichenko on Pexels

An international study led by the University of Colorado Cancer Center has uncovered why a widely used treatment for acute myeloid leukaemia (AML) doesn’t work for everyone. The findings could help doctors better match patients with the therapies most likely to work for them.

The study was published in Blood Cancer Discovery.

Researchers analysed data from 678 AML patients, the largest group studied to date for this treatment, and found that both gene mutations and the maturity of leukaemia cells affect how patients respond to a drug combination of venetoclax and hypomethylating agents (HMA).

“Venetoclax-based therapies are now the most common treatment for newly diagnosed AML,” said Daniel Pollyea, MD, MS, professor of medicine at University of Colorado. “But not all patients respond the same way. Our goal was to figure out why and give doctors better tools to predict outcomes at the start.”

Mutations and maturity of leukaemia cells

AML is a fast-growing cancer of the blood and bone marrow, most often seen in older adults. Many patients can’t tolerate traditional chemotherapy, so doctors treat them with venetoclax plus HMA. This combination has improved survival for many, but some patients still relapse or don’t respond.

The study found that patients with a certain type of AML, called “monocytic,” had worse outcomes especially if they did not have a helpful gene mutation known as NPM1. These patients were also more likely to carry other mutations, such as KRAS, that are linked to drug resistance.

“Patients with monocytic AML and no NPM1 mutation were nearly twice as likely to die from the disease,” said Pollyea. “So, it’s not just about the gene mutations. It’s also about how developed or mature the cancer cells are when treatment begins.”

Previous research often focused only on either genetic mutations or cell type. Pollyea’s team looked at both, giving them a clearer understanding of how these two factors work together to influence treatment response.

Designing therapies that shut down cancer cell escape routes

“We learned that some cancer cells basically find a back door to evade the treatment,” said Pollyea. “By identifying how and why that happens, we can begin designing therapies that shut down those escape routes.”

This is a powerful new way to classify AML patients by risk, enabling doctors to better predict who is likely to respond to venetoclax and who might need another approach.

“This is a major step toward personalised medicine in AML,” said Pollyea. “We’re moving closer to a world where we can look at a patient’s leukaemia on day one and know which therapy gives them the best chance and ultimately improve survival rates.”

Pollyea and his team are working to expand the study with even more patient data and hope to design a clinical trial that uses this model to guide treatment decisions.

Source: University of Colorado Anschutz Medical Campus

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SSRIs Could Help the Immune System Fight Cancer

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Photo by Danilo Alvesd on Unsplash

Selective serotonin reuptake inhibitors (SSRIs) could help the immune system fight cancer, according to recent UCLA research. The study, published in Cell, found that SSRIs significantly enhanced the ability of T cells to fight cancer and suppressed tumour growth across a range of cancer types in both mouse and human tumour models.

“It turns out SSRIs don’t just make our brains happier; they also make our T cells happier – even while they’re fighting tumours,” said Lili Yang, PhD, senior author of the new study. “These drugs have been widely and safely used to treat depression for decades, so repurposing them for cancer would be a lot easier than developing an entirely new therapy.”

According to the CDC, one out of eight adults in the US takes an antidepressant, and SSRIs are the most commonly prescribed. These drugs increase levels of serotonin the brain’s “happiness hormone” by blocking the activity of a protein called serotonin transporter, or SERT. 

While serotonin is best known for the role it plays in the brain, it’s also a critical player in processes that occur throughout the body, including digestion, metabolism and immune activity. 

Dr Yang and her team first began investigating serotonin’s role in fighting cancer after noticing that immune cells isolated from tumours had higher levels of serotonin-regulating molecules. At first, they focused on MAO-A, an enzyme that breaks down serotonin and other neurotransmitters, including norepinephrine and dopamine. 

In 2021, they reported that T cells produce MAO-A when they recognise tumours, which makes it harder for them to fight cancer. They found that treating mice with melanoma and colon cancer using MAO inhibitors, also called MAOIs – the first class of antidepressant drugs to be invented – helped T cells attack tumours more effectively. 

However, because MAOIs have safety concerns, including serious side effects and interactions with certain foods and medications, the team turned its attention to a different serotonin-regulating molecule: SERT. 

“Unlike MAO-A, which breaks down multiple neurotransmitters, SERT has one job – to transport serotonin,” explained Bo Li, PhD, first author of the study and a senior research scientist in the Yang lab. “SERT made for an especially attractive target because the drugs that act on it – SSRIs – are widely used with minimal side effects.” 

The researchers tested SSRIs in mouse and human tumour models representing melanoma, breast, prostate, colon and bladder cancer. They found that SSRI treatment reduced average tumour size by over 50% and made the cancer-fighting T cells, known as killer T cells, more effective at killing cancer cells. 

“SSRIs made the killer T cells happier in the otherwise oppressive tumour environment by increasing their access to serotonin signals, reinvigorating them to fight and kill cancer cells,” said Dr Yang, who is also a professor of microbiology, immunology and molecular genetics and a member of the UCLA Health Jonsson Comprehensive Cancer Center.

How SSRIs could boost the effectiveness of cancer therapies 

The team also investigated whether combining SSRIs with existing cancer therapies could improve treatment outcomes. They tested a combination of an SSRI and anti-PD-1 antibody – a common immune checkpoint blockade (ICB) therapy – in mouse models of melanoma and colon cancer. ICB therapies block immune checkpoint molecules that normally suppress immune cell activity, allowing T cells to attack tumours more effectively. 

The results were striking: the combination significantly reduced tumour size in all treated mice and even achieved complete remission in some cases. 

“Immune checkpoint blockades are effective in fewer than 25% of patients,” said James Elsten-Brown, a graduate student in the Yang lab and co-author of the study. “If a safe, widely available drug like an SSRI could make these therapies more effective, it would be hugely impactful.”

To confirm these findings, the team will investigate whether real-world cancer patients taking SSRIs have better outcomes, especially those receiving ICB therapies. About 20% of cancer patients are already taking the medication, Dr Yang said.

Dr Yang added that using existing FDA-approved drugs could speed up the process of bringing new cancer treatments to patients, making this research especially promising.

“Studies estimate the bench-to-bedside pipeline for new cancer therapies costs an average of $1.5 billion,” she said. “When you compare this to the estimated $300 million cost to repurpose FDA-approved drugs, it’s clear why this approach has so much potential.”

Source: University of California – Los Angeles Health Sciences

Categories : Injury & Trauma NeurologyTags : Leave a comment

Glasgow Coma Scale Joined by New Measures to Assess TBI

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Trauma centres in the United States will begin to test a new approach for assessing traumatic brain injury (TBI) that is expected to lead to more accurate diagnoses and more appropriate treatment and follow-up for patients.

The new framework, which was developed by a coalition of experts and patients from 14 countries and spearheaded by the National Institutes of Health (NIH), expands the assessment beyond immediate clinical symptoms. Added criteria would include biomarkers, CT and MRI scans, and factors such as other medical conditions and how the trauma occurred.

The framework appears in the May 20 issue of Lancet Neurology.

For 51 years, trauma centres have used the Glasgow Coma Scale to assess patients with TBI, roughly dividing them into mild, moderate, and severe categories, based solely on their level of consciousness and a handful of other clinical symptoms.

That diagnosis determined the level of care patients received in the emergency department and afterward. For severe cases, it also influenced the guidance doctors gave the patients’ families, including recommendations around the removal of life support. Yet, doctors have long understood that those tests did not tell the whole story.

“There are patients diagnosed with concussion whose symptoms are dismissed and receive no follow-up because it’s ‘only’ concussion, and they go on to live with debilitating symptoms that destroy their quality of life,” said corresponding author Geoffrey Manley, MD, PhD, professor of neurosurgery at UC San Francisco and a member of the UCSF Weill Institute for Neurosciences. “On the other hand, there are patients diagnosed with ‘severe TBI’ who were eventually able to live full lives after their families were asked to consider removing life-sustaining treatment.”

In the US, TBI resulted in approximately 70 000 deaths in 2021 and accounts for about half-a-million permanent disabilities each year. Motor vehicle accidents, falls, and assault are the most common causes.

New system will better match patients to treatments

Known as CBI-M, the framework comprises four pillars – clinical, biomarker, imaging, and modifiers – that were developed by working groups of federal partners, TBI experts, scientists, and patients.

“The proposed framework marks a major step forward,” said co-senior author Michael McCrea, PhD, professor of neurosurgery and co-director of the Center for Neurotrauma Research at the Medical College of Wisconsin in Milwaukee. “We will be much better equipped to match patients to treatments that give them the best chance of survival, recovery, and return to normal life function.”

The framework was led by the NIH National Institute of Neurological Disorders and Stroke (NIH-NINDS), for which Manley, McCrea, and their co-first and co-senior authors are members of the steering committee on improving TBI characterisation.

The clinical pillar retains the Glasgow Coma Scale’s total score as a central element of the assessment, measuring consciousness and pupil reactivity as an indication of brain function. The framework recommends including the scale’s responses to eye, verbal, and motor commands or stimuli, presence of amnesia, and symptoms like headache, dizziness, and noise sensitivity.

“This pillar should be assessed as first priority in all patients,” said co-senior author Andrew Maas, MD, PhD, emeritus professor of neurosurgery at the Antwerp University Hospital and University of Antwerp, Belgium. “Research has shown that the elements of this pillar are highly predictive of injury severity and patient outcome.”

Biomarkers, imaging, modifiers offer critical clues to recovery

The second pillar uses biomarkers identified in blood tests to provide objective indicators of tissue damage, overcoming the limitations of clinical assessment that may inadvertently include symptoms unrelated to TBI.

Significantly, low levels of these biomarkers determine which patients do not require CT scans, reducing unnecessary radiation exposure and health care costs. These patients can then be discharged. In those with more severe injuries, CT and MRI imaging – the framework’s third pillar – are important in identifying blood clots, bleeding, and lesions that point to present and future symptoms.

Source: University of California – San Francisco