US Senate approves budget increase for biomedical research; The latest health stories from around the world

Article by Lalita Panicker, Consulting Editor, Views and Editor, Insight, Hindustan Times, New Delhi

To the relief of biomedical research advocates, a US Senate spending panel has approved a modest budget increase of 2% for the National Institutes of Health (NIH). The bump to $47.8 billion roughly matches President Joe Biden’s request for the 2024 fiscal year that begins this fall. Although below the rate of biomedical inflation, it is far more generous than a corresponding House of Representatives bill that would slash NIH’s budget by 6%. Advocacy groups welcomed the measure approved on 27 July by the Senate appropriations committee. www.science.org/content/article/senate-panel-approves-2-bump-nih-budget-2024?

Mental health and Alzheimer’s disease research are each tagged for $100 million increases in the bill, and cancer research for a boost of $60 million. The Senate panel would provide level funding of $1.5 billion for the Advanced Research Projects Agency for Health, whereas the House measure would cut the 1-year-old agency to $500 million.

The Centres for Disease Control and Prevention (CDC), which is cut 17% in the House bill, would stay flat at $9.2 billion in the Senate measure. It would also preserve a new CDC centre for forecasting disease outbreaks that is zeroed out in the House bill, but would trim its $50 million budget by 10%.

The bill does not include three funding bans in the House measure awaiting approval by the full appropriations committee. The House bill would ban NIH research using fetal tissue from elective abortions; funding for EcoHealth Alliance, a non-profit that collaborated with virologists in Wuhan, China, on studies some claim caused the COVID-19 pandemic; and funding for any government lab in China or other countries considered foreign adversaries. They are Republican proposals that are unlikely to survive in a final spending bill.

The Senate committee has proposed one big change at NIH that enjoys bipartisan support: More turnover of leadership. NIH should end its “long-standing practice of allowing its top officials to effectively serve indefinitely,” states a report accompanying the bill.

Citing advice from a 2003 Institute of Medicine panel, the Senate panel urges NIH to adopt a policy that would limit directors of NIH’s 27 institutes or centres to two 5-year terms.

Although many NIH directors have been on the job less than a decade, a few have served much longer. They include Nora Volkow, director of the National Institute on Drug Abuse since 2003, and Richard Hodes, who has headed the National Institute on Aging since 1993. Anthony Fauci stepped down last year as director of the National Institute of Allergy and Infectious Diseases after serving in that position for 38 years. The limit would not apply to the NIH director, who serves at the pleasure of the president.

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US President Joe Biden’s administration last week appointed Paul Friedrichs, a surgeon and retired Air Force major general, as the inaugural director of the White House Office of Pandemic Preparedness and Response Policy. www.science.org/content/article/news-glance-glimpsing-forming-planets-hunting-hydrogen-iconic-parrots-return?

The unit is responsible for coordinating and implementing plans to respond to biological threats and pathogens that could lead to a pandemic. It replaces a response team focused on COVID-19. Public health specialists have warned that despite COVID-19, the world remains underprepared for future pandemics.

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The Chinese lab at the centre of the debate about the origin of the COVID-19 pandemic was suspended last week from receiving funding from the U.S. Department of Health and Human Services (HHS). www.science.org/content/article/news-glance-glimpsing-forming-planets-hunting-hydrogen-iconic-parrots-return?

From 2014 to 2019, the Wuhan Institute of Virology (WIV) obtained money from the National Institutes of Health, an HHS branch, through a subcontract to a U.S. non-profit, the EcoHealth Alliance. HHS faulted WIV for not sharing laboratory notebooks and electronic files related to a mouse experiment that engineered a bat coronavirus and may have made it more dangerous to humans. HHS’s suspension order carries more symbolic than practical impact and includes a proposal to permanently bar the lab from future grants or contracts. HHS does not allege that the mouse experiments created SARS-CoV-2, but suspects they violated biosafety conditions stipulated with that grant. Critics of HHS say it bowed to political pressure and the action undermines relations with Chinese scientists who could help prevent future pandemics.

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More than three million cases of dengue have been reported in the Americas so far this year. That means 2023 already has the second-highest annual incidence of the disease since 1980, when the Pan American Health Organization began collecting data on the number of cases (see ‘Dengue on the rise’). https://www.nature.com/articles/d41586-023-02423-w?

“We do observe an increase in cases beyond what was expected for this period,” says Cláudia Codeço, an epidemiologist at the Oswaldo Cruz Foundation, a biosciences and public-health institution in Rio de Janeiro, Brazil. Whether the record of 3.2 million cases reported in 2019 will be broken in 2023 depends on how the disease spreads in Central and North America, because most researchers think the peak of dengue season in South America has passed.

But rising temperatures and changes in rainfall patterns might help to explain the trend, researchers say. Dengue’s main vector, the Aedes aegypti mosquito, thrives at temperatures around 30 °C and in humid conditions, which have become more frequent in the past few years as a result of record heat and extreme weather events.

There is no specific treatment for the disease, which can cause fever, headache and fatigue. Severe cases can be fatal: more than 1,300 people have died from dengue in the Americas so far this year.

Dengue is spreading to regions that were once off-limits to A. aegypti. In Brazil — which has reported nearly 2.4 million cases this year — the disease is expanding into southern states, which were previously too cold for the mosquito. Over the past 5 years, 481 Brazilian municipalities have registered sustained local transmission of dengue for the first time, according to an analysis by Codeço and her colleagues. And Mexico City, at an altitude of 2,240 metres, recorded its first A. aegypti invasion in 2015. “If you read books about the biology of the Aedes aegypti, they say the mosquito doesn’t reproduce at altitudes above 1,200 metres,” says José Ramos-Castañeda, a virologist at the Mexican National Institute of Public Health in Cuernavaca. “In that aspect, global warming is affecting the distribution of the vector and therefore the possible distribution of cases.”

Researchers at the University of Michigan in Ann Arbor have investigated how rising temperatures in parts of Brazil might affect dengue’s epidemic potential — the chance of it spreading among people — in the late 2040s.

The phenomenon is not restricted to South America. In the continental United States, local transmission of dengue has already been registered in Florida, Texas and Arizona.

Dengue is typically seasonal — case numbers tend to go up in summer or the rainy season and down in winter or the dry season. But global temperature increases mean that dengue seasons might get longer.

In the short term, the ongoing El Niño weather event — which is expected to bring floods, droughts and record temperatures — could have consequences for dengue. In late June, the director-general of the World Health Organization, Tedros Adhanom Ghebreyesus, warned that the phenomenon “could increase transmission of dengue and other so-called arboviruses such as Zika and chikungunya”.

El Niño will probably have the greatest impact on dengue incidence in Central America and parts of North America, regions that are now going through the rainy season.

Several strategies have been used to control dengue transmission. They include the use of traps or insecticides to kill the mosquito host, and getting rid of open containers of stagnant water, where the insects can breed. There are also efforts to develop modified mosquitoes that cannot transmit the disease.

All these approaches can help, says Ramos-Castañeda, but “the thing that could really impact the transmission is immunity in the population”. Two dengue vaccines have been approved by authorities in some locations since 2015, but they haven’t been widely adopted, owing to issues with efficacy, safety concerns and high prices.

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A study that followed thousands of people over 25 years has identified proteins linked to the development of dementia if their levels are unbalanced during middle age. https://www.nature.com/articles/d41586-023-02374-2?

The findings, published in Science Translational Medicine on 19 July, could contribute to the development of new diagnostic tests, or even treatments, for dementia-causing diseases.

Most of the proteins have functions unrelated to the brain.

“We’re seeing so much involvement of the peripheral biology decades before the typical onset of dementia,” says study author Keenan Walker, a neuroscientist at the US National Institute on Aging in Bethesda, Maryland.

Equipped with blood samples from more than 10,000 participants, Walker and his colleagues questioned whether they could find predictors of dementia years before its onset by looking at a person’s proteome — the collection of all the proteins expressed throughout the body. They searched for any signs of dysregulation — when proteins are at levels much higher or lower than normal.

The samples were collected as part of an ongoing study that began in 1987. Participants returned for examination six times over three decades, and during this time, around 1 in 5 of them developed dementia.

The researchers found 32 proteins that, if dysregulated in people aged 45 to 60, were strongly associated with an elevated chance of developing dementia in later life. It is unclear how exactly these proteins might be involved in the disease, but the link is “highly unlikely to be due to just chance alone”, says Walker.

As expected, some of the proteins that researchers identified are active in the brain — but most have other roles in the body. A handful were linked to proteostasis — the process of carefully balancing protein levels in the proteome.

This regulation is important in preventing proteins from going rogue and clumping together, which is what happens to the amyloid and tau proteins in the brains of people with Alzheimer’s disease, the most common cause of dementia.

The study found altered levels of many of the proteins both in the brain tissues of those who had died with Alzheimer’s disease, and in the blood of those still living with it. These were associated with the presence of amyloid and tau proteins, which suggests they are somehow involved in processes specific to the disease.

There is still a long way to go in understanding exactly how any of these proteins fit into the physiology of dementia, and a much better understanding of the underlying mechanisms is needed before people can benefit.

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