Tomas Cihlar and Wesley Sundquist Are on the 2025 TIME100
Today, antiviral medications can turn HIV, a once fatal infection, into a chronic condition. Nonetheless, the cocktail of pills remains out of reach for many—and lapses in the daily regimen make them less effective. Wesley Sundquist, a biochemist at University of Utah, and Tomas Cihlar, a virologist at Gilead, a biopharmaceutical company, have labored for more than a dozen years to turn one antiviral treatment, lenacapavir, into a twice-a-year therapy to prevent HIV infection in those at high risk. Sundquist laid the groundwork in studying one of HIV's proteins, the capsid, which creates a protective shell around the virus' genome; Cihlar visited his labs and was impressed enough to take his discoveries to Gilead. There, his team found ways to extend the effect of the drug over six months, meaning infected patients only receive two injections a year to treat HIV. Researchers are now studying lenacapavir in people who are not HIV positive but are at high risk of exposure. If approved, it would be the first twice-a-year injected drug to prevent HIV. Early results show great promise.
Park is a TIME senior correspondent
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Medscape
6 hours ago
- Medscape
Novel Tuberculosis Shots May Benefit HIV-Positive Population
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Vox
6 hours ago
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What happens when we lose global health data?
is a fellow for Future Perfect. He reports on global health, science, and biomedicine, focusing on how policies and systems shape progress. A census enumerator, right, talks with a Maasai woman during the population and housing census, the first time being conducted digitally, at a village in Engikaret on August 23, 2022. AFP via Getty Images When President Donald Trump and Elon Musk fed the US Agency for International Development into the wood chipper earlier this year, one of the lesser-known casualties was the shutdown of an obscure but crucial program that tracked public health information on about half of the world's nations. For nearly 40 years, the Demographic and Health Surveys (DHS) Program has served as the world's health report card. In that time, it has carried out over 400 nationally representative surveys in more than 90 countries, capturing a wide range of vital signs such as maternal and child health, nutrition, education levels, access to water and sanitation, and the prevalence of diseases like HIV and malaria. Taken together, it offered perhaps the clearest picture ever compiled of global health. And that clarity came from how rigorous these surveys were. Each one started with a globally vetted blueprint of questions, used by hundreds of trained local surveyors who went door-to-door, conducting face-to-face interviews in people's homes. The final, anonymized data was then processed by a single contractor ICF International, a private consulting firm based in Reston, Virginia, which made the results standardized and comparable across countries and over time. Its data powered global estimates from institutions like the Institute for Health Metrics and Evaluation, which in turn shaped public health policy, research, and funding decisions around the world. 'If DHS didn't exist, comparing anemia across countries would be a PhD thesis,' said Doug Johnson, a senior statistician at the nonprofit IDinsight. Crucially, DHS also tracked things few other systems touched, like gender-based violence, women's autonomy, and attitudes toward domestic abuse. Doctor's offices aren't representative and only capture folks who can access a formal health care system. Also, since DHS data is anonymized, unlike a police report, responders don't have to fear intervention if they don't want it. 'You can't get answers from other sources to sensitive questions like the ones DHS posed,' said Haoyi Chen from the UN Statistics Division, pointing to one example: Is a husband justified in beating his wife if she burns the food? Then, earlier this year, DHS was shut down. The decision came as part of the Rescissions Act of 2025, a bill passed in June that clawed back $9.4 billion from foreign aid and other programs. Eliminating DHS saved the government some $47 million a year — only about 0.1 percent of the total US aid budget, or half the cost of a single F-35 fighter jet. Future Perfect Explore the big, complicated problems the world faces and the most efficient ways to solve them. Sent twice a week. Email (required) Sign Up By submitting your email, you agree to our Terms and Privacy Notice . This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. That tiny budget cut has had immediate consequences. The move halted around 24 in-progress country surveys – 10 of which were just short of final publication, and three in Ethiopia, Guinea, and Uganda that were stopped mid-fieldwork. The program's public-facing website remains up, but the machinery behind it is gone. With no one to approve new applications, the process for researchers to access the underlying microdata has ground to a halt. How the DHS has saved lives The shutdown isn't just about numbers on a spreadsheet. Here's how DHS data has shaped policy and saved lives across the globe. Guinea: DHS data was used to help tailor the rollout of the new malaria vaccine India: The 2019–2021 national survey (India's version of the DHS) showed a stark gap in menstrual hygiene between urban and rural areas, which prompted a new national policy to address the disparity. Nepal: A 2016 DHS survey revealed stagnating maternal mortality rates. This spurred the government to enhance its Safe Motherhood Program , resulting in more women delivering babies in health facilities rather than homes — and fewer women dying in childbirth. Nigeria: DHS surveys showed child marriage rates as high as 76 percent in some states. Advocates used that as evidence to successfully push local governments to strengthen their laws against the practice. There will also be long-term damage. When governments or aid organizations can no longer see exactly where children are malnourished, where malaria outbreaks are quietly spreading, or where mothers are dying in childbirth, they can't effectively target life-saving interventions, leaving the most vulnerable populations to pay the price. For 24 countries, including the Democratic Republic of Congo and Mali, the DHS was the sole data source for the UN's official maternal mortality estimates. Going forward, 'it would just be basically estimates that are based on other countries' data,' says Saloni Dattani, a editor on science and global health at Works in Progress magazine and 2022 Future Perfect 50 honoree. 'We just wouldn't know.' Without the data DHS provided, foreign aid becomes less effective, and less accountable 'We have no way of externally or objectively estimating the positive impact that those [aid] programs are having, or negative,' said Livia Montana, the former deputy director of the DHS Program, who is now a survey director for the Understanding America Study at the University of Southern California. Naturally, the global health community has been scrambling to plug the enormous gap. The Gates Foundation recently committed $25 million in emergency funding to rescue some ongoing surveys, and Bloomberg Philanthropies has also stepped in with a separate commitment to support the effort. This funding is a crucial lifeline, but only a stopgap. The search for a long-term fix has forced a reckoning with the old programs' flaws. Everyone agrees that DHS delivered high-quality, trusted data — but it wasn't perfect. Many experts have criticized it as fundamentally 'donor-driven,' with priorities that didn't always align with the national interests of the countries it surveyed. For instance, the program's historic focus on reproductive health was a direct reflection of the priorities of its primary funder, USAID, and some country officials privately felt the data served the accountability needs of international organizations better than their own immediate planning needs. This has created a central dilemma for the global development community: is it possible to build a new system that is both genuinely country-led and also globally comparable? A lifeline and a reckoning Faced with this data vacuum, an obvious question arises: Why can't other global organizations like the World Health Organization or the United Nations simply step in and take over? It's not out of the question, but it would be really, really difficult. Think of it this way: The DHS Program was like a single, powerful architecture firm that perfected a blueprint and built houses in 90 neighborhoods for 40 years. Because it was a single program managed by private contractor, ICF International, and backed by one major funder, USAID, it could enforce a standardized methodology everywhere it worked. As a for-profit firm, ICF's interest was also financial, it managed the global contract and profited from the work. The UN and WHO, by contrast, act as the global city planners: Their mandate isn't to design and build the houses themselves, but to set the building codes and safety standards for everyone. According to WHO, its role is not to 'directly fund population-based surveys,' but to provide leadership and bring the right stakeholders together. While that mandate may prevent the UN from simply inheriting the old program's work, it makes it an ideal coordinator for the path forward, says Caren Grown, a senior fellow at the Brookings Institution's Center for Sustainable Development. Grown argues that the UN is the only body that can handle the 'heavy lift' of coordinating all the different countries, donors, and organizations. And now that the DHS has been dissolved, both Grown and Chen are now part of a UN task force attempting to establish new internationally agreed-upon standards for how health data should be collected and governed. At the same time, other efforts are more focused on the practical work of implementation rather than on global governance. Montana is leading a coalition to 'rebuild elements of DHS' by creating a global consortium of research institutions that can provide technical support to countries. These efforts were catalyzed by initial conversations hosted by organizations like the Population Reference Bureau, which brought together donors, government agencies, and global data users to grapple with the shutdown's immediate aftermath. Critics argue that for every India, there are a dozen other nations where the program's sudden collapse is proof that a deep, sustainable capacity was never built. Between this mishmash, the most practical development has been a lifeline from the Gates Foundation, which announced a $25 million investment in 'bridge funding.' Separately, in a statement to Vox, Bloomberg Philanthropies confirmed its commitment to fund the completion of an additional 12-country surveys over the next eight months. A source from the Gates Foundation clarified that Bloomberg's commitment is on top of theirs, confirming the two are distinct but coordinated rescue efforts. The Gates Foundation framed its effort as a temporary, stabilizing measure designed to give the global health community a much-needed respite. 'We believe data is — and must remain — a global public good,' said Janet Zhou, a director focused on data and gender equality at the Gates Foundation. 'Our interim support is helping to stabilize 14 ongoing country surveys. … This investment is designed to give global partners and national governments the time and space needed to build a more sustainable, country-led model for health data.' That support is aimed at the most urgent work: finishing surveys that were nearly complete, like in Ethiopia, and reopening the four-decade-old data archive. But rather than giving each respective country the money to complete their ongoing surveys, the Gates funding will be administered by ICF International, the same for-profit firm that ran the original DHS. The decision to work with the existing contractor, ICF International, was a pragmatic one. Continuing with the same implementer was the 'quickest, most affordable way' to prevent waste, and 'multiple host countries have shared a preference' to complete their work with the firm, said a source at the Gates Foundation. A Sudanese mother sits with her children at a shelter in the al-Qanaa village in Sudan's southern White Nile state on September 14, 2021. Ashraf Shazly/AFP via Getty Images It's a powerful argument for triage in an emergency, but it also papers over deeper flaws. Take a look at Nigeria, for example: Fieldwork for its 2023–'24 DHS finished in May 2024, and the questionnaires gathered new estimates of maternal and child deaths. Nigeria also ran a separate study to probe exactly why mothers and children are dying. In principle, the two datasets should dovetail but beyond a headline-numbers report, the full DHS micro-dataset is still in ICF's processing queue — likely frozen after DHS's shuttering. That bottleneck illustrates what critics mean by 'donor-driven.' With barely 3 percent of household surveys in low-income countries fully-financed by the local government, the WHO notes, most nations must rely on 'externally led surveys…limiting continuity and national ownership.' When the donor funding stops, so does the data pipeline. An ICF spokesperson pushed back saying survey priorities were 'primarily shaped by the participating countries.' Yet, of the $25 million that arrived from Gates, a large portion of it will go toward completing large-scale surveys in Nigeria and Kenya, two countries that also happen to be key 'geographies of interest' for the Gates Foundation's own strategic priorities, underscoring how funders still steer the spotlight. Insiders I spoke with described ICF's system as a 'black box,' with key parts of its methodology controlled by the contractor, leaving countries without the capacity to stand on their own. That matters because without home-grown statisticians and know-how, ministries can't rerun surveys or update indicators without outside help. In response, ICF stated that the program has a 'proven track record of building a long-term capacity,' noting that countries like India no longer require its assistance. But critics argue that for every India, there are a dozen other nations where the program's sudden collapse is proof that a deep, sustainable capacity was never built. This dependency creates a fragile system that can, as just happened, collapse overnight, leaving countries unable to continue that work on their own. This unresolved tension brings the debate back to a central question from the UN's Chen. 'DHS has been there for four decades,' she asks, 'and why are we still having this program doing the survey for countries?' Chen's question gets to the heart of the debate. But grappling with the flaws of the past can't get in the way of surviving the present. Existing global health data is already several years out of date due to the pandemic, while crises in maternal mortality and child nutrition continue to unfold. The need is for reliable data now, because the fundamental reality remains: You can't help people you can't see.
Yahoo
7 hours ago
- Yahoo
Humans may have untapped 'superpowers' from genes related to hibernation, scientists claim
When you buy through links on our articles, Future and its syndication partners may earn a commission. Hibernating mammals rely on particular genes to adjust their metabolisms as they enter that unique, low-energy state — and humans actually carry that same hibernation-related DNA. Now, early research hints that leveraging this particular DNA could help treat medical conditions in people, scientists say. Hibernation offers "a whole bunch of different biometrically important superpowers," senior study author Christopher Gregg, a human genetics professor at the University of Utah, told Live Science. For example, ground squirrels can develop reversible insulin resistance that helps them rapidly gain weight before they hibernate but starts fading as hibernation gets underway. A better understanding of how hibernators flip this switch could be useful for tackling the insulin resistance that characterizes type 2 diabetes, Gregg suggested. Hibernating animals also protect their nervous systems from damage that could be caused by sudden changes in blood flow. "When they come out of hibernation, their brain is reperfused with blood," Gregg said. "Often that would cause a lot of damage, like a stroke, but they've developed ways to prevent that damage from happening." Gregg and his colleagues think tapping into hibernation-related genes in people could unlock similar benefits. Related: Best-ever map of the human genome sheds light on 'jumping genes,' 'junk DNA' and more A 'hub' of hibernation genes In a pair of studies published Thursday (July 31) in the journal Science, Gregg and his team pinpointed key levers that control genes related to hibernation, showing how they differ between animals that hibernate and those that don't. Then, in the lab experiments, they delved into the effects of deleting these levers in lab mice. Although mice don't hibernate, they can enter torpor — a lethargic state of decreased metabolism, movement and body temperature that typically lasts for less than a day — after fasting for at least six hours. This made mice a suitable genetic model for studying these effects. Using the gene-editing technique CRISPR, the scientists engineered mice with one of five conserved noncoding cis elements (CREs) deactivated, or "knocked out." These CREs act as levers to control genes that, in turn, code for proteins that carry out biological functions. The CREs targeted in the study lie near a gene cluster called the "fat mass and obesity-related locus," or the FTO locus, which is also found in humans. Gene variants found within the cluster have been tied to an elevated risk of obesity and related conditions. Broadly speaking, the FTO locus is known to be important for controlling metabolism, energy expenditure and body mass. By knocking out the CREs, the researchers were able to change the mice's weights, metabolic rates and foraging behaviors. Some deletions sped up or slowed down weight gain, others turned metabolic rate up or down, and some affected how quickly the mice's body temperatures recovered after torpor, the researchers said in a statement. This finding is "highly promising," particularly given the FTO locus plays a well-known role in human obesity, Kelly Drew, a specialist on hibernation biology at the University of Alaska Fairbanks, told Live Science in an email. Knocking out one CRE — called E1 — in female mice caused them to gain more weight on a high-fat diet than did a comparison group with all of their DNA intact. Deleting a different CRE, called E3, changed the foraging behavior of both male and female mice, specifically changing how they searched for food hidden in an arena. "This suggests that important differences in foraging and decision processes may exist between hibernators and non-hibernators and the elements we uncovered might be involved," Gregg said. Unknowns to address The study authors said their results could be relevant to humans, since the underlying genes don't differ much between mammals. "It's how [the mammals] turn those genes on and off at different times and then for different durations and in different combinations that shape different species," Gregg said. However, "it's definitely not as simple as introducing the same changes in human DNA," Joanna Kelley, a professor who specialises in functional genomics at the University of California, Santa Cruz, told Live Science in an email. "Humans are not capable of fasting-induced torpor, which is the reason why mice are used in these studies," said Kelley, who was not involved in the work. She suggested that future work include animals incapable of torpor, and focus on unpacking all the downstream effects of the deleted CREs. As is, the current study "definitely points the field in a new direction" in terms of how scientists understand the genetic controls driving changes in hibernators throughout the year, she added. Drew also highlighted that torpor in mice is triggered by fasting, while true hibernation is triggered by hormonal and seasonal changes and internal clocks. So while the CREs and genes the study identified are likely critical parts of a metabolic "toolkit" that responds to fasting, they may not be a "master switch" that turns hibernation on or off. RELATED STORIES —Scientists may be able to put Mars-bound astronauts into 'suspended animation' using sound waves, mouse study suggests —'Let's just study males and keep it simple': How excluding female animals from research held neuroscience back, and could do so again —Weight loss may 'rejuvenate' fat tissue in the body "Nevertheless, uncovering these fundamental mechanisms in a tractable model like the mouse is an invaluable stepping stone for future research," Drew said. Gregg emphasized that much remains unknown, including why the effects of some deletions differed in female mice versus male mice or how the changes in foraging behavior seen in mice might manifest in humans. The team also plans to research what would happen if they deleted more than one hibernation-linked CRE at a time in mice. Down the line, Gregg thinks it could be possible to tweak the activity of humans' "hibernation hub genes" with drugs. The idea would be that this approach could yield the benefits of that gene activity — like neuroprotection — without patients having to actually hibernate, he said. Solve the daily Crossword
