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Why Africa – and the World – Remain Dangerously Unprepared for the Next Pandemic

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Oyewale Tomori, Nigerian Academy of Science

As the news spread about the outbreak of Ebola in mid-May 2026, the World Health Organization (WHO) released a report about pandemics. The title was: A World on the Edge: Priorities for a Pandemic-Resilient Future.

The document was prepared by the WHO’s Global Preparedness Monitoring Board. It sets out why the world isn’t better prepared for pandemics a decade after Ebola exposed dangerous gaps. And six years after COVID-19 turned those gaps into a global catastrophe.

It adds that investment in pandemic preparedness has not kept pace with the rising risk of pandemics.

The Global Preparedness Monitoring Board is an independent monitoring and accountability body established in 2018 by the WHO and the World Bank. The aim was to strengthen preparedness for global health crises. It is composed of political leaders, agency principals and world-class experts. Its task is to provide assessments of global progress in building and sustaining the capacity to prevent, detect and respond to health emergencies.

The report was released during another Ebola epidemic. This time starting in the Democratic Republic of Congo. On 17 May the WHO declared the outbreak a public health emergency of international concern. This means that it is a risk to many countries through international spread and hence requires global coordinated efforts.

As a virologist and former global health administrator, I believe the monitoring board’s diagnosis and recommendations are vitally important for managing pandemics.

My first observation about the report is that its recommendations remain largely unimplemented by many countries. This is particularly true in Africa, where pandemics thrive and disease epidemics rage and ravage.

Africa needs to specially build trust in its own ability to prepare for and prevent disease outbreaks, and control them when they do occur.

To achieve this, and in line with the recommendations, Africa must sustain:

  • independent pandemic risk monitoring
  • health workforce capability and retention
  • equitable access to countermeasures such as vaccines
  • financing
  • political attention.

Independent pandemic risk monitoring

Using local resources and financing, African countries must own the solution to health through establishing data systems that uphold health sovereignty.

They must also ensure that data derived from surveillance, research and pathogen processing are securely managed and accountable to African institutions rather than foreign entities. Recent agreements with the US have brought this issue to the fore. Some were asking African countries to sign away their health data or prodigally release their precious pathogens in a barter exchange for donor funding.

But health data are an invaluable asset for public health, clinical management and research. They help countries identify diseases and develop vaccines and treatments.

What African countries should be doing instead is mobilising locally sourced counterpart funds. These should be used to create the local environment to support and enhance the capacity of indigenous scientists and researchers to develop innovations from national/natural pathogens for global benefits.

Two African health institutions should be at the centre of these endeavours: the WHO-Africa Region and the Africa Centers for Disease Control, an agency of the African Union. They must not compete, but collaborate and spearhead these efforts through centralised disease control and tracking scorecards.

Health workers

Fostering the well-being of health workforce results in growth, higher productivity, national pride and loyalty.

It also helps in long-term retention of health workers.

African countries need to prioritise capacity retention over capacity building. They must build and sustain a conducive work environment which involves physical workspace and psychological safety.

Availability of adequate resources is needed to function effectively and productively. This includes materials, laboratory facilities, supplies, reagents and consumables for a trained African health workforce and researchers.

Under such enabling conditions, the health workforce can focus on relevant and local health issues and find appropriate solutions to them.

Equitable access to countermeasures

Africa must not compromise on the ratification of international health pacts that guarantee fair technology transfer, intellectual property waivers, and robust regional manufacturing.

Countries must equally expand local production of laboratory diagnostic kits, vaccines and medical supplies as well as non-medical products. Such include gloves, personal protective equipment and masks.

This will reduce reliance on external donation and supply chains in and out of global crises.

Sustainable financing

The greater challenge for many African countries is the waste of available resources and spending on misplaced priorities.

To address this, governments must commit to sustained domestic investment in healthcare. At the same time they must use blended financing (involving both the public and private sectors) to close remaining gaps. Initiatives such as the African Epidemic Fund offer a practical model for building financial reserves for rapid, locally led responses. The fund, launched in 2025, is designed to mobilise funding to support preparedness and response efforts to combat public health threats on the continent. The African Epidemic Fund, though relatively new, must operate at the highest level of accountability. It must provide regular updates on contributions, projects supported and their impact on disease preparedness, prevention and control in Africa.

Sustained political attention

African leaders must keep pandemic preparedness high on the political agenda to ensure continuous resource allocation and accountability. The advocacy for preparedness must go beyond political campaign slogans. It must be driven by regional bodies like the African Union. Countries must then translate commitments into tangible national policies.

There can be no recess or holiday from pandemic preparedness.

African political leaders and elites, at the continental, national and sub-national levels, have crucial roles to play in achieving trusted community engagement and involvement for successful and reliable pandemic preparedness. Above all, there must be active community engagement and involvement.

Oyewale Tomori, Fellow, Nigerian Academy of Science

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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New Research Could Improve Bioluminescence-based Applications in Medicine

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Killer T cells surround a cancer cell. Credit: Alex Ritter, Jennifer Lippincott Schwartz and Gillian Griffiths, National Institutes of Health (CC BY 2.0).

Like fireflies and many deep-sea creatures, certain fungi can naturally emit light through bioluminescence pathways in which specialised enzymes convert chemical energy into visible light. Medical researchers have used fungal light-producing enzymes in the Fungal Bioluminescence Pathway (FBP) to visually track processes like tumour progression and inflammatory responses. New research published in The FEBS Journal provides insights that may help improve and expand such bioluminescence-based tools and applications.

One of the products of the FBP is oxyluciferin, which in fungi is subsequently degraded and recycled back into the pathway, sustaining the bioluminescent process. Previous studies have suggested a role for the caffeylpyruvate hydrolase (CPH), the last of four enzymes involved in the FBP, in breaking down oxyluciferin, but results have been inconclusive. In this latest study, investigators characterised CPH from one of the largest and brightest bioluminescent fungal species described to date, confirming that the enzyme converts oxyluciferin into caffeic and pyruvic acids. Caffeic acid can re-enter the pathway to sustain light emission, while pyruvic acid may be redirected into central metabolism to help generate cellular energy, potentially reducing the energetic cost of bioluminescence. The scientists also developed a new method to monitor CPH activity, thereby providing a useful resource for further studies on bioluminescence.

The findings could be used to develop self-sustained light-emitting systems in other organisms, with potential applications across medicine, agriculture, environmental monitoring, and biotechnology.

“After eight years of work, we were finally able to demonstrate that the breakdown of fungal oxyluciferin by CPH produces caffeic acid and pyruvic acid. This finding helps explain how fungi sustain bioluminescence through metabolite recycling while potentially recovering part of the energy invested in light emission,” said co–corresponding author Cassius V. Stevani, PhD, of the University of São Paulo, in Brazil. “It also provides important insights for the design of engineered cells capable of emitting brighter light in a more efficient and sustainable way.”

Source: Wiley

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Younger Adults Face Risks With ‘Quick-Fix’ for Heart Valve Surgery

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University of Rochester Medicine researchers urge collaborative decision making

Artificial heart valve. Credit: Scientific Animations CC4.0

Growing demand for a minimally invasive aortic valve replacement by adults under 65 with aortic stenosis may put many at greater risk for potentially more complicated heart surgeries later, according to University of Rochester Medicine research published in The Annals of Thoracic Surgery.

Scientists recommend patients work with a multidisciplinary heart care team to assess their short- and long-term needs when facing surgery.

The procedure, transcatheter aortic valve replacement (TAVR), is less invasive than open heart surgery, offering a faster recovery. Since its introduction in 2011, TAVR is the recommended alternative for frail adults over 65 who cannot withstand surgical aortic valve replacement (SAVR) and younger adults whose mortality risk is high.

However, analysis of the Vizient Clinical Database of nearly 14 000 aortic stenosis cases between 2018 and 2023 showed nearly half of the lowest risk patients under 65 underwent TAVR despite the recommendation that they undergo SAVR. And SAVR can be performed using less invasive techniques that can reduce recovery times.

“It’s not surprising that people want a ‘quick fix’ that lets them get back to their normal routine. However, TAVR is not without risks,” said Laurent G. Glance, MD, lead author and professor of Anesthesiology and Perioperative Medicine. “The bioprosthetic valve can wear out or leak and lead to additional complicated surgeries later.” 

Aortic stenosis is diagnosed when the aortic valve gets thick and narrow, restricting blood flow, forcing the heart to work harder. It causes shortness of breath, fatigue, dizziness and can lead to heart failure.

The TAVR technique delivers the new valve through a catheter in the groin and threaded through the femoral artery into the heart. Once inside, it is placed and expanded inside the failing valve.

Researchers reviewed hospital practice data and risk calculations and concluded “the marked use of TAVR among low-risk younger patients…may not represent the optimal long-term strategy for young patients.”

Explanting and replacing a failed TAVR valve requires SAVR, the open surgical approach, which the younger patients initially aimed to avoid. They face potentially slow and painful recovery and face risk of serious complications such as life-threatening stroke.

Co-author and chief of Cardiac Surgery Peter Knight, MD, said the rapid adoption of TAVR for younger adults has outpaced the data to assess durability of the valve and long-term patient outcomes. 

“Careful decision-making is needed and patients should do their homework and talk with their physicians,” Knight said. “You have to look at the short- and long-term needs when making this important choice.”

Source: University of Rochester Medical Center

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How Macrophages Fail Their Jobs in Cystic Fibrosis

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Respiratory tract. Credit: Scientific Animations CC4.0

Researchers have discovered how part of the body’s immune system could better combat a leading cause of death for people with cystic fibrosis (CF). 

A team led by The University of Queensland’s Professor Peter Sly and Dr Abdullah Tarique has identified how macrophages – the white blood cells that fight infection in the body – function differently in people with CF, compared to others.

“Macrophages play a critical role in fighting infection, especially in the lungs,” Professor Sly said.

“They’re the ‘Pac-Man’ cells that find and ‘gobble up’ bacteria and pathogens such as mycobacterium abscessus (MABS). 

“We found people with CF have multiple defects in their macrophages that leave them more vulnerable to infection, even when taking the most effective CF drug treatment available.”

Professor Sly said MABS posed the biggest infection risk for people with CF.  

“MABS is resistant to many antibiotics which makes treatment complex and often unsuccessful,” he said. 

“The infection can exclude a patient from being eligible for a lung transplant and is a leading cause of death for people with CF.

“And because of antibiotic resistance, MABS infections are increasing at alarming rates.”

Professor Sly said in people with CF, macrophages aren’t as efficient at both recognising and killing off bugs in the body.

“CF involves a defect in the CFTR protein, the channel on the cell’s surface responsible for transporting ions and chlorine in and out of cells,” he said.

“That lack of chlorine transport means macrophages don’t activate their killing functions to ‘eat’ the bugs. 

“A second important mechanism in macrophages is also deficient – the zinc transport of proteins. 

“Zinc is a potent antibacterial mechanism used to poison bacteria, but with less zinc and less zinc transporter proteins in CF macrophages, they’re less able to fight the infection.”

Professor Sly said a third defect – in the mitochondria – is perhaps the most significant.

“Mitochondria are the batteries or power packs of cells, and produce things called reactive oxygen species to kill bacteria.

“In CF, not only are macrophages less able to make these reactive oxygen species, but they’re also not able to keep reproducing them to increase their mitochondrial mass when infected.”

The research also examined treatments for CF and found even the most effective drug doesn’t boost macrophage’s ability to kill MABS.

“Elexacaftor-tezacaftor-ivacaftor (ETI) has been revolutionary in CF treatment by improving lung function in many people, meaning fewer exacerbations and hospitalisations,” Professor Sly said.

“But it doesn’t fix this part of the immune system, which is why people with CF still get these infections.

“Our findings show we now need to accelerate research into different mechanisms of increasing macrophage function, to identify and initiate killing strategies for MABS. 

“This could significantly reduce the impact of these infections for people with CF.”

Read the research in Proceedings of the National Academy of Sciences.

Source: University of Queensland

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Clinical Trials Are Part of UP Professor’s Dream of ‘Making Deafness History’

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University of Pretoria’s Professor Mashudu Tshifularo is leading a groundbreaking clinical trial for 3D-printed ossicles,

Forty-five patients with conductive hearing loss from middle-ear damage are eagerly awaiting the start of clinical trials, led by University of Pretoria’s Professor Mashudu Tshifularo, on a ground-breaking procedure to restore hearing.

The trials, due to begin within weeks at Steve Biko Academic Hospital in Pretoria, come seven long years after Prof Tshifularo successfully performed the world’s first middle-ear transplant using 3D-printed bones made from titanium. The patient was Thabo ***, whose middle-ear bones – the ossicles – had been injured in an accident, causing almost total hearing loss until he had the transplant in March 2019.

In a video screened at a UP Roundtable event held in April this year to announce the launch of the upcoming clinical trials, a beaming Thabo *** confirmed he had regained his hearing after the transplant and had continued to enjoy excellent hearing ever since.

While this procedure was hailed as a surgical breakthrough at the time, its full acceptance by the South African and global ear, nose and throat (ENT) community depends on formal clinical validation. Despite the many obstacles he knew would lie ahead, Prof Tshifularo, joint head of UP’s Department of Otorhinolaryngology, was determined to take his innovation through clinical trials.

“Today is a culmination that I never thought would come. There was a time when I cried, there was a time when I was very depressed, there was a time when I nearly gave up, but something inside me told me to remain steady,” he said at the Roundtable, where the announcement was made that clinical trials could finally move ahead now that all the necessary regulatory, ethical and licensing clearances have been obtained, including from the South African Health Products Regulatory Authority (SAHPRA).

The years since Prof Tshifularo performed that first transplant have also been spent developing, perfecting, testing and patenting a prototype of the titanium material and implants for the clinical trials. UP’s engineering partner on this project, the Council for Scientific and Industrial Research (CSIR), was responsible for the materials and prototype development, while HH Industries manufactures the implants, using 3D printing technology, and Marcus Medical is providing the robotic technology to be used during the surgery. Seed funding was provided by the Motsepe Foundation.

Ready to transform lives

Now that it is all-systems-go for this all-South African collaborative effort, Prof Tshifularo and his team aim to perform this life-changing surgery in the next 12 months on all 45 patients who have expressed interest in participating in the clinical trials.

The team will then focus on publishing their research and training future researchers and medical teams so that the work can be amplified far and wide for the benefit of humanity.

“My dream is to make deafness history,” Prof Tshifularo said, noting that an estimated two billion youth are living with undiagnosed, mostly noise-induced hearing loss, which would become a severe problem in the next 20 to 25 years. Hearing loss is also common among the world’s rapidly ageing population.

The procedure itself takes about three hours and uses advanced robotics to remove the damaged middle-ear bones and replace them with the 3D printed titanium bones. This is minimally invasive, carries significantly less risk than conventional procedures and leaves minimal scarring. The titanium used to manufacture the ossicles is biocompatible, meaning it can be introduced into the ear without causing harmful reactions.

“This innovation will ultimately transform the lives of many people, including newborn babies born with congenital middle-ear defects,” said Prof Themba Mosia, Vice-Principal: Student Life, who gave the opening address at the Roundtable. “It exemplifies the spirit of innovation and collaboration at the university, combined with the deep medical expertise needed to restore hearing.”

UP at the forefront of healthcare advancements

Prof Flavia Senkubuge, Dean of UP’s Faculty of Health Sciences, said innovations such as Prof Tshifularo’s middleear surgical procedure place the university “front and centre” of healthcare advancements on the African continent and the world stage.

She reiterated UP’s commitment to deploying its innovations for the benefit of local communities, such as by establishing a “one-stop shop” – most likely in the form of a private day hospital – where community members could benefit from advanced clinical technologies and the expertise of its researchers.

Paying tribute to Prof Tshifularo, long-time colleague Dr Christian Quitter thanked Prof Tshifularo “for having the guts” to persevere with his innovation, even when it was not always supported by the ENT establishment.

He also thanked the university for supporting researchers who “think out of the box in seeking to improve the lives of all humanity”.

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Updated Colorectal Cancer Guidelines: New Stool Tests, Limited Use of Blood Tests

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Source: CC0

With colorectal cancer a growing concern among younger people, the American Cancer Society has endorsed two new types of stool tests to encourage people to get screened while also recommending a limited role for new blood tests many patients find appealing.

The recommendations are an update to the ACS’s screening guidelines – an update led by Andrew Wolf, MD, a cancer-prevention expert at UVA Health. He and a blue-ribbon panel of cancer experts conducted a systemic review of the available colorectal cancer tests to determine which are most effective. In addition to recommending a next-generation DNA stool test and a new type of RNA stool test, the group is advising doctors to recommend blood tests only to  patients who decline all other options.

The recommendations come with a dose of pragmatism: “The most effective screening test,” the panel concludes, “is the one that the patient completes.”

“The new guidance adds a stool RNA test and an updated stool DNA test to the menu of preferred options for colorectal cancer screening, which currently include colonoscopy and stool tests that detect tiny amounts of blood, among other options,” said Wolf, a professor emeritus at the University of Virginia School of Medicine. “Although the idea of a blood test for colorectal cancer sounds very attractive, they aren’t yet as good as the other tests at detecting precancerous growths and early-stage cancer, so we don’t believe they are as effective as a screening test. That said, we’re very hopeful that broadening the array of options will get more folks screened and reduce the burden of suffering from colorectal cancer.”

About Colorectal Cancer

Colorectal cancer is the second-leading cause of cancer deaths in the United States, killing 55 000 people in 2026. Improvements in detection, screening and treatment have contributed to declining colorectal cancer death rates over the last several decades, but that decline has been accompanied since 2013 by an alarming increase in the cancer among people under the age of 50. Among that age group, colorectal cancer is now the leading cause of cancer death for men and the second-leading cause for women.

In response, the American Cancer Society in 2018 lowered the recommended age for initial colorectal cancer screening from 50 to 45 for people at average risk. It also affirmed the importance of screening tools such as stool-based tests as well as visual exams such as colonoscopies. Since then, however, new, multi-target stool tests and blood-based screening tests have become available. The new blood tests proved popular in a patient survey, with 53% of respondents saying they would prefer blood testing every three years to taking a stool test every year or receiving a colonoscopy every 10.

For the latest guideline update, Wolf and his colleagues examined the effectiveness of the new tests to provide doctors with guidance on if, how and when they should be used. The experts conclude that the DNA and RNA tests had high sensitivity for detecting colorectal cancer and moderate sensitivity for detecting advanced precancerous lesions that are about to turn into cancer. The blood tests, on the other hand, showed lower sensitivity for both advanced precancerous lesions and stage 1 cancers.

“While colorectal screening blood tests may not be as effective as other options, they are certainly better than not screening,” Wolf said. “So if a patient declines a stool test or a visual exam like a colonoscopy, a blood test would be the way to go, as long as the patient understands it is not as effective, and, if it is positive, they will still need to have a colonoscopy.”

Based on their results, the experts endorse the stool tests for patients at average risk but urge doctors to reserve the blood tests for patients who refuse other screening options. And they recommend that anyone who tests positive on any stool or blood test should receive a colonoscopy promptly.

It’s important, they note, that doctors explain to patients the strengths and weaknesses of the available tests so that patients can make informed decisions.

“Currently, almost a third of adults are not up to date with colorectal cancer screening, and among those ages 45 to 49, it’s twice that number,” Wolf said. “We hope these new options will help to close this gap. The most important message is that colorectal cancer is a disease you don’t have to die from, and there’s a screening test out there that’s right for you.”

Better preventing, detecting and treating cancer is the core mission of UVA Comprehensive Cancer Center, one of only 57 cancer centers in the nation to earn the prestigious “comprehensive” designation from the National Cancer Institute. That designation is awarded only to elite cancer centers with the most outstanding cancer care and research programs in the country.

Guidelines Published

The ACS researchers have published the new colorectal cancer guidelines online. 

Source: EurekAlert!

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What a List of Black Death Survivors Reveals About the Way People Recovered from Plague

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The Dance of Death by John of Kastav (1490). National Gallery of Slovenia

Alex Brown, Durham University and Grace Owen, Durham University

In our research in the British Library’s medieval collections, we have identified a previously unnoticed document that provides fresh insights into the survivors of the outbreak of plague known as the Black Death (1346–53).

The document – a scrap of parchment inserted into an account of the Ramsey Abbey manor of Warboys in Huntingdonshire – records how much time peasants were absent from work when struck down by the plague. It also reveals the names of those who survived and how long their employers believed recovery could take.

In our recent paper with Barney Sloane we shed new light on a group of 22 tenants who probably contracted plague, languished on their sickbeds for several weeks, and then recovered.

As one of the deadliest pandemics in recorded history, it has been estimated that between a third and two-thirds of the population of medieval Europe died during the Black Death.

Painting of a grim landscape destroyed by plague
The Triumph of Death by Pieter Bruegel the Elder (1562) shows the social upheaval that followed the plague. Museo del Prado

Given the sheer scale, many historians have focused on discovering details about those who died. Yet this has left the histories of those who contracted plague and recovered largely untold.

Despite the deadliness of the disease, it was possible to recover from plague, and medieval chroniclers mention the possibility – however unlikely – of survival. For example, Geoffrey le Baker, a clerk of Swinbrook in Oxfordshire, wrote in the following decade that he thought recovery depended on people’s symptoms:

People who one day had been full of happiness, on the next were found dead. Some were tormented by boils which broke out suddenly in various parts of the body, and were so hard and dry that when they were lanced hardly any liquid flowed out. Many of these people escaped, by lancing the boils or by long suffering. Other victims had little black pustules scattered over the skin of the whole body. Of these people very few, indeed hardly any, recovered life and health.

But who recovered? Why did so many succumb to the disease when others survived? And just how long was this “long suffering”? Unfortunately, there is remarkably little documentary evidence because most medieval sources record information about mortality rather than ill health.

Unique list of plague survivors

A unique inclusion in the account of the manor of Warboys details a group of people who fell ill between the end of April and the start of August 1349. The monks of Ramsey Abbey wrote a list of their tenants who had fallen sufficiently sick that they could not work on the lord’s lands and detailed the length of time that they were absent.

People were clearly affected differently by their experience of plague.

The quickest recovery was that of Henry Broun who missed just a single week of work. By contrast, John Derworth and Agnes Mold had much more protracted illnesses and were both absent for nine weeks.

The average length of illness was between three and four weeks, with three-quarters of people returning to work in under a month. The speed of their recoveries is all the more surprising given that they were entitled to up to a year and a day of sick leave from work.

This list of survivors includes a preponderance of tenants who occupied larger holdings on the manor. It has long been debated by historians and archaeologists whether the plague killed indiscriminately, with no regard to status, sex or age, or whether the poor and elderly were more vulnerable.

The survival of so many wealthier tenants could indicate that their higher living standards enabled them to recover more readily than their poorer neighbours, perhaps because they were able to stave off secondary infections and complications. We should not read any significance into the fact that 19 out of the 22 people were men: this reflects the gender bias of manorial landholding rather than any sex-selectivity of plague.

Although 22 people may not seem like many, in a regular year during the 1340s, only two or three absences were recorded during the summer months. It, therefore, represents a tenfold increase in regular illnesses on the manor. Put another way, these sick tenants were absent for 91 weeks’ worth of labour services during just a 13-week period.

Medieval drawing of men harvesting wheat
Medieval peasants at work harvesting wheat (circa 1310). Queen Mary’s Psalter (Ms. Royal 2. B. VII)

Our understanding of the impact of the Black Death has been influenced by the appalling scale of death. Yet it is only when we add those who fell ill and recovered back into the picture that we can truly understand the seismic shock the pandemic had on society. The dead, dying and sick must have considerably outnumbered the living in villages and cities across Europe.

The consequences of this can be seen in medieval accounts and chronicles, one of which records that “there was so great a shortage of servants and labourers that there was no one who knew what needed to be done”. As a result of this combination of high mortality, unprecedented illness and abysmal weather, the two harvests of 1349 and 1350 have been described as the worst experienced in medieval England, worse even than those that caused the great famine of 1315-17.

This archival discovery allows us to write the history of sickness and recovery back into the Black Death, demonstrating that recovery was possible even during one of the worst pandemics in recorded history.

This new evidence reveals the remarkable resilience of medieval peasants. Many of them lay languishing on their sickbeds, exhibiting buboes (the painful, swollen and inflamed lymph nodes on the groin and neck that were typical of the Black Death), vomiting blood and wracked by fevers and not only survived but returned to work in just a few short weeks.

Alex Brown, Associate Professor of Medieval History, Durham University and Grace Owen, Postdoctoral Research Associate (Late Medieval History), Durham University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Early Fitness Linked to Healthier Arteries

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Photo by Ketut Subiyanto on Unsplash

People with good physical fitness in their 30s and 50s have more elastic arteries later in life. This is shown in a new study from Karolinska Institutet, published in the journal Scientific Reports. The association remains regardless of cholesterol levels and other risk factors.

Cardiovascular disease is the leading cause of death worldwide. One early sign of increased risk is stiffening of the arteries, which can contribute to heart attack and stroke. In the present study, researchers investigated whether physical fitness earlier in life can predict how elastic the blood vessels are in older age.

The study is based on data from the Swedish longitudinal study SPAF‑1958, led by Maria Westerståhl, senior lecturer at the Department of Laboratory Medicine, where 425 individuals were followed across adulthood. Participants were examined at ages 34, 52, and 63. The researchers assessed fitness using a cycle ergometer test, analysed blood samples to study lipids, and measured arterial stiffness at age 63 using a non-invasive method.

Fitness more important than blood lipids

The results show that individuals with higher fitness at ages 34 and 52 had more elastic arteries at age 63. The association remained even after accounting for factors such as blood pressure, body weight, smoking, and cholesterol levels. However, neither cholesterol nor more advanced measures of so-called “good” HDL cholesterol could predict arterial stiffness.

“Our findings show that good physical fitness early in life is linked to vascular health later in life, independently of traditional risk factors,” says Andrea Tryfonos, postdoctoral researcher at the Department of Laboratory Medicine, Karolinska Institutet.

According to the researchers, the results suggest that regular physical activity may have long-term effects on cardiovascular health that are not captured by blood lipids and other common risk markers alone.

“This highlights the importance of maintaining good fitness from early adulthood to reduce the risk of cardiovascular disease,” says Andrea Tryfonos.

Next step

The researchers are now planning a follow-up of the participants at age 68 to investigate how changes in fitness over time affect vascular health later in life.

The study was conducted in collaboration with the division of clinical physiology and the division of clinical chemistry at the department of laboratory medicine, as well as Karolinska University Hospital in Huddinge. Information on funding and potential conflicts of interest is not available in the provided material.

Source: Karolinska Institutet

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Gene Analysis Predicts Breast Cancer Response to Chemotherapy

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Photo by National Cancer Institute on Unsplash

A new study from Karolinska Institutet shows that gene analysis of breast cancer tumours can identify patients who do not benefit from chemotherapy given before surgery. The findings, published in the journal Nature Communications, could in the long term contribute to more personalised treatment.

The study included 179 patients with hormone dependent, HER2 negative breast cancer who took part in the Swedish PREDIX LumB trial. Before surgery, all patients received both treatments, but in different sequences. They were given either chemotherapy followed by hormone blocking therapy together with the drug palbociclib, which slows the division of cancer cells, or the reverse sequence.

When the researchers analysed the results, they found that the treatments led to similar reductions in tumour size overall. Survival was also similar regardless of whether treatment started with chemotherapy or with palbociclib and hormone blocking therapy.

Not all tumours responded

At the same time, the analyses showed that there was a subgroup of tumours with a poorer response to chemotherapy but a better response to palbociclib in combination with hormone‑blocking therapy.

To understand why some tumours did not respond to chemotherapy, the researchers analysed tumour gene expression, how active different genes are in the tumour, in tissue samples taken before treatment started. Based on these analyses, they developed a model called CDKPredX, which can identify tumours that respond poorly to chemotherapy but better to palbociclib combined with hormone blocking therapy.

“Today, we lack reliable ways to determine in advance which patients will actually benefit from chemotherapy before surgery. Our results show that tumour gene expression can provide important information in this respect,” says first author Alexios Matikas, docent at the Department of Oncology‑Pathology, Karolinska Institutet. 

The model is based on patterns of gene expression in the tumour, including genes involved in cell division, hormone signalling and the immune system. When the researchers tested the model in other patient groups, they observed similar patterns.

Further studies are needed

“In the longer term, this type of analysis could help patients avoid treatments that do not benefit them, such as chemotherapy, and instead receive treatment that has a better chance of working. At the same time, further studies are needed before the method can be used in clinical practice,” says senior author Theodoros Foukakis, professor at the same department. 

The researchers emphasise that the study is exploratory and that the genetic analysis is not yet ready for clinical use. Nevertheless, the results provide new insights into why different tumours respond differently to treatment.

Source: Karolinska Institutet

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SAMED Calls for Urgent Action as Gauteng Health Supplier Debt Crisis Reaches Critical Point

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The South African Medical Technology Industry Association (SAMED) has called for urgent and measurable action to resolve the escalating supplier debt crisis within Gauteng’s public health system, warning that continued delays in payments and procurement failures are placing both healthcare delivery and supplier sustainability at serious risk.

The call comes ahead of the Gauteng Department of Health’s hospital-level engagements with suppliers on 27 May, following MEC for Health and Wellness Faith Mazibuko’s recent acknowledgement that approximately R8 billion is owed to suppliers.

SAMED’s latest member data shows that R245 517 666.12 is owed to 27 medical technology suppliers, with a significant portion overdue well beyond the public sector’s 30-day payment requirement. Many affected suppliers are South African SMEs now operating under severe financial strain, forced to absorb the consequences of systemic procurement and payment failures while continuing to supply essential medical devices, diagnostics, consumables, and other critical technologies needed for patient care.

While SAMED welcomes the Department’s willingness to engage directly with suppliers, the association stresses that these discussions must lead to concrete commitments and operational action.

For SAMED and its members, this crisis is not new.

The association has spent more than a decade raising concerns about systemic procurement dysfunction, delayed payments, weak supply chain controls, and administrative failures that continue to undermine the effective functioning of the public healthcare system.

Today, those longstanding failures have evolved into a critical risk for both the healthcare sector and the businesses that support it.

In some cases, suppliers are delivering urgently needed products to hospitals while administrative bottlenecks make timely payment structurally impossible. This is particularly acute where delayed purchase orders, including for consignment stock arrangements, create a mismatch between supply delivery and budget allocation.

Monica Lucas, SAMED Board Member said, “SAMED members have continued supporting public healthcare under extraordinary financial strain because patient care cannot simply pause. But suppliers cannot indefinitely act as the financiers of a dysfunctional system. This is no longer just a debt issue; it is a structural operational failure that requires urgent executive intervention.”

Following the Department’s engagement with service providers on 23 May, SAMED has formally written to MEC Mazibuko requesting greater transparency on the Department’s debt reduction plans, and stronger accountability across finance, supply chain management, and hospital leadership.

SAMED will participate constructively in the upcoming hospital engagements and remains committed to finding practical solutions in partnership with government.

However, the association cautions that engagement without accountability will not restore supplier confidence.

After years of repeated commitments and limited progress, the sector requires clear timelines, written commitments, and measurable implementation.

“Direct engagement with leadership is welcome, but suppliers need more than reassurance. We need transparency, accountability, and a credible plan to resolve both the immediate debt burden and the underlying operational failures that continue to create it. Without that, the risks to healthcare continuity will only deepen.” – Scott de Oliveira, SAMED Chairperson

SAMED is calling for immediate action, including:

  • Publication of a verified and transparent debt position
  • A time-bound repayment plan for outstanding supplier debt
  • Executive oversight of hospital procurement and payment failures
  • Improved responsiveness from finance and supply chain leadership
  • Structured follow-up engagements with measurable progress reporting

SAMED remains committed to constructive engagement but warns that the public healthcare system cannot continue relying on suppliers to absorb systemic dysfunction indefinitely.

This week’s engagements must mark the beginning of real corrective action, not another cycle of discussion.