The Human Cost of Cuts at the CDC and NIH
The 2026 presidential budget proposes to cut roughly 40% of the budgets for the Centers for Disease Control and Prevention and the National Institutes of Health, which perform state-of-the-art research on a broad spectrum of public-health threats.
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Washington Post
24 minutes ago
- Washington Post
How states should spend all that opioid settlement money
State and local governments are about to get a lot of money to combat the opioid epidemic. They could fritter it away on nice-sounding programs — or save the most lives. Last month, attorneys general from 55 U.S. states and territories as well as the District of Columbia approved a $7.4 billion settlement with Purdue Pharma, the maker of opioid painkiller OxyContin. If the settlement is finalized, the vast majority of that money would, over the next 15 years, flow to states, local governments and Native American tribes for opioid abatement. The deal would also shut down Purdue and replace it with a public-benefit company committed to combating the crisis, to be run by a court-approved board.
Indianapolis Star
27 minutes ago
- Indianapolis Star
Indiana's infant mortality progress at risk without sustained health funding
As a first-time mom, I took a deep breath of relief at my daughter's 1-year-old birthday party as she dug into a giant chocolate cupcake. A maternal health researcher and anxious new parent, I had lived the past year constantly checking for breath and movement while she slept, and her first birthday signaled an end to the anxiety of monitoring for sudden infant death syndrome, or SIDS. But more than 500 Hoosier mothers a year never get to experience that sigh of relief; their babies don't make it to their first birthday. Although preliminary data suggests a decrease in Hoosier infant mortality, current trends in public health funding endanger this recent progress. The Indiana Department of Health has released provisional infant mortality data, showing infant deaths in Indiana decreasing from 6.6 out of every 1,000 live births in 2023 to 6.3 infant deaths out of every 1,000 live births in 2024. Assuming a birth rate similar to 2023, we can guess that about 16 fewer Hoosier babies died in 2024 than in 2023. Understandably, the dedicated public servants that comprise IDOH celebrated their hard work over the last decades, and especially since the inception of the pandemic, lauding the 'lowest infant mortality rate since the 1900s.' Opinion: Indiana misses out on good ideas by caring more about politics than results We won't know how Indiana ranks nationally until the CDC releases all states' 2024 data, but with a rate still well above the national average of 5.6 infant deaths per 1,000 live births, we can expect that Indiana has not solved the crisis that left us ranked 45th for infant deaths as recently as 2022. And while saving 16 babies should most certainly be promoted as a success of our state and local public health agencies, current public health funding in Indiana will not sustain these gains. When preventing infant deaths, many think of safe sleep practices, timely pediatric care and vaccinations. But, in reality, most infant deaths are due to prenatal influences. Almost 75% of infant deaths result from congenital conditions (like birth defects), conditions of preterm birth, low birth weight and maternal pregnancy complications, such as preeclampsia. Some of these are unpreventable, like congenital conditions that disallow a baby from developing the organs needed to sustain life. Many others are preventable through early and consistent prenatal care, quick referral to specialists, and early medical intervention. IDOH and local health departments provide programs to new moms that offer these preventive measures. But the most recent state budget and a series of other legislative actions endanger these programs. Projected shortfalls attributed to economic uncertainty led to the decimation of historic public health funding supported by the Holcomb administration, leaving just $40 million for Indiana's 92 counties, down from $100 million in previous budgets. Opinion: Nurses are drowning while Braun ignores Indiana's health care crisis Add that to the nearly $40 million in federal public health dollars lost from cancellation of COVID-era funding for myriad public health programs, and programs that support healthy pregnancies and healthy babies are in grave danger. And when Hoosier babies do make it past infancy, public health funding clawbacks and policy changes in the last six months won't bolster efforts to Make Indiana Healthy Again. Cuts to programs such as Indiana Immunization Coalition in the midst of a (now-ended) measles outbreak and ongoing COVID threat, policies privileging business growth over environmental regulations that protect lung and heart health, and the elimination of critical reproductive health services across the state leave vulnerable Hoosiers in a state of precarity. To be sure, even one fewer Hoosier infant death should be celebrated. But when that celebration is not backed by sustainable policy, we will soon find ourselves seeking solutions that take years to rebuild. Now that my daughter is an energetic 6-year-old, my worries about SIDS and lethal respiratory viruses have been replaced by new concerns. But regardless of standard parental anxiety, I consider myself lucky to have to tackle these challenges as she grows. For years, Indiana has trended in the right direction for public health. Indiana should support the systems that allow all Hoosier infants to grow into healthy kids and adults.
Medscape
an hour ago
- Medscape
Esketamine Monotherapy Safe, Effective for TRD: Phase 4 Data
TOPLINE: Esketamine monotherapy was associated with significantly alleviated symptoms of treatment-resistant depression (TRD) at day 28 compared to placebo in a new phase 4 trial. The research extends findings from an earlier trial that served as the basis for the January FDA approval of an expanded indication for esketamine alone in patients with TRD. METHODOLOGY: The phase 4, double-blind, placebo-controlled, randomized clinical trial was conducted from 2020 to 2024 at 51 outpatient centers in the US. Adults with major depressive disorder (mean age, 45.4 years; 61% women) with inadequate response to two or more oral antidepressants during the current depressive episode were included. After an antidepressant-free period of 2 or more weeks, participants were randomly assigned to receive intranasal esketamine monotherapy 56 mg (n = 86) or 84 mg (n = 95) or matching placebo (n = 197) twice weekly for 4 weeks. The primary outcome was a change in the Montgomery-Åsberg Depression Rating Scale (MADRS) score from baseline to day 28. Other outcomes included change in MADRS score at 24 hours post-first dose, rates of response and remission, and occurrence of adverse events. TAKEAWAY: Compared with placebo, esketamine at 56-mg and 84-mg doses was associated with a significant reduction in depressive symptoms at day 28 ( P < .001 for both), with corresponding effect sizes of 0.48 and 0.63, respectively. Both doses of esketamine were also linked to significantly alleviated depressive symptoms at 24 hours post-first dose compared to placebo (P = .004 and P = .006, respectively). Response and remission rates were significantly higher in both esketamine groups at all timepoints assessed than in the placebo group. The most common treatment-emergent adverse events for combined doses of esketamine were nausea (25%), dissociation (24%), dizziness (22%), and headache (19%). IN PRACTICE: 'This study supports esketamine monotherapy as an important option in the management of patients for whom [oral antidepressants] or other pharmacological treatments are no longer appropriate or acceptable,' the investigators wrote. 'Esketamine monotherapy can potentially address a significant unmet need for the especially vulnerable, untreated TRD subpopulation at risk of serious outcomes,' they added. SOURCE: The study was led by Adam Janik, MD, Department of Neuroscience, Johnson & Johnson, San Diego. It was published online on July 2 in JAMA Psychiatry. LIMITATIONS: The study's generalizability was limited by the exclusion of patients with significant psychiatric or medical comorbidities and substance dependence, as well as by limited racial and ethnic diversity among participants. DISCLOSURES: The study was funded by Janssen Research & Development. Several investigators reported being employees of, holding stocks in, or having financial ties with various organizations and pharmaceutical companies, including Johnson & Johnson and its Janssen division. Some investigators also reported holding patents for esketamine for the treatment of depression, with rights assigned to Johnson & Johnson. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
