Science Policy For All

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Science Policy Around the Web – July 15, 2016

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By: Leopold Kong, Ph.D.

Healthcare Policy

United States Health Care Reform – Progress to Date and Next Steps

On Monday, President Obama published a special communication in The Journal of the American Medical Association summarizing the impact of the Affordable Care Act (ACA) during his tenure in office.  The report outlined the president’s initial motivations for health care reform, including his frustration over the relatively low insurance coverage across the US population when he first entered office, even though the U.S. was devoting over 16% of its economy to health care.  The report noted that since the implementation of Medicare and Medicaid in 1965, the uninsured population in the United States had stabilized to around 15% since the early 1990s.  With the creation of the ACA, the uninsured population has dropped 43% from 16% in 2010 to 9.1% in 2015.  Importantly, the health care reform has not decreased employment rates, while it has decreased insurance payment prices in the private sector by improving detection of health care fraud and by increasing insurance provider competition.  President Obama is optimistic that coverage will further expand, considering that many of the reforms that are part of the ACA have not yet reached their maximum effect. Policymakers must be on guard, however, against backtracking in the years ahead, considering there are continued attempts to repeal parts of the ACA. The report notes: “We need to continue to tackle special interest dollars in politics. But we also need to reinforce the sense of mission in health care that brought us an affordable polio vaccine and widely available penicillin.” (Barack Obama, JAMA)

HIV Health Policy

South Africa ushers in a new era for HIV

Next week, the International AIDS Conference returns to Durban, South Africa to discuss research and health care policy challenges in the country with the largest HIV epidemic in the world. Nearly 7 million people in South Africa have HIV, about 15% of the global HIV infected population. Remarkable progress has been made over the last two decades with the advent of more effective antiretroviral therapeutics and their wide dissemination.  South Africa’s average life expectancy has increased from 54.4 years in 2004 to 62.5 in 2015, and mother-to-child transmission has fallen from 30% to 1.5%.  Furthermore, AIDS-related deaths have been cut in half since 2006, from 400 to 200 thousands per year.  It is hopeful that continued gains in therapeutics accessibility would greatly improve the situation in South Africa, though substantial challenges remain. These include maintaining patient compliance in the face of a disease that no longer appears to be immediately life threatening, and dealing with the inevitable development of drug resistance that would require constant and costly patient monitoring.  Surprisingly, in South Africa, but not in Europe, people on therapy appeared to have better quality of life than their HIV-negative peers, highlighting the general benefit of increased interaction with health practitioners. Health policymakers in a country with over 3 million on antiretroviral therapy must also consider the side effects of the drugs, which include increased risk of hypertension, diabetes and obesity for older populations. With continued advances in small molecule and antibody therapeutics, as well as novel vaccine platforms, there is increased hope for millions of people living with HIV. (Linda Nordling, Nature)

NASA

First virus-hunter in space will test DNA-decoding device

Earlier this week, virus-hunter turned astronaut Kate Rubins arrived at the International Space Station with a pocket-sized DNA sequencer, the MinION (9.5 x 3.2 x 1.6 centimeters, ~ 120 grams) developed by Oxford Nanopore Technologies.  Unlike conventional sequencers, the MinION “reads” DNA strands by passing them through nanopores on the device that detect changes in electrostatic charge.  The small size of MinION is important to curb expenses, as it costs about $10,000 per pound of equipment flown to the space station. “Altogether, it’s an extremely exciting research package and a great capability on board station,” Rubins said. NASA hopes this project will improve scientific microbial research and disease diagnostics in space.  The MinION technology may also be used to detect extraterrestrial life, though further development may be needed, especially if non-DNA based life forms are expected.  Importantly, the experiments in space could encourage the expansion of genomics-based medicine utilizing MinION technology to more remote and poorer areas on Earth where the use of large, conventional DNA sequencers would not be practical. (Marcia Dunn, Associated Press)

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Written by sciencepolicyforall

July 15, 2016 at 1:45 pm

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