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Science Policy Around the Web – June 10, 2017

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By: Allison Dennis, BS

Source: pixabay

Animal Testing

Lack of Clarity Puts Chemical Safety and Animal Welfare at Odds

In the lineup of American stereotypes, the health-nut who cares about the chemicals in his shampoo is often the same person who cares if that shampoo was tested on animals or not. However, a bill signed June 22, 2016, known as the Frank R. Lautenberg Chemical Safety for the 21st Century Act, may be placing those two views at odds. The bill requires the U.S. Environmental Protection Agency (EPA) to implement a risk-based process to evaluate the safety of chemical substances currently being used in the marketplace and approve the use of new chemicals before their introduction. The bill was passed with bipartisan support and offered EPA the new-found power to fully regulate the use of well-known carcinogens like asbestos.

Yet the pathway forward for the EPA is daunting. More than 62,000 substances find their way into and onto our bodies through the products we use and our environment. While many of these substances have become associated with disease over time, how can the EPA certify the risks associated with different exposures to varying amounts of each substance on such an extensive list? The Act itself suggested that once the EPA has evaluated the existing information on the 62,000 substances currently in use, it spend the next twelve months triaging chemicals according to their potential risk. Next, the highest priority chemicals will be evaluated on a three-year deadline to develop knowledge of their toxicity and guidelines for their regulation. Ultimately, by clearly cataloging the risk of common chemicals the Frank R. Lautenberg Chemical Safety for the 21st Century Act promises to greatly reduce the amount of animal testing needed in the long-term.

In the meantime, however, the companies that use to-be-regulated substances in their products may be inclined to undertake independent toxicity testing, collecting enough data to guarantee that their favorite substances meet the low-risk criteria and avoid a drawn-out evaluation. Defining toxicity requires careful experimentation, which can sometimes be carried out in human cells outside of the body, but often require evaluation in animals. Animal rights groups like the Human Society find concern with the lack of transparency in the pre-prioritization process. They fear the eagerness of companies to provide data without any clear guidelines about how that data will be evaluated or what substances will require extensive evaluation could result in extensive and unnecessary animal testing. Further they suggested that the EPA require any new pre-approval data obtained by companies to be collected using non-animal methods. (Maggie Koerth-Baker, FiveThirtyEight)

CRISPR

Small Study may Reveal Big Concerns over CRISPR-Based Therapy

A one-page letter published in Nature Methods last week reports unexpectedly high levels of unintended changes to the genomes of mice that underwent a CRISPR-based therapy. Since it’s renaissance as a therapeutic tool in 2012, CRISPR has occupied the imaginations of scientists, doctors, patients, investors, and ethicists. CRISPR technology provides a relatively straight-forward and reproducible means to gene editing on the cellular level, but its applications to create heritable mutations in the human germ line is on hold until more is understood about the long-term effects such treatments would have.

The original study sought to explore potential long-term effects of germline manipulation by CRISPR in a mouse model. Guide RNA along with the Cas9 enzyme were injected into mouse zygotes, which introduced a correction in a mutation in the rd1 gene of otherwise blind mice. Initiating this change before the first cell division enabled this corrected mutation to be inherited by all cells arising in the developing mouse, consequently restoring the ability for the eyes to develop normally. In a follow-up experiment described in their one page letter, the researchers looked for mutations in the genomic DNA of two CRISPR-treated adult mice compared with a control mouse, revealing over 2,000 unintended mutations following CRISPR treatments. None of these mutations appeared to affect the mice, suggesting that deep genomic sequencing may be required to reveal unanticipated changes in an outwardly healthy mouse. Further, the nature of these unintended mutations offered few clues explaining how they might have occurred.

This result stands in contrast with other reports quantifying the extent of these unintended changes, which found CRISPR to be highly specific. While the CRISPR-Cas9 system has been observed to sometimes alter off-target regions of the genome, this activity can usually be curbed through the careful design and evaluation of the guide RNA. The limitations of this small study have been discussed extensively since its publication. However, the findings have sparked the need for further investigation into the long-term-whole-animal effects of germline-editing by CRISPR. As human germline-editing creeps closer to reality, the FDA will be tasked with developing an entirely new means of evaluating the safety of such technologies (Megan Molteni, Wired)

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June 10, 2017 at 11:33 am

How GMOs Could Help with Sustainable Food Production

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By: Agnes Donko, PhD

World Population estimates from 1800 to 2100

           The world population has exceeded 7.5 billion and by 2050 it is expected to reach 9.7 billion. The challenge of feeding this ever-growing population is exacerbated by global warming, which may lead to more frequent droughts or the melting of Arctic sea and Greenland ice. The year 2016 was the warmest ever recorded, with the average temperature 1.1 °C above the pre-industrial period, and 0.06 °C above the previous record set in 2015. According to the United Nations, the world faces the largest humanitarian crisis in East-Africa since the foundation of the organization in 1945, particularly in Yemen, South Sudan, Somalia and Nigeria. In these countries, 20 million people face starvation and famine this year because of drought and regional political instability.

How could genetically modified organisms (GMO) help?

The two main GMO strategies  are the herbicide-tolerant (HT) and insect-resistant crops. HT crops were developed to help crops survive application of specific herbicides (glyphosate) that would otherwise destroy the crop along with the targeted weeds. Insect-resistant crops contain a gene from the soil bacterium Bt (Bacillus thuringiensis) that encodes for a protein that is toxic to specific insects, thus protecting the plant. Insect-resistant crops can reduce pesticide use, which decreases the ecological footprint of cultivation in two ways – first by reducing insecticide use, which in turn will reduce the environmental impact of insecticide production, and second by reducing the fuel usage and carbon dioxide (greenhouse gas) emission, by fewer spraying rounds and reduced tillage. Thus, adoption of GM technology by African nations and other populous countries like India could help with sustainable agriculture that can ameliorate the burden of changing climate and growing populations.

In developed nations, especially in the US, GM technology has been widely used since the mid-1990s, mainly in four crops: canola, maize, cotton and soybean. GM crops account for 93 percent of cotton, 94 percent of soybean and 92 percent of corn acreage in the US in 2016. Although the appearance of weed resistance to glyphosate increased herbicide usage, in 2015 the global insecticide savings from using herbicide-tolerant maize and cotton were 7.8 million kg (84% decrease) and 19.3 million kg (53% decrease), respectively, when compared with pesticide usage expected with conventional crops. Globally these savings resulted in more than 2.8 million kg of carbon dioxide, which is equivalent to taking 1.25 million cars off the road for one year.

Another way in which GM crops can help sustainable food production is by reducing food wastage in developed nations. The Food and Agriculture Organization of the United Nations (FAO) estimates that one-third of all food produced for human consumption in the world (around 1.3 billion tons) is lost or wasted each year, which includes 45% of all fruits. For example, when an apple is bruised, an enzyme called polyphenol oxidase initiates the degradation of polyphenols that turns the apple’s flesh brown. But nobody wants to buy brown apples, so the bruised apples are simply trashed. In Arctic apples, the level of the enzyme is reduced by gene silencing, thereby preventing browning. The Arctic Apple obtained USDA approval in 2015, and is expected to reach the market in 2017.

In 2015, the FDA approved the first GMO food for animal consumption, a genetically modified Atlantic salmon called AquAdvantage. Conventional salmon farming has terrible effects on the environment. However, AquAdvantage contains a growth hormone regulating transgene, which allows for accelerated growth rates, thus decreasing the farming time from 3 years to 16-18 months. This would dramatically reduce the ecological footprint of fish farming, leading to more sustainable food production. Even though FDA did not find any difference in the nutritional profile between AquAdvantage and its natural counterpart, AquAdvantage will not hit the U.S. market any time soon, because the FDA banned import and sale until the exact guidelines on how this product should be labelled are published.

This FDA action was initiated by bill S. 764 that was signed by former president Barack Obama in 2016. Bill S. 764 requires food companies to disclose GMOs without necessarily using a GMO text label on packaging. They may choose to label GM ingredients with a symbol or a QRC (quick response code) that, when scanned by a smartphone, will lead the consumer to a website with more information on the product. But this requires the consumer to have both a smartphone and access to the internet. The bill also has ‘lax standards and broad definition’. For instance, if the majority of a product contains meat, but some other less significant ingredient is produced from GM crops, then it need not be labelled. Oil extracted from GM soybean, or starch purified from GM corn are exempt from labeling, because they were only derived from GM sources, but no longer contain any genetic material in them. Contrarily, in the European Union (EU), regulations require that the phrase “genetically modified” or “produced from genetically modified [name of the organism]” must appear clearly next to the ingredient list. If the food is not packaged, the same phrase must be on the food display or next to it. The EU also unequivocally determines the level of GMO (below 0.9 %) in conventional food or feed that is exempt from labelling.

Despite its controversial guidelines for GMO labeling, bill S. 764 could end the long-fought battle of Just Label It campaign. The bill was a huge step toward the right to know, which will let individuals decide if they want to consume GM foods or not. GMOs can significantly support sustainable food production and reduce the destructive environmental impact of humanity, but only if we let it.

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May 12, 2017 at 5:13 pm

Science Policy Around the Web – February 24, 2017

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By: Alida Palmisano, PhD

Source: usda [Public domain], via Wikimedia Commons

Public Access to Data

Lawsuit Aims to Force USDA to Repost Scrubbed Animal Welfare Records

“Put the records back on the internet.”

An article published in Science discusses a lawsuit filed on February 13 against the U.S. Department of Agriculture (USDA) by an animal law expert at Harvard University. According to the plaintiffs, USDA violated the federal Freedom of Information Act (FOIA) when it removed thousands of animal welfare inspection reports and other records from a publicly accessible website. USDA generated records that document animal facility inspections, enforcement actions, animal censuses, and other information collected by the agency in the course of enforcing the federal Animal Welfare Act.  The law covers animals in more than 7800 facilities, including zoos, roadside circuses, and research laboratories at government agencies and academic medical centers.

The decision to remove the public access to these records may have been a response to a lawsuit involving another law, the Horse Protection Act. The plaintiffs in a 2016 Texas lawsuit accused USDA of violating their rights under the Privacy Act by posting inspection documents required by the Horse Protection Act. A resulting USDA review of all its public postings led the agency to scrub from its website documents generated under both the Horse Protection Act and the Animal Welfare Act.  In the future, the agency announced, people who want access to those records will need to file a FOIA request. The agency’s most recent FOIA report states that it takes an average of 94 days for the agency to respond to a simple FOIA request and 234 days on average for more complicated requests.

In February 13’s lawsuit, the plaintiffs invoke a section of FOIA that requires agencies to make publicly available electronically all records that it has released under FOIA which “because of the nature of the subject matter, the agency determines have become or are likely to become the subject of subsequent requests for substantially the same records.” (Meredith Wadman, ScienceInsider)

Science and Immigration

Grad Students, Postdocs with U.S. Visas Face Uncertainty

While U.S. courts are busy handling President Donald Trump’s travel ban on immigration from seven majority-Muslim countries, the temporary shut down of the executive order, the appeal to reinstate the travel ban, the rejection of the immediate restoration of the ban, and more appeals and rulings, graduates and postdoctoral students already in the United States are weighing their options and trying to plan rationally in an unpredictable and fluid situation.

Many scientists in the U.S. are on student or other working visas. All these visas may not be renewable, depending on future executive orders and regulations. The dilemma “simply ruins their future. It’s a catastrophe,” says a Yemeni biologist who is on a university faculty on an H-1B, a 3-year visa for professionals. For years, lawmakers in Washington have tried to reform abuses of visa regulations by companies using visas to bring workers to the U.S. to learn the ropes, and then send the trained workers to other countries where the job can be done cheaply. The H-1B system is contentious: on one side labor advocates want the exploitation of the H-1B system to stop supporting an outsourcing business model. On the other hand, tech companies like Google and Facebook say they can’t get enough visas for top foreign talent, as the cap on the number of H-1Bs issued every year means that sometimes foreign graduates from top U.S. universities, places like the Massachusetts Institute of Technology and the University of California, Berkeley, can’t get one. The travel ban already has harmed the top universities in the U.S., stranding students, faculty and scholars abroad, and making foreign schools more attractive to some of the world’s brightest students.

In papers filed in Brooklyn federal court, the schools (that include Columbia, Duke, Harvard, Johns Hopkins, Princeton, Stanford, Yale, Massachusetts Institute of Technology and several more) said that the order blocking travel from seven predominantly Muslim countries threatens their abilities to educate future leaders from every continent. They said the executive order has “serious and chilling implications” and that the ban “casts doubt on the prospect and value of studying and working here for everyone,” the papers said. (Meredith Wadman, Richard Stone, Science)

Genetic Engineering

US Science Advisers Outline Path to Genetically Modified Babies

“Scientists should be permitted to modify human embryos destined for implantation in the womb to eliminate devastating genetic diseases such as sickle-cell anaemia or cystic fibrosis — once gene-editing techniques advance sufficiently for use in people and proper restrictions are in place. That’s the conclusion of a 14 February report from the US National Academies of Science, Engineering, and Medicine.”

The report follows a 2015 National Academies summit between scientists, ethicists, legal experts and patient groups from around the world. At the time of the meeting, given the outstanding scientific, ethical and legal questions surrounding the issue, the organizers concluded that scientists shouldn’t yet perform germline editing on embryos intended for establishing a pregnancy. However, the organizers also stated that altering human embryos for basic research was acceptable.

The latest iteration of this ongoing CRISPR debate moves the bar a little further. The report recommends restricting the technique to severe medical conditions for which no other treatment exists. Eric Lander, president of the Broad Institute of MIT and Harvard, said, “It’s a very careful, conservative position that’s just a little bit beyond an absolute bar.” In the report, the committee also called for international cooperation, strict regulatory and oversight framework, public input into decisions and long-term follow-ups of children who have edited genomes. The report adds that for now, genome editing should not be used for human enhancement, such as improving a person’s intelligence or giving them super-strength.

The report drew immediate criticism from a California-based non-profit organization called the Center for Genetics and Society. “This report is a dramatic departure from the widespread global agreement that human germline modification should remain off limits,” said Marcy Darnovsky, executive director of the center. “It acknowledges many of the widely recognized risks, including stigmatizing people with disabilities, exacerbating existing inequalities, and introducing new eugenic abuses. Strangely, there’s no apparent connection between those dire risks and the recommendation to move ahead.” (Sara Reardon, Nature)

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February 24, 2017 at 11:23 am

Genetically Modified Animal Vectors to Combat Disease

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By: Sarah L Hawes, PhD

Mosquito larvae: ©ProjectManhattan via Wikimedia Commons

Diseases transmitted through contact with an animal carrier, or “vector,” cause over one million deaths annually, many of these in children under the age of five. More numerous, non-fatal cases incur a variety of symptoms ranging from fevers to lesions to lasting organ damage. Vector-borne disease is most commonly contracted from the bite of an infected arthropod, such as a tick or mosquito. Mosquito-borne Zika made recent, regular headlines following a 2015-2016 surge in birth defects among infants born to women bitten during pregnancy. Other big names in vector-borne disease include Malaria, Dengue, Chagas disease, Leishmaniasis, Rocky Mountain spotted fever and Lyme.

Vaccines do not exist for many of these diseases, and the Centers for Disease Control (CDC) Division of Vector-Borne Diseases focuses on “prevention and control strategies that can reach the targeted disease or vector at multiple levels while being mindful of cost-effective delivery that is acceptable to the public, and cognizant of the world’s ecology.” Prevention through reducing human contact with vectors is classically achieved through a combination of physical barriers (i.e. bed nets and clothing), controlling vector habitat near humans (i.e. dumping standing water or mowing tall grass), and reducing vector populations with poisons. For instance, the Presidential Malaria Initiative (PMI), initiated under President Bush in 2005, and expanded under President Obama, reduces vector contact through a complement of educating the public, distributing and encouraging the use of bed nets, and spraying insecticide. Now a 600 million dollar a year program, PMI has been instrumental in preventing several million Malaria-related deaths in the last decade.

But what if a potentially safer, cheaper and more effective solution to reduce human-vector contact exists in the release of Genetically Modified (GM) vector species? Imagine a mosquito engineered to include a new or altered gene to confer disease resistance, sterility, or to otherwise impede disease transmission to humans. Release of GM mosquitos could drastically reduce the need for pesticides, which may be harmful to humans, toxic to off-target species, and have led to pesticide-resistance in heavily-sprayed areas. Health and efficacy aside, it is impossible to overturn or poison every leaf cupping rainwater where mosquitos breed. GM mosquitos could reach and “treat” the same pockets of water as their non-GM counterparts. However, an insect designed to pass on disease resistance to future generations would mean persistence of genetic modifications in the wild, which is worrisome given the possibility of unintended direct effects or further mutation. An elegant alternative is the release of GM vector animals producing non-viable offspring – and this is exactly what biotech company Oxitec has done with mosquitos.

Oxitec’s OX513A mosquitos express a gene that interferes with critical cellular functions in the mosquitos, but this gene is suppressed in captivity by administering the antibiotic tetracycline in the mosquitos’ diet. Release of thousands of non-biting OX513A males into the wild results in a local generation of larvae which, in the absence of tetracycline, die before reaching adulthood. Release of OX513A has proven successful at controlling mosquito populations in several countries since 2009, rapidly reducing local numbers by roughly 90%. Oxitec’s OX513A line may indeed be a safe and effective tool. But who is charged with making this call for OX513A and, moreover for future variations in GM vector release?

Policy governing use of genetically modified organisms must keep pace with globally available biotechnology. Regulatory procedures for the use of GM vector release are determined by country, and there is a high degree of international policy alignment. The Cartagena Protocol on Biosafety is a treaty involving 170 nations currently (the US not included) that governs transport of “living modified organisms resulting from modern biotechnology” with potential to impact environmental or human health. The World Health Organization (WHO) and the Foundation for the National Institutes of Health (FNIH) published the 2014 guidelines for evaluating safety and efficacy of GM mosquitos.

Within the US, the 2017 Update to the Coordinated Framework for the Regulation of Biotechnology was published this January in response to a solicitation by the Executive Office of the President for a cohesive report from the Food and Drug Administration (FDA), Environmental Protection Agency (EPA), and US Department of Agriculture (USDA). Separately, biotech industry has been given fresh guidance on whether to seek FDA or EPA approval (in brief):  if your GM product is designed to reduce disease load or spread, including vector population reduction, it requires New Animal Drug approval by FDA; if it is designed to reduce pest population but is un-related to disease, it requires Pesticide Product approval by EPA under the Federal Insecticide, Fungicide, and Rodenticide Act.

Thus, for a biotech company to release GM mosquitos in the US with the intent of curbing the spread of mosquito-borne disease, they must first gain FDA approval. Oxitec gained federal approval to release OX513A in a Florida suburb in August 2015 because of FDA’s “final environmental assessment (EA) and finding of no significant impact (FONSI).” These FDA assessments determined that the Florida ecosystem would not be harmed by eliminating the targeted, invasive Aedes aegypti mosquito. In addition, they affirmed that no method exists for the modified gene carried by OX513A to impact humans or other species. Risks were determined to be negligible, and include the accidental release of a few, disease-free OX513A females. For a human bitten by a rare GM female, there is zero risk of transgene transfer. There is no difference in saliva allergens, and therefore the response to a bite, from GM and non-GM mosquitos. In addition, as many as 3% of OX513A offspring manage to survive to adulthood, presumably by spawning in tetracycline-treated water for livestock. These few surviving offspring will not become a long-term problem because their survival is not a heritable loop-hole; it is instead analogous to a lucky few mosquitos avoiding contact with poison.

Solid scientific understanding of the nature of genetic modifications is key to the creation of good policy surrounding the creation and use of GMOs. In an updated draft of Guidelines For Industry 187 (GFI 187), the FDA advises industry seeking New Animal Drug Approval to include a molecular description of the intentional genetic alteration in animals, method for alteration, description of introduction to the animal, and whether the alteration is stable over time/across generations if heritable, and environmental and food safety assessments. Newer genomic DNA editing techniques such as CRISPR offer improved control over the location, and thus, the effect of genetic revisions. In light of this, the FDA is soliciting feedback from the public on the GFI 187 draft until April 19th, 2017, in part to determine whether certain types of genetic alteration in animals might represent no risk to humans or animals, and thus merit reduced federal regulation.

Following federal clearance, the decision on whether to release GM vectors rests with local government. Currently, lack of agreement among Florida voters has delayed the release of OX315A mosquitos. Similar to when GM mosquito release was first proposed in Florida following a 2009-2010 Dengue outbreak, voter concern today hinges on the perception that GM technology is “unproven and unnatural.” This illustrates both a healthy sense of skepticism in our voters, and the critical need to improve scientific education and outreach in stride with biotechnology and policy. Until we achieve better public understanding of GM organisms, including how they are created, controlled, and vetted, we may miss out on real opportunities to safely and rapidly advance public health.

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February 16, 2017 at 9:46 am

Science Policy Around the Web – August 5, 2016

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By: Fabrício Kury, MD

Genetic engineering

‘Gene drive’ organisms should be tested in field trials, not widely released, experts say

While the Zika virus shows spread into the US, with mosquito-borne transmission having been reported in Miami, the scientific community is eager to kick-start the use of the new biotechnology called Gene Drive. This technique allows for the creation of genes that cheat the trial of chance and get passed on to nearly 100% of the offspring. This way, it is possible to alter the genome of entire populations of species, for example, by making populations of Aedes mosquitoes unable to transmit the Zika or Malaria viruses — if not plainly kill all the Aedes.

The danger of Gene Drive is our lack of knowledge about the impact of drastic alterations in the behavior or biology of one species, and also the consequences from the quick removal of a pervasive species from an ecosystem. The slow progress of Zika into the U.S. through warmer and wetter edges such as Florida and Puerto Rico seems like a window of opportunity for attacking the spread of the disease while it is still relatively isolated. However, the National Academies of Sciences, Engineering and Medicine call for tightly controlled experiments before wide use of the gene drive. As MIT Media Lab professor Kevin Esvelt put it, “there is a nontrivial chance that [the genes] will spread from a single organism released into a wild population into most or all members of the local population — and very possibly into every population of the target species around the globe.” (Ike Swetlitz, STAT news)

Technology and Healthcare

Why lawmakers are trying to make ransomware a crime in California

Ransomware is a type of malware (a “virus”) that can make money for a hacker very quickly. The ransomware program encrypts files in the target computer, then demands a ransom, usually to be paid in cryptocurrency (the most popular is Bitcoin) which can be hard to track, to release the key that decrypts the files. Hospitals are perfect targets for ransomware attacks because they are often big institutions, are mostly unprepared to defend themselves against cybercrime, and hold precious data in its computers. Most often, ransomware makes the system of computers functionally “locked inside a black box” or completely unable to be used, creating mounting losses and outright risks that outweigh the price of the ransom.

This includes the medical data that is kept private inside those computers and becomes locked behind the ransomware’s military-grade encryption. Other times, the cyberattack consists of “kidnapping the privacy” of the patients. Here the hacker makes a copy of the data and requests a ransom not to release it to the public. In 2015 alone, 113 million patients had some or all of their health records stolen, and the hospital hacks showed increase of 600%. It has been called “The Year of the Hospital Hack.” Moreover, according to the FBI, ransomware as a broader industry is on the rise. In the first three months of 2016, victims of ransomware lost more than $209 million, compared to $25 million in the entire 2015. (Jazmine Ulloa, Los Angeles Times)

Affordable Care Act Effects

How I Was Wrong About ObamaCare

The strategy implemented by the Patient Protection and Affordable Care Act (PPACA, “ObamaCare”) for the purpose of controlling health care costs is one that strives for paying for healthcare by value provided instead of service provided. The promoted understanding, as summarized by former health policy advisor to the Obama administration Dr. Ezekiel Emanuel, 2011, is that such force will pressure the health care industry to undergo vertical consolidation into Integrated Delivery Systems. These systems, whose likes could be named as Kaiser Permanente, Geisinger Health Care System, and Intermountain Healthcare, are consolidations of all types of providers (physician, imaging, therapy, nursing, surgery, home care, specialty care etc.) and strives to be at least internally coordinated to provide the best value per cost, since its payment is not completely tied to the number of procedures or services performed.

Two PPACA-derived value-based reimbursed programs were launched in 2012 — the smaller and more cautious Pioneer Accountable Care Organizations, reserved for groups of providers with more experience in integrated health care delivery, and the larger and more ambitious Shared Savings Program Accountable Care Organizations. Their data has been released along the past year. The data shows that, along the first performance year of the Medicare Shared Savings Program, 58 ACOs generated $705 million in savings, feat which earned them $315 in bonuses as per the program’s workings, leaving net $260 million in savings to CMS. In April this year, the first study of the official CMS claims data indicated that the better savings were among the ACOs classified as small groups of providers. This is understood as evidence against the “Kaiserification” of healthcare as envisioned by Dr. Emmanuel, since the savings come not from having all providers as employees of a big conglomerate, but instead in giving more autonomy and power to the health care provider at the forefront of the contact with the patient. (Bob Kocher, Wall Street Journal)

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August 5, 2016 at 11:00 am

Science Policy Around the Web – April 15, 2016

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By: Daniël P. Melters, Ph.D

Photo credit: Holly Pavlika at Shot@Life.org

Social health policy

Paid maternity leave reduces infant death

In developing nations, more generous maternity leave can save the lives of babies, according to a recent study in PLoS Medicine. The paper estimates that each extra month of maternity leave is linked to about eight fewer infant deaths for each 1,000 live births, or a reduction of 13% in infant mortality. The advantages of paid maternity leave are that mothers-to-be will be able to make use of health services before and after childbirth as their income and jobs are protected. It will also reduce anxiety in mother, improving her health besides that of her baby, the study says. Maternity leave also increase the likelihood that mothers will breastfeed their child and stick to vaccination schedules, potentially increasing the power of paid maternity leave.

Based on our analysis, I’m fairly convinced that increasing the duration of paid leave is an effective way to reducing infant mortality”, the lead author Nandi from McGill University says. He adds that his team controlled for other factors that reduce infant death, such as gross domestic product and national health spending. The researchers compared rates of infant death in two groups of low- and middle-income countries, covering 300,000 life births between 2000 and 2008.

Child health researcher Zulfiqar Bhutta from the University of Toronto is cautious about extrapolating the results from this study over all low- and middle-income countries. “The major limitation here is the assumption that maternity leave policies in a country are universally applied, which they are not.” A cautionary note that Nandi agrees with on the end of implementation, as they did not study this. He also points to research in other areas, which suggest that policies improving the conditions of employees tend to have spillover effects. (PLoS Medicine)

Gene-editing technology

Committee to study oversight of GMOs

The United States is revamping its rules for regulating GMOs, which collectively are known as the Coordinated Framework for Regulation of Biotechnology. To that end, the National Academies of Sciences have convened a committee that is charged with predicted what advances will be made in biotechnology products over the next 5-10 years. It will hold its first meeting on April 18th. To date, GMOs are regulated by three US agencies: US Food and Drug Administration (FDA), US Environmental Protection Agency (EPA), and US Department of Agriculture (USDA). The USDA’s Animal and Plant Health Inspection Service (APHIS) regulates any genetically engineered organisms that may pose a risk to plant health. In addition, GMOs may still undergo a voluntary review at the FDA (as Oxitec did with their GMO mosquito), or face oversight by the EPA.

Recently, the USDA allowed a mushroom that has been genetically modified with the new gene-editing technology CRISPR (removing several base-pairs knocking-out a gene responsible for browning) to allowed on the US market without going through a review process. It is one of about 30 GMOs to sidestep the USDA regulatory system in the past five years. In each case, the USDA deemed that each GMO did not qualify, as something the agency must regulate. In other words, the USDA itself acknowledges that it might be overregulating some crops if they have traits that have already been scrutinized.

This is of course not to say that no oversight is needed. The use of gene editing technology in humans is still controversial, especially in human embryos, as became clear again by a second study published by a Chinese group where they used CRISPR to alter human embryos, or the approval of project in the United Kingdom. New hurdles will be encountered as well. The successful removing of HIV from an HIV infected cell by CRISPR was hailed, but its success was short-lived as HIV found a way to outsmart the power of the current CRISPR technology. The fast moving pace at which gene-editing technology is developing and how its use if being exploited highlights the need for the US regulatory agencies to keep up with these chances both from economical growth as well as a public safety perspective. (Heidi Ledford, Nature)

Precision Medicine Initiative

Dishman to lead PMI Cohort

Dr. Francis Collins, the director of the National Institutes of Health, has announced that the permanent director of the Precision Medicine Initiative (PMI) Cohort Program will be Eric Dishman, taking over the helm from interim director Dr. Josephine Briggs. Dishman, 48, who now heads the Health and Life Sciences Group at Intel Corporation in Santa Clara, California, will start his new job next month. He is not an obvious choice to lead the cohort program as he does not have a background in genomics or large, long-term health studies, nor a PhD or MD degree. He does have a trove of knowledge about health technologies, which will play a key role in the PMI-cohort. At Intel, he oversaw research on devices to help Alzheimer’s patients and elderly living independently. Dishman also battled and overcome a rare type of kidney cancer at the age of 23. Several years ago he has his tumor sequences, which pointed to a treatment that might help save his life. According to Collins, Dishman is the right person to the lead PMI-Cohort program with his “wealth of health innovation experience … as a social scientist and researcher, entrepreneur and business leader, patient and patient advocate, and policy advocate and thought leader.” (Joselyn Kaiser, Science Insider)

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April 15, 2016 at 1:00 pm