Axios Vitals: The other global threat

Plus, pandemic pathogen research oversight problems | Thursday, January 19, 2023

Open in app View in browser   Presented By AHCA/NCAL   Axios Vitals By Tina Reed · Jan 19, 2023 Good morning, Vitals readers. Today's newsletter is 868 words or a 3½-minute read. Situational awareness: The House Oversight Committee has become ground zero for partisan clashes on Capitol Hill, Axios' Sophia Cai and Simran Parwani report. Their top issue: The pandemic.     1 big thing: The struggle to contain the global threat of superbugs Illustration: Lazaro Gamio/Axios   Antibiotic-resistant superbugs are killing more people each year than HIV and malaria combined, but progress against them worldwide has largely stalled in the wake of the pandemic. Why it matters: As COVID-19 made crystal clear, disease doesn't recognize borders, and one country's problem can quickly become a global threat. The pandemic undercut years of progress fighting superbugs, in part due to overprescribing of antibiotics to patients and the increased use of catheters and ventilators that can lead to infections. Driving the news: A study published this week in The Lancet looked at more than 100 countries' action plans for fighting antimicrobial resistance and found wide variations in their policy designs, and capacity to implement tools and monitor their interventions. The University of Edinburgh-led research team looked at factors like dedicated R&D budgets for new antibiotics, whether annual antimicrobial resistance progress reports were published and if data on the proliferation of superbugs was sent to international surveillance systems. An "international response might not be commensurate with the scale and severity of antimicrobial resistance," they concluded. What they're saying: "Globally, we still have a long way to go in terms of putting the tools and policies in place that can effectively combat antibiotic resistance," David Hyun, project director of the Antibiotic Resistance Project at The Pew Charitable Trusts, told Axios. On its face, it's not terribly surprising that countries' action plans, as well as their ability to carry them out, vary so widely, particularly among poorer nations, Hyun said. It is a sober reminder of "how resource-intensive combating antibiotic resistance can be," he said. The big picture: The WHO in December chronicled increasing drug resistance in several bacteria causing common bloodstream, sexually transmitted and urinary tract infections. Antimicrobial resistance killed nearly 1.3 million people worldwide in 2019, per a study in The Lancet. Go deeper.     2. Pathogen research oversight issues Photo: Saul Loeb/AFP via Getty Images   The federal health department's framework for monitoring high-risk research on viruses and other agents that can cause pandemics doesn't meet key criteria for effective oversight, a new watchdog report concludes, Axios' Adriel Bettelheim writes. What they found: The Government Accountability Office found HHS has an unclear policy for reviewing and approving research involving pathogens that are altered to make them more transmissible or deadly — and that other policy gaps may allow the research to occur without appropriate oversight. The report faults HHS for not fleshing out what work "reasonably anticipated to create, transfer, or use enhanced potential pandemic pathogens" under a 2017 framework should be subject to extra reviews. Don't forget: The report comes as House Republicans plan to ramp up oversight of federal health agencies' response to COVID-19 — long a front-burner issue for the GOP. Background: HHS does its own research to identify and prepare for public health threats. But it also funds and reviews work at universities, medical schools, biotech companies and other research institutions. The department has reviewed three research proposals under the 2017 framework, per the GAO report. Two studies involving highly infectious avian influenza have concluded, while a third influenza proposal was revised so that didn't involve enhanced pathogen research. Share this story.     3. Higher maternal mortality risks Data: Gender Equity Policy Institute; Chart: Axios Visuals Women in states with abortion bans are nearly three times more likely to die during pregnancy, childbirth or soon after giving birth, according to a report from the Gender Equity Policy Institute shared first with Axios' Oriana Gonzalez. The big picture: The U.S. has the highest maternal mortality rate among developed nations. Government officials and health experts are concerned that conditions will worsen now that a federal right to abortion has been struck down. "People in banned and restrictive states have worse outcomes than their counterparts in supportive states," adding that anti-abortion states "are less likely to enact policies, like paid parental leave, which have been shown to improve outcomes for new parents and babies," the reports says. These conditions, the report says are "more precarious" for the six in 10 women (59%) live in states that ban or restrict abortion or other reproductive care. Related: Health experts see rise in maternal mortality post-Roe     A message from AHCA/NCAL The domino effect of failing to support long term caregivers     The long term care labor shortage has created bottlenecks in hospitals as patients wait for beds in nursing homes. What you need to know: A federal staffing mandate will worsen the strain by forcing nursing homes to limit their number of residents. We need solutions now.     4. Hospitals still not posting prices Illustration: Gabriella Turrisi/Axios   Only 19% of hospitals fully comply with the Centers for Medicare and Medicaid Services rule that requires facilities to post estimated costs for items and services, an analysis published in the Journal of General Internal Medicine has found, Axios' Arielle Dreher writes. Why it matters: The U.S. continues to spend more on health care than other countries for less value, and federal efforts to bring transparency to pricing have so far yielded little. What they found: A team of researchers from Harvard, Yale and GoodRx analyzed a nationally representative sample of nonprofit, for-profit, teaching and other hospitals to evaluate whether or not they were posting their prices online. Of the 64 acute care hospitals selected, just 19% fully complied with CMS price transparency rules. Teaching hospitals were significantly more likely to comply with half of the requirements. Nonprofit hospitals were more likely than for-profit hospitals to comply with accessibility requirements, the analysis found.     5. Catch up quick 👀 Governments haven't learned lessons of COVID-19 pandemic, Pfizer CEO says at Davos. (WSJ) 💻 Websites selling abortion pills are sharing sensitive data with Google. (ProPublica) 💰West Virginia announced an $83 million opioid settlement with Walgreens. (Associated Press) 👉 DeSantis targets trans health care in Florida universities. (Politico)     A message from AHCA/NCAL Long term care needs hiring help, not impossible mandates     Nursing homes are working hard to recruit caregivers, but they can't find workers. The solution: We need investments in our long term care workforce — not unfunded staffing mandates — to offer better wages, build a pipeline of nurses and bolster staff retention. Learn more.   Thanks for reading, and thanks to senior editor Adriel Bettelheim and senior copy editor Bryan McBournie for the edits. 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