A post-pandemic transformation in TB care

The ideas and innovators shaping health care

Jan 17, 2024 View in browser   By Erin Schumaker, Carmen Paun, Daniel Payne and Ruth Reader INNOVATORS The medication regimen for tuberculosis patients is tough to stick to. | JEKESAI NJIKIZANA/AFP via Getty Images Telehealth is reducing the burden and stigma traditionally associated with treatment for tuberculosis, the deadly bacterial lung disease. How so? For years, the standard way — and in many states and countries, the legally required way — of ensuring someone with TB takes their medicine has been having a public health worker watch them do so in person, former POLITICO health care editor Joanne Kenen, now journalist-in-residence at Johns Hopkins’ School of Public Health and School of Nursing, reports. However, Dr. Maunank Shah, medical director of the Baltimore City TB program and a physician/researcher at the Johns Hopkins School of Medicine, saw a use case for telehealth. Now, using a platform Shah and his colleagues developed, public health workers are tracking patients on video. They can observe patients seven days a week, wherever and whenever they take their drugs. A health worker can watch in real time, or increasingly, patients can record themselves taking the medicine, with a time and date stamp, and the health worker can verify. Why it matters: Tracking patients in person could be invasive and stigmatizing — the oversight often occurs in their workplaces. Nor was it comprehensive or foolproof, largely because it was done only on work days, and during regular working hours, meaning patients weren’t monitored on weekends and holidays. When the pandemic made telemedicine essential, “everybody pivoted immediately,” Shah told Future Pulse. The Centers for Disease Control and Prevention has said his system is as effective — and usually cheaper — than the old way of tracking medication adherence. What are the incentives for patients to use a video-tracking app? Maybe it will be as simple as support, said Shah. “Someone who is reaching out to you every day, cheering you on and giving you feedback, helping people get well and stay well.” What’s next? The researchers are working to identify who else with complex drug regimens, such as people who are undergoing substance abuse treatment, have undergone a transplant or have chronic conditions, might benefit from the approach.   JOIN 1/31 FOR A TALK ON THE RACE TO SOLVE ALZHEIMER’S: Breakthrough drugs and treatments are giving new hope for slowing neurodegenerative diseases like Alzheimer’s disease and ALS. But if that progress slows, the societal and economic cost to the U.S. could be high. Join POLITICO, alongside lawmakers, official and experts, on Jan. 31 to discuss a path forward for better collaboration among health systems, industry and government. REGISTER HERE.     WELCOME TO FUTURE PULSE Washington, D.C. | Mark Wilson/Getty Images This is where we explore the ideas and innovators shaping health care. Chinese researchers may have found a solution to the shortage of monkeys used for medical research: They successfully cloned the first rhesus monkey, whose physiology is similar to humans and thus valuable for research, the BBC reports. Yet a U.K.-based animal welfare group said animals' suffering would outweigh any immediate benefit to humans. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Ruth Reader at rreader@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp.   IDEAS LAB An NIH-funded center aims to reduce the need for animal testing in drug development. | China Photos/Getty Images Thanks to a $7.5 million grant from the National Institutes of Health, the University of Rochester will soon be the home of a research center that could reduce scientific testing on animals. How so? The Translational Center for Barrier Microphysiological Systems will develop tissue-on-chip devices for drug development — to reduce the need for animal testing and develop drugs faster. Over the course of the five-year grant, in partnership with Duke University, researchers want to create FDA-approved tools for central nervous system disorders; fibrosis; autoimmune disorders that affect the muscles, joints and bones like rheumatoid arthritis and multiple sclerosis; sepsis; and bone infections. “Drug discovery is moving into an era where fewer animals are used to test for safety and efficacy,” James McGrath, a biomedical engineering professor and the center’s director, said in a University of Rochester press release. In addition to faster drug development and moving away from using animals, testing on chips instead of lab rats has a key benefit: Results from animal research don’t always translate to humans. “Instead, more screening will be done on tissue chips that pattern human cells in a way that mimics human tissue and disease,” McGrath said. “Our chips are designed to provide the higher throughput and more reliable indications that pharmaceutical companies need to get their drugs approved for clinical trials and use by patients.” What’s next? If the FDA approves the forthcoming devices, it would put the researchers one step closer to a future of running clinical trials on a chip.   Enter the “room where it happens”, where global power players shape policy and politics, with Power Play. POLITICO’s brand-new podcast will host conversations with the leaders and power players shaping the biggest ideas and driving the global conversations, moderated by award-winning journalist Anne McElvoy. Sign up today to be notified of new episodes – click here.     IN THE COURTS Agency rulemaking authority could be curtailed if the Supreme Court overturns a 1984 decision. | Francis Chung/POLITICO The Supreme Court heard arguments today on whether it should overturn Chevron v. Natural Resources Defense Council, with big potential ramifications for AI regulation and health care rules broadly. The 1984 decision establishing the so-called Chevron doctrine said courts should defer to agency regulatory decisions if they’re reasonable, in cases where Congress had not issued a clear directive. Opponents of fishing rules have challenged that principle, arguing the courts should take a stronger hand in reining in the agencies, but a decision in the fishermen’s favor would affect rulemaking writ large. POLITICO’s Morning Tech reports that overturning the Chevron doctrine could mean: — President Joe Biden’s ambitions to set guardrails on artificial intelligence are threatened. A key plank at risk in Biden’s AI executive order is the one tasking the Commerce Department with imposing AI safety testing reporting requirements for companies developing highly capable AI models. — Federal Trade Commission Chair Lina Khan’s expansive use of her agency’s rulemaking authority might be an easy target. Khan has tried to boost patient privacy by targeting health care organizations for collecting patient data without consent, and also proposed to ban non-compete agreements in employment contracts, pitting hospitals against doctors.   Follow us on Twitter Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker   Follow us

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