Assessing gain-of-function’s cost-benefit

The ideas and innovators shaping health care

Mar 01, 2024 View in browser   By Carmen Paun, Daniel Payne, Ruth Reader and Erin Schumaker DANGER ZONE The Wuhan Institute of Virology is at the center of the lab leak theory of the pandemic. | Ng Han Guan/AP Photo Any research using pathogens with the potential to cause a pandemic if they escape from the lab must have a high probability of yielding public health benefits. That’s according to an international task force of two dozen scientists who proposed guardrails for risky research in a report presented at the United Nations in New York City this week. Convened by the Bulletin of the Atomic Scientists, a nonprofit that tracks manmade threats to humanity, the group said potential benefits of such research should be concrete, easy to anticipate and helpful for people worldwide, David Relman, a professor at Stanford University’s Center for International Security and Cooperation and one of the group’s chairs, said. The type of risky research the task force focused on is sometimes referred to as gain-of-function, in which scientists make a pathogen more transmissible with the goal of improving vaccines and treatments. “In cases when there is not a proportionate harm-benefit ratio, researchers and their institutions have an ethical obligation to respect prohibitions on that particular piece of research,” said Filippa Lentzos, an associate professor in science and international security at King’s College London and one of the task force leaders. Why it matters: The group aims to gain public trust by creating a safe, secure and responsible research environment, Lentzos said. The debate about biosafety has become more urgent in the wake of the Covid-19 pandemic, which some scientists think started after a virus leaked from a lab in Wuhan, China. That hypothesis has prompted attempts in Congress to restrict gain-of-function research, and the White House plans to issue new rules about how to conduct such studies. The task force included researchers that lean toward the lab leak theory, such as Alina Chan, a viral vector engineer at the Broad Institute of the Massachusetts Institute of Technology and Harvard, and those who believe Covid came from an animal, such as Dr. Ian Lipkin, an epidemiology professor at Columbia University, who co-authored a study in 2020 arguing that a lab leak wasn’t plausible. “There is space to talk about better biosafety without having to reach agreement on the origin of Covid-19,” Chan said. What’s next? The group is working with the World Health Organization and the United Nations Office for Disarmament Affairs to convince governments to implement the recommendations, Lentzos said. “It’s always difficult to tell sovereign countries how to implement national legislation. But the first step is setting standards,” she said.   CONGRESS OVERDRIVE: Since day one, POLITICO has been laser-focused on Capitol Hill, serving up the juiciest Congress coverage. Now, we’re upping our game to ensure you’re up to speed and in the know on every tasty morsel and newsy nugget from inside the Capitol Dome, around the clock. Wake up, read Playbook AM, get up to speed at midday with our Playbook PM halftime report, and fuel your nightly conversations with Inside Congress in the evening. Plus, never miss a beat with buzzy, real-time updates throughout the day via our Inside Congress Live feature. Learn more and subscribe here.     WELCOME TO FUTURE PULSE Genti Bay | Shawn Zeller/POLITICO This is where we explore the ideas and innovators shaping health care. Telling a patient they’re dying may be the hardest thing doctors have to do. Fernando Rodriguez-Villa, an assistant professor of psychiatry at Harvard Medical School, has advice on how to do it. 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.  The Workforce AI may not ease the paperwork burden if doctors have to review the tech's work. | John Moore/Getty Images Doctors are enthused about the possibility of AI tools reducing the paperwork load that they find to be tedious and time-consuming, surveys have found. But physicians also insist that AI will always need a human overseeing it to ensure it’s working right and patients aren’t harmed. That's a conflict, some health care leaders are arguing. How’s that? “The argument that AI is going to alleviate burnout? I don’t believe it,” said Dr. C.K. Wang, chief medical officer at COTA, a health data company working to advance AI models. “With all technology, you can solve one problem but create another.” It’s the same point that Tarun Kapoor, chief digital transformation officer at Virtua Health, made to MedCity News at the ViVE conference of digital health executives in Los Angeles last month. “What a lot of folks are saying right now is, ‘We’re using AI technology, but we still have a clinician in the loop.’ That has a double-edged sword to it,” he said, arguing it’s a reason AI adoption in health care is slower than many expected. Even so: Health workers have expressed excitement about less paperwork if it means seeing more patients — which many point out is the reason they entered the health sector in the first place. “I think that burnout is an issue that needs to be addressed holistically and that not one solution is going to help,” Wang said.   YOUR TICKET INSIDE THE GOLDEN STATE POLITICAL ARENA: California Playbook delivers the latest intel, buzzy scoops and exclusive coverage from Sacramento and Los Angeles to Silicon Valley and across the state. Don't miss out on the daily must-read for political aficionados and professionals with an outsized interest in California politics, policy and power. Subscribe today.     WORLD VIEW Obesity is now a major, worldwide problem, the WHO says in a new report. | AFP via Getty Images Over 1 billion people — 1 in 8 worldwide — are obese, according to a report published today by the Lancet. It’s now a more common type of malnutrition than hunger in most countries, the World Health Organization and a network of scientists across the globe found. Upward trajectory: Obesity in adults worldwide has more than doubled since 1990. And 159 million children were obese in 2022, up from just 31 million in 1990. Here in the U.S., the obesity rate for men has shot up from 16.9 percent to 41.6 percent in the past 30-plus years. Researchers cast a wide net, calculating Body Mass Index measurements for over 220 million people in more than 190 countries. What’s next? The WHO has urged nations to sign onto its plan to stop obesity. Among the recommendations: restrictions on food marketing to kids, healthier meals in schools, updated nutrition education and food labeling standards. “Getting back on track to meet the global targets for curbing obesity will take the work of governments and communities, supported by evidence-based policies from WHO and national public health agencies,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus in a release. “Importantly,” he added, “it requires the cooperation of the private sector, which must be accountable for the health impacts of their products.”   Follow us on Twitter Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker   Follow us

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