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Close-up of a yellow fever mosquito biting human skin. It is a Culicidae vector of malaria, yellow fever, chikungunya, dengue and Zika virus in Brazil locally known as Mosquito da Dengue.

João Paulo Burini | moment | Getty Images

Nigeria this week joined Ghana in tentatively approving a new malaria vaccine being developed by Oxford University scientists, potentially paving the way to saving millions of lives and improving Africa’s long-term economic prospects.

Africa’s largest economy, which accounts for 31.3% of all malaria deaths worldwide according to the World Health Organization, on Tuesday granted regulatory approval to roll out the R21/Matrix-M malaria vaccine, just a week after Ghana became the first country to give approval received the new shot.

Both nations have approved the vaccine for use in children between the ages of five and 36 months – the age group at highest risk of death from the mosquito-borne disease.

Oxford University’s Jenner Institute, which developed the vaccine, estimates that malaria kills about 800,000 people annually. These casualties are occurring predominantly in sub-Saharan Africa, where one in five childhood deaths is linked to the disease. The WHO estimated that in 2020 there were 241 million clinical cases of malaria, resulting in 627,000 deaths, mostly among children in Africa.

“This marks the culmination of 30 years of malaria vaccine research at Oxford with the development and delivery of a highly effective vaccine that can be supplied in reasonable volumes to the countries that need it most,” said Professor Adrian Hill, principal investigator at R21/ That’s what Matrix-M program and director of the Jenner Institute said when announcing Ghana’s regulatory approval on April 13.

A health worker vaccinates a child against malaria in Ndhiwa, Homabay County, western Kenya, Sept. 13, 2019, during the launch of Kenya’s malaria vaccine.

Brian Ongoro | AFP | Getty Images

In 2021, WHO approved GSK’s RTS,S malaria vaccine for rollout in sub-Saharan Africa, following pilot programs in Ghana, Kenya and Malawi that have tracked 800,000 children since 2019. Studies so far have shown that R21 will likely be much more effective in fighting the disease.

The R21 vaccine was the first of its kind to meet the WHO’s 75% efficacy target, although data from late-stage studies are still pending.

The vaccine is being manufactured by India’s Serum Institute, which it says has the capacity to supply around 200 million doses a year, while the vaccine is reportedly both cheap to manufacture and easy to transport.

“Big boost for long-term growth”

The US Centers for Disease Control and Prevention emphasizes that malaria is a major burden on many economies, especially as many poorer nations are among the hardest hit. As such, the disease “perpetuates a vicious circle of disease and poverty,” says the CDC.

While the economic impact of the vaccine will depend on a variety of currently unknown factors — such as logistical challenges, the extent to which immunity can be afforded to older children and adults, and the duration of immunity — a successful rollout “could have a large positive economic impact.” said William Jackson, chief emerging markets economist at Capital Economics.

Lower infant mortality will lower the population’s prevention and treatment costs, with various estimates suggesting that in hard-hit countries, about 3.8% of household income could be spent on such interventions, Jackson noted.

“It would also reduce the burden on public health spending. These resources could be freed for other consumption or conserved, which would increase the resource pool that can be used for domestic investment,” Jackson said in a research note Thursday.

“Lower infant mortality may also impact lower fertility rates in the region – which are currently very high. This, combined with less need to care for sick children, may in turn encourage more women to enter the labor market and increase participation and labor supply.”

Should the vaccine provide durable immunity to older children and adults, fewer malaria-related absences from school and work could increase human capital, or labor supply, Jackson suggested.

“Of course, the labor supply is not an obstacle to growth in the region. The working-age population is growing rapidly, but given that impact, combined with lower costs for prevention and treatment, the increase in GDP could be significant,” he added.

Jackson pointed to a study in the American Journal of Tropical Medicine and Hygiene that found that between 1965 and 1990, GDP per capita in malaria-intensive countries grew 1.3 percentage points less per year than in comparable countries. The same study showed that Jamaica and Taiwan saw growth acceleration of 0.2 to 0.8 percentage points per year compared to other companies after malaria eradication.

A more recent study published in 2019 models the impact of a vaccine covering 100% of children under the age of five in Ghana. This particular vaccine had an efficacy rate of 50% against clinical malaria – much lower than R21 – and 20% against malaria mortality. The study still estimated an increase in GDP growth of 0.5 percentage points per year over 30 years at this level of vaccine coverage and effectiveness.

“In short, the vaccine has the potential to be a major boost to long-term growth across much of Africa,” Jackson concluded.

In this photo illustration, Novo Nordisk insulin pens are on display on March 14, 2023 in Miami, Florida.

Joe Raedle | Getty Images

A bipartisan Senate bill introduced this week would limit the price of insulin to $35 a month for people with private insurance.

The bill, drafted by Sens. Jeanne Shaheen, DN.H., and Susan Collins, R-Maine, comes two months after President Joe Biden called on Congress during his State of the Union address to extend the insulin price cap to millions of people with diabetes who are privately insured.

“Americans living with diabetes and those who love them can no longer wait for Congress to act — the time is now,” Shaheen and Collins said in a statement Friday.

“We urge the Senate leadership to submit this bill for consideration as soon as possible,” the senators said. The law was introduced on Thursday.

Biden’s Inflation Reduction Act, which went into effect last year, capped the price of insulin for seniors on Medicare at $35 per month.

But efforts to include people with private insurance were stymied by Republican opposition last year in Congress.

More than 2 million diabetics who take insulin are privately insured, according to the Health Ministry.

About 150,000 patients who take insulin are uninsured, according to HHS.

In March, Eli Lilly, Novo Nordisk and Sanofi announced they were reducing the prices of their top insulin products in response to mounting public pressure to address rising costs.

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These three drug companies control 90% of the global insulin market, according to HHS.

Shaheen and Collins said Congress must step in and legislate the price cap to ensure insulin is affordable for patients.

“We are encouraged by the proactive steps taken by private companies, but this is a drop in the bucket of the measures needed to bring prices down across the board and keep them there,” the senators said.

The legislation would require that beginning in January 2024, private insurance plans limit the price patients pay to no more than $35 per month and waive deductibles for at least one of each insulin type and dosage form.

Types of insulin include fast, short, medium, long-acting, and premixed. Dosage forms include vials, pens, and inhalers.

In 2025, legislation would cap the amount patients pay at the lower of two possible rates — $35 a month, or 25% of the manufacturer’s list price.

The bill also seeks to rein in pharmacy service administrators, the intermediaries who negotiate drug prices with drug manufacturers on behalf of health plans.

Although pharmacy service administrators are said to negotiate lower prices, they have come under scrutiny for pocketing some of the rebates and rebates they receive from manufacturers.

Senate legislation would require administrators of pharmacy benefits to pass on 100% of discounts and rebates they negotiate off the insulin manufacturer’s list price to health insurers, which could help lower premiums for patients.

The bill would also give the Food and Drug Administration the power to expedite approval of biologic products like insulin that resemble branded products, which could help increase competition and drive down prices.

So far, the FDA has only approved two insulins — Rezvoglar and Semglee — that are interchangeable with branded products. These are manufactured by Lilly and Mylan Pharmaceuticals respectively.

Correction: The legislation was introduced on Thursday. A previous version of this story got the date wrong.

Participants of the HIMSS conference walk around the exhibition area

Source: HIMSS

Debates about artificial intelligence and its role in healthcare were the focus of this week’s HIMSS Global Health Conference in Chicago, which brought together more than 35,000 physicians, other healthcare professionals, executives and engineers to discuss the latest advances in healthcare and technology.

companies such as Microsoft, Google And Amazon they prominently promoted new health applications for AI at booths across a sprawling exhibition space, and expert panels answered questions on how the technology can be used to address industry-wide challenges such as staff shortages and physician burnout.

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Many healthcare organizations and companies have used AI in various capacities for years, but a subset known as generative AI exploded into public awareness late last year when Microsoft-backed OpenAI launched its viral new chatbot called ChatGPT. Generative AI refers to programs that can use fairly complicated end-user prompts to generate text or images.

Just as generative AI has captured the attention of the general public, it has also captivated the medical community.

AI was the focus of the opening speech at the HIMSS conference, and HIMSS CEO Hal Wolf opened the discussion by revealing that he asked ChatGPT how to solve global healthcare challenges. The Healthcare Information and Management Systems Society (HIMSS) hosts the conference every year.

Wolf jokingly posed the question to ChatGPT, but David Rhew, global chief medical officer at Microsoft, told CNBC in an interview that generative AI could really be “transformative” to solve big problems in the healthcare industry.

“The opportunity to apply these large language models and artificial intelligence to clinical workflows is tremendous, and we need to be responsible about it,” he said.

For Rhew, that means starting with “high-impact, low-risk” uses of the technology, such as streamlining administrative tasks.

The development of diagnostic or direct patient-centric generative AI applications is associated with higher risk as it raises significant regulatory questions for companies, academics and federal agencies such as the Food and Drug Administration. Rhew said to think of AI as if the healthcare industry has just been introduced into a car, while stop signs, traffic lights or roads have not yet been created.

“We have yet to figure out how to do this together,” he said.

HIMSS CEO Hal Wolf speaks at the HIMSS conference

Source: HIMSS

But in the meantime, administrative or “back office” tasks require less regulatory oversight and there is a real need for efficient solutions as office work is often onerous for clinicians.

A 2016 study funded by the American Medical Association found that for every hour a doctor spends with a patient, they spend an additional two hours on administrative work. The study states that physicians also tend to do an extra hour or two of office work outside of work hours.

Similarly, in 2017, the Journal of the Association of American Medical Colleges published a survey in which respondents indicated that about 24% of their working hours are spent on administrative tasks. More than two-thirds of physicians surveyed said administrative tasks “negatively affect their ability to provide quality care.”

HIMSS participants told CNBC they believe generative AI can help with these tasks.

Let AI do the office work

On Monday, Microsoft announced an expanded partnership with Epic Systems, a healthcare software company that helps hospitals and other healthcare systems store, share, and access electronic medical records. More than 160 million people use Epic’s MyChart software, which gives patients direct access to their health information and their care team.

Epic’s first application of AI technology automatically generates draft responses to the messages doctors receive from patients via MyChart. Doctors don’t have to use the proposed draft at all, but it saves them time when editing or sending it.

Seth Hain, senior vice president of R&D at Epic, told CNBC in an interview that AI could serve as a powerful hypothesis generation tool for doctors in the future. He said they will be able to ask patient-specific questions such as: What do you think I should look at next regarding this issue?

Peter Lee, corporate vice president of research and incubations at Microsoft, told CNBC that an early look at Epic’s AI developments brought tears to his eyes.

“It just blew me away,” he said.

Nuance Communications, a speech recognition subsidiary of Microsoft, also announced a clinical note-taking application called DAX Express ahead of HIMSS in March. DAX Express is designed to help reduce the administrative burden for physicians by automatically creating a clinical note within seconds of a patient visit.

In a live demo at HIMSS, Nuance previewed future projects and showcased the capabilities of DAX Express, which was met with gasping breaths and exclamations of joy from a few doctors, nurses and caregivers in the room.

More than 35,000 people attended the HIMSS conference in 2023

Source: HIMSS

Other companies are also working to use generative AI to reduce administrative burdens.

Amazon Web Services on Monday announced an expanded partnership with Philips, a healthcare technology company based in the Netherlands. AWS has already supported many of Philips’ existing cloud-based and AI initiatives, such as those that help radiologists analyze scans and medical images faster – even from home.

However, Monday’s announcement means that Philips will also leverage AWS generative AI technology to simplify its clinical workflows and enhance its imaging capabilities even further.

“What’s most exciting is the fact that we’re approaching a precipice where we have this tipping point where we’re making right easy,” said Shez Partovi, Philips chief innovation and strategy officer, in an interview with CNBC. “And right now, in most technology, the right thing is many clicks away.”

Partovi said that all the small tasks doctors have to do are like “death by 1,000 cuts,” so using AI to address administrative challenges can have a real impact on doctors’ quality of life.

On Tuesday, 3M Health Information Systems also announced that it is also working with Amazon Web Services’ machine learning and generative AI to reduce the administrative burden for physicians. 3M HIS powers a conversational AI platform used by more than 300,000 physicians, and the company said in a press release that AWS technology will make it easier for physicians to automate and complete accurate clinical notes in the electronic medical record.

Similarly, Google Cloud last week announced a Claims Acceleration Suite that leverages AI to streamline health insurance claim processing and pre-approval.

According to the Centers for Medicare & Medicaid Services, the current pre-approval process takes an average of 10 days. Google’s AI will help alleviate some of this administrative burden for providers by converting the unstructured data that appears in images, PDFs or other health records into a more digestible, structured format.

“They actually require a human being to go in there and take that data and put it into the system for review,” Amy Waldron, director of strategy and solutions for global health plans at Google Cloud, said during a media briefing with reporters from HIMSS. “Which makes absolutely no sense to me as someone has to take the time to put all this rich data in there and we have AI that can unlock that value.”

Generative AI has “tremendous” potential to improve managerial efficiency in healthcare, Microsoft’s Rhew said. However, as healthcare and technology companies make increasingly sophisticated advances, industry leaders, regulators, and community academics must ensure that generative AI is fair and harmless to communities.

The technology is prone to bias and discrimination when trained on health data that does not properly represent a patient population, which could ultimately lead to inadequate decision-making or treatment plans.

As a result, Rhew says, there is a collective responsibility to figure out how to use AI with care.

“It’s a transformative technology,” he said, “but we have to figure out how to use it responsibly.”