She asked: “If they got all the cancer out, why do I still need radiation?” It should have been easy to explain. Instead, I found myself saying things like “to be safe” and “to reduce recurrence risk” without actually telling her what her risk was without treatment, how much radiation might reduce it, or what that difference meant for her. I was describing what we did, not why it mattered for the person in the room. That question has stayed with me. It is the question that changed how I practice.

The question has changed

For most of my early career, breast radiation meant a fairly predictable course: five days a week, often for five or six weeks, treating the entire breast. The discussion was not nuanced. What I spend time asking now is completely different: How much treatment does this particular woman actually need?

That shift has moved through all of cancer medicine. We are getting better at identifying cancers that carry completely different risks even when they look similar under a microscope and arise in the same place. Breast cancer is not one disease. A small, estrogen-sensitive cancer in a woman in her seventies is biologically and clinically a different problem from an aggressive triple-negative cancer in a woman in her thirties. Tumor size. Lymph-node involvement. Hormone receptors. HER2 status. Age. Systemic treatment. These characteristics change not just how aggressive we need to be, but whether we need to be aggressive at all. The word breast cancer tells us where the disease started. It does not tell us the whole story. As we became better at measuring those differences, my conversations with patients changed too.

What “we got it all” actually means

When a surgeon says the cancer was completely removed, that statement has a specific meaning: the tumor came out with a rim of normal tissue around it, and a pathologist found no cancer cells at the edge. That is excellent news. But it does not mean zero percent chance that an individual cancer cell remains somewhere in the breast. No imaging can find a microscopic cluster. No surgeon can see it during an operation.

That is where radiation comes in. After breast-conserving surgery, radiation substantially reduces the chance that cancer will return in the breast. For generations of women, that combination allowed us to preserve the breast without sacrificing cancer control. But there is another part of the story: not every woman benefits by the same amount.

Some women can consider skipping radiation

This is one of the things that surprises many patients: there are women with breast cancer for whom radiation after lumpectomy may reasonably be omitted. Two landmark trials followed carefully selected older women with favorable, hormone-sensitive breast cancers after lumpectomy. Radiation substantially reduced the chance of local recurrence. Without radiation, roughly 1 in 10 women experienced a local recurrence within 10 years; with radiation, it was closer to 1 in 100. But that large reduction in local recurrence did not translate into longer survival. At 10 years, overall survival was essentially the same whether women received radiation or not.

That creates a very different conversation. Suppose one treatment reduces a woman’s chance of cancer returning in her breast but does not appear to change how long she lives. Is that treatment worth having? There isn’t one answer. One woman may say, “I want to do everything reasonable to minimize the chance this cancer ever comes back.” Another may say, “If my risk is already low, avoiding another treatment matters more to me.” Both can be rational choices. My job is not to tell someone that radiation works. My job is to help her understand how much it is likely to help her.

Less radiation does not necessarily mean worse treatment

The amount of radiation we deliver has changed too. For years, five or six weeks was standard. Then strong evidence showed that shorter courses worked just as well for many patients. Three- to four-week schedules became common. Now some appropriately selected women can complete breast radiation in five treatments. Others may not need the entire breast treated at all. Partial-breast radiation focuses treatment on the region surrounding the original tumor, where recurrence is most likely.

To someone who learned medicine under the assumption that more treatment equals better treatment, this sounds counterintuitive. It shouldn’t. The goal of cancer treatment is not to deliver the maximum amount of therapy a person can tolerate. It is to deliver enough.

A mastectomy doesn’t always eliminate the need for radiation

I hear this question regularly too: “If the whole breast is gone, why would I need radiation?” The logic makes sense. A mastectomy removes almost all breast tissue. For many women with early-stage breast cancer, no radiation is needed afterward.

But a mastectomy does not automatically make the risk of recurrence disappear. Cancer can extend beyond the breast into lymph nodes or surrounding tissues. Certain combinations of tumor size, lymph-node involvement, and other features can leave enough risk that radiation to the chest wall and regional lymph nodes meaningfully reduces the chance of recurrence. This is why two women who both undergo mastectomy may receive completely different recommendations. One may need no radiation. Another may benefit substantially from it. The operation is only part of the story.

The deeper shift

When I started in this field, I spent much of my thinking on how to deliver radiation effectively while protecting the normal tissues around the tumor. That remains enormously important. But somewhere in the middle of my career, another question became equally important to me: How much treatment does this person actually need?

I cannot point to the moment that changed. It happened gradually, through hundreds of conversations with women after treatment. I began paying more attention not only to whether treatment worked, but to what we were asking someone to endure for the benefit we expected it to provide.

And I started asking myself a harder question: Did I know that benefit existed before I recommended treatment? Or did I know it theoretically? There is a difference.

The theoretical position is: radiation prevents recurrence. The specific position is: How likely is this woman’s cancer to return without radiation? How much will treatment lower that risk? What does that difference mean to her? How does she weigh it against the inconvenience, side effects, and risks of treatment? That is a different conversation. It respects her time, her body, and her right to decide how much benefit is enough. I was not having that conversation early enough.

Sometimes the answer to “how much treatment” is more than a patient expected. A woman may undergo a mastectomy and still benefit substantially from radiation. A tiny tumor may have biological characteristics that make more treatment appropriate. But increasingly, the answer can also be less. Less surgery. Less radiation. Fewer treatments. Smaller treatment areas. For some carefully selected women, no radiation at all.

I did not learn this from being a better doctor. I learned it from listening to women describe what treatment actually costs them. That is not retreating from cancer. It is understanding what progress in cancer medicine actually looks like. When I began my career, progress often meant finding ways to treat cancer more aggressively. Thirty-six years later, I think progress sometimes means having enough evidence to know when we don’t have to.

The question I couldn’t answer well early in my career is the one I now spend the most time trying to answer: How much treatment does this particular woman actually need?

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The post I’ve Treated Breast Cancer for Decades. Here’s What I’ve Learned About Radiation appeared first on Medika Life.

This is the world that reproductive psychiatry tries to fix. It is the branch of medicine that treats mental health problems tied to pregnancy, childbirth, and the months after birth. It covers depression, severe anxiety, panic attacks, obsessive thoughts about the baby’s safety, bipolar disorder, and the rare but severe break from reality called postpartum psychosis.

Roughly one in five pregnant and postpartum women deal with some kind of mental health condition, from anxiety to depression to more severe illness. Yet only about one in four women with postpartum depression symptoms ever gets a diagnosis, and about half of those get no treatment at all.

For years, physicians and hospitals focused mostly on physical dangers like blood loss during birth. Nurses were trained to watch a mother’s blood pressure, bleeding, and vital signs, but not always her mood, sleep, or thoughts. The numbers now tell a different story, and it is not a comfortable one.

A Killer Hiding in Plain Sight

Federal health reviewers looked closely at deaths connected to pregnancy across dozens of states. Mental health conditions, including suicide and drug overdose, caused close to a quarter of those deaths. Suicide alone accounted for nearly a third of the mental health-related deaths in the most recent review.

A separate large study presented to maternal health doctors went even further. It found that homicide and suicide combined were the single leading cause of death among pregnant and postpartum women, ahead of every physical complication doctors traditionally worry about, including bleeding and high blood pressure.

The danger is not shared equally. Black mothers between the ages of eighteen and twenty-four die from violence during pregnancy and the months after birth at nearly four times the national rate. Researchers also found that states with stronger gun laws saw meaningfully fewer of these violent deaths, suggesting that policy choices outside the hospital walls still shape what happens inside it.

Most of these deaths did not have to happen. Review boards that study them in detail found that the overwhelming majority were preventable, with earlier warning, better screening, or faster access to care. That finding sits at the center of why reproductive psychiatry matters. It is not a small corner of medicine. It is a matter of life and death for young families, and it has been treated as an afterthought for far too long.

When the Warning Signs Are Missed

One of the most frightening conditions in this field is postpartum psychosis. It is rare, striking roughly one or two mothers out of every thousand births, but it can move fast and turn deadly within days. A woman can go from mild sleep trouble to hearing voices or believing things that are not true in hours.

Studies show that a meaningful share of mothers with untreated postpartum psychosis will attempt suicide, and a smaller number will harm their child. Physicians and advocates who work in this space are clear about one thing. Postpartum psychosis is a medical emergency, and with fast, proper treatment, most mothers recover fully.

This condition drew national attention when a Massachusetts nurse named Lindsay Clancy went on trial after the deaths of her three young children. Her attorneys argued that severe, untreated postpartum psychosis, not any intent to harm, drove her actions that day. The trial ended without a verdict after jurors could not agree on whether she was criminally responsible. One juror held out in the case. The defense attorney has requested an investigation into his actions.

Physicians who study the condition say cases like hers expose a hard truth. There is no standard screening test for postpartum psychosis, the way there is for postpartum depression, so doctors and family members are often left guessing until symptoms become severe.

Warning signs can include not sleeping for several nights in a row, racing or jumbled thoughts, sudden confusion about what is real, and strange new beliefs about the baby. Legal experts add that courts rarely weigh a mother’s mental state fairly. Only one state currently allows undiagnosed or untreated postpartum psychosis to count in a mother’s favor during sentencing. The gap between what medicine knows about this illness and what the legal system recognizes remains wide. How do you find someone guilty of murder when the research is so limited and faulty, and the treatment is almost pure guesswork?

Confusion at the Pharmacy Counter

Reproductive psychiatry is also fighting a newer problem, public confusion over which medications are actually safe. In September 2025, federal health officials warned that Tylenol use during pregnancy might raise a child’s risk of autism, based on studies that many scientists consider far from settled. In the months that followed, emergency rooms saw pain medication orders for pregnant patients drop by about ten percent, even as new large studies kept finding no clear link between Tylenol and autism.

Antidepressants came under a similar kind of pressure. A federal advisory panel questioned the safety of these drugs during pregnancy, and several panel members claimed, without solid evidence, that the medications cause autism or do not work at all. Leading reproductive psychiatrists pushed back hard.

One new study tracked thousands of patients who had been taking antidepressants for depression or anxiety before becoming pregnant. Those who stopped their medication during pregnancy needed emergency mental health care far more often than those who stayed on it. Untreated depression on its own raises the risk of early birth and dangerous high blood pressure during pregnancy. Doctors in the field say there is no convincing evidence that antidepressants cause autism or birth defects.

This kind of public confusion often pushes women toward the riskier choice, going without needed treatment, out of fear of a smaller and far less certain risk. On top of the confusion, there simply aren’t enough specialists. It’s the same in geriatrics, where few specialists are available.

Many towns and even entire regions have no reproductive psychiatrist at all. To close that gap, hospitals and universities have started programs that let a family doctor or an obstetrician call a psychiatric expert for guidance on the spot, rather than sending every patient to a specialist who might be hours away. These access programs are growing, but they still reach only a fraction of the mothers who need them.

Reproductive psychiatry sits at a hard crossroads. The evidence is clear that mental health, not bleeding or high blood pressure, is now the greatest threat to mothers in the weeks surrounding childbirth. Yet screening tools remain incomplete, public trust has been shaken by conflicting claims from officials, and specialists are spread thin across a country where many families live far from real help.

The good news is that nearly everything described here responds to treatment. Depression and anxiety improve with therapy and medication. Even postpartum psychosis, as frightening as it is, gets better with fast psychiatric care. The real danger is rarely the illness itself. Silence, delay, and bad information often stand between a mother and the help she needs.

Family members often notice first that something is wrong. Physicians in this field give the same advice again and again. Do not wait. Do not assume the feeling will simply pass. And do not let fear over a medication rumor stand between a mother and the treatment that could save her life. A mother’s mental health is not a footnote to her physical recovery from childbirth. It is central to whether she and her baby come through this season of life safely.

The post When Having a Baby Becomes a Mental Health Emergency appeared first on Medika Life.

We all know how this goes though. The wooden knife bends before it cuts. The fork leaves a faint taste of timber. The bamboo plate, if you’re unlucky, catches your thumb on a rough edge. We accept this as the price of doing the right thing. It’s a small sacrifice for a cleaner planet.

What makes the problem harder is that the plastic we can see is only part of it. Paper cups are lined on the inside with a thin polyethylene film, the layer that keeps hot liquid from seeping through. Cardboard food containers that look recyclable often carry a similar lining that disqualifies them from most recycling streams. The plastic embedded in materials that present as something else is, in many cases, harder to address than the fork on the table.

Except, according to Dillon Baxter, Founder and CEO of PlantSwitch, it may not actually be doing the right thing. Many of those alternatives aren’t genuinely more sustainable. Some aren’t biodegradable in any practical sense. The infrastructure required to compost the ones that technically qualify, (i.e. industrial composting facilities) is so sparse that most of it ends up in the same landfill as everything else. “We live in an imperfect world,” Baxter says. “What kind of products are we creating that help solve the imperfect world that we live in?”

That question sits at the center of what PlantSwitch is building. The company’s CompostZero material is designed to close the gap that Baxter spent years watching the industry fail to close: something that performs like plastic, is as cost-efficient as plastic, and actually breaks down when it enters the environment, without leaving microplastics behind.

The stakes for getting this right are rising. Of all the plastic ever produced, only about 9% has been recycled, while around 79% has accumulated in landfills, dumps, or the natural environment. Single-use items are the hardest part of that equation, moving through too many hands too quickly to be reliably collected.

Meanwhile, the health picture is getting harder to look away from. A 2025 review published in the journal Microplastics found that common plastic polymers can cause inflammation in the respiratory and gastrointestinal systems, compromise immune function, and raise the risk of cardiovascular disease and neurotoxicity. Causation for specific diseases is still being established, but the presence of microplastic particles in blood, lung tissue, and placental tissue is now documented across multiple peer-reviewed studies.

Baxter watched this evidence accumulate before deciding the materials problem was the one worth solving. “It went from, oh, a plastic straw is bad, to, oh wow, plastic is really harming us,” he says. “We need to figure out a way to get plastic out of our food supply for the future generations quickly, because this is going to have some really negative outcomes.”

Waste Not, Want Not

CompostZero starts with upcycled rice husks, sourced from rice producers who generate them as a large-volume byproduct with few good disposal options. At PlantSwitch’s vertically integrated facility, bacteria fed on that material produce a polymer naturally, a process that occurs in nature that the company has scaled commercially. The resin is compatible with existing plastic manufacturing machinery, which means customers don’t need to retool to adopt it.

The biodegradable resin handles like conventional plastic. Baxter says it’s actually stronger and breaks down when exposed to microorganisms in soil, water, or a home compost bin. “Our CompostZero™ resin made from plants comes from the ground, and gets eaten by the ground when the user is done with it,” he says. “It’s true circular economics.”

The company has moved well past proof of concept. PlantSwitch’s customer list includes Walmart’s Taylor Farms brand, Live Nation concerts, SoFi Stadium in Los Angeles, the Toronto Blue Jays at Rogers Centre and Wonder. Across those accounts, the company supplies compostable forks, spoons, knives, straws, hot cups and lids, bowls, and food packaging shells. To support that scale, PlantSwitch recently expanded from a 50,000 square foot manufacturing facility to 300,000 square feet. A $17 million Series A raise brings the company’s total funding to $28 million.

On the production side, PlantSwitch is now producing CompostZero resin at meaningful commercial volume, with Baxter describing a roughly five-times growth trajectory for the current year.

Baxter argues that PlantSwitch is the first plastic alternative to reach this combination of scale, cost parity, and corporate adoption, a claim that points to a specific structural advantage: because CompostZero resin runs on the same equipment as conventional plastic, it doesn’t ask manufacturers or food-service operators to absorb switching costs. “Solving our global plastic crisis isn’t about cutting down on plastic use or recycling efforts, which have largely failed,” he says. “The solution is changing what our plastic is made of.”

Regulation advancing systems-level change

Two regulatory currents are running in the company’s favor. Single-use plastic restrictions are spreading across U.S. cities and states unevenly, sometimes city by city, sometimes county by county, creating compliance pressure on food-service procurement regardless of corporate sustainability commitments.

The larger policy conversation is around Extended Producer Responsibility (EPR), which shifts end-of-life costs onto manufacturers. EPR frameworks under development include eco-modulation provisions that would reduce a producer’s fee for using materials less costly to collect or process, though timing for those provisions to come into effect remains uncertain.

A broader shift in how we think about materials

PlantSwitch is one piece of a growing field that starts from the same premise: we already have the feedstocks we need. The question is whether we’re using them effectively.

The waste-to-materials approach extends well beyond packaging and single-use items. Household mixed waste is being converted into a substitute for virgin plastic in durable goods. Scrap tires are being broken down and reformed into rubber surfaces for playgrounds and athletic tracks. Oyster shells, a byproduct of shellfish farming that accumulates in enormous volumes along coastlines, are being processed into materials for textiles, including swimwear and lingerie. In each case, a waste stream that previously represented a disposal problem becomes a raw material.

The logic behind all of it becomes harder to ignore when you consider the scale of what’s coming. A century ago, the world held roughly 2 billion people. Today the number is over 8 billion, and the UN projects a peak of around 10.4 billion before the end of this century. More people means more resource consumption, more food packaging, more single-use items, that is, unless the materials from which those items are made stop requiring the extraction of new resources to produce them.

Change at the system level

There is a persistent assumption embedded in much of the sustainability conversation: that the consumer has to do something different. Choose the compostable option. Pay the premium. Seek out the certified product. Accept the inferior fork.

Consumer willingness to pay for sustainable alternatives exists, but it runs directly into cost in an economy where discretionary spending is under pressure. Behavior change at the margins does not move systems.

What PlantSwitch is demonstrating, and what the broader waste-to-materials field is working toward, is a different model. If the alternative performs the same, costs the same, and simply replaces what’s already on the shelf, the consumer doesn’t have to decide anything. The sustainable option becomes the default option.

The responsibility shifts upstream, where it belongs: to manufacturers, procurement teams, and the regulatory frameworks that shape which materials reach the market in the first place.

That is also where EPR legislation is pushing. When producers bear the cost of end-of-life, and when eco-modulation discounts reward materials that don’t create disposal burdens, the business case for switching starts to close.

Baxter is clear-eyed about what makes this model work: “Everyone hates paper straws, no one wants wooden forks, and pretty much every alternative is either a huge drop off in quality, or many times it’s not even more sustainable, or way more expensive.”

The point of CompostZero is that none of those objections should apply. The product should simply be there, doing what plastic does, without what plastic leaves behind.

The post Single Use Plastics are a Health Problem, and Rice Husk Waste Might Be the Cure appeared first on Medika Life.

The Exhibition Floor as a Market Signal

However, after several days walking the exhibition floor and listening to discussions across multiple stages, another story emerged. The most interesting development at HLTH Europe was not the continued rise of AI. It was the growing number of companies applying artificial intelligence to solve very specific challenges faced by researchers, physicians, health systems and patients.

What appears on the stages and exhibition floor at HLTH often reflects where the market sees opportunity. Conferences do not create trends. They reveal them. HLTH Europe brought together more than 400 speakers, some 350 sponsors and approximately 5,000 participants from across the global health ecosystem. Artificial intelligence was not simply one topic among many. The conference featured a dedicated AI @ HLTH Zone, AI-focused exhibitors and numerous sessions exploring implementation, governance, clinical applications and operational adoption.

The prominence of AI across both the agenda and exhibition hall was revealing. Conference organizers dedicate space and programming to topics that matter to attendees, investors and sponsors. The visibility of AI at HLTH Europe suggested that health-specific applications of artificial intelligence have moved beyond emerging interest and are now a significant market focus.

That shift matters because health has always demanded more than technological capability. New tools must operate within environments where privacy, safety, accountability and trust are essential. Researchers are looking for ways to accelerate discovery. Physicians want to reduce administrative burdens that consume valuable time. Health systems seek efficiencies that improve operations without compromising quality. Increasingly, innovators are designing AI solutions around those specific needs.

That reality helps explain why many of the most compelling AI companies at HLTH Europe are building solutions specifically for health rather than adapting tools designed for other industries.

As Sophie Taylor-Roberts, managing partner and FINN Partners UK Health Group Lead, shared: “A mistake in healthcare carries a human cost: it can literally mean life or death. That’s why healthcare needs bespoke AI models, tools and solutions that allow for diverse patient populations, differing clinical guidelines, funding and regulatory structures.”

She added, “As with all aspects of health, one size doesn’t fit all. AI must be treated like a highly specialized medical instrument, built to respect national sovereignty, multilingual patient care, and absolute data privacy.”

Health-Specific AI Moves from Possibility to Practice

The trend was visible throughout the exhibition hall, where companies focused on clinical research, physician workflow, diagnostics, patient engagement, digital safety and operational efficiency demonstrated how specialized AI is rapidly becoming a category of its own.

The trend was visible throughout the exhibition hall, where companies focused on clinical research, physician workflow, diagnostics, patient engagement, digital safety and operational efficiency demonstrated how specialized AI is rapidly becoming a category of its own. Their growth reflects a broader shift occurring across the health sector as organizations seek tools designed for specific scientific, clinical and operational challenges.

Gabriele Ricci, Chief Data & Technology Officer at Takeda, captured that evolution when discussing AI’s growing role across the research and development continuum. “AI is transforming the future of healthcare by accelerating every stage of the R&D value chain through purpose-built capabilities tailored to specific scientific and clinical challenges,” he said.

His emphasis on purpose-built capabilities mirrors what was visible throughout HLTH Europe. The conversation is no longer centered exclusively on artificial intelligence as a technology platform. Increasingly, attention is turning toward how specialized applications can address distinct needs across research, clinical care and health operations.

Among the companies reflecting this shift was Briya, whose AI-powered platform helps researchers interact with complex data through conversational interfaces. Rather than requiring users to navigate multiple databases, coding environments and analytical tools, the platform seeks to simplify the path from question to insight.

David Lazerson, Briya’s co-founder and chief executive officer, believes many organizations misunderstand where the greatest challenge in AI adoption resides.

“Many people assume AI adoption is about choosing the right model,” he said. “In reality, the model is only a small part of the solution. The hard part is everything around it: security, governance, data harmonization, domain expertise, and the methodology required to produce trustworthy outcomes.”

His observation reflects a reality becoming increasingly evident throughout the health sector. Access to powerful AI models is expanding rapidly, shifting competitive advantage toward organizations that can generate reliable outcomes within specific health environments. That reality helps explain the growing number of exhibitors focused on narrowly defined use cases rather than general-purpose AI.

A similar perspective emerged from conversations with Keith Grimes, MD, Chief Innovation Officer at Curistica. A physician who spent 24 years in primary care, Grimes approaches artificial intelligence through the lens of risk management, governance and patient safety.

“Physicians have always governed risk,” he explained. “We do it instinctively for doctors, drugs and devices. Digital is just the fourth D, and the discipline is much the same, but it is the one we were never trained for, so the commitment to ‘do no harm’ runs ahead of the know-how.”

His comments address one of the most significant challenges facing health organizations today. Many leaders recognize the promise of AI, yet remain uncertain about implementation, oversight and accountability, particularly in smaller physician practices and community-based care settings.

Dr. Grimes emphasizes that smaller organizations should not view those limitations as barriers.

“Small practices are the cornerstone of primary care, but they cannot out-resource a hospital trust, and it does not need to,” he said. “Good governance scales down, and the same standards that protect a large organization can be borrowed rather than rebuilt.”

“We give whoever is responsible for AI and digital safety both the platform and the people,” Dr. Grimes said. “Power tools that guide them, whatever their experience, with clinical safety experts behind the software.”

Taken together, the perspectives of Dr. Grimes and Lazerson point to the emergence of a new category of innovation. The most promising health AI companies are not focused exclusively on algorithms. They are creating environments that combine technology, expertise and governance to solve specific high-friction problems.

The Future Belongs to Reliable Outcomes

For smaller organizations, this evolution may prove particularly significant. Historically, adopting advanced technology often required substantial investment, specialized technical talent and complex integration efforts. Many health organizations lacked the resources to pursue those initiatives.

Lazerson believes that model is changing. “That’s why we’re seeing the emergence of a new layer of domain-specific AI,” he said. “Instead of every organization hiring AI engineers and building custom infrastructure, they can access a complete, purpose-built environment as a service.”

The implications extend far beyond research organizations. Physician practices, community health providers, home health agencies and emerging life science companies increasingly have access to capabilities that previously required significant internal resources.

“For smaller organizations in particular, it’s a no-brainer,” Lazerson added. “They can start generating value immediately without complex integrations, dedicated AI teams, or having to solve privacy, security, and compliance challenges on their own.”

Throughout HLTH Europe, companies focused on clinical research, workflow automation, diagnostics, care coordination and patient engagement demonstrated how artificial intelligence is becoming increasingly specialized. Rather than attempting to transform every aspect of health simultaneously, they are concentrating on areas where measurable value can be achieved quickly and responsibly.

That focus on practical outcomes may ultimately become the defining characteristic of the next generation of health innovation.

Dr. Grimes summarized the principle succinctly. “Safety is not a box-ticking exercise; it works when everyone knows the part they play,” he said. “The advantage is not scale, it is fit.”

Walking through HLTH Europe, I was reminded that innovation rarely advances through a single breakthrough. More often, progress emerges through focused efforts to solve meaningful problems. The companies attracting attention were helping researchers move faster, supporting clinicians facing administrative burdens and enabling organizations to adopt new capabilities with greater confidence.

Perhaps among the more important lessons from HLTH Europe. The future of AI in health will not be defined solely by the largest platforms. It will be shaped by innovators who combine technology, expertise, and specificity to deliver reliable outcomes. As Lazerson observed, “The future won’t belong to organizations with the biggest models. It will belong to those who can turn AI into reliable outcomes.”

Judging by what appeared across the stages and exhibition floor in Amsterdam, that future is taking shape.

The post At HLTH Europe, the Most Important AI Story Was Happening Beyond the Headlines appeared first on Medika Life.

Despite living longer than men, women spend approximately 25 percent more of their lives in poor health, according to research from the World Economic Forum and the McKinsey Health Institute. Across reproduction, brain health, autoimmune conditions, cardiovascular disease, and mental health, the gaps in research, funding, and care are persistent.

That reality provided important context for the launch of The Shift, a new mini documentary series from BBC StoryWorks Commercial Productions, unveiled at HLTH Europe. The series explores issues ranging from reproductive health and cardiovascular disease to autoimmune disorders, menopause, mental health and healthy aging. Through storytelling, the documentary project elevates the experiences of women while highlighting the challenges that persist and the opportunities for progress.

The HLTH EU panel discussion was timed for the opening of The Shift and featured Shahnoor Abbas, Senior Series Developer and Research Development Lead for The Shift at BBC StoryWorks Commercial Productions; Elena Bonfiglioli, General Manager, Global Health & Life Sciences at Microsoft, and Priya Agrawal, MD, Vice President, Global Health Equity and Partnerships at MSD. Their conversation, moderated by Jody Tropeano Greene, Head of Content for HLTH, explored why women’s health remains one of the most significant opportunities for innovation, investment and system improvement.

A Conversation Decades in the Making

The panelists approached the topic from different perspectives, yet a common theme emerged. Women’s health has received increasing attention for more than a decade, but many of the barriers women encounter remain rooted in the design of health systems.

For BBC StoryWorks, The Shift represents an effort to sustain attention on issues that too often receive episodic interest. The series combines personal stories with broader insights into the realities women face across different countries, cultures and stages of life.

The BBC initiative and the HLTH EU mainstage conversation arrive at a time when women’s health is attracting growing attention from investors, entrepreneurs, policymakers and health industry leaders. New companies are emerging. New technologies are being developed. More organizations are recognizing both the societal and economic importance of addressing longstanding gaps in care.

The timing of The Shift is notable. Women’s health innovation is receiving growing attention from investors, entrepreneurs, policymakers and health leaders. Industry analysts estimate that approximately $2 billion was invested in venture-backed women’s health companies across the United States and Europe in 2025, reflecting increased interest in addressing challenges that extend beyond reproductive health to include cardiovascular disease, menopause, mental health, oncology and healthy aging.

The trend signals growing recognition that improving women’s health is a societal imperative and a significant economic opportunity. Yet as the discussion at HLTH Europe made clear, investment and innovation alone will not be enough if women continue to face fragmented systems that are difficult to navigate.

When Access Exists but Navigation Fails

Dr. Agrawal, an obstetrician-gynecologist by training, whose work has included clinical practice in the UK NHS, global pharma brand stewardship in emerging middle-income nations, maternal health awareness initiatives, and the creation of sustainable health markets, described a reality familiar to many women. Access to care may exist on paper; however, reaching that care, understanding available options and navigating fragmented systems remains a challenge.

“We’ve built systems like mazes with different entry points, different providers and different messages,” said Dr. Agrawal. “Women are often left navigating all of this themselves at the moments where they are most vulnerable.”

Her observation echoed the comments by fellow panelists, which touched on an issue that extends beyond women’s health. Across many countries, patients frequently encounter disconnected providers, inconsistent communication and care journeys that require them to coordinate appointments, referrals and information on their own. The burden of connecting those pieces often falls on the individual seeking care rather than the system intended to support them.

For women, that complexity can be especially challenging. Responsibilities related to caregiving, work, family and personal health often intersect at the very moment care is needed. Understanding what symptoms are normal, knowing when to seek help, determining where to go and finding trusted sources of information become added obstacles.

That reality led to one of the discussion’s compelling observations. “This is not an access problem. It’s a design problem.”

The distinction matters. Discussions about women’s health often focus on whether services exist. Design asks a different question: can people realistically find, understand and benefit from those services when they need them most?

The Power of Stories to Sustain Change

The panel also explored the role technology may play in addressing those challenges. Rather than adding new layers of complexity, emerging digital tools and artificial intelligence applications are increasingly being developed to simplify navigation, improve continuity and support people between clinical encounters.

“What excites me is that technology is finally starting to reduce friction instead of adding layers of complexity,” Dr. Agrawal observed.

That perspective aligned with comments from Bonfiglioli, whose work at Microsoft focuses on helping health systems leverage data, cloud technologies and artificial intelligence to improve outcomes. Technology, however, was not presented as a solution on its own. The discussion repeatedly returned to the importance of human connection.

Those themes are central to the documentary series itself. BBC StoryWorks has built a reputation for transforming complex issues into compelling narratives that audiences can understand and relate to. Through The Shift, the goal is not merely to document challenges but to foster greater understanding of the experiences women face and the opportunities that exist to improve care.

Abbas emphasized the power of storytelling to connect data and lived experience. Statistics can identify a problem. Research can explain it. Stories help people understand why it matters and why action is necessary.

That may be the enduring value of The Shift. The series does not introduce a new conversation. Instead, it brings fresh perspectives to longstanding challenges. Through stories from around the world, the films remind viewers that behind every statistic is a person navigating the complexities of health and care. By fostering greater understanding and empathy, the series encourages health leaders, innovators and policymakers to view women’s health not as a periodic topic of interest, but as an ongoing priority deserving sustained attention and action.

The women featured throughout the series deserve more. The discussion at HLTH Europe reinforces that improving women’s health is more than developing new technologies and expanding services. It is also about creating systems that are easier to navigate, more responsive to people’s medical priorities and ultimately more human in their design.

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The Centers for Medicare & Medicaid Services released the rules on June 1. That deadline was set last year in the GOP tax-and-spending law known as the One Big Beautiful Bill Act, which established a work requirement for certain people enrolled in Medicaid, the state-federal health insurance program for people with low incomes or disabilities.

Medicaid agencies are scrambling to rework IT systems and make sure they have staff to effectively enforce the rules, while also keeping enrollees from losing coverage for administrative reasons, such as difficulty navigating state eligibility portals.

The newly announced regulations offer a clearer picture of what roughly 18.5 million Medicaid enrollees will have to do to prove they qualify for benefits.

Jim Torres, who helps people enroll in health coverage at the Samuel U. Rodgers Health Center in Kansas City, Missouri, said a “very small percentage” of his clients have heard of the changes coming to Medicaid.

“These folks have very busy lives. They’re doing the best they can to get by,” he said. “It’s just not a top-of-mind thing for most of them.”

Health policy researchers and consumer advocates said enrollees should keep a few things in mind as the Jan. 1, 2027, rollout approaches in most states.

1. The work rules won’t apply to everyone.

The new rules will apply to people covered through what’s known as Medicaid expansion. Since 2014, more than 40 states and the District of Columbia have decided to allow more people into their Medicaid programs, generally low-income adults without dependents. Georgia and Wisconsin offer coverage to some people in this group, so they’ll be subject to the rules.

Children and pregnant people, as well as individuals with disabilities who receive Social Security payments — all groups that already qualify for Medicaid — won’t be subject to the rules. Nor will people determined to be “medically frail,” or too sick to work.

People subject to the work rules are “crowding out” people in the Medicaid program who are “truly in need,” CMS Administrator Mehmet Oz claimed during a June 1 press call. “Work requirements are going to turn this around, we hope.”

The rules are set to take effect in most places in January. Nebraska started enforcing them in May. Montana plans to start in July but won’t kick people off until October. Arkansas will do a “soft” launch in July — it will start enforcing the rules but with no penalties until next year.

2. States will take your word that you’re too sick to work. For now.

Federal officials have stressed that states should make the process of reporting hours and requesting exemptions as simple as possible for Medicaid enrollees by creating automated systems and using existing data sources, such as unemployment and education records.

If states cannot determine you’re performing 80 hours of qualifying activities a month using those data sources, you may be allowed to “self-attest” to that in 2027, health policy researchers said.

People will also be allowed to “self-attest” that they are too sick to work in 2027, and do so one time in 2028. Then states will start asking for proof, if they can’t find it through available data.

But after the initial rollout, the burden of proof is likely to still fall on many enrollees, said researchers and consumer advocates.

People may need to dig up pay stubs, medical records, and doctors’ notes and submit them for state review, said Morgan Henderson, who has studied Medicaid work programs in Georgia and Arkansas at The Hilltop Institute, a research center at the University of Maryland-Baltimore County.

“The higher this manual reporting burden, the less people are going to do it,” he said. “That means that we’re going to see coverage drop-offs.”

3. The rules are tougher than expected for people too sick to work.

One of CMS’ primary goals has been to “protect vulnerable populations” through “strong exemptions to make sure people who can’t reasonably be expected to work are not subject to the requirements,” Dan Brillman, a deputy administrator at the agency, said during the June 1 press call.

Consumer and patient advocates, however, said the final rules’ exemptions are more restrictive than expected. Enrollees will eventually have to provide documentation, such as a statement from a medical professional, to prove that a health condition keeps them from working. And each individual state will have to determine the severity of beneficiaries’ medical conditions.

“Someone could be medically frail in Nebraska but not medically frail in Delaware,” said Carolyn Sheridan, associate director of state policy for the National Organization for Rare Disorders, which lobbies for patients with rare diseases. She said her group had hoped the rules would offer a standardized definition of who counted as medically frail and not leave the decision up to states.

Trump administration officials have publicly crusaded against fraud in government health programs, such as Medicaid, and states could face financial penalties for incorrectly granting people exemptions from the work rules, said Jennifer Tolbert, who researches Medicaid at KFF, a health information nonprofit that includes KFF Health News.

“States may be more cautious,” she said. “That will likely lead to people losing coverage who may still be eligible.”

4. Only certain qualifying activities count.

Enrollees can satisfy the rules by working 80 hours a month. They can also be enrolled in college courses, volunteer through a community organization, or do “in-kind” work that doesn’t result in pay.

The rules set out, in detail, how many academic credit hours translate to 80 hours a month — students need to be enrolled in six credit hours per semester to meet the “half-time” requirement. An unpaid internship can count toward the 80 hours.

People can also prove they’re volunteering with “a document from a community service organization.”

Consumer advocates say it might be hard for people to obtain proof they’re performing these kinds of informal activities. But supporters of the rules say volunteerism can already be tracked.

“If you run into trouble with the law and the judge says, ‘Hey, you need some volunteering and community service to serve your time,’ there are already ways that we verify that,” said Niklas Kleinworth, who works on state health policy for the conservative Paragon Institute.

5. You have time to prepare.

Make sure your state Medicaid agency has your current mailing address and keep your eye on your mailbox, said researchers and consumer advocates. State Medicaid agencies must inform you in two ways if you’ll be subject to the rules — by either regular mail or email, and by one other form of communication, such as a text or phone call or by posting a notice online.

“The important stuff comes by mail,” Henderson said.

And check in with your state Medicaid agency, said researchers and advocates. Some states, including Arkansas, California, and Wisconsin, have already posted information about the work rules on their websites. If you can’t find what you’re looking for there, visit or call a local office. A caseworker should be able to tell you whether you’ll be subject to the rules.

“Get ahead of this,” said Joan Alker, who is executive director of the Georgetown University Center for Children and Families and studies Medicaid. “So that you don’t end up going to the pharmacy one day and they say, ‘Oh, you’re not insured anymore’ when you’re trying to get your prescriptions refilled.”

KFF Health News correspondent Samantha Liss and senior correspondent Rachana Pradhan contributed to this report.

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Loneliness, it turns out, isn’t just an emotion. It’s a biological signal, as powerful and urgent as hunger or thirst. When you’re lonely, your brain doesn’t just feel sad. It sounds an alarm. Your body responds. And if that alarm keeps ringing, day after day, real physical damage begins.

Your Brain Treats Loneliness Like Starvation

Here’s something researchers at MIT discovered when they had people sit alone in a room for ten hours: afterward, when those isolated individuals looked at pictures of people laughing and connecting, the same part of their brain lit up that activates in people who are starving and looking at food. That’s not a metaphor. The craving for company and the craving for food share the same neural real estate.

Kay Tye, a neuroscientist at the Salk Institute for Biological Studies in California, has spent years mapping what she calls “social homeostasis” in the brain. Homeostasis is the fancy word for the way your body stays balanced. Your temperature stays near 98.6 degrees. Your blood sugar stays in a range. Tye’s research suggests that your need for human connection operates in the same way. Your brain has a set point. Stray too far from it, and systems start firing to bring you back.

In 2025, a paper published in Biological Psychiatry by Tye and colleagues formally introduced “social homeostasis” as a new way to think about mental health. The authors argue that chronic loneliness or overcrowding can shift the brain’s set point, leading to the kind of nervous system imbalance seen in many psychiatric conditions.

Deep Inside the Brain, a Social Thermostat

Catherine Dulac, a neuroscientist at Harvard University, wanted to know exactly where in the brain this social regulation lives. She looked to the hypothalamus, the ancient region buried deep in our skulls that controls hunger, thirst, and sleep. It turned out to be the right place to look.

In 2025, her team published findings from experiments on mice that had been separated from their companions for 5 days. They found two distinct clusters of neurons in the hypothalamus. One cluster fired when the animals were alone. The other fired when they were reunited. More telling: the longer the animals had been isolated, the more intensely they sought contact once reunion was possible. Greater deprivation, greater need. Just like thirst.

When researchers artificially activated the “separation” neurons, the mice actively avoided whatever chamber triggered the signal. Being alone felt bad, in a physical, measurable way. When they activated the “reunion” neurons, which connect to the brain’s dopamine reward system, the mice sought out that feeling. Connection felt good. Not just emotionally. Chemically.

These deep brain structures look nearly identical in mice and humans. We share this wiring because it’s ancient. The need to belong is not a modern luxury. It’s a survival code, written into the oldest parts of who we are.

Touch Matters More Than You Think

In Dulac’s experiments, vision didn’t count for much. Neither did sound or smell. Mice separated by a screen that still let them hear and smell each other reacted as if they were fully alone. The only sense that truly registered “I’m not alone” was touch. The physical presence of another body against their own.

Ishmail Abdus-Saboor, a neurobiologist at Columbia University, studies the specific nerve pathways dedicated to social touch in human skin. Our bodies actually have neurons in hairy skin that respond specifically to slow, gentle stroking, the kind a friend or family member might offer. These aren’t generic touch receptors. They’re wired for connection. A hug or a hand on the shoulder isn’t just a nice gesture. It’s information your nervous system uses to update its social score.

This is why phone calls help but don’t completely fill the gap. Why video chats feel better than nothing, but still leave something missing. Your brain needs data that only physical proximity can provide.

When Loneliness Goes Untreated, Your Body Pays

Social disconnection isn’t just hard on the heart emotionally. It’s hard on the actual heart. Research published in Cureus in 2025 reviewed data spanning decades and found that loneliness nearly doubles the risk of stroke and recurrent coronary artery disease, driven largely by increased inflammatory responses in the body.

The American Heart Association has stated that social isolation and loneliness raise the risk of heart attack, stroke, or death from either condition by about 30 percent. And a 2025 narrative review published in the journal Stress mapped the full internal chain of events: loneliness activates the body’s stress response system, raises cortisol levels, increases inflammatory proteins in the blood, changes how the amygdala reacts to social threat, and contributes to cardiometabolic risk markers.

Research published in Frontiers in Human Neuroscience in 2026 linked chronic loneliness to reduced gray matter in brain regions involved in memory and emotional regulation, including the hippocampus. It also found that loneliness is a significant risk factor for accelerated cognitive decline and dementia.

Put simply: isolation doesn’t just make us miserable. It changes our brain structure, disrupts our hormones, inflames our blood vessels, and shortens our lives.

What This Means for How We Live

Knowing that connection is a biological need rather than a preference changes the conversation. You’re not weak if you feel lonely. You’re not clingy if you crave company. You’re responding to an ancient alarm system that has kept our species alive for hundreds of thousands of years.

The research also offers a practical insight. Because touch plays such a central role, the quality of our physical presence with others matters enormously. Abdus-Saboor says he’s intentional about physical contact with his family every single day. Not grand gestures. Just a hug before the kids leave for school. A hand on a shoulder. A back rub. These aren’t small things. They’re medicine.

Tye adds another useful idea: building a variety of social settings into your life. Spending time alone, in small groups, and occasionally in larger groups can help your social thermostat stay flexible and resilient. The goal isn’t constant togetherness. It’s a healthy range.

It’s also worth noting that the damage from loneliness isn’t inevitable. Research on loneliness as a health issue consistently points to the same takeaway: these effects are modifiable. Community programs, social prescribing in healthcare, nature-based group activities, and intentional outreach to isolated neighbors all show measurable results.

The Bottom Line

If you feel lonely, don’t brush it off as a mood that’ll pass. Your brain is signaling something real. Your body is already responding. The good news is that connection, real physical presence with people who matter to you, works as powerfully in the other direction. It turns the alarm off. It restores the balance. It’s not a luxury. It’s what your biology has been asking for all along.

Science is saying what our hearts have always known: we need each other. Now we know exactly why.

The post Loneliness Is Not Just a Feeling. It’s a Biological Emergency appeared first on Medika Life.

Diabetes

40 million Americans have diabetes mellitus, or 12% of the population. Of these 38 million have type 2 diabetes (previously known as “adult onset”) and 2 million have type 1 (previously known as “juvenile diabetes.) 29 million have been diagnosed, yet 11 million are unaware that they have the disease. Our focus is type 2 diabetes.

Diabetes type 2 incidence increases with age, such that nearly 30% of those over 65 have diabetes, compared to ages of 40 to 59 with a 12% incidence, and 4% for those under 40.

Of great concern is the rising incidence over time. In 2000, a total of 8% of Americans had diabetes. This has risen to about 12% or a 50% increase in just two decades. Some would term this an epidemic. Of further concern, many young people are now developing diabetes.

Diabetes substantially increases the risk of multiple diseases. Among them are blindness, kidney failure (the most common reason for a kidney transplant is diabetes damage), cardiovascular disease, including heart attacks and strokes, loss of sensation in the feet and lower legs (neuropathy and paresthesia), reduced vascular supply to the lower legs and the feet, often resulting in amputation of toes, feet, or legs, and Alzheimer’s disease.

Diabetes and its associated diseases combined cost America $640 billion per year, or 25% of all healthcare spending.

The major risk factors for type two diabetes include being substantially overweight, having a family history, being inactive or sedentary, and being over the age of 45.

You can’t change your family history. But your genes need not be your destiny. The basics of prevention include losing weight, increasing activity, eating healthy foods, and substantially reducing the intake of ultra-processed foods.

Diabetes and Alzheimer’s disease

Type 2 diabetes increases the risk of Alzheimer’s disease by 50 to 65%. It’s a shared risk factor with increased blood pressure and increased cholesterol, all leading to brain cell inflammation.

The increased risk of diabetes correlates with insulin resistance not only throughout the body but also in the brain. Some scientists think that brain insulin resistance is separate from the resistance in other parts of the body, and as a result, use the term “type 3 diabetes” as a synonym for Alzheimer’s disease. The brain cells are in effect “starved” for glucose, which is the neurons’ principal source of energy, despite plenty of glucose circulating in the bloodstream.

Insulin resistance of brain cells is associated with increased oxidative stress and neuroinflammation, which in turn leads to neurodegeneration.

Bottom line — reducing the possibility of developing diabetes markedly reduces your chances of developing Alzheimer’s disease. Diabetes begins with prediabetes, so the place to start your preventive work is there.

Prediabetes

115 million Americans have prediabetes. 81% do not know it. 18% of teens have prediabetes, and this number is on the rise.

The typical person with prediabetes is overweight, has excess belly fat, and is sedentary. They tend to eat a diet high in sugar and foods that are quickly digested into sugar, as well as ultra-processed foods. Many will also have a family history of diabetes.

Those with prediabetes have a 5–10% chance of progressing to diabetes each year, which accumulates so that in 3–5 years, 15–30% will have developed diabetes. And, if followed for enough years, up to 70% will progress.

Prediabetes is diagnosed by measuring your average blood glucose over the course of 2 to 3 months. This is done with a test called A1c, a blood test that can be drawn at any time of day. If the A1c is between 5.7% and 6.4%, that is diagnostic of prediabetes. If it’s 6.5% or higher, that’s diagnostic of diabetes. As noted, most people with prediabetes don’t know it. However, the A1c test is simple and inexpensive. If you have any of the risk factors for prediabetes, it’s well worth your while to have the test. Your doctor may order it at your annual evaluation. Ask to have it done and then ask for the result.

Knowing you have prediabetes is essential because the progression to diabetes can be reversed with lifestyle changes. Yes, these can be challenging, but they are well worth the time and effort so that you do not progress to diabetes and all of its downstream complications, including dementia.

The other reason to reverse prediabetes is that it is not a benign condition. It is silent but causes trouble over time. Prediabetes leads to slow but long-term damage to blood vessels, the heart, and the kidneys. Prediabetes can be part of the metabolic syndrome — a combination of any three of elevated blood sugar, high blood pressure, high LDL cholesterol and low HDL cholesterol, elevated triglycerides, and excess belly fat. These conditions in combination lead to diabetes, heart disease, stroke, fatty liver disease, and cognitive decline.

Although usually not measured, the underlying problem is the early stages of insulin resistance when the pancreas can still compensate by producing excessive insulin to overcome the resistance. Once it can no longer do that, blood glucose remains high, and you now have diabetes.

Reversing prediabetes

The good news is that you can reverse prediabetes back to normal. The steps are straightforward and usually do not require medication. Since prediabetes develops because of being overweight, being sedentary, and eating too much sugar and foods that readily convert to sugar, the steps are straightforward.

Check your waist-to-height ratio. Your waist should be less than 50% of your height. Details here.

Losing just 5 to 7% of body weight will reduce the risk of progressing to diabetes by 50%. For a 200-pound person, this is only 10–14 pounds. The second step is to get about 150 minutes of aerobic exercise each week. A brisk 30-minute walk five days a week will suffice. Add resistance exercises 2 to 3 times per week.

The third step is to eat a low-glycemic (meaning food that does not digest to sugar rapidly and thereby leads to rapid increases in blood sugar — think candy, ice cream, cakes), micronutrient-dense diet that includes increased fiber intake, non-starchy vegetables (for example, dark green veggies), whole grains (whole wheat, brown rice), legumes (beans and lentils), lean meats, fish, eggs, nuts, and avocados.

It is very important to reduce sugary drinks and high-sugar foods, such as pastries, pies, and ice cream. Eating only whole grains means no products made from white flour, such as white bread, most prepared cereals, pastries, and donuts.

Avoid ultra-processed foods, as they contain high levels of sugar, salt, and white flour. Ultra-processed foods themselves are linked to dementia. It is also important to get adequate sleep and to reduce chronic stress.

It’s a good idea to monitor your progress with continuous glucose monitoring. It will show you whether certain foods cause spikes in blood sugar and how exercise affects it. These monitors are now available at most pharmacies.

These lifestyle changes can reverse prediabetes within a few months.

You want to get your A1c level down, not just to the upper limit of normal at 5.6, but lower still, because the cutoff from normal to prediabetes, although highly useful, is still a static number. You want to be well under the top limit of “normal.”

Some people have tried but cannot lose weight or can’t keep it down after losing. They often benefit from using a GLP1 drug such as Wegovy (semaglutide) and Zepbound (tirzepatide). For many people, these have proven highly valuable. A word of caution. Weight loss usually includes both fat and muscle, so you need to do resistance exercises to counteract muscle loss. Once started, many people need to continue indefinitely, otherwise they regain weight, fat, but not muscle.

It is to your definite advantage to learn if you have prediabetes and then to do what is needed to reverse it. Habits can be difficult to modify, but the benefits are so great that the time and effort are well worth it, including a major risk reduction in dementia. And remember, it is never too late to get started.

With thanks to retired long-time expert diabetes educator Charlene Freeman, RN CDE CPT

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A bill passed by the state legislature in March then signed into law by Democratic Gov. Jared Polis allows Colorado to further uncouple itself from federal guidance.

The law allows health officials to follow the recommendations of national medical groups when making decisions such as purchasing bulk vaccines for the Medicaid program.

“We are insulating our state from the dysfunction coming out of Washington,” said Democratic state Sen. Kyle Mullica, a co-sponsor of the bill and a registered nurse. “We’re going to rely on science.”

“From fighting during the pandemic for Coloradans to get vaccines as quickly as possible to combating the Trump Administration’s barriers to getting vaccinated, we have expanded access to vaccines for Coloradans who want them,” Polis said in a statement when he signed the law.

Colorado is one of at least 29 states that, along with Washington, D.C., have taken steps to bypass the new federal recommendations amid worries that the changes could chip away at public trust in vaccines and erode broad vaccine coverage.

Previously, Colorado, like most states, had followed federal guidance set by the Centers for Disease Control and Prevention. In January, CDC advisory panelists, selected by Health and Human Services Secretary Robert F. Kennedy Jr., removed six pediatric immunizations from the agency’s universal recommendation list.

Last year, doctors, scientists, local leaders, and other supporters came together to form an outreach and advocacy coalition called Colorado Chooses Vaccines.

The group aims to offer a clear, unified voice on the proven benefits of vaccines and reassure residents confused by the many federal changes.

Carol Boigon, a former Denver City Council member, joined the group because she wants more people to hear her own chilling story about vaccine-preventable illness.

“Every summer everybody got sick,” Boigon said, recounting her childhood in 1950s Detroit.

The illness was polio, a highly contagious viral disease that attacks the nervous system, sometimes causing partial or full paralysis.

During the summer of 1953, “the whole block was sick and some of us got crippled, and that was just the way it was,” she said.

New Group Steps Up

Boigon’s personal history will be part of the coalition’s work to educate new generations about the dangers of infectious diseases that were once common in the U.S. but are now relatively rare.

The group, which formed last September, will also compile vaccine information from medical groups and the state health department and advocate for policy proposals with the state government.

“It was in direct response to the federal threats,” said another coalition member, former state lawmaker Susan Lontine. She leads the nonprofit Immunize Colorado.

Another member, public relations specialist Elizabet Garcia, wants more outreach to Hispanics, whose vaccination rates lag behind other groups’.

“A lot of time it’s this fear that they’re going to have to pay out-of-pocket, that their insurance doesn’t cover it, that they might not even have insurance in general,” Garcia said.

Boigon was 5 when she got sick and was hospitalized for six weeks with a fever. The virus attacked her spine.

“None of my limbs worked immediately afterwards,” Boigon said.

Although she regained function in her other limbs, her right arm never fully recovered. She had to adapt, relearning everyday tasks such as reaching out to shake hands with people with her left hand.

In 1955, not long after she got sick, the new polio vaccine became more widely available to the public. As vaccinations took off, U.S. cases of polio, once one of the nation’s most feared diseases, dropped by an estimated 85%-90%.

Increasing Public Trust

State leaders have taken other steps to promote public health. After the Trump administration pulled the U.S. out of the World Health Organization, several states, including Colorado, decided to join the WHO’s Global Outbreak Alert and Response Network on their own.

Colorado also joined a multistate lawsuit challenging the Trump administration’s changes to the childhood vaccine schedule.

And the new state law has provisions besides allowing the state to diverge from federal recommendations. It codifies pharmacists’ ability to prescribe and give vaccines themselves. It also increases legal protections for healthcare workers who give vaccines.

“This law will provide more clarity to guide all Coloradans, including providers who administer vaccines,” Lontine said.

But the legislation has opponents who say it would interfere with parental choice and claim vaccines might be unsafe or ineffective.

“I just want to make sure we’re not just getting into a big political dispute between the federal recommendations — the CDC and so forth — and different political views in Colorado here,” said Republican state Sen. John Carson, who voted against the vaccine bill.

NPR contacted the U.S. Department of Health and Human Services about Colorado’s new law. Spokesperson Emily Hilliard answered in an email: “The updated CDC childhood schedule continues to protect children against serious diseases.”

Preventable Illnesses Surge

The flurry of statewide activity comes as Colorado and the nation have seen surges in illnesses such as flu and measles.

As of mid-May, Colorado had recorded 22 measles cases this year. In 2025, it registered 36 cases, according to the state health department, far surpassing totals from previous years.

Across Colorado, kindergarten vaccination rates for measles were 88% last school year — with only a few counties achieving rates of 95%, the level needed for herd immunity, according to data published by The Washington Post in December.

This has also been Colorado’s worst flu season in recent years.

Vaccination rates for both flu and covid-19 have dropped slightly in Colorado, according to the state health department.

Eight children in Colorado have died this season from flu; one from covid; and one from RSV, or respiratory syncytial virus. Vaccines for all three are available for children and recommended by the state’s health department.

Kennedy, a longtime anti-vaccine activist, has defended his decisions to overhaul the recommended schedule for childhood vaccinations.

In March, a federal judge put on hold many of the changes.

“We’re not taking vaccines away from anybody. If you want to get the vaccine, you could get it. It’s going to be fully covered by insurance just like it was before,” Kennedy told CBS News in January.

When a reporter suggested the new changes could result in fewer people getting a flu vaccine, Kennedy said: “Well, that may be, and maybe that’s a better thing.”

Boigon is sometimes incredulous at everything that has happened.

“It’s like we’re going backwards,” she said. “It’s like we have decided we don’t want a modern life; we want to be back in the 1950s, where children are sick and dying.”

This article is from a partnership with Colorado Public Radio and NPR.

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An operational model developed in Algeria may show a way that countries can make childhood vaccines more effective, more acceptable and more economical. It is a model that may provide a framework for middle-income countries across the globe, including many across the rest of Africa.

Six-in-one (or hexavalent) vaccines are cutting the number of clinic visits needed to prevent multiple life‑threatening infections and easing pressure on already stretched health systems. Growing economic evidence from Algeria and several Latin American countries suggests that while these vaccines may cost more upfront, the investment may be largely or entirely recovered through fewer appointments, streamlined logistics, and a reduction in cases of vaccine-preventable diseases and potential adverse events from vaccination. Yet the children who could benefit most – those living in low‑ and middle‑income countries are still the least likely to receive them, widening an avoidable gap between what modern vaccines can do and the protection children actually receive.

Most hexavalent vaccines save money in another way: they reduce the number of adverse events – side effects – that require treatment in a hospital or clinic. Acellular hexavalent vaccines include a type of protection against pertussis, or whooping cough, which is the gold standard for immunization in higher-income countries but has not yet been widely adopted beyond them.

With more than a decade of historical data supporting safety and efficacy, these acellular pertussis vaccines have a notable track record of improving vaccination coverage rates (VCR) and parents’ willingness to have their children protected, as they cause fewer painful adverse events [1].

Acellular pertussis (aP) vaccines are formulated using isolated antigens, which are purified and detoxified, thereby removing most of the components of the bacterium that cause undesirable reactions [2].

Most low- to middle-income countries still use whole-cell pertussis vaccines, which include a suspension of the entire inactivated Bordetella pertussis organism – some 3,000 antigens. Although the inclusion of far more antigens can result in a marginally higher immune response, the complexity of the vaccine leads to varying amounts of reaction-causing components between batches of vaccine and varying levels of protection [2].

The combination of more adverse events and variable efficacy means that developing countries bear a disproportionate share of the burden incurred through side effects. The side effects in children lead to an increased reluctance among parents to agree to future vaccines for their children and higher costs for the healthcare system. These problems often arise in healthcare systems that are inadequately equipped to deal with them.

Expert opinion from Algeria indicates that acellular hexavalent vaccination has improved vaccination coverage levels and simplified the vaccination schedule by reducing the number of appointments. It reduces the required number of immunization visits from ten to six. This eases pressure on overstretched health services, simplifies logistics and cold-chain management, and reduces indirect societal costs, including the time parents spend away from work.

Algeria is the third WHO African region country to adopt the acellular hexavalent vaccine into its national immunization schedule. Economic data from those countries and several in Latin America demonstrate that a rollout of the vaccine across African countries is not only possible but also economically advantageous [3,4,5,6].

Algeria’s vaccination metrics: an operational model for success

Vaccines have transformed child health in Algeria, as they have across the world. Since the initial introduction of vaccination in Algeria, followed by sustained efforts to expand the vaccination schedule, infant mortality rates have dropped dramatically from 163 per 1,000 live births in 1966 to 20 per 1,000 in 2023, a reduction of around 87% [7].

The percentage of children protected in Algeria has exceeded the targets set by the World Health Organization (WHO) for decades, with diphtheria, tetanus toxoid and pertussis (DTP) coverage consistently above 90% [8]. As in many countries, the COVID-19 pandemic disrupted healthcare systems, leading to a decline in vaccination rates, with DTP-3 coverage, a key measure of childhood vaccination, reduced to 77% in 2022 [9]. This situation was quickly improved, with coverage increasing to 92% by 2024 [9].

In 2022, three cases of polio caused by circulating vaccine-derived poliovirus type 2 were reported [10]. Rarely, the circulating vaccine-derived virus causes polio, highlighting the necessity of timely vaccination with IPV, with which these vaccine-derived cases do not occur [11].

The shift to hexavalent vaccination

Algeria’s shift from its former schedule to hexavalent vaccination was not a straightforward process. Initially, the five-in-one (or pentavalent) vaccine was replaced by a combination of the tetravalent vaccine (DTP-Hib) and the monovalent Hepatitis B vaccine (HBV), administered across 10 separate healthcare visits, necessitating additional appointments [12].

The change in the vaccination schedule resulted in delays in dose administration and a decrease in vaccination coverage. This issue was resolved with the introduction of the new schedule, which integrated an acellular hexavalent vaccine in 2023, reducing the number of required healthcare visits to six [13].

While polio vaccination was present in the previous schedule (with one IPV dose at 3 months and 3 OPV doses at 2, 4, and 12 months), inclusion as part of a hexavalent vaccine simplified the schedule (giving three doses of IPV at 2, 4, and 12 months associated with three OPV doses), helping to maintain the global strategy for polio eradication. The WHO recommends that all countries using OPV adopt a vaccination schedule with at least two doses of inactivated vaccine, which gives individual protection without the risk of vaccine-related polio [14].

The financial metrics of the switch

A recent whitepaper conducted a pharmacoeconomic analysis of the budgetary impact of transitioning from a whole-cell tetravalent vaccination schedule to an acellular hexavalent schedule. While the switch was associated with an increase in annual program expenditure of approximately 26 million Euros (around a 58% rise in upfront costs), this was substantially offset by nearly 19 million Euros in annual savings generated through the management of adverse events, improved logistics and transportation, and increased parental productivity [13]. Overall, roughly 73% of the upfront cost was offset by these savings.

Algeria is the latest in a series of examples where this is the case. The nominal, upfront cost of acellular hexavalent vaccines is typically higher than that of whole-cell vaccines; this has, in many cases, deterred countries from adopting them. However, there are many benefits at both the economic and systemic levels that recoup much of the costs of acellular hexavalent vaccines. In many instances, these costs are hidden and not factored into initial value calculations.

Similar experiences have been seen in other countries. In Argentina, Peru, and South Africa, the switch to hexavalent vaccines led to higher initial costs, but these were substantially offset by savings from fewer adverse events, lower programmatic expenses, and improved logistics. For example, in data from Argentina, roughly 90% of the initial investment into acellular hexavalent vaccines was recovered through fewer adverse event-associated costs and lower programmatic costs [15]. Peru reported a reduction in logistical costs by nearly 60%, with roughly 44% of the initial increase in costs recovered [16]. South Africa achieved overall savings of about 10 USD per child [3].

These calculations overlook benefits that are more difficult to quantify. For example, what costs are generated because of vaccines missed and infections caused by increased vaccine hesitancy on the part of parents. Across these settings, the higher upfront investment in hexavalent vaccines has proven to be economically viable, with much of the cost recouped through broader system efficiencies.

Programmatic benefits of hexavalent vaccination

Hexavalent vaccination offers the potential for simpler systems and higher levels of acceptance among patients. For the child, integrating six antigens into a single injection drastically reduces the number of needle sticks, alleviating injection-related anxiety and the prevalence of local reactions. This increases parental acceptance and helps to improve vaccination coverage.

Parents are relieved of the burden of coordinating multiple medical appointments, covering travel costs, and dealing with lost workdays. By reducing parental anxiety and the strain of repeated visits, combined vaccines help mitigate vaccine hesitancy within communities. This has been demonstrated in multiple studies across Africa, with investigations in Gambia and South Africa documenting concerns among parents about a child receiving more than two injections in a single visit [17,18]. Limiting the number of healthcare visits is also a crucial factor in increasing vaccine coverage in areas with limited healthcare infrastructure, such as those in rural southern Algeria.

For healthcare professionals, particularly in resource-limited settings such as rural areas in Africa, the adoption of combined vaccines helps to ease the administrative burden of multiple appointments. These formulations optimize consultation efficiency by drastically reducing the required administration time and simplifying inventory management [19].

The use of ready-to-use liquid vaccines, such as the hexavalents, has been shown to simplify and enhance the safety of the vaccination procedure when compared to vaccines that come as a powder that has to be reconstituted [20]. The preference for this approach among frontline workers is overwhelming: one study indicated that 97.6% of healthcare providers favored these liquid, combined formulations in their daily work [21]. Evidence supports this preference, demonstrating that the switch led to a dramatic reduction in administration errors (from 42.8% to 4%) and needlestick injuries (from 42.3% to 9.5%), while also yielding an average time savings of 1.1 minutes per dose [22].

The case for Hexavalent vaccination across Africa

Across the WHO Africa region, VCR has improved significantly over the last few decades; however, unfortunately, this improvement has stalled. The level of coverage for the third dose of DTP-containing vaccines, a standard benchmark for immunization system performance, has sat in the mid-70s for over a decade, with a current coverage of 76% [23].

This stagnation of the VCR is reflective of the ongoing issue of inequality. The gap in vaccine access runs not only between Africa and higher‑income regions, but also within the continent itself, where some countries consistently outperform others. Diseases, however, do not recognize borders; any outbreak that affects one country is likely to increase the risk to surrounding countries. Air travel enables a disease case to be spread to virtually any country in the world within just two days [24].

The COVID-19 pandemic was a clear example of the rapid spread in today’s world. Within a period of weeks, the virus spread from its origin in China to the entire globe, despite public health measures and lockdowns. With this in mind, any country that is falling behind on vaccination coverage becomes a weak link in a global chain where diseases can flourish and form reservoirs of cases that can allow diseases such as polio to spread unchecked.

Bringing vaccine equity to lower- and middle-income countries is therefore vital to addressing global health concerns. Hexavalent vaccination has demonstrated its ability to increase vaccine coverage in these countries. Among the WHO Africa region, Mauritius, which adopted hexavalent vaccination in 2017 [4] currently stands notably above the average for the region, with 96% coverage for the first dose of inactivated polio vaccine, and 93% for the benchmark based on DTP-containing vaccines [25].

Vaccine coverage translates into increased prosperity. Vaccination cannot be viewed as an inconvenient expense but as an investment. The WHO estimates that for every dollar spent, vaccination can yield a return on investment of around 54 USD – provided, of course, that the vaccines actually find their way into the arms of children [26].

As the Algerian case study demonstrates, higher upfront costs for acellular hexavalent      vaccines are often paid back by improvements in logistical efficiency, reduced healthcare burdens, and improved parental compliance. By bridging the gap between high- and low-income immunization standards through this investment, the life-saving benefits of gold standard vaccinations can become more than a privilege of geography, but a universal foundation for human health.

[This consensus paper is based on the findings of a white paper discussing the findings of a group of vaccination experts focusing on paediatric immunisation, supported by Sanofi. Intended for professional use.]

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