The world is on track to miss its health targets

Every year the World Health Organization publishes a global health statistics report. It features the numbers behind world health trends and, importantly, assesses whether we’re on track to reach ambitious goals set in 2015. It’s a bit like a health grade.

The 2026 report was published on Wednesday. And the results aren’t looking brilliant. While we are seeing some improvements, they are uneven, and they’re far too slow.

The targets themselves are part of the United Nations’ Sustainable Development Goals, a sprawling and ambitious plan focused on improving life around the world. The 17 goals were set to tackle poverty and climate change and to boost education, gender equality, health, and well-being, among many other quality of life issues. Those targets were meant to be met by 2030.

Perhaps they were a little too ambitious. Here are the numbers and statistics that stood out to me on this year’s world health report card.

1.3 million new cases of HIV in 2024

Before the SDGs, there were the Millennium Development Goals. One MDG target was to halt and reverse the spread of HIV—and that target was exceeded by 2015. Back then, we were considered on track to “end the AIDS epidemic by 2030.”

How depressing, then, to see that in 2024 there were an estimated 1.3 million new cases of HIV. That’s 40% lower than the figure from 2010. But it’s still 1.3 million additional people with HIV. The SDG target is to reduce HIV incidence by 90% by 2030—we’re not likely to meet it.

10.7 million new cases of TB

The picture is even bleaker for tuberculosis, which ranks 10th on the WHO’s list of top global causes of death. The goal was to reduce cases by 80% between 2015 and 2030. So far, cases have only fallen by a measly 12%. And when you break the change down by region, the Americas saw an increase of 13%

An 8.5% rise in malaria cases

And then there’s malaria, the mosquito-borne disease with a 7% fatality rate. The European region has been free of malaria since 2015, but the disease is a significant concern in many countries in the Global South, particularly in Africa. The goal was to lower rates by 90% between 2015 and 2030. In 2024, there were an estimated 282 million cases of malaria globally—representing an 8.5% increase in incidence rates.

Antimalarial drug resistance is a major challenge here—forms of the malaria virus that are resistant to drugs have been confirmed or suspected in eight countries in Africa, according to a separate WHO report. Mosquitoes that are resistant to commonly used insecticides are present in nine African countries. And climate change, which can alter mosquito habitats, may be making things worse.

42.8 million children are wasting

We’re not meeting child health targets, either. Take malnutrition, for example. As of 2024, the global prevalence of wasting in children was 6.6%—that’s a staggering 42.8 million children who are literally wasting away because of a lack of adequate food. On the other end of the spectrum, 5.5% of children are now considered overweight. Both figures were meant to be below 5% by 2030, which now seems unlikely.

Vaccination rates are dropping in the Americas

Progress in improving childhood vaccination coverage has stalled. Globally, an estimated 76% of children are getting their second dose of a measles vaccine—a figure far below the the approximately 95% needed to prevent outbreaks. The Americas currently has lower rates of vaccine coverage for three of the four “core” vaccines than it did in 2015.

This is partly due to a lack of investment, says Goodarz Danaei, an epidemiologist at the Harvard T.H. Chan School of Public Health. “But now we have a misinformation campaign going around vaccines that makes it worse,” he adds.

The covid-19 pandemic didn’t exactly help, either. The impact on health services led to millions of children missing out on routine vaccinations.

22.1 million pandemic-related deaths

And of course the pandemic affected progress toward health goals in more direct ways: 7 million people died of covid-19. The WHO report estimates that, for each of these, there were an additional two “excess” deaths related to the pandemic, due to disruptions in health care, for example. That puts the total figure at 22.1 million pandemic-related deaths.

A woman dies every two minutes from “maternal causes”

Maternal mortality rates fell by about 40% between 2020 and 2023. But today’s rate equates to 712 maternal deaths every single day. That’s one every two minutes. The WHO report notes that we’d have to reduce the mortality rate by almost 15% per year in order to meet the 2030 target. This seems incredibly unlikely, particularly given the recent decimation of US funding for global aid programs, which is expected to result in thousands of additional maternal deaths.

Progress has also slowed in reducing the risk of death from noninfectious diseases like cancer, diabetes and cardiovascular disease. “Overall, neither the world nor any WHO region is currently on track to meet the 2030 SDG target,” the report states.

2.1 billion people struggle to afford health care

Despite plans to make health care more affordable, a significant chunk of the population is being pushed into poverty by health-care costs. In 2022, 2.1 billion people faced financial hardship due to health spending—and 1.6 billion of them were living in or had been pushed into poverty.

Across the board, there have been some important improvements in global health. But the achievements have not gone far enough. “The good news is that there is progress,” says Danaei. “But as always, the glass is half empty.”

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

Here’s how technology transformed babymaking

Technology is changing the way we make babies. The pioneering work of the scientists who invented IVF led to the birth of the first “test tube baby” in 1978. We’ve come a long, long way since then.

This week, I’ve been working on a piece about the cutting edge of IVF technologies and what’s coming next. Think AI and robots and, potentially, gene-edited embryos.

My reporting has also made me think about just how much progress has been made in the last five decades. Clinicians have improved hormonal treatments. Embryologists have devised ways to culture embryos in the lab for longer. IVF clinics today offer multiple genetic tests for embryos.

In recent years, we’ve had reports of babies born with DNA from three people, babies born following “IVF on wheels,” babies born from decades-old embryos, and even babies “conceived” with the aid of a sperm-injecting robot.

The technology has also had a huge social impact. It has allowed for changes in the structure of families and provided more reproductive choices for would-be parents. So this week, let’s consider the technologies that have transformed babymaking.

Alan Penzias, a reproductive endocrinologist at Boston IVF, has been working in IVF since the early 1990s. In those days, his lab at Yale would collect a person’s eggs, fertilize them, and culture any resulting embryos for two days, until the embryos had two or four cells.

The embryos couldn’t survive any longer outside a body, so they’d be transferred to the uterus at that point. All of them. Even if there were, say, five embryos in total. Typical healthy patients could expect a live birth rate of 12% to 15%, he says.

Then Penzias heard that other teams were managing to culture embryos for three days. “We thought, No, that’s not possible,” he recalls. He learned that scientists had achieved this by tinkering with the culture medium—the nutrient-rich fluid the embryos are grown in.

Those three-day embryos, which had around six to 10 cells, seemed to have a better chance of resulting in a live birth. The teams culturing embryos for longer saw their success rates climb to 25% among similar patient groups, says Penzias. Again, he couldn’t believe it. “We thought they were making it up,” he says.

In the years since, teams have made more improvements to culture medium. Today, most IVF embryos are cultured for five or six days—a point at which they have 80 to 100 cells. The culturing process can act a little like a stress test—the embryos that make it to day six are generally more likely to go all the way and develop into a healthy baby.

Over the same period, advances in other technologies have opened up the options for what we can do with those embryos. Scientists learned they were able to freeze embryos and use them at a later date. A little over a decade ago, clinics shifted to a “vitrification” approach that rapidly cools the embryos to a glassy state. Vitrified embryos are more likely to survive freezing and thawing, so this approach quickly caught on.

As a result, doctors no longer needed to transfer multiple embryos at once. This made it less likely that patients would have twins or triplets, which can increase the risk of pregnancy complications.

Vitrification has also made IVF safer in other ways, including by affording patients a bit of time between fertility treatments. The hormonal treatments used in the first phase of IVF are designed to increase the production of mature eggs that can be collected. These treatments carry a small risk of a condition called ovarian hyperstimulation syndrome (OHSS), which in rare cases can be life-threatening. The ability to freeze all your embryos and use them at a later date is thought to give the body a chance to recover from hormonal treatment and reduces the risk of OHSS.

And because clinics are now able to culture embryos for up to a week, they can take a few of the 100 or so cells and send them for genetic testing before freezing the embryos. People undergoing IVF can get genetic readouts of all the embryos before deciding which to implant. (It is worth noting, however, that these testing technologies are not perfect.)

“Those are really radical changes, and we take them for granted,” says Penzias.

These technologies have also changed the function of IVF. What was once a treatment for infertility is now used to preserve fertility. People who want to delay parenthood can opt to freeze their eggs or embryos and use them later. They might opt to transfer one embryo in a year’s time and a second several years later. “We’ve been able to empower women to be able to have much more reproductive choice and get more reproductive mileage from a single IVF cycle,” says Penzias.

People who are about to undergo cancer treatments that might damage the testes or ovaries can opt to store their eggs or sperm ahead of time, too. Scientists have even been able to preserve pieces of ovarian and testicular tissue and reimplant them later, enabling recipients to have healthy babies.

Today, more people than ever have access to safe IVF options that offer multiple paths to parenthood. Those options look set to expand. But if you want to find out more about the AI and IVF robots, you’ll have to read this week’s story, here!

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

Trump’s mass firing just dealt another blow to American science

This past week delivered another gut punch for science in the US. This time, the target was the National Science Foundation—a federal agency that funds major research projects to the tune of around $9 billion. The foundation’s efforts were overseen by a board of 22 prominent scientists. On Friday last week, they were all fired.

The NSF has been without a director since April 2025, when former director Sethuraman Panchanathan stepped down in the wake of DOGE-led funding cuts and mass firings. Trump’s nominee for the role is Jim O’Neill, an investor and longevity enthusiast who does not have a science background.

It’s hard to predict exactly how things will shake out for science. But it’s not looking great.

The NSF was established in 1950 to “promote the progress of science,” among other goals. It has served as a major source of support for research and education since then. In 2024, the agency spent $9.39 billion—a substantial figure but only 0.1% of all federal spending.

Key decisions about how that money is spent have been made by the National Science Board. Each of the scientists who made up the board until last week was appointed by a US president to serve, at least initially, a six-year term. Those members were responsible for establishing NSF policies, authorizing major expenditures and providing oversight, says Keivan Stassun, a physicist and astronomer at Vanderbilt University who was appointed to the board in late 2022.

A few years ago, the board was responsible for establishing a new “directorate” within the agency to channel funding to “technology, innovations and partnerships,” for example. The board also authorized funding for the US Extremely Large Telescope Program.

“It’s a relatively small group with a tremendous amount of responsibility and authority,” says Stassun. He viewed his appointment as “a tremendous honor.”

Then, last Friday, the email landed in his inbox. “It said: On behalf of President Trump, this letter is to notify you that your position as a member of the National Science Board is terminated effective immediately. Thank you for your service,” says Stassun. “It was deeply disappointing.”

Still, Stassun wasn’t surprised, given the administration’s actions across federal science agencies over the past year.

Since Donald Trump took office at the start of 2025, the NSF—along with many other federal agencies—has frozen, unfrozen, and terminated grants. “The board was not involved in any of those [terminations],” says Stassun. Members had no say in the firing of agency staff either, he says. Staff numbers are currently down 40%, he adds.

In a 2026 budget request, the Trump administration sought to cut the NSF’s budget by around 57%. Last summer, NSF staffers wrote a letter of dissent arguing that such substantial cuts would “cripple American science.” The proposed cuts would have hit biological sciences, engineering, and STEM education particularly hard.

Those cuts were rejected by Congress earlier this year. But grant terminations and firings are essentially allowing them to take effect regardless, says Stassun. “The funds that the White House has been dispersing to the agency … have been far less than what Congress intended,” he says.

Many ambitious research projects are grinding to a halt as a result. “The Extremely Large Telescope Program appears to be dead in the water for now,” says Stassun. And the NSF arm dedicated to science education “has effectively zeroed out,” he says.

But not all of them. While the administration’s 2027 budget request states that NSF will “close out” its directorate for social, behavioral, and economic sciences, it describes AI and quantum information science as key “frontier initiatives.” Biotechnology is described as a “focal point.” 

When asked for comment, the NSF directed MIT Technology Review to the White House press office. The White House did not respond directly to questions about the firing of NSB members and said in a statement, “The National Science Foundation’s work continues uninterrupted.”

Jim O’Neill, Trump’s current candidate for the position of NSF director, is certainly interested in biotechnology. Specifically, when I spoke to O’Neill in February, he told me that he supposes he is a Vitalist—a hardcore supporter of efforts to extend human longevity who believes that death is wrong.

O’Neill was deputy secretary of the Department of Health and Human Services and acting director of the Centers for Disease Control and Prevention until a leadership shakeup a couple of months ago. But he isn’t a scientist. And that has some scientists worried. He has yet to be confirmed by the Senate for the role.

In the meantime, the administration’s efforts are having a real impact on research. “We [NSB members] tried to stand for a continued investment in science, engineering, and technology, and in science education broadly,” says Stassun. “The administration will now be able to operate the agency the way that [it wants to, with] no governance body in the way.”

Health-care AI is here. We don’t know if it actually helps patients.

I don’t need to tell you that AI is everywhere.

Or that it is being used, increasingly, in hospitals. Doctors are using AI to help them with notetaking. AI-based tools are trawling through patient records, flagging people who may require certain support or treatments. They are also used to interpret medical exam results and X-rays.

A growing number of studies suggest that many of these tools can deliver accurate results. But there’s a bigger question here: Does using them actually translate into better health outcomes for patients?

We don’t yet have a good answer.

That’s what Jenna Wiens, a computer scientist at the University of Michigan, and Anna Goldenberg of the University of Toronto, argue in a paper published in the journal Nature Medicine this week.

Wiens tells me she has spent years investigating how AI might benefit health care. For the first decade of her career she tried to pitch the technology to clinicians. Over the last few years, she says, it’s as though “a switch flipped.” Health-care providers not only appear much more interested in the promise of these technologies, they have also begun rapidly deploying them.

The problem is that many providers aren’t rigorously assessing how well they actually work.

Take “ambient AI” tools, for example. Also known as AI scribes, they “listen” to conversations between doctors and patients, then transcribe and summarize them. Multiple tools are available, and they are already being widely adopted by health-care providers.

A few months ago, a staffer at a major New York medical center who develops AI tools for doctors told me that, anecdotally, medics are “overjoyed” by the technology—it allows them to focus all their attention on their patients during appointments, and it saves them from a lot of time-consuming paperwork. Early studies support these anecdotes and suggest that the tools can reduce clinician burnout.

That’s all well and good. But what about patient health outcomes? “[Researchers] have evaluated provider or clinician and patient satisfaction, but not really how these tools are affecting clinical decision-making,” says Wiens. “We just don’t know.”

The same holds true for other AI-based technologies used in health-care settings. Some are used to predict patients’ health trajectories, others to recommend treatments. They are designed to make health care more effective and efficient.

But even a tool that is “accurate” won’t necessarily improve health outcomes. AI might speed up the interpretation of a chest X-ray, for example. But how much will a doctor rely on its analysis? How will that tool affect the way a doctor interacts with patients or recommends treatment? And ultimately: What will this mean for those patients?

The answers to those questions might vary between hospitals or departments and could depend on clinical workflows, says Wiens. They might also differ between doctors at various stages of their careers.

Take the AI scribes, as another example. Some research on AI use in education suggests that such tools can impact the way people cognitively process information. Could they affect the way a doctor processes a patient’s information? Will the tools affect the way medical students think about patient data in a way that impacts care? These questions need to be explored, says Wiens. “We like things that save us time, but we have to think about the unintended consequences of this,” she says.

In a study published in January 2025, Paige Nong at the University of Minnesota and her colleagues found that around 65% of US hospitals used AI-assisted predictive tools. Only two-thirds of those hospitals evaluated their accuracy. Even fewer assessed them for bias.

The number of hospitals using these tools has probably increased since then, says Wiens. Those hospitals, or entities other than the companies developing the tools, need to evaluate how much they help in specific settings. There’s a possibility that they could leave patients worse off, although it’s more likely that AI tools just aren’t as beneficial as health-care providers might assume they are, says Wiens.

“I do believe in the potential of AI to really improve clinical care,” says Wiens, who stresses that she doesn’t want to stop the adoption of AI tools in health care. She just wants more information about how they are affecting people. “I have to believe that in the future it’s not all AI or no AI,” she says. “It’s somewhere in between.”

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.
 

What’s in a name? Moderna’s “vaccine” vs. “therapy” dilemma

Is it the Department of Defense or the Department of War? The Gulf of Mexico or the Gulf of America? A vaccine—or an “individualized neoantigen treatment”?

That’s the Trump-era vocabulary paradox facing Moderna, the covid-19 shot maker whose plans for next-generation mRNA vaccines against flus and emerging pathogens have been dashed by vaccine skeptics in the federal government. Canceled contracts and unfriendly regulators have pushed the Massachusetts-based biotech firm to a breaking point. Last year, Robert F. Kennedy Jr., head of the Department of Health and Human Services, zeroed in on mRNA, unwinding support for dozens of projects—including a $776 million award to Moderna for a bird flu vaccine. By January, the company was warning it might have to stop late-stage programs to develop vaccines against infections altogether.

That raises the stakes for a second area of Moderna’s research. In a partnership with Merck, it’s been using its mRNA technology to destroy tumors through a very, very promising technique known as a cancer vacc—

“It’s not a vaccine,” a spokesperson for Merck jumped in before the V-word could leave my mouth. “It’s an individualized neoantigen therapy.”

Oh, but it is a vaccine. And here’s how it works. Moderna sequences a patient’s cancer cells to find the ugliest, most peculiar molecules on their surface. Then it packages the genetic code for those same molecules, called neoantigens, into a shot. The patient’s immune system has its orders: Kill any cells with those yucky surface markers.

Mechanistically, it’s similar to the covid-19 vaccines. What’s different, of course, is that the patient is being immunized against a cancer, not a virus.

And it looks like a possible breakthrough. This year, Moderna and Merck showed that such shots halved the chance that patients with the deadliest form of skin cancer would die from a recurrence after surgery.

In its formal communications, like regulatory filings, Moderna hasn’t called the shot a cancer vaccine since 2023. That’s when it partnered up with Merck and rebranded the tech as individualized neoantigen therapy, or INT. Moderna’s CEO said at the time that the renaming was to “better describe the goal of the program.” (BioNTech, the European vaccine maker that’s also working in cancer, has shifted its language too, moving from “neoantigen vaccine” in 2021 to “mRNA cancer immunotherapies” in its latest report.)

The logic of casting it as a therapy is that patients already have cancer—so it’s a treatment as opposed to a preventive measure. But it’s no secret what the other goal is: to distance important innovation from vaccine fearmongering, which has been inflamed by high-ranking US officials. “Vaccines are maybe a dirty word nowadays, but we still believe in the science and harnessing our immune system to not only fight infections, but hopefully to also fight … cancers,” Kyle Holen, head of Moderna’s cancer program, said last summer during BIO 2025, a big biotech event in Boston.

Not everyone is happy with the word games. Take Ryan Sullivan, a physician at Massachusetts General Hospital who has enrolled patients in Moderna’s trials. He says the change raises questions over whether trial volunteers are being properly informed. “There is some concern that there will be patients who decline to treat their cancer because it is a vaccine,” Sullivan told me. “But I also felt it was important, as many of my colleagues did, that you have to call it what it is.”

But is it worth going to the mat for a word? Lillian Siu, a medical oncologist at the Princess Margaret Cancer Centre, in Toronto, who has played a role in safety testing for the new shots, watches US politics from a distance. She believes name change is acceptable “if it allows the research to continue.”

Holen told me the doctors complaining to Moderna were basically motivated by a desire to defend vaccines—which are, of course, among the greatest public health interventions of all time. They wanted the company to stand strong. 

But that’s not what’s happening. When Moderna’s latest results were published in February, the paper’s main text didn’t use the word “vaccine” at all. It was only in the footnotes that you could see the term—in the titles of old papers and patents.

All this could be a sign that Kennedy’s strategy is working. His agencies often appear to make mRNA vaccines a focus of people’s worries, impede their reach, devalue them for companies, and sideline their defenders. 

Still, Moderna’s strategy may be working too. So far, at least, the government hasn’t had much to say about the company’s cancer vacc— I mean, its individualized neoantigen therapy.

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

Here’s why some people choose cryonics to store their bodies and brains after death

This week I reported on some rather unusual research that focuses on the brain of L. Stephen Coles.

Coles was a gerontologist who died from pancreatic cancer in 2014. He had spent the latter part of his career specializing in human longevity. And before he died, he decided to have his brain preserved by a cryonics facility. Today, it’s being stored at −146 °C at a center in Arizona, where it sits covered in a thin layer of frost.

Coles also tasked his longtime friend Greg Fahy with studying pieces of his brain to see how they had fared (partly because he was worried his brain might crack). Fahy, a renowned cryobiologist, has found that the brain is “astonishingly well preserved.”

But that doesn’t mean Coles could be reanimated. Over the past few years, I’ve spoken to people who run cryonics facilities, study cryopreservation, or just want to be cryogenically stored. All those I’ve spoken to acknowledge that the chance they’ll one day be brought back to life is vanishingly small. So why do they do it?

The first person to be cryonically preserved was James Hiram Bedford, a retired psychology professor who died of kidney cancer in 1967. Affiliates of the Cryonics Society of California, an organization headed by a charming TV repairman with no scientific or medical training, perfused his body with cryoproctective chemicals to protect against harmful ice formation and “quick-froze” him.

Today, Bedford’s body is still in storage at Alcor, a cryonics facility based in Scottsdale, Arizona. It’s one of a handful of organizations that offer to collect, preserve, and store a person’s whole body or just their brain—pretty much indefinitely. It’s where Coles’s brain is stored.

Both men died from cancer. Medicine could not cure them. But in the future, who knows? One of the premises of cryonics is that modern medicine will continue to advance over time. Cancer death rates have declined significantly in the US since the early 1990s. I don’t know what exactly drove Coles and Bedford to their decisions, but they might have hoped to be reanimated at some point in the future when their cancers became curable.

Others simply don’t want to die, period. Last year, I attended Vitalist Bay, a gathering for people who believe that life is good and that death is “humanity’s core problem.” Emil Kendziorra, CEO of the cryonics organization Tomorrow.Bio, spoke at the event, and a healthy interest in cryonics was obvious among the attendees.

Many of them believe that science will find a way to “obviate” aging. And some were keen on the idea of being preserved until that happens. Think of it as a way to cheat not only death but aging itself.

This sentiment might have support beyond the realms of Vitalist Bay, according to research by Kendziorra and his colleagues. In 2021, they surveyed 1,478 US-based internet users who were recruited via Craigslist. They found that men were more aware of cryonics than women, and more optimistic about its outcomes. Just over a third of the men who completed the survey expressed interest “a desire to live indefinitely.”

Still, cryonics is a niche field. Worldwide, only around 5,000 or 6,000 people have signed up for cryopreservation when they die, Kendziorra told me when we chatted at Vitalist Bay. He also told me that his company gets between 20 and 50 new signups every month.

And there are plenty of reasons why people don’t do it. A small fraction of the people who responded to Kendziorra’s survey said that they thought the idea of cryonics was dystopian, and some even said it should be illegal.

Then there’s the cost. Alcor charges $80,000 to store a person’s brain, and around $220,000 to store a whole body. Tomorrow.Bio’s charges are slightly higher. Many people, including Kendziorra himself, opt to cover this cost via a life insurance policy.

Perhaps the main reason people don’t opt for cryonic preservation is that we don’t have any way to bring people back. Bedford has been in storage for more than 50 years, Coles for more than a decade. All the scientists I’ve spoken to say the likelihood of reanimating remains like theirs is vanishingly small.

The fact that the possibility—however tiny—is above zero is enough for some, including Nick Llewellyn, the director of research and development at Alcor. As a scientist, he says, he acknowledges that the chances reanimation will actually work are “pretty low.” Still, he’s interested in seeing what the future will look like, so he has signed himself up for the cryonic preservation of his brain.

But Shannon Tessier, a cryobiologist at Massachusetts General Hospital, tells me that she wouldn’t sign up for cryonic preservation even if it worked. “It turns into a philosophical question,” she says.

“Do I want to be revived hundreds of years later when my family is gone and life is different?” she asks. “There are so many complicated philosophical, societal, [and] legal complications that need to be thought through.”

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

Mind-altering substances are (still) falling short in clinical trials

This week I want to look at where we are with psychedelics, the mind-altering substances that have somehow made the leap from counterculture to major focus of clinical research. Compounds like psilocybin—which is found in magic mushrooms—are being explored for all sorts of health applications, including treatments for depression, PTSD, addiction, and even obesity.

Over the last decade, we’ve seen scientific interest in these drugs explode. But most clinical trials of psychedelics have been small and plagued by challenges. And a lot of the trial results have been underwhelming or inconclusive.

Two studies out earlier this week demonstrate just how difficult it is to study these drugs. And to my mind, they also show just how overhyped these substances have become.

To some in the field, the hype is not necessarily a bad thing. Let me explain.

The two new studies both focus on the effectiveness of psilocybin in treating depression. And they both attempt to account for one of the biggest challenges in trialing psychedelics: what scientists call “blinding.”

The best way to test the effectiveness of a new drug is to perform a randomized controlled trial. In these studies, some volunteers receive the drug while others get a placebo. For a fair comparison, the volunteers shouldn’t know whether they’re getting the drug or placebo.

That is almost impossible to do with psychedelics. Almost anyone can tell whether they’ve taken a dose of psilocybin or a dummy pill. The hallucinations are a dead giveaway. Still, the authors behind the two new studies have tried to overcome this challenge.

In one, a team based in Germany gave 144 volunteers with treatment-resistant depression either a high or low dose of psilocybin or an “active” placebo, which has its own physical (but not hallucinatory) effects, along with psychotherapy. In their trial, neither the volunteers nor the investigators knew who was getting the drug.

The volunteers who got psilocybin did show some improvement—but it was not significantly any better than the improvement experienced by those who took the placebo. And while those who took psilocybin did have a bigger reduction in their symptoms six weeks later, “the divergence between [the two results] renders the findings inconclusive,” the authors write.

Not great news so far.

The authors of the second study took a different approach. Balázs Szigeti at UCSF and his colleagues instead looked at what are known as “open label” studies of both psychedelics and traditional antidepressants. In those studies, the volunteers knew when they were getting a psychedelic—but they also knew when they were getting an antidepressant.

The team assessed 24 such trials to find that … psychedelics were no more effective than traditional antidepressants. Sad trombone.

“When I set up the study, I wanted to be a really cool psychedelic scientist to show that even if you consider this blinding problem, psychedelics are so much better than traditional antidepressants,” says Szigeti. “But unfortunately, the data came out the other way around.”

His study highlights another problem, too.

In trials of traditional antidepressant drugs, the placebo effect is pretty strong. Depressive symptoms are often measured using a scale, and in trials, antidepressant drugs typically lower symptoms by around 10 points on that scale. Placebos can lower symptoms by around eight points.

When a drug regulator looks at those results, the takeaway is that the antidepressant drug lowers symptoms by an additional two points on the scale, relative to a placebo.

But with psychedelics, the difference between active drug and placebo is much greater. That’s partly because people who get the psychedelic drug know they’re getting it and are expecting the drug to improve their symptoms, says David Owens, emeritus professor of clinical psychiatry at the University of Edinburgh, UK.

But it’s also partly because of the effect on those who know they’re not getting it. It’s pretty obvious when you’re getting a placebo, says Szigeti, and it can be disappointing. Scientists have long recognized the “nocebo” effect as placebo’s “evil twin”—essentially, when you expect to feel worse, you will.

The disappointment of getting a placebo is slightly different, and Szigeti calls it the “knowcebo effect.” “It’s kind of like a negative psychedelic effect, because you have figured out that you’re taking the placebo,” he says.

This phenomenon can distort the results of psychedelic drug trials. While a placebo in a traditional antidepressant drug trial improves symptoms by eight points, placebos in psychedelic trials improve symptoms by a mere four points, says Szigeti.

If the active drug similarly improves symptoms by around 10 points, that makes it look as though the psychedelic is improving symptoms by around six points compared with a placebo. It “gives the illusion” of a huge effect, says Szigeti.

So why have those smaller trials of the past received so much attention? Many have been published in high-end journals, accompanied by breathless press releases and media coverage. Even the inconclusive ones. I’ve often thought that those studies might not have seen the light of day if they’d been investigating any other drug.

“Yeah, nobody would care,” Szigeti agrees.

It’s partly because people who work in mental health are so desperate for new treatments, says Owens. There has been little innovation in the last 40 years or so, since the advent of selective serotonin reuptake inhibitors. “Psychiatry is hemmed in with old theories … and we don’t need another SSRI for depression,” he says. But it’s also because psychedelics are inherently fascinating, says Szigeti. “Psychedelics are cool,” he says. “Culturally, they are exciting.”

I’ve often worried that psychedelics are overhyped—that people might get the mistaken impression they are cure-alls for mental-health disorders. I’ve worried that vulnerable people might be harmed by self-experimentation.

Szigeti takes a different view. Given how effective we know the placebo effect can be, maybe hype isn’t a totally bad thing, he says. “The placebo response is the expectation of a benefit,” he says. “The better response patients are expecting, the better they’re going to get.” Tempering the hype might end up making those drugs less effective, he says.

“At the end of the day, the goal of medicine is to help patients,” he says. “I think most [mental health] patients don’t care whether they feel better because of some expectancy and placebo effects or because of an active drug effect.”

Either way, we need to know exactly what these drugs are doing. Maybe they will be able to help some people with depression. Maybe they won’t. Research that acknowledges the pitfalls associated with psychedelic drug trials is essential.

“These are potentially exciting times,” says Owens. “But it’s really important we do this [research] well. And that means with eyes wide open.”

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

Measles cases are rising. Other vaccine-preventable infections could be next.

There’s a measles outbreak happening close to where I live. Since the start of this year, 34 cases have been confirmed in Enfield, a northern borough of London. Most of those affected are children under the age of 11. One in five have needed hospital treatment.

It’s another worrying development for an incredibly contagious and potentially fatal disease. Since October last year, 962 cases of measles have been confirmed in South Carolina. Large outbreaks (with more than 50 confirmed cases) are underway in four US states. Smaller outbreaks are being reported in another 12 states.

The vast majority of these cases have been children who were not fully vaccinated. Vaccine hesitancy is thought to be a significant reason children are missing out on important vaccines—the World Health Organization described it as one of the 10 leading threats to global health in 2019. And if we’re seeing more measles cases now, we might expect to soon see more cases of other vaccine-preventable infections, including some that can cause liver cancer or meningitis.

Some people will always argue that measles is not a big deal—that infections used to be common, and most people survived them and did just fine. It is true that in most cases kids do recover well from the virus. But not always.

Measles symptoms tend to start with a fever and a runny nose. The telltale rash comes later. In some cases, severe complications develop. They can include pneumonia, blindness, and inflammation of the brain. Some people won’t develop complications until years later. In rare cases, the disease can be fatal.

Before the measles vaccine was introduced, in 1963, measles epidemics occurred every two to three years, according to the WHO. Back then, around 2.6 million people died from measles every year. Since it was introduced, the measles vaccine is thought to have prevented almost 59 million deaths.

But vaccination rates have been lagging, says Anne Zink, an emergency medicine physician and clinical fellow at the Yale School of Public Health. “We’ve seen a slow decline in people who are willing to get vaccinated against measles for some time,” she says. “As we get more and more people who are at risk because they’re unvaccinated, the higher the chances that the disease can then spread and take off.”

Vaccination rates need to be at 95% to prevent measles outbreaks. But rates are well below that level in some regions. Across South Carolina, the proportion of kindergartners who received both doses of the MMR vaccine, which protects against measles as well as mumps and rubella, has dropped steadily over the last five years, from 94% in 2020-2021 to 91% in 2024-2025. Some schools in the state have coverage rates as low as 20%, state epidemiologist Linda Bell told reporters last month.

Vaccination rates are low in London, too. Fewer than 70% of children have received both doses of their MMR by the time they turn five, according to the UK Health Security Agency. In some boroughs, vaccination rates are as low as 58%. So perhaps it’s not surprising we’re seeing outbreaks.

The UK is one of six countries to have lost their measles elimination status last month, along with Spain, Austria, Armenia, Azerbaijan, and Uzbekistan. Canada lost its elimination status last year.

The highly contagious measles could be a bellwether for other vaccine-preventable diseases. Zink is already seeing signs. She points to a case of polio that paralyzed a man in New York in 2022. That happened when rates of polio vaccination were low, she says. “Polio is a great example of … a disease that is primarily asymptomatic, and most people don’t have any symptoms whatsoever, but for the people who do get symptoms, it can be life-threatening.”

Then there’s mumps—another disease the MMR vaccine protects against. It’s another one of those infections that can be symptom-free and harmless in some, especially children, but nasty for others. It can cause a painful swelling of the testes, and other complications include brain swelling and deafness. (From my personal experience of being hospitalized with mumps, I can attest that even “mild” infections are pretty horrible.)

Mumps is less contagious than measles, so we might expect a delay between an uptick in measles cases and the spread of mumps, says Zink. But she says that she’s more concerned about hepatitis B.

“It lives on surfaces for a long period of time, and if you’re not vaccinated against it and you’re exposed to it as a kid, you’re at a really high risk of developing liver cancer and death,” she says.

Zink was formerly chief medical officer of Alaska, a state that in the 1970s had the world’s highest rate of childhood liver cancer caused by hepatitis B. Screening and universal newborn vaccination programs eliminated the virus’s spread.

Public health experts worry that the current US administration’s position on vaccines may contribute to the decline in vaccine uptake. Last month the US Centers for Disease Control and Prevention approved changes to childhood vaccination recommendations. The agency no longer recommends the hepatitis B vaccine for all newborns. The chair of the CDC’s vaccine advisory panel has also questioned broad vaccine recommendations for polio.

Even vitamin injections are being refused by parents, says Zink. A shot of vitamin K at birth can help prevent severe bleeding in some babies. But recent research suggests that parents of 5% of newborns are refusing it (up from 2.9% in 2017).

“I can’t tell you how many of my pediatric [doctor] friends have told me about having to care for a kiddo in the ICU with … bleeding into their brain because the kid didn’t get vitamin K at birth,” says Zink. “And that can kill kids, [or have] lifelong, devastating, stroke-like symptoms.”

All this paints a pretty bleak picture for children’s health. But things can change. Vaccination can still offer protection to plenty of people at risk of infection. South Carolina’s Department of Public Health is offering free MMR vaccinations to residents at mobile clinics.

“It’s easy to think ‘It’s not going to be me,’” says Zink. “Seeing kiddos who don’t have the agency to make decisions [about vaccination] being so sick from vaccine-preventable diseases, to me, is one of the most challenging things of practicing medicine.”

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

RFK Jr. follows a carnivore diet. That doesn’t mean you should.

Americans have a new set of diet guidelines. Robert F. Kennedy Jr. has taken an old-fashioned food pyramid, turned it upside down, and plonked a steak and a stick of butter in prime positions.

Kennedy and his Make America Healthy Again mates have long been extolling the virtues of meat and whole-fat dairy, so it wasn’t too surprising to see those foods recommended alongside vegetables and whole grains (despite the well-established fact that too much saturated fat can be extremely bad for you).

Some influencers have taken the meat trend to extremes, following a “carnivore diet.” “The best thing you could do is eliminate out everything except fatty meat and lard,” Anthony Chaffee, an MD with almost 400,000 followers, said in an Instagram post.

And I almost choked on my broccoli when, while scrolling LinkedIn, I came across an interview with another doctor declaring that “there is zero scientific evidence to say that vegetables are required in the human diet.” That doctor, who described himself as “90% carnivore,” went on to say that all he’d eaten the previous day was a kilo of beef, and that vegetables have “anti-nutrients,” whatever they might be.

You don’t have to spend much time on social media to come across claims like this. The “traditionalist” influencer, author, and psychologist Jordan Peterson was promoting a meat-only diet as far back as 2018. A recent review of research into nutrition misinformation on social media found that the most diet information is shared on Instagram and YouTube, and that a lot of it is nonsense. So much so that the authors describe it as a “growing public health concern.”

What’s new is that some of this misinformation comes from the people who now lead America’s federal health agencies. In January Kennedy, who leads the Department of Health and Human Services, told a USA Today reporter that he was on a carnivore diet. “I only eat meat or fermented foods,” he said. He went on to say that the diet had helped him lose “40% of [his] visceral fat within a month.”

“Government needs to stop spreading misinformation that natural and saturated fats are bad for you,” Food and Drug Administration commissioner Martin Makary argued in a recent podcast interview. The principles of “whole foods and clean meats” are “biblical,” he said. The interviewer said that Makary’s warnings about pesticides made him want to “avoid all salads and completely miss the organic section in the grocery store.”

For the record: There’s plenty of evidence that a diet high in saturated fat can increase the risk of heart disease. That’s not government misinformation. 

The carnivore doctors’ suggestion to avoid vegetables is wrong too, says Gabby Headrick, associate director of food and nutrition policy at George Washington University’s Institute for Food Safety & Nutrition Security. There’s no evidence to suggest that a meat-only diet is good for you. “All of the nutrition science to date strongly identifies a wide array of vegetables … as being very health-promoting,” she adds.

To be fair to the influencers out there, diet is a tricky thing to study. Much of the research into nutrition relies on volunteers to keep detailed and honest food diaries—something that people are generally quite bad at. And the way our bodies respond to foods might be influenced by our genetics, our microbiomes, the way we prepare or consume those foods, and who knows what else.

Still, it will come as a surprise to no one that there is plenty of what the above study calls “low-quality content” floating around on social media. So it’s worth arming ourselves with a good dose of skepticism, especially when we come across posts that mention “miracle foods” or extreme, limited diets.

The truth is that most food is neither good nor bad when eaten in moderation. Diet trends come and go, and for most people, the best reasonable advice is simply to eat a balanced diet low in sugar, salt, and saturated fat. You know—the basics. No matter what that weird upside-down food pyramid implies. To the carnivore influencers, I say: get your misinformation off my broccoli.

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

An experimental surgery is helping cancer survivors give birth

This week I want to tell you about an experimental surgical procedure that’s helping people have babies. Specifically, it’s helping people who have had treatment for bowel or rectal cancer.

Radiation and chemo can have pretty damaging side effects that mess up the uterus and ovaries. Surgeons are pioneering a potential solution: simply stitch those organs out of the way during cancer treatment. Once the treatment has finished, they can put the uterus—along with the ovaries and fallopian tubes—back into place.

It seems to work! Last week, a team in Switzerland shared news that a baby boy had been born after his mother had the procedure. Baby Lucien was the fifth baby to be born after the surgery and the first in Europe, says Daniela Huber, the gyno-oncologist who performed the operation. Since then, at least three others have been born, adds Reitan Ribeiro, the surgeon who pioneered the procedure. They told me the details.

Huber’s patient was 28 years old when a four-centimeter tumor was discovered in her rectum. Doctors at Sion Hospital in Switzerland, where Huber works, recommended a course of treatment that included multiple medications and radiotherapy—the use of beams of energy to shrink a tumor—before surgery to remove the tumor itself.

This kind of radiation can kill tumor cells, but it can also damage other organs in the pelvis, says Huber. That includes the ovaries and uterus. People who undergo these treatments can opt to freeze their eggs beforehand, but the harm caused to the uterus will mean they’ll never be able to carry a pregnancy, she adds. Damage to the lining of the uterus could make it difficult for a fertilized egg to implant there, and the muscles of the uterus are left unable to stretch, she says.

In this case, the woman decided that she did want to freeze her eggs. But it would have been difficult to use them further down the line—surrogacy is illegal in Switzerland.

Huber offered her an alternative.

She had been following the work of Ribeiro, a gynecologist oncologist formerly at the Erasto Gaertner Hospital in Curitiba, Brazil. There, Ribeiro had pioneered a new type of surgery that involved moving the uterus, fallopian tubes, and ovaries from their position in the pelvis and temporarily tucking them away in the upper abdomen, below the ribs.

Ribeiro and his colleagues published their first case report in 2017, describing a 26-year-old with a rectal tumor. (Ribeiro, who is now based at McGill University in Montreal, says the woman had been told by multiple doctors that her cancer treatment would destroy her fertility and had pleaded with him to find a way to preserve it.)

Huber remembers seeing Ribeiro present the case at a conference at the time. She immediately realized that her own patient was a candidate for the surgery, and that, as a surgeon who had performed many hysterectomies, she’d be able to do it herself. The patient agreed.

Huber’s colleagues at the hospital were nervous, she says. They’d never heard of the procedure before. “When I presented this idea to the general surgeon, he didn’t sleep for three days,” she tells me. After watching videos from Ribeiro’s team, however, he was convinced it was doable.

So before the patient’s cancer treatment was started, Huber and her colleagues performed the operation. The team literally stitched the organs to the abdominal wall. “It’s a delicate dissection,” says Huber, but she adds that “it’s not the most difficult procedure.” The surgery took two to three hours, she says. The stitches themselves were removed via small incisions around a week later. By that point, scar tissue had formed to create a lasting attachment.

The woman had two weeks to recover from the surgery before her cancer treatment began. That too was a success—within months, her tumor had shrunk so significantly that it couldn’t be seen on medical scans.

As a precaution, the medical team surgically removed the affected area of her colon. At the same time, they cut away the scar tissue holding the uterus, tubes, and ovaries in their new position and transferred the organs back into the pelvis.

Around eight months later, the woman stopped taking contraception. She got pregnant without IVF and had a mostly healthy pregnancy, says Huber. Around seven months into the pregnancy, there were signs that the fetus was not growing as expected. This might have been due to problems with the blood supply to the placenta, says Huber. Still, the baby was born healthy, she says.

Ribeiro says he has performed the surgery 16 times, and that teams in countries including the US, Peru, Israel, India, and Russia have performed it as well. Not every case has been published, but he thinks there may be around 40.

Since Baby Lucien was born last year, a sixth birth has been announced in Israel, says Huber. Ribeiro says he has heard of another two births since then, too. The most recent was to the first woman who had the procedure. She had a little girl a few months ago, he tells me.

No surgery is risk-free, and Huber points out there’s a chance that organs could be damaged during the procedure, or that a more developed cancer could spread. The uterus of one of Ribeiro’s patients failed following the surgery. Doctors are “still in the phase of collecting data to [create] a standardized procedure,” Huber says, but she hopes the surgery will offer more options to young people with some pelvic cancers. “I hope more young women could benefit from this procedure,” she says.

Ribeiro says the experience has taught him not to accept the status quo. “Everyone was saying … there was nothing to be done [about the loss of fertility in these cases],” he tells me. “We need to keep evolving and looking for different answers.”

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.