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Our Biggest Health
Challenges. Heart Disease and Stroke. Cancer. Opioid Addiction. Infectious
Diseases. Diabetes.
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A Healthy Mind.
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The Future of
Biomedicine.
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Transformative
Technologies.
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Research for Healthy
Living.
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The Promise of
Precision Medicine.
·
Looking Forward.
1. Biggest Health Challenges. Heart Disease and Stroke. Cancer. Opioid Addiction. Infectious Diseases.
Diabetes.
- Heart Disease and Stroke:
These are
leading causes of death globally, often linked to risk factors like high blood
pressure, high cholesterol, unhealthy diet, and lack of physical activity. In the years after World War II, heart attacks killed thousands of middle-aged Americans, many of them soldiers who had returned from conflict. Since then, NIH research has fueled major progress. Beginning with the landmark Framingham Heart Study in the 1940s, key risk factors were identified for cardiovascular disease, including smoking, cholesterol, high blood pressure, and diabetes. Research studies funded by NIH then tested interventions to reduce those risks, showing they could work. These included cholesterol- and blood pressurelowering drugs and lifestyle modifications such as physical activity, a healthy diet, and quitting smoking. Since 1969, heart disease deaths have dropped nearly 70 percent.
Cancer is one of our nation’s most feared diseases, with more than 1.6 million new cases diagnosed each year. But thanks to NIH research, this number is now falling. Between 1991 and 2014, cancer death rates went down 25 percent. A broad group of
diseases characterized by uncontrolled cell growth, cancer is a major cause of
death and disability. Many cancers are linked to lifestyle factors like
tobacco use, diet, and exposure to carcinogens.
NIH research has transformed the way we think about cancer from
affecting specific parts of the body to a much more precise understanding of
the molecular cause. For example, the drug pembrolizumab is one of a new class
of cancer drugs that works by engaging a patient’s immune system to attack his
or her tumors. Doctors already use this drug to treat some patients with
several specific cancer types, including lung cancer and head and neck cancer.
And, very recently, it became the first cancer therapy approved by the Food and
Drug Administration (FDA) to treat any type of tumor, regardless of its
location in the body, as long as the tumor has specific genetic features that
make it much more likely to shrink after treatment with the drug. This is just
one example of how genomics has revolutionized our understanding of cancer (see
Precision Oncology, p.18).
Despite gains, there is much work to do. Many clinical trials
are testing new targeted treatments, as well as combinations of different
cancer therapies. With other federal agencies, NIH is participating in the
Cancer MoonshotSM, a bold initiative to accelerate cancer research that aims to
make more therapies available to more patients while also improving our ability
to prevent cancer and detect it at an early stage.
This refers to a
substance use disorder involving opioid drugs, which can lead to physical and
psychological dependence, overdose, and death. Addiction used to be considered a lack of willpower that could be overcome with sufficient effort and restraint. We now know that misuse of substances disrupts brain circuits related to pleasure and reward, and that chronic substance use actually alters brain structures. These changes can persist long after a person stops using these substances, increasing risk for relapse.Addiction to opioids — prescription pain relievers, heroin, and synthetic opioids such as fentanyl — is a national crisis. The epidemic’s impact has been vast, disproportionately affecting military personnel and veterans, and estimates put the annual U.S. economic burden for prescription opioid misuse alone at more than $504 billion. NIH-supported research has led to effective strategies that can be implemented right now to save lives and to prevent and treat opioid addiction. For example, NARCAN® Nasal Spray can revive individuals from opioid overdose. NIH is working with other federal agencies and the pharmaceutical industry to develop new medications and technologies to prevent and treat opioid addiction.
A tandem issue to tackling opioid dependency is finding safe, effective, non-addictive strategies to manage chronic pain. NIH is actively involved in building a partnership with FDA and industry to accelerate these efforts. NIH researchers are also studying the neurobiology of pain and investigating complementary therapies such as yoga, acupuncture, and behavioral therapies to treat pain.
While antibiotic resistance is
a growing concern, infectious diseases remain a significant global health
challenge, including diseases like influenza, HIV/AIDS, and tuberculosis.
This chronic
condition affects how the body regulates blood sugar, and can lead to serious
health complications if not managed effectively. Diabetes affects 30 million American adults and children. People with the type 1 form of diabetes have an autoimmune disorder and are unable to produce sufficient amounts of the hormone insulin, which is made by the pancreas. NIH research contributed to development of a “bionic pancreas,” which connects a smartphone app to a small implanted sensor-pump system that measures blood sugar every 5 minutes and delivers insulin when needed.
The vast majority of Americans with diabetes have the type-2 form of the disorder, in which the body does not manage its insulin levels correctly. Genetics research has identified more than 80 heritable risk factors, but NIH research has shown that lifestyle changes, such as diet and physical activity, can significantly lower the risk of developing type 2 diabetes in high-risk adults.
NIH-funded technological advances offer much promise. For example, using electronic health records and genomic data, scientists have identified what appear to be three distinct subtypes of type 2 diabetes. Since each may cause different health complications such as blindness, cancer, or high blood pressure, this information should eventually help doctors provide individualized treatment.
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