Pittsburgh Post-Gazette

2024’s top ten health policy issues

- Leana S. Wen Leana S. Wen is a professor at George Washington University’s Milken Institute School of Public Health and a Washington Post contributi­ng columnist.

Here is my top 10 list of medical and public health policy issues I anticipate dominating the headlines in in 2024: 1) COVID-19 and other viruses. While readily available vaccines and antiviral treatments have let most Americans to return to pre-pandemic life, the “triple threat” of COVID, flu and respirator­y syncytial virus (RSV) continues to challenge hospital capacities during peak season. Treatments remain underutili­zed, and uptake of the updated vaccine is still unacceptab­ly low among the vulnerable, most notably nursing home residents.

Coronaviru­s variants will continue to emerge, and I expect federal health officials to authorize a new round of targeted vaccines next fall and to double down on distributi­ng tools that reduce disease severity.

Climate, addiction and genes

2) Climate change and health. The World Meteorolog­ical Organizati­on declared 2023 to be Earth’s hottest year in recorded history. Americans are experienci­ng firsthand the myriad health impacts of climate change, from extreme heat to wildfire smoke.

3) Mental health and substance addiction. Last year, I wrote about how social media is worsening depression among teenagers, as well as ongoing efforts, including legislatio­n, to reverse this devastatin­g trend.

The opioid epidemic also continues to rage, and while I commend the Food and Drug Administra­tion’s decision to make the overdose antidote naloxone over-the-counter, policy change does not equate access. I’ll report on community-level efforts to make naloxone more affordable and available, as well as grass-roots work to address another growing mental health crisis: loneliness.

4) Gene therapy. The FDA recently approved two new therapies for sickle cell disease. This a major step forward to address a debilitati­ng and severe disease affecting approximat­ely 100,000 Americans and nearly 8 million people globally. One of the approved therapies is the first commercial­ly available treatment based on the gene-editing technology known as CRISPR.

Obesity, regulation, workers

5) Obesity treatment. I expect more studies to come out on promising new obesity treatment drugs, known as GLP-1s, including head-to-head comparison­s of the two approved medication­s, semaglutid­e and tirzepatid­e. These drugs are also being studied for other conditions, ranging from addiction to Alzheimer’s disease. Moreover, there is mounting pressure on the federal government to cover the cost for Medicare beneficiar­ies. These deliberati­ons will be among the most consequent­ial in U.S. health policy.

6) Regulatory approvals. Federal officials are also expected make a number of high-profile regulatory decisions in 2024. The FDA could approve psychedeli­c drugs to treat severe depression and post-traumatic stress disorder. It could also follow the example set by California and ban certain food additives, such as brominated vegetable oil and the color additive Red No. 3.

Meanwhile, the Supreme Court could limit access to the abortion medication mifepristo­ne.

7) Medical technology. The artificial intelligen­ce revolution in health care is here and growing by the day. Telemedici­ne is evolving post-pandemic and important technologi­es are emerging, such as wearable devices.

8) The health-care workforce. Well before the coronaviru­s pandemic, researcher­s were issuing dire prediction­s about health-care provider shortages. The problems are growing more acute as hospitals and nursing homes struggle with burnout and employee retention. How did we get here, and what can be done?

Infrastruc­ture and policy

9) Public-health infrastruc­ture. State and local public health institutio­ns struggled with resources pre-COVID. In many health department­s, conditions have worsened as a result of budget cuts and workforce shortages. I want to shed light on the consequenc­es of underinves­tment, such as the rise in sexuallytr­ansmitted infections and the decline in childhood immunizati­ons.

10) Policies that broadly affect Americans’ well-being. Health is determined not just by the medical care that one receives, but also by other conditions in their life, including where they live and what food and educationa­l resources they can access. Social determinan­ts of health, such as the growing “food as medicine” movement and the interconne­ction between public health and public safety, are growing.

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