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Trinity Health Michigan lays off 557 in IT and engineering
The health system sent notices that numerous roles will be impacted between October and November due to outsourcing and a need to keep pace with healthcare sector innovation.
McInnes on 'fire and ice', derby first & 'godsend' Miovski
Rangers manager Derek McInnes has been speaking to the media before the League Cup quarter-final against Celtic on Sunday at Ibrox. The Ibrox boss emphasised the importance of striking the first blow against a good Celtic team to deliver the chance to "be relevant domestically again in terms of winning trophies". McInnes stressed the need for discipline alongside being competitive and aggressive, adding a "bit of fire and ice at the right times can help matters".
TCB Selects Christophe Beck as Its 2026 Person of the Year
Ecolab CEO Christophe Beck refuses to shrink from complicated and thorny problems. As the opponents to data centers have grown exponentially, Beck has become a major public spokesman on how to reduce the water and electricity used in the centers. As Minnesota’s economy has produced slow growth, Beck’s spoken bluntly about needed changes in the
Smith: Canada is Choosing Politics Over People
Rep. Jason Smith backs Trump’s tariffs on Canada, arguing Missouri producers need fairer access to Canadian markets.
Three Free Agents Knicks Need to Target Before Training Camp
The defending champions have one veteran minimum slot to spend before Sept. 29, and three names left on the market fit the hole Mitchell Robinson left behind.
Nearly All Health Systems and Health Plans Need Better Provider Data. Few Have It, and AI Investment Is at Risk.
/PRNewswire/ -- Health systems and health plans rank network and market expansion as the strategic priority that would benefit most from better provider data....
Packers may need to rely on Jordan Love more than usual
The unsettled nature of Green Bay’s rushing attack because of three-time Pro Bowl running back Josh Jacobs' legal situation means the Packers may have to depend on their passing game more than usual.
The jail is a hospital: 90 percent of inmates need physical, mental healthcare
Alexandria Vega, a behavioral health specialist in the Deschutes County Jail, transitions from cell to cell. In one, an inmate is suicidal. In another she provides formal therapy. For a […]
Consulting firm Keystone opens new D.C. office — and already needs more space
Keystone opened its D.C. office in June and already needs at least 25% more space to accommodate its growing headcount, its CEO said.
Children and students often need mental health days. Here's what 2 Pittsburgh-area doctors said parents should know.
Mental health days aren't just for adults; oftentimes, children need them, too, so here's what parents need to be on the lookout for.
Do children need mental health days? Here's what 2 psychologists say
Home health care jobs expected to skyrocket amid "critical" need in Tennessee
The Bureau of Labor Statistics projects a surge of new home health and personal care aide jobs.
After 9/11, Hollywood stars were the healers we didn't know we needed
From “SNL” to “Friends,” see how TV, music and pop culture gave Americans space to grieve, escape and eventually laugh again after 9/11.
Exeter need to 'stand up and be counted' in attack
Exeter City manager Matt Taylor says he is looking for his attacking players to "stand up and be counted".
The GOP heads into the general election with a significant enthusiasm deficit
It remains to be seen whether this week’s unusual GOP midterm convention will fire up the base for the final two months of the campaign, but the party clearly needs some help.
When a Friend Becomes a Caregiver
People outside the family frequently step into helping roles when older adults need assistance.
Zuckoff app can detect Meta smart glasses recording nearby
The Zuckoff app detects nearby smart glasses using Bluetooth signals. Its creator says Meta needs to do more to address privacy concerns.
Want to Do Business With the Chinese? Here’s What You Need to Know
China’s growing commercial footprint across the Global South is creating new opportunities, but major knowledge gaps remain over how Chinese businesses build trust, negotiate, and form partnerships. Guanxi, institutional norms, and long-term relationships can matter as much as contracts and competitive pricing. At the same time, Chinese companies are still ...
As AI transforms science, researchers need far more support
Prospect of AI creating “new scientific paradigm” necessitates big picture responses from across research community
Here’s the full Bay View Bash entertainment lineup, vendor list, and everything else you need to know
We’ll see you Saturday, September 19!
HS Football Preview #87: Pearl
Pearl football is looking to take a step forward this season. The Pirates say they have the talent, but they’re young and going to need to build each game to get ready for district play.
Rutgers vs Boston College Prediction: The Battle For Survival
After horrendous first games, both Rutgers and Boston College desperately need a win. Here's the CFN prediction and game preview.
iPhone Duo moves the needle for Apple; continue to like the business: CIO
Jason Ware, CIO at Albion Financial Group, remains bullish on Apple following the unveiling of the iPhone Duo. He adds that he is optimistic about the company’s outlook as John Ternus takes the baton from Tim Cook.
Red Sox drop series behind timely Angels home runs
The Red Sox haven’t been super sharp in September, though they haven’t exactly needed to be. There shouldn’t be a ton of panic after the Angels took two of three in Boston with the 6-4 loss for the Red Sox in the rubber match. The magic number will fall. The team will be whole soon. […]
Oregon Already Getting Disrespected by ESPN After Week 1 Win
Oregon had a very strange opening game on Saturday against Boise State. I think some are forgetting that Boise State is one of the better teams in the country, and while Oregon could have and should have played better, there's a very good scenario in which Boise State is a playoff team. We have to remember that at the end of the day, especially with Oregon still winning this game, the defense stepped up when needed.
Viewpoint: Unlocking Europe’s wildfire data
Europe is already investing in the science, technology and infrastructure needed to understand, prevent and fight wildfires. Copernicus provides satellite-based Earth observation and environmental information, while the European Forest Fire Information System provides information on fire danger and forest fires across Europe. Weather and climate systems add forecasts of heat, drought, wind and humidity; historical fire databases show where fires have occurred; and researchers generate increasingly detailed knowledge about fuels, fire behaviour, forecasting, modelling and risk management. Meanwhile, new European research projects are adding digital twins and other tools to this growing ecosystem.However, these data do not necessarily sit together, nor are they necessarily described, structured or governed in ways that allow them to be used together. Much of the information is public, but some is commercially held. Some is sensitive. Some is subject to legal, security or operational restrictions. Even when data can be legally accessed, different systems may use different formats, terminology and rules.Europe therefore faces an unusual paradox: we have vast amounts of relevant information to respond to the wildfire challenge, but not the means to bring it together. For example, a wildfire researcher or emergency service might need to ask whether a particular combination of vegetation, drought, wind and topography has historically been associated with rapid fire spread. The relevant information may exist in several institutions, using different systems and subject to different conditions of access.The challenge is to conduct an authorised analysis that interacts with these sources, combines the results and respects the rules imposed by each data custodian.An important part of the answer can be found in the Fair principles, the idea that data should be findable, accessible, interoperable and reusable. Developed more than a decade ago, these principles have become a central reference point for modern data stewardship, making it easier for people and machines to find data, understand what it means and determine whether it can be reused.Readability by machines is essential, since AI systems will be key to meeting the data challenge. Bring analysis to the dataThe proposition is not to give an AI system unrestricted access to sensitive databases. Quite the opposite. The goal is to make it possible for approved algorithms to go to the data, rather than requiring sensitive data or large datasets to be copied to wherever the analysis happens.Imagine an analysis asking a series of questions of different data stations. At one station it might examine weather and climate data; at another, historical fire records; at another, experimental measurements of fire behaviour. The algorithm does not need to download everything. It can operate within the environment permitted by each data custodian and return only the results that the rules allow to leave.This is sometimes described as data visiting, and related approaches already exist in areas such as federated analysis and federated learning.Sensitive data should therefore not be treated as a free-for-all for machines. This requires appropriate governance at multiple levels. Access needs to be authenticated and authorised. The purpose of an analysis should be defined. The code or model being run should be controlled. Data custodians should be able to specify what can be queried and what results can leave their environment. Activities should be auditable and human oversight should remain where the consequences require it.In other words, the objective is not to trust AI with the data. It is to design systems in which AI never has more access than it needs.As open as possible, as closed as necessaryFair data should also not be confused with open data. Some wildfire data should be openly available. Other information may legitimately need to remain restricted because it concerns critical infrastructure, security, commercial interests, privacy or operational capabilities. The principle should be: as open as possible, as closed as necessary.The important point is that restricted data should not automatically become unusable data. If machines can discover what information exists, understand its meaning, establish where it came from and determine the conditions under which it can be used, authorised analyses can potentially be carried out without the underlying data ever leaving the environment in which it is protected.Restricted data can still be Fair and machine-actionable.This is also an important question of data sovereignty. European institutions should not have to surrender control of their data to a handful of technology platforms in order to benefit from AI. Nor does Europe need to start again by building one giant repository for every piece of wildfire information. The better approach is to connect what already exists.This is the principle behind emerging approaches such as Tryangle, developed through the Leiden Initiative for Fair and Equitable Science. Rather than creating another centralised data warehouse, the approach seeks to provide an interoperable layer through which approved algorithms can visit distributed data sources while respecting the rules of their custodians.In this way, a data station can remain where it is. Its custodians can retain control. Existing databases and applications do not have to be abandoned. What changes is their ability to communicate with other systems through common, machine-readable descriptions, access rules and interoperability mechanisms.But approaches like this need data that meets the Fair principles. Only then can an interoperable ecosystem safely begin to turn fragmented information into collective intelligence.Data infrastructure is wildfire infrastructureThe implications of this approach are entirely practical. Firefighters could gain better intelligence about local and evolving risks. Land managers could test prevention strategies using more comprehensive information about fuels, weather and past fires. Researchers could compare evidence across ecosystems without repeatedly moving huge datasets between institutions. Smaller regions and resource-constrained teams could access analytical capabilities without having to build large data infrastructures themselves.Europe is already investing heavily in satellites, databases, research programmes, forecasting systems and scientific expertise. The question is whether we will connect those investments well enough to turn them into actionable intelligence.That requires policymakers and funders to treat data infrastructure as seriously as physical infrastructure. Data generated or supported through European public funding should be Fair, verifiable and machine actionable by design, wherever legally and ethically possible.Related articlesData Corner: Europe’s burning need for wildfire mitigation researchClimate monitoring must remain a global enterprise, experts sayIn practice, that means funding not only the production of data, but also the infrastructure that makes data usable across systems: metadata, provenance, interoperability, access mechanisms and governance. Where data must remain restricted, we should ensure that it can still be securely discovered, verified and used for authorised analysis.Initiatives such as the European Open Science Cloud offer an existing framework through which these principles can be put into practice. What is needed now is to accelerate implementation and make them a standard part of how Europe funds and builds research and innovation systems.We do not need another generation of disconnected databases. The data is already there. The opportunity is to make it work together, securely, responsibly and quickly enough to help prevent the next fire, rather than simply document the last one.Jean-Claude Burgelman is professor emeritus at the Free University of Brussels (VUB) and editor-in-chief at Frontiers Policy Lab. For more than 20 years he held leading roles in research and innovation policy at the European Commission.
Closing health workforce gaps for emergency response: the Western Pacific steps up
Over 100 health emergency experts from 56 institutions across 21 countries in the World Health Organization (WHO) Western Pacific Region who are part of the Global Outbreak Alert and Response Network (GOARN) concluded their annual regional partners’ meeting with a commitment to bridge gaps in emergency workforce capacities and advance regional emergency readiness and resilience.Co-hosted by WHO and the Korea Disease Control and Prevention Agency in the Republic of Korea, the two-day event aimed to strengthen the Region’s collective ability to detect, prepare for and respond to health emergencies.Partners mapped capacities and priority technical gaps across the Region — including cybersecurity and critical infrastructure resilience; water, sanitation and hygiene (WASH) and environmental health; biological emergencies, nuclear emergencies, and nuclear and radiological security.The result: a renewed commitment to close these gaps by working together through shared expertise and coordinated action. Advancing the Global Health Emergency CorpsReflective of regional solidarity and partnerships in action, GOARN – which is coordinated globally by WHO - enables a stronger, better-connected emergency health workforce that is ready to surge wherever and whenever requested by WHO Member States.This year alone, GOARN partners across the Western Pacific have supported nine experts on six missions - from measles outbreaks in Viet Nam to HIV outbreak response in Fiji - providing surge support in epidemiology, surveillance and clinical case management.Photo: Participants at the Global Alert and Response Network (GOARN) Partners Meeting 2026. Credit: KDCA/Shin Dong Myoung“GOARN partners across the Western Pacific and globally have repeatedly demonstrated the power of what we can do collectively, when we join forces, share expertise and build on each other’s strengths,” noted Dr Gina Samaan, WHO Regional Emergency Director for the Western Pacific, in her opening remarks at the gathering. “Let us continue to forge long-term partnerships grounded in mutual respect that will protect the Region for generations to come. We are smarter, faster and infinitely stronger when we work together,” she added.Reiterating Dr Samaan's call, Dr Seung-kwan Lim, Commissioner of the Korea Disease Control and Prevention Agency, emphasized the value of GOARN: “The Republic of Korea is pleased to stand alongside our regional partners in building an emergency workforce that is ready and resilient. GOARN turns national expertise into regional readiness - catalysing national strengths into collective resilience.”GOARN advances the Global Health Security Action Framework (GHEC) initiative by “convening, connecting and capacitating” regional leaders and surge workforce – “the three Cs”. Years of GOARN leadership and outbreak response training programmes have cultivated a deep bench of fit-for-purpose, seasoned outbreak response experts and forged an alumni network of emergency leaders worldwide. The Western Pacific network alone has now grown to 94 partner institutions across 19 countries. Photo: Participants at the Global Alert and Response Network (GOARN) Partners Meeting 2026. Credit: KDCA/Shin Dong Myoung Putting partnerships into practiceDuring the Regional Partners’ Meeting, health experts identified and catalogued the technical expertise currently available across the Western Pacific Region, so that the right skills could be better matched quickly to needs wherever emergencies occur.Three priority areas emerged for further strengthening:Cybersecurity and critical infrastructure resilience - protecting essential systems, including healthcare networks, from digital disruptions.Water, sanitation and hygiene (WASH) and environmental health - reflecting the ongoing nexus between climate change and health.Biological emergencies, nuclear emergencies, and nuclear and radiological security - requiring specialized technical capability that remains limited across many national response systems.Meeting participants reaffirmed their commitment to strengthening workforce capacities in the Region, with a particular focus on these three areas, and to working collectively to better prepare the Western Pacific for the next health emergency.Photo: Dr Gina Samaan, WHO Regional Emergency Director for the Western Pacific, delivers opening remarks at the Global Alert and Response Network (GOARN) Partners Meeting 2026. Credit: KDCA/Shin Dong Myoung“GOARN is truly turning preparedness into action - giving our Region the surge capacity it needs for fast, coordinated response when it matters most - and building more resilient health systems along the way,” said Dr Samaan. “As health emergencies mount in this age of permacrisis, emergency preparedness and response must be woven into the fabric of health. This is not an option, but an imperative as we seek to achieve health for all.”____ About GOARNThe Global Outbreak Alert and Response Network (GOARN), coordinated by the World Health Organization since 2000, strengthens global health security by advancing preparedness for and response to public health emergencies. The network brings together more than 390 institutions, including national public health agencies, technical organizations and nongovernmental partners, to support coordinated international action during outbreaks and other health emergencies. There are 94 GOARN partners in the Western Pacific Region (as of August 2026), accounting for approximately 25% of global partners. For more information and media interviews, please contact: WHO Western Pacific Communications: wprocom@who.intAra Johannes: johannesa@who.int
Duke's Walker Eget is Grateful, but Needs to Play Better
It was an important opening night for Duke, taking down Tulane 17-3, a good program. Tulane, which has a chance to win a lot of games this season, couldn't do anything on the offensive side of the football. We have to give a lot of credit to what Duke did on defense, something Manny Diaz has pointed to multiple times over the past couple of months.
Alonso 'takes responsibility' as Chelsea subs rescue cup hopes
Chelsea get the better of Leeds in a cup thriller, but Blues boss Xabi Alonso has food for thought after needing rescue act from his star substitutes.
New AI health tools need ‘L-plates’, says UK review
Proposals following national consultation on health tech regulation call for live monitoring as AI moves deeper into patient care
Atlanta Braves Have Starting Pitching Concern That Needs Addressing
Tuesday's game indicated the Braves may need to keep a closer eye on a struggling starting pitcher.
$30,000 grant will strengthen dental education and community oral health efforts in El Paso
Hunt School of Dental Medicine students will work with local organizations to address oral health needs through service, education and research
Community Health Center of Lubbock holds 34th annual needs assessment
The Community Health Center of Lubbock gather for the Annual Needs Assessment.
Can Patrick Paul, Dolphins, needle Raiders' 'hothead' Maxx Crosby?
Miami Dolphins offensive lineman Patrick Paul has seen Raiders edge rusher Maxx Crosby lose control. Can Paul take advantage in the opener?
Before construction on Commanders stadium begins, roster of small business contractors needs to be filled
While the Commanders will be kicking off their first game of the season this weekend against the Philadelphia Eagles, the team behind the new stadium at the old RFK site is looking to fill out their rosters with subcontractors and small businesses.
Partnership Health Center closes Missoula clinics Wednesday over safety concerns
Patients in Missoula will need to make alternate plans for medical care after Partnership Health Center said its Missoula clinics are closed for the remainder o
What parents should know before letting kids skip school for mental health?
Every school year, children eventually need to take a sick day. Dr. Emily Mudd, a psychologist for Cleveland Clinic Children’s Hospital, addressed whether a mental health day may also be appropriate.
Dolly Parton paid for her longtime driver’s gender-affirming care
If people need another reason to understand why Dolly Parton was so beloved in American culture, the entertainer, who died Aug. 25 at age 80, was known for being genuinely
Apple Increases Older iPhone Prices By $100
I am fine, I am fine, I am fine, I am fine, I just need...
macOS Golden Gate Release Candidate Now Available
Apple today seeded the release candidate version of macOS Golden Gate, with the update coming a week after Apple seeded the eighth beta. The release candidate is the final version of macOS Golden Gate that developers and beta testers will get before the software sees a public launch. Tessters can download macOS Golden Gate by going to System Settings > General > Software Update. Beta Updates will need to be enabled, and a free developer account is required.
Healthy Aging - What’s Normal, What’s Not & Simple Ways to Stay on Top of Your Health
As we get older, our health needs often become more complex. Staying proactive can help but knowing where to start can be confusing. What should older adults focus on to keep their bodies and minds healthy?
Former DINK: My lifestyle changed less than I expected after baby
I feared motherhood came with an expiration date for freedom. Then I had my son and realized my life didn't need to change as much as I had expected.
Arkansas, Ryan Silverfield need a downfield passing attack
It can't be dink and dunk the whole season for KJ Jackson
Fall Entertainment and Essentials
Lifestyle Expert, Limor Suss, joins The Morning Blend to talk about all the products you need for a cozy and fun fall season.
Titans’ 1st impression vs. the Jets will say a lot
Do the Tennessee Titans “need” to beat the New York Jets in Week 1?
This Week's Health IT Jobs
It can be very overwhelming scrolling through job board after job board in search of a position that fits your wants and needs. Let us take that stress away by
The Cost of Cutting American Science: How Federal Cuts Diminish Public Health Capacity
Among the federal government’s many responsibilities is the work it does to protect public health. Federal agencies monitor our food supply to ensure safety, conduct research to better understand emerging health threats, provide funding for public health programs in communities and work to detect and respond to disease outbreaks. Americans rely on these efforts every day—in a 2024 online survey, 74% of respondents said that “if the federal government issued safety guidance about food you eat regularly,” they would follow it. Changes to Federal Public Health Capacity The Trump administration’s efforts to reshape the federal government have resulted in significant impacts on our nation’s public health capacity over the past 20 months, affecting the response to health concerns such as measles, Ebola and cyclosporiasis. Agencies with core public health, food safety and disease prevention responsibilities experienced large workforce decreases during the first year of the administration. At the Centers for Disease Control and Prevention, for instance, the workforce in February 2026 was 26.7% smaller than in September 2024 before the start of the Trump administration. The Food and Drug Administration saw a similarly steep decline of 21.6%. Agencies such as the National Institutes of Health, Substance Abuse and Mental Health Services Administration and Food Safety and Inspection Service also experienced large workforce decreases. (function(){function e(){window.addEventListener(`message`,function(e){if(e.data[`datawrapper-height`]!==void 0){var t=document.querySelectorAll(`iframe`);for(var n in e.data[`datawrapper-height`])for(var r=0,i;i=t[r];r++)if(i.contentWindow===e.source){var a=e.data[`datawrapper-height`][n]+`px`;i.style.height=a}}})}e()})(); Changes can also be seen in crucial public health occupations. The number of federal food inspectors, for example, decreased by more than half between September 2024 and February 2026, going from 1,035 to 473. This is the lowest number of food inspectors employed by the federal government since at least 2005. By February 2026, there were also 33.3% fewer federal public health program specialists, whose work includes advising federal funding recipients on public health activities and analyzing the effectiveness of public health programs. Government’s capacity is diminished as employees with specialized knowledge and experience in protecting the public and responding to health risks depart, leaving agencies less prepared to carry out their public health missions. There also have been vacancies in critical high-level leadership positions at public health agencies, most notably at the CDC, which had a permanent Senate-confirmed director for less than a month between January 2025 and early August 2026. Although the CDC has previously been led by acting directors at the start of an administration, the nearly yearlong gap since the departure of the administration’s first permanent director in August 2025 is without precedent. As of August 2026, the FDA is also currently without a Senate-confirmed commissioner following the previous commissioner’s resignation in May 2026. Additionally, public health agencies are experiencing increased politicization of their leadership ranks. In agencies such as the CDC and Food Safety and Inspection Service, the number of individuals in the Senior Executive Service—the most senior career leaders in government—has declined significantly, while at the same time the number of political appointees has reached record levels. (function(){function e(){window.addEventListener(`message`,function(e){if(e.data[`datawrapper-height`]!==void 0){var t=document.querySelectorAll(`iframe`);for(var n in e.data[`datawrapper-height`])for(var r=0,i;i=t[r];r++)if(i.contentWindow===e.source){var a=e.data[`datawrapper-height`][n]+`px`;i.style.height=a}}})}e()})(); (function(){function e(){window.addEventListener(`message`,function(e){if(e.data[`datawrapper-height`]!==void 0){var t=document.querySelectorAll(`iframe`);for(var n in e.data[`datawrapper-height`])for(var r=0,i;i=t[r];r++)if(i.contentWindow===e.source){var a=e.data[`datawrapper-height`][n]+`px`;i.style.height=a}}})}e()})(); At the CDC, for example, the number of career SES decreased 42.9% between December 2024 and February 2026, while the number of non-Senate confirmed political appointees at the agency was six times larger than the agency’s historical average from 2009 and 2024. Knowledgeable career leaders are integral to the ability of public health agencies to carry out their work with scientific integrity and professional judgment, and rapid leadership turnover and increased politicization threaten agencies’ ability to make evidence-based decisions to protect our health. The upheaval and politicization in public health agencies have also negatively affected employee engagement. Strong employee engagement is crucial to the ability of agencies to carry out their mission and successfully provide essential services to the public. In the 2025 Public Service Viewpoint Survey conducted by the Partnership for Public Service, the Department of Health and Human Services—which encompasses major public health agencies such as the CDC and FDA—had an employee engagement and satisfaction score of 20.4 out of 100, one of the lowest among large agencies. Only 2.8% of HHS employees indicated trust in their political leaders and only 8.7% reported confidence that they could report a suspected violation of law or regulation without retaliation. Employees at HHS also reported that the agency’s ability to provide services to the public had suffered. Nearly half of employees at HHS, 47.5%, said their work unit was worse at delivering quality services compared to its performance in 2024. In addition, 57.8% said their work unit was performing worse at fulfilling stakeholder needs. In addition to the work done within federal agencies, the federal government also distributes significant funding for public health and disease prevention work to state and local governments, nonprofits and small businesses—funding which has been significantly disrupted. At the CDC, for example, there was a 71.9% decrease in the amount of project grant funding issued in fiscal year 2025 compared to fiscal year 2024. The FDA also issued far less funding in fiscal year 2025—a 21.3% decrease from its fiscal year 2024 funding. Changes in federal funding include the ending of grants to community organizations that worked on HIV prevention and the cancellation of funding for research into improvements to patient safety and healthcare quality. These changes go beyond federal agencies to impact the broader public health ecosystem, including the state and local health departments responsible for much of the on-the-ground public health work in their communities. About 80% of the CDC’s domestic funding is directed towards state and local partners—meaning that cuts to CDC funding can ultimately result in cuts to state and local public health capacity. Federal agencies also provide expertise and assistance to state and local health agencies as they deal with particular health challenges, but workforce cuts have resulted in fewer federal employees available to help. The Impact of Changes to Public Health Capacity These changes to federal public health capacity are not abstract concerns. Disrupted programs, reduced funding and lost expertise at public health agencies across all levels of government threaten the public’s physical well-being and safety. In some cases, this has already led to harm. The most immediate impacts of federal cuts were seen in interruptions to ongoing public health programs and crisis responses. In one instance, when CDC grants were canceled during the 2025 Texas measles outbreak—the most severe measles outbreak in 25 years—public health officials in Lubbock, Texas were forced to pause parts of their measles response work supported by the frozen funding. Lubbock’s director of public health further said that a lack of available CDC experts to reach out to for advice “definitely” impacted the department’s response to the measles crisis. Cuts to federal funding also forced Dallas County Health and Human Services to cut staff and cancel 50 community vaccination clinics during the outbreak. Public health work outside of major outbreak responses was also disrupted. For example, in April 2025, the Milwaukee Public Health Department was unexpectedly unable to reach experts on lead poisoning due to firings at the CDC when responding to concerns about lead contamination in Milwaukee public schools. Due to federal workforce cuts, several programs at the CDC, including Alzheimer’s and epilepsy programs, have also become trapped in limbo—existing on paper, but without the staff necessary to operate. More recent crises reveal how federal cuts have weakened the public health infrastructure needed to prevent and respond to dangerous new outbreaks. Internationally, cuts at the U.S. Agency for International Development eliminated funding for disease testing and contact tracing abroad, which delayed detection of and responses to the 2026 Ebola outbreak in the Democratic Republic of Congo. While international outbreaks may seem far removed, the unchecked spread of disease in any country can quickly pose a danger to economic well-being, security and health around the world. Within the United States, public health cuts inhibited responses to the summer 2026 outbreak of the food-borne parasite cyclospora. At the federal level, cuts to funding for lab equipment and for CDC staff with expertise in parasitic infections—including 9 out of 11 staff members at the lab responsible for identifying parasitic outbreaks in 2025— contributed to the largest reporting delay in outbreak cases at the CDC in 15 years. Conflicting communications from the FDA about the source of the outbreak, which followed cuts to the agency’s communications department, additionally led to confusion among the public about how to best avoid infection. At the same time, cuts to HHS funding and support for local and state public health slowed some health departments’ responses to the crisis. The exact costs of these delays, constraints and confusion in public health responses are difficult to estimate. However, their message is clear: federal cuts have already made containing threats to public health even more of a challenge. Conclusion Protecting public health—from food safety to disease prevention—is one of the federal government’s most important missions. Dramatic and haphazard cuts to federal agencies and funding have already disrupted the public health system, impacting the response to challenges such as measles, lead poisoning and cyclosporiasis. The U.S. public health system needed improvement before these disruptions. Since 2022, federal leadership and coordination in response to public health outbreaks has been on the Government Accountability Office’s High-Risk List of areas in need of attention to improve government effectiveness and efficiency. Recent cuts only compound these concerns. The chaotic dismantling of government and resulting disruptions to crucial functions like public health and disease prevention highlight the need for meaningful reform and concrete policy proposals to reimagine how government can better serve the public and be more effective, responsive and accountable. To learn more about the impact of federal cuts to public health and science more broadly, visit The Cost of Cutting American Science. Learn more For more information on the Partnership for Public Service’s government reform initiative, visit Government for a New Era. View here In line with The Cost of Cutting American Science, federal workforce data in this brief is as of February 2026
The Cost of Cutting American Science: How Federal Cuts Diminish Public Health Capacity
Among the federal government’s many responsibilities is the work it does to protect public health. Federal agencies monitor our food supply to ensure safety, conduct research to better understand emerging health threats, provide funding for public health programs in communities and work to detect and respond to disease outbreaks. Americans rely on these efforts every day—in a 2024 online survey, 74% of respondents said that “if the federal government issued safety guidance about food you eat regularly,” they would follow it. Changes to Federal Public Health Capacity The Trump administration’s efforts to reshape the federal government have resulted in significant impacts on our nation’s public health capacity over the past 20 months, affecting the response to health concerns such as measles, Ebola and cyclosporiasis. Agencies with core public health, food safety and disease prevention responsibilities experienced large workforce decreases during the first year of the administration. At the Centers for Disease Control and Prevention, for instance, the workforce in February 2026 was 26.7% smaller than in September 2024 before the start of the Trump administration. The Food and Drug Administration saw a similarly steep decline of 21.6%. Agencies such as the National Institutes of Health, Substance Abuse and Mental Health Services Administration and Food Safety and Inspection Service also experienced large workforce decreases. (function(){function e(){window.addEventListener(`message`,function(e){if(e.data[`datawrapper-height`]!==void 0){var t=document.querySelectorAll(`iframe`);for(var n in e.data[`datawrapper-height`])for(var r=0,i;i=t[r];r++)if(i.contentWindow===e.source){var a=e.data[`datawrapper-height`][n]+`px`;i.style.height=a}}})}e()})(); Changes can also be seen in crucial public health occupations. The number of federal food inspectors, for example, decreased by more than half between September 2024 and February 2026, going from 1,035 to 473. This is the lowest number of food inspectors employed by the federal government since at least 2005. By February 2026, there were also 33.3% fewer federal public health program specialists, whose work includes advising federal funding recipients on public health activities and analyzing the effectiveness of public health programs. Government’s capacity is diminished as employees with specialized knowledge and experience in protecting the public and responding to health risks depart, leaving agencies less prepared to carry out their public health missions. There also have been vacancies in critical high-level leadership positions at public health agencies, most notably at the CDC, which had a permanent Senate-confirmed director for less than a month between January 2025 and early August 2026. Although the CDC has previously been led by acting directors at the start of an administration, the nearly yearlong gap since the departure of the administration’s first permanent director in August 2025 is without precedent. As of August 2026, the FDA is also currently without a Senate-confirmed commissioner following the previous commissioner’s resignation in May 2026. Additionally, public health agencies are experiencing increased politicization of their leadership ranks. In agencies such as the CDC and Food Safety and Inspection Service, the number of individuals in the Senior Executive Service—the most senior career leaders in government—has declined significantly, while at the same time the number of political appointees has reached record levels. (function(){function e(){window.addEventListener(`message`,function(e){if(e.data[`datawrapper-height`]!==void 0){var t=document.querySelectorAll(`iframe`);for(var n in e.data[`datawrapper-height`])for(var r=0,i;i=t[r];r++)if(i.contentWindow===e.source){var a=e.data[`datawrapper-height`][n]+`px`;i.style.height=a}}})}e()})(); (function(){function e(){window.addEventListener(`message`,function(e){if(e.data[`datawrapper-height`]!==void 0){var t=document.querySelectorAll(`iframe`);for(var n in e.data[`datawrapper-height`])for(var r=0,i;i=t[r];r++)if(i.contentWindow===e.source){var a=e.data[`datawrapper-height`][n]+`px`;i.style.height=a}}})}e()})(); At the CDC, for example, the number of career SES decreased 42.9% between December 2024 and February 2026, while the number of non-Senate confirmed political appointees at the agency was six times larger than the agency’s historical average from 2009 and 2024. Knowledgeable career leaders are integral to the ability of public health agencies to carry out their work with scientific integrity and professional judgment, and rapid leadership turnover and increased politicization threaten agencies’ ability to make evidence-based decisions to protect our health. The upheaval and politicization in public health agencies have also negatively affected employee engagement. Strong employee engagement is crucial to the ability of agencies to carry out their mission and successfully provide essential services to the public. In the 2025 Public Service Viewpoint Survey conducted by the Partnership for Public Service, the Department of Health and Human Services—which encompasses major public health agencies such as the CDC and FDA—had an employee engagement and satisfaction score of 20.4 out of 100, one of the lowest among large agencies. Only 2.8% of HHS employees indicated trust in their political leaders and only 8.7% reported confidence that they could report a suspected violation of law or regulation without retaliation. Employees at HHS also reported that the agency’s ability to provide services to the public had suffered. Nearly half of employees at HHS, 47.5%, said their work unit was worse at delivering quality services compared to its performance in 2024. In addition, 57.8% said their work unit was performing worse at fulfilling stakeholder needs. In addition to the work done within federal agencies, the federal government also distributes significant funding for public health and disease prevention work to state and local governments, nonprofits and small businesses—funding which has been significantly disrupted. At the CDC, for example, there was a 71.9% decrease in the amount of project grant funding issued in fiscal year 2025 compared to fiscal year 2024. The FDA also issued far less funding in fiscal year 2025—a 21.3% decrease from its fiscal year 2024 funding. Changes in federal funding include the ending of grants to community organizations that worked on HIV prevention and the cancellation of funding for research into improvements to patient safety and healthcare quality. These changes go beyond federal agencies to impact the broader public health ecosystem, including the state and local health departments responsible for much of the on-the-ground public health work in their communities. About 80% of the CDC’s domestic funding is directed towards state and local partners—meaning that cuts to CDC funding can ultimately result in cuts to state and local public health capacity. Federal agencies also provide expertise and assistance to state and local health agencies as they deal with particular health challenges, but workforce cuts have resulted in fewer federal employees available to help. The Impact of Changes to Public Health Capacity These changes to federal public health capacity are not abstract concerns. Disrupted programs, reduced funding and lost expertise at public health agencies across all levels of government threaten the public’s physical well-being and safety. In some cases, this has already led to harm. The most immediate impacts of federal cuts were seen in interruptions to ongoing public health programs and crisis responses. In one instance, when CDC grants were canceled during the 2025 Texas measles outbreak—the most severe measles outbreak in 25 years—public health officials in Lubbock, Texas were forced to pause parts of their measles response work supported by the frozen funding. Lubbock’s director of public health further said that a lack of available CDC experts to reach out to for advice “definitely” impacted the department’s response to the measles crisis. Cuts to federal funding also forced Dallas County Health and Human Services to cut staff and cancel 50 community vaccination clinics during the outbreak. Public health work outside of major outbreak responses was also disrupted. For example, in April 2025, the Milwaukee Public Health Department was unexpectedly unable to reach experts on lead poisoning due to firings at the CDC when responding to concerns about lead contamination in Milwaukee public schools. Due to federal workforce cuts, several programs at the CDC, including Alzheimer’s and epilepsy programs, have also become trapped in limbo—existing on paper, but without the staff necessary to operate. More recent crises reveal how federal cuts have weakened the public health infrastructure needed to prevent and respond to dangerous new outbreaks. Internationally, cuts at the U.S. Agency for International Development eliminated funding for disease testing and contact tracing abroad, which delayed detection of and responses to the 2026 Ebola outbreak in the Democratic Republic of Congo. While international outbreaks may seem far removed, the unchecked spread of disease in any country can quickly pose a danger to economic well-being, security and health around the world. Within the United States, public health cuts inhibited responses to the summer 2026 outbreak of the food-borne parasite cyclospora. At the federal level, cuts to funding for lab equipment and for CDC staff with expertise in parasitic infections—including 9 out of 11 staff members at the lab responsible for identifying parasitic outbreaks in 2025— contributed to the largest reporting delay in outbreak cases at the CDC in 15 years. Conflicting communications from the FDA about the source of the outbreak, which followed cuts to the agency’s communications department, additionally led to confusion among the public about how to best avoid infection. At the same time, cuts to HHS funding and support for local and state public health slowed some health departments’ responses to the crisis. The exact costs of these delays, constraints and confusion in public health responses are difficult to estimate. However, their message is clear: federal cuts have already made containing threats to public health even more of a challenge. Conclusion Protecting public health—from food safety to disease prevention—is one of the federal government’s most important missions. Dramatic and haphazard cuts to federal agencies and funding have already disrupted the public health system, impacting the response to challenges such as measles, lead poisoning and cyclosporiasis. The U.S. public health system needed improvement before these disruptions. Since 2022, federal leadership and coordination in response to public health outbreaks has been on the Government Accountability Office’s High-Risk List of areas in need of attention to improve government effectiveness and efficiency. Recent cuts only compound these concerns. The chaotic dismantling of government and resulting disruptions to crucial functions like public health and disease prevention highlight the need for meaningful reform and concrete policy proposals to reimagine how government can better serve the public and be more effective, responsive and accountable. To learn more about the impact of federal cuts to public health and science more broadly, visit The Cost of Cutting American Science. Learn more For more information on the Partnership for Public Service’s government reform initiative, visit Government for a New Era. View here In line with The Cost of Cutting American Science, federal workforce data in this brief is as of February 2026
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The 98 Biggest TV Show Flops, Bombs and Misses in the First Half of 2026
(Welcome to the Entertainment Strategy Guy, a newsletter on the entertainment industry and business strategy. I write a weekly Streaming Ratings Report and a bi-weekly strategy column, along with occasional deep dives into other topics, like today’s article. Please subscribe.) In July, I updated my look at how the “streaming bubble” popped since 2023, showing the decline in streaming TV shows over time. But after compiling and analyzing and writing about over one hundred TV show flops in the first half of 2026—I counted 99 “nominees” and there are even more honorable mentions—I couldn’t have told you that the number of shows is going down. When it comes to scripted, English-language TV shows, it feels like we have as many bombs as ever. I don’t keep a specific count, but some streamers probably had as many flops as they’ve ever had.1 That’s right, it’s time for part two of my analysis of the biggest flops, bombs and misses on streaming in the first half of 2026. Two weeks ago, I took a look at films. Today, TV shows. If you want to read the full methodology for how I assemble this list, you can find it at the bottom of this article. In short, this list is… ...scripted and unscripted TV shows,...from the nine major streamers,...in the US (using US-only ratings),...excluding true crime, kids and foreign-language shows,...that got no/poor ratings,...from Jan-2026 to the end of June-2026. Reminder: this article does not represent my personal opinion—many of these shows are great!—but I follow the data, and a miss is a miss and a bomb is a bomb. Also, price matters. If a TV show costs north of $100 million, it needs to get lots and lots of streaming viewership to justify that budget. As with past editions, I ordered this list by streamer, going from best (fewest flops) to worst (the most misses)—taking the size of the flops into consideration—and like the last edition, three or four streamers vied to take the win/loss of having the most flops. (But the actual winner is no surprise.) I try to avoid tooting my own horn too much, but seriously, in just under 5,000 words (including the methodology section) I provide a mostly comprehensive overview of the eight major streamers (Netflix, Disney+, Prime Video, Hulu, HBO Max, Peacock, Paramount+, and Apple TV) for the first half of the year, mentioning most of their hits and all their misses. It summarizes the entire first half of 2026! If you want to support this work, please subscribe. Subscribe Tubi Big Mood Boarders The Freak Brothers Twenty Twenty Six Honorable Mentions: Busted on Bodycam, Deestroying the Pitch, Destination World Cup 2026 I don’t think that Tubi spends all that much making or (mostly) licensing these original TV shows—Big Mood, Boarders and Twenty Twenty Six all come from the UK—but they’re not free and they didn’t chart anywhere. Winner: The Freak Brothers Have you even heard of this show? It’s an animated comedy...that’s on its third season! And Pete Davidson, Woody Harrelson, John Goodman and Tiffany Haddish all provide voice talent for it. Yes, animated shows don’t cost as much as live action shows, but cheap isn’t free! So a show with this level of talent needs to perform better. Disney+ Daredevil: Born Again Star Wars: Maul – Shadow Lord Honorable Mentions: Behind the Attraction, Donna Hay Coastal Celebrations, We Call It Imagineering Disney+ doesn’t make all that many original shows anymore. They had two flops, and one was animated. Their one not-a-miss show, Wonder Man, got just good enough viewership to not be considered a “miss”...but it’s since been cancelled. At this point, Disney has pivoted entirely away from making big budget TV shows for Disney+ to making...almost nothing for Disney+? Sure, Disney’s spending circa 2019-2022 was unsustainable, but now they’re pivoting too far in the other direction. At some point, Disney needs to stop shifting strategies so wildly. Really, Disney should have made fewer shows for Disney+ at launch and the shows they did make at that time needed to be made at more reasonable budgets. And they should adopt that strategy now. Winner: Daredevil: Born Again Daredevil, the Marvel Comics character, is on my personal Mount Rushmore of favorite superheroes, so it pains me to give him the win/loss today, but this show deserves it. I’ll repeat my hot take from last spring: “Based on his popularity, Daredevil should be in movies, and probably ones that cost a lot less than the MCU’s usual price tag. Disney/Bob Iger/Ike Perlmutter (who, based on reporting, made the decision) made a huge mistake selling TV shows to Netflix in the 2010s, thus limiting this character to the small screen. Daredevil could have anchored Marvel’s post-Infinity War plans, and if he did, the MCU would probably be in a better place than it is now.” HBO Max We’re just getting started with this issue, but the rest is for paid subscribers of the Entertainment Strategy Guy, so if you’d like to find out… What four streamers had the most misses... HBO’s strong start to 2026… The caveat to Peacock’s turnaround this year... Paramount+’s key man problem… What country isn’t delivering hits for Netflix or Hulu... The cavalcade of stars on a streamer where no one is watching their shows... Across nearly 5,000 words of analysis… And a lot more... ...please subscribe! We can only keep doing this great work with your support. If you’d like to read more about why you should subscribe, please read this article about the Streaming Ratings Report, why it matters, why you need it, and why we cover streaming ratings best.
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It will offer no-strings-attached funding along with mentorship from games industry leaders, a combination intended to aid the development of groundbreaking new games, Cerny and Keighley told me. Nova will begin accepting applications in December, from class of 2026 and 2027 students from 13 affiliated gaming programs at universities in eight countries. The schools working with Nova include the New York University and the University of Southern California in the U.S., along with Abertay University in Scotland, Cnam-Enjmin in France, TH Köln in Germany, and the Royal Melbourne Institute of Technology in Australia, Cerny and Keighley said. The plan: $100,000 per recipient, with about a quarter of Nova fellows eligible for up to $500,000 more for projects that are shaping up particularly well. Payments will be delivered based on development milestones, and recipients will own their games. Nova will help promote the work, and developers will be free to pursue the publishers and platforms of their choice. Nova can help introduce fellows to publishers, but won’t take a cut. “I’ve always wanted to give back, but given my role in the industry, I’ve never felt it appropriate to commercially invest in games,” Keighley told Game File. “I’ve never owned stock in a game company or taken a financial stake in a game. Nova is philanthropy: we aren’t taking equity or looking to recoup the grants. The return we’re hoping for is creative—helping new voices make games and find their footing. “Mark and I have each made multi-million-dollar donations to establish the foundation, and we intend to keep contributing. We hope others will join us.” Cerny and Keighley have already hired an executive director, John Maconga, and a head of grants, recent Game Developers Conference director Ashley Corrigan, to help launch the effort. They’re working to recruit game industry leaders to join the effort. Keighley says “dozens of leading game directors have already expressed interest in contributing their time.” To name one, they’ve already gotten Josef Fares, lead designer from It Takes Two and Spit Fiction studio Hazelight on board with a donation and pledge to help out. “I’m proud to support Nova because it gives the next generation of creators the freedom to explore their creativity and hopefully bring their unique visions to life,” Fares told Game File. A plan forged from a friendship Keighley and Cerny have known each other a long time. It’s been so long, Cerny isn’t even sure exactly when they met. “We travel in much the same circles and I’m sure first intersected in the 90s or early 2000s,“ Cerny said. Keighley thinks it might have been during his stint writing a column about the mid-’90s console 3DO for a gaming magazine while Cerny was working on games with Crystal Dynamics or on Way of the Warrior with Naughty Dog. They became genuine friends about a 10 years ago, Keighley said, as they bonded over a shared love of games and a hope to improve the industry. “About a decade ago, we started having dinner a few times a year in LA,” Keighley said. “Just to catch up on life and the industry. Those conversations continued over Zoom during COVID. Nova grew out of that friendship and a question we kept coming back to: ‘What could we do to help the next generation of game directors get started?’” Keighley credits Cerny with the idea to figure out a way to put their money and time back into the industry. At one of those dinners, Keighley proposed the idea of a fellowship program. He’d recalled applying for a Rhodes Scholarship when he was younger. “Spoiler: I didn’t get it,” he said. He’d admired the MacArthur Foundation’s so-called “genius grants.” He liked these kinds of programs that recognized people’s talents and gave them the financial boost and the freedom to realize their potential. With Cerny, he had pondered what a game industry version of that could be. Keighley liked the idea of centering the fellowship on students, drawing inspiration from the accomplishments of Jenova Chen, the USC game design graduate who went on to lead the creation of gently moving, ambitious games such as Flower and Journey. Keighley also thought it could be useful to help promising graduates bridge the transition from student to professional. “Joining an established studio isn’t always possible—especially in today’s market—and even then, it isn’t the right path for everyone,” Keighley said. A fellowship, he realized, could give “graduates the time, resources and guidance to pursue a game of their own and not worry about the commercial viability.” As the idea took shape, Cerny also saw an opportunity to enable more games of a certain type: “The target with the grants is games as an artistic medium,” Cerny told me. “We like to say games with ‘artistic, literary and societal value.’” He added: “I’m a pretty big gamer myself, though I tend to gravitate towards the smaller and more unique or artistic titles, games like Neva, Abzu, Gorogoa, Stray or Outer Wilds. I was just playing and Roger on a flight to Japan, and was getting misty eyed to a degree that I was concerned that a flight attendant would ask me if I was OK. “So one fun benefit here is the games that will come out of the Nova Games Foundation – I can’t wait to play them myself.” Cerny believes it will also be useful for Nova fellows to hone their craft and team leadership skills. “We are looking for the next generation of visionaries,” he said. “The trick is that they will also need to have the executive function necessary to drive a small project to completion.” Game File is a reader-supported publication. To receive new posts and support my reporting, please consider becoming a free or paid subscriber. Subscribe Going big with this Keighley and Cerny may have started Nova and may be the ones primarily backing it right now, but they’re dreaming of something that goes beyond them. “Mark and I may have helped get it started, but one of our measures of success is that Nova grows into something the entire games industry feels a sense of ownership in,” Keighley said. “Our ambition is to build a lasting endowment supported by people and companies across the industry, and an equally broad community of creators willing to give their time and experience to the next generation.” The industry has a lot of knowledge that it can pass to the next generation, Keighley said: “Nova can hopefully become a way to connect that generosity with talented young creators at the moment when it can make the biggest difference.” Cerny, who told me he believes Nova can mature “over the next 10 or 20 years,” sees an opportunity to give generations of game makers momentum. “The industry has changed immeasurably since I started in games in 1982,” he said. “These graduates have talent, training and tools that outclass what we had back in the day by an astonishing amount. But they face a tough road ahead getting traction in the industry, and many could benefit from our support. We want to be there to give it to them.” “There’s a personal side to this, too,” Keighley said. “I don’t have children, and I’ve spent a lot of time thinking about what I can do for future generations. Games have been my entire career. I’ve been incredibly fortunate, and helping someone else build a life in this industry feels like a meaningful way to give back.” Cerny’s oeuvre dates back to Marble Madness and Sonic the Hedgehog 2. He has stood on stage multiple times to reveal the future of PlayStation hardware. He’s been an executive producer for a string of modern PlayStation classics such as The Last Guardian and Marvel’s Spider-Man. Nevertheless, of Nova, he said, “It’s certainly not like anything I’ve done before.” Nova Foundation applications will be due in December and the first wave of fellows will be announced in March 2027. A full list of participating universities and steps students and recent graduates can take to apply to become a Nova Fellow is forthcoming.
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AZ's R&D chief Barr touts internal 'science success story' after IL-33 antibody's stellar showing in COPD
With a detailed data drop that AstraZeneca’s R&D chief described as an internal “science success story,” the British Big Pharma has secured an FDA priority review for what it believes could become a flagship biologic in chronic obstructive pulmonary disease (COPD). In detailed results from the late-stage Oberon and Titania trials—first teased in March and detailed in full at the European Respiratory Society Congress in Barcelona this week—the drugmaker laid out the extent of its IL-33 inhibitor’s potential to reduce moderate and severe exacerbations in a wide range of COPD patients still struggling with those “lung attacks,” as AstraZeneca’s Sharon Barr, Ph.D., called them, despite using standard-care inhaled therapy. In the headline results, a 300 mg dose of tozorakimab given once every four weeks curbed those moderate and severe exacerbations in the studies’ primary population of former smokers by 29% in the Oberon study and 34% in Titania. In the overall population of both current and former smokers, these reductions were 30% and 29%, respectively, versus placebo and inhaled standard of care. The benefits also extended to clinically meaningful exacerbation reductions in all prespecified patient subgroups and specifically turned up promising signals in patients across a range of blood eosinophil counts, with Barr telling Fierce that “it’s the details that make this even more exciting than the high-level results that we’ve already shared.” In fact, during AZ’s tozorakimab poster presentation at the ERS 2026 Congress this past weekend, attendees were so enamored by the data that event organizers had to encourage people to clear the room and look at the other presentations on offer, Barr said in an interview. “I think it really speaks to the fact that there is a lot of buzz around these data because the entire respiratory community has been so desperate for new therapies for these patients,” she explained. The respiratory disease continues to represent a “staggering unmet medical need,” Barr said, highlighting the COPD exacerbations that the Oberon and Titania studies homed in on, which she added carry a greater mortality risk than a heart attack. “When a patient has a severe exacerbation, only about half of them are still alive within three and a half years,” she pointed out. As for tozorakimab specifically, Barr christened the molecule “an AstraZeneca science success story,” harkening several years back to the point at which researchers began to explore IL-33 as a driver of respiratory disease, and COPD in particular. At the same time, “there was still so much that wasn’t understood,” she admitted, highlighting the insight that IL-33 signals through both ST2 and EGFR through the RAGE pathway, a discovery Barr attributed to AstraZeneca's own scientists. Understanding the need to tackle both pathways in COPD—and aware of competitor candidates in the hopper, including one that bound ST2—the company ultimately had to make some “courageous decisions,” Barr said. These included taking a prior COPD molecule offline and going back to the drawing board to reinvent its potential IL-33 label “to make sure that we had a molecule that could block signaling through both arms of the pathway, through both the reduced form and the oxidized form, knowing that we wouldn’t be first, but striving to be best.” “When we put [tozorakimab] into the clinic, we firmly believed that we had a differentiated molecule, and we saw the other molecules blocking just ST2 or partially blocking IL-33, unable to deliver two positive pivotal studies in COPD,” Barr explained. “We kept marching forward because we believed our molecule was differentiated, and now I think we have the clinical validation that supports that.” Ultimately, AstraZeneca finds itself on much better footing these days when it comes to potential biologic rivals to tozorakimab in COPD. Sanofi and Regeneron’s Dupixent, for instance, is approved to treat COPD exacerbations in patients with high eosinophil counts, but not low ones. Meanwhile, the future has become cloudier for other next-gen IL-33 candidates from Sanofi and Regeneron, as well as Roche, which have suffered trial flops in recent years. One other potential ingredient for AstraZeneca’s success in its duo of studies was that the company was “ambitious in the trial design, willing to look at an all-comers population,” Barr said, “and willing to enroll the most severe patients.” Prior studies for would-be biologics rivals in COPD “avoided enrolling” those patients, she pointed out. She also highlighted the Big Pharma’s painstaking design of exacerbations in its trial, which “gave us a very rigorous readout,” and pointed to “the extra effort and investment” the company put in to understand the effect of mucus plugs in patients. Barr described mucus production as a “key feature in disease diversity,” noting that mucus plugs—obstructing clumps of mucus that block patients’ airways—are associated with worse outcomes in COPD. In its data announcement, AstraZeneca noted that an integrated analysis of Oberon and Titania found tozorakimab “demonstrated a reduction in patients’ mucus plug score,” with the pharma claiming its biologic is the first to deliver such results in a broad COPD population. “So being able to reduce those mucus plugs, we expect, is an important part of driving benefit for patients who are living with COPD,” Barr said. Again touching on the breadth of the study populations, Barr added that tozorakimab “worked across all eosinophil levels in both current and former smokers across all levels of lung function,” which she suggested “really simplifies decision-making for clinicians, and it allows them to offer therapy to the broadest possible patient population.” In the highest patient eosinophil count group, tozorakimab helped chart a 43% reduction in exacerbation risk, which Barr stressed were “unprecedented data.” In the mid-level group, AZ’s drug delivered a 23% reduction and, in the lowest group, a 34% reduction in eosinophils, which Barr said suggests efficacy “in all patient subgroups.” As for AZ’s recent guidance upgrade on the medicine’s sales opportunity, the lift from a $3 billion to $5 billion range to $5 billion plus was informed by multiple factors, Barr said, including the fact that “in 2024, there were multiple competitors, and there aren’t anymore.” Additionally, “we know that this is a massive unmet medical need, and this is a really incredible set of data that we think will be very convincing to the clinical community,” Barr said. Looking ahead to a potential evolution of the COPD treatment landscape, Barr noted that most patients start treatment in the community with an option like a triple therapy, and for them, having an option like AstraZeneca’s inhaler Breztri will remain a “really important part” of that journey. But of the patients uncontrolled on triple therapy, which Barr described as “about half of them today,” just a “small fraction” are currently eligible for biologic therapy, which she emphasized AstraZeneca is working to change. Understanding that COPD is not a “one-size-fits-all” disease, AstraZeneca is also looking at its antibody drug Tezspire for patients with T2-driven disease, and the company continues to think about new mechanisms for tackling COPD through both systemic and inhaled drugs, Barr said.
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