September 28, 2026
India’s bidi tax gap is hurting the people it should protect.
In a collaborative opinion piece, OHT’s Dr. Amit Summan argues that bidis, despite being India’s most widely used tobacco product, were excluded from the country’s latest tobacco tax revisions. This has further widened the tax gap between bidis and cigarettes. The authors cited OHT research models suggesting that increasing taxes on bidis could produce significant health and economic benefits. The research estimates that a 30 percent tax-driven increase in bidi prices, combined with removing tax exemptions for small producers, could result in an additional 48 million years of life over 50 years and generate ₹68 billion in tax revenue in the first year. The authors also challenge concerns that higher bidi taxes would harm low-income households and bidi workers, affirming that the additional tax revenue could instead be used to fund welfare programs for bidi workers, provide opportunities for skill development, and strengthen enforcement of minimum-wage laws. [Indian Express]
Structural uncertainties are driving prolonged antibiotic prescribing in low- and middle-income countries.
Shorter antibiotic courses are increasingly recognized as safe and effective yet remain uncommon in many low- and middle-income countries (LMICs). In a commentary, researchers, including OHT’s Dr. Deepshikha Batheja, argue that prolonged prescribing may be better understood as a rational response to clinical uncertainty rather than as a simple stewardship failure. Diagnostic limitations, delayed test results, and constrained healthcare resources paired with poor healthcare access may push clinicians to prescribe longer courses. These prescribing habits represent attempts to manage medical uncertainty and ensure patient safety when post-treatment follow-up care remains highly unreliable. Therefore, reducing unnecessary use requires strengthening health systems to lower uncertainty and not just change in prescriber behavior. [The American Journal of Bioethics]
Rethinking antimicrobial resistance
Antimicrobial resistance (AMR) is often inferred by the presence of antimicrobial resistance genes (ARGs) or susceptibility phenotypes measured in laboratory conditions. In Trends in Microbiology, authors argue that this picture may be incomplete. The majority (around 90 percent) of acquired ARGs encode enzymes which may behave differently depending on their surroundings. In vivo conditions such as pH, temperature, oxygen levels, antibiotic concentration, and even neighboring bacteria can greatly influence how much protection a gene actually provides. Treating AMR as a context-dependent state rather than a fixed trait carries real-world implications. Mapping how enzymes that confer AMR perform under real-world conditions could improve antibiotic choice and dosing and distinguish clinically relevant ARGs from those whose effects are ecological or reservoir- associated. [Trends in Microbiology]
Five decades of pneumococcal meningitis cases reveal shifting serotypes in Spain.
A retrospective, single-center study tracked 387 cases of adult pneumococcal meningitis at a Spanish hospital over nearly 5 decades, from 1974 to 2023. It assessed shifts in infection sources, pathogen serotypes, and antimicrobial resistance (AMR), incorporating whole-genome sequencing of 200 isolates to identify 60 distinct global pneumococcal sequence clusters. Acute otitis media was identified as the most common infection source (45 percent), dominated by serotype 3. However, cases originating from hematogenous dissemination (spread of the infection through the bloodstream), carried the highest 30-day fatality rate of 48 percent. Introducing pneumococcal conjugate vaccines led to a decline in vaccine-targeted serotypes and beta-lactam resistance over time, emphasizing the ongoing clinical implications of vaccination programs for reducing severe meningitis mortality and AMR. [Lancet Microbe]
A single gene could track livestock antibiotic resistance risk worldwide.
Livestock farms are major reservoirs of antimicrobial resistance (AMR), but scalable ways to measure the risk worldwide are limited. To test whether Class 1 integrons could serve as a direct proxy for livestock-associated AMR risk, researchers analyzed 4,017 livestock metagenomes, 9,625 livestock isolate genomes, and roughly 1.2 million clinical genomes using a custom Class 1 Integrase Database. They found that intI1 (the class 1 integrase gene) abundance is linked to host- and geography-dependent risk patterns, with livestock integrons carrying compact, conserved resistance cassettes closely matching those in clinical bacteria. A random-forest model predicted global risk with high accuracy (R² = 0.93), revealing persistent hotspots across Asia, sub-Saharan Africa, and South America. These findings suggest intI1 abundance could serve as a robust indicator for monitoring livestock-associated AMR risk worldwide. [Environmental Science and Ecotechnology]
GPS tracking predicts avian flu risk at poultry farms.
Tracking wintering geese could help predict avian influenza outbreaks. Researchers utilized high-frequency GPS tracking of 59 Greater Snow Geese and 9 Canada Geese over 4 winters (2019-2023) to evaluate highly pathogenic avian influenza exposure risks for commercial poultry on the Delmarva Peninsula. The methodology involved developing a risk ranking system for poultry facilities based on exposure to wintering waterfowl, as well as a modeling of the exposure based on different factors, including time, geography, and temperature. The ranking successfully flagged risk; all seven facilities that experienced H5N1 outbreaks fell in the 78-99th risk percentile. One-third of facilities had marked geese nearby, with exposure increasing during colder temperatures and near specific geographic features such as water bodies or refuges. This targeted modeling approach offers a promising strategy to optimize limited biosecurity resources. [PLOS One]
World Health Organization review reaffirms vaccines do not cause autism.
A comprehensive systematic review commissioned by the World Health Organization examined literature published between 2010 and 2025 to reassess whether vaccines including the mercury-based preservative thiomersal are associated with autism spectrum disorder (ASD). Across 36 primary studies and meta-analyses, the most methodologically rigorous evidence—large cohort and registry-based studies covering hundreds of thousands of children—consistently found no causal link. The handful of studies reporting an association came almost entirely from a single author group and relied on weak designs prone to bias and confounding. The authors conclude that the overwhelming weight of the evidence strongly affirms the safety of current vaccines in regard to ASD and other neurodevelopmental disorders. [World Health Organization]
Community trust could determine whether a new dengue control strategy takes hold.
Copepods are tiny freshwater crustaceans that feed on the larvae of Aedes aegypti, the mosquitoes that spread dengue. A Knowledge, Attitudes, and Practices (KAP) survey investigated whether communities in eastern Guatemala would embrace copepod-based management as a substitute or addition to chemical treatments to control dengue spread. The majority of respondents across 346 households in 8 urban and rural communities were aware that mosquitoes spread dengue, however their understanding of breeding sites and preventive measures was inconsistent. Over one-third were taking no action to eradicate breeding sites. Although there was little knowledge of copepods, communities were more inclined to think about using them when given assurances regarding water safety and technical assistance. While field studies are still required to determine the intervention’s efficacy, safety, and sustainability, trusted local engagement and open communication will be essential in implementing community-based measures to eradicate vector-borne infectious diseases. [PLOS Neglected Tropical Diseases]
Africa’s immunization recovery is underway but still falling behind.
Africa’s progress in rebuilding routine immunization following the COVID-19 pandemic remains incomplete, uneven, and too slow to meet the Immunization Agenda 2030 targets set at the World Health Assembly in 2020. Between 2021 and 2025, coverage for vaccines against diphtheria, pertussis, and tetanus (DPT) increased from 81 percent to 84 percent and 73 percent to 77 percent, for doses 1 and 3 respectively. However, the projection for 2025 estimated 7.1 million zero-dose children and 3.3 million under-vaccinated children in Africa, with DPT3 still below its 2019 levels. In a commentary, experts emphasize that to maintain immunization gains, nations must concentrate not just on reaching children who have been missed but also on preventing dropouts in between doses. They stress the importance of targeted financing, robust primary healthcare systems, and community participation in reaching the 2030 goal. [Lancet Regional Health]
Smart regulation should reward good behavior, not just punish bad behavior.
In the Hindustan Times, OHT’s Dr. Ramanan Laxminarayan argues that India’s regulatory strategy depends heavily on punishment, despite the fact that lax enforcement makes it easier to avoid sanctions. He argues that rather than counting the number of inspections or fines levied, the effectiveness of regulations should be determined by whether they improve health and safety outcomes. Drawing on examples from road safety, workplace safety, food safety, and antimicrobial resistance control, he suggests that rewarding companies and individuals that continuously exhibit good practices with incentives such as reduced insurance premiums, quicker approvals, public safety ratings, and stewardship certifications, could increase the effectiveness of regulations and reduce their reliance on enforcement capabilities. [Hindustan Times]
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