Increases are expected to be largest in countries where life expectancy is lower, contributing to a convergence of increased life expectancy across geographies. The trend is largely driven by public health measures that have prevented and improved survival rates from cardiovascular diseases, COVID-19, and a range of communicable, maternal, neonatal, and nutritional diseases (CMNNs).

This study indicates that the ongoing shift in disease burden to non-communicable diseases (NCDs) — like cardiovascular diseases, cancer, chronic obstructive pulmonary disease, and diabetes — and exposure to NCD-associated risk factors — such as obesity, high blood pressure, non-optimal diet, and smoking — will have the greatest impact on disease burden of the next generation.

As the disease burden continues to shift from CMNNs to NCDs and from years of life lost (YLLs) to years lived with disability (YLDs), more people are expected to live longer, but with more years spent in poor health. Global life expectancy is forecasted to increase from 73.6 years of age in 2022 to 78.1 years of age in 2050 (a 4.5-year increase). Global healthy life expectancy (HALE) — the average number of years a person can expect to live in good health — will increase from 64.8 years in 2022 to 67.4 years in 2050 (a 2.6-year increase).

To come to these conclusions, the study forecasts cause-specific mortality; YLLs; YLDs; disability-adjusted life years (DALYs, or lost years of healthy life due to poor health and early death); life expectancy; and HALE from 2022 through 2050 for 204 countries and territories.

“In addition to an increase in life expectancy overall, we have found that the disparity in life expectancy across geographies will lessen,” said Dr. Chris Murray, Chair of Health Metrics Sciences at the University of Washington and Director of the Institute for Health Metrics and Evaluation (IHME). “This is an indicator that while health inequalities between the highest- and lowest-income regions will remain, the gaps are shrinking, with the biggest increases anticipated in sub-Saharan Africa.”

Dr. Murray added that the biggest opportunity to speed up reductions in the global disease burden is through policy interventions aimed to prevent and mitigate behavioral and metabolic risk factors.

These findings build upon the results of the GBD 2021 risk factors study, also released today in The Lancet. This accompanying study found that the total number of years lost due to poor health and early death (measured in DALYs) attributable to metabolic risk factors has increased by 50% since 2000. Read more on the risk factors report at https://bit.ly/GBDRisks2021.

The study also puts forth various alternative scenarios to compare the potential health outcomes if different public health interventions could eliminate exposure to several key risk factor groups by 2050.

“We forecast large differences in global DALY burden between different alternative scenarios to see what is the most impactful on our overall life expectancy data and DALY forecasts,” said Dr. Stein Emil Vollset, first author of the study who leads the GBD Collaborating Unit at the Norwegian Institute of Public Health. “Globally, the forecasted effects are strongest for the ‘Improved Behavioral and Metabolic Risks’ scenario, with a 13.3% reduction in disease burden (number of DALYs) in 2050 compared with the ‘Reference’ (most likely) scenario.”

The authors also ran two more scenarios: one focused on safer environments and another on improved childhood nutrition and vaccination.

“Though the largest effects in global DALY burden were seen from the ‘Improved Behavioral and Metabolic Risk’ scenario, we also forecasted reductions in disease burden from the ‘Safer Environment’ and ‘Improved Childhood Nutrition and Vaccination’ scenarios beyond our reference forecast, said Amanda E. Smith, Assistant Director of Forecasting at IHME. “This demonstrates the need for continued progress and resources in these areas and the potential to accelerate progress through 2050.”

“There is immense opportunity ahead for us to influence the future of global health by getting ahead of these rising metabolic and dietary risk factors, particularly those related to behavioral and lifestyle factors like high blood sugar, high body mass index, and high blood pressure,” continued Dr. Murray.

The finding, reported May 17 in the journal Cell, not only provides proof that a vaccine can elicit these antibodies to fight diverse strains of HIV, but that it can also initiate the process within weeks, setting in motion an essential immune response.

The vaccine candidate targets an area on the HIV-1 outer envelope called the membrane proximal external region (MPER), which remains stable even as the virus mutates. Antibodies against this stable region in the HIV outer coat can block infection by many different circulating strains of HIV.

“This work is a major step forward as it shows the feasibility of inducing antibodies with immunizations that neutralize the most difficult strains of HIV,” said senior author Barton F. Haynes, M.D., director of the Duke Human Vaccine Institute (DHVI). “Our next steps are to induce more potent neutralizing antibodies against other sites on HIV to prevent virus escape. We are not there yet, but the way forward is now much clearer.”

The research team analyzed data from a phase 1 clinical trial of a vaccine candidate developed by Haynes and S. Munir Alam, Ph.D., at DHVI.

Twenty healthy, HIV-negative people enrolled in the trial. Fifteen participants received two of four planned doses of the investigational vaccine, and five received three doses.

After just two immunizations, the vaccine had a 95% serum response rate and a 100% blood CD4+ T-cell response rate — two key measurements that demonstrated strong immune activation. Most of the serum responses mapped to the portion of the virus targeted by the vaccine.

Importantly, broadly neutralizing antibodies were induced after just two doses.

The trial was halted when one participant experienced a non-life-threatening allergic reaction, similar to rare incidents reported with COVID-19 vaccinations. The team investigated the cause of the event, which was likely from an additive.

“To get a broadly neutralizing antibody, a series of events needs to happen, and it typically takes several years post-infection,” said lead author Wilton Williams, Ph.D., associate professor in Duke’s Department of Surgery and member of DHVI. “The challenge has always been to recreate the necessary events in a shorter space of time using a vaccine. It was very exciting to see that, with this vaccine molecule, we could actually get neutralizing antibodies to emerge within weeks.”

Other features of the vaccine were also promising, most notably how the crucial immune cells remained in a state of development that allowed them to continue acquiring mutations, so they could evolve along with the ever-changing virus.

The researchers said there is more work to be done to create a more robust response, and to target more regions of the virus envelope. A successful HIV vaccine will likely have at least three components, all aimed at distinct regions of the virus.

“Ultimately, we will need to hit all the sites on the envelope that are vulnerable so that the virus cannot escape,” Haynes said. “But this study demonstrates that broadly neutralizing antibodies can indeed be induced in humans by vaccination. Now that we know that induction is possible, we can replicate what we have done here with immunogens that target the other vulnerable sites on the virus envelope.”

In addition to Haynes and Williams, study authors include S. Munir Alam, Gilad Ofek, Nathaniel Erdmann, David Montefiori, Michael S. Seaman, Kshitij Wagh, Bette Korber, Robert J. Edwards, Katayoun Mansouri, Amanda Eaton, Derek W. Cain, Mitchell Martin, Robert Parks, Maggie Barr, Andrew Foulger, Kara Anasti, Parth Patel, Salam Sammour, Ruth J. Parsons, Xiao Huang, Jared Lindenberger, Susan Fetics, Katarzyna Janowska, Aurelie Niyongabo, Benjamin M. Janus, Anagh Astavans, Christopher B. Fox, Ipsita Mohanty, Tyler Evangelous, Yue Chen, Madison Berry, Helene Kirshner, Elizabeth Van Itallie, Kevin Saunders, Kevin Wiehe, Kristen W. Cohen, M. Juliana McElrath, Lawrence Corey, Priyamvada Acharya, Stephen R. Walsh, and Lindsey R. Baden.

The search for new, more efficient materials involving complex chemical compositions has been labor-intensive, requiring experimental testing of each proposed new multi-material composition, and has often involved the use of toxic or rare elements. In a paper published Thursday, May 16, in the journal Science, researchers from the University of Houston and Rice University report a new approach to predict the realization of band convergence in a series of materials and, after demonstrating that one so-designed material, a p-type Zintl compound, would offer highly efficient thermoelectric performance, fabricated a thermoelectric module. They reported a heat-to-electricity conversion efficiency exceeding 10% at a temperature difference of 475 kelvin, or about 855 degrees Fahrenheit.

Zhifeng Ren, director of the Texas Center for Superconductivity at UH (TcSUH) and corresponding author for the paper, said the materials’ performance remained stable for more than two years.

While a variety of approaches have been used to improve efficiency, a concept known as electronic band convergence has gained attention for its potential to improve thermoelectric performance. “It is normally difficult to get high performance from thermoelectric materials because not all of the electronic bands in a material contribute,” Ren said. “It’s even more difficult to make a complex material where all of the bands work at the same time in order to get the best performance.”

For this work, he said, the scientists first focused on devising a calculation to determine how to build a material in which all the different energy bands can contribute to the overall performance. They then demonstrated that the calculation worked in practice as well as in theory, building a module to further verify the obtained high performance at the device level.

Band convergence is considered a good approach for improving thermoelectric materials because it increases the thermoelectric power factor, which is related to the actual output power of the thermoelectric module. But until now, discovering new materials with strong band convergence was time-consuming and resulted in many false starts. “The standard approach is trial and error,” said Ren, who is also the Paul C.W. Chu and May P. Chern Endowed Chair in Condensed Matter Physics at UH. “Instead of doing a lot of experiments, this method allows us to eliminate unnecessary possibilities that won’t give better results.”

To efficiently predict how to create the most effective material, the researchers used a high-entropy Zintl alloy, Yb_xCa_1-xMg_yZn_2-ySb₂, as a case study, designing a series of compositions through which band convergence was achieved simultaneously in all of the compositions.

Ren described how it works like this: If a team of 10 people try to lift an object, the taller members will carry most of the load while the shorter members do not contribute as much. In band convergence, the goal is to make all the band team members more similar — tall band members would be shorter, in this example, and short members taller — so all can contribute to carrying the overall load.

Here, the researchers started with four parent compounds containing five elements in total — ytterbium, calcium, magnesium, zinc and antimony — running calculations to determine which combinations of the parent compounds could reach band convergence. Once that was determined, they chose the best among these high-performance compositions to construct the thermoelectric device.

“Without this method, you would have to experiment and try all possibilities,” said Xin Shi, a UH graduate student in Ren’s group and lead author on the paper. “There’s no other way you can do that. Now, we do a calculation first, we design a material, and then make it and test it.”

The calculation method could be used for other multi-compound materials, too, allowing researchers to use this approach to create new thermoelectric materials. Once the proper parent compounds are identified, the calculation determines what ratio of each should be used in the final alloy.

In addition to Ren and Shi, the paper’s authors include Dr. Shaowei Song, a researcher at the Texas Center for Superconductivity, and Dr. Guanhui Gao from the Department of Materials Science and Nanoengineering at Rice. Gao is now at UH.