Blink and another year goes by: but 2025 brings a chance for a fresh start, and some reflection on where we have got to and what is to come. I don’t have a crystal ball and I can’t fully predict what the year will bring (astrology is still not a recognised science at the University of Edinburgh, where I work), but what I can do is draw on my expertise and data signals from around the world to suggest seven topics in public health – from potential pandemics to widespread weight-loss drugs – that I believe are likely to be important in the coming months.
So first with the not so cheery news: bird flu will continue its worrying prominence. Since my last column, the US has confirmed the first severe case of H5N1 in Louisiana from a patient infected with the strain circulating in birds (in contrast to the mild infections in humans linked to the strain in cattle). California has also issued a state of emergency over the growing number of humans infected with the disease and concerns it could mutate further. Given how widespread H5N1 is in birds, wild and domestic, across the world, and in dairy cows in the US, human infections will continue to be detected. The question is whether these remain isolated cases, each tied to contact with an infected animal, or whether we start to see clusters of human cases in the coming months – the latter would suggest the virus could be transmitting between humans, which would be the next major step in a pandemic scenario. Let’s hope this remains a scenario and not a future reality.
On the positive side, an increasing number of studies are showing the beneficial impact regular movement and exercise have not only on the body but on the mind. We now have good evidence on the effect exercise has on reducing depression and delaying dementia, in addition to improving overall health such as reducing the risk of type 2 diabetes, high blood pressure, cancer, stroke and chronic pain. Expect this good news to keep rolling in, and for more findings on the biological and cellular mechanisms that explain this brain-body connection.
Linked to mental health, I bet we will see more regulation of social media use by adolescents in the coming year. We now have scientific evidence that extended periods of screen time, especially on social media platforms, is detrimental to mental health. It’s no surprise that the Oxford word of the year of 2024 is brain rot. As the evidence accumulates, expect to see country after country putting in legislation trying to protect minors under the age of 16 from social media algorithms and harmful content, especially as it is a topic that has cross-party support.
Something else that can bring us down? Drinking alcohol. It’s been well known that alcohol is a depressant, but we now have solid evidence that alcohol, even red wine, is bad for our bodies, and that ethanol (a key ingredient in alcoholic drinks) causes cellular mutations. Enjoy a drink if you want to – we balance risks and benefits each day as humans – but don’t pretend it is good for your health. This year is likely to bring more evidence on the harmful effects alcohol has on our bodies, especially cancer risk.
In 2024, we saw celebrity after celebrity lose a large amount of weight in a short time, then admit to taking drugs such as Ozempic or Wegovy. These injections contain semaglutide which suppresses appetite by mimicking the role of a natural hormone called GLP-1 that tells the brain we’ve eaten and are full. However, far from being a magic weight-loss solution, the side effects (including kidney damage, gallbladder issues and certain types of cancer) are being documented, as well as the rebound weight when injections are stopped. In 2025, expect to see increased hesitation about using these drugs and awareness that they should be limited to those with a clear medical need; not for those who want to drop 15 pounds to fit into a size 0 dress.
To send you into 2025 with some good news: we are getting ever closer to eliminating cervical cancer using the HPV vaccine; and also seeing more being done to reduce child deaths of malaria thanks to the rollout of the malaria vaccine in African countries. Vaccines are sometimes seen as controversial, but the science is straightforward: they train our immune system in how to respond and fight off pathogens. Safety and efficacy are carefully studied and documented for scientists to analyse and discuss. A child dies every minute from malaria and a woman dies from cervical cancer every two minutes. There is now a real possibility of preventing these early deaths and giving millions of children and women the chance to live longer. That is worth celebrating this new year.
