Paige Vickers/Vox
This was a hard year. But these 10 news stories remind us a better future is possible.
I’m not going to lie to you: 2023 was an ugly year. War rages in Gaza, Ukraine, and Sudan, with millions displaced, injured, or dead. On top of global strife, AI-fueled misinformation runs rampant, we’re barreling past climate goals, and abortion access dwindles.
But when the world is mired in horrible things, it’s important to imagine a better future; without hope, new solutions wouldn’t be possible. In 2023, despite everything, there were moments when that hope actualized into meaningful wins.
From the Supreme Court upholding America’s toughest animal cruelty law to new developments in curing sickle cell disease, 2023 saw progress across policy and scientific research that will help shape well-being for humans and animals alike for years to come. Here are 10 breakthroughs in 2023 that help remind us that a better future is worth fighting for. —Izzie Ramirez
The economy started undoing 40 years of rising inequality
Among the many surprises of the post-pandemic economy was a deep reversal in long-running trends of wage inequality. Over the last three years, an unusually tight labor market has undone an estimated 38 percent of the wage inequality between poor and wealthy workers that shot up between 1980 and 2019. Researchers dubbed this “the unexpected compression.”
Young workers without college degrees benefited the most. That’s especially good news given the ongoing debates around “deaths of despair,” where economists are trying to figure out how to counter the rising mortality rates from heart disease and drug overdose among Americans with the least education. The boosted wages were concentrated among workers who changed jobs. Low-wage workers tend to raise their pay faster by switching jobs than by staying put, but the costs of leaving a bad and low-paying job, especially with the relatively weak American safety net, often keep workers in place.
Toward the end of 2023, the wage compression looked to be cooling off, but not reversing. To be clear, inequality remains a defining feature of the American economy, evidenced by calling its reduction an “unexpected” compression. The Biden White House is pushing some ideas that could help solidify these trends, like banning noncompete agreements or boosting workers’ bargaining power. With a few structural changes and a bit of luck, 2024 could build on these trends, transforming our expectations so that reducing inequality becomes the norm. —Oshan Jarow
After completing phase 3 trials, psychedelic-assisted therapy seeks FDA approval
In September, MAPS Public Benefit Corporation (BPC) — a company developing prescription psychedelics — published positive results from their second phase 3 clinical trial on MDMA-assisted therapy for PTSD. (Phase 3 trials feature thousands of patients, and are mostly randomized and blinded.) CEO Amy Emerson stated that these results, published in Nature Medicine, were the last hurdle before applying for FDA approval of MDMA-assisted therapy.
For decades, new and effective treatments for mental illnesses like PTSD, depression, and anxiety have been scant. Over the same period, a resurgence in clinical research on psychedelics has been amassing evidence of their potential for treating precisely these conditions (the potential benefits of psychedelics extend beyond therapy, but that’s another story).
The Multidisciplinary Association for Psychedelic Studies (MAPS), the nonprofit that owns MAPS PBC, has been patiently working toward FDA approval of MDMA therapy since its founding in 1986. This most recent randomized study included 104 participants who’ve lived with PTSD for an average of 16 years. Participants were split into a treatment group that received MDMA plus three monthly therapy sessions, and a placebo group that received extended therapy sessions but no MDMA.
86.5 percent of the treatment group experienced measurable benefits, and 71.2 percent no longer met the criteria for a PTSD diagnosis. The therapy-only group still experienced significant benefits, but less so: 69 percent recorded clinically significant improvements, with 47.6 percent no longer meeting PTSD criteria.
In December, MAPS PBC officially filed its application to the FDA, concluding a nearly 40-year effort. The approval of MDMA-assisted therapy would mark a watershed moment in the world of mental health, and likely pave the way for other psychedelic drugs, like psilocybin, to follow. —OJ
It’s another year of massive progress in developing and deploying vaccines
This past year saw a wave of progress in vaccines and treatments for malaria (a disease that still kills about half a million people in Africa each year), tuberculosis (that killed 1.3 million people in 2022), and respiratory syncytial virus, or RSV (the leading cause of infant hospitalization in the US and the killer of over 100,000 children worldwide in 2019).
In October 2021, the World Health Organization (WHO) recommended its first-ever malaria vaccine, RTS,S. In July 2023, the WHO, Unicef, and Gavi (a global vaccine alliance) committed to delivering 18 million doses of RTS,S across 12 African countries over the next two years. Then, this October, the WHO recommended a new and improved R21 malaria vaccine with an efficacy of 75 percent that can be maintained with booster shots.
On the tuberculosis front, there hasn’t been a new vaccine in over a century, but a promising option, the M72 vaccine, is entering its final phase of clinical trials. And more are in the works. The advent of mRNA vaccines for Covid-19 has inspired similar efforts to develop mRNA vaccines for TB, too.
And in July, the FDA approved a new preventative treatment for RSV. The only approved antiviral treatment for RSV before that was a monoclonal antibody developed in 1998 called palivizumab, a monthly treatment that was expensive, approved only for certain at-risk infants, and reduced infant hospitalizations by about 58 percent. The new treatment, Beyfortus, offers a number of upgrades. It’s approved for all infants up to 24 months, not just those at high risk. Its efficacy in reducing not just hospitalizations but all doctors’ visits is up to 70 percent as compared to placebo. And immunity lasts five months, enough to cover the full RSV fall season. As with the others, more promising treatments are already in the works. —OJ
Mexico decriminalizes abortion
Latin America’s abortion rights movement — colloquially called the “Green Wave” after the verdant scarves Argentine activists wore in the late 2010s — notched another win this year.
In September, Mexico’s Supreme Court eliminated all criminal penalties at the federal level for people seeking abortions. The ruling will require all federal health institutions to offer abortion to anyone who requests it. As my colleague Nicole Narea explains, states will have to change their laws to comply, new clinical standards and guidelines will have to be rolled out, and the public will have to be educated on their newfound right to an abortion and how they can access it. It’s a big shift, one that will have cascading effects for years to come.
Mexico’s decriminalization of abortion fits in a wider discussion around femicide and women’s rights across all of Latin America. Thanks to the Green Wave stemming from the 2015 Ni Una Menos (Not One Woman Less) protests, Argentine lawmakers voted to legalize the procedure in 2020, Colombia’s highest court decriminalized abortion in 2022, and Ecuadorian lawmakers made abortion legal in cases of rape in 2022. There’s still progress to be made, but considering the US backslide, Mexico’s shift comes at an opportune time. —IR
Bangladesh gets the lead out of turmeric
We all know lead isn’t good for you, but its true deadliness can often be overlooked. Lead poisoning contributes to as many as 5.5 million premature deaths a year — more than HIV, malaria, and car accidents combined.
In poorer countries, lead remains ever-present, but Bangladesh has a story of success where scientists, advocates, and government officials worked together to lower lead exposure levels.
Despite phasing out leaded gasoline in the 1990s, high blood lead levels continued to be a problem in Bangladesh. When researchers Stephen Luby and Jenny Forsyth tried to isolate the source in 2019, it turned out to be a surprising one: turmeric, a spice commonly used for cooking, was frequently adulterated with lead.
With this in mind, the Bangladeshi government and other stakeholders launched an education campaign to warn people about the dangers of lead. Once producers had been warned that lead adulteration was illegal, the government’s Food Safety Authority followed up with raids and fines to those who were caught.
A 2023 paper found that these efforts appear to have eliminated lead contamination in turmeric outright in Bangladesh. “The proportion of market turmeric samples containing detectable lead decreased from 47 percent pre-intervention in 2019 to 0 percent in 2021,” the study found. And blood lead levels dropped in the affected populations, too. —IR
The Supreme Court upheld America’s strongest animal welfare law
In 2018, Californians voted to pass Proposition 12, a law requiring that much of the eggs, pork, and veal sold in the state come from animals given more space on factory farms — essentially cage-free conditions. The change is incremental, as cage-free farming is still pretty terrible for the animals, but it represents progress on a massive scale: Californians buy about 12 percent of the US meat and egg supply. (Disclosure: From 2012 to 2017, I worked at the Humane Society of the United States, which led the effort to pass Prop 12.)
It was the biggest legislative victory yet for the farm animal welfare movement, reducing the suffering of more animals than any other US law. But this year, the Supreme Court came close to striking it down.
After Prop 12 passed in 2018, pork producers sued the state to repeal the part that covers pork. The case went all the way to the Supreme Court, and I anticipated the business-friendly conservative majority would side with the pork producers. They didn’t. The court upheld Prop 12 in a 5-4 decision.
The vote guarantees that the 700,000 or so breeding pigs raised for California’s pork supply won’t be confined in cages so small they can’t even turn around in a circle for virtually their entire lives. It also protects a number of similar laws animal advocates have helped pass since the early 2000s, ensuring millions of animals don’t go back into cages. —Kenny Torrella
You can now buy slaughter-free meat
Almost a century ago, Winston Churchill predicted that eventually humans would grow meat directly from animal cells, rather than raising animals on farms. It wasn’t until 2015 that a company, Upside Foods, was launched to give it a shot.
This summer, eight years after its founding, the startup sold its first “cell-cultivated” product — chicken grown from animal cells, no slaughter required — at an upscale restaurant in San Francisco, after the US Department of Agriculture gave final approval. Another startup, GOOD Meat, gained final regulatory approval on the same day and is selling its cell-cultivated chicken at a José Andrés restaurant in Washington, DC.
Each company is serving up very limited quantities of meat, so it’s nowhere near coming close to displacing conventional meat. The two startups, and the other 150 or so cell-cultivated meat companies around the world, have a long way to go to scale up their technology and bring prices down to compete with farmed meat. It’s far from certain they’ll ever get there. But it’s promising that, in under a decade, the nascent field has made major technological and political strides in the attempt to transform the inefficient, inhumane, and unsustainable factory farming system. —KT
Governments around the world are investing in a meat-free future
Animal farming accounts for around 15 to 20 percent of global greenhouse gas emissions, yet governments have invested only about $1 billion since 2020 in developing meat alternatives, and very few policymakers have proposed initiatives to help humanity cut back on its meat consumption. By comparison, governments have invested $1.2 trillion since 2020 to scale up clean energy.
The lack of attention to making food production more sustainable is starting to change, and some big developments occurred this year.
Most notably, the government of Denmark invested nearly $100 million into a fund to help farmers grow more plant-based foods and companies develop meat- and dairy-alternative products. It also launched the world’s first “action plan” to guide new plant-based food initiatives, like training chefs to cook plant-based meals, reforming agricultural subsidies, and increasing exports of Danish plant-based food products. South Korea announced a similar plan this year too, while German policymakers are putting 38 million Euros toward building up the country’s plant-based industry sector and helping farmers transition to growing plant-based foods amid falling meat production and consumption.
Canada announced a renewal of $110 million into its multi-year program for plant-based food R&D and investments in plant-based companies, while Catalonia, the UK, and other countries also put down money this year to develop alternative proteins.
Much more is needed, and fast, but increasingly, policymakers are grasping the necessity of transforming food systems in order to meet critical climate goals. —KT
Europe is quickly phasing out the ugly practice of “male chick culling”
Each year, the global egg industry hatches 6.5 billion male chicks, but because they can’t lay eggs and they don’t grow big or fast enough to be efficiently raised for meat, they’re economically useless to the industry. So they’re killed hours after hatching, and in horrifying ways: ground up or burned alive, gassed with carbon dioxide, or suffocated in trash bags.
In the last five years, however, scientists have begun to commercialize technologies to identify the sex of a chick while still in the egg, enabling egg hatcheries to destroy the eggs before the males hatch. The first machine came online in Europe in 2018, and the technology is now being adopted by European egg companies at a rapid pace.
According to the animal welfare organization Innovate Animal Ag, at the end of September 2023, 15 percent — or 56 million — of Europe’s 389 million egg-laying hens came from hatcheries that use this technology. That percentage is expected to further rise in the years ahead as several more egg-scanning machines will come online soon.
In the realm of animal farming, technology is often deployed in ways that hurt animals, like breeding them to grow bigger and faster while sacrificing their health and welfare. But here, it’s used to end one of the industry’s cruelest practices. I hope we’ll see even more technologies used for good in the food and farming sectors in the years ahead. —KT
The FDA has approved the first-ever gene editing treatment for use in humans, offering a cure for sickle cell disease
In December, the Food and Drug Administration approved the first-ever therapy using CRISPR gene editing technology for patients 12 and older, offering a potential cure for sickle cell disease (SCD). The disease affects 100,000 people in the US and millions more abroad. Prior to the approval, the only cure for SCD was a bone marrow transplant, a procedure that requires a compatible donor, and kills 5 to 20 percent of patients.
SCD is a collection of inherited blood disorders where a mutation in hemoglobin, a protein found in red blood cells, shapes them into crescents (”sickles”) that restrict blood flow and limit oxygen delivery across the body’s tissues, causing severe pain and organ damage.
The new therapy, under the brand name Casgevy, uses CRISPR like a molecular pair of scissors. It edits a specific portion of a patient’s DNA to make bone marrow cells produce more fetal hemoglobin, which boosts oxygen delivery. In clinical trials, 29 of 31 patients who received treatment were cured of the events that cause pain and organ damage. A second therapy was also approved, Lyfgenia, which adds to a patient’s DNA the functional hemoglobin genes that are resistant to sickling.
As with many novel therapies that rely on frontier technology, the treatment will be expensive, time-consuming, and unavailable to the majority of those in need. At least at first. Roughly three-quarters of those living with sickle cell disease are concentrated in sub-Saharan Africa. And with price tags of $2.2 million for Casgevy and $3.1 million for Lyfgenia, they remain a pipe dream for most (though racking up payments across a lifetime of SCD is also expensive, averaging about $1.7 million for those with insurance).
Still, the news of a cure is providing hope to millions who live with severe chronic pain, and the question of how to expand accessibility is already at the forefront of many doctors’ minds. Clearing the major hurdle of getting the first-ever gene editing therapy approved for use in humans will allow experts to turn their attention to the question of how to make the treatment available for the millions of people with SCD whose lives could be dramatically improved by it. —OJ