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The US has blocked Canadian access to a library straddling the Canada-US border, drawing criticism from a Quebec town where people have long enjoyed easy entry to the space.The Haskell Free Library and Opera House is located between Stanstead, Quebec, and Derby Line, Vermont. It was built deliberately to straddle the frontier between the two countries – a symbol of cooperation and friendship between Canada and the US.The library’s entrance is on the Vermont side. Previously, Canadian visitors were able to enter using the sidewalk and entrance on the American side but were encouraged to bring documentation, according to the library’s website.Inside, a line of electrical tape demarcates the international boundary. About 60% of the building, including the books, is located in Canada. Upstairs, in the opera house, the audience sits in the US while the performers are in Canada.Under the new rules, Canadians will need to go through a formal border crossing before entering the library.“This closure not only compromises Canadian visitors’ access to a historic symbol of cooperation and harmony between the two countries but also weakens the spirit of cross-border collaboration that defines this iconic location,” the town of Stanstead said in a press release on Thursday.US Customs and Border Protection did not immediately respond to queries posed on Friday.In a statement to Reuters, a Department of Homeland Security spokesperson said the US was responding to drug trafficking.“Drug traffickers and smugglers were exploiting the fact that Canadians could use the US entrance without going through customs. We are ending such exploitation by criminals and protecting Americans,” the statement said.The department provided no evidence of drug trafficking or smuggling and did not immediately respond to a request for additional information.In 2018 a Quebec man named Alexis Vlachos pleaded guilty in a Vermont court to charges relating to a plot to use the library to smuggle backpacks full of handguns into Canada on at least two occasions. He was later sentenced to 51 months in a US prison.Relations between the United States and Canada, longtime allies, have deteriorated since Donald Trump threatened to annex Canada as the 51st state and imposed tariffs.The library is a relic of a time when Americans and Canadians could cross the border with simply a nod and a wave at border agents, residents say. It was the gift of a local family in the early 1900s to serve the nearby Canadian and American communities.A small group of American and Canadian protesters gathered outside on Friday.Peter Welch, a Democratic senator from Vermont, called reports of the closure troubling.“Vermont loves Canada. This shared cultural institution celebrates a partnership between our two nations,” Welch said on X. More
This year the world should have been “talking about the virtual elimination of HIV” in the near future. “Within five years,” says Prof Sharon Lewin, a leading researcher in the field. “Now that’s all very uncertain.”Scientific advances had allowed doctors and campaigners to feel optimistic that the end of HIV as a public health threat was just around the corner.Then came the Trump administration’s abrupt cuts to US aid funding. Now the picture is one of a return to the drugs rationing of decades ago, and of rising infections and deaths.But experts are also talking about building a new approach that would make health services, particularly those in sub-Saharan Africa, less vulnerable to the whims of a foreign power.The US has cancelled 83% of its foreign aid contracts and dismantled USAid, the agency responsible for coordinating most of them.Many fell under the President’s Emergency Plan for Aids Relief (Pepfar) programme, which has been the backbone of global efforts to tackle HIV and Aids, investing more than $110bn (£85bn) since it was founded in 2003 and credited with saving 26 million lives and preventing millions more new infections. In some African countries it covered almost all HIV spending.View image in fullscreenThere is a risk, says Lewin, director of Melbourne University’s Institute for Infection and Immunity and past president of the International Aids Society, of “dramatic increases in infections, dramatic increases in death and a real loss of decades of advances”.There is no official public list of which contracts have been cancelled, and which remain. It appears that virtually no HIV-prevention programmes funded by the US are still in operation, save a handful principally providing drugs to stop pregnant women passing on the infection to their babies. Countries report disruption to the most basic measures, such as condom distribution.Some treatment programmes have been spared, but not those whose focus conflicted with the Trump administration’s war on “gender ideology” or diversity, equity and inclusion (DEI), such as those working with transgender communities. Doctors, nurses and other healthcare workers have been laid off, while worried patients are hoarding drugs or stretching supplies, according to UNAids surveillance. UNAids itself has lost more than half of its funding.Even programmes that have survived the cull have faced turmoil since February, with instructions to stop work rescinded but with no certainty that funding will continue.View image in fullscreenIn only one example, the Elizabeth Glaser Paediatric Aids Foundation says it has had to halt HIV treatment for 85,000 people in Eswatini, including more than 2,000 children, and tests for thousands of pregnant women and babies to prevent transmission and begin life-saving medication.Access to drugs represents an “immediate crisis”, Lewin says. “If people with HIV stop the medications, then not only do they get sick themselves, which is tragic, but they also then become infectious to others.”As clinics on the frontline of treating the disease scrabble to secure access to basic drugs, scientists at this month’s Conference on Retroviruses and Opportunistic Infections in San Francisco were hearing that HIV might soon be preventable with a once-a-year injection.The drug lenacapavir was already generating huge excitement in the field, after trial results showed that a six-monthly jab could prevent HIV. New results from the manufacturer Gilead suggest that a tweak to the formula and how it is given could see its protective effects last even longer.Nevertheless, Lewin says, the mood at the meeting, packed with many of the world’s leading HIV specialists, was “dire”.As well as programme cancellations, there are “huge concerns around science and what’s going to happen to the [US] National Institutes of Health, [whose] funding of science has been so significant on every level”, she says.Some scientists in receipt of US funding have been told to remove their names from DEI-linked research, she says, even though DEI is fundamental to the HIV response.View image in fullscreen“I don’t mean that in a sort of touchy-feely way, I mean that’s what we need to do: you need to actually get those treatments to these diverse communities.”In 2022, 55% of all new HIV infections were within “key populations”, such as gay men, other men who have sex with men, sex workers, transgender people, prisoners and people who inject drugs.Prof Linda-Gail Bekker, of South Africa’s Desmond Tutu Health Foundation, has seen US funding for three trials of potential HIV vaccines involving eight countries cancelled and only reinstated after an appeal to the US supreme court.“We’re running around like chickens without heads to at least get one going, because the vaccines are sitting in the fridge and will expire,” she says.She led the lenacapavir trial that showed it offered 100% protection to young women in sub-Saharan Africa, but now worries about HIV/Aids prevention “falling off the radar completely”.The global community had been making headway towards the United Nations’ goal of ending Aids by 2030, she says, with a five-year plan to use “amazing new innovative tools and scale them up”, which would have led to “less dependence on foreign aid and more self-reliance” as new infections fell and attention shifted to maintaining treatment for people with HIV.“All of that is hugely at risk now because, without these funds, our governments will have to step up but they will concentrate on treatment,” she says. “We know they will do that, because that is what we did for the first 30 years.”Efforts to control Aids were entering “the last mile”, which was always likely to be more expensive, she says. “The people who were happy to come into health facilities, they would have come into health facilities.”It would be difficult to rely on government funding to reach the remaining groups, she says, not only because of fewer resources but also because in some countries it means targeting groups whose existence is illegal and unrecognised, such as sex workers or sexual minorities, and young girls may be reluctant to use government clinics if they are not supposed to be sexually active.“I feel like the odds are very stacked against us,” says Bekker, adding: “We’re obviously going to have to re-programme ourselves [and] formulate a different plan.”Pepfar had pledged funding to the Global Fund to Fight Aids, Tuberculosis and Malaria, to deploy 10m doses of lenacapavir in low-income countries. While the Global Fund has promised to maintain its commitment, it might receive fewer than the planned number of doses, Bekker fears.“Six months ago, I was saying the best thing we can do with lenacapavir is offer it to everybody in a choice environment. [Now] I think we’re gonna have to say who needs [injectable] prep,” she says, “and the rest have to do the best they can.“How do we make that decision? And what does that look like? It is back to sort of rationing.“When we started ARVs [antiretroviral drugs] way back in 2000,” Bekker recalls, “you would go, ‘you get treatment; you don’t, you don’t, you don’t’.“It feels terrible … but you have to get over that. You have to say it will be infection-saving for some people. And we’ve got to make it count.”View image in fullscreenFor Beatriz Grinsztejn, president of the International Aids Society, the disruption is critical and threatens many vulnerable people. But, she adds, it could present “an important opportunity for ownership – otherwise we are always left in the hands of others”.She worries about the impact of cuts to funding on younger scientists, with their potential loss from the research field “a major threat for the next generation”. But, she adds, the HIV community is “powerful and very resilient”.There have already been calls for new ways of doing things. It is “time for African leadership”, members of the African-led HIV Control Working Group write in the Lancet Global Health. There are now plans for Nigeria to produce HIV drugs and tests domestically.Christine Stegling, deputy director of UNAids, says it began “a concerted effort” last year to develop plans with countries about how their HIV programmes could become more sustainable domestically “but with a longer timeframe … now we are trying to do some kind of fast-tracking”.Governments are determined, she says, but it will require fiscal changes either in taxation or by restructuring debt.The goal of ending Aids by 2030 is still achievable, Stegling believes. “I think we have a very short window of opportunity now, in the next two, three months, to continue telling people that we can do it.“I keep on reminding people, ‘look, we need to get back to that same energy that we had when people were telling us treatment can’t be available in the global south, right?’ And we didn’t accept it. We made it happen.“We have national governments now who are also very adamant, because they can see what can happen, and they want to make it happen for their own populations.” More
Donald Trump’s policies could leave the US more vulnerable to dangerous synthetic drug trafficking from abroad, even as the administration has vowed to stop fentanyl from entering the country, former government officials say.This week, Trump imposed tariffs on Mexico, Canada and China, ostensibly as a tactic to stem the flow of illicit drugs into the US.Jim Crotty, the former Drug Enforcement Administration deputy chief of staff, called the approach “coercive” and said it has the potential to backfire. Federal funding cuts could also leave US borders more insecure, according to Enrique Roig, a former Department of State official who oversaw Bureau of International Narcotics and Law Enforcement Affairs (INL) portfolios and who has also worked with USAid.US overdose deaths began to decrease significantly for the first time in 2023, after rising for decades. But Crotty notes this progress is fragile.“We’re seeing this decrease in overdose deaths and everyone’s still trying to suss out exactly why. I don’t think now is the time that we want to stop any of those existing efforts because we know that at least some, or a combination of them, have been working,” Crotty said.Roig agreed: “All this has to be working together in concert.”Federal funding cuts could put the US behind when it comes to drug detection technology. The global drug supply has increasingly shifted towards highly potent synthetic substances such as fentanyl and newly emerging nitazenes. Often, these drugs arrive in the US in the form of powders or precursor chemicals that take up minimal space, and are difficult to detect by odor.Roig says advanced drug detection technology is therefore vital, but Trump’s federal funding and staff cuts mean less money for the latest technology and equipment, and fewer people to install it.Ram Ben Tzion, the CEO of Publican, which provides drug detection technology to government agencies outside the US, says cutting-edge methods detect suspicious shipments even before they get to the border. Publican uses large language models to flag shipments that “don’t make sense” and are likely to contain illicit substances. For example, his company once found fentanyl precursors in a shipment to a residential address in California. The shipment claimed to contain fashion items, but came from a Chinese construction company.Similarly, the UN Container Control Programme, which has historically received state department funding, helps authorities flag suspicious shipments before they reach their destination. This program has helped authorities around the world seize hundreds of tonnes of illicit drugs each year. Roig says federal funding cuts have stalled CCP’s implementation in Mexico, even though it’s a primary security target for Trump.Some of Trump’s measures are more showy than they are constructive, Crotty and Roig said. The designation of certain cartels as terrorist organizations “doesn’t do much of anything”.It’s symbolic, says Crotty, given that they were already designated transnational criminal organizations. Other measures are a harmful waste of money, according to Roig. Just this week, for instance, the administration suspended the use of military planes to deport immigrants, including those accused of drug related crimes, due to the extravagant cost.Roig says this measure was completely unnecessary, as “Ice already has its own fleet of airplanes” that are much cheaper.Crotty is concerned the aggression could backfire.“The Mexican people are protective of their culture and their sovereignty. If you push them too hard, could it do more harm than good?” he said.Mexico sent 10,000 troops to its US border to cooperate with Trump’s demands, but Crotty says “while in a vacuum that sounds like a whole lot”, Mexico’s border is vast, and drugs are often transported in “minute quantities”. So, the US needs Mexico’s cooperation when it comes to intelligence – otherwise “you’re not going to find the proverbial needle in the haystack”, Crotty said.Roig said that “it’s important that we do this in cooperation with Mexico and not alienate them,” adding that Trump’s aggressive stance toward China could harm the Biden administration’s progress negotiating with the Chinese government to cooperate on counternarcotics initiatives.Massive USAid cuts also threaten programs intended to curb the “root causes” of the drug trade, says Roig. Some USAid-funded programs simultaneously tackled drug smuggling and another one of Trump’s key issues, migration – as cartels that traffic drugs also traffic people.When Roig worked with USAid, he says he spent a lot of time on “community violence prevention efforts”, including programs to keep young people from joining international crime organizations and cartels. (Notably, the Trump administration has purged many websites describing USAid programs.)If the drug supply does increase, it could mean US overdoses begin to rise again as well. But Crotty is worried we won’t even know if that happens. Layoffs at the Centers for Disease Control and Prevention could leave fewer people to track overdose deaths, and Trump’s attack on government data sharing could keep everyone in the dark.“ CDC maintains the overdose death dashboard. A lot of that stuff is data driven. Are they still going to have access to the data?” he said.The Guardian contacted INL and UNODC for comment. More
After years as one of US authorities’ most wanted men, the Mexican drug cartel boss Rafael Caro Quintero was brought into a New York courtroom on Friday to answer charges that include orchestrating the 1985 killing of a US federal agent.Caro Quintero pleaded not guilty to running a continuing criminal enterprise. Separately, so did Vicente Carrillo Fuentes, the leader of another cartel. Carrillo is accused of arranging kidnappings and killings in Mexico but not accused of involvement in the death of the DEA agent Enrique “Kiki” Camarena.Caro Quintero, Carrillo Fuentes and 27 other Mexican prisoners were sent on Thursday to eight US cities, a move that came as Mexico sought to stave off the Donald Trump administration’s threat of imposing 25% tariffs on all Mexican imports next week.For Camarena’s family, the arraignments marked a long-awaited moment.“For 14,631 days, we held on to hope – hope that this moment would come. Hope that we would live to see accountability. And now, that hope has finally turned into reality,” the family said in a statement thanking Trump and everyone who has worked on the case over the years.The White House, in a statement Friday ahead of the arraignments, called Caro Quintero “one of the most evil cartel bosses in the world”.In exchange for delaying tariffs, Trump had insisted that Mexico crack down on cartels, illegal immigration and fentanyl production.But members of Mexico’s security cabinet on Friday framed the transfer of the 29 prisoners as a national security decision.“It is not a commitment to the United States. It is a commitment to ourselves,” said Mexican attorney general Alejandro Gertz Manero. “The problem of drug trafficking and organized crime has been a true tragedy for our country.”Mexican security secretary Omar García Harfuch said the people sent into US custody were “generators of violence” in Mexico and represented a security threat to both countries.Caro Quintero had long been one of America’s top Mexican targets for extradition.He was one of the founders of a Guadalajara-based cartel and one of the primary suppliers of heroin, cocaine and marijuana to the US in the late 1970s and 1980s.Caro Quintero had Camarena kidnapped, tortured and killed in 1985 because he blamed the agent for a raid on a huge marijuana plantation the year prior, authorities said. Camarena’s killing marked a low point in US-Mexico relations and was dramatized in the popular Netflix series Narcos: Mexico.Caro Quintero had been 28 years into a 40-year sentence in Mexico when an appeals court overturned his verdict in 2013.After his release, he returned to drug trafficking and unleashed bloody turf battles in the northern Mexico border state of Sonora until he was arrested by Mexican forces in 2022, authorities said.skip past newsletter promotionafter newsletter promotionCaro Quintero told the Spanish newspaper El País in 2018 that he “never went back to drugs”.“Whoever’s saying it is a liar!” he said, according to the newspaper. “I’m not working any more, let’s be clear about that! I was a drug trafficker 23 years ago, and now I’m not, and I won’t ever be again.”The US, which had added Caro Quintero to the FBI’s 10 most wanted list in 2018 with a $20m reward, sought his extradition immediately after his 2022 arrest. It happened days after the Mexican and US presidents at the time, Andrés Manuel López Obrador and Joe Biden respectively, met at the White House.But the request remained in limbo as López Obrador severely curtailed his country’s cooperation with the US to protest undercover American law enforcement operations targeting Mexican political and military officials.Then, in January, a non-profit group representing the Camarena family sent a letter to the new Trump administration urging it to renew the extradition request.Carrillo Fuentes is the brother of the drug lord Amado Carrillo Fuentes, known as “The Lord of The Skies”, who died in a botched plastic surgery in 1997. Carrillo Fuentes, who was known as “The Viceroy”, continued his brother’s business of smuggling drugs over the border until his arrest in 2014.He was sentenced in 2021 to 28 years in prison for organized crime, money laundering and weapons violations.Among the others extradited are leading members of Mexican organized crime groups recently designated by the Republican administration as “foreign terrorist organizations”.They include cartel leaders, security chiefs from both factions of the Sinaloa cartel, cartel finance operatives and a man wanted in connection with the killing of a North Carolina sheriff’s deputy in 2022. More
“To me, the most beautiful word in the dictionary is tariff, and it’s my favorite word,” said Donald Trump last month. Pundits, politicians and financial markets are trying to figure out why, since he announced a week ago that he would impose tariffs on the United States’s three biggest trading partners: 25% for Mexico and Canada, and 10% for China.One theory is that tariffs can be a beautiful distraction. Trump, more than any previous US president, has fed on distractions for years, both to campaign and to govern. He can move seamlessly from one distraction to the next, like a magician preparing for the opportune moment to pull a coin from where it appears to have been hidden behind your ear.Although he still has seven weeks before he takes office, he could use a distraction that can start sooner. He has run into problems with cabinet and other appointments that require Senate confirmation. Of course he could easily find people who would do his bidding and be acceptable to a Senate with a Republican majority. But that would defeat the main purpose of nominating people who seem indefensible: to force Republican senators to display the abject subservience that Trump needs to be public, in order to ensure his unwavering dominance within his party.This is no small part of his governing strategy; it involves a big takeaway from the failures of his first term, from his point of view. The lesson is: loyalty to Trump first. Violators will be banished. And with small margins in the Senate and the House, things could begin to unravel if this core imperative goes unenforced.But the days before Trump actually takes office could also be the best time for him to use the threat of tariffs to begin bullying foreign governments for things that might benefit his allies, donors or himself. Other governments besides the three that he named are trying to figure out what they can offer Trump to avoid the economic disruption of tariffs. Christine Lagarde, the head of the European Central Bank, who does not see Trump as a friend, has urged the EU to negotiate with him, rather than adopt a retaliatory, eg tariff, response.Trump’s two offered pretexts for the tariff threat – migration and drugs, in this case fentanyl – are not credible. About 18% of the undocumented people encountered by border patrol over the past year have been from Venezuela and Cuba, two countries that have been devastated economically by sanctions imposed by the US government. If reducing immigration were really Trump’s concern, he would not have deployed sanctions that have driven millions of people from their homes to the US border; and he could end these sanctions in January by himself.Broad economic sanctions are a form of economic violence which targets civilians in order to achieve political ends, including regime change. US congressman Jim McGovern, a Massachusetts Democrat, made this clear in a letter that he wrote to Joe Biden asking for the sanctions on Venezuela to be dropped. The Trump sanctions in Venezuela in 2017 killed tens of thousands of civilians during the first year, and many more in the years that followed, including under Biden.As for fentanyl, about 75,000 people died from overdoses of this drug in 2023. But it’s difficult to see how Trump’s tariffs could help solve this problem. It’s a glaring example of how more than four decades of a failed “war on drugs”, based on criminalization of use and supply-side intervention, have made things worse. In this case the drug war has led to an innovation – fentanyl – that is vastly more powerful than heroin, much cheaper to produce, more addictive and easier to transport, distribute and produce.There is general agreement in the economic research on the effects of Trump’s trade and tariff wars in his first term as president, in which he placed tariffs on about $380bn of US imports. The overall impact on living standards for US workers and most Americans is found to be negative, with the cost of the tariffs being absorbed by US consumers. Employment overall did not increase, and may have fallen due to the negative impact of retaliatory tariffs.The economic research looking at the expected impacts of tariffs that Trump has talked about going forward also finds the impact on the US economy to be negative. And there is potential for much more damage if other countries respond with more retaliatory tariffs than they did in 2018-2020.Meanwhile, the productivity of Trump’s tariff offensive in generating distractions remains high. On Sunday he took a shot at the so-called Brics countries – Brazil, Russia, India, China and other economic powers: “We require a commitment from these countries,” Trump wrote on Truth Social, “that they will neither create a new Brics currency nor back any other currency to replace the mighty US dollar or they will face 100% tariffs and should expect to say goodbye to selling into the wonderful US economy.”None of these things will happen while Trump is in office. Nor will threats like this deter the majority of the world, when it is ready, from replacing a system of global governance that is overwhelmingly run by one country with help from the richest people in other rich countries. Our current system is one in which the “exorbitant privilege” that the dollar-based financial system bestows upon the US government gives the president the power to destroy whole economies with the stroke of a pen.But this is a longer story; for Trump it’s just another threat and another distraction in the post-truth world that he, as much as anyone, helped create. But he will need more than distractions to take this country further down the road toward de-democratization, which is what brought to him and his party the power that they now have.
Mark Weisbrot is co-director of the Center for Economic and Policy Research. He is the author of Failed: What the “Experts” Got Wrong About the Global Economy More
Donald Trump’s pick to lead the Drug Enforcement Administration (DEA), Chad Chronister, said on Tuesday that he was withdrawing from consideration.“Over the past several days, as the gravity of this very important responsibility set in, I’ve concluded that I must respectfully withdraw from consideration,” Chronister, a Florida sheriff, said in a social media post.Trump announced his intention to pick Chronister, the current sheriff of Hillsborough county, Florida, to lead the DEA on Sunday, saying he would focus on stemming the flow of fentanyl across the US border with Mexico. The agency is part of the justice department and responsible for enforcing US drug laws.Chronister did not offer further details on his decision on social media and the Trump transition team did not immediately respond to a request for comment.Chronister follows former Republican representative Matt Gaetz, Trump’s first pick to serve as attorney general, in withdrawing his name for a post in the administration. Gaetz withdrew following scrutiny over a federal sex-trafficking investigation that cast doubt on his ability to be confirmed as the country’s chief federal law enforcement officer.Trump’s pick of Chronister for the DEA job drew backlash from conservatives, who raised concerns over his actions during the Covid-19 pandemic and him saying that his office “does not engage in federal immigration enforcement activities”.In March 2020, Chronister arrested the pastor of a megachurch who held services with hundreds of people and violated a safer-at-home order in place aimed at limiting the spread of the coronavirus.“Shame on this pastor, their legal staff and the leaders of this staff for forcing us to do our job. That’s not what we wanted to do during a declared state of emergency,” Chronister said at the time. “We are hopeful that this will be a wake-up call.”US representative Thomas Massie of Kentucky was among those airing public complaints, saying Chronister should be “disqualified” for the arrest.skip past newsletter promotionafter newsletter promotionTrump’s transition team said it had reached an agreement on Tuesday with the justice department that would allow it to submit names for background checks and security clearances, needed for access to classified information. More
Anti-opioid campaigners in the US have welcomed Donald Trump’s threat to hit Mexico, China and Canada with increased trade tariffs if they do not curb the smuggling of the powerful drug driving the US opioid epidemic.Families and doctors grappling with a crisis that has claimed about 900,000 lives say the move may signal that a second Trump administration will finally get serious about tackling the flow of fentanyl into the US. But they also warn that much more needs to be done to reduce demand for opioids and to rein in the power of the pharmaceutical industry which created the epidemic.Trump said last week that he will issue an executive order on his return to the US presidency next month imposing a 25% tariff on goods from Mexico and Canada until their governments clamp down on the smuggling of fentanyl and other drugs into the US, and on people crossing the northern and southern borders illegally.The president-elect also said he will impose a 10% additional tariff on imports from China as the leading manufacturer of the precursor chemicals used by drug cartels to manufacture fentanyl, a highly potent synthetic opioid that is now the single largest cause of drug overdose deaths in the US.Ed Bisch, who lost his 18-year-old son Eddie to a prescription opioid overdose in 2001, said that tariffs are a sign that Trump “means business”.“I’m optimistic that the threat of substantial tariffs will lead to major cooperation in reducing the fentanyl poisoning of America,” he said.Bisch and other campaigners also say that some of Trump’s cabinet choices may signal a greater engagement with the crisis by the next administration, particularly as Robert F Kennedy Jr, who is nominated as health secretary, was a heroin user and the vice-president-elect, JD Vance, wrote a bestselling book, Hillbilly Elegy, about growing up in a household and region hit by drug addiction.Trump campaigned in 2016 and again this year on commitments to tackle the opioid epidemic which has devastated regions of America in ways that are often unseen in other parts. The crisis dragged entire communities deeper into poverty, drove up crime and greater dependency on welfare, and tore families apart.Millions of children have been raised by their grandparents because the intervening generation was imprisoned, dead or in no condition to parent. In West Virginia, the state worst hit by the epidemic, nearly half of all grandparents are raising their grandchildren.The opioid crisis has also played an important part in undermining public confidence in government institutions and medical practice in parts of the US because the epidemic grew out of the pharmaceutical industry pushing the wide prescribing of narcotic pain killers from which drug makers made billions of dollars with the complicity of the Food and Drug Administration (FDA). The epidemic then evolved as illegal supplies of heroin and then fentanyl drove up the death toll.But critics say Trump failed to follow through on his campaign promises in 2016 and his next administration will be a test of how really committed is he is on the issue in the face of what is likely to be major pushback from the drug industry.As president in 2017, Trump declared the opioid crisis a public health emergency.“No part of our society, not young or old, rich or poor, urban or rural has been spared this plague,” he said at the time.But two years later, the Government Accountability Office (GAO) criticised the Trump administration for a lack of coordination of efforts and failing to fulfill a legal requirement to issue a national drug control strategy.Robert Kent, who served as general counsel for the White House office of national drug control policy under Joe Biden, credits Trump with declaring the epidemic an emergency and establishing an opioid commission that issued guidelines on how to combat the crisis.“In Trump’s first term, he was the one who declared an opioid public health emergency, which is still in effect. The problem was there were no concrete actions taken specifically as a result. He didn’t put significant new resources into it,” he said.Kent said that the Biden administration put a greater emphasis on “harm reduction” such as the provision of overdose antidotes and test strips allowing drug users to detect fentanyl. But he fears those may be in danger from Republicans who see such measures as enabling drug use.Andrew Kolodny, director of Physicians for Responsible Opioid Prescribing and one of the first doctors to raise the alarm about the dangers of mass prescribing prescription painkillers, said harm reduction was necessary but did not get to the root causes of the epidemic.“It’s not hard for Trump to do better than Biden did on opioids. There were some good things that came out of the Biden administration. It was nice to see the federal government move more in a direction of harm reduction. But beyond that there wasn’t really that much done so by Biden,” he said.“When Biden ran for office, he put out a platform on how he would address the opioid crisis if he was president, and it was an excellent platform. But he never really implemented the plan.”Kolodny said that if Trump wants to have a significant impact in reducing opioid addiction he needs to create cheaper and easier access to treatment.“The vast majority of people with opioid use disorder actually want help for it. The reason they keep using fentanyl is that it’s much easier to get fentanyl and cheaper to get fentanyl than it is to get yourself onto buprenorphine or methadone treatment or find a doctor or programme that will very quickly enroll you in treatment when you ask for it,” he said.Researchers are still trying to decipher a drop in overdose deaths in the US last year. They believe better treatment and prevention are playing a part. The Drug Enforcement Administration said earlier this month that the amount of fentanyl found laced into other drugs had dropped and that they were therefore less potent and dangerous. The DEA head, Anne Milgram, attributed that to the Biden administration’s targeting of Mexican cartels and their supply chains.But Kent is cautious.“There’s a lot of people running around because we’ve seen a slight reduction in overdose deaths feeling like that’s mission accomplished when we’re only losing 93,000 people versus 111,000 a year. I would never define that as success in my world. Even within those numbers, underserved communities are being higher impacted at this point. In Black and brown communities the numbers are going up while the other numbers are going down. So there’s work to be done,” he said.Kent said he agrees with the need for an increased focus on the border.“We need to increase the number of staff at the border, just for a whole bunch of reasons, including illicit drugs coming across. There needs to be an investment in screening technology. And there needs to be a continued effort with China, trying to convince China to work with its chemical companies to stop selling the chemical precursors to the Mexican cartels so they can create the fentanyl,” he said.Bisch and others whose lives have been hit by the opioid epidemic are also keen to see broader reform of a system that enabled the drug companies to push mass prescription of opioids on the public in ways not permitted in other countries.Bisch supports Trump’s nomination for attorney general, Pam Bondi, who as Florida’s attorney general cracked down on doctors and “pill mills” churning out opioid prescriptions to anyone who would pay. In 2010, Florida dispensed more opioid prescriptions than every other US state combined as people travelled from across the country to buy the painkillers in bulk. Bisch wants to see Bondi use federal laws to prosecute the drug company executives who made false claims about the safety of prescription opioids in order to get them approved.He also backs Trump’s nomination of Kennedy, who has accused the FDA of putting the financial interests of the pharmaceutical industry ahead of people’s health by effectively encouraging the prescribing of too many drugs and the selection of Marty Makary to head the FDA. Makary has said doctors in the US prescribe too many medications compared with the rest of the world.“The best way to lower drug costs in the US is to stop taking drugs we don’t need,” he told the US Senate in September.In nominating Makary, Trump said the “FDA has lost the trust of Americans and lost sight of its primary goal as a regulator”. He said Makary and Kennedy would work together to “properly evaluate harmful chemicals poisoning our nation’s food supply and drugs”.Bondi is expected to have a relatively easy path to approval by the US Senate. But Kennedy and Makary may face a more difficult time. Kennedy, in particular, will face scrutiny over his rejection of vaccines. But Kolodny said they will also be up against the pharmaceutical industry.“I’ll actually be shocked if Kennedy gets confirmed and if Makary gets confirmed for FDA commissioner because big pharma doesn’t want them, and big pharma has a lot of muscle on Capitol Hill,” he said. More
Claudia Sheinbaum has said her “very kind” phone conversation with Donald Trump, in which they discussed immigration and fentanyl, means “there will not be a potential tariff war” between the US and Mexico.The president of Mexico spoke to reporters on Thursday following Trump’s threat earlier in the week to apply a 25% tariff against Mexico and Canada, and an additional 10% tariff against China, when he takes office in January if the countries did not stop all illegal immigration and fentanyl smuggling into the US.Trump, in a post on Truth Social on Wednesday, claimed that during the phone call with Sheinbaum she had “agreed to stop Migration through Mexico, and into the United States, effectively closing our Southern Border”.During her Thursday address Sheinbaum clarified she did not agree to shut down the border.“Each person has their own way of communicating,” Sheinbaum said. “But I can assure you, I guarantee you, that we never – additionally, we would be incapable of doing so – proposed that we would close the border in the north [of Mexico], or in the south of the United States. It has never been our idea and, of course, we are not in agreement with that.”She added that the two did not discuss tariffs, but that the conversation with Trump had reassured her that no tit-for-tat tariff battle would be needed in future.On Monday this week, Trump threatened to impose a 25% percent tariff on Mexico until drugs, including fentanyl, and undocumented immigrants “stop this Invasion of our Country”. He declared that Mexico and Canada should use their power to address drug trafficking and migration and, until they do, “it is time for them to pay a very big price!”The following day, Sheinbaum suggested Mexico could retaliate with tariffs of its own.On Wednesday, however, the conversation between Sheinbaum and Trump was “very kind”, the Mexican president said. She said she told Trump of the various migration initiatives her government has undertaken, including providing resources and support to central American countries and to migrants arriving in Mexico. Potential immigrants “will not reach the northern border, because Mexico has a strategy”, Sheinbaum said.Trump “recognized this effort” by the Mexican government, Sheinbaum added.She also said Trump expressed interest in the government-driven programs to address fentanyl addiction and overdoses in Mexico. And she raised the problem of American-made weapons entering Mexico from the US to be used by drug cartels.Sheinbaum further added that she encouraged Trump to stop the blockades against Cuba and Venezuela, since “people suffer and it leads to the phenomenon of migration”.Asked by a reporter from Rolling Stone magazine that quoted anonymous Trump-aligned sources discussing a “soft invasion” of Mexico by deploying the US military inside the country against drug trafficking groups, Sheinbaum dismissed the idea, calling it “entirely a movie”.“What I base myself on is the conversation – the two conversations – that I had with President Trump, and then, at the moment, the communication we will have with his work team and when he takes office,” Sheinbaum said. “We will always defend our sovereignty. Mexico is a free, independent, sovereign country – and that is above everything else.” More
