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      in US Politics

      Conservatives are trumpeting a new abortion-pill study. One problem: it’s bogus | Moira Donegan

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      Almost two-thirds of US abortions are induced with pills. The drug mifepristone blocks the pregnancy hormone progesterone, ending the growth of the fetus. Mifepristone was designed for abortions: its primary purpose, from its development through its regulatory approval and now on the market, has always been to allow women to control their own bodies and lives by ending their pregnancies. Because it exists as a tool of women’s independence, mifepristone has been the object of controversy, misinformation and intense scrutiny for the entirety of its existence. Originally synthesized by French pharmaceutical researchers in 1980, the drug went through a rigorous, prolonged and heavily politicized approval process in the US, and wasn’t approved by the Food and Drug Administration (FDA) for the US market until 2000.The anti-abortion movement – including several prominent Republican lawmakers – is looking to undo that. Since the 2022 Dobbs v Jackson Women’s Health Organization decision that eliminated the nationwide right to abortion, women living in anti-choice states have relied increasingly on mifepristone, particularly pills shipped by mail from providers in pro-choice states who prescribe the drug via telehealth. It is estimated that as many as 20% of abortions in the US are now accessed via telehealth appointments, a technological marvel that has allowed many people living in anti-choice states to avert the worst consequences to their lives, health and dignity that were threatened by the Dobbs decision by circumventing the unjust abortion bans that their states have attempted to impose on them. Dobbs has already been devastating for American women, causing needless deaths, driving up maternal mortality, derailing women’s lives, constraining their prospects, and injuring their standing as equal citizens. The post-2022 explosion of telehealth abortion using mifepristone is the reason why the consequences have not been even worse.Now, Trump’s new FDA commissioner, Marty Makary, is under pressure to restrict access to the drug. Pressed by reporters at the Semafor World Economy Summit late last month, Makaray said that he had “no plans” to review the status of mifepristone. But he added a crucial caveat: that he would reconsider the drug’s accessibility if new information emerged about the drug’s safety. “If the data suggests something or tells us that there’s a real signal, we can’t promise that we’re not going to act on that data,” he said.As if on cue, a conservative thinktank published a new study just days later that purported to find that mifepristone caused serious adverse effects in more than 10% of patients. The study – which contradicts all previous tests of the drug and the resounding consensus of the medical field – was published by the Ethics and Public Policy Center, a rightwing advocacy group that aims to “apply the richness of the Jewish and Christian traditions to contemporary questions of law” and “push back against the extreme progressive agenda while building a consensus for conservatives”.The study was rapidly amplified on conservative social media, and was pushed by several Republican senators who had previously called on Makaray to ban mifepristone at his March confirmation hearing. Missouri’s Josh Hawley, the author of a book on “manhood” who once raised a fist in solidarity with the January 6 insurrectionists, declared in a statement directed at Makaray: “Well, the new data is here. And it’s a signal that can’t be missed: Mifepristone is not safe.” Hawley went on to urge the FDA to restrict access to the drug and revert to pre-pandemic regulations, in which mifepristone could only be dispensed by a doctor after multiple in-person visits: a regulatory regime that would cut off abortion access to millions of women in anti-choice states.But the study that is being proposed as a pretext for restricting abortion access has come under scrutiny from doctors and statisticians for its questionable methodology. Drawing from insurance claim data from 2017 to 2023, the EPPC study claims that 10% of women who take mifepristone experience “sepsis, infection, hemorrhaging, an emergency room visit, or another serious adverse event within 45 days”. This would be alarming if it were true, but it isn’t.Instead, the study seems to have been designed to dramatically overstate the side-effects of mifepristone, in part by counting the normal and intended functioning of the drug – such as vaginal bleeding as the pregnancy terminates and post-medication doctor visits to confirm the completion of the miscarriage – as serious adverse effects. The study also claimed that a vast range of health experiences in the 45 days following the medication – such as mental health symptoms – were caused by the drug, a claim that the data does not support. The EPPC study also seems to include those who were prescribed mifepristone for non-abortion uses, such as miscarriage management, as well as those who took it alone, without the standard misoprostol dose that accompanies it. The study is not peer-reviewed and has not been published in a medical journal, because its authors could not meet the standards that such publication requires: their work is not up to snuff. Dr Stella Dantas, the president of the American College of Obstetricians and Gynecologists, called the paper “seriously flawed” and said that it “manipulates data to drive a myth that medication abortion isn’t safe”.The truth is that abortion pills have a lower rate of serious complications than Tylenol, and that the anti-abortion movement is in fact a great danger to American women’s health. It is because of abortion bans – not abortion access – that women in America are facing dramatically rising rates of “sepsis, infection, hemorrhaging” and death in pregnancy. In Texas alone, the rate of sepsis in pregnant women experiencing second-trimester miscarriages increased by more than 50% in the years since the state’s near-total abortion ban went into effect, and experts say that the laws prohibiting abortion are the cause. The adverse effects that the anti-abortion movement sees in mifepristone’s availability is not a matter of women’s health, which they are indifferent to. It is women’s freedom.

      Moira Donegan is a Guardian US columnist More

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      in US Politics

      Casey Means: influencer, RFK Jr favorite – and Trump’s pick for surgeon general

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      Donald Trump nominated Casey Means, a wellness influencer and medical doctor with an inactive license for US surgeon general this week – the president’s second nominee to serve as “the nation’s doctor”.Trump abruptly withdrew his first nominee, Dr Janette Nesheiwat, before her Senate confirmation hearing, amid criticism from the right and confusion about her medical credentials.His new nominee, Means, is a 37-year-old Los Angeles-based medical entrepreneur who shot to prominence in right-leaning wellness circles by criticizing mainstream medicine and advocating for a healthier food supply.In a social media post, Trump said that Means “has impeccable ‘Maha’ credentials”.Means’s nomination is a testament to the influence of health secretary Robert F Kennedy Jr in the administration. Just a day after Trump nominated Means, he told reporters: “I don’t know her. I listened to the recommendation of Bobby.”Kennedy is the figurehead of “Make America healthy again” (Maha), a loosely defined wellness movement embraced by the right alongside vaccine skepticism, new food politics and criticism of the medical establishment.Means’s brother, self-described former food lobbyist Calley Means, already works for the administration. He serves as a senior adviser to Kennedy and as one of the secretary’s leading online mudslingers.However, major hurdles remain for Means’s nomination – including her inactive medical license and criticism from the same rightwing forces that helped tank Trump’s first nominee.“We should not toss out the window everything Casey is saying, but I would proceed with caution given her training,” said Gabby Headrick, as assistant professor and director of nutrition programs at George Washington University’s Milken School of Public Health.“Typically and historically, the person appointed to that role and confirmed is someone who has an active medical license, someone who has completed residency, and has held a leadership role in a medical institution. Casey Means does not have the resumé … She also is not trained in nutrition.”Means also faces opposition from the far right. Activist Laura Loomer, who was critical of Trump’s first nominee, is skeptical of Means – calling her “unfit” for surgeon general and promoting events with Means’s critics.Loomer previously described Nesheiwat as “a pro-Covid vaccine nepo appointee who is currently embroiled in a medical malpractice case”. Covid vaccines and the technology that underpins them have become a target of right-leaning politicians.Similarly, anti-vaccine activists have sought to reassure the “medical freedom” base of Means’s bone fides. The anti-vaccine activist John Leake argued in a newsletter: “I have not seen any evidence that Casey Means is serving the vaccine cartel with her stated objective of scrutinizing the food supply.”Means describes herself as a “medical doctor, New York Times bestselling author, tech entrepreneur … aspiring regenerative gardener, and outdoor enthusiast who lives in a state of awe for the miracle and mystery of existence and consciousness”.She and her brother wrote a bestselling book called Good Energy: the Surprising Connection Between Metabolism and Limitless Health. The pair shot to fame on the political right around the time that Kennedy dropped out of the race and endorsed Trump. They began appearing at Maha events, on former Fox News host Tucker Carlson’s podcast, on The Joe Rogan Show and on HBO’s Real Time with Bill Maher.Casey Means’s public statements about how Americans should be wary about microplastics and agricultural chemicals and the importance of organic produce could easily serve as liberal dinner-party chatter. They also show how Maha has adopted concerns once considered the dominion of the left.“The thing that is so imperative for people to understand is that the reasons we’re having surgery, the reasons why we’re getting sick, the reasons American competitiveness is plummeting, the reasons why our kids are chronically ill … are all from preventable issues,” Means told Carlson.Means has adopted more inflammatory aspects of Kennedy’s agenda – including questioning the value of vaccines and criticizing Ozempic, the blockbuster GLP-1 drug.“I bet that one vaccine probably isn’t causing autism. But what about the 20 that they’re getting before 18 months?” she said on Rogan’s podcast.Nutrition experts such as Headrick have applauded Good Energy for its effort to elevate disease prevention. But Means ignores the “root causes” of chronic conditions, she says.“Not once in this book does Casey Means point out that millions of Americans do not have access to a full-service grocery store,” said Headrick.Means graduated from Stanford University in 2014 with a medical degree, and attended residency at Oregon Health & Science University the next year, but she left in 2018 before the five-year program finished. She said she left because she became disillusioned with medicine, while professors and former classmates said it was due to stress and anxiety, per the Los Angeles Times. Her medical license lapsed in 2024, according to the Oregon medical board.By 2019, she and a few others founded Levels, a business based around selling continuous glucose monitors and a subscription health tracking app. The devices, once available only to diabetics, have become popular in the “bio-hacking” movement. Such apps also collect reams of data on their customers, a valuable asset.“I am terrified about any company having this granular a look at my life and my medical information,” said Albert Fox Cahn, the executive director of the Surveillance Technology Oversight Project.“This should be someone committed to protecting [and] promoting public health, and I’m terrified to see this administration double down on its willingness to treat health as just another commodity.”One of her co-founders is Sam Corcos, who has become a key figure in the Elon Musk-led “department of government efficiency” inside the Internal Revenue Service. The unofficial department helped eliminate more than 280,000 federal workers, including nearly a quarter of the federal health workforce. The company’s backers have also included Trump advisers.Similarly, Calley Means has also invested in health technology. He co-founded TrueMed, a business that helps people purchase wellness devices – including Levels glucose monitors – through taxpayer-subsidized health savings accounts (HSAs) and flexible spending accounts (FSAs). About one in five Americans has access to an HSA, according to the American Bankers Association. Republicans have proposed expanding the accounts for decades.Although Means’s lack of a medical license would normally be disqualifying, health law experts said they would not rule out the administration attempting an end-run around the requirement.“A medical license requires that the individual maintains her medical knowledge through mandatory continuing medical education,” Gostin told NPR. “She is not licensed and therefore should be ineligible to become surgeon general of the United States.” More

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      in US Politics

      Trump health cuts create ‘real danger’ around disease outbreaks, workers warn

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      Mass terminations and billions of dollars’ worth of cuts at the Department of Health and Human Services (HHS) have gutted key programs – from child support services to HIV treatment abroad – and created a “real danger” that disease outbreaks will be missed, according to former workers.Workers at the HHS, now led by Robert F Kennedy Jr, and in public health warned in interviews that chaotic, flawed and sweeping reductions would have broad, negative effects across the US and beyond.While Donald Trump’s administration is cutting the HHS workforce from 82,000 to 62,000 through firings and buyouts, grant cuts by Elon Musk’s so-called “department of government efficiency” (Doge) have also had a stark impact on state governments – and resulted in firings at state public health agencies.At the South Carolina department of public health, for example, more than 70 staff were laid off in March due to funding cuts.“Disease surveillance is how we know when something unusual is happening with people’s health, like when there are more food-poisoning cases than usual, or a virus starts spreading in a community,” an epidemiologist at the department, whose role was eliminated, said. “It’s the system that lets us spot patterns, find outbreaks early, and respond before more people get sick.”“When you lose public health staff, you lose time, you lose accuracy, you lose responsiveness, and ultimately that affects people’s health,” they added. “Without us, outbreaks can fly under the radar, and the response can be delayed or disorganized. That’s the real danger when these roles get cut.View image in fullscreen“It’s invisible work, until it’s not. You may not think about it day to day, but it’s protecting your drinking water, your food, your kids’ schools and your community.”A spokesperson for South Carolina’s public health department declined to comment on specifics, but noted employees hired through grants are temporary. “When funding for grants is no longer available, their employment may end, as happened with some temporary grant employees who were funded by these grants,” they said.In Washington, the HHS has been cut harder by Doge than any other federal department. Hundreds of grants to state, local and tribal governments, as well as to research institutions, have been eliminated, worth over $6.8bn in unpaid obligations.The HHS receives about a quarter of all federal spending, with the majority disbursed to states for health programs and services such as Medicare and Medicaid, the insurance programs; medical research; and food and drug safety. Trump’s budget proposal calls for cutting the department’s discretionary spending by 26.2%, or $33.3bn.RFK Jr, who has a history of promoting conspiracy theories and medical misinformation, was nominated by Trump and approved by the Senate along party lines, with Mitch McConnell the sole Republican dissenter.Following a reduction in force of 10,000 employees on 1 April, Kennedy Jr claimed 20% of the firings were in error and that those workers would be reinstated, though that has not happened.An HHS spokesperson blamed any such errors on data-collection issues, and did not comment on any other aspects of the Guardian’s reporting.Aids relief program ‘dismantled’At the Centers for Disease Control and Prevention, an operating division of the HHS, employees working on maternal and child health at the President’s Emergency Plan for Aids Relief (Pepfar) program were shocked to be included in the reduction in force, as earlier in the administration their work had received a waiver for parts of the program from federal funding freezes.All federal experts on HIV prevention in children overseas were fired as part of the reduction in force.“Our concern initially was that it was a mistake with the name. We hoped around that time it came out that there were 20% errors, that we would be included,” said an epidemiologist who was included in the reduction in force, but requested to remain anonymous as they are currently on administrative leave. They also noted that they were in the middle of planning and delivering a new pediatric HIV treatment medication set to be dispersed this year, and that that work was now at risk.View image in fullscreenThey said 22 epidemiologists in the branch of their CDC division had been fired. Pepfar was created in 2003 by George W Bush to prevent mother-to-child HIV transmission and credited with saving 26 million lives.“We were very shocked on April 1 that we were put immediately on admin leave,” said another epidemiologist affected by the reduction in force at the CDC. “We really feel our branch being cut was a mistake. The state department had said services were a priority and needed to continue, but then we were cut by HHS.”They noted HIV treatment had already stopped in regions of countries that had been reliant on USAID programs, such as Zambia.“It is one of the most successful global health programs in history, data driven with high levels of accountability and the dollars spent achieve impact. Our concern now is, yes, they are continuing Pepfar in name, but they are dismantling all the systems and structure that allowed it to succeed,” they added. “The US made a huge investment in this program in 20 years and a lot of it is now undone. We’ve now disrupted those systems that could have reduced and eventually removed US investment in these programs.”‘Long-term impact’ on US familiesInside the HHS, the Administration for Children and Families is responsible for enforcing court-ordered child-support payments. For every dollar it receives in federal funding, ACF says it is able to collect $5 in child support.A child-support specialist with the HHS, who requested to remain anonymous for fear of retaliation, said reductions in force at the department have increased workloads on those who were not fired by multiple times, making it so state and tribal agencies have no way of ensuring they are compliant with federal requirements.“The regional staff with direct oversight of the program are gone,” they said. “There are entire regions that have two staff members managing a quarter of the work for the program with no management, no support, no knowledge of the program.”After the Trump administration took office, the agency was under an unofficial stop-work order, where staff were not permitted to provide guidance or support to grantees or even answer phones, until late February, the specialist said. A reduction in force followed on 1 April, when, the child-support specialist claimed, about half the ACF staff working on child support were fired.Their department is responsible for overseeing child-support programs at state, tribal and local levels. States “could very well lose millions of dollars in funding” if ACF does not provide key training and assistance and the states do not have qualified staff, the specialist cautioned. “And that is the long-term impact to vulnerable children and families in the country.”They added: “The entire function of the program is to give economic stability to children and families, so that they do not depend on any other government program, or their reliance on these programs is lower, because the children are supported by both parents.”‘A living hell’At the Centers for Medicare and Medicaid Services, also within the HHS, one of 300 workers terminated as part of a reduction in force claimed it had been illegal, and had not followed any proper procedures. The National Treasury Employees Union has filed a grievance over how the firings were carried out, including incorrect information on notices.They explained that, on 1 April, they received a generic letter informing them of an intent of reduction in force. Hours later, they were locked out of their government logins. “We started emailing the management that was left, trying to get clarification on what our status was. Nobody could give us an answer,” the worker said.On 7 April, they discovered through their paystub that they had been placed on administrative leave, despite never receiving a notice. They didn’t receive an RIF notice until weeks later, after requesting it.“Based on my tenure, and as a disabled veteran, I should at least have a chance of reassignment,” they said. “I’m not mad about losing my job. It happens. I’ve been laid off. The first time was in the private sector, and it was way more humane, more empathetic, and I was given different offers.“This, on the other hand, is unbridled hate. This administration has gone out of their way to make it a living hell for all of its public servants.” More

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      in UK Politics

      What is chlorinated chicken and will it be sold in the UK after Trump trade deal?

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      The government has insisted Britain’s food standards would not be compromised after the UK and the US agreed on a trade deal to eliminate a series of tariffs.Agriculture is a key part of the new trade deal announced on Thursday by Sir Keir Starmer and Donald Trump. Tariffs have been reduced on US products, including beef and ethanol, in return for moves that help British cars and steel.After the deal was announced, government sources insisted imports of hormone-treated beef or chlorinated chicken, previously described as red lines for the UK in any agreement, would remain illegal.The agreement on beef provides a tariff-free quota for 13,000 tonnes of US exports, but the government said there would be no drop in food standards as a result of the deal. It also includes access to British beef exports to the US.Chlorine-washed chicken – a controversial method of cleaning farmed animals to kill bacteria – was a major product being touted as part of the deal.While evidence suggests the chlorine wash itself is not harmful, critics argue treating chicken with the chemical will allow for poorer hygiene earlier on in the production process.However, Liz Webster, founder of Save British Farming, told The Independent: “The British public is rightly appalled by chlorinated chicken and hormone-fed beef. We are an animal-loving nation that values high standards, and we must not trade them away.”Packs of ‘Brexit Selection Freshly Chlorinated Chicken’ sit on display at ‘Costupper’ Brexit Minimart pop-up store, set up by the People’s Vote campaign group, in November 2018 More

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      in US Politics

      Trump nominates Dr Casey Means, influencer close to RFK Jr, for surgeon general

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      Donald Trump has tapped Dr Casey Means, a wellness influencer with close ties to Robert F Kennedy Jr, the US health secretary, as nominee for surgeon general after withdrawing his initial pick for the influential health post.The US president said in a social media post on Wednesday that Means has “impeccable ‘MAHA’ credentials” – referring to the “make America healthy again” slogan – and that she will work to eradicate chronic disease and improve the health and wellbeing of Americans.“Her academic achievements, together with her life’s work, are absolutely outstanding,” Trump said. “Dr Casey Means has the potential to be one of the finest Surgeon Generals in United States History.”The news signals Trump’s withdrawal of his original pick for the post: Janette Nesheiwat, a former Fox News medical contributor. It marks at least the second health-related pick from Trump to be pulled from Senate consideration. Nesheiwat had been scheduled to appear before the Senate health, education, labor and pensions committee on Thursday for her confirmation hearing.Means and her brother, former lobbyist Calley Means, served as key advisers to Kennedy’s longshot 2024 presidential bid and helped broker his endorsement of Trump last summer. The pair made appearances with some of Trump’s biggest supporters, winning praise from conservative pundit Tucker Carlson and podcaster Joe Rogan. Calley Means is currently a White House adviser who appears frequently on television to promote restrictions on Snap benefits, removing fluoride from drinking water and other Maha agenda items.Casey Means has no government experience and dropped out of her surgical residency program, saying she became disillusioned with traditional medicine. She founded a health tech company, Levels, that helps users track blood sugar and other metrics. She also makes money from dietary supplements, creams, teas and other products sponsored on her social media accounts.In interviews and articles, Means and her brother describe a dizzying web of influences to blame for the nation’s health problems, including corrupt food conglomerates that have hooked Americans on unhealthy diets, leaving them reliant on daily medications from the pharmaceutical industry to manage obesity, diabetes and other chronic conditions.Few health experts would dispute that the US diet – full of processed foods – is a contributor to obesity and related problems. But Means goes further, linking changes in diet and lifestyle to a raft of conditions including infertility, Alzheimer’s, depression and erectile dysfunction.“Almost every chronic health symptom that Western medicine addresses is the result of our cells being beleaguered by how we’ve come to live,” Means said in a 2024 book co-written with her brother.Food experts say it’s overly simplistic to declare that all processed foods are harmful, since the designation covers an estimated 60% of US foods, including products as diverse as granola, peanut butter and potato chips.“They are not all created equal,” said Gabby Headrick, a nutrition researcher at George Washington University’s school of public health. “It is much more complicated than just pointing the finger at ultra-processed foods as the driver of chronic disease in the United States.”Means has mostly steered clear of Kennedy’s debunked views on vaccines. But on her website, she has called for more investigation into their safety and recommends making it easier for patients to sue drugmakers in the event of vaccine injuries. Since the late 1980s, federal law has shielded those companies from legal liability to encourage development of vaccines without the threat of costly personal injury lawsuits.She trained as a surgeon at Stanford University but has built an online following by criticizing the medical establishment and promoting natural foods and lifestyle changes to reverse obesity, diabetes and other chronic diseases.If confirmed as surgeon general, Means would be tasked with helping promote Kennedy’s sprawling Maha agenda, which calls for removing thousands of additives and chemicals from US foods, rooting out conflicts of interest at federal agencies and incentivizing healthier foods in school lunches and other nutrition programs.Nesheiwat, Trump’s first pick, is a medical director for an urgent care company in New York and has appeared regularly on Fox News to offer medical expertise and insights. She is a vocal supporter of Trump and shares photos of them together on social media. Nesheiwat is also the sister-in-law of former national security adviser Mike Waltz, who has been nominated to be Trump’s ambassador to the United Nations.Nesheiwat also recently came under criticism from Laura Loomer, a far-right ally of Trump who was instrumental in ousting several members of Trump’s national security council. Loomer posted on Twitter/X earlier this week that “we can’t have a pro-COVID vaccine nepo appointee who is currently embroiled in a medical malpractice case and who didn’t go to medical school in the US” as the surgeon general.Independent freelance journalist Anthony Clark reported last month that Nesheiwat earned her medical degree from the American University of the Caribbean School of Medicine in St Maarten, despite saying that she has a degree from the University of Arkansas School of Medicine.The surgeon general, considered the nation’s doctor, oversees 6,000 US Public Health Service Corps members and can issue advisories that warn of public health threats.In March, the White House pulled from consideration the nomination of former Florida Republican Dave Weldon to lead the Centers for Disease Control and Prevention. His skepticism on vaccines had raised concerns from key Republican senators, and he withdrew after being told by the White House that he did not have enough support to be confirmed.The withdrawal was first reported by Bloomberg News. More

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      in US Politics

      The Trump administration is defending abortion pill access in court. What?

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      The Trump administration on Monday asked a federal court to dismiss a lawsuit that takes aim at the abortion pill mifepristone – a move that stunned many observers for what seemed a defense of the drug by a president who has overseen the most dramatic rollback of abortion rights in modern US history.At first blush, it may seem a victory for abortion access – but experts worry that, in reality, the move preserves the administration’s ability to play coy about any future plans to attack abortion rights.When Donald Trump first returned to the White House earlier this year, US anti-abortion activists had high hopes for the man who helped orchestrate the downfall of Roe v Wade. They thought he might use a 19th-century anti-vice law to effectively ban abortion nationwide. Failing that, they imagined that he might use the power of the Food and Drug Administration to roll back access to mifepristone or even yank it from the market entirely.Instead, over the last few months, the Trump administration has attempted to dodge the issue entirely. The Monday request, to a Texas judge who has become a reliable vote for abortion opponents, continued that pattern.The lawsuit seeks to roll back several FDA regulatory changes that have, over the last decade, considerably expanded access to mifepristone, one of two drugs typically used in US medication abortions. It revives a lawsuit that led to a stinging 9-0 defeat for abortion rights opponents when the court ruled the lawsuit’s plaintiffs, a group of anti-abortion doctors, did not have the legal standing to sue in the first place.Rather than let the matter die, the Republican attorneys general of Idaho, Kansas and Missouri moved to take over the case as its new plaintiffs. Judge Matthew Kacsmaryk of the US district court for the northern district of Texas, where the case is being heard, agreed to let the attorneys general move forward.However, in its Monday filing, the Trump administration argued that there is no reason why the case should proceed in Texas.“At bottom, the states cannot keep alive a lawsuit in which the original plaintiffs were held to lack standing, those plaintiffs have now voluntarily dismissed their claims, and the states’ own claims have no connection to this district,” the administration wrote.Abortion rights supporters have long pointed to one reason why the case was filed in Texas: Kacsmaryk. A Trump appointee with a track record of abortion opposition, Kacsmaryk once took the unprecedented step of ruling to reverse the FDA’s 2000 approval of mifepristone, which would lead to its removal from the market.Nicole Huberfeld, a health law professor at Boston University’s School of Public Health, found it “a little funny” that the Trump administration’s filing seemed to call out its own side for judge-shopping.It is possible that Trump, who was never exactly a true believer in the anti-abortion movement, has now soured on it. While the movement helped propel him to the White House in 2016, it became something of an albatross for him in 2024, as outrage over Roe’s collapse led abortion rights to become one of the election’s top issues.Yet Huberfeld found the filing more notable for what it did not say: namely, it shied away from revealing the Trump administration’s plans for mifepristone. She believes the administration may try to change mifepristone access through the FDA, and that the legal reasoning in Monday’s filing could be used against a future lawsuit by blue states against new restrictions.“They’re basically saying that the states don’t get to just challenge FDA policy because they want to,” Huberfeld said. “Which, in my view, is a set-up for anticipating that blue states may try to challenge any changes on mifepristone rules.”FDA Commissioner Martin Makary could, for example, move to reverse regulations that permit people to dispense abortion pills through telehealth – which accounts for about a fifth of all US abortions – or eliminate mifepristone’s approval. Project 2025, the notorious playbook of policy proposals authored by the conservative thinktank the Heritage Foundation, urged the FDA to do exactly that.Last month, Makary told the Semafor World Economy Summit that he had “no plans to take action” on mifepristone. However, he added: “There is an ongoing set of data that is coming into the FDA on mifepristone. So if the data suggests something or tells us that there’s a real signal, we can’t promise we’re not going to act on that data.”Decades of studies, conducted in more than a dozen countries, have found that mifepristone is safe and effective. However, anti-abortion groups have repeatedly pushed studies that claimed to find that mifepristone is dangerous. (Some of those studies have been retracted.)“My guess is that the Trump administration is trying to walk the fine line of not looking like it’s threatening access to mifepristone while also, potentially, through the FDA trying to limit access to mifepristone,” Huberfeld said. “In other words, I don’t think the FDA’s actually going to be hands-off.” More

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      in UK Politics

      ‘Social care will collapse’: Independent readers react to family visa crackdown

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      A government crackdown on visas for overseas care workers has sparked fierce debate among Independent readers, with many warning it could tip an already fragile care system into outright collapse.New visa rules introduced by the Labour government in March 2025 have made it harder for foreign care workers to come to the UK, including preventing them from bringing children or dependents and requiring a minimum salary of £25,000. As a result, applications for Britain’s health and care worker visa have plunged by 70 per cent in a year, from 129,000 to just 26,000, at a time when more than 100,000 vacancies remain across England’s care sector.Charities such as Age UK warn that overseas staff have been “keeping many services afloat” and say care home closures could pile yet more pressure onto NHS hospitals already struggling to cope.Our readers are divided over how to respond to the growing crisis. Some argue Britain must urgently attract more overseas workers to plug critical gaps, as an ageing population and declining birth rate leave fewer working-age people to provide care. Others believe it is time to reform the benefits system, train unemployed British workers for these roles, and ensure carers, whether foreign or domestic, are paid properly and treated with respect.While views differ, few dispute the scale of the challenge facing social care today. Without decisive action, many warn that the consequences for the NHS, care homes, and vulnerable people could be dire.Here’s what you had to say:The government must be honest about care gapsWe are living in challenging times and the Government needs to speak honestly about them – and dismiss the harbingers of chaos and turmoil who are trying their hardest to get into power so they can suck us all dry. The fact is that we have more elderly than younger workers, and the birth rate has been in decline for some years. There are huge job gaps in the NHS and care homes. This has enormous implications. If we don’t have enough care workers, more elderly people and people with disabilities, and chronic health conditions will end up in the hospital, meaning that people waiting for treatment or surgery will have to wait longer. There will also be an impact on healthcare workers, such as nursing staff, which will make things worse. It is pretty annoying that political parties use issues such as net migration (which receives a pretty negative reaction) and unemployment figures as political footballs to stir up the ire of the ‘hard-working taxpayer’. The plain fact is we need more people of working age to pick up the slack. If people from other countries want to come here to work and build their lives, why not? If we don’t go down this route, we are going to end up in a much worse situation than we are already in. Some countries allow asylum seekers to work while they go through their application procedure. We should do the same where possible. That way, there won’t be such pressure on the government purse. Meanwhile, housebuilding is a number one priority. The lack of social housing is not caused by immigrants; it was caused by the policies of Margaret Thatcher, and that loophole of selling off social housing at giveaway prices must be closed. If more people are paying taxes, there will be more money to spend.Brodric11Social care will simply collapse in some partsIn some parts of the country, on this basis, social care will simply collapse. I have a small home care company as a client. They have a few foreign workers, and sorting out work visas is bureaucratic and expensive. Fortunately, they manage mostly with home-grown workers. On top of dealing with the hike in employers’ NI and above-inflation National Living Wage rise, the sector will struggle and reach a crisis point. This sector has required action for years, but political dithering and division have just made matters worse.49ninerDon’t get ill, don’t get oldSpeaking as a former NHS nurse and hospital care manager, this will completely compound the existing bed, A&E, and health logistics crisis. This isn’t a Labour Government, but hey, at least we’ve now got some local authorities that will be saved by imported MAGA policies from the new and talented Reform councillors skillfully managing local authority community care and care home funding. “Don’t get ill, don’t get old.” — Neil KinnockHerbaciousThe care my mother received was second to noneMy mother was diagnosed with terminal cancer a few years ago and died within three months of that diagnosis, as per the specialist’s prognosis. As she grew weaker, my sister (who gets paid a fair bit more than the minimum wage) tried to help my mother by moving her to be more comfortable. This resulted in my mother suffering a fractured leg, which had been weakened by cancer spreading into it. This meant that after a month of being diagnosed with three months to live, my mother was in sheer agony thanks to my sister trying to help her. For readers with empathy, you can imagine the trauma and guilt my sister felt. The NHS patched her up and she returned to die in her own home as per her wishes. The care she received from her six-person rota of African caregivers was second to none. These people were experts. Highly trained and nothing but utterly professional from start to finish. If anyone thinks for a second that I, or anyone related to me, would allow some otherwise unemployable person within a mile of my mother at this point, they have another thing coming. I will never forget the care and attention they bestowed on my mother at the end of her life.Jim987Where’s the infrastructure?ChrisMatthewsNet migration of over 1.5 million in two years. The consensus here seems to be fine, no problem… in fact, we need more. But where’s the housing, where are the extra hospitals and GP surgeries, new schools, and improvements to transport infrastructure? An extra 7.5 million in 10 years is a heck of a lot of extra people, and already we lack the housing and services to effectively look after people. Importing millions and their families isn’t the answer. We have to find another way. In 2024, there were 1 million NEETs (not in education, employment, or training) – train them up and get them working as carers, withholding benefits if they refuse.Two choicesIs this a phase the country needs to go through to understand immigration? As services are stretched and care becomes increasingly unavailable, will people recognise we have two choices? Either we allow and facilitate immigration into these roles, or we say to those on benefits: you must work in these jobs or lose benefits. Either way, the complaints will be loud and long. AI can’t help with this! A political move to bring home the reality to the electorate, where words and discussion will not work.LongsandsPay British carers moreIt’s shameful that proud British care workers have had their salaries plundered by conniving private care shareholders for over 40 years, leading to what is effectively healthcare worker slavery today. There is no easy way to restore value for our health sector other than using the supply and demand principle. Cut supply, and the unscrupulous private shareholders will pay our British carers more for their incredible work.DynamicBritainThe toughest job I ever didI did the job for four years at the age of fifty – probably the most difficult job I have ever taken on. I had no experience at all, a few days shadowing someone, and then I was left to sink or swim. I nearly sank a few times for sure. The first six months I was in total shock at the things I had to do. It was rough for sure. But you get used to the smell and mess and just get on with it. At least you could get out at the end of a visit – they could not get away from their living hell, and for some, it was hell. Poor wages and conditions; if anything goes wrong, you get the blame. Zero support – you’re on your own. And you wonder why no one wants to do it? No respect from the rest of the public at all. Yes, despite all of that, some times were very good and I got a lot from it – but four years was enough and I joined the NHS. Never looked back after that. Not many people last long if they haven’t done it before – an hour or so, and they’re running out the door.gtvv61Why do carers earn less than supermarket staff?Maybe one of the reasons there are so many shortages in the care sector is the appalling lack of pay carers get. Most of them are on minimum wage or close to it, despite it being a high-skilled and physically demanding job. Why would people do that when they can earn more working at Tesco or Starbucks? Almost everywhere else in Europe, being a carer is considered a good profession with a salary to match. Here we pay poverty wages. And yet social care in the UK is among the most expensive in Europe, so where’s the money going? Not to pay staff, that’s for sure. Maybe the councils [Reform] run should announce a huge pay rise for all their social care staff. Private providers would have to follow suit in order not to lose staff to the council care homes. Then, more UK citizens might decide that it’s a field they’d like to go into, and staff already working in the field may stay because they can make ends meet.WellActually Visa rules should require self-sufficiencyIt is usual, notably in the EU, that visas are issued for individuals, each on their own merit. After a given period without having been a burden on the state, the visa holder or a family member can apply for their own visa under family unification rules. The most important of these is that the initial visa holder must show they can support family members in full. If the follow-on members intend to work, then they must apply for a work visa, not a family visa. I’m not sure of the UK system, but it appears a bit more ‘open door’.Jonathan MillsFamily visa rules need urgent reformIn general, family visa rules need to be changed. This comes from a husband and father divided from his family by irrational financial requirements. To all the people who see any immigrant as a threat, and not an opportunity to grow the economy, I wish they could try living my life for just one day – then they would understand how ruthless these policies are. Labour must wake up to reality and understand that families belong together.EUVisaTrain the unemployed to be carersTraining always works, so get these unemployed people into training as care workers. Oh, and increase care workers’ pay at the same time, like we’ve seen for train drivers and junior doctors. I’d rather pay more for care workers than train drivers. As the years go by, we are all getting older.KeithneathImmigrants are a benefit, not a burdenOne of the many ways in which immigrants are of benefit to us is through their work in social care. People coming to our shores are a valuable resource that we can use to our advantage. Demonising them, as Reform does, is not only wrong but misguided.BigDogSmallBrainBritain must train its own workers for care“The social care sector relies on skilled overseas workers to fill posts, stabilise services, and deliver care and support to the people who need it.” Then it looks like the Brits will have to grow and train their own to stabilise the economy and the service sector. That should be a priority. Oh, and make sure qualified people aren’t excluded due to some diversity requirement.9DiamondsWho would you want looking after your loved ones?I am in a very conflicted position. My wife is dying in a care home. She needs constant medical supervision. Most of the staff are foreign nationals. Some are engineers and lawyers whose qualifications are not recognised in this country. There is a whole army of unemployed people in this country who could do the job. But who do I want looking after her? A feckless school leaver forced into work by having their benefits withdrawn, or someone who travelled halfway across the world in search of a better life?TomHawkSpain has given an amnesty to their “illegal” migrants and people working illegally for cash. They are using the skills that the migrants already have and are training them up for shortage jobs. As a result, they will have the fastest growth in Western Europe.ListenVeryCarefullyFourteen wasted yearsSadly, this Government has decided policy by dog whistle, not from the public but from Reform, while failing ideologically to address inequality and unfairness beyond easy targets. We need workers. Europe largely provided them without bringing the cultural baggage we see today, while allowing criminals to take over refugee and asylum routes simply because most people have no alternative – yet they still fail to allow such arrivals to work while their applications are assessed over months, even years, living at taxpayers’ expense in misery or detention. Now we see student visas and worker visas targeted by fraudsters as an easier route, not for essential workers who must leave their families behind. No joined-up thinking whatsoever – and 14 wasted years failing to come up with policy solutions to the UK’s problems that were hardly invisible.TopshamThe benefits system is the real problemThe number of net foreign economic migrants (i.e., those who come to work, in the vast majority of cases with higher qualifications than required for the jobs they take) is approximately the same, if not lower, than the number of chronically unemployed and NEETs. The issue is that in the UK, if you’re one of these types who can’t be bothered to study, train or work, the Government will bend over backwards to provide for you — housing, food, and a bit of extra money on top. These migrants have nothing like that in their home countries – it’s either work or starve. Put the two things together and you’ll find the solution to the problem. The benefits system needs a complete overhaul, not the immigration system. The elephant in the room is that in the UK you can afford not to work. That’s the source of 90 per cent of the issues we have. In an ideal world, the NEETs would emigrate to other countries, and we should replace them with skilled, able, and willing migrants.AgeOfStoopidThe root problemPresumably, the reason that UK residents are not volunteering to work in care is that the wages on offer are barely enough to pay the rent. That, in turn, is because rents have been encouraged to rise through the roof, not least by housing benefit, which used to be spent mainly on building and maintaining housing. At the centre of this cost-of-living crisis, in which ever fewer vital workers can afford to live in the cities where they are required, is the fact that successive governments have been robbing the poor to give to the rich, largely through privatisation and so-called austerity.ReasonTruthAndLogicOverseas staffI work in a complex care home, and some nights all of the staff on duty are from overseas. You have to wonder why Reform voters, who would rather these people not be here, don’t apply for jobs in care homes themselves.RobSacrifices are part of working abroadWhen I went to work in Switzerland, I didn’t have the automatic right to bring my family with me straight away. I would pre-book monthly EasyJet flights – out on a Friday evening, back on a Sunday night – just to see them for the first nine months. Unfortunately, these are sacrifices you have to make in your working life.VonGenschlerLabour must stop pandering to FarageIt is time for Starmer to stop pandering to Farage and act like a socialist. People are unhappy with the Government because it is not doing enough for ordinary people. The argument that the economy was in a mess when they took over is wearing thin. It was nothing like as bad as in 1945 when Labour introduced the NHS and nationalisation. Unfortunately, Starmer and co are as much in the pockets of big business and the super-rich as the Tories and Reform. Labour must get rid of Starmer, Reeves and their policies now if they are to stand any chance of stopping Farage.AlrumSome of the comments have been edited for this article for brevity and clarity.Want to share your views? Simply register your details below. Once registered, you can comment on the day’s top stories for a chance to be featured. 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      in US Politics

      My rare disease was getting closer to a cure. RFK Jr could undermine that | Jameson Rich

      by

      Since Robert F Kennedy Jr assumed control of the US health department in February, with a mandate to “[lower] chronic disease rates and [end] childhood chronic disease”, he has moved quickly to remake the US’s federal health infrastructure. But the Trump administration’s actions on medical research are already threatening that goal – and could end medical progress in this country for good.Kennedy’s office oversees the National Institutes of Health, the control center of disease research in the United States. Kennedy’s agency has killed almost 800 active projects, according to Nature, affecting medical research into HIV/Aids, diabetes, women’s health, heart disease, cancer, Alzheimer’s and more. The administration wants to cut the NIH’s budget up to 40% while consolidating its 27 agencies – separated by disease area – into just eight. Elon Musk’s Doge has been reviewing previously awarded grant funding, reportedly requiring researchers to explain how they are using their grants to advance the Trump administration’s political goals. (Audio obtained by the Washington Post suggests this “Defend the Spend” initiative may be a smokescreen, with one NIH official admitting: “All funding is on hold.”) Separately, Donald Trump has aggressively targeted universities such as Harvard and Columbia over alleged antisemitism and diversity initiatives, using federal contracts that fund research as leverage. And just recently, the NIH passed a new rule banning any university from receiving future federal grants if the universities use DEI programs or boycott Israeli firms.Medical research is a wonkish issue usually kept far away from political discussions. Even popular initiatives like former presidents Barack Obama and Joe Biden’s cancer moonshot require long-term vision in a political landscape rarely concerned with anything beyond the day’s news. But in recent years, public and private investments in medical research have seeded a wave of potential cures across major disease areas. Now, just as that wave is about to crest, RFK Jr and the Trump administration’s incursion against the NIH threatens to ensure these cures are never finished.For me, the promise of those cures is personal. At three days old, I was diagnosed with a rare version of the most common type of birth defect: congenital heart disease. CHD affects one in every 100 babies born in the US and is the leading cause of birth defect-related deaths. Congenital heart problems can range from a small hole in the heart to being born with only one ventricle. Many defects are underdiagnosed, and chances are good that you know somebody who lives with one. Even JD Vance does: his relative was born with Ebstein’s anomaly, a deformity of the tricuspid valve that has resulted in her now needing a heart transplant at the age of 12.When I was six weeks old, doctors performed the first in a series of three surgeries aimed at correcting the circulation of blood within my heart and between the other organs of my body. The final surgery in that sequence had first been described in medical journals in 1971, and crucial refinements had been made only a few years before I was brought under the knife.Before the surgery’s advent, the prognosis was grim. Many children like me died before their first birthday. Of congenital patients in the 1950s, “half died before the age of twenty”, writes cardiologist Sandeep Jauhar in his book Heart: A History. “In short, they were cardiac cripples, their existence doomed.” But after the surgery, more of us started living into adulthood. Today, most of these patients live at least another 30 years after the operation. My survival past infancy was an accident of history, the product of being born at the right moment in the lifespan of medical research. “Don’t worry,” my first surgeon told my parents when I was a child. “He’s going to long outlive you both.”But my future and the future of others like me is not guaranteed. As I grew up, my doctors acknowledged that the surgery was merely palliative, not curative – a stopgap, medicine’s way of buying me some time. With medicine advancing so quickly, though, we could hope that new solutions would be brought into existence by the time I needed them. In the decades since, we have come to understand the surgery’s long-term consequences: likely progressive damage across organ systems, leading to the need for heart or multi-organ transplants in most patients by the age of 40. Last year, shortly after turning 31, I was formally diagnosed with cardiac cirrhosis and informed that I will need a combined heart-liver transplant within the decade. The time that those early developments bought me seems to be running out.In recent years, as the patient population has grown, more of us have been able to advocate for the need for new solutions. Private foundations have started pouring tens of millions of dollars into research aimed at discovering new treatments and identifying the root causes of birth heart defects so they can be prevented. These foundations have also begun correcting an imbalance in funding – historically, pediatric cancer has received five times the amount of funding that CHD does, despite similar prevalence and mortality rates.I volunteer on the patient board of one such organization, a privately funded non-profit aimed at curing heart defects like mine. With the help of researchers and hospital systems across the country, the organization has been making remarkable progress in a short period of time. But this work relies on the infrastructure of university labs. Even before Kennedy took office, the Trump administration ordered that the NIH change how grant funding is allocated by limiting what are known as “indirect costs”, which go beyond the direct needs of a given study. But often, these costs go into funds that help universities keep their labs running: things like building operations and upgrades, legal compliance and paying researchers. Even with this support, university labs struggle to keep the lights on, and researchers are constantly fighting to secure and retain funding. (The order has since been paused by a federal judge and is the subject of continuing litigation.)Some insist the US shouldn’t be funding research with taxpayer dollars at all. Instead, they would leave the task to pharmaceutical companies and biotech firms. But this fundamentally misunderstands the reality: in the decade leading up to 2020, researchers found, government funding played a role in the development of every new pharmaceutical drug; these drugs are then sold back to patients at a premium. The research that for-profit companies do fund is narrowly focused on things that are guaranteed to make money, or to advance discoveries begun in the public sector. For example, the new blockbuster medication category of GLP-1s – Ozempic, Wegovy, Mounjaro – would not exist without a discovery that was first made by an NIH scientist. When people debate the American healthcare system, they often point to the innovations and cutting-edge treatments we’ve pioneered to support the idea that our system, while flawed, is the best in the world. That impression of a world-class system is due almost entirely to the quality and breadth of our university research infrastructure and our medical schools.Private non-profits, like the one I volunteer with, already fund a large amount of medical research. If more university labs start closing, there will be nowhere for this money to go or for this research to be performed. As Dr Kimryn Rathmell, former director of the National Cancer Institute, told the AP: “Discoveries are going to be delayed, if they ever happen.” The result will be both patients and the government spending even more money on emergency and palliative healthcare. That will only benefit the healthcare profiteers Kennedy claims to be going after: pharmaceutical companies, hospital systems and healthcare entrepreneurs such as Brad Smith, who, by some accounts, has been leading Doge’s firings within HHS.My disease isn’t the only one that will be affected by these cuts. Ongoing research has indicated that targeted mRNA vaccines may show promise in preventing or treating Aids and certain types of cancers. The technology is also being studied for its ability to treat cystic fibrosis, heart failure, sickle cell anemia and other genetic birth defects. But scientists working in these areas through the NIH have already been instructed to strike mention of mRNA vaccines from grant applications and materials, perhaps owing to Kennedy’s hostility towards vaccines and his repeated lies about mRNA technology.If the proposed funding cuts and changes at the NIH are allowed to proceed, Kennedy’s mandate to lower chronic disease rates will fail, and his failure will be obvious. We will see it in rising rates of cancer, birth defects, diabetes and other chronic illnesses. We will see it in the exodus of medical experts to other countries, and the collapse of the researcher pipeline in US universities. We will see the quality of our supposed world-class medical system crash as treatments stagnate. We will pay for this cruelty in blood and lives and lost generations.In truth, today’s congenital heart research has arrived too late to save my own life. My future is at the whim of our broken transplant system, itself already showing signs of strain under Kennedy. But I continue championing the work being done because of the hope that future children won’t be consigned to the same fate. The only thing that will have made the suffering I’ve faced worth it is if I’m a part of the last generation to do so.

      Jameson Rich is a writer and film-maker from Massachusetts who covers healthcare and culture More