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    CDC in crisis: who are the top officials resigning or being forced out?

    A dispute over the dismissal of Susan Monarez, director of the US Centers for Disease Control and Prevention (CDC), has intensified, with her attorneys asserting she will not leave unless the president himself takes action.Monarez was officially removed late on Wednesday following a heated exchange in which the US health secretary, Robert F Kennedy Jr, attempted to oust her, according to the White House. Her lawyer has countered that Monarez has no intention of resigning.As she was confirmed by the Senate, unlike previous CDC directors, Monarez technically serves at the will of the president, so Kennedy alone may not have had the authority to terminate her.Monarez, an infectious disease expert, was sworn in just a month ago by Kennedy but soon found herself at odds with him over vaccine policy, according to individuals familiar with the matter. In the wake of her removal, four senior CDC leaders abruptly resigned, apparently out of frustration with Kennedy’s approach to vaccines and his management style.Here’s a breakdown of the CDC leaders involved.Susan Monarez Director, Centers for Disease Control and Prevention View image in fullscreenMonarez is a microbiologist with bachelor’s, master’s and doctoral degrees from the University of Wisconsin. She joined the CDC as principal deputy director in January 2025, briefly served as acting director, and was confirmed by the Senate as the agency’s 21st director on 31 July. She became the first director without a medical degree and the first confirmed under a 2023 law.On 27 August, she was dismissed over conflicts about vaccine policy, a move her legal team has argued was improper because only the president has the authority to remove her.Debra HouryFormer chief medical officer and deputy director for program and science at the CDCView image in fullscreenHoury, a physician with degrees from Emory University and Tulane University, previously worked as an emergency doctor and at various facilities in Atlanta, as well as serving in academic leadership roles. At the CDC, she served as chief medical officer and deputy director for program and science.She resigned in late August 2025 following Monarez’s removal, citing the spread of vaccine misinformation, looming budget reductions and political meddling that she said undermined the agency’s mission.Demetre DaskalakisFormer director of the National Center for Immunization and Respiratory Diseases at the CDCView image in fullscreenDaskalakis, a public health physician known for his leadership in HIV prevention and vaccination programs, led the CDC’s National Center for Immunization and Respiratory Diseases. He received his medical degree from the NYU School of Medicine and completed postgraduate medical training at Harvard Medical School in 2003, before joining the CDC in 2020 as director of the division of HIV/Aids Prevention.He resigned from the CDC on 28 August, publishing a letter that denounced political interference, data manipulation and what he called a decline in scientific integrity.Daniel JerniganFormer director of the National Center for Emerging and Zoonotic Infectious Diseases at the CDCView image in fullscreenJernigan, a longtime CDC official, directed the National Center for Emerging and Zoonotic Infectious Diseases and played a key role in influenza and pandemic preparedness. Jernigan first joined the CDC’s epidemic intelligence service in 1994 and worked in the respiratory diseases branch on the prevention and control of bacterial respiratory pathogens.He left his position in August 2025 after Monarez’s ouster, joining other top officials in objecting to what they saw as the politicization of science and diminished trust in the agency’s leadership.Jennifer LaydenFormer director of office of public health data, science, technology at the CDCView image in fullscreenLayden, who led the office of public health data, surveillance, and technology at the CDC, focused on modernizing outbreak tracking and response systems. Layden received both her doctor of medicine and her doctorate in epidemiology from the University of Illinois at Chicago.Formerly Illinois’ chief medical officer, she also resigned after Monarez’s removal in August 2025, warning about the damaging effects of political influence on science-based decision-making. More

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    Burner phones, wiped socials: the extreme precautions for visitors to Trump’s America

    Keith Serry was set to bring a show to New York City’s Fringe festival this year, but pulled the plug a few weeks out. After 35 years of traveling to the United States, he says he no longer feels safe making the trip.“The fact that we’re being evaluated for our opinions entering a country that, at least until very recently, purported to be an example of democracy. Yeah, these are things that make me highly uncomfortable,” said Serry, a Canadian performer and attorney.“You’re left thinking that you don’t want to leave evidence of ‘bad opinions’ on your person.”Serry is among a substantial cohort of foreign nationals reconsidering travel to the US under the Trump administration, after troubling reports of visitors facing intense scrutiny and detention on arrival.In March, a French scientist who had been critical of Donald Trump was refused entry to the US after his phone was searched. An Australian writer who was detained and denied entry in June said he was initially grilled about his articles on pro-Palestinian protests, and then watched as a border agent probed even the most personal images on his phone. He was told the search uncovered evidence of past drug use, which he had not acknowledged on his visa waiver application, leading to his rejection. German, British and other European tourists have also been detained and sent home.More than a dozen countries have updated their travel guidance to the US. In Australia and Canada, government advisories were changed to specifically mention the potential for electronic device searches.On the advice of various experts, people are locking down social media, deleting photos and private messages, removing facial recognition, or even traveling with “burner” phones to protect themselves.In Canada, multiple public institutions have urged employees to avoid travel to the US, and at least one reportedly told staff to leave their usual devices at home and bring a second device with limited personal information instead.“Everybody feels guilty, but they don’t know exactly what they’re guilty of,” said Heather Segal, founding partner of Segal Immigration Law in Toronto, describing the influx of concerns she’s been hearing.“‘Did I do something wrong? Is there something on me? Did I say something that’s going to be a problem?’”She advised travelers to assess their risk appetite by reviewing both the private data stored on their devices and any information about them that’s publicly accessible, and to consider what measures to take accordingly.US Customs and Border Protection (CBP) has broad powers to search devices with minimal justification. Travelers can refuse to comply, but non-citizens risk being denied entry. CBP data shows such searches are rare; last year, just over 47,000 out of 420 million international travelers had their devices examined. This year’s figures show a significant increase, with the third quarter of 2025 reflecting an uptick in electronic device searches higher than any single quarter since 2018, when available data begins.“Anecdotally, it seems like these searches have been increasing, and I think the reason why that’s true is, undoubtedly, I think they are more targeted than before,” said Tom McBrien, counsel at the Electronic Privacy Information Center.“It seems like they are targeting people who they just don’t generally like politically.”Travelers who are concerned about their privacy should consider minimizing the amount of data they carry, McBrien said.“The less data you have on you, the less there is to search, and the less there is to collect,” he said. Beyond using a secondary device, he suggested securely deleting data, moving it to a hard drive or storing it in a password-protected cloud account.A Department of Homeland Security (DHS) spokesperson rejected claims that CBP had stepped up device searches under the new administration or singled out travelers over their political views.“These searches are conducted to detect digital contraband, terrorism-related content, and information relevant to visitor admissibility, all of which play a critical role in national security,” the spokesperson told the Guardian in a statement.“Allegations that political beliefs trigger inspections or removals are baseless and irresponsible.”The statement acknowledged, however, that there had been heightened vetting under Trump and the homeland security secretary, Kristi Noem.skip past newsletter promotionafter newsletter promotion“Under the leadership of the Trump Administration and Secretary Noem, we have the most secure border in American history,” it said. “This has allowed CBP to focus to actually vet and interview the people attempting to come into our country.”Alistair Kitchen, the Australian writer who was denied entry to the US in June, said the DHS’s denial of political targeting directly contradicts what he was told on arrival.Border officials “bragged actively that the reason for my targeting, for my being pulled out of line for my detainment, was explicitly because of what I’d written online about the protests at Columbia University”, he told the Guardian.While he doesn’t plan to return to the US under the Trump administration, Kitchen said that if he ever did, he would either not take a phone or bring a burner.“Under no conditions would I ever hand over the passcode to that phone,” he added. “I would accept immediate deportation rather than hand over the passcode. People should think seriously before booking travel, especially if they are journalists or writers or activists.”Various foreign nationals told the Guardian they are rethinking travel plans for tourism, family visits, academic events and work.Donald Rothwell, a professor who teaches international law at the Australian National University, says he no longer plans to accept speaking invitations to the US over fears of being detained or denied entry – which, he noted, could also trigger red flags on his record for future travel.He’s even considered traveling without a device at all, but is concerned his academic commentary in the media could be used against him regardless.“I might be commenting on matters that could be quite critical of the United States,” he said. “For example, I was very critical of the legal or lack of legal justification for the US military strikes on Iran in June.”Kate, a Canadian whose name has been withheld due to privacy concerns, said she has wrestled with complicated decisions about whether to travel across the border to see American relatives, including for an upcoming wedding. During a trip earlier this year, she deleted her social media apps before going through customs.Despite DHS assurances that travelers are not flagged for political beliefs, she said “it’s hard to believe things that this government is saying”.“It would be really nice to have trust that those kinds of things were true, and that these kinds of stories that you hear, while absolutely horrific, are isolated incidents,” she said.“But I do feel like in many ways, the United States has sort of lost its goodwill.” More

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    ‘Impossible to rebuild’: NIH scientists say Trump cuts will imperil life-saving research

    Last week, the office of management and budget (OMB) revealed plans to freeze all outside funding for National Institutes of Health research this fiscal year, but reversed course later that day, leaving the scientific community in a state of whiplash. A senior official at the NIH who spoke on condition of anonymity said this was just the latest in a “multi-prong” approach by the Trump administration to destroy American scientific research.In July, the National Cancer Institute, which is part of the NIH, updated its website to reflect Trump administration plans to significantly cut cancer research spending as well. Since January, the administration has been cancelling NIH grants, in some cases targeting other specific research areas, such as HIV treatment and prevention.“It’s really, really bad at NIH right now,” said the official, who added that researchers working outside the NIH have been unaware of the severity of the situation until recently, even though they have also faced funding upheaval since the winter.“The Trump administration is, for the first time in history, substantially intervening inside NIH to bring it under political control,” the official said. “That’s what we saw this week with the OMB freeze on funding.”“I think the core of it is that they want to destroy universities, or at least turn them into rightwing ideological factories,” the official said, since the majority of the NIH’s grants are distributed to researchers in universities, medical schools and similar institutions.In 2021, JD Vance gave a speech entitled The Universities Are the Enemy. The official said they were alarmed at how little universities are fighting back – many have settled with the administration, which has “gotten Columbia to completely knuckle under. One of America’s most significant universities and a place that is a worldwide magnet for talents. Same thing at Penn. Now they’re going after UCLA.”Institutions such as the National Academies of Sciences, Engineering, and Medicine have also stayed on the sidelines, refusing to sufficiently resist Trump, the official said.If the administration does manage to freeze NIH funding, it will push to rescind the funds permanently using a rescission motion, the official said. This type of motion only requires a simple majority of 50 votes to pass the Senate, instead of the supermajority necessary to beat a filibuster. Republicans would have enough votes to “ram through these motions to effectively cut the budget without Democrats in Congress weighing in. It’s an ongoing disaster.”Researchers at the many universities where the administration has frozen funding, such as Northwestern University in Evanston, Illinois, are starting to feel the gravity of the situation, said the official. Carole LaBonne, a biologist at Northwestern, said “university labs are hanging by a thread”, explaining that even though the OMB reversed its decision to freeze outside NIH funding, “the baseline reality is not much better”.Other recent changes at the NIH include allocating research grants all at once rather than over multiple years, so that fewer projects are funded. Reductions in cancer research funding also mean that only 4% of relevant grant applications will move forward. “This will effectively shut down cancer research in this country and destroy the careers of many scientists. This is devastating,” LaBonne said.The extreme uncertainty surrounding scientific research is also negatively affecting scientists’ mental health. “I do not know any faculty who are not incredibly stressed right now, wondering how long they will be able to keep their labs going and if/when they will have to let laboratory staff go,” LaBonne said. “It also very hard to motivate oneself to write grants, a painstaking and time-intensive processes, when there is a 96% chance it will not be funded.”Ryan Gutenkunst, who heads the department of molecular and cellular biology at the University of Arizona, said: “The chaos at NIH is definitely freaking [faculty and students] out and wasting huge amounts of emotional energy and time. We were emailing about the latest pause, only to find it unpaused hours later.”skip past newsletter promotionafter newsletter promotionThe senior NIH official found last week’s events unsurprising, they said: “They’re throwing everything at the wall to stop NIH from spending. What struck me was that many of my colleagues at universities were like, ‘Oh, my God, they’re stopping grants.’ And it really seemed to activate people in a way that I hadn’t seen before, whereas a lot of us at NIH thought, ‘Oh, they just did another thing.’”Science is an engine for American economic dominance, and scientific clusters such as Silicon Valley could not exist without federal funding, the official said. “Once you break them, it will be impossible to rebuild them. We’re on the path to breaking them.”LaBonne said she worried about the impact on progress in cancer specifically. “My own research touches on pediatric cancers. Forty years ago more than 60% of children diagnosed with cancer would have died within five years of diagnosis. Today there is a 90% survival rate. We should not put progress like that in danger,” she said.Although many major scientific institutions have complied with the administration, grassroots organizations and individual scientists, including those within the NIH, are finding ways to resist.The senior NIH official said they were most hopeful about grassroots organizers who are resisting the Trump administration openly, rather than relying on older strategies such as litigation and negotiations with Congress. For example, Science Homecoming, a website to promote science communication, is encouraging scientists to get the word out about the importance of federal funding to their home towns.The Bethesda Declaration, signed by 484 NIH staff, directly accused NIH director Jay Bhattacharya of “a failure of your legal duty to use congressionally appropriated funds for critical NIH research. Each day that the NIH continues to disrupt research, your ability to deliver on this duty narrows.” More

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

    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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    ‘It’s back to drug rationing’: the end of HIV was in sight. Then came the cuts

    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

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    Trump’s NIH pick makes pitch for good science – in this administration?

    Donald Trump’s nominee to run the National Institutes of Health (NIH), Jay Bhattacharya, told senators he was committed to ensuring scientists “have the resources they need” – even as the $48bn agency he hopes to lead has become a focus of the administration’s ideological war and cost-cutting efforts.At a confirmation hearing on Wednesday, Bhattacharya made a pitch for free scientific inquiry and an examination of the chronic disease epidemic, now a cornerstone of Republican health rhetoric, while hoping to serve in an administration that has frightened scientists into self-censorship.“Science should be an engine for freedom – knowledge and freedom. It shouldn’t be pushing mandates for vaccines,” said Bhattacharya, referring to pandemic-era mandates, and articulating a vein of libertarian thinking that has rejuvenated Republican health rhetoric in the time since. “If science is a force for freedom and knowledge, it will have universal support.”Bhattacharya ignored the Republican party’s role in sowing distrust of the scientific establishment, argued “good data” would change minds and, in the words of one senator, strained credulity by asserting the US president would not ask him to do anything illegal.For a man whose pandemic-era rise was built on questioning authority, some assertions landed between wishful thinking and willful blindness. But for all of Bhattacharya’s remarkable answers, dissent was muted.Some in academia now see Bhattacharya as the least bad option to run the NIH. And, after confirming Robert F Kennedy Jr, the nation’s leading vaccine critic, to lead the department of health, there is little doubt Republicans have the votes.“Maybe I’m naive, senator,” Bhattacharya said in response to a question about vaccine skepticism, “but I believe very fundamentally that research, if replicable, if done right, is so persuasive will move people to take actions.”Bhattacharya was at one time a low-profile researcher at Stanford University, himself receiving $3.7m in NIH grants, according to an agency database. His star rose among conservatives when he advocated against lockdowns in 2020. He was ostracized by the scientific establishment and blacklisted by Twitter – only to be invited to the platform’s headquarters by the billionaire Elon Musk.In turn, he became a darling of the right: hosting his own podcast devoted to questioning medical consensus, working as an expert witness in courts (even if courts did not always find him convincing) and often appearing on Catholic radio programs.But Bhattacharya’s pitch for free scientific inquiry is in striking conflict with the administration’s actions. His nomination comes as the research world has been rattled by mass firings, funding freezes, censorship and a measles outbreak that claimed the first American life in nearly a decade.Some of the most pressing questions came from the Republican senator Bill Cassidy, a physician from Louisiana who has steadfastly refused to engage in the anti-vaccine conspiracy theories peddled by some colleagues.“There is now a child who died of a vaccine preventable disease in Texas,” Cassidy said about the measles outbreak.Would the nominee spend even more taxpayer dollars to research a link between vaccines and autism when the idea has been “exhaustively” debunked?“I don’t think there’s a link between the [measles, mumps and rubella] vaccine and autism,” said Bhattacharya. “The only reason I’m not saying wholeheartedly yes” – that federal dollars could be better spent elsewhere – is “there are people who might disagree with me.”“There are people who disagree that the world is round,” Cassidy retorted. “People still think Elvis is alive.”“My sense, my inclination is to give people good data,” said Bhattacharya. “That’s how you address those concerns.”“I’m not sure at what end point we say we have good data,” said Cassidy, appearing unsatisfied.At the NIH alone, the Musk-led “department of government efficiency” (Doge) fired roughly 1,200 workers. Bhattacharya characterized this as “personnel decisions” to which he was not privy. The administration has also frozen grant funding in a probably illegal scheme, is still gumming up orders to thaw funding and is seeking to cut $4bn from grants that primarily go to universities and colleges.Trump touted his campaign to end “the tyranny of diversity, equity and inclusion policies all across the entire federal government” in his state of the union speech only the evening before – a policy that in practical terms is an ideological review of NIH grants.“I wasn’t involved in any decision making at the NIH up to this point,” was a common refrain for Bhattacharya when questioned about whether he would protect research funding.More broadly, the funding freezes and proposed cuts have sown chaos in the research world – academic institutions have frozen hiring, postgraduate researchers are struggling to find placements amid budget cuts, and delayed funding has many researchers worried their projects are on the verge of shuttering.Arguably the most pointed question of the hearing came from the Democratic senator Maggie Hassan of New Hampshire: “If directed by the president to take action that would break the law, would you follow the law or would you follow the president’s directive?”“Senator, I don’t believe the president will ever ask me to break the law,” said Bhattacharya.Hassan said: “Well, that strains credulity given, especially the last few weeks, and it’s a disappointing answer.” More

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    Saying ‘women’ is not allowed, but ‘men’ and ‘white’ are OK? I’m (not) shocked | Arwa Mahdawi

    From banning books to policing wordsThanks to the intolerant left, nobody can say the word “women” anymore! Do you remember when that was a major talking point in certain quarters? Prominent columnists wrote endless pieces declaring that the word “women” had “become verboten”. The thought police, these people claimed, were forcing everyone to say “bodies with vaginas” and “menstruators” instead. Even the likes of Margaret Atwood tweeted articles with headlines like: “Why can’t we say ‘woman’ anymore?”That, of course, was complete nonsense. While there was certainly a push for more inclusive language, nobody with any influence was trying to ban the word “women”.Now, however? Now, it’s a very different story. Thanks to Donald Trump’s sweeping executive orders attacking “gender ideology” and DEI programs, the word “women” – along with a number of other terms – is quite literally being erased. The likes of Nasa have been busy scrubbing mentions of terms related to women in leadership from public websites in an attempt to comply with Trump’s executive orders, for example. Agencies like the Centers for Disease Control and Prevention (CDC) have taken down numerous webpages related to gender in the wake of Trump’s orders – although a federal judged ordered on Tuesday that they should be reinstated.Meanwhile, the National Science Foundation (NSF) has an internal list of hot-button words (which include “women”, “gender”, “minority”, “biases”) that they are cross-referencing against active research projects and grant applications. The Washington Post reports that once one of these very dangerous words is identified, staff then have to go through a flowchart to see whether a research project should be flagged for further review.The National Institutes of Health and multiple university research departments are going through a similar dystopian exercise. Researchers at the University of California at San Diego, for example, have said their work is now at risk if it contains language deemed potentially problematic, including the word “women”.Rebecca Fielding-Miller, a UCSD public health scientist, told KPBS that the list of banned words circling in scientific communities was Orwellian and would hamper important research. “If I can’t say the word ‘women,’ I can’t tell you that an abortion ban is going to hurt women,” Fielding-Miller said.Fielding-Miller also noted that it was illuminating to see which words hadn’t been flagged as problematic. “I guess a word that’s not on here is ‘men’, and I guess a word that I don’t see on here is ‘white’, so I guess we’ll see what’s going on with white men and what they need,” Fielding-Miller added.Amid all the anxiety about what you are allowed to say in this brave new world, a lot of researchers are erring on the side of caution. Some scientists have said that they are considering self-censoring to improve their chances of getting grants. Others are gravitating towards “safe” topics – like, you know, issues that concern white men. This is a dance we’ve seen many times before: Republicans will advance ambiguous, and possibly unconstitutional, legislation. Because no one knows what the hell is going on or how they might get punished for violating these vague new laws, people self-censor and aggressively police themselves.So, I guess this is where we are now: Republicans aren’t just banning books, they’re policing words. An administration effectively fronted by Elon Musk – a self-proclaimed “free speech absolutist” – is so touchy about the language that we use that scientists are now self-censoring. It’s so prescriptive about what things are called that it’s blocking journalists from events for continuing to refer to the Gulf of Mexico instead of the Gulf of America. It’s so obsessed with controlling how we think that it’s erasing references to trans people from the website for the Stonewall national monument. Under the disingenuous guise of “restoring freedom of speech”, the Trump administration has made clear it is intent on controlling the very words we use.Errol Musk, who impregnated his former stepdaughter, says Elon is a bad dadElon Musk seems to get some of his extreme views about pro-natalism from his father, Errol, who also has multiple children. Errol has even fathered two kids with his former stepdaughter, who was only four years old when he married her mother. I bring this up because Errol is currently in the news calling Elon a terrible father. He’s certainly not wrong about that – the Tesla billionaire seems to treat his kids like props rather than people – but his statements bring to mind certain adages about pots and kettles as well as glass houses.Investigation launched into human egg trafficking ringThailand and Georgia have said they are investigating a human-trafficking ring accused of harvesting human eggs from Thai women who came to Georgia thinking they’d be surrogates. Instead, they were reportedly held captive and had their eggs harvested. This story is just the latest example of the way in which the global egg trade has given rise to black markets and abuse. Last year, for example, a Bloomberg Businessweek investigation reported that Greek police had identified up to 75 cases of alleged theft of eggs taken from the ovaries of IVF patients at a clinic on Crete.Infant mortality rates rise in US states with abortion bans, study findsJust your latest reminder that anti-abortion activists are in no way “pro-life”.Domestic violence study that strangled rats should not have been approved, animal advocates argueThe rats were non-fatally strangled as part of research that aimed to improve the detection of brain injury resulting from intimate partner violence.The Syrian feminists who forged a new world in a land of warThe Guardian has a fascinating piece on the autonomous region of Rojava, in north-eastern Syria, which has a government with arguably the most complete gender equality in the world.A pregnant woman in the West Bank was shot by Israeli soldiersSondos Shalabi, 23, was eight months pregnant. Her killing comes as Israeli settlers are unofficially annexing large areas of the occupied West Bank and escalating violence has displaced around 40,000 Palestinians. The West Bank is becoming another Gaza.How Sasha DiGiulian broke climbing’s glass ceilingThe big-wall climber talks to the Guardian about sexism in climbing – including a tendency for routes that women have climbed getting “immediately downgraded by male climbers”.The ‘puppygirl hacker polycule’ leaks numerous police filesThe group told the Daily Dot there are not “enough hacks against the police”, adding: “So we took matters into our own paws.”The week in pawtriarchyPalmerston is a black-and-white cat who was – until recently – retired after a long and distinguished career as chief mouser for the UK’s Foreign and Commonwealth Office in London. The “DiploMog” has emerged from retirement to start work work as feline relations consultant to the new governor of Bermuda. If only the US would learn from this: government needs more cats and fewer Doges. More