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    Why the US is burning $10m worth of birth control | Moira Donegan

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    There are few better metaphors for the receding status of American women than one offered up by the Trump administration at a medical waste disposal facility outside Paris this week: rather than distribute nearly $10m worth of birth control, which had been purchased by USAID and was destined to be given to women in low-income countries, primarily in Africa, the Americans decided to burn it.The incinerated contraceptives included 900,000 birth control implants, 2m doses of injectable long-acting birth control, 2m packs of contraceptive pills and 50,000 IUDs. The medicine is just the latest in the far-reaching fallout from cuts made by the so-called “department of government efficiency,” or Doge, a project in which Elon Musk and a group of his very young, overwhelmingly male acolytes unilaterally slashed congressionally appropriated funding to government programs they did not like. The cuts have been devastating for non-profits that work to improve women’s health and safety worldwide. Sarah Shaw, an associate director at the global family planning group MSI Reproductive Choices, says that the cuts will put women at risk as they strain their health with unplanned pregnancies and seek out illegal abortions; other women who are denied access to birth control will lose out on the opportunities for education, professional development or remunerative work that can help them escape abuse, rise out of poverty, pursue their talents and ambitions and better provide for the children they already have.When MSI attempted to buy the contraceptives, the administration would only accept full price, which the organization couldn’t afford, she said. Several non-profits, including MSI, had offered to pay to ship and repackage the supplies, according to another representative. But the Trump administration refused, partially due to federal rules the prohibit the US from providing such goods to groups that perform, provide referrals for or offer education about abortions. In addition to the cost of purchasing the contraceptives, American taxpayers will now be on the hook for about $167,000 for the cost of burning them.It’s just the latest in a series of signs that the Trump administration is turning against the provision of birth control, particularly the safe, effective and woman-controlled hormonal methods that have been a cornerstone of healthcare policy for decades and which were a precondition of women’s advancement in work and education over the past 60 years.In April, the Trump administration abruptly announced that it was suspending a large swath of the domestic service grants distributed under Title X, the program meant to help low-income Americans access birth control, STD treatment and other sexual and reproductive healthcare. Of the 86 Title X grants awarded for fiscal year 2024, nearly 25% were “temporarily withheld”, mostly based on highly suspect allegations that the grant-receiving institutions – including 13 Planned Parenthood affiliates – had failed to comply with Trump executive orders banning things like DEI programs. Eight states now receive zero Title X dollars: California, Hawaii, Maine, Missouri, Mississippi, Montana, Tennessee and Utah. Alaska, Minnesota and Pennsylvania have also lost most of their contraception funding.The domestic cuts – along with the exclusion of Planned Parenthood clinics from Medicaid reimbursements – mean that American women, too, are now facing dramatically greater obstacles to accessing birth control. Clinics that relied on Title X funding are now set to close: 11 Planned Parenthood clinics already have, including in Democratically controlled states like California. Planned Parenthood says that cumulatively, the cuts could lead the organization to close about 200 of its 600 clinics nationwide – a devastating cut to abortion providers in particular that will make a wide range of reproductive services inaccessible to women regardless of where they live.But the Trump administration is not merely forcing these programs for women’s health and dignity go up in flames. They are redirecting them to better suit their preferred cultural outcome: one in which women’s lives, ambitions and talents are all subordinated to the task of childbearing. The New York Times reported last month that the White House is redirecting Title X funds that once went to birth control to instead fund an “infertility training center” and programs in something called “restorative reproductive medicine”. If Title X’s original aim was to help American women control their fertility so as to build healthier families and to enable them to pursue other aims – like learning or work – in the new administration’s version, the program exists mainly to encourage women to have more children. But the switch should not be seen as a genuine investment in infertility, an often devastating condition with which many Americans struggle. Because the new Title X priorities do not, by and large, direct more money to IVF. Trump promised, on the campaign trail, to make IVF free. But the procedure, which has opponents on the Christian right, is not included in the administration’s new priority of “restorative” reproductive medicine, a practice that avoids controversial fertility treatments; instead, doctors seek the “root cause” of a woman’s infertility, which may involve telling them they can conceive with proper diet and exercise.In government, money allocation is a statement of values. With its dramatic cuts to contraceptive funding at home and abroad, the Trump administration is making its values clear. It does not value women’s health; it does not value their dignity, their control over their own lives, their aspirations, their earning potential, their desire to be freed from ignorance, or poverty, or the abuse they suffer under the hands of husbands and fathers. It does not value their ability to control their own bodies, and by extension, it does not value their ability to enter the public sphere. It does not value their dreams, their gifts, their hard work or invention or aspiration to anything other than making babies. American women, like women everywhere, depend on birth control to live lives of freedom and to pursue their dreams. But because of the Trump administration, those dreams are going up in smoke.

    Moira Donegan is a Guardian US columnist More

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      Top medical body concerned over RFK Jr’s reported plans to cut preventive health panel

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      A top US medical body has expressed “deep concern” to Robert F Kennedy Jr over news reports that the health secretary plans to overhaul a panel that determines which preventive health measures including cancer screenings should be covered by insurance companies.The letter from the the American Medical Association comes after the Wall Street Journal reported on Friday that Kennedy plans to overhaul the 40-year old US Preventive Services Task Force because he regards them as too “woke”, according to sources familiar with the matter.During his second term, Donald Trump has frequently raged against organizations and government departments that he considers too liberal – often without any evidence. The US president, and his cabinet members such as Kennedy, have also overseen huge cuts and job losses across the US government.The taskforce is made up of a 16-member panel appointed by health and human services secretaries to serve four-year terms. In addition to cancer screenings, the taskforce issues recommendations for a variety of other screenings including osteoporosis, intimate partner violence, HIV prevention, as well as depression in children.Writing in its letter to Kennedy on Sunday, the AMA defended the panel, saying: “As you know, USPSTF plays a critical, non-partisan role in guiding physicians’ efforts to prevent disease and improve the health of patients by helping to ensure access to evidence-based clinical preventive services.”“As such, we urge you to retain the previously appointed members of the USPSTF and commit to the long-standing process of regular meetings to ensure their important work can be continued without disruption,” it added.Citing Kennedy’s own slogan of “Making America healthy again,” the AMA went on to say: “USPSTF members have been selected through an open, public nomination process and are nationally recognized experts in primary care, prevention and evidence-based medicine. They serve on a volunteer basis, dedicating their time to help reduce disease and improve the health of all Americans – a mission well-aligned with the Make America Healthy Again initiative.”According to the Affordable Care Act, public and private insurance companies must cover any services recommended by the Preventive Services Task Force without cost sharing.In a statement to MedPage Today, Department of Health and Human Services spokesperson Andrew Nixon did not confirm the reports, instead saying: “No final decision has been made on how the USPSTF can better support HHS’ mandate to Make America Healthy Again.”Reports of Kennedy’s alleged decision to overhaul the taskforce come after the American Conservative published an essay earlier this month that described the taskforce as advocating for “leftwing ideological orthodoxy”.It went on to accuse the panel of being “packed with Biden administration appointees devoted to the ideological capture of medicine”, warning that the “continued occupation of an important advisory body in HHS – one that has the capacity to force private health insurers to cover services and procedures – by leftwing activists would be a grave oversight by the Trump administration”.In response to the essay, 104 health organizations, including the American Medical Association, issued a separate letter to multiple congressional health committees in which they urged the committees to “protect the integrity” of the taskforce.“The loss of trustworthiness in the rigorous and nonpartisan work of the Task Force would devastate patients, hospital systems, and payers as misinformation creates barriers to accessing lifesaving and cost effective care,” the organizations said.In June, Kennedy removed all 17 members of a US Centers for Disease Control and Prevention panel of vaccine experts. Writing in a Wall Street Journal op-ed, he accused the committee of having too many conflicts of interest.Kennedy’s decision to overhaul the immunization panel was met with widespread criticism from health experts, with the American Public Health Association executive director Georges Benjamin calling the ouster “a coup”.“It’s not how democracies work. It’s not good for the health of the nation,” Benjamin said. More

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      Trump cracks down on homelessness with executive order enabling local governments

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      The federal government is seeking to crack down on homelessness in the US, with Donald Trump issuing an executive order to push local governments to remove unhoused people from the streets.The order the US president signed on Thursday will seek the “reversal of federal or state judicial precedents and the termination of consent decrees” that restrict local governments’ ability to respond to the crisis, and redirect funds to support rehabilitation and treatment. The order aims to “restore public order”, saying “endemic vagrancy, disorderly behavior, sudden confrontations, and violent attacks have made our cities unsafe”, according to the order.The action comes as the homelessness crisis in the US has significantly worsened in recent years driven by a widespread shortage of affordable housing. Last year, a single-day count, which is a rough estimate, recorded more than 770,000 people experiencing homelessness across the country, the highest figure ever documented.Cities and states have adopted an increasingly punitive approach to homelessness, seeking to push people out of parks and city streets, even when there is no shelter available. The supreme court ruled last year that cities can impose fines and even jail time for unhoused people for sleeping outside after local governments argued some protections for unhoused people prevented them from taking action to reduce homelessness.Karoline Leavitt, the White House press secretary, told USA Today, which first reported on the executive order, that the president was “delivering on his commitment to Make America Safe Again” and end homelessness.“By removing vagrant criminals from our streets and redirecting resources toward substance abuse programs, the Trump Administration will ensure that Americans feel safe in their own communities and that individuals suffering from addiction or mental health struggles are able to get the help they need,” she said.The president’s order comes after last year’s US supreme court ruling, which was one of the most consequential legal decisions on homelessness in decades in the US.That ruling held that it is not “cruel and unusual punishment” to criminalize camping when there is no shelter available. The case originated in Grants Pass, Oregon, a city that was defending its efforts to prosecute people for sleeping in public.Unhoused people in the US have long faced crackdowns and sweeps, with policies and police practices that result in law enforcement harassment, tickets or jail time. But the ruling supercharged those kinds of aggressive responses, emboldening cities and states to punish encampment residents who have no other options for shelter.In a report last month, the American Civil Liberties Union found that cities across the US have introduced more than 320 bills criminalizing unhoused people, the majority of which have passed. The crackdowns have taken place in Democratic- and Republican-run states alike.Advocates for unhoused people’s rights have long argued that criminalization only exacerbates the housing crisis, shuffling people in and out of jail or from one neighborhood to the next, as they lose their belongings and connections to providers, fall further into debt and wind up in increasingly unsafe conditions.During his campaign last year, Trump used dark rhetoric to talk about the humanitarian crisis, threatening to force people into “tent cities”, raising fears that some of the poorest, most vulnerable Americans could end up in remote locations in settings that resemble concentration camps. More

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      Consent decrees force schools to desegregate. The Trump administration is striking them down

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      In late April, the Department of Justice announced that it was ending a decades-long consent decree in Plaquemines parish, Louisiana, in a school district that has been under a desegregation order since the Johnson administration in the 1960s.The Plaquemines parish desegregation order, one of more than 130 such orders nationwide, was in place to ensure that the school district, which initially refused to integrate, followed the law. Many consent decrees of the era are still in existence because school districts are not in compliance with the law.Some experts, including former justice department employees, say the change in direction for the department could be worrying.These orders “provide students with really important protections against discrimination”, said Shaheena Simons, who was the chief of the educational opportunities section of the civil rights division at the justice department for nearly a decade. “They require school districts to continue to actively work to eliminate all the remaining vestiges of the state-mandated segregation system. That means that students have protections in terms of what schools they’re assigned to, in terms of the facilities and equipment in the schools that they attend. They have protection from discrimination in terms of barriers to accessing advanced programs, gifted programs. And it means that a court is there to protect them and to enforce their rights when they’re violated and to ensure that school districts are continuing to actively desegregate.”The justice department ended the Plaquemines parish desegregation order in an unusual process, one that some fear will be replicated elsewhere. The case was dismissed through a “joint stipulated dismissal”. Previously, courts have followed a specific process for ending similar cases, one in which school districts prove that they are complying with the court orders. That did not happen this time. Instead, the Louisiana state attorney general’s office worked with the justice department in reaching the dismissal.“I’m not aware of anyone, any case, that has [ended] that way before,” said Deuel Ross, the deputy director of litigation of the Legal Defense Fund (LDF); the LDF was not specifically involved with the Plaquemines parish case. “The government as a plaintiff who represents the American people, the people of that parish, has an obligation to make sure that the district has done everything that it’s supposed to have done to comply with the federal court order in the case before it gets released, and the court itself has its own independent obligation to confirm that there’s no vestiges of discrimination left in the school district that are traceable to either present or past discrimination.”Despite the district not proving that it is compliant with the order, the justice department has celebrated the end of the consent decree.“No longer will the Plaquemines Parish School Board have to devote precious local resources over an integration issue that ended two generations ago,” Harmeet K Dhillon, assistant attorney general of the justice department’s civil rights division, said in a statement announcing the decision. “This is a prime example of neglect by past administrations, and we’re now getting America refocused on our bright future.”But focusing on the age of the case implies that it was obsolete, according to Simons, who is now the senior adviser of programs and strategist at the Lawyers’ Committee for Civil Rights Under Law. “The administration is trying to paint these cases as ancient history and no longer relevant.”In 1966, the Johnson administration sued school districts across the country, particularly in the south, that refused to comply with desegregation demands. At the time, Plaquemines parish was led by Leander Perez, a staunch segregationist and white supremacist.Perez had played a large role in trying to keep nearby New Orleans from desegregating, and once that effort failed, he invited 1,000 white students from the Ninth Ward to enroll in Plaquemines parish schools. By 1960, nearly 600 had accepted the offer. Perez was excommunicated by Archbishop Joseph Francis Rummel for ignoring his warning to stop trying to prevent schools run by the archdiocese of New Orleans from integrating.Perez attempted to close the public schools in Plaquemines parish, and instead open all-white private academies, or, segregation academies, which became a feature of the post-integration south. An estimated 300 segregation academies, which, as private schools, are not governed by the same rules and regulations as public schools, are still in operation and majority white.Students and teachers working in school districts today might be decades removed from the people who led the push for desegregation in their districts, but they still benefit from the protections that were long ago put in place. Without court oversight, school districts that were already begrudgingly complying might have no incentive to continue to do so.According to the Century Foundation, as of 2020, 185 districts and charters consider race and/or socioeconomic status in their student assignment or admissions policies, while 722 districts and charters are subject to a legal desegregation order or voluntary agreement. The justice department currently has about 135 desegregation cases on its docket, the majority of which are in Louisiana, Mississippi, Alabama and Georgia.skip past newsletter promotionafter newsletter promotion“Separate but equal doesn’t work,” said Johnathan Smith, former deputy assistant attorney general in the civil rights division at the justice department. “The reality is that students of color do better when they are in integrated classrooms … We know that the amount of resources that are devoted to schools are greater when there are a higher number of white students. So to have students attend majority-minority school districts means that they’re going to be shut out, whether that’s from AP classes, whether that’s from extracurricular activities. All the activities that make it possible for students to fully achieve occur when you have more integrated classrooms.”“Public education isn’t just about education for the sake of education,” he added. “It’s about preparing people to be citizens of our democracy and to be fully engaged in our democratic institutions. When you have students that are being shut out from quality public education, the impact is not just on those communities. It’s on our democracy writ large.”Smith, the current chief of staff and general counsel for the National Center for Youth Law, said that the decision “signals utter contempt for communities of color by the administration, and a lack of awareness of the history of segregation that has plagued our nation’s schools”.“Even though we are 71 years after the Brown v Board [of Education] decision, schools of this country remain more segregated today than they were back in 1954,” he said. “The fact that the administration is kind of wholeheartedly ending these types of consent decrees is troubling, particularly when they’re not doing the research and investigation to determine whether or not these decrees really should be ended at this point.”Smith said that the decision in the Plaquemines parish case may be a “slippery slope” in which other school districts begin reaching out to the Trump administration.“The impact they can have across the country and particularly across the south is pretty huge,” he said. “I worry that we’re going to see more and more of these decrees falling and more and more of these districts remaining segregated without any real opportunity to address that.” More

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      Should we ban opinion polls?

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      Ahead of the 2016 US presidential election, opinion polls predicted a win for Hillary Clinton. She lost, and the polling industry went through one of its regular spasms of self-criticism and supposed reform. Alas, it did not vote itself entirely out of existence. France and Spain ban the publication of opinion polls in the days leading up to an election, but we should go one better and ban their publication at any time.No doubt it adds much to the gaiety of the British nation to see the Conservative party slip to third or fourth in the polls, but any poll asking who you would vote for if there were a Westminster election tomorrow, held at a time when there almost certainly will not be an election for another four years, is meaningless as a guide to the makeup of the next Parliament.If polls were simply useless that would be no reason to ban them, though. A better reason is that they are actively harmful: a species of misinformation that pollutes the public sphere.One fundamental problem, recognised long ago, is that there is no such thing as “the public”, thought of as a hive mind with a single homogeneous view. To report the results of any poll as “the British public thinks…” is simply a falsehood, except perhaps in the unlikely circumstance that fully 100% of respondents agree on some point. There is, for the same reason, no such thing as “the will of the British people”, a spectre conjured into being only when something very dubious is being proposed.So what is it exactly that opinion polls measure? A random sample, hopefully statistically reliable, of differing and irreconcilable opinions. Not informed opinions exclusively, of course, but also the opinions of conspiracy theorists, the news-phobic and the merely deranged. By such a scientific operation we may uncover the valuable truths that a third of Conservative voters would prefer to see Nigel Farage as prime minister, while 7% of American men believe they could beat a grizzly bear in unarmed combat.A deeper question is whether polls actually create, in whole or in part, what they purport to be revealing. Does everyone go around with settled, reasoned views on every hot-button issue of the day, just waiting to be revealed by a questioning pollster? The answer was clear to the American journalist Walter Lippmann in his 1922 book Public Opinion. It is unrealistic, he argued, to expect people to be able to form “sound public opinions on the whole business of government”, and they shouldn’t actually have to. “It is extremely doubtful whether many of us would … take the time to form an opinion on ‘any and every form of social action’ which affects us.”The act of asking a question, though, heightens the importance of the subject in the mind of the questionee, creating an urge to have one’s say where there might previously have been neither urge nor say at all. As Walter Bagehot, the 19th-century political theorist and editor of the Economist, once observed: “It has been said that if you can only get a middle-class Englishman to think whether there are ‘snails in Sirius’, he will soon have an opinion on it.” As though to prove him right, in 1980 a third of American respondents helpfully offered their view on whether the “1975 Public Affairs Act” should be repealed, even though that legislation did not actually exist.The way you ask the question, moreover, can profoundly influence the outcome. A 1989 study by the American social scientist Kenneth A Rasinski found that varying verbal framings of political issues changed the outcome: “More support was found for halting crime than for law enforcement, for dealing with drug addiction than for drug rehabilitation, and for assistance to the poor than for welfare.” Other such experiments have shown that the order of questioning also matters, that Americans express more support for government surveillance if terrorism is mentioned in the question, and that nearly twice as many people think that the government “should not forbid speeches against democracy” than it “should allow speeches against democracy”, though the options are exactly equivalent.Modern opinion polls, then, are part of the machinery behind the “manufacture of consent”, a phrase originally coined by Lippmann to describe the propaganda operations of politicians and the press. It is no accident, after all, that George Gallup had been an advertising man, with the Madison Avenue firm Young & Rubicam, before he helped to pioneer the methods of systematic opinion polling by borrowing from market research and PR. In 1936, Gallup and his colleagues correctly predicted the election of Franklin D Roosevelt, proving the old-fashioned forecasting methods outdated. Using the “new instrument” of polling, he declared happily in 1938, “the will of the majority of citizens can be ascertained at all times”. This was, of course, partly by way of advertising his own commercial interest as founder, in 1935, of the American Institute of Public Opinion (Gallup Poll). His fellow pollster Elmo Roper described their nascent industry as “a veritable goldmine”.Profitable it may be, but the constant drizzle of polling also incentivises short-term, knee-jerk decision-making by governments. A leader may make a hasty policy change merely in response to a poll, and then if the polling improves, take that as proof that the new policy is correct. Keir Starmer was no doubt cheered when, following his Enoch Powell-adjacent speech on immigration in May, polling found that “more Britons [now] believe that the government wants to reduce net migration”. But a policy designed to massage approval ratings over the course of weeks is not always going to be the same as a good policy that will last years.It would be invidious after all this not to mention one consideration that strongly favours opinion polls, which is that they provide a steady stream of pseudo-news to the media. If each day did not bring a new revelation about the imaginary public’s confected opinion on one or another issue, there would be much less for news programmes to report on. And what would we all do then?Further readingPublic Opinion by Walter Lippmann (Wilder, £7.49)Manufacturing Consent by Edward S Herman and Noam Chomsky (Vintage, £12.99)Lies, Damn Lies, and Statistics by Michael Wheeler (WW Norton & Company, £13.99) More

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      Trump administration to destroy nearly $10m of contraceptives for women overseas

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      The Trump administration has decided to destroy $9.7m worth of contraceptives rather than send them abroad to women in need.A state department spokesperson confirmed that the decision had been made – a move that will cost US taxpayers $167,000. The contraceptives are primarily long-acting, such as IUDs and birth control implants, and were almost certainly intended for women in Africa, according to two senior congressional aides, one of whom visited a warehouse in Belgium that housed the contraceptives. It is not clear to the aides whether the destruction has already been carried out, but said they had been told that it was set to occur by the end of July.“It is unacceptable that the State Department would move forward with the destruction of more than $9m in taxpayer-funded family planning commodities purchased to support women in crisis settings, including war zones and refugee camps,” Jeanne Shaheen, a Democratic senator from New Hampshire, said in a statement. Shaheen and Brian Schatz, a Democratic senator from Hawaii, have introduced legislation to stop the destruction.“This is a waste of US taxpayer dollars and an abdication of US global leadership in preventing unintended pregnancies, unsafe abortions and maternal deaths,” added Shaheen, who in June sent a letter to the secretary of state, Marco Rubio, about the matter.The department decided to destroy the contraceptives because it could not sell them to any “eligible buyers”, in part because of US laws and rules that prohibit sending US aid to organizations that provide abortion services, counsel people about the procedure or advocate for the right to it overseas, according to the state department spokesperson.Most of the contraceptives have less than 70% of their shelf life left before they expire, the spokesperson said, and rebranding and selling the contraceptives could cost several million dollars. However, the aide who visited the warehouse said that the earliest expiration date they saw on the contraceptives was 2027, and that two-thirds of the contraceptives did not have any USAID labels that would need to be rebranded.The eradication of the contraceptives is part of the Trump administration’s months-long demolition of the Agency for International Development (USAID), the largest funding agency for humanitarian and development aid in the world. After the unofficial “department of government efficiency” (Doge) erased 83% of USAID’s programs, Rubio announced in June that USAID’s entire international workforce would be abolished and its foreign assistance programs would be moved to the state department. The agency will be replaced by an organization called America First.In total, the funding cuts to USAID could lead to more than 14m additional deaths by 2030, according to a recent study published in the journal the Lancet. A third of those deaths could be children.“If you have an unintended pregnancy and you end up having to seek unsafe abortion, it’s quite likely that you will die,” said Sarah Shaw, the associate director of advocacy at MSI Reproductive Choices, a global family planning organization that works in nearly 40 countries. “If you’re not given the means to space or limit your births, you’re putting your life at risk or your child’s life at risk.”MSI tried to purchase the contraceptives from the US government, Shaw said. But the government would only accept full price – which Shaw said the agency could not afford, given that MSI would also have to shoulder the expense of transportingthe contraceptives and the fact that they are inching closer to their expiration date, which could affect MSI’s ability to distribute them.The state department spokesperson did not specifically respond to a request for comment on Shaw’s allegation, but MSI does provide abortions as part of its global work, which may have led the department to rule it out as an “eligible buyer”.In an internal survey, MSI programs in 10 countries reported that, within the next month, they expect to be out of stock or be on the brink of being out of stock of at least one contraceptive method. The countries include Burkina Faso, the Democratic Republic of Congo, Mali, Ethiopia, Nigeria, Tanzania, Timor-Leste, Senegal, Kenya and Sierra Leone.Shaw expects the stock to be incinerated. “The fact that the contraceptives are going to be burned when there’s so much need – it’s just egregious,” she said. “It’s disgusting.” The Department of State spokesperson did not respond to a request for information on the planned method of destruction.The destruction of the contraceptives is, to Shaw, emblematic of the overall destruction of a system that once provided worldwide help to women and families. USAID funding is threaded through so much of the global supply chain of family planning aid that, without its money, the chain has come apart. In Mali, Shaw said, USAID helped pay for the gas used by the vehicles that transport contraceptives from a warehouse. Without the gas money, the vehicles were stuck – and so were the contraceptives.“I’ve worked in this sector for over 20 years and I’ve never seen anything on this scale,” Shaw said. “The speed at which they’ve managed to dismantle excellent work and really great progress – I mean, it’s just vanished in weeks.”Other kinds of assistance are also reportedly being wasted. This week, the Atlantic reported that almost 500 metric tons of emergency food were expiring and would be incinerated, rather than being used to feed about 1.5 million children in Afghanistan and Pakistan. Meanwhile, almost 800,000 Mpox vaccines that were supposed to be sent to Africa are now unusable because they are too close to their expiration date, according to Politico.The cuts to foreign aid are slated to deepen. Early on Friday morning, Congress passed a bill to claw back roughly $8bn that had been earmarked for foreign assistance.“It’s not just about an empty shelf,” Shaw said. “It’s about unfulfilled potential. It’s about a girl having to drop out of school. It’s about someone having to seek an unsafe abortion and risking their lives. That’s what it’s really about.” More

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      US Senate passes aid and public broadcasting cuts in victory for Trump

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      The US Senate has approved Donald Trump’s plan for billions of dollars in cuts to funding for foreign aid and public broadcasting, handing the Republican president another victory as he exerts control over Congress with little opposition.The Senate voted 51 to 48 in favour of Trump’s request to cut $9bn in spending already approved by Congress.Most of the cuts are to programmes to assist foreign countries stricken by disease, war and natural disasters, but the plan also eliminates the $1.1bn the Corporation for Public Broadcasting was due to receive over the next two years.Trump and many of his fellow Republicans argue that spending on public broadcasting is an unnecessary expense and reject its news coverage as blighted by “anti-right bias”.Standalone rescissions packages have not passed in decades, with lawmakers reluctant to cede their constitutionally mandated control of spending. But the Republicans, who hold narrow majorities in the Senate and House, have shown little appetite for resisting Trump’s policies since he began his second term in January.The $9bn at stake is small in the context of the $6.8tn federal budget, and represents a tiny portion of all the funds approved by Congress that the Trump administration has held up while it has pursued sweeping cuts, many ordered by Elon Musk’s Department of Government Efficiency (Dog)e.By mid-June, Trump was blocking $425bn in funding that had been appropriated and approved by Congress, according to Democratic lawmakers tracking frozen funding.However, the president and his supporters have promised more of the “rescission” requests to eliminate previously approved spending in what they say is an effort to pare back the federal government.The House of Representatives passed the rescissions legislation, without altering Trump’s request, by 214-212 last month. Four Republicans joined 208 Democrats in voting no.But after a handful of Republican senators balked at the extent of the cuts to global health programmes, Russell Vought, the director of the Office of Management and Budget, said on Tuesday that Pepfar, a global programme to fight HIV/Aids launched in 2003 by President George W Bush, was being exempted.The change brought the size of the package of cuts to $9bn from $9.4bn, requiring another House vote before the measure could be sent to the White House for Trump to sign into law.The rescissions must pass by Friday. Otherwise, the request would expire and the White House required to adhere to spending plans passed by Congress.Two of the Senate’s 53 Republicans , Lisa Murkowski of Alaska and Susan Collins of Maine, joined Democrats in voting against the legislation. “You don’t need to gut the entire Corporation for Public Broadcasting,” Murkowski said told the Senateskip past newsletter promotionafter newsletter promotionShe said the Trump administration had not provided assurances that battles against diseases such as malaria and polio worldwide would be maintained. Murkowski called for Congress to assert its role in deciding how federal funds were spent.The Republican Senate majority leader, John Thune of South Dakota, called Trump’s request a “small, but important step toward fiscal sanity”.Democrats scoffed at that, noting that congressional Republicans had this month passed a massive package of tax and spending cuts that nonpartisan analysts estimated would add more than $3tn to the country’s $36.2tn debt.Democrats accused Republicans of giving up Congress’s constitutionally mandated control of federal spending.“Today, Senate Republicans turn this chamber into a subservient rubber stamp for the executive, at the behest of Donald Trump,” Chuck Schumer, the Senate Democratic leader, representing New York, said. “Republicans embrace the credo of cut, cut, cut now, and ask questions later.”The cuts would overturn bipartisan spending agreements most recently passed in a full-year stopgap funding bill in March. Democrats warn a partisan cut could make it more difficult to negotiate government funding bills that must pass with bipartisan agreement by 30 September to avoid a shutdown.Appropriations bills require 60 votes to move ahead in the Senate but the rescissions package needs just 51, meaning Republicans can pass it without Democratic support. More

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      Zohran Mamdani’s campaign proposes free childcare. Is it finally a winning policy?

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      Maggie Stockdale hadn’t given much thought to childcare before welcoming her first child last year. But once she learned the high price of full-time daycare tuition in Brooklyn, New York, she knew she had to find another solution.Now, her care duties are split between Stockdale’s parents, who relocated from Wisconsin to help out, and her husband, who cut his hours down to part time and arranged with his employer to let him bring their 10-month-old to work several days a week.“You feel fragile,” said Stockdale, lamenting that so many families have to choose between financial stability and their child’s wellbeing.So when Zohran Mamdani campaigned on a platform of affordability, proposing free childcare for children aged six weeks and older, it made her feel that the pain she and other parents had experienced had not gone unnoticed.Mamdani, the 33-year-old state assemblymember who won the Democratic primary for New York City mayor last month, has put forth a variety of kid- and family-focused ideas, including distributing baby baskets containing formula and postpartum supplies to new parents, building up mental health infrastructure in schools and closing off high-traffic streets adjacent to school zones. But what’s garnered the most attention is his promise of free childcare, a system he plans to fund by raising taxes on corporations and the city’s richest residents.As he told supporters in his victory speech: “We have won because New Yorkers have stood up for a city they can afford. A city where they can do more than just struggle … where childcare doesn’t cost more than [college].”For Stockdale, seeing these policies at the center of a major political campaign has underscored how childcare affordability is not only a core concern for voters – but also a winning issue.“It’s got so much support,” said Stockdale, also an organizer with the advocacy group New Yorkers United for Childcare. “People have started to realize that this should be a key component of any candidate’s platform.”In many ways, Mamdani’s platform responds to the surge of activism that New York has seen in favor of making childcare a public good – activism that first emerged at the height of the Covid-19 pandemic, when the importance and fragility of the country’s childcare system was laid bare. Since then, elected officials have begun to take the issue seriously, explained Allison Lew, senior organizer with New Yorkers United for Child Care.A report released from the New York City comptroller’s office this year shows the average cost of center-based care across the five boroughs was $26,000 a year, and that to afford the cost of care for a two-year-old in New York City, a family would need to earn $334,000 annually. “People are draining their savings, going into debt, borrowing on their 401ks [retirement funds],” said Lew. “You have to be wealthy in order for childcare to not be an issue.”For many would-be parents, the inaccessibility is affecting their family-planning decisions, causing them to delay having kids or to only have one child, despite wanting more. “We would love to have another, but financially, we don’t know if we can afford it,” said Nancy Keith, who is raising a 15-month-old in the Bedford-Stuyvesant neighborhood in Brooklyn. Keith says that she and her husband waited until they were in their late 30s, and more settled in their career, to have a child. Even still, they need financial assistance from their parents to afford the $26,000 a year they pay for childcare.Should Mamdani win the mayoral election in November and make his childcare vision a reality, these challenges could become things of the past, experts say.Most immediately, parents and childcare workers alike would experience improved financial security. Families would see thousands more dollars in their bank accounts every month, while childcare workers would be paid salaries and receive benefits at parity with New York public school employees.Gregory Brender, chief policy and innovation officer at the Day Care Council of New York, explains that pay parity has been a priority for the provider network for decades, making it a relief to finally see it be a legislative priority. “Early childhood education depends on a talented and educated workforce, and they need to be compensated appropriately,” he said.These family-focused policies would also improve equity in the city, as more parents – especially women – would be able to remain in the workforce. And in making the city more affordable for everyone, families from diverse backgrounds with a range of incomes would be able to remain in their communities.Down the line, such policies would also bolster the city’s economy. Collectively, New Yorkers spend as much as $15bn on childcare every year. And in 2022, families not being able to afford childcare cost the city $23bn between lost tax revenues and workplace departures as parents were forced to drop out of the workforce.“We just cannot afford to not have universal childcare,” Lew said.Universal childcare isn’t cheap. But the city has the money, said Justin Brannan, a New York City councilmember representing parts of Brooklyn and chair of the city’s committee on finance. “We have been stuck in this cycle of false austerity where we are supposed to believe that we have to choose between little and even less, and it’s just not true,” Brannan said, noting that the city’s budget totals almost $116bn (universal childcare would cost $12bn per year). “We just need to do a better job of spending our money,” he said.Implementing such a system may not be as simple as carving out room in the budget, however. Some facets of the plan – like raising taxes – need to be approved by the state legislature and the governor. Kathy Hochul, the New York governor, has already said she will not raise income taxes. Mamdani has acknowledged these challenges, saying in an interview with Morning Edition, “Any mayor that has an ambition that meets the scale of the crisis of the people that they’re seeking to represent will have to work with [the state].”Still, the ideas have momentum.New York has been a pioneer in accessible childcare infrastructure for several years, including universal preschool for three- and four-year-olds (known as pre-K and 3-K). And although many doubted Bill de Blasio’s ability to pull off his promise of universal preschool when he ran for mayor more than a decade ago, the program is now a national model. Before that, the city instituted a voucher program that enabled low-income families to access childcare for children aged six weeks to 15 years – although seats are limited. As a result of those developments, advocates like Lew say some degree of publicly funded childcare is now a “non-negotiable” for many New Yorkers.Mamdani says his campaign promises to build on those past successes. “These platform planks are rooted in very recent New York City history,” he said in an interview with the Nation. “Universal childcare is something that many candidates are in support of because of the success of universal pre-K.”New York isn’t alone in its quest for solutions to the nationwide childcare crisis. In 2022, New Mexico made childcare free for most families. That same year, Washington DC raised childcare workers’ wages through a tax on the district’s wealthiest residents. And in 2023, Vermont guaranteed financial support for childcare for all families with incomes below 575% of the federal poverty level – amounting to 90% of families in the state.Hailey Gibbs, associate director of early childhood policy at the Center for American Progress, said it’s an issue that crosses the political aisle. “Folks, regardless of what state they represent or how far they sit in the political extremes, understand that the lack is meaningful,” she said.“It’s a unifying issue,” echoed Karen Schulman, senior director of state childcare policy at the National Women’s Law Center, pointing out that even staunchly Republican states like Alabama, Georgia and Montana have created early childhood education funds.But Mamdani’s campaign is the first in the country to put children and childcare front and center – and win, at least at the primary level. “That’s pretty bold for the US,” Gibbs said. More

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      Trans youth fight for care as California clinics cave to Trump: ‘How can this happen here?’

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      Eli, a 16-year-old Los Angeles student, is spending his summer juggling an internship at a natural history museum, a research project, a physics class and cheer practice – and getting ready to apply for college.But in recent weeks, he has been forced to handle a more urgent matter: figuring out how he is going to access vital medical treatments targeted by the Trump administration.Last month, Eli was stunned to get an email alerting him that Children’s hospital Los Angeles (CHLA) was shutting down its Center for Transyouth Health and Development, which had provided him critical healthcare for three years. The center, which has served transgender youth for three decades, offered Eli counseling and helped him access gender-affirming hormone therapy that he said allowed him to live as himself and flourish in school.CHLA said it was shuttering the center due to the federal government’s threats to pull funding, part of the president’s efforts to eradicate trans youth healthcare. The move has forced Eli and his mother to scramble for alternatives, taking time out of his busy summer to contact new providers and ensure he doesn’t run out of medications.California became the first sanctuary state for trans youth healthcare in 2022 and has long positioned itself as having the strongest protections for LGBTQ+ children. Now, for families like Eli’s, it feels like that safety is rapidly disappearing.View image in fullscreen“I was always worried for people in conservative states and had a lot of fear for my community as a whole. But I never thought it would directly affect me in California,” Eli said on a recent afternoon, seated with his mom at a Latino LGBTQ+ organization in Boyle Heights. “I wish people understood they’re doing so much more harm than they could possibly imagine – that so many lives will be hurt and lost and so many people torn apart.”Eli is one of nearly 3,000 patients who learned on 12 June they would be abruptly losing their healthcare at CHLA, one of the largest and most prominent centers in the nation to treat trans kids. Then, on 24 June, Stanford Medicine revealed it had also paused gender-affirming surgeries for trans minors and 18-year-olds, with reports that some families had appointments suddenly canceled and leaving other patients fearful it was the beginning of a wider crackdown on their care.Families across California told the Guardian they were exploring options to stockpile hormones, researching how to get care outside the US, growing increasingly fearful that parents could face government investigations or prosecutions, and discussing options to permanently flee the country.CHLA, in a letter to staff, said its decision to close the trans center was “profoundly difficult”, but as California’s largest pediatric safety net provider, it could not risk losing federal dollars, which makes up a majority of its funds and would affect hundreds of thousands of patients. Stanford said its disruption in services followed a review of “directives from the federal government” and was done to “protect both our providers and patients”.“This is Los Angeles – how can this be happening here?” said Emily, Eli’s mother, who is an educator; the Guardian is identifying them by only their first names to protect their privacy. “My parents left their Central American countries for a better life – fleeing poverty and civil war, and I cannot believe I’m sitting here thinking: what would be the best country for my family to flee to, as so many immigrant families have done? I never thought I might have to leave the US to protect my son.”‘This care gave me my life’Katie, a 16-year-old film student who lives two hours outside Los Angeles, started going to CHLA for gender-affirming care in 2018 when she was nine. For several years, the care involved therapy and check-ins, but no direct medical interventions. Throughout that time, Katie was consistent about her identity as a girl, which CHLA providers supported.“It was so meaningful and incredible for them to say: ‘We see you for who you are, but also you can be who you are,’” recalled Katie, who asked to go by a pseudonym to protect her privacy. “It was like, I have a future. I’ll get to have my life.”In gender-affirming care, young children may first socially transition by using new names, pronouns and clothes. When youth are persistent about their gender, doctors can consider prescribing puberty blockers, which pause puberty, and eventually hormone therapies that allow for medical transition. Trans youth surgeries are rare.View image in fullscreenThe treatment has for years been considered the standard of care in the US, endorsed by major medical groups, including the American Academy of Pediatrics and the American Medical Association, and linked to improved mental health. In recent years, Republicans have passed bans on gender-affirming care in more than 25 states, and Trump has called the treatments “chemical and surgical mutilation”. There has also been a growing international backlash against the care, including in the UK, which has banned puberty blockers for trans kids.Last month, the US supreme court upheld Tennessee’s ban on gender-affirming care for trans youth. Families and civil rights groups have argued the bans are discriminatory, as cisgender children can still receive the same treatments; cis boys with delayed puberty may be prescribed testosterone, for example, while trans boys cannot.Katie, who was eventually prescribed puberty blockers and hormones, broke down crying recounting how the care saved her. “Sometimes I think: What would my life be if I never got this?” she said. “And I just don’t see myself here. I can’t see myself at 16 if I didn’t come out and transition … Losing this now would destroy my life.”Sage Sol Pitchenik, a 16-year-old CHLA patient, who is non-binary, said the care helped them overcome debilitating depression caused by their severe gender dysphoria: “Every day, I couldn’t even get up because I just didn’t want to see myself, not even my reflection in the window. I was so terrified to look at my body.”They compared the care to the essential treatment their twin brother had earlier received at the same institution: a liver transplant. “CHLA saved my life, just like they saved my brother,” they said.Eli, who came out as trans while in middle school during pandemic lockdowns, said it was hard to return to school when he felt so uncomfortable in his body. At the start of high school, he avoided making friends: “I’m really sociable. I love talking to people and joining clubs, but I felt restricted because of how embarrassed I felt and scared of how people would react to me.”The testosterone therapy helped restore his confidence, he said, recounting “euphoric moments” of his transition: growing facial hair, his voice deepening, staying in the boys’ cabin at camp. His friends celebrated each milestone, and his mom said the positive transformation was obvious to his whole family: “It was like day and night – we are a traditional Latino Catholic family, but they were all loving and accepting, because he is such a happier kid.”View image in fullscreen‘Treating our kids as disposable’CHLA started treating trans children around 1991, and that legacy was part of its appeal for parents. “It’s not just the best place in LA to get care, it’s also one of the most important research centers in the country,” said Jesse Thorn, a radio host who has two trans daughters receiving care there.Critics of gender-affirming care have claimed that vulnerable youth are rushed into transitioning without understanding treatment consequences, and that there is not enough research to justify the care. CHLA, Thorn said, countered those claims; families have appointments and build long-term relationships with doctors, psychologists, psychiatrists and social workers. The process is slow and methodical, and the center was engaged in extensive research on the effects of treatments, he said.“The youth most in danger with the clinic closing are those with parents who aren’t sure about this care,” Thorn added. “That’s a lot of parents. They’re not hateful bigots. They’re overwhelmed and scared, and the institution means a lot.”View image in fullscreenOne LA parent, who requested anonymity to protect her trans son’s privacy, said she knew parents who traveled from Idaho to get CHLA’s care: “It really was a beacon of the entire western United States. It is a remarkable loss.”Parents told the Guardian that they were putting their children on waitlists at other clinics and beginning intake processes, but remained worried for families who have public health insurance and fewer resources.Like CHLA, Stanford has long researched and championed trans youth healthcare. The prestigious university’s recent pullback on care only affects surgeries, which are much more rare than hormone therapy and puberty blockers. But families whose care has remained intact, for now, say they are on edge.“There’s a constant feeling of not knowing what you need to prepare for,” said one mom of a 17-year-old trans boy, who said her son waited six months to first be seen by Stanford. “We all understand the pressures the doctors and institutions are under. But ceding the surgeries doesn’t mean the pressure will end. It’s just showing us our kids are seen as disposable.”Parents and advocates say they fear that other institutions could follow CHLA and Stanford, particularly as the White House significantly escalates attacks in ways that go far beyond funding threats.Fears of prosecutionTrump’s focus on California trans youth and gender-affirming care has been relentless. The president has directly attacked a 16-year-old trans track runner, with the US justice department and federal Department of Education fighting, so far unsuccessfully, to force the state’s schools to ban trans female athletes and bar trans girls from women’s facilities. Trump has threatened to withhold billions of dollars in education funding over a state law meant to prevent schools from forcibly outing LGBTQ+ youth to their parents.Perhaps most troubling for families and providers, the FBI has said it is investigating providers who “mutilate” children “under the guise of gender-affirming care”, and the DoJ said this week it had issued subpoenas to trans youth clinics and doctors.This has led to growing fears that the US will seek to prosecute and imprison clinicians, similar to efforts by some Republican states to criminally charge abortion providers. Many parents say they worry they could be targeted next.“There’s an outcry of terror,” said another LA mother of a trans child. “It feels like there is a bloodlust to jail any doctor who has ever helped an LGBTQ+ kid. There’s this realization that the world is constricting around us, and that any moment they could be coming for us.”Some families hope that California will fight back, but are wary of how committed the governor, Gavin Newsom, really is. Newsom faced widespread backlash in March when he hosted a podcast with a conservative activist and said he agreed with the suggestion that trans girls participating in sports was “deeply unfair”.California’s department of justice, meanwhile, has repeatedly emphasized that when institutions withhold gender-affirming care for trans youth, they are violating the state’s anti-discrimination laws.A spokesperson for Rob Bonta, the state’s attorney general, said Trump was “seeking to scare doctors and hospitals from providing nondiscriminatory healthcare”: “The bottom line is: this care remains legal in California … While we are concerned with the recent decisions by CHLA, right now we are focused on getting to the source of this problem – and that’s the Trump administration’s unlawful and harmful threats to providers.”A CHLA spokesperson shared a copy of its staff letter, noting that Trump’s threats to its funding came from at least five federal departments, and saying it was working with patients to identify alternative care and would “explore” reassigning affected employees to other roles. A Stanford spokesperson did not answer questions about how many patients were affected by its recent changes, but said in an email it was “committed to providing high quality, thorough and compassionate medical services for every member of our community”.Kush Desai, a White House spokesperson, said in an email that Trump has a “resounding mandate” to end “unproven, irreversible child mutilation procedures”, adding: “The administration is delivering.”Katie’s mother said she expected the state’s leaders to do more: “The quiet from the governor and others on trans rights is very unsettling. My husband and I grew up in California, went to public schools here, and always thought we’d be safe here and that the state would hold the line. It’s hard to tell right now if that’s true.”Izzy Gardon, Newsom’s spokesperson, defended the governor, saying in an email that his “record supporting the trans community is unmatched”.“Everyone wants to blame Gavin Newsom for everything. But instead of indulging in Newsom-derangement syndrome, maybe folks should look to Washington.”‘We can’t be quiet’Affected youth are increasingly speaking out. Since the news broke, protesters have organized weekly demonstrations in front of CHLA to call for the healthcare to be restored.At one recent evening rally, organized by the LA LGBT Center, families and supporters marched and chanted outside the busy hospital on Sunset Boulevard, holding signs saying “Trans joy is resistance” and “blood on your hands”, and at one point shouting: “Down with erasure, down with hate, shame on CHLA!”View image in fullscreen“We can’t be quiet any more. We’ve been polite for too long and taken so much bullshit from people who hate us,” said Sage, who spoke at an earlier rally. “I didn’t stand up just for myself or the people affected by this, but also for the trans people who came before us who still have incorrect names on their graves, who don’t have a voice.” Sage, who is now in a creative writing program, said they hoped to become a journalist.Katie, who aspires to be a television writer in LA, said she could not be silent as anti-trans advocates force families to consider fleeing: “How dare you try to drive me out of the place where I was born, where my best friends are, where the job I want to do is, where I’ve experienced my whole life? This is my home.”Eli said he didn’t feel as if he was being an activist. He was simply asking for the “bare minimum”: to be left alone and able to access basic healthcare. “Trans services like hormone therapy truly saves lives,” he said. “We just want people to be able to live their lives. I’m just asking for what is commonsense.” More