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      US overdose deaths decreased in 2023 – will Trump continue this trend?

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      The Biden administration saw unprecedented levels of US opioid overdose fatalities, but those deaths are now declining faster than they have in decades – progress a second Trump administration could continue or threaten, experts say.The number of overdose deaths in the US declined for the first time in five years in 2023, and have continued to decline more rapidly this year, according to provisional data.Some of the decline may have resulted from Biden administration efforts to expand access to harm-reduction services, especially the overdose-reversal drug naloxone, which received over-the-counter approval for the first time last year. Public health experts worry that the second Trump administration will gut access to healthcare, including addiction treatment.The president-elect’s legacy on opioids is complicated. When Trump first took office, he inherited a rapidly escalating overdose crisis. Opioid overdose deaths more than doubled during the Obama administration,according to data from the Centers for Disease Control and Prevention. The three most recent presidential administrations have all failed to quell escalating opioid overdose deaths, which nearly doubled again during the Trump and Biden administrations, dipping slightly in 2018 but overall jumping by 62% during Trump’s first term in 2020. Under Biden, deaths increased by 19% from 2020 to 2022, to 81,806, before declining by 2% last year.At times, the Trump administration seemed to work against itself when it came to the crisis. For example, Trump repeatedly attempted to gut funding for the Office of National Drug Control Policy, although Congress blocked his efforts. Similarly, Trump was frequently in disputes with Congress over attempts to repeal elements of the Affordable Care Act and its expansions to Medicaid, which funds treatment for 40% of adults with opioid use disorder.Still, experts contacted by the Guardian within and outside the first Trump administration credit the president-elect for putting unprecedented focus on the crisis.Trump signed an executive order in 2017 forming the Presidential Commission on Combating Drug Addiction and the Opioid Crisis. Bertha Madras, a professor in Harvard’s psychiatry department who served on the commission, said it wasn’t until Trump “established the commission that a significant integrated national response materialized”.Adm Brett Giroir, who served as an assistant secretary in Trump’s Department of Health and Human Services, says that he was given the authority to head up an unofficial “opioids cabinet … which met every week at the White House under Kellyanne Conway to make sure every department was working on this crisis”.Others praise Trump for supporting harm-reduction efforts, despite past opposition from his party.“President Trump publicly supported syringe services programs, a first for a Republican president,” said Jerome Adams, who served as surgeon general under Trump. Indeed, the Trump administration in some ways paved the way for the Biden administration’s response to the crisis. Access to naloxone expanded significantly under Trump, and even more under Biden.But despite these efforts, the number of US overdose deaths climbed for the majority of Trump’s first term. Giroir and Madras both attribute the huge overdose spike in 2020 to the Covid-19 pandemic, which overwhelmed the healthcare system and increased depression and suicide.Andrew Kolodny, medical director for the Opioid Policy Research Collaborative at Brandeis University, says the administration should have done more.“The first time around, President Trump did an excellent job of calling attention to the opioid crisis and designating it as a public health emergency,” he conceded, but he also said the then president failed to take sufficient action or establish a long-term plan.While the Trump administration allocated unprecedented amounts of funding to combat the crisis, Kolodny said the impact was limited, because states were usually given funds in the form of one- or two-year grants.“That’s not really adequate for building out a treatment system that doesn’t exist yet,” Kolodny said. “If you were to hire a whole bunch of staff, what would you do if you don’t get that appropriation the next year? Do you lay everybody off?”skip past newsletter promotionafter newsletter promotionExperts disagree on whether the administration spent too much of that funding on law and border enforcement, rather than treatment. Giroir supported harm-reduction and treatment expansion during his time under Trump, and is proud of his efforts to remove red tape and increase access to the opioid-cessation drug buprenorphine. Still, he says, “enforcement has to dominate the discussion”, because treatment is less effective than preventing addiction in the first place.Other experts say that criminalization only exacerbates the crisis.“Under Trump’s previous administration, they federally criminalized all fentanyl-related substances in 2018 – and overdose deaths increased from 67,367 that year to 70,630 and 93,331 in 2019 and 2020 respectively,” said Kassandra Frederique, executive director of the Drug Policy Alliance.Kolodny didn’t necessarily agree that criminalization drove the overdose increases, but he did say “the balance should be different” when it comes to prioritizing treatment over law enforcement. He said the best way to immediately reduce the overdose death count would be to make treatment “basically free” and overall easier to access than fentanyl.“[People with opioid use disorder] are not out there using fentanyl because it’s so much fun. If they don’t use, they’re gonna be very, very sick … People can really feel like they’re gonna die,” he said.It’s hard to predict how Trump will tackle the overdose crisis the second time around. He avoided the topic during his recent presidential campaign, and instead focused on inaccurate talking points about immigrants trafficking drugs across the border. He also falsely claimed he had never wanted to repeal the Affordable Care Act. But a Republican-controlled Congress could cut ACA subsidies and Medicaid.Frederique worries that Trump will continue prioritizing drug arrests during his second term, but said during his first term “he also dedicated billions of dollars toward research, education, prevention and treatment. We are committed to supporting the Trump administration’s previous efforts to advocate for health approaches such as increasing access to treatment and naloxone.” More

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      Karoline Leavitt named as Donald Trump’s White House press secretary

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      Donald Trump named his White House press secretary on Friday, placing Karoline Leavitt, a 27-year-old firebrand from his inner circle, in position to aggressively defend him.The job of the White House press secretary typically is to help inform the American people about presidential activities without betraying the confidence of the boss.“Karoline is smart, tough, and has proven to be a highly effective communicator. I have the utmost confidence she will excel at the podium …, ” the statement read.The challenge for Leavitt will be to impart reliable information and gain credibility with reporters, while maintaining strong loyalty to Trump. Leavitt has been seen as a staunch and camera-ready advocate for Trump who is quick on her feet and delivers aggressive defenses of the president-elect in television interviews.In a June interview on CNN’s This Morning, Leavitt became embroiled in a heated exchange with host Kasie Hunt, bashing Dana Bash and Jake Tapper for their “biased coverage” of Trump before the highly anticipated debate between him and Joe Biden. Bash and Tapper had been moderators for that debate. Hunt abruptly ended that interview after Leavitt refused to be deflected.Leavitt will be the youngest person ever to hold the title of White House press secretary. Ron Ziegler was previously the youngest press secretary at age 29 when Richard Nixon gave him the position in 1969.Leavitt, a New Hampshire native, was an assistant press secretary during the latter part of Trump’s first term, from 2017 to 2021.When Trump was defeated by Joe Biden in 2020, Leavitt became communications director for Elise Stefanik, the Republican US representative, who has been tapped by Trump as his US ambassador to the United Nations.Leavitt ran for a seat in the US House of Representatives from New Hampshire in 2022, winning the Republican primary. She lost the general election to Democrat Chris Pappas, but the experience appeared to give her valuable experience with public speaking.She joined Trump’s 2024 campaign and has been the chief spokesperson for the president-elect’s transition team.Trump had four press secretaries during his 2017-2021 term: Sean Spicer, Sarah Sanders, Stephanie Grisham and Kayleigh McEnany. Spicer got off on the wrong foot with the White House press corps at his first appearance in 2017 after falsely claiming that the crowd gathered in Washington DC for Trump’s inauguration had been “the largest audience to ever witness an inauguration, period, both in person and around the globe”.Spicer was replaced after just sixth months in the role, making his tenure the sixth-shortest since the position was created in 1929, according to data from the White House Transition Project. The average term is just under three years.Sanders, who is now the Republican governor of Arkansas, got praise from Trump for her parrying with the press corps.After Sanders left, Trump turned to Grisham, who never held a briefing, which she said was at Trump’s direction. Grisham resigned after the events of 6 January 2021, and is now a sharp Trump critic.Trump’s last chief spokesperson at the White House was McEnany, who sparred with reporters during the pandemic year of 2020 and is now an on-air personality at Fox News. More

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      Two Trump cabinet choices in jeopardy over sexual misconduct allegations

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      The confirmation prospects of two of Donald Trump’s most controversial cabinet choices were in jeopardy over sexual misconduct allegations on Friday in developments mirroring the president-elect’s own history of abusive behavior towards women.Uncertainty surrounded the nomination of Pete Hegseth, Trump’s choice as defense secretary – whose path to Senate confirmation was already complicated over concerns about his inexperience and extreme views – following revelations that police in California investigated a sexual assault allegation against him in 2017.No charges were pressed. But the allegations were sufficiently serious for Trump’s newly appointed chief of staff, Susie Wiles, to reportedly speak to Hegseth after she learned of them on Wednesday evening, the day after his nomination.According to Vanity Fair, which initially reported the story, the incoming president’s own lawyers also talked to Hegseth, a 44-year-old Fox News host and army veteran who has railed against – among other things – women serving in military combat roles.The disclosure compounded the controversy over Matt Gaetz, the far-right Florida congressman nominated as attorney general despite having faced a two-year Department of Justice investigation over sex-trafficking allegations. They included allegations that he had sex with a 17-year-old minor.Republican and Democratic senators pressed on Friday to see a House of Representatives ethic committee report into Gaetz’s conduct that was commissioned despite the criminal investigation ending without charges.Gaetz forestalled Friday’s scheduled publication of the report – the contents of which were widely expected to be damaging to him – by resigning from the House immediately after Trump announced his nomination on Wednesday. The House speaker, Mike Johnson, has also said he would “strongly request” the report not be published.But the report’s existence could still in effect torpedo his nomination after senior senators – including Republican John Cornyn of Texas, a member of the Senate judiciary committee – demanded that it be preserved for use in Senate confirmation hearings.The inquiry was originally launched in 2021 to investigate whether the congressman “may have engaged in sexual misconduct and/or illicit drug use, shared inappropriate images or videos on the House floor, misused state identification records, converted campaign funds to personal use, and/or accepted a bribe, improper gratuity, or impermissible gift, in violation of House rules, laws, or other standards of conduct”.Trump is believed to have picked Gaetz as the ideal candidate to conduct a wholesale purge of the justice department, against which he harbors bitter grievances for pressing criminal investigations into his conduct during his first presidency.Hegseth, likewise, has been selected with a view to purging the armed forces, which he has accused of being hampered by “woke leadership”.His prospects of doing so seemed to be clouded by disclosure of the 2017 investigation, which stemmed from an alleged incident at the Hyatt Regency hotel and spa in Monterey, California, which was hosting a Republican women’s conference.The Monterey city manager’s office confirmed the investigation in a brief statement, adding that the alleged incident occurred between midnight on 7 October 2017 and 7am the following morning.Hegseth reportedly told Wiles and the Trump legal team that it stemmed from a consensual encounter and described the allegation as “he said, she said”, Vanity Fair reported.The magazine’s website also quoted a source as saying Hegseth had not been vetted. This was countered by a source in Trump’s transition team, who said: “Hegseth was vetted, but this alleged incident didn’t come up.”The dispute over vetting followed separate reports that standard FBI background checks on some of Trump’s most controversial nominees – designed to uncover past criminal activity and other potentially disqualifying liabilities – had been set aside.The questions over the sexual behavior of his nominees echo Trump’s own past. The president-elect was ordered to pay $83m damages to the writer E Jean Carroll last year after a New York jury in a civil trial found him liable for sexual assault and defamation. Carroll alleged Trump raped her in 1996, which Trump denied.His candidacy in the 2016 presidential election was almost derailed following the emergence of an Access Hollywood tape from more than a decade earlier in which he boasted of using his celebrity status to grab women’s genitals.Sexual misconduct allegations have also dogged Robert F Kennedy Jr, Trump’s selection as secretary of the Department of Health and Human Services. A former babysitter for his children alleged that Kennedy groped her in his home in 1998. Kennedy responded to the accusation, again reported in Vanity Fair, by saying: “I’m not a church boy.” More

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      Environmental groups alarmed as Doug Burgum picked for US interior secretary

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      Donald Trump’s nomination of North Dakota’s Republican governor, Doug Burgum, as the interior secretary has prompted swift backlash from environmental advocacy groups alarmed at the incoming administration’s plans to use federal lands for oil and gas drilling.Trump also announced in a statement on Friday his intention to make Burgum chair of a National Energy Council he intends to form to “oversee the path to U.S. ENERGY DOMINANCE” and to focus on “the battle for AI superiority”.Burgum, a former businessman, has been governor since 2016 of North Dakota, which is the third largest oil and natural gas producer in the country. Burgum, if confirmed by the Senate, would manage US federal lands including national parks and wildlife refuges, as well as oversee relations with 574 federally recognized Native American tribes.Major concerns have loomed over the country’s wildlife refuges and public lands as Trump prepares to enter the White House for a second term. Throughout his campaign trail, Trump has repeatedly said “drill, baby, drill” and has vowed to carve up the Arctic national wildlife refuge in Alaska’s northern tundra for oil and gas drilling.The Sierra Club, the country’s largest non-profit environmental organization, said: “It was climate skeptic Doug Burgum who helped arrange the Mar-a-Lago meeting with wealthy oil and gas executives where Donald Trump offered to overturn dozens of environmental rules and regulations in exchange for $1bn in campaign contributions.”The April meeting at Trump’s club earlier this year prompted Citizens for Responsibility and Ethics in Washington, the country’s top ethics watchdog, as well as House Democrats, to investigate the dinner over constitutional and campaign violations.“If that weren’t disqualifying enough, he’s long advocated for rolling back critical environmental safeguards in order to let polluters profit. Doug Burgum’s ties to the fossil fuel industry run deep and, if confirmed to this position, he will surely continue Donald Trump’s efforts to sell out our public lands to his polluter pals. Our lands are our nation’s greatest treasure, and the interior department is charged with their protection,” the Sierra Club continued.Similarly, the Center for Western Priorities, a conservation policy organization focused on land and energy issues across the western states, said: “Doug Burgum comes from an oil state, but North Dakota is not a public lands state. His cozy relationship with oil billionaires may endear him to Donald Trump, but he has no experience that qualifies him to oversee the management of 20% of America’s lands.”It went on to add: “If Doug Burgum tries to turn America’s public lands into an even bigger cash cow for the oil and gas industry, or tries to shrink America’s parks and national monuments, he’ll quickly discover he’s on the wrong side of history.”The Center for Biological Diversity equally condemned the nomination, saying that Burgum would be a “disastrous secretary of the interior who’ll sacrifice our public lands and endangered wildlife on the altar of the fossil fuel industry’s profits”.skip past newsletter promotionafter newsletter promotionBurgum was not always aligned with Trump’s extreme climate agenda. He has said he believes that climate change is real and in 2021 had called for North Dakota to be carbon neutral by 2030, advocating for a plan that retained the state’s fossil fuel industries while investing in carbon capture and storage technologies to offset emissions.At the time, environmental groups supported Burgum’s pledge, but noted the impracticality of relying on unproven carbon capture technology rather than a transition away from fossil fuels.“Could be worse for sure,” said Jared Huffman, a progressive Democrat of California and senior member of the House natural resources committee who has championed climate action. “I look forward to trying to work productively with him.”Burgum’s views on matters outside of climate and energy, however, have long been reactionary. He signed a number of bills targeting LGBTQ+ people in North Dakota, including ones that banned gender-affirming care for minors, restricted drag shows, and banned trans people from using bathrooms and shower facilities that match their gender identity in prisons, domestic violence shelters or state university families. More

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      RFK Jr could have disastrous global impact on public health, experts fear

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      The appointment of a US health secretary with anti-vaccine views could cause deaths and have profound consequences around the world, global health experts fear.Robert F Kennedy Jr, Donald Trump’s pick for the position, has a history of spreading misinformation on vaccines and questioning the science of HIV and Aids.His nomination has been greeted with bemusement and alarm. One global health activist, speaking on background, said the move was akin to making the disgraced doctor Andrew Wakefield, who falsely claimed that the MMR vaccine caused autism, the UK’s health secretary.Prof Sir Simon Wessely, a regius professor of psychiatry at King’s College London, said of the move: “That sound that you just heard was my jaw dropping, hitting the floor and rolling out of the door.”Prof Sir Andrew Pollard, the director of the Oxford Vaccine Group, said there was real concern that Kennedy might use the platform “to pursue the same anti-science positions on life-saving public health interventions that he has advanced previously”.He added: “If this makes families hesitate to immunise against the deadly diseases that threaten children, the consequence will be fatal for some.”Prof Beate Kampmann, of the London School of Hygiene & Tropical Medicine, said the measles vaccine had averted more than 60m deaths worldwide in the last 25 years.“Progress will be rapidly lost in societies where vaccine hesitancy is promoted – as I fear will be the case in the US if Kennedy is appointed,” she said. Beyond US shores, the influence “could swing either way”, she said. “My worry is that polarisation on the topic will further increase.”The US is a huge force in global health as the largest funder and the home to many big pharmaceutical companies and leading health research institutes. The decisions of its regulators, such as the Food and Drug Administration, are closely watched by their equivalents elsewhere.Some of those institutions are likely to be disrupted by Kennedy’s pledge to “clear out corruption” at US health agencies and potentially eliminate entire departments. But the impact of a Trump administration on global health will be broader than any policies pursued by Kennedy alone. Trump could reinstate plans to withdraw from the World Health Organization and is almost certain to cut funding to UNFPA, the United Nations sexual and reproductive health agency that works in many poorer countries.As under all Republican presidents since Ronald Reagan, NGOs expect there to be a “global gag rule” banning recipients of US health funding from performing or promoting abortions anywhere in the world, which will potentially expand to cover even recipients of humanitarian aid.Kennedy’s stance on vaccination is being watched warily. Globally, routine vaccination coverage has yet to return to pre-pandemic levels. Lower immunisation rates led to a 20% annual increase in measles cases in 2023.Kennedy has previously made common cause with anti-vaccine groups overseas. In June 2019 he visited Samoa, where the measles vaccine was being blamed for the deaths of two babies a year earlier. It later emerged that the deaths had been caused by incorrect preparation of the vaccine mixture.Immunisation rates halved to 31% and not long after his visit a measles outbreak ended up infecting more than 57,000 people and killed 83, including children. Even as the outbreak raged, Kennedy wrote to the Samoan prime minister suggesting it might have been caused “by a defective vaccine” rather than inadequate coverage. Kennedy said previously he bore no responsibility for the outcome.His nomination was greeted with cautious civility in Berlin, where Kennedy made a name for himself as a coronavirus sceptic during the pandemic. The health minister, Karl Lauterbach, a qualified doctor, offered his congratulations but couched it in language that made his scepticism clear. “Here’s to a constructive collaboration. Will certainly not be just easy. But the choice of the voters is to be respected,” he wrote on X.Kennedy managed to enter Germany in 2020 despite tight travel restrictions in order to address coronavirus sceptics at a rally in the capital. He became a hero of the so-called Querdenker anti-coronavirus conspiracy theorist group, speaking to a demonstration attended by about 18,000 people.Kennedy drew parallels between his presence in Berlin, as a “fighter against totalitarianism”, and his uncle John F Kennedy’s appearance there in June 1963 during the cold war when he said the city had previously been a front against totalitarianism.On Friday, individuals and groups linked to the Querdenker movement welcomed the appointment, with some claiming Kennedy would “save the rest of the world”.The Hartmannbund association of German doctors voiced its concern about the overall effect a Trump presidency could have on Germany’s healthcare system. Its chair, Klaus Reinhardt, warned of the potential impact of any trade war between the US and Europe on the supply of medicines, saying issues over tariffs could greatly increase health costs and the individual contributions currently required by Germany’s health insurers.Scientific leaders say another pandemic is inevitable and that while during the Covid-19 pandemic Trump’s Operation Warp Speed aided the development, approval and mass manufacture of vaccines in record times, similar US leadership under Kennedy appears less likely.On other issues, experts are waiting for more detail on Kennedy’s plans. He has pledged to tackle chronic diseases and address the issue of overly processed foods. Leadership in those areas could be welcome in a world where diabetes rates have doubled in the past three decades.Many global health activists said they would agree with Kennedy that big pharma has questions to answer, but that companies should not be falsely accused of making vaccines that harm people; rather, they should be asked why so much of the world does not have access to affordable medicines. More

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      Mike Pence urges Senate Republicans to reject RFK Jr for US health secretary

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      Mike Pence, the former vice-president, urged Senate Republicans on Friday to reject Donald Trump’s choice of Robert F Kennedy Jr as health secretary – although he cited Kennedy’s support for abortion rights, while other critics are most outraged at his stance against vaccines.Pence’s comments came as public alarm mounted among Democrats and in health circles about Kennedy, while there were bipartisan warnings that another of Trump’s choices, the far-right congressman Matt Gaetz for attorney general, faces “an uphill battle” to win confirmation in the US Senate, despite Republicans winning the majority in the upper congressional chamber.Pence cited his conservative views on abortion for his opposition to Kennedy’s elevation to secretary of health and human services (HHS).“The Trump-Pence administration was unapologetically pro-life for our four years in office. There are hundreds of decisions made at HHS every day that either lead our nation toward a respect for life or away from it, and HHS under our administration always stood for life,” Pence said in a statement released by his conservative non-profit, Advancing American Freedom.“I believe the nomination of RFK Jr to serve as Secretary of HHS is an abrupt departure from the pro-life record of our administration and should be deeply concerning to millions of Pro-Life Americans who have supported the Republican Party and our nominees for decades.”Prominent medical professionals have joined leading Democrats in speaking out against Kennedy, who has embraced a multitude of debunked health-related conspiracy theories, and whose proposed elevation to the government’s top health job represents “a clear and present danger to the nation’s health” and “a catastrophe”, according to some critics.“I think this is an extraordinarily bad choice. He does not plan to lean on evidence and rigorous analysis to make decisions but instead to use his own ideas,” Dr Ashish Jha, Covid-19 coordinator for the Biden White House and dean of Brown University’s School of Public Health, told CNN.Dr Richard Besser, former acting director of the powerful US Centers for Disease Control and Prevention (CDC), told the network that Kennedy’s views criticizing childhood vaccines, including the false claim that they cause autism, were “dangerous”.“Frankly, I find it chilling. He has done so much to undermine the confidence that people have in that incredible intervention,” he said.Trump has been assembling a cabinet for his second term in office, making announcements this week from his residence in Florida, and on Thursday named Kennedy to lead HHS and its associated agencies.He praised the politician, a former independent presidential candidate and outcast from the Democratic Kennedy political dynasty, at a black-tie gala at Mar-a-Lago on Thursday night.“If you like health and if you like people that live a long time, it’s the most important position,” he said. Directly addressing Kennedy, who was in the ballroom of Trump’s Mar-a-Lago residence and private resort club, he added: “We want you to come up with things and ideas, and what you’ve been talking about for a long time.”Democrats were quick to express outrage. The California representative Robert Garcia called it “fucking insane” and described Kennedy as “a tin foil hat conspiracy theorist”.The Massachusetts representative Jake Auchincloss promised to “fight back in Washington to protect the integrity” of federal public health agencies if Kennedy is confirmed by the Senate.“RFK Jr is a conspiracist & quack who threatens the health of Americans. He’s not simply angling for more sunshine & exercise (no one disagrees with that). He seeks to overturn evidence-driven, peer-reviewed research on medicines & more,” Auchincloss posted to X.Shares in several of the world’s biggest pharmaceutical companies and vaccine manufacturers, including Moderna, AstraZeneca and GSK, plummeted on Friday in reaction to the news.Kennedy has previously said “there’s no vaccine that is safe and effective” but told NBC in a post-election interview that he “won’t take away anybody’s vaccines”.skip past newsletter promotionafter newsletter promotionTrump on Thursday nominated a vocal ally of his to be interior secretary – Doug Burgum, the Republican North Dakota governor. The role would put him in charge of national parks and public lands, and he has strong links to the fossil fuel industry, where many companies have strong appetites for government permits to drill and mine on federal land.Republicans will have a majority of at least 53-47 seats in the chamber during the next Congress, but even so, two other of Trump’s picks are already receiving bipartisan pushback: Gaetz and the former Democratic congresswoman turned Republican Tulsi Gabbard, named for director of national intelligence. Former secretary of state Hillary Clinton once described her as a “favorite of the Russians”.Gaetz resigned as a US representative for Florida on Wednesday, in effect suspending the planned release on Friday of a report by the House of Representatives ethics committee into allegations of sexual misconduct, including that he had sex with a 17-year-old girl, which he has denied. His nomination as the nation’s leading law enforcement officer was seen by some as a direct challenge by Trump to the incoming Republican Senate majority to defy his authority.“For me the message to the administration is simply that Matt Gaetz has a very long, steep hill to get across the finish line and it will require the spending of a lot of capital,” North Dakota’s Republican senator Kevin Cramer told the Washington Post.“That ethics report is clearly going to become a part of the record.”On Friday, Joni Ernst, Republican senator for Iowa, also said the report was expected to feature prominently in a confirmation hearing. “We’ll talk about it for certain, but I know he’s going to have an uphill battle [for confirmation],” she told NBC News.Other Republicans demanded the release of the report, including Washington congressman Dan Newhouse and Texas senator John Cornyn.Meanwhile former defense secretary and Republican US senator Chuck Hagel published an opinion piece in the New York Times challenging Trump’s controversial nominee for defense secretary, Pete Hegseth, as a potential “danger” to political independence, good ethics and progress towards equality in the US military. He also questioned the potential for Trump to sidestep Senate confirmations.Trump has signaled he could resort to rare recess appointments, the archaic process allowing a president to install his nominees while Congress is not in session. More

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      Hardliners, loyalists and a dog killer: Trump’s new White House team – podcast

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      When Donald Trump entered the White House in 2017, he came with a team of veteran Republicans, conventional politicians and celebrated generals, as well as the odd Trump ideologue or family member.As Guardian US political correspondent Lauren Gambino explains to Michael Safi, it was often a bad fit – marked by a record churn of senior staff.This week, as Trump again prepares a cabinet for office, he is doing things differently, valuing loyalty above all, and – from the Department of Defence to Justice to Homeland Security – nominating a series of extreme figures for his next government.Will the Republican-controlled Senate still wave them through? And what effect will the appointments have on Trump’s four years in power if it does? More

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      Trump 2.0: are his cabinet picks more extreme than in 2016?

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      Donald Trump has wasted no time in assembling his incoming cabinet, issuing a flurry of nominations this week that – in some cases – have further heightened fears that his return to the White House will lead to an extremist agenda.The roster of names has inevitably drawn comparisons with Trump’s 2016 victory, when he was reported to have devoted relatively little attention to a transition effort. Back then, his picks were described as “conventional” and the incoming cabinet was said have been broadly in line with that of a traditional Republican.Eight years on and the shape of the Trump 2.0 White House so far has spurred serious concerns about public health and reproductive rights, and left military leaders “stunned” and former intelligence experts “appalled”.Some senators have already expressed doubt that some of Trump’s nominees will garner sufficient votes to be confirmed – even in the Republican-majority chamber which holds the power to deny his appointments.So how do Trump’s cabinet nominees in 2024 compare with those he made in 2016?Secretary of health and human servicesIn 2016, Trump appointed Tom Price, an orthopedic surgeon and prominent critic of Obamacare but he was sacked a year later for using at least $400,000 of taxpayer money for private jets. He was replaced by Alex Azar, former executive at pharmaceutical giant Eli Lilly, prompting outcry over the proximity of Big Pharma to Congress.On Thursday, Trump said he will nominate Robert F Kennedy Jras the US secretary of health and human services. The scion of the Democratic dynasty rose to national prominence as a persistent and influential vaccine denier, and one rights group responded to his nomination by calling him “a clear and present danger to the nation’s health” . He has amplified unfounded claims that vaccines are tied to autism in children, promoted the false idea HIV is not the cause of Aids and baselessly linked certain antidepressants to a rise in school shootings, and the use of a certain herbicide to a rise in young people coming out as transgender.Secretary of defenseView image in fullscreenTrump’s pick of James Mattis in 2016 was well received by those in establishment defence circles, who reportedly had faith that he would “moderate” Trump. The retired marine general also had deep wells of support on Capitol Hill and Trump himself said he had been impressed by Mattis’s forceful argument against torture. His resignation less than two years into Trump’s first term was described by some analysts as “the last proverbial adult in the room” leaving.This week Trump named national guard veteran and Fox News presenter Pete Hegseth for the role. Hegseth served as a prison guard at Guantánamo Bay detention camp, as well as in Iraq and Afghanistan, before becoming an outspoken rightwing critic of the military. He has called for a purge of generals for pursuing “woke” diversity policies.Pentagon officials were said to be stunned by the choice and the Army Times quoted an unnamed senior military officer as saying there are concerns that Hegseth – who has minimal managerial experience – will be able to manage a government department with a budget of more than $800bn.Secretary of stateView image in fullscreenIn 2016, Donald Trump’s decision to nominate Rex Tillerson – the head of the biggest oil company in the world – as secretary of state triggered alarm among environmentalists and critics of Russian influence. As president and chief executive of ExxonMobil, Tillerson had a history of close business ties to Vladimir Putin.At the time, senator Marco Rubio said he had “serious concerns” about the nomination. In his time in the role, Tillerson clashed with Trump over Iran, North Korea – and the response to Russia’s nerve agent attack on British soil, which the then secretary of state said would have consequences. Trump went on to fire him in March 2018 and Tillerson later that year warned of a “crisis of ethics and integrity” in America.Trump’s choice of Marco Rubio for the role in 2024 was arguably the most hawkish option on his shortlist. The senator has in past years advocated for a muscular foreign policy with respect to China, Iran and Cuba. Over the last few years he has softened some of his stances to align more closely with Trump’s views, but his selection was greeted with relief by many in foreign policy circles.Attorney generalView image in fullscreenTrump’s 2016 pick of senator Jeff Sessions to be chief law enforcement officer for the government was backed by many Republicans, but criticised by rights groups who accused of him of making racist comments in the past.His tumultuous time in the role saw him recuse himself from an investigation into Russia’s role in the election and clash with Trump over the justice department’s independence. He was sacked in November 2018.Congressman Matt Gaetz’s nomination this week has been variously described as “silly”, “the worst in American history” and unlikely to be confirmed by the senate. Robert Weissman, the co-president of the watchdog group Public Citizen said “Gaetz has demonstrated contempt for the rule of law, truth and decency” and was “singularly unqualified to lead an agency that enforces civil rights laws and environmental protection statutes.”A loyal Trump follower, Gaetz’s nomination comes a little over a year after the justice department decided not to charge him as part of a sex trafficking investigation. He also faced investigation from the House ethics committee over allegations that he “engaged in sexual misconduct and illicit drug use”. He has denied all wrongdoing.National security adviserView image in fullscreenIn 2016, the pick of retired three-star army general Michael Flynn to help shape foreign and military policy in the White House drew sharp criticism for his ties to Russia and comments about Muslims.In the end, Flynn lasted just 23 days in the job and resigned after it was revealed that he had misled the vice-president, Mike Pence, about his communications with the Russian ambassador.Congressman Mike Waltz has been seen as a more conventional pick for the role in 2024. A former Green Beret, Waltz has been a leading critic of China who has voiced the need for the US to be ready for a potential conflict in the region.Director of national intelligenceView image in fullscreenThe choice of Dan Coats – a former senator, ambassador and lobbyist – as director of national intelligence in 2016 was seen by many Republicans as the elevation of a dependable conservative voice. Coats went on to clash with his boss on several issues and was eventually fired three days after Trump’s now-infamous phone call with Ukrainian president Volodymyr Zelenskyy which resulted in his first impeachment.On Wednesday, Trump named Tulsi Gabbard, a former Democratic representative who left the party in 2022 and who has little direct experience with intelligence work, for the role. Gabbard endorsed Trump for president in August.In the past she has criticised the Biden administration’s support for Ukraine in its war against Russia and publicly doubted the intelligence community – which she is now set to lead – after it concluded that Syrian president Bashar al-Assad carried out a chemical attack that killed dozens of his own citizens.Former intelligence officer and Democrat representative Abigail Spanberger said she was “appalled at the nomination” adding she was “deeply concerned about what this nomination portends for our national security.”Secretary of homeland securityView image in fullscreenIn 2016, Trump picked former Marine Corps Gen John Kelly to run the cabinet department responsible for enforcing US immigration laws, as well as a number of important agencies including the coast guard and the Secret Service. His nomination was greeted warmly on both sides of politics, including from the top Democrat on the Senate homeland security committee.Kelly went on to serve as Trump’s chief of staff, but later fell out with the president. Last month he claimed his former boss “falls into the general definition of fascist” and recalled the former president repeatedly lauding Hitler’s achievements when he was in the White House.This week Trump chose Kristi Noem, the governor of South Dakota, for the role. She rose to national prominence after refusing to impose a statewide mask mandate during the Covid pandemic. In January she said the US was “in a time of invasion” and offered to send razor wire and agents to help shore up the border.Noem was reportedly on Trump’s shortlist for the role of vice-president, but was removed after an outcry over her admission that she once shot dead a pet dog, as well as a family goat. More