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      F.D.A. Expands Access to Clozapine, a Key Treatment for Schizophrenia

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      Federal regulators will no longer require patients to provide blood tests before receiving the drug from pharmacies.The Food and Drug Administration has taken a crucial step toward expanding access to the antipsychotic medication clozapine, the only drug approved for treatment-resistant schizophrenia, among the most devastating of mental illnesses.The agency announced on Monday that it was eliminating a requirement that patients submit blood tests before their prescriptions can be filled.Clozapine, which was approved in 1989, is regarded by many physicians as the most effective available treatment for schizophrenia, and research shows that the drug significantly reduces suicidal behavior. Clozapine is also associated with a rare side effect called neutropenia, a drop in white blood cell counts that, in its most severe form, can be life-threatening.In 2015, federal regulators imposed a regimen known as risk evaluation and mitigation strategies, or REMS, that required patients to submit to weekly, biweekly and monthly blood tests that had to be uploaded onto a database and verified by pharmacists.Physicians have long complained that, as a result, clozapine is grossly underutilized.Dr. Frederick C. Nucifora, director of the Adult Schizophrenia Clinic at the Johns Hopkins School of Medicine, said he believed that around 30 percent of patients with schizophrenia would benefit from clozapine — far more than the 4 percent who currently take it.“I have had many patients who were doing terribly, who struggled to function outside the hospital, and cycled through many medications,” he said. “If they go on clozapine, they really tend to not be hospitalized again. I’ve had people go on to finish college and work. It’s quite remarkable.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      As Trump Courts Putin, China’s Leader Xi Emphasizes Close Ties With Russia

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      The Chinese and Russian leaders reaffirmed their relationship in a video call on Monday, an apparent rebuff to the idea that the Trump administration could drive a wedge between them.China’s leader said his country and Russia were “true friends who have been through thick and thin together” after a video call with President Vladimir V. Putin on Monday, according to Chinese state media.The warm words attributed to Xi Jinping were clearly intended to dampen speculation that the Trump administration might succeed in driving a wedge between Beijing and Moscow.The call came on the anniversary of Russia’s 2022 invasion of Ukraine, after three years in which China has served as Russia’s most important foreign partner amid Moscow’s isolation in the West.“History and reality show us that China and Russia are good neighbors who won’t move away, and true friends who have been through thick and thin together, support each other and develop together,” Mr. Xi was quoted as saying by Chinese state media.Mr. Xi said relations between China and Russia were not “affected by any third party,” in what appeared to be an oblique reference to the United States. And he said the two countries’ foreign policies were for the “long term.”The Kremlin issued a similarly cordial statement after the call, describing Mr. Xi and Mr. Putin’s conversation as “warm and friendly.” In a rebuff of the idea that President Trump could divide the two countries, the Kremlin added: “The leaders emphasized that the Russian-Chinese foreign policy link is the most important stabilizing factor in world affairs,” and said the relationship was “not subject to external influence.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Trump Has the Same Idea in Mind for Ukraine and the Department of Justice

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      I grew up a Reagan Republican in the middle of the Cold War, and I never thought I’d see the day when the president of the United States became the world’s most prominent and effective Russian propagandist.Yet that’s exactly what happened last week, when President Trump began a diplomatic offensive against the nation of Ukraine and the person of President Volodymyr Zelensky.This month, the administration couldn’t seem to get its message straight. First it seemed to want to offer unilateral concessions to the Russian government — including by taking NATO membership for Ukraine off the table and recognizing Russia’s territorial gains in Ukraine — only to walk back the concessions days (or hours) later.The cumulative effect was confusing. What was the administration’s position on Ukraine? Last week, however, the words and actions of the administration left us with no doubt — the United States is taking Russia’s side in the conflict.What other conclusion should we draw when Marco Rubio, the secretary of state, begins peace negotiations with Russia without Ukraine or any of our NATO allies at the table, dangling “historic economic and investment opportunities” for Russia if the conflict ends?What other conclusion should we draw when Trump demands ruinous economic concessions from Ukraine to compensate America for its prior aid? He’s demanding a higher share of gross domestic product from Ukraine than the victorious Allies demanded from Germany after World War I.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Trump Team Plans Cuts at HUD Office That Funds Disaster Recovery

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      The Trump administration plans to all but eliminate the office that oversees America’s recovery from the largest disasters, raising questions about how the United States will rebuild from hurricanes, wildfires and other calamities made worse by climate change.The Office of Community Planning and Development, part of the Department of Housing and Urban Development, pays to rebuild homes and other recovery efforts after the country’s worst disasters, such as Hurricane Helene in North Carolina and Hurricane Milton in Florida.The administration plans to cut the staff in that office by 84 percent, according to a document obtained by The New York Times. The number of workers would be cut to 150, from 936 when Mr. Trump took office last month.Those cuts could slow the distribution of recovery money to North Carolina and other recent disasters, depending how quickly they happen.“HUD is carrying out President Trump’s broader efforts to restructure and streamline the federal government to serve the American people at the highest standard,” a spokeswoman for the department, Kasey Lovett, said in a statement. The primary responsibility for rebuilding communities after major disasters falls to the Federal Emergency Management Agency, which helps state and local governments pay to repair or rebuild damaged roads, bridges, schools, water treatments plants and other public infrastructure. The agency also provides money to help repair damaged homes.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Can the Federal Reserve Look Past Trump’s Tariffs?

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      Top officials are grappling with how to handle potential price increases caused by the administration’s policies.As President Trump’s efforts to restructure the global trade system with expansive tariffs begin to take shape, one question continues to dog officials at the Federal Reserve: How will these policies impact the central bank’s plans to lower interest rates?One influential Fed governor made clear on Monday that he did not expect Mr. Trump’s policies to derail the Fed’s efforts to get inflation under control, suggesting instead that fresh interest rate cuts are still in play this year.“My baseline view is that any imposition of tariffs will only modestly increase prices and in a nonpersistent manner,” Christopher J. Waller, the official, said in remarks at an event in Australia Monday evening. “So I favor looking through these effects when setting monetary policy to the best of our ability.”Economists are concerned that tariffs, which are essentially taxes on American consumers, will increase prices in the United States, at least temporarily, and over time slow economic growth.Mr. Waller acknowledged that the economic impact of the tariffs could be larger than anticipated depending on how they are structured and later put in place. But he suggested that any uptick in prices from tariffs could be blunted by other policies, which could have “positive supply effects and put downward pressure on inflation.”Mr. Waller’s views matter given that he is one of the seven officials who make up the Board of Governors and votes at every policy meeting.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Israel and Hamas Make 6th Exchange, Keeping Cease-Fire Intact for Now

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      Days after the fragile truce appeared to be teetering, Hamas freed three Israeli hostages as Israel released 369 Palestinian prisoners. But it is far from clear whether the deal will reach a second phase.Hamas freed three more Israeli hostages on Saturday as Israel released 369 Palestinian prisoners, prolonging a fragile cease-fire in the Gaza Strip that appeared to be teetering only days ago.The hostages — Alexander Troufanov, 29, known as Sasha; Iair Horn, 46; and Sagui Dekel-Chen, 36, one of the few Americans still held in Gaza — were noticeably thinner and paler after spending 16 months in captivity. They had been abducted from the Israeli border village of Nir Oz during the Hamas-led attack on Oct. 7, 2023, that ignited the war in Gaza.But they did not appear as emaciated as the three hostages released last Saturday, whose condition prompted outrage and horror in Israel.Palestinian militants once again used the exchange, the sixth carried out under the first phase of the cease-fire, to stage a show intended to demonstrate that they still dominate Gaza, despite Israel’s devastating bombardment and ground invasion in response to the 2023 attack.Dozens of gun-toting fighters affiliated with Hamas and Palestinian Islamic Jihad forced Mr. Troufanov, Mr. Horn and Mr. Dekel-Chen to mount a stage in the southern Gaza city of Khan Younis and to give speeches in Hebrew, with portraits of Hamas leaders on the stage behind them.The hostages being freed — Mr. Horn, 46, Mr. Dekel-Chen, 36, and Mr. Troufanov, 29 — on a stage erected by Hamas in Khan Yunis, Gaza. Saher Alghorra for The New York TimesWe are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      The Barrage of Trump’s Awful Ideas Is Doing Exactly What It’s Supposed To

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      The first month of the second Trump presidency has put the lie to the widespread wisdom that Donald Trump has no ideology and no ideas, only an insatiable thirst for power and money. Trump has shown that he has ideas. So many ideas. They are just really bad ideas:The United States can own, ethnically cleanse and redevelop Gaza as a luxury resort. The U.S. will buy Greenland and take possession of the Panama Canal. The government will become more efficient by cutting the Department of Education, U.S.A.I.D., medical and science research and many many jobs. D.E.I. caused the collision of an Army helicopter and a passenger plane in the air near Washington, D.C. Immigrants and transgender people are an existential threat to Americans. The president can and should rule by decree. These are all ideas, in the sense that they are opinions, beliefs or expressions of a possible course of action.Some of these ideas would have seemed unthinkable just weeks ago. But now that they have been thought and uttered by the man in possession of the world’s biggest megaphone, all of us are forced to engage with them. Otherwise sane people start debating questions like: Could the U.S. really take over Gaza? Would Egypt or Jordan go along with the ethnic cleansing project? Can trillions of dollars really be cut from the federal budget with a few keystrokes? Is there evidence that D.E.I. caused the crash? Are all immigrants criminals? Do trans people exist? Did the founders intend to check the power of the executive?Flooding the ether with bad ideas isn’t Trump’s unique know-how — it’s standard autocratic fare. Hannah Arendt used the word “preposterous” to describe the ideas that underpinned 20th-century totalitarian regimes. Bad ideas do a lot of the work of building autocracy. By forcing us to engage with them, they make our conversations, our media and our society dumber. By conjuring the unimaginable — radical changes in the geography of human relationships, the government and the world itself as we have known it — they plunge us into an anxious state in which thinking is difficult. That kind of anxiety is key to totalitarian control.Life under autocracy can be terrifying, as it already is in the United States for immigrants and trans people. But those of us with experience can tell you that most of the time, for most people, it’s not frightening. It is stultifying. It’s boring. It feels like trying to see and breathe under water — because you are submerged in bad ideas, being discussed badly, being reflected in bad journalism and, eventually, in bad literature and bad movies.Much has been said about the Democrats’ failure to sound the alarm loudly enough, fast enough or broadly enough as Trump has mounted his campaign of destruction. Some of the criticism is not entirely fair. The American system of checks and balances isn’t designed to move as fast as Trump is moving or to stop a bad-faith individual intent on breaking it. A real problem, though, is that Democrats’ objections to these ideas have been primarily procedural. Trump understands politics as the interplay of power and ideology. His opponents see politics as procedure. The contrast has never been starker — and never has the Democrats’ technocratic, legalistic approach been more detrimental to the cause of democracy. It’s not Trump who doesn’t have ideas; it’s the people who should be fighting to stop Trump’s autocratic breakthrough.It is not enough to say that Trump and his crony Elon Musk are staging a coup, though they are. Many of the people who voted for Trump want to see him smash what he has successfully framed as a useless, wasteful government. It is not enough to say that Trump is destroying American democracy. Many of the people who voted for him did so because they have long felt that the system as it is constituted doesn’t represent their interests — and both Trump and Musk have argued that they are wresting democracy back from unelected bureaucrats. It is not enough to say that Trump’s actions have caused a constitutional crisis or that his executive orders may violate laws passed by Congress. Many of the people who voted for Trump longed to see their frustrations addressed by decisive, spectacular action, which he is delivering.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      I’ve Covered Authoritarians Abroad. Trump’s Actions Look Familiar.

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      President Trump’s second term dizzies many Americans, but I find it oddly familiar — an echo of the time I lived in China as a reporter.Americans sometimes misperceive Trump’s actions as a fire hose of bizarre and disparate moves, a kaleidoscope of craziness. Yet there is a method to it, and I’ve seen parallels in authoritarian countries I’ve covered around the world over the past four decades.It’s not that I offer a unified theory of Trumpism, but there is a coherence there that requires a coherent response. Strongmen seek power — political power but also other currencies, including wealth and a glittering place in history — through a pattern of behavior that is increasingly being replicated in Washington.But let’s get this out of the way: I think parallels with 1930s Germany are overdrawn and diminish the horror of the Third Reich; the word “fascism” may likewise muddy more than clarify. Having covered genuinely totalitarian and genocidal regimes, I can assure you that this is not that.Democracy is not an on-off switch but a dial. We won’t become North Korea, but we could look more like Viktor Orban’s Hungary. This is a question not of ideology but of power grabs: Leftists eroded democracy in Venezuela and Nicaragua, and rightists did so in Hungary, India and (for a time) the Philippines and Poland. The U.S. is the next test case.When authoritarians covet power, they pursue several common strategies.First, they go after checks and balances within the government, usually by running roughshod over other arms of government. China, for example, has a Supreme Court and a National People’s Congress — but they are supine. Here in the United States, many Republican members of Congress have similarly been reduced to adoring cheerleaders.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More