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      Woman’s life-saving treatment delayed by Trump cuts to NIH: ‘Cancer shouldn’t be political’

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      A 43-year-old woman and mother of two with advanced cancer says she is experiencing life-or-death delays in treatment because of the Trump administration’s cuts to the National Institutes of Health (NIH).Natalie Phelps, who has stage 4 colorectal cancer, has spoken publicly, raising the alarm about a setback in care for herself and others who are part of clinical trials run by the agency. Her story has made it into congressional hearings and spurred a spat between a Democratic senator and the US health secretary, Robert F Kennedy Jr. Behind the scenes, she and others are advocating to get her treatment started sooner.So far, Phelps has been told that her treatment, which should have started around mid-June, will not begin until after mid-July.“I’ve done everything I can do,” Phelps, who lives in Washington state, told the Guardian. “There’s nothing else I can do. I’m really just out of options. There’s very limited treatments approved for colorectal cancer.”Phelps is one of many Americans whose lives have been disrupted or altered by the ongoing cuts to government services made by the Trump administration’s so-called “department of government efficiency”, or Doge. Some NIH scientists have lost their jobs, and others have seen their grants ended. Researchers told the Associated Press that cuts to the agency and its programs would end treatment for cancer patients and delay cures and treatment discoveries.View image in fullscreenPhelps was diagnosed in 2020, soon after giving birth to her second child, and after her symptoms were dismissed by doctors for months. Since then, she’s gone through 48 rounds of chemotherapy. She had an 18-hour surgery to remove her primary tumor, plus two follow-up liver surgeries. She’s had radiation therapy to her brain, leg and pelvis.Dr Steven Rosenberg’s cell-based immunotherapy trial at the NIH offered hope. The treatment uses a person’s own cells to fight cancer and has seen some promise for patients with colon, rectal and GI cancers. This was deemed an exciting step by the medical community because the process had previously worked on blood cancers, but not solid cancers, the Washington Post reported.But these promising developments are coming alongside cuts to federal agencies, including ones that have affected these trials, Rosenberg has publicly confirmed. The trial itself was not cut, but it is experiencing delays because of staff reductions, Rosenberg has said.Phelps passed the initial medical steps to enter the trial in March, then flew to Bethesda, Maryland, at the end of April this year. There, they drew her blood to use to engineer T-cells for her treatment, which she previously was told takes about four weeks. Instead, she was told it would now take eight weeks, which the doctors said was because of funding cuts imposed by Doge.“That got me motivated enough to start to really panic, because my cancer between March and April really exploded and progressed to my lymph nodes and my bones,” she said. “My oncologist was very anxious about the difference between four and eight weeks could make, waiting for those treatment products.”One month can make a huge difference in late-stage cancer treatment, but the delay also brought up major decisions for Phelps. She wouldn’t be able to do chemo for a month before the treatment began. With a delay, she could maybe do chemo for a bit, then stop a month before.Then there was the size of her tumors – which would become the subject of the spat in a congressional hearing. She needed a tumor of at least one centimeter in size to start the trial, or an exemption – her disease was spreading in the number of tumors, not in one large tumor. The tumor would help scientists track how the treatment was working.View image in fullscreenIf she underwent chemo before doing a final scan needed to start the trial, tumors could shrink, affecting her eligibility. But if she waited for two months and did nothing, the disease could keep spreading. Her oncologist thought maybe the trial would have to be placed on the back burner, given the extended timeline.Phelps posted on social media, explaining her predicament. After seeing her videos, friends suggested she reach out to her members of Congress, who could intervene with the agency and help her get treated sooner.The office of Patty Murray, a Washington Democratic senator, got involved. On 14 May, Murray questioned Kennedy during a Senate health, education, labor and pensions committee hearing, sharing Phelps’ story and asking how many staff have been cut from the NIH’s clinical center. Kennedy said to reach out to his office for specifics on Phelps and claimed no cuts had been made to clinical trials. “I don’t think that should happen to anybody,” he said.Later in the hearing, though, Kennedy said his office had looked into the case and claimed that Phelps was “medically ineligible” for the trial, so her case had nothing to do with staff reductions. “That was a canard,” he told the committee, and he told Murray: “You don’t care. You don’t care about Natalie.” The exchange became a Fox News headline.It was a “spurious statement” to say she was medically ineligible, Phelps said – she was waiting for one final scan to see if her tumor was one centimeter, but had met all other criteria. She had a scan the day after the hearing, which showed her tumor had now grown large enough to qualify.“It’s been so much extra stress. The night after the hearing, I threw up all night. I barely made it to my scan because I was so stressed out,” she said. “It’s been very intense emotionally and an extreme added stress that nobody needs. Cancer just shouldn’t be political.”In a Senate appropriations hearing the next week, Kennedy again argued with Murray, saying it was “untrue” that Phelps’ care was delayed. In statements after the second exchange, Murray said her staff has been in “constant touch” with career staff at the NIH and the FDA to get help on Phelps’ case.“I still have no answer about how many NIH clinical staff have been fired,” Murray’s 20 May statement says. “I still have no answer why Natalie was told by her NIH doctor that her care was being delayed due to staffing cuts. For weeks, my staff has been demanding answers about agency staffing cuts.”In a statement, a spokesperson for the Department of Health and Human Services (HHS) said cancer research is a “high priority” for the NIH and HHS.“Ongoing investments reflect our dedication to addressing both urgent and long-term health challenges,” the agency said. “There have been no cuts to clinical trials.”In another statement sent after publication, the agency said the claim that patients were seeing treatment delays because of reductions in force was “false”.“No clinical trials have been cut. No personnel involved in direct patient care were affected by the RIF,” the agency said.“Clinical trials continue to be conducted in accordance with established protocols and patient safety standards. NIH investigators are responsible for ensuring trials are appropriately staffed, that patient enrollment aligns with trial capacity, and that participants are fully informed of timelines and potential risks of experimental treatments. We do not comment on individual patient cases in accordance with the Privacy Act and to protect patient confidentiality.”But Rosenberg, the doctor leading the trial Phelps is in, confirmed to the Washington Post in April that two patients were delayed care because of staff cuts and “purchasing slowdowns”, and these delays were confirmed before big layoffs hit the agency.Rosenberg didn’t respond to requests for comment this week. He previously told the Cancer Letter, an oncology publication, that Phelps was, at the time of the hearing, not eligible because of her tumors’ size, but was scheduled for additional scans to see if they had grown. He confirmed that, if determined eligible, her case would be delayed by a month because of reductions in force.Phelps wasn’t alone, he told the publication – nearly all of the trial patients were seeing a delay of about a month, which he attributed to a “loss of technicians” as part of reductions in force done by the Trump administration. It isn’t just delays, either.“We’ve had to drop the number of pa­tients we treat by about half. We’re just having to turn away more patients,” Rosenberg said.Phelps is still waiting to hear when she can start treatment. As of last Thursday, she was told she had a spot in the queue and the agency was seeing if her treatment could be moved up. On Tuesday, she was told it would now be 21 July. The NIH told her the agency tried to hire back staff, but it hasn’t worked out.“I have nothing to lose at this point. I’m pleading for my life. I’m begging for help,” she said. More

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      RFK Jr’s ‘Maha’ report found to contain citations to nonexistent studies

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      Robert F Kennedy Jr’s flagship health commission report contains citations to studies that do not exist, according to an investigation by the US publication Notus.The report exposes glaring scientific failures from a health secretary who earlier this week threatened to ban government scientists from publishing in leading medical journals.The 73-page “Make America healthy again” report – which was commissioned by the Trump administration to examine the causes of chronic illness, and which Kennedy promoted it as “gold-standard” science backed by more than 500 citations – includes references to seven studies that appear to be entirely invented, and others that the researchers say have been mischaracterized.Two supposed studies on ADHD medication advertising simply do not exist in the journals where they are claimed to be published. Virginia Commonwealth University confirmed to Notus that researcher Robert L Findling, listed as an author of one paper, never wrote such an article, while another citation leads only to the Kennedy report itself when searched online.Harold J Farber, a pediatric specialist supposedly behind research on asthma overprescribing, told Notus he never wrote the cited paper and had never worked with the other listed authors.The US Department of Health and Human Services has not immediately responded to a Guardian request for comment.The citation failures come as Kennedy, a noted skeptic of vaccines, criticized medical publishing this week, branding top journals the Lancet, New England Journal of Medicine and Jama as “corrupt” and alleging they were controlled by pharmaceutical companies. He outlined plans for creating government-run journals instead.Beyond the phantom studies in Kennedy’s report, Notus found it systematically misrepresented existing research.For example, one paper was claimed to show that talking therapy was as effective as psychiatric medication, but the statistician Joanne McKenzie said this was impossible, as “we did not include psychotherapy” in the review.The sleep researcher Mariana G Figueiro also said her study was mischaracterized, with the report incorrectly stating it involved children rather than college students, and citing the wrong journal entirely.The Trump administration asked Kennedy for the report in order to look at chronic illness causes, from pesticides to mobile phone radiation. Kennedy called it a “milestone” that provides “evidence-based foundation” for sweeping policy changes.A follow-up “Make our children healthy again strategy” report is due in August, raising concerns about the scientific credibility underpinning the administration’s health agenda. More

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      RFK Jr drops Covid-19 boosters for kids and pregnant women from CDC list

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      The US health secretary, Robert F Kennedy Jr, announced that the federal Centers for Disease Control and Prevention (CDC) would remove Covid-19 booster shots from its recommended immunization schedule for healthy children and pregnant women.Legal experts said the Trump administration appointee’s decision, which Kennedy announced on social media, circumvented the CDC’s authority to recommend such changes – and that it is unprecedented for a health secretary to unilaterally make such a decision.“I couldn’t be more pleased to announce that as of today, the Covid vaccine shot for healthy children and healthy pregnant women has been removed from the CDC’s recommended immunization schedule,” Kennedy said in the announcement.Kennedy claimed Joe Biden’s administration last year “urged healthy children to get yet another Covid shot despite the lack of any clinical data to support the repeat booster strategy in children”.The secretary was flanked by Food and Drug Administration (FDA) commissioner – Dr Marty Makary – and the head of the National Institutes of Health (NIH), Dr Jay Bhattacharya. Neither the head of the FDA nor of the NIH would typically be involved in making vaccine administration recommendations.Bhattacharya said the announcement was “common sense and good science”.Removing the booster shot from the recommended immunization schedule could make it more difficult to access – and it could affect private insurers’ willingness to cover the vaccine. About half of Americans receive healthcare through a private insurance company.Such a unilateral change is highly unusual if not unprecedented for a typical US Department of Health and Human Services (HHS) secretary. And it could leave the HHS department open to litigation, said one vaccine law expert.“The secretary has never been involved in making Covid-19 vaccine recommendations – any vaccine recommendations,” said Dorit Reiss, a law professor at the University of California San Francisco who has closely followed attempts to circumscribe access to Covid-19 vaccines.It is not clear whether the social media announcement was accompanied by formal documentation of the change. Annual Covid-19 booster shots were still recommended for children on the CDC’s website Tuesday morning. It is unclear how Tuesday’s announcement could affect federal programs, such as Vaccines for Children, which provides shots to uninsured and under-insured children.“I am surprised at the open contempt they are showing to the process and not even pretend to do it in a substantive and deliberative way,” Reiss said. “If only because I would think they want to make it as litigation-proof as they can.”The change further sends conflicting messages about the importance of Covid-19 vaccination during pregnancy. The CDC says people are at increased risk of severe illness if they contract Covid-19 during pregnancy, including heightened risk of hospitalization and the need for intensive care.That evidence was acknowledged by Makary in a similarly unprecedented article in the New England Journal of Medicine, which announced changes to the way the FDA would license Covid-19 vaccines. In that article, pregnancy and recent pregnancy were listed among “underlying medical conditions that can increase a person’s risk of severe Covid-19”.Further, there is evidence that mothers who are vaccinated pass protective immunity to infants. Infants younger than six months are at the highest risk of severe disease among children, with the risk to children younger than four years old on par with that of 50-64-year-old adults, according to the Journal article.Typically, changes to vaccine administration recommendations are first considered by the CDC’s advisory committee on vaccine practices (ACIP), a group of independent vaccine experts. ACIP meetings are public, meaning in a normal process Americans can watch experts debate the validity of different approaches in real time before a vote. Although the CDC does not always take the group’s advice, it often does. The CDC was without a permanent director as of Tuesday, a little more than four months into Donald Trump’s second presidency.ACIP recommendations are then counter balanced by recommendations from the FDA’s vaccine and related biologics products advisory committee, which has a similar structure and transparency measures. That group met five days earlier to recommend strains to include in this fall’s Covid-19 booster shot, settling on the JN.1 lineage.Kennedy’s announcement comes as the Trump administration has packed HHS with “Covid contrarians” – a colloquial term used by researchers to describe people, typically critics, who do not accept mainstream public health’s recommendations to prevent Covid-19.Congressional Republicans allied with Trump have also continued to flog the Biden administration’s response to the pandemic in hearings. Vaccine hesitancy has become much more common among Republican party voters than it once was, a Gallup poll has found. More

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      This doctor calls LGBTQ+ rights ‘satanic’. He could now undo healthcare for millions

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      Steven Hotze, a Republican donor from Texas, has spent decades fighting against LGBTQ+ rights, with campaigns seeking to roll back protections for people he has deemed “termites”, “morally degenerate” and “satanic”.The Houston-area physician is not well-known in mainstream politics, and his efforts targeting queer and trans people have generally been local, with limited impact.His latest cause could be different. Hotze, 74, has sued the federal government to roll back healthcare coverage for pre-exposure prophylaxis (PrEP), the HIV prevention medication. The case is now before the US supreme court, which is expected to rule in the coming weeks. A decision in his favor could upend healthcare access for LGBTQ+ people across the country – and derail a wide array of preventive treatments for tens of millions in the process.“People will die,” said Kae Greenberg, staff attorney with the Center for HIV Law and Policy, which filed a brief in the case. “Preventive healthcare saves lives, and this case is about whose lives we consider worth protecting. It’s about cutting off people’s care based on them being gay or substance users or living their lives in a way the plaintiffs do not approve of. It’s using the law to legitimize bigotry.”The case, Kennedy v Braidwood, originated with Hotze’s Christian healthcare firm, Braidwood Management, which filed a lawsuit in 2020 objecting to the federal requirement that his company’s insurance plan cover PrEP. Braidwood, another Christian business and two individuals argued the daily PrEP medications “facilitate and encourage homosexual behavior”, saying the government violated their religious beliefs by making them support “sexual promiscuity”.Braidwood challenged the requirement under the Affordable Care Act, also known as Obamacare, that insurers and group health plans cover preventive services, a provision that includes diabetes and cancer screenings, medications to reduce heart disease risks, contraception and vaccinations. Along with opposing PrEP, Hotze explicitly objected to STI screenings, counseling for alcohol use and childhood obesity interventions.A Texas district court sided with Braidwood, saying the US violated the firm’s religious freedom. The ruling also found that a taskforce of medical experts that recommended the preventive services covered by the ACA was unconstitutional because the experts hadn’t been confirmed by the Senate, and therefore health plans should not be required to cover the care.The US government appealed the ruling on the taskforce, which is the issue now before the supreme court. The coverage mandates have remained in effect as the case has progressed, though the individual plaintiffs have been shielded from covering the services. The Trump administration has continued to defend the taskforce’s constitutionality, and the supreme court is not weighing religious objections.If the supreme court sides with Braidwood, it could lead to widespread loss of access to free preventive healthcare, with one study finding 39 million people received the threatened services. A 2023 Yale study estimated the loss of free PrEP could result in more than 2,000 preventable HIV infections within one year.The outcome of the case could threaten coverage for every service recommended by the taskforce, not just the provisions opposed by the right. “We’re talking about people who cannot afford this care, who will have to choose between a mammogram and rent,” added Susan Polan, associate executive director of the American Public Health Association.A decades-long missionThe high-stakes case, and Hotze’s role in it, have flown under the radar. But research from the progressive watchdog organization Accountable.US, which shared its findings with the Guardian, reveal the rightwing activist’s long history of pushing fringe ideologies before getting a signature cause before the supreme court.Hotze and his lawyers did not respond to requests for comment.In 1982, 31-year-old Hotze launched a petition in the city of Austin to legalize housing discrimination against gay people, the AP reported at the time. Heading a group called Austin Citizens for Decency, Hotze called gay residents “criminals” and “sodomites”, saying: “The issue is not housing. The issue is whether we allow our city council to grant public sanction to homosexual activity.” He said protecting LGBTQ+ people from discrimination is “like thieves or murderers trying to gain political power”. Hotze said in one interview he was less concerned about “property rights” and more worried about the “deviant, perverted lifestyle”. Voters overwhelmingly rejected his referendum.In 1985, Hotze backed a group of eight “anti-homosexual” Houston city council candidates identified as the “straight slate”. On ABC News, he stated, “We’re intolerant of those who participate in homosexual activity.” All eight candidates lost.Hotze runs the Hotze Health & Wellness Center, which has been in operation since 1989; Braidwood is his management firm that employs the center’s staff. He has marketed hormone therapies to treat a wide range of conditions and sold a vitamin product called Skinny Pak, the New York Times reported. Over the years, he has donated extensively to the Republican party and Texas politicians, including Senator Ted Cruz.Hotze’s public anti-LGBTQ+ activism picked up after the supreme court legalized gay marriage nationwide in 2015, with Hotze launching a “Faith Family Freedom Tour” and using the same homophobic language from his activism decades prior. Hotze said he was fighting a “wicked, evil movement” that celebrates anal sex, telling the Houston Chronicle: “Kids will be encouraged to practice sodomy in kindergarten.”View image in fullscreenDuring the tour, he said “satanic cults” were behind gay rights, brandished a sword during a speech, and likened his fight to battling Nazis, the Texas Observer reported. That year, he and other rightwing activists successfully campaigned to repeal an equal rights Houston ordinance.At a 2016 evangelical conference, Hotze was filmed describing the LGBTQ+ rights movement as “termites [that] get into the wood of the house and … eat away at the moral fabric”. In 2017, Hotze rallied for Roy Moore, the failed Alabama senate candidate accused of sexually coercing teenagers in the 1970s.Hotze has also recently promoted anti-trans causes, testifying in 2023 in favor of a school district policy requiring staff to notify parents if students change their names or pronouns. Trans people, he said, “have a reprobate, perverted and morally degenerate mind”.His ACA case was not his first effort to undo federal civil rights protections. In a case that began in 2018, Braidwood sued the Equal Employment Opportunity Commission (EEOC), challenging a ban on anti-LGBTQ+ discrimination in the workforce. Braidwood said it enforces a “sex-specific dress code that disallows gender-non-conforming behavior”, the courts summarized, prohibiting women from wearing ties and men from wearing nail polish. Hotze said he would not employ candidates engaged in “sexually immoral” behaviors.In 2023, an appeals court ruled that a religious freedom law protected Hotze’s rights to enforce dress codes and refuse to hire LGBTQ+ people.In that case, and in the one now before the supreme court, Hotze has been represented by America First Legal, the rightwing legal group co-founded by Stephen Miller, Donald Trump’s influential adviser. The organization has brought a string of lawsuits, including efforts to undo trans rights and complaints accusing companies of discriminating against white men.Hotze has also been represented by Jonathan Mitchell, an anti-abortion lawyer behind Texas’s so-called “bounty hunter law” that allows private citizens to sue providers or people who “aid or abet” the procedure.America First Legal and Mitchell did not respond to inquiries.Gabbi Shilcusky, Accountable.US senior investigative specialist, noted that Hotze’s supreme court case was founded on hypotheticals: “He’s not hiring men who wear nail polish or are asking for PrEP. This is manufactured to build upon his most fringe beliefs and not about actual issues he’s being confronted with in his company.”Hotze has in recent years made headlines outside of anti-LGBTQ+ advocacy. In 2020, during George Floyd protests, he left a voicemail for the Texas governor urging that he “kill the son of a bitches”, referring to demonstrators. Later that year, the Food and Drug Administration sent his company a warning advising it was promoting “unapproved and misbranded products” for Covid.In 2022, Hotze was charged with unlawful restraint and aggravated assault with a deadly weapon in an elections dispute. Hotze hired a contractor who claimed a local air conditioner repairman was holding fraudulent ballots in his truck. The contractor ran his vehicle into the man’s car and held him at gunpoint, according to prosecutors, who said the voter fraud claims were false. Hotze was later charged with aggravated robbery and organized criminal activity from the incident.View image in fullscreenHotze pleaded not guilty, and this week, a newly elected DA dropped the charges, accusing his predecessor of bringing a politically motivated case. The criminal case did not stop his attacks on voting rights; in October, just before the election, he filed a lawsuit against the local registrar seeking to invalidate tens of thousands of voters.It’s unclear if Hotze will succeed at the supreme court. In oral arguments last month, some justices, including conservatives, appeared skeptical of the arguments by Hotze’s lawyers. The case hinges on whether the taskforce members who make ACA recommendations are akin to department heads requiring Senate approval or are “inferior” officers. Brett Kavanaugh and Amy Coney Barrett at times appeared sympathetic to the notion that the experts are not sufficiently independent so as to merit a congressional vote.The case is part of longstanding attacks against the ACA, with legal strategies focused on religious claims as well as objections to how the law was crafted. Hotze previously challenged the ACA in a failed lawsuit that began in 2013, an effort he promoted with a bizarre original song called God Fearing Texans Stop Obamacare.Even if Hotze fails, the threats to PrEP and LGBTQ+ healthcare will continue, said Jeremiah Johnson, executive director of advocacy group PrEP4All, noting the Trump administration’s continued funding cuts and dismantling of HIV prevention, and ongoing rightwing efforts to attack civil rights under the guise of religious liberty.The case also comes as the FDA is considering a new injectable PrEP considered a major prevention breakthrough, he said. “We’re at the precipice of science delivering real pathways to ending this epidemic, but if we turn our backs now on all these protections, including private insurance through the ACA, we’re not just going to backtrack on progress, we’re going to lose out on that promise for the future.” More

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      Key takeaways: RFK Jr’s ‘Maha’ report on chronic disease in children

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      Donald Trump’s health secretary and long-time vaccine skeptic, Robert F Kennedy Jr, presented a highly anticipated report on children’s health this week.The “Maha commission” report, referring to the “Make America healthy again” movement, was required by a presidential executive order in February. The report focuses on chronic disease among children.The 68-page report broadly summarizes five areas affecting children’s health, with a focus on ultra-processed foods, environmental chemical exposure, lack of physical activity, “overmedicalization”, and “capture” of regulatory agencies.It notably omits some of the most common causes of chronic disease and death in children, insinuates there could be harms where there is lack of evidence, and avoids discussing how Republicans have already changed the health system in ways researchers believe are harmful.Art Caplan, a professor of bioethics at New York University’s Grossman School of Medicine, told the Guardian that the report has “interesting ideas about health and children’s health and crackpot fringe tin-hat-wearing nonsense – it’s got it all”.Here are five of the key takeaways from the report.1. The report ignores some common dangers to childrenThe most common causes of death among children are car crashes and firearm accidents. The report ignores these issues, as well as behaviors that often start in adolescence and lead to chronic disease in adulthood, such as smoking and alcohol use. It also criticizes water fluoridation, without mentioning its protective effects against cavities.Also, absent from the report is a discussion of how the administration has already changed the health department in ways that advocates argue will benefit industry and could exacerbate chronic disease.For instance, Kennedy eliminated two smoking prevention offices at the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) in what one former regulator told Stat was “the greatest gift to the tobacco industry in the last half century”. He also eliminated a world-leading sexually transmitted infection laboratory.In another example, one of the nation’s leading researchers of ultra-processed foods quit his “dream job” after facing what he described as censorship from the administration (the health department reportedly asked him to return). In a similar vein, the Trump administration cut a program that delivered local whole foods to schools soon after taking office, in spite of Kennedy calling for healthier school meals.2. The report focuses on issues key to Kennedy’s view of healthThe report is roughly broken up into five sections focusing on ultra-processed foods, environmental chemical exposures, children’s mental health, “overmedicalization” and “corporate capture” of regulators by the industries they are supposed to oversee.Kennedy has harped on many of the issues listed in the report for months in public appearances and even though his defunct presidential campaign – especially including ultra-processed foods and obesity. Although some of these concerns may find bipartisan support – such as the focus on “forever chemicals” such as Pfas – it also pushes into areas where the science is unsettled.For instance, the report mentions that high levels of fluoride are potentially associated with reduced IQ, but does not mention its well-established protective effects against cavities – the most common chronic condition in children, according to the National Institute of Dental and Craniofacial Research.Similarly, the report argues that the childhood vaccine schedule is causing concern among parents for,“their possible role in the growing childhood chronic disease crisis” – without citing evidence that vaccines are linked to any specific chronic disease.3. It’s likely to face diverse pushback – and create new alliancesEven before the report was published, congressional lawmakers were being bombarded by calls from agricultural and chemical lobbyists wary of how the report would criticize their products – and indeed it did.One of the report’s sections questions whether “crop protection tools” including “pesticides, herbicides and insecticides” could harm human health. It then specifically name-drops glyphosate, the key ingredient in Roundup, and atrazine, a common herbicide. That is sure to make for strange political bedfellows and consternation within the Republican party. Similarly, the report cites synthetic dyes and ultra-processed foods are potentially harmful.Chemicals and food additives have been issues of concern for decades on the left. However, the Maha movement has also catalyzed opposition to them on the right.4. The report’s authors are not namedThe commission’s members are made up of the heads of intersecting agencies, including Kennedy at the Department of Health and Human Services, and the heads of the departments of agriculture, housing, education, veterans affairs and the Environmental Protection Agency, among others.However, the exact authors of the report are unknown. This contrasts with Kennedy’s repeated promise at his confirmation hearing that his health department would practice “radical transparency”.The work of the “Maha” commission was reportedly spearheaded by senior Kennedy adviser Calley Means, a former food lobbyist and healthcare entrepreneur who rose to prominence as a Maha truth-teller. Means co-wrote a bestselling book with his sister, current US surgeon general nominee Casey Means, which blames many of America’s ills on sedentary lifestyle and poor diet.5. Changing any of the issues identified is likely to be toughOne of the key issues the report identifies is the influence of food, pharmaceutical and chemical companies on American policy. They are monied and powerful.As a result, getting real change through Congress is certain to be tough – especially in an administration devoted to reducing regulations. More

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      Forget the DEI hires – meet Trump’s latest WTF hire | Arwa Mahdawi

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      The US health secretary doesn’t think you should really listen to him when it comes to health issues. During an appearance before House and Senate committees this week, Robert F Kennedy Jr, famous for his unconventional views about medicine and his revelation that a parasite ate part of his brain, seemed to think it was strange that lawmakers were asking him about vaccines.“What I would say is my opinions about vaccines are irrelevant,” Kennedy said when pressed on whether he would vaccinate his child for measles. “I don’t want to seem like I’m being evasive, but I don’t think people should be taking advice, medical advice, from me.” The US health secretary repeated his refrain about not wanting to give advice a number of other times.I, on the other hand, am desperate to dole out a bit of advice. Namely: it would probably be a good idea if a few people who actually knew what they were talking about were brought into the US government. I know, I know. Look at me being a crazy idealist! Still, at the very least, it might be wise to at least ensure that the people who are in charge of health issues know a thing or two about medicine.Alas, judging by some of Donald Trump’s latest appointments, it would seem that I am asking far too much. See, for example, Dr Casey Means, who was nominated for US surgeon general last week. Means has got “Dr” in front of her name, which sounds promising, but she’s more of an influencer than a practitioner. Though she trained as a surgeon at Stanford, she never completed her medical residency afterward. Why? She says it’s because she was disillusioned with traditional medicine, but a former colleague told the Los Angeles Times that it was due to anxiety. Means also doesn’t have an active medical license. In short: she wouldn’t be able to get a job as a doctor at your local hospital but she’s being considered for the role of “the nation’s doctor”. As for experience working in government? She doesn’t have any of that, either.What Means does have, Trump announced in a recent social media post, are “impeccable ‘MAHA’ credentials”. That’s the “Make America healthy again” movement: a movement that is preoccupied with some very valid issues (processed food, corruption in the health industry) but mired in conspiracist thinking. Means has been on TV a lot to talk about Maha obsessions such as removing fluoride from drinking water. She also makes money from dietary supplements that she promotes on social media and has co-authored a book with her brother that claims “almost every chronic health symptom that Western medicine addresses is the result of our cells being beleaguered by how we’ve come to live”. Which, of course, isn’t completely false but has been accused of being overly simplistic. Means’s brother, by the way, is also a prominent adviser to Kennedy.So are all the Maha crowd rejoicing in the streets at the idea of Means becoming surgeon general? Not quite. Her nomination has actually sparked Maha infighting. Some Maha voices think Means is not extreme enough, particularly when it comes to the Covid shot. These people seem to want a surgeon general who declares Covid was a hoax and bans vaccines altogether.The far-right conspiracy theorist Laura Loomer, meanwhile, who seems to have become one of Trump’s most influential albeit unofficial advisers, isn’t happy with Means because she thinks she’s unserious. Writing on Twitter/X, Loomer said Means “PRAYS TO INANIMATE OBJECTS, COMMUNICATES WITH SPIRIT MEDIUMS, USES SHROOMS AS ‘PLANT MEDICINE’ AND TALKS TO TREES! SHE ALSO DOESN’T EVEN HAVE AN ACTIVE MEDICAL LICENSE.”Loomer isn’t the only one a little worried about Means’s enthusiasm for psychedelic drugs including magic mushrooms – which the prospective surgeon general once suggested in a newsletter helped her find a romantic partner. Psilocybin, a psychedelic compound found in certain mushrooms, is currently listed as a schedule I drug, defined as a substance “with no currently accepted medical use and a high potential for abuse”.Means should probably be a little worried about what Loomer thinks, as Loomer may have played a part in ousting Trump’s original pick for the position. That was Janette Nesheiwat, a former Fox News medical contributor and the sister-in-law of Mike Waltz, the former national security adviser. On X this month, Loomer called Nesheiwat “a pro-Covid vaccine nepo appointee” who “didn’t go to medical school in the US”. (Nesheiwat has said that she got a degree from the University of Arkansas School of Medicine, but it would seem that she actually earned her medical degree from a school in Sint Maarten.)Will Loomer topple Means before her confirmation (which hasn’t been scheduled yet) as well? I don’t know but I can tell you that if she does, it’s unlikely that her successor will be any more qualified. The Trump administration, as we all know, has been waging war on diversity, equity and inclusion (DEI). If you’re a (non-Trump-loving) woman or a minority, it doesn’t seem to matter how many qualifications you have, you’re automatically considered a “DEI hire” and looked upon with suspicion. Many prominent people in the Trump administration, meanwhile, seem to be WTF hires. They are there because they’re white, Trumpy and often in the family of someone influential (or they have been on Fox News). Whether we get Means or not, you can be sure that whoever is confirmed as the nation’s top doctor will be completely unqualified to treat the US’s Trump-induced ailments.

      Arwa Mahdawi is a Guardian columnist More

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

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

      Moira Donegan is a Guardian US columnist More

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

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