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Former Director of USAID: Millions Will Die Because of Musk’s Chainsaw

By dianeravitch
April 9, 2025 //
2

This important article appeared on the blog called “Inside Medicine,” which appears on Substack. It describes the terrible consequences of Elon Musk’s decision to eliminate USAID. Many of us are still wondering how he got the authority to dismantle an agency authorized and funded by Congress. Many of us wonder why the Republicans in Congress ceded their Constitutional powers to this one man.

Musk said merrily that he was “feeding it to the woodchipper.” He strutted onstage at a Trump rally, waving a bejeweled chainsaw to flaunt his power. What a cruel and callous man he is. How little he cares about human life. He tells us we must procreate (I think he means whites), yet he is completely uncaring about the people who will die because he cut off medical services, medicine, and food to those in need.

Inside Medicine is written by Dr. Jeremy Faust, MD, MS, a practicing emergency physician, a public health researcher, writer, spouse, and girl Dad. He blends his frontline clinical experience with original and incisive analyses of emerging data to help readers make sense of complicated and important issues. Thanks for supporting it!

This past week, Dr. Atul Gawande briefed US Senators on the effects that the destruction of USAID is already having. Here are the facts we need to know. 

Over the last couple of months, the Inside Medicine community has been fortunate to hear and learn about USAID directly from Dr. Atul Gawande. 

Today, I’m sharing the first public release of Dr. Gawande’s latest update provided to members of the United States Senate, remarks that were delivered in person in Washington, D.C. last week. 

This is essential and up-to-date information that we all need to know. When people ask what the human costs of this administration’s brazen actions have been, we must respond with facts. Well, here they are…

First, a quick reminder: Inside Medicine is 100% supported by reader upgrades.

Thank you!👇

(And, as always, if you can’t upgrade due to financial considerations, just email me and it’s all good). 

Do you have any idea where things stand with USAID? With everything else going on, I realized that even I needed an update. So, I again reached out to our friend Dr. Atul Gawande, who, until noon on January 20, 2025, ran global health for USAID.

Here’s where things stand: While the Supreme Court ruled last month that the Trump administration still has to pay its bills for work already completed by USAID contractors, that was not exactly a high bar to clear—and even that decision was a narrow 5-4 ruling. Meanwhile, all of the contract terminations and personnel purges have been permitted to go through while the overall issues are litigated. Therefore, the reality is that even if the courts eventually determine that the complete gutting of USAID was not lawful, it will already be a fait accompli—that is, practically impossible to reverse. 

So, what of USAID’s crucial work remains, and what has—in Elon Musk’s own words—already been ‘fed to the wood chipper’? In testimony to members of the US Senate this past week, Dr. Gawande summarized what has already been destroyed by callous and brutal DOGE-directed terminations since January. We are only just beginning to be able to estimate the number of deaths these cuts will cause in the coming months and years, but unless something changes, it will surely amount to millions of human lives lost. A particularly depressing aspect is that these are senseless deaths (not to mention other suffering from disease and poverty), without reasonable or accurate justifications, as Dr. Gawande explicitly delineated in his presentation. 

I’m grateful that Atul has provided his remarks for publication here in Inside Medicine. Please read his words and share them. 

Senate Roundtable on The Dangerous Consequences of Funding Cuts to U.S. Global Health Programs.

Tuesday, April 1 from 2:30-3:30PM. U.S. Senate Visitors’ Center, Room 200/201.

Testimony of Atul Gawande, MD, MPH:

I was the Assistant Administrator for Global Health at USAID during the last administration. It was the best job in medicine most people haven’t heard of. I led 800 health staff in headquarters working alongside more than 1600 staff in 65-plus countries. With less than half the budget of my Boston hospital system – about $9 per U.S. household – they saved lives by the millions and contained disease threats everywhere.

Before my departure on January 20, I briefed this committee about several major opportunities ahead for the next few years. Among them were three breakthroughs. The journal Science had just declared one of them the scientific breakthrough of 2024. American scientists had developed a drug called Lenacapavir that could prevent or treat HIV with a single injection that lasted six months and perhaps even a year. Deploying this game-changer in high-risk communities through PEPFAR could finally bring an end to HIV as a devastating public health threat.

Similarly, USAID launched a trial of a four-dose pill that could prevent tuberculosis in exposed individuals and dramatically reduce cases – while three TB vaccines complete testing.

And USAID was just about to scale up a novel, inexpensive package of existing drugs and treatments that was found to reduce severe hemorrhage after childbirth – the leading cause of maternal death – by 60%.

American companies, nonprofits, and scientists played key roles in these breakthroughs, and they were poised to transform global health over the next five to ten years. The next administration had no reason not to pursue these objectives. Congress had already funded them. There was nothing partisan about them at all.

But instead of saving millions of lives, we got surgery with a chainsaw. The new administration not only shuttered this work, they fired the staff of the entire agency, terminated 86% of its programs, and kneecapped the rest – all against Congressional directives. They dismantled the US’s largest civilian force advancing global stability, peace, economic growth, and survival. And they have done it in a way maximized loss of life and mismanagement of taxpayer dollars.

Here are few specific examples of the global health damage:

● Our 50-country network for stronger surveillance to deadly diseases from bird flu to swine fever – gone.

● Our emergency response system that cut response times to global outbreaks from >2 weeks to <48 hours – gone.

● AIDS programs to prevent new cases of HIV in high-risk populations – gone.

● Programs for preventing child and maternal deaths that reached 93 million women and children under 5 in 2023 and added 6 years of life on average – cut 92%.

● Lifesaving tuberculosis programs – cut 56%.

● Lifesaving water and sanitation programs – cut 86%.

● Funding for Gavi, the global vaccine alliance, which was set to vaccinate half a billion children — terminated and, if not restored, will cost 500,000 lives a year and drive higher exposure to measles in the US.

The damage is already devastating. And it is all part of a larger dismantling of America’s world-leading capacity for scientific discovery, health care delivery, and public health that goes well beyond USAID. They are using the same playbook to purge staff and destroy programs in across our entire domestic infrastructure in government, universities, and medical center. And they are inserting political controls on NIH science research, FDA approvals, and CDC guidance.

For the sake of power, they are destroying an enterprise that added more than 30 years to US life expectancy and made America the world leader in medical technology and innovation. We need you in Congress to stop this process. USAID cannot be restored to what it was. But we must salvage what we can of our health, science, and development infrastructure and stop the destruction.

Thank you, Dr. Gawande!

Categories Cruelty, Disruption, Ethics, Evil, Extremism, Funding, Health, International, Musk, Elon, Science, Trump

Washington Post: Trump and RFK Jr. Are Destroying Public Health Agencies

By dianeravitch
April 6, 2025 //
4

The Washington Post editorial board warned that Robert Kennedy’s deep cuts at the Department of Health and Human Services will damage the economy. They will also damage the nation’s health. Kennedy is not laying off paper-pushing bureaucrats. He is firing scientists and closing divisions working on drugs and cures for dangerous diseases and conditions.

The editorial board wrote:

The market took no time to weigh in on Robert F. Kennedy Jr.’s mass layoffs at the nation’s health agencies. As Health and Human Services employees arrived to work on Tuesday to discover their badges no longer worked, stock prices for health-care and biotech companies plunged. By the end of the day, the S&P’s index for the pharmaceutical industry had dropped 4 percent.

This should be a warning to the new HHS secretary and President Donald Trump: The employees of these institutions are as essential to the U.S. economy as they are to public health.

HHS officials have defended their planned 25 percent reduction in force (affecting about 20,000 employees) as a means to achieve efficiency. They claim it will save taxpayers about $1.8 billion annually. But this amount — minuscule relative to the multitrillion-dollar federal budget — could be wiped out by the economic damage that comes from discarding broad institutional knowledge.

The Food and Drug Administration, for instance, is slated to shed 3,500 staffers, or about 19 percent of its workforce. Among those who received layoff notices on Tuesday were many experts who assist with reviews at the Office of New Drugs. The director of this office, Peter Stein, resigned after being reassigned to patient affairs. Other top leaders have also been pushed out, including Hilary Marston, the FDA’s chief medical officer, and Peter Marks, its highest-ranking vaccine scientist.

HHS insists these layoffs will not weaken the agency’s core functions, especially drug approvals — but given how many high-level positions now sit vacant, this is hard to believe. Scott Gottlieb, who was FDA commissioner during Trump’s first term, said on X that the “barrage” threatens to bring “frustrating delays for American consumers, particularly affecting rare diseases and areas of significant unmet medical need.”

The National Institutes of Health, a sturdy engine of biomedical innovation, also saw many of its leaders defenestrated. Directors of at least four of the 27 institutes that make up the agency were removed from their posts, including Jeanne Marrazzo, the country’s most senior infectious-diseases official.

Meanwhile, hundreds of other layoffs at the agency’s research centers threaten to diminish its scientific prowess. The National Human Genome Research Institute, for one, which has made countless discoveries about the roles genes play in diseases, lost dozens of staffers as well as its acting chief, Vence L. Bonham Jr., who was installed just last month.

This turmoil comes amid the administration’s attempt to slash funding that NIH provides to outside research institutions. The administration seems not to care about U.S. investments in science that have been essential to building and maintaining a strong economy.

Equally concerning is what these layoffs could mean for public health. At the Centers for Disease Control and Prevention, which is set to lose 2,400 workers (an 18 percent reduction in staff), HHS cost-cutters have erased entire offices, including those dedicated to curbing HIV, tuberculosis, tobacco use, lead poisoning, substance abuse, birth defects and many other health threats. Kennedy — who also laid off many of the department’s communications staffers — has provided little rationale for any of these cuts. But if his goal is to save money, this is the wrong strategy. By keeping health-care costs down, public health programs often bring substantial returns on investment.

What makes these risky cuts especially baffling is that they’re being made only a few years after the covid-19 pandemic taught Americans about the need for a strong public health system, and amid the worst domestic measles outbreak in years. Bird flu also has begun spreading to humans — yet among those laid off were nearly all of the leading staffers at the FDA’s Center for Veterinary Medicine, which is assisting the government with its bird flu response.

It’s true that HHS’s vast bureaucracy has long needed serious — even radical — reforms to eliminate waste and make its agencies more effective. The CDC often acted clumsily during the pandemic and struggled to communicate effectively with the public. And although the FDA was streamlined during the Biden administration, it could use innovative ideas to energize its food division — perhaps by making it a stand-alone agency.

But the job cuts this week do not amount to efficient reform. The Trump administration has shown great skill at “moving fast and breaking things,” to borrow the motto used by chief bureaucracy-smasher Elon Musk. But Trump and Kennedy should remember, too, that when “you break it, you buy it.” The damage they do to the country’s public health and biomedical research infrastructure is their responsibility, and they will bear the political consequences.

Categories Accountability, Budget Cuts, Disruption, Extremism, Funding, Health, Science, Stupid, Trump

DOGE Creates Chaos and Fear at HHS

By dianeravitch
April 1, 2025 //
3

Government Executive reports that the Secretary Of Health and Human Services Robert F. Kennedy Jr. plans to lay off 10,000 of the Department’s 80,000 employeees. Entire divisions will be eliminated or merged. But no one knows who will be laid off. Decisions about layoffs are being made by Elon Musk’s DOGE. Since no one knows who will be fired or why, everyone is fearful.

Government Executive writes:

The Health and Human Services Department has told its employees that 10,000 of them will soon receive layoff notices, though it has not offered any details on who will be impacted or when they will learn of their fates. 

The uncertainty has dangled over the more than 80,000 HHS employees since Thursday, when the department first announced it was planning to shed around 25% of its workforce and half of those eliminations would come through reductions in force. Leadership at individual components and offices are regularly seeking to update their employees on what is happening, according to seven individuals within HHS, though they have all said they have been fully kept out of the loop and only a small group of political leaders within HHS know the plans.

The Food and Drug Administration is expected to lay off 3,500 employees, the Centers for Disease Control and Prevention 2,400, the National Institutes of Health 1,200 and the Centers for Medicare and Medicaid Services 300, according to an HHS fact sheet. HHS did not respond to an inquiry into why the notices were delayed or when they would go out.

Several employees were told to expect RIF notices to hit inboxes on Friday. When that did not happen, they were told to expect them Friday evening or over the weekend. As of Monday afternoon, the notices have still not gone out. 

“FDA leadership doesn’t know who will be cut,” said an employee briefed on the matter. “They didn’t have any input into these cuts whatsoever.” 

Employees at CDC and NIH expressed similar messages were going out from leadership to the workforce. 

“It’s unnecessarily cruel,” said one CDC employee of the uncertainty and delays. 

A second CDC employee said they spent the entire weekend refreshing their email waiting to see if a RIF notice arrived. The employee was resigned to their fate, but wanted an answer: “Just put me out of my misery,” the staffer said. 

Prior to an “all hands” meeting at one NIH office, employees were encouraged to download their complete personnel files, current position description, pay stubs, tax documents, awards information and contact information for human resources and their supervisor in case they lost access upon being laid off. 

The department will not allow those who are subject to RIFs to be allowed back onto HHS campuses, according to two employees briefed on the matter. Some staff were told to bring their laptops homes each day in case they were laid off and not allowed back into their offices. Unlike other agencies that have gone through RIFs, which have immediately placed impacted staff on administrative leave, at least some HHS employees will be expected to work until their date of separation. 

At FDA, conversations with office directors were taking place to identify U.S. Public Health Service Commission Corps members who could escort laid off employees to their desks to collect their laptops and personal belongings. The uniformed personnel would be available for the RIF-affected staff who need to retrieve items on campus.

The RIFs are expected to take effect May 27, according to the National Treasury Employees Union, which represents much of the HHS workforce. That date could get pushed back given the delay in sending out official RIF letters, however, as agencies typically provide 60 days notice before separations take effect. 

Directors at the highest level of the component agencies have communicated “have no knowledge over what is happening,” one employee said in a sentiment echoed by those throughout the department. 

A senior HHS official said even HR at component agencies have received no information on who is being laid off or when the notices were going out, though the latest expectation was the letters would be delivered Monday. 

“Radio silence,” the official said. “It is madness!” 

Government Executive previously reported that top officials were being left out of the workforce reduction process. At NIH, for example, liaisons from the Department of Government Efficiency dictated staffing targets without input from the agency or anyone else at HHS. 

Some informal notices were beginning to trickle out Monday afternoon. CDC is planning to eliminate its entire Freedom of Information Act office, according to an impacted employee, which could create legal questions as agencies are required to maintain those functions. The official notices had not yet gone out as of Monday afternoon but all of the office’s 40 employees are expected to receive them. 

The reductions will be part of a comprehensive reorganization of HHS. The cuts will save $2 billion annually, department Secretary Robert Kennedy said last week, and HHS will go from 28 divisions throughout the department down to 15. Department-wide functions such as human resources, IT, procurement, external affairs and policy will be centralized into the Administration for Healthy America and regional offices will be slashed in half to just five.

The new AHA will fold into its structure the Substance Abuse and Mental Health Services Administration, Agency for Toxic Substances and Disease Registry and National Institute for Occupational Safety and Health. HHS will divide up the functions of the Administration for Community Living, which provides oversight of those serving older and disabled Americans, into CMS, the Administration for Children and Families and the Assistant Secretary for Planning and Evaluation. ASPE itself will be combined with the Agency for Health Research and Quality into the Office of Strategy.

This hurried reorganization is being imposed by the young engineers and computer geeks who work for Musk, apparently without consulting anyone who has done the work. The changes are rushed, haphazard, and carried out without the participation of those with knowledge and experience.

Please open the link to continue reading the article.

Categories Accountability, Budget Cuts, Cruelty, Disruption, Evil, Extremism, Health, Musk, Elon, Science, Trump

CDC Downplays Importance of Vaccines, Reflecting Malign Influence of RFK Jr.

By dianeravitch
March 30, 2025 //
10

ProPublica reported that the Centers for Disease Control (CDC) recently watered down its advice about how to respond to the danger of measles. Pre-Trump and RFK Jr., the CDC was quick to warn the public about the importance of getting vaccinated, especially when there was an uptick in contagious diseases. Now, with vaccine critic RFK Jr. in charge of the Department of Health and Human Services of which the CDC is a part, the message has been muted. Now, getting vaccinated is a matter of personal choice, not a matter of public health.

Leaders at the Centers for Disease Control and Prevention ordered staff this week not to release their experts’ assessment that found the risk of catching measles is high in areas near outbreaks where vaccination rates are lagging, according to internal records reviewed by ProPublica.

In an aborted plan to roll out the news, the agency would have emphasized the importance of vaccinating people against the highly contagious and potentially deadly disease that has spread to 19 states, the records show.

A CDC spokesperson told ProPublica in a written statement that the agency decided against releasing the assessment “because it does not say anything that the public doesn’t already know.” She added that the CDC continues to recommend vaccines as “the best way to protect against measles.”

But what the nation’s top public health agency said next shows a shift in its long-standing messaging about vaccines, a sign that it may be falling in line under Health and Human Services Secretary Robert F. Kennedy Jr., a longtime critic of vaccines:

“The decision to vaccinate is a personal one,” the statement said, echoing a line from a column Kennedy wrote for the Fox News website. “People should consult with their healthcare provider to understand their options to get a vaccine and should be informed about the potential risks and benefits associated with vaccines.”

ProPublica shared the new CDC statement about personal choice and risk with Jennifer Nuzzo, director of the Pandemic Center at Brown University School of Public Health. To her, the shift in messaging, and the squelching of this routine announcement, is alarming.

“I’m a bit stunned by that language,” Nuzzo said. “No vaccine is without risk, but that makes it sound like it’s a very active coin toss of a decision. We’ve already had more cases of measles in 2025 than we had in 2024, and it’s spread to multiple states. It is not a coin toss at this point.”

For many years, the CDC hasn’t minced words on vaccines. It promoted them with confidence. One campaign was called “Get My Flu Shot.” The agency’s website told medical providers they play a critical role in helping parents choose vaccines for their children: “Instead of saying ‘What do you want to do about shots?,’ say ‘Your child needs three shots today.’”

Nuzzo wishes the CDC’s forecasters would put out more details of their data and evidence on the spread of measles, not less. “The growing scale and severity of this measles outbreak and the urgent need for more data to guide the response underscores why we need a fully staffed and functional CDC and more resources for state and local health departments,” she said.

Kennedy’s agency oversees the CDC and on Thursday announced it was poised to eliminate 2,400 jobs there.

Open the link to continue reading.

Measles is very serious. The World Health Organization estimated that 107,500 people--mostly unvaccinated children under the age of 5–died in 2023 from measles.

Categories Health, Science

Top Vaccine Official Resigns to Protest RFK Jr.’s “Lies and Misinformation”

By dianeravitch
March 29, 2025 //
8

Dr. Peter Marks, the leading vaccine expert at the Department of Health and Human Services resigned to protest Secretary Robert F. Kennedy Jr.’s persistent lies about the efficacy of vaccines. At his Senate hearings, Kennedy assured the committee that his days as a vaccine opponent were over. He lied.

The New York Times reported:

The Food and Drug Administration’s top vaccine official, Dr. Peter Marks, resigned under pressure Friday and said that Health Secretary Robert F. Kennedy Jr.’s aggressive stance on vaccines was irresponsible and posed a danger to the public.

“It has become clear that truth and transparency are not desired by the secretary, but rather he wishes subservient confirmation of his misinformation and lies,” Dr. Marks wrote to Sara Brenner, the agency’s acting commissioner. He reiterated the sentiments in an interview, saying: “This man doesn’t care about the truth. He cares about what is making him followers.”

Dr. Marks resigned after he was summoned to the Department of Health and Human Services Friday afternoon and told that he could either quit or be fired, according to a person familiar with the matter.

Dr. Marks led the agency’s Center for Biologics Evaluation and Research, which authorized and monitored the safety of vaccines and a wide array of other treatments, including cell and gene therapies. He was viewed as a steady hand by many during the Covid pandemic but had come under criticism for being overly generous to companies that sought approvals for therapies with mixed evidence of a benefit.

His continued oversight of the F.D.A.’s vaccine program clearly put him at odds with the new health secretary. Since Mr. Kennedy was sworn in on Feb. 13, he has issued a series of directives on vaccine policy that have signaled his willingness to unravel decades of vaccine safety policies. He has rattled people who fear he will use his powerful government authority to further his decades-long campaign of claiming that vaccines are singularly harmful, despite vast evidence of their role in saving millions of lives worldwide.

“Undermining confidence in well-established vaccines that have met the high standards for quality, safety and effectiveness that have been in place for decades at F.D.A. is irresponsible, detrimental to public health, and a clear danger to our nation’s health, safety and security,” Dr. Marks wrote.

Mr. Kennedy has, for example, promoted the value of vitamin A as a treatment during the major measles outbreak in Texas while downplaying the value of vaccines. He has installed an analyst with deep ties to the anti-vaccine movement to work on a study examining the long-debunked theory that vaccines are linked to autism.

And on Thursday, Mr. Kennedy said on NewsNation that he planned to create a vaccine injury agency within the Centers for Disease Control and Prevention. He said the effort was a priority for him and would help bring “gold-standard science” to the federal government.

An H.H.S. spokesman said in a statement Friday night that Dr. Marks had no place at the F.D.A. if he was not committed to transparency.

In his letter, Dr. Marks mentioned the deadly toll of measles in light of Mr. Kennedy’s tepid advice on the need for immunization during the outbreak among many unvaccinated people in Texas and other states.

Dr. Marks wrote that measles, “which killed more than 100,000 unvaccinated children last year in Africa and Asia,” because of complications, “had been eliminated from our shores” through the widespread availability of vaccines.

Dr. Marks added that he had been willing to address Mr. Kennedy’s concerns about vaccine safety and transparency with public meetings and by working with the National Academies of Sciences, Engineering and Medicine, but was rebuffed.

With the outbreak of measles in several states, Kennedy’s refusal to advocate immunization is a danger to public health. Only someone as dumb or malevolent as Trump could put a conspiracy theorist and vaccine opponent in charge of public health.

Categories Accountability, Ethics, Extremism, Health, Science

Trump Takes Control of the Smithsonian

By dianeravitch
March 28, 2025 //
23

Trump can’t keep his hands off anything. In his mad dash to be king, he has decided to reshape the Smithsonian Institution. Will he close exhibits he doesn’t like? We know he’s completely ignorant of history, so whatever he does will suit his prejudices. He has put JD Vance in charge. Will he withdraw references to “the trail of tears”? Will he remove references to the brutality of slavery?

Kelsey Ables of The Washington Post reported:

The Smithsonian, a sprawling, 21-museum institution tasked with telling the story of the United States and much more, could see changes under President Donald Trump, who in a Thursday executive order set his sights on ridding the institution of ideas that he says “undermine the remarkable achievements of the United States.”

According to a White House fact sheet summarizing the order, the president has instructed the vice president “to eliminate improper, divisive, or anti-American ideology” from the institution’s entities.

Trump’s unprecedented call to influence programming at an institution that has operated largely independently for its more than 175-year history raises questions about the fate of millions of items the country holds in what’s sometimes called “the nation’s attic.”

But who runs and funds the Smithsonian and can Trump overhaul it like he is the federal government? Here’s what to know.

The Smithsonian was created by Congress in 1846 with funds from James Smithson, a British scientist who left his estate to the United States to establish an institution “for the increase and diffusion of knowledge.” Smithson never visited the United States, though his remains are now housed at the Smithsonian Institution Building, known as the Castle.

These days, the Smithsonian is about 62 percent federally funded by a combination of congressional appropriation along with federal grants and contracts. The rest comes from trust funds or nonfederal sources, which include endowments, donations and memberships, as well as revenue from magazines, restaurants, concessions and more. The institution’s federal budget for the 2024 fiscal year was more than $1 billion.

Is the Smithsonian a government agency?

No, the Smithsonian is not a federal agency but a “trust instrumentality” of the United States, tasked with carrying out the responsibilities undertaken by Congress when it accepted Smithson’s donation. It’s overseen by the secretary, currently Lonnie G. Bunch III, who is appointed by the Board of Regents — made up of the chief justice, vice president, three members of the Senate, three members of the House and nine citizens.

The Smithsonian describes itself as the “world’s largest museum, education, and research complex” and includes 21 museums — two in development — 14 education and research centers, and the National Zoo. It holds a dizzying array of objects, from fighter jets hanging from the high ceilings of the Udvar-Hazy Center all the way down to the tiny specimens at the National Museum of Natural History.

Categories Art, Bigotry, Disruption, Freedom to Learn, Freedom to Read, Funding, Science, Stupid, Trump, Vance, J.D.

Trump Administration Cuts Funding for Vaccines for World’s Poorest Nations

By dianeravitch
March 27, 2025 //
3

The cruelty and sheer meanness of the Trump administration can never be overestimated. As the administration closes down USAID, without Congressional authorization, it announced a series of cuts that will kill millions of people. Having an ardent opponent of vaccines in charge of Heakth and Human Services removes any advocacy to distribute proven methods to save lives and prevent epidemics.

Stephanie Nolen of The New York Times reported:

The Trump administration intends to terminate the United States’ financial support for Gavi, the organization that has helped purchase critical vaccines for children in developing countries, saving millions of lives over the past quarter century, and to significantly scale back support for efforts to combat malaria, one of the biggest killers globally.

The administration has decided to continue some key grants for medications to treat H.I.V. and tuberculosis, and food aid to countries facing civil wars and natural disasters.

Those decisions are included in a 281-page spreadsheet that the United States Agency for International Development sent to Congress Monday night, listing the foreign aid projects it plans to continue and to terminate. The New York Times obtained a copy of the spreadsheet and other documents describing the plans.

The documents provide a sweeping overview of the extraordinary scale of the administration’s retreat from a half-century-long effort to present the United States to the developing world as a compassionate ally and to lead the fight against infectious diseases that kill millions of people annually.

The cover letter details the skeletal remains of U.S.A.I.D. after the cuts, with most of its funding eliminated, and only 869 of more than 6,000 employees still on active duty.

In all, the administration has decided to continue 898 U.S.A.I.D. awards and to end 5,341, the letter says. It says the remaining programs are worth up to $78 billion. But only $8.3 billion of that is unobligated funds — money still available to disburse. Because that amount covers awards that run several years into the future, the figure suggests a massive reduction in the $40 billion that U.S.A.I.D. used to spend annually.

A spokesperson for the State Department, which now runs what is left of U.S.A.I.D., confirmed the terminations on the list were accurate and said that “each award terminated was reviewed individually for alignment with agency and administration priorities, and terminations were executed where Secretary Rubio determined the award was inconsistent with the national interest or agency policy priorities.”

The memo to Congress presents the plan for foreign assistance as a unilateral decision. However because spending on individual health programs such as H.I.V. or vaccination is congressionally allocated, it is not clear that the administration has legal power to end those programs. This issue is currently being litigated in multiple court challenges.

Among the programs terminated is funding for the United Nations Food and Agriculture Organization, which conducts surveillance for diseases that can be transmitted from animals to humans, including bird flu, in 49 countries. Some major programs to track and fight malaria, one of the world’s top killers of children, have also been ended.

Dr. Austin Demby, the health minister of Sierra Leone, which relies on Gavi’s support to help purchase vaccines, said he was “shocked and perturbed” by the decision to terminate U.S. funding and warned that the ramifications would be felt worldwide.

“This is not just a bureaucratic decision, there are children’s lives at stake, global health security will be at stake,” he said. “Supporting Gavi in Sierra Leone is not just a Sierra Leone issue, it’s something the region, the world, benefits from.”

“The guiding principle of my work is ‘go there.’ I want to hear directly from the people who are affected by disease, or lack of access to a new drug. I’ve been writing about global health for 30 years and have reported from more than 80 countries.”

In addition to trying to reach all children with routine immunizations, Sierra Leone is currently battling an mpox outbreak, for which Gavi has provided both vaccines and critical support to deliver them, he said.

“We hope the U.S. government will continue to be the global leader it always been — putting money in Gavi is not an expenditure, it’s an investment,” Dr. Demby said

Gavi is estimated to have saved the lives of 19 million children since it was set up 25 years ago. The United States contributes 13 percent of its budget.

The terminated grant to Gavi was worth $2.6 billion through 2030. Gavi was counting on a pledge made last year by President Joseph R. Biden Jr. for its next funding cycle.

New vaccines with the promise to save millions of lives in low-income countries, such as one to protect children from severe malaria and another to protect teenage girls against the virus that causes cervical cancer, have recently become available, and Gavi was expanding the portfolio of support it could give those countries.

The loss of U.S. funds will set back the organization’s ability to continue to provide its basic range of services — such as immunization for measles and polio — to a growing population of children in the poorest countries, let alone expand to include new vaccines.

By Gavi’s own estimate, the loss of U.S. support may mean 75 million children do not receive routine vaccinations in the next five years, with more than 1.2 million children dying as a result.

Categories Cruelty, Ethics, Evil, Extremism, Funding, Health, International, Science, Trump

Why Does Trump Want to Destroy America’s Biomedical Research Institutions?

By dianeravitch
March 17, 2025 //
30

Jeff Nesbit, who worked at both the National Institutes of Health and the National Science Foundation, wrote this article for The Contrarian. The question is one that I keep asking about many federal government programs that are being eliminated by Trump and Musk, like USAID.

Why? It makes no sense.

The fact that Trump chose Robert F.Kennedy Jr. as Secretary of Health and Human Services should have been an alarm bell; Kennedy is not only unqualified, he is stridently hostile to science.

The only beneficiary of this insane and reckless slashing of our most successful programs would be our international enemies, Russia and China. They want us to fail. Trump and Musk are making their dreams come true.

Nesbit wrote:

A siren call is cascading wildly through the corridors of every major academic center in America right now with a huge question firmly at its epicenter: Why are Health and Human Services Secretary Robert F. Kennedy, Elon Musk’s Department of Government Efficiency, and President Donald Trump’s White House team hellbent on destroying the National Institutes of Health, the world’s gold standard of biomedical research?

There isn’t an easy answer to the question, unfortunately.

What is true and known is that Kennedy’s HHS team has halted communications activities about NIH grants; throttled necessary peer-reviewed grant-review meetings; ordered the federal agency staff to review dozens of keywords in thousands of existing grants and issue termination letters based on what it finds; threatened to fire hundreds of expert reviewers and core staff at the agency; placed a cap on indirect costs that underpin basic scientific and medical research; and put woefully unprepared, lower-level career staff in charge of key functions at the agency.

The actions have ground NIH to a halt and sent shockwaves through academia and the biomedical research institutions that have created nearly all our life-saving breakthroughs in the past quarter century. Higher education leaders have halted Ph. D. programs in response. Major research labs are being shuttered or told to stop most of their research.

An American biomedical research enterprise that has been the envy of the world’s science and medical community for decades has been surprised and shocked by the careless destruction of core staff functions and almost mindless efforts to purge NIH of hundreds or thousands of grants for reasons that seem ideological at best and irrational and dangerous at worst.

The question, again, is why? Why are Kennedy, Musk and Trump determined to eviscerate the most successful biomedical research system the world has ever known—a scientific enterprise that produces life-saving medicines and leads to breakthroughs (via basic scientific and medical research) that the private sector would never support?

There was a time, once, that NIH was supported by majorities of Republican and Democratic politicians. NIH’s budget, which supports the entire biomedical research field, has grown year after year with large, non-controversial, bipartisan majorities in Congress.

Until now. Trump and Musk have clearly determined that NIH and the National Science Foundation (NIH’s companion in the world of basic scientific research funding) need to be eviscerated and then reoriented away from life-saving scientific and medical research toward some destination not yet revealed. And while this effort has been racing forward, there has been almost no pushback from politicians—at least not yet.

One reason for this is that scientists are historically apolitical and, to be blunt, quite bad at the political game that dominates Washington, D.C. Scientists aren’t nearly as adept as others at advocating for themselves or their priorities to politicians who make funding decisions…

Trump, Musk and Kennedy don’t trust scientists or academia—and clearly don’t hear or recognize the immense value that the biomedical research enterprise brings to American progress.

NSF funding built and then supported the internet and led to nearly every modern computer and basic scientific advancement we recognize in the hard sciences. NIH medical and scientific research led directly to the creation of nearly all the life-saving drugs developed in the past quarter century that Americans rely on today.

The economic impact to states with large bioscience research centers would be enormous. Tennessee, for instance, would be devastated by the NIH cuts. Vanderbilt University Medical Center is one of the top research hospitals in America. It received nearly half a billion dollars in 2024 for medical research, the second most in the country. Its budget would be cut by more than 10 percent. Nearly 50,000 jobs and 4,000 businesses in Tennessee are dependent on the biosciences research enterprise in the state and would be severely impacted by the NIH cuts.

Other states, such as Missouri, Michigan, Pennsylvania, and North Carolina, would be similarly devastated by the cuts. Washington University in St. Louis received $717 million from NIH last year and would lose an estimated $108 million. The University of Michigan received $708 million and stands to see a cut of $119 million. Two Pennsylvania universities – the University of Pennsylvania and the University of Pittsburgh – received nearly $1.3 billion and could lose $244 million. All of those add up to massive job losses and devastating impacts to each state’s economies.

But Trump, Musk and Kennedy don’t trust the scientific and medical research enterprise. They don’t hear the entreaties by scientists who merely want to do great work that benefits the greater good. And they don’t listen to those calls of bewilderment from scientific and medical research leaders that are falling on deaf ears. This could be happening because scientists are particularly bad at politics.

But it also could be that Trump, Musk and Kennedy are willing to destroy the most successful biomedical research enterprise the world has ever known simply because it is a direct way to harm elite academic institutions that they believe harbor leaders and academics who are ideologically opposed to their aims and politics.

And that is a dangerous story that every American needs to hear and fully take to heart right now—before the Trump administration capriciously destroys a hundred years of scientific and medical progress in a matter of weeks or months.

Jeff Nesbit was the assistant secretary for public affairs at Health and Human Services (which includes NIH) in the Biden administration, and the director of legislative and public affairs at NSF during the Bush and Obama administrations.

After I put this article in the queue, I came across this article about John’s Hopkins University:

More than 2,000 positions related to global health are being cut from the Johns Hopkins University after the Baltimore institution saw $800 million in federal grants disappear, a spokesperson confirmed Thursday.

Hopkins’ medical school; the Bloomberg School of Public Health, including its Center for Communication Programs; and JHPIEGO, the university’s health initiative that focuses on global public health, will be affected by the cuts. USAID was the main funder for both JHPIEGO and CCP.

“This is a difficult day for our entire community. The termination of more than $800 million in USAID funding is now forcing us to wind down critical work here in Baltimore and internationally,” Hopkins’ spokesperson said in a statement.

The Trump administration, through advisor Elon Musk and his Department of Government Efficiency, is slashing federal spending across agencies in an effort to end wasteful spending. Such cuts have an outsized effect on Hopkins, which comes in first of all universities in federally funded research. By extension, those cuts affect Baltimore and Maryland, where Hopkins is the city and state’s largest largest private employer. Hopkins says it accounts for more than $15 billion in economic output in the state.

The funding cuts for research institutions are hurting universities in multiple states.

Who determines that basic research in science and medicine are unimportant?

Categories Accountability, Budget Cuts, Corruption, Democracy, Ethics, Evil, Extremism, Funding, Health, Insane, Musk, Elon, Science, Trump, Tyranny

Quick: What’s the Purpose of the EPA?

By dianeravitch
March 13, 2025 //
3

The EPA is the Environmental Protection Agency. It was established in 1970 during the Nixon administration. The creation of EPA was a response to public and scientific concern about pollution of the air, land, and water by chemicals discarded by industry.

Republicans at the time were conservatives, and they prided themselves on championing clean air and clean water.

But in the age of Trump, environmental protection is considered a hindrance to industry. It also is a burden to the coal industry.

Trump appointed one of his most loyal allies to lead EPA. This is how he defines its mission:

“We are driving a dagger straight into the heart of the climate change religion to drive down cost of living for American families, unleash American energy, bring auto jobs back to the U.S. and more,” EPA Administrator Lee Zeldin said in a news release.

  1. To drive down the cost of living.
  2. To unleash American energy.
  3. To bring back auto jobs to the U.S.

Notice what’s missing? Any reference to reducing toxic pollution from the air, land, and waters.

Zeldin announced that he intends to eliminate dozens of EPA regulations. More toxic chemicals will be dumped into lakes and streams. More smokestacks will belch smoke into the air. More brownfields of chemicals will poison the land.

A sad day for America.

Categories Corruption, Environment, Evil, Extremism, Health, Science, Trump

Robert Kennedy Blames Child’s Measles Death on Poor Nutrition and Exercise, Not Lack of Vaccination

By dianeravitch
March 13, 2025 //
5

Secretary of Health and Human Services Robert F. Kennedy Jr. promised at his confirmation hearings that he was no longer a vaccine-denier and swore he would follow the science.

He lied.

When addressing the death of a Mennonite child in Texas who was unvaccinated, Kennedy attributed the death to poor nutrition and lack of exercise, not to her parents’ failure to get her vaccinated. He emphasized that the choice to get vaccinated was personal, not a matter of public health. And he reiterated the risks of getting vaccinated. He is an unrepentant vaccine-denier. The Atlantic just published a story by Tom Bartlett, who interviewed the child’s father. Mennonites don’t trust vaccines. Bartlett points out that before the measles vaccine was introduced in 1963, 400-500 measles deaths occurred every year. Measles deaths are rare now.

The New York Times reported:

In a sweeping interview, Robert F. Kennedy Jr., the health and human services secretary, outlined a strategy for containing the measles outbreak in West Texas that strayed far from mainstream science, relying heavily on fringe theories about prevention and treatments.

He issued a muffled call for vaccinations in the affected community, but said the choice was a personal one. He suggested that measles vaccine injuries were more common than known, contrary to extensive research.

He asserted that natural immunity to measles, gained through infection, somehow also protected against cancer and heart disease, a claim not supported by research.

He cheered on questionable treatments like cod liver oil, and said that local doctors had achieved “almost miraculous and instantaneous” recoveries with steroids or antibiotics.

The worsening measles outbreak, which has largely spread through a Mennonite community in Gaines County, has infected nearly 200 people and killed a child, the first such death in the United States in 10 years.

Another suspected measles death has been reported in New Mexico, where cases have recently increased in a county that borders Gaines County.

The interview, which lasted 35 minutes, was posted online by Fox News last week, just before the President Trump’s address to Congress. Segments had been posted earlier, but the full version received little attention.

Mr. Kennedy offered conflicting public health messages as he tried to reconcile the government’s longstanding endorsement of vaccines with his own decades-long skepticism.

Mr. Kennedy acknowledged that vaccines “do prevent infection” and said that the federal government was helping ensure that people have access to “good medicines, including those who want them, to vaccines.”

“In highly unvaccinated communities like Mennonites, it’s something that we recommend,” he said.

Mr. Kennedy described vaccination as a personal choice that must be respected, then went on to raise frightening concerns about the safety of the vaccines.

He said he’d been told that a dozen Mennonite children had been injured by vaccines in Gaines County. People in the community wanted federal health workers arriving in Texas “to also look at our vaccine-injured kids and look them in the eye,” Mr. Kennedy said.

Yet the M.M.R. vaccine itself has been thoroughly studied and is safe. There is no link to autism, as the secretary has claimed in the past. While all vaccines have occasional adverse effects, health officials worldwide have concluded that the benefits far outweigh the very small risks of vaccination.

Mr. Kennedy asserted otherwise: “We don’t know what the risk profile is for these products. We need to restore government trust. And we’re going to do that by telling the truth, and by doing rigorous science to understand both safety and efficacy issues….”

In later comments, Mr. Kennedy suggested that severe symptoms mainly affected people who were unhealthy before contracting measles.

“It’s very, very difficult for measles to kill a healthy person,” he said, adding later that “we see a correlation between people who get hurt by measles and people who don’t have good nutrition or who don’t have a good exercise regimen.”

West Texas is “kind of a food desert,” he added. Malnutrition “may have been an issue” for the child who died of measles in Gaines County.

Texas health officials said the child had “no known underlying conditions.”

Dr. Wendell Parkey, a physician in Gaines County with many Mennonite patients, said the idea that the community was malnourished was mistaken.

Mennonites often avoid processed foods, raise their own livestock and make their own bread, he noted. From a very young age, many members of the community also help with farming and other physically demanding jobs.

“They’re the healthiest people out here,” he said. “Nutritionally, I would put them up against anybody.”

Categories Accountability, Cruelty, Ethics, Extremism, Health, Science
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