In my last post I expressed concerns about healthcare. The concerns have only worsened. This is only some of the issues, and almost every day I put off finishing this article something else would come along.
- PEPFAR – On the first day of his second term President Trump cancelled funding for PEPFAR ? Between 2003, when the program was signed into law, until 2024, it’s credited with saving about 25 million lives. AIDS was fatal for almost everyone who was infected with HIV forty years ago but starting in the 1990s treatments became available that turned it into a manageable chronic disease. It’s estimated that 20 million people had their treatment cut off without warning. Such a system of care cannot just be replaced immediately, even if there was another source of funding. In just South Africa alone it was calculated that the funding cut would lead to 565,000 new infections, life expectancy would decrease by 3.71 years, and deaths would increase by 38%. Not only might we have up to a million people die per year from untreated HIV, interrupting treatment increases the risk of developing drug resistant HIV, and that can spread to the whole world. The United Nations agency that fights HIV announced they are cutting their employee count in half due to funding cuts, with the U.S. funding 40% of their activities in 2023. They estimated that if funding is not restored more than 6 million additional people could die from AIDS in the next 4 years, and an additional 2,000 people a day could become infected with HIV. Just in the US it can end up costing more than we saved by the funding cuts, not to mention the inhumanity of it.
- Food Safety Checks – According to the U.S. Public Interest Research Group Education Fund there was a 41% increase in food recalls for possible contamination by E. coli, salmonella, and listeria in 2024 compared with 2023. Food born illness increased by 20% and related hospitalizations and death double. But as a result of staff cuts at the Department of Health and Human Services, the Food and Drug Administration (FDA) has suspended its quality control program for food testing laboratories.
- Food Security – The government agency responsible for running Meals on Wheels, among other things, is being dismantled by Health Secretary Robert F. Kennedy Jr. It also funds programs at senior centers and independent living.
- Withholding Research Funds – The Department of Health and Human Services announced that they were going to cut funding for the Women’s Health Initiative, a ground breaking study that has been ongoing since 1990 and that has been following tens of thousands of women. Fortunately they reversed their decision a day later after a loud outcry. The National Institute of Health (NIH) had funded research on almost every drug on the market here. They announced they would invest $500 million dollars to study a universal vaccine using old, traditional technology. This will come at the expense of research on mRNA vaccines, which created the highly successful COVID-19 vaccines. This technology allows vaccines to be made much more quickly, important for future pandemics, and has been shown to increase survival in pancreatic cancer, an may cure chronic and genetic diseases, such as Type 1 diabetes and multiple sclerosis.
- Preventive Health Research – Despite Robert F Kennedy Jr proclaiming he would Make America Healthy Again, President Trump recently proposed cutting the budget almost in half for the Centers for Disease Control and Prevention. Last month 2400 jobs were cut from the National Center for Chronic Disease Prevention and Health Promotion. That includes programs for lead poisoning prevention, HIV, firearm injuries, smoking cessation, preventing cancer, heart disease, diabetes, Alzheimer’s, epilepsy and Alzheimer’s disease, and for states to deal with public emergencies and things like blood pressure screening. The proposed budget would also cut the Eliminating the Office on Smoking and Health. It’s hard to see how that will make use more healthy.
- Infection Control – The Trump administration shut down the Healthcare Infection Control Advisory Committee (HICPAC) that helps set national standards on controlling infections in hospitals, including hand washing, mask use, and isolating sick patients. The current recommendations date back to 2007 and an update was being prepared.
- World Health Organization – President Trump issued and executive order withdrawing the United States from the WHO. It takes year for it to be fully implemented, given that countries have to give notice first, and it could be reversed by congress, but this will hurt global health and can affect us in the event of another pandemic or other medical issues.
- Measles – Thanks to low vaccination rates we are experiencing a measles outbreak. There have been over 880 cases in the US this year as of late April. Two doses of MMR vaccine is 97% effective in preventing measles, and we need at least 95% of people to be vaccinated to prevent additional outbreaks. Yet in the 2023-24 school year only 92.7% of kindergartners were vaccinated. If that rate persists it’s estimated we’d have more than 850,000 cases in the next 25 years. If it drops 10% more then we could expect more than 11 million cases in the next 25 years. But if we increased the rate by 5% then we’d only have about 5,800 cases in that same period. That should be a no brainer, yet Robert F Kennedy Jr has only given lip service to promoting vaccination and has talked about the value of vitamin A and other non-effective treatments.
- Silicosis – This is a deadly lung disease that affects people who work with silicon, including miners and people who fabricate and install artificial-stone kitchen countertops. From closing Occupational Safety and Health Administration (OSHA) and Mine Safety and Health Administration (MSHA) offices, to firing Coal Workers Health Surveillance Program (CWHSP) and National Institute for Occupational Safety and Health (NIOSH) staff, more people will develop silicosis, and they won’t get diagnosed until their disease has progressed even more, if they get diagnosed at all.
- Surgeon General – After withdrawing his initial nomination for surgeon general due to her providing misleading or incorrect credentials, he has nominated Dr. Casey Means, despite that she has not compleated a residency, sells supplements on her website, and has expressed vaccine skepticism. For a position that oversees the U.S. Public Health Service (USPHS) Commissioned Corps and provides “Americans with the best scientific information available on how to improve their health and reduce the risk of illness and injury,” we can do better.
- Opioid Drug Deaths – At the same time the CDC announced significant progress is decreasing drug overdose deaths, their opioid surveillance programs may get a $30 million funding cut per preliminary budget reports.
- PFAS – The Environmental Protection Agency (EPA) announced that they will be scaling back rules on limiting some PFAS, or per- and polyfluoroalkyl substances, virtually indestructible chemicals, in drinking water. They are associated with some cancers, decreased fertility, developmental delay in children, and metabolic disorders. It doesn’t sound like the EPA is protecting the environment.
One small positive is that the Agriculture Department is fast-tracking state requests to remove candy and soda pop from coverage under the Supplemental Nutrition Assistance Program (SNAP), otherwise know as food stamps.
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