Category: The Lancet

Robert Kennedy Jr’s Promises

Volume 405, Issue 10480
1 March 2025
WORLD REPORT    To earn enough Senate votes for confirmation as Secretary of the US Department of Health and Human Services (HHS), Robert F Kennedy Jr made some surprising promises for someone aspiring to become the nation’s top health official. He had to reassure a few sceptical Republican senators that he would not overturn years of accepted public health policies, medical practice, and scientific consensus. And yet, in just the short time since assuming his new post on Feb 13, Kennedy’s actions—and inaction—appear to undermine those commitments as thousands of HHS employees are laid off under President Donald Trump’s executive orders shrinking the size and cost of government. [Continued here.]

 

 

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Trump agenda ignites legal challenges

Volume 405, Issue 10477
8 February 2025 
WORLD REPORT  After just 3 weeks in the White House, US President Donald Trump’s executive orders have caused chaos and concern—and now, resistance. Susan Jaffe reports from Washington, DC.

“There’s nothing unusual about an executive order”, said Professor Emeritus Laurence Tribe, an expert in constitutional law at Harvard Law School. “What is unusual is for the President of the United States to say, ‘I can do anything I want, as long as I package it in an executive order. I can exercise not only the power to enforce the laws, which is basically what the executive branch does, but also the power to ignore law.’ ”  Lawsuits have been filed to block executive orders affecting federal funding, workforce protections, closing the US Agency for International Development, and information on government websites including the Center for Disease Control and Prevention.[Full article here, includes links to updates on legal actions and executive orders.]

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Can the US health-care workforce keep pace with demand?

Volume 404, Issue 10469
7 December 2024 
WORLD REPORT  A physician and nurse shortage hinders access to care but efforts to educate, recruit, and retain more providers may be threatened. Susan Jaffe reports from Washington, DC.

The uninsured rate in the United States is at an historic low. But a shortage of health-care providers means even people who can afford to go to the doctor might not be able to find one.[Full story here, from The Lancet’s special issue, “A Presidential Briefing Book.”]…

Harris or Trump? Health in the US election

Volume 404, Issue 10464
2 November 2024 
WORLD REPORT  Aside from abortion, health issues have largely been neglected in the run-up to the Nov 5 election. What have the candidates proposed to improve health? Susan Jaffe reports.

As election day approaches on Nov 5, the US presidential race remains a tense and close competition despite unprecedented events—the Democratic candidate was  replaced in August, and two attempts have been made to assassinate the Republican candidate. And despite the sharp contrast between former President Donald Trump, a Republican, and Democrat Vice President Kamala Harris, neither has so far managed to emerge as the frontrunner as The Lancet went to press. [Here‘s what the candidates say they would do on abortion, Affordable Care Act and other key health issues.]…

Why aren’t the Republicans talking about health?

Volume 403, Issue 10450
27 July 2024 

WORLD REPORT  Health-care issues were conspicuously absent from the 4-day party convention culminating in Donald Trump’s nomination as the Republican 2024 presidential candidate. Susan Jaffe reports.

Former US President Donald Trump spent 93 minutes accepting the Republican Party’s nomination for president last week, exceeding his own 2016 record for the longest acceptance speech at a political convention. But there was no time to mention major health-care issues such as abortion, the COVID-19 pandemic, medical research funding, the Affordable Care Act (ACA), or the opioid epidemic, to name a few. Yet domestic and global healthcare spending consume the largest part of the US budget. [Continued here.]…

Dr. Mandy Cohen’s first year as Director of the Centers for Disease Control and Prevention


23 July 2024 

PROFILE  Mandy Cohn: public health advocate and CDC director

“My North Star has been about building healthier communities”, Dr. Cohen said. “Sometimes that’s about access to doctors and hospitals and sometimes that’s about larger issues, and how we build healthier communities where we live, work, play, and pray.” That goal has motivated Cohen throughout her career. “I loved being a physician, but I’m always thinking about the broader context in which my patients live.” [Full article here.]

 

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Doctors on call for the Biden campaign

Volume 403, Issue 10448
13 July 2024 

WORLD REPORT  Health-care workers are urging Americans to support the Democratic candidates for president and vice president, emphasising the health issues at stake. Susan Jaffe reports. [Continued here.]…

US Supreme Court protects access to abortion medication

Volume 403, Issue 10445
22 June 2024 

WORLD REPORT  Justices did not address claims that mifepristone endangered patients and that its approval by the FDA was flawed. Opponents vow to continue the legal fight. Susan Jaffe reports [continued here].

 

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10 years on: the legacy of the Flint water crisis

Volume 403, Issue 10437
27 April1 2024 

WORLD REPORT  The exposure of residents to lead in drinking water caused a national outcry, prompting requirements to update infrastructure and tighten water quality standards. Susan Jaffe reports.  

“Flint is making an impact beyond Flint”, said Mona Hanna-Attisha, a Flint paediatrician who collected data on children’s lead blood levels in 2015. “We’re sharing those big lessons—the need to respect science, the need to invest in prevention, the need to pay attention to things like infrastructure and inequities, but also the really amazing lesson of doing something about it.”. [Continued here]…

Biden prioritises health care in State of the Union speech

Volume 403, Issue 10431
16 March 2024 

WORLD REPORT  Plans to protect reproductive rights, further reduce drug prices, and improve women’s health research have been welcomed by some experts. Susan Jaffe reports from Washington, DC.  

The State of the Union address is typically a report to Congress on the nation’s progress and goals entwined with occasional lofty rhetoric, but this one was different…. “This speech signals that health care will be a big part of President Biden’s campaign this year”, said Larry Levitt, Executive Vice President for Health Policy at KFF, formerly the Kaiser Family Foundation. [Continued here]…

Volume 403, Issue 10427  ♦  17 February 2024

 

PROFILE  Dr. Monica Bertagnolli, Director of the National Institutes of Health  

“I imagine a health-care system where clinical decisions are informed in real time by current research data,” the new National Institutes of Health director tells The Lancet. “And one where patients have the opportunity to both contribute their data for research and get back research results so that they can experience the best that science has to offer.” [Susan Jaffe reports here.]…

Imported drugs unlikely to lower US prices any time soon

Volume 403, Issue 10423
20 January 2024 

WORLD REPORT  Americans pay some of the highest prices in the world for prescription drugs, but the decision by the US Food and Drug Administration to allow Florida to import cheaper medications from Canada won’t cut prices any time soon. Although the ruling represents a shift in the decades-long fight for drug importation, opposition from the US pharmaceutical industry, Canadian health officials, and others is expected to block implementation at every stage. [Susan Jaffe reports, here]…

New US initiative to prevent gun violence welcomed

Volume 402, Issue 10418
9 December 2023 

WORLD REPORT  Thwarted by Congress, President Joe Biden has created the first White House Office of Gun Violence Prevention. Susan Jaffe reports from Washington, DC.  

With Congress unable to ban even the most dangerous firearms made for war zones, US President Joe Biden announced a new strategy to deal with gun violence afflicting the nation: creating the first White House Office of Gun Violence Prevention. Frustrated by the congressional impasse, Biden essentially conceded that the new Office was not the best solution for reducing the unrelenting toll of gun violence in the USA.

“I’ll continue to urge Congress to take common sense actions that the majority of Americans support, like enacting universal background checks and banning assault weapons and high-capacity magazines”, Biden said in his announcement. “But in the absence of that sorely needed action, the Office of Gun Violence Prevention along with the rest of my Administration will continue to do everything it can to combat the epidemic of gun violence that is tearing our families, our communities, and our country apart.” [Continued here]…

Abortion foes threaten PEPFAR

Volume 402, Issue 10402
19 August 2023 

 

WORLD REPORT  Republicans question funding for the President’s Emergency Plan for AIDS Relief, one of the USA’s most effective global health programmes. Susan Jaffe reports from Washington, DC.

As Congress considers next month whether to renew funding for the President’s Emergency Plan for AIDS Relief (PEPFAR), global health advocates fear its two decades of bipartisan support might fracture. Created by President George W Bush in 2003, the programme is often cited as proof that adversaries across the political spectrum can agree on healthcare policy. …But this time is looking different.  [Continued here.]…

US pharmaceutical companies sue to halt cuts in drug prices

Volume 402, Issue 10399
29 July 2023 

 

WORLD REPORT  Medicare will soon be able to negotiate some drug prices to reduce costs for patients and taxpayers. Susan Jaffe reports from Washington, DC.

The first set of ten drugs subject to price negotiations by the US Medicare programme will be unveiled on Sept 1, 2023, but some pharmaceutical companies and their allies are not waiting to find out which products will be on the list. So far, four manufacturers and two trade associations are suing to stop the process before it begins. [Continued here.] 

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US affirmative action ruling may harm health equity

 8 July 2023
Volume 402, Issue 10396 

WORLD REPORT  Health and science groups warn the Supreme Court ‘s decision threatens workforce diversity and patient care. Susan Jaffe reports from Washington, DC.

Leading medical and scientific organisations have criticised the June 29 US Supreme Court decision severely limiting how colleges and universities consider an applicant’s race in the admissions process. A 6 to 3 majority abandoned 45 years of legal precedent protecting affirmative action, which is widely expected not only to reduce the number of Black and Latinx college students but also roll back their representation in medicine, law, science, and other postgraduate programmes, diversity advocates say.  [Continued here.] …

Sackler money to go towards reducing overdose deaths

Volume 401, Issue 10392  ||  10 June 2023  

WORLD REPORT  A US $6 billion settlement must help to expand treatment access, harm reduction programmes, and recovery services. Susan Jaffe reports.

Federal, state and local governments along with community organisations may soon receive an infusion of US$6 billion to fight the opioid epidemic, including at least $775 million for victims and their families, after a federal appeals court approved a bankruptcy settlement for Purdue Pharma and its founders, the multi-billionaire Sackler family. However, in a controversial move last month, the court also restored protections for the Sacklers from civil lawsuits, despite accusations that their illegal schemes to boost sales of the company’s strongly addictive pain killer, OxyContin (oxycodone), vastly increased their wealth. But without this shield, the agreement would have remained mired in court challenges. [Continued here.] …

US health experts divided on social media age restrictions

27 May 2023
Volume 401, Issue 10390 

WORLD REPORT  Some medical associations support restrictions on social media use to protect adolescent’s health, while others focus on making companies provide safer platforms. 

Laws intended to protect adolescents from the harms of social media are spreading across the USA but, among some of the nation’s leading medical and public health associations, there is not yet a consensus on limiting social media access for young people. Nearly two dozen states are considering legislation. Several have already enacted a patchwork of age restrictions and partial bans. [Continued here.]
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US Surgeon General: loneliness is a public health crisis

Volume 401, Issue 10388   ||   13 May 2023  

 

WORLD REPORT  A new report by the USA’s leading public health advocate calls for widespread efforts to address social isolation. Susan Jaffe reports from Washington, DC.

The USA has an “epidemic of loneliness”, according to a new advisory from the Surgeon General, Vivek Murthy. “Loneliness is far more than just a bad feeling—it harms both individual and societal health”, Murthy warns. “It is associated with a greater risk of cardiovascular disease, dementia, stroke, depression, anxiety, and premature death.” [Continued here.] …

Drug developers caution against US mifepristone ban

Volume 401, Issue 10385
22 April 2023 

 

WORLD REPORT     A lawsuit against the FDA embroils pharmaceutical companies in debates over access to
abortion. Susan Jaffe reports from Washington, DC.

Less than 1 year after the US Supreme Court ended its 1973 constitutional guarantee to an abortion and told state lawmakers that they could decide whether a person ends their pregnancy, abortion is now back before the court. But this fresh legal challenge has dragged the nation’s entire drug approval system along with it, rousing a powerful lobbying group and economic force that has mostly managed to avoid the fray—the pharmaceutical industry. [Continued here.]…

Hazardous train spills prompt calls for tougher safety rules

Volume 401, Issue 10383
8 April 2023 

 

WORLD REPORT  New bipartisan legislation has been proposed to protect health and safety following a train derailment in East Palestine, Ohio, USA. Susan Jaffe reports from Washington, DC.

A flammable brew of toxic chemicals from a freight train that went off the tracks in the Ohio village of East Palestine is no longer burning but the impact of the wreck is far from over. A massive clean-up continues along with water, soil, and air monitoring. Several government agencies are involved in recovery efforts and are investigating what went wrong. And in a rare show of bipartisanship, Democrats and Republicans in Congress have proposed legislation aimed at closing the gaps in rail safety rules that the accident exposed. The accident’s aftermath has also reached the courts. [Continued here.]…

Modest health goals for new US Congress

Volume 400, Issue 10369
17 December 2022 

 

WORLD REPORT  With Congress almost evenly split between Republicans and Democrats, consensus on any major health legislation is unlikely.  Susan Jaffe reports. 

When a new US Congress convenes in January, 2023, the slim Republican majority in the House of Representatives and the Democrats’ even smaller margin in the Senate will not enable either party to make major changes in the health-care system. With President Joe Biden promising to use his veto power to defend his health-care agenda, no significant fixes are expected. But there appears to be bipartisan support for some less ambitious legislation on issues that will overcome congressional gridlock.[Continued here.]…

US CDC begins agency-wide changes after pandemic failures

Volume 400, Issue 10365
19 November 2022 

 

WORLD REPORT  An independent review made several recommendations for improving the public health agency. Susan Jaffe reports from Washington, DC.

The US Centers for Disease Control and Prevention (CDC) is on a mission to reorganise and modernise itself, so that its mistakes during the pandemic will not happen again. The aim is to make the nation’s leading disease detective more nimble and accountable, and fortify its role as public health protector. But although some changes have been made, progress will be limited without support from Congress. [Continued here.] 
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FDA panel says preterm birth drug should be withdrawn

Volume 400, Issue 10362
29 October 2022 

 

WORLD REPORT  Makena has been given to hundreds of thousands of patients over the past 11 years. Susan Jaffe reports from Washington, DC.  

The only treatment in the USA to prevent premature births is ineffective and should be withdrawn from the market, according to the Food and Drug Administration’s (FDA) Obstetrics, Reproductive and Urologic Drug Advisory Committee. The recommendation has renewed scrutiny of a special drug approval process that raises patients’ hopes by allowing them to take medications that have not been fully tested for efficacy and safety [Continued here.] 

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Health organisations welcome US climate crisis law

Volume 400, Issue 10354
3 September 2022 

 

WORLD REPORT  The recently passed Inflation Reduction Act will provide billions of dollars of incentives to reduce greenhouse gas emissions. Susan Jaffe reports.

There are no emission limits or pollution penalties in the landmark Inflation Reduction Act that Congress approved in August. Instead of forcing cuts, the climate change and healthcare law provides US$370 billion worth of incentives to ratchet down the planet-warming greenhouse gases from fossil fuels that have caused record-breaking heat waves, wild fires, droughts, and floods.  …The law provides $60 billion for communities that have been disproportionately affected by toxic hazards and the consequences of climate change.  [Continued here.] 

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