Category: The Lancet
Grants under threat at the US National Institutes of Health
Volume 406, Issue 10522
20 December 2025
WORLD REPORT Changes to how research grants are assessed and awarded are undermining the world’s largest public funder of biomedical research. Washington Correspondent Susan Jaffe reports.
So far this year, the Trump administration has fired more than 1000 scientists and grant administrators at the National Institutes of Health (NIH) and cut thousands of its research grants, including clinical trials with 74 000 patients. But long-time grant recipients and former institute directors worry that changes in how grants are awarded—and who receives them—threaten the pathways for new discoveries and the many academic research centres that train future scientists. [Continued here.]
… Health experts condemn US vaccine recommendations
Volume 406, Issue 10510
27 September 2025
WORLD REPORT The Advisory Committee on Vaccine Practices’ recommendations for COVID-19 vaccination prompt questions and concern. Washington Correspondent Susan Jaffe reports.
The first meeting of a vaccine advisory committee with all 12 of Health and Human Services (HHS) Secretary Robert F Kennedy Jr.’s handpicked members — bypassing the usual vetting process — produced confusing recommendations, condemned by medical associations and public health experts. Even some members were puzzled at times: they decided to delay a vote on one proposal and approved another after earlier rejecting it. They recommended that Americans should still be vaccinated to prevent serious complications of COVID-19, but added that patients should first discuss the benefits and risks with a health-care provider. Physician groups and public health advocates say the prerequisite is unnecessary and will restrict access. [Continued here.]
CDC is “in the ICU right now” former officials say
Volume 406, Issue 10508
13 September 2025
WORLD REPORT Senior officials say HHS Secretary Robert F Kennedy Jr is eviscerating the CDC. Washington Correspondent Susan Jaffe reports.
The US Centers for Disease Control and Prevention (CDC) implosion was months in the making, senior officials tell The Lancet after they resigned in protest following the dismissal of CDC Director Susan Monarez by Health and Human Services (HHS) Secretary Robert F Kennedy Jr. They describe a gutted agency so damaged that it might not be able to fulfil its core mission to protect Americans from public health threats. An HHS spokeswoman called their comments “the gripes of disgruntled former employees.” [Continued here.]
… Millions to lose Medicaid coverage under new law
Volume 406, Issue 10500
19 July 2025
WORLD REPORT President Trump’s One Big Beautiful Bill Act makes the largest cuts to Medicaid since its creation, with doctors warning that patients will suffer. Susan Jaffe reports.
Republicans in the US Congress gave President Donald Trump his first major legislative victory, which provides the largest amount of tax and spending cuts in US history. The One Big Beautiful Bill Act (OBBB) slashes nearly $1 trillion over a decade from Medicaid—the most sweeping cuts since the health insurance programme for people with low incomes was created 60 years ago. The law will hit another historic first by taking health insurance away from more US residents than ever before—nearly 17 million, according to the Congressional Budget Office.
This seismic shift in the US health-care system was opposed by patient advocacy groups and nearly every major health-care provider and industry organisation. Despite their significant collective influence during previous administrations, the groups’ arguments failed to deter Republicans eager to implement Trump’s domestic agenda. {Continued here]
… US Supreme Court upholds Tennessee law denying adolescents gender-affirming care
Volume 405, Issue 10497
28 June 2025
WORLD REPORT Conservative justices agreed with the state and Trump administration that banning minors’ treatment for gender dysphoria is not discriminatory. Susan Jaffe reports.
On behalf of the court’s five other conservative members, Chief Justice John Roberts wrote that the law is not discriminatory because the ban restricts specific medical treatment for a specific purpose and applies equally to boys and girls. “The law does not prohibit conduct for one sex that it permits for the other.” But he also wrote that since the treatment is controversial (despite support from major medical associations), the court should defer to the judgement of state lawmakers. “Questions regarding the law’s policy are thus appropriately left to the people, their elected representatives, and the democratic process”, he wrote.[Continued here.]
AMA protests changes to key vaccine advisory committee
Volume 405, Issue 10496
21 June 2025
WORLD REPORT The organisation, which represents more than 270 000 physicians and medical students, has
been reluctant to criticise the Trump administration’s actions, until now. Susan Jaffe reports.
After months of relative quiet while the Trump administration overhauls US health and science agencies, the American Medical Association has had enough. When Health and Human Services Secretary Robert F Kennedy Jr dismissed all 17 members of the independent Advisory Committee on Immunization Practices, delegates attending AMA’s annual meeting strongly condemned the action. On June 10, more than 700 delegates approved an emergency resolution calling on Kennedy to reverse his decision [and] required AMA leadership to “immediately” ask the Senate committee overseeing HHS to investigate Kennedy’s actions “regarding his administration of the Centers for Disease Control and Prevention and Advisory Committee on Immunization Practices”. [Continued here.]
Trump works towards US tariffs on drug imports
Volume 405, Issue 10490
10 May 2025
WORLD REPORT Observers warn of the negative health consequences if US President Donald Trump follows through on his promise to impose tariffs on pharmaceuticals. Susan Jaffe reports.
Prescription drugs were excluded from US President Donald Trump’s tariffs that have rocked global markets and fuelled trade wars. But two recent actions signal the administration’s intention to eliminate that protection. Last month, Trump ordered the Department of Commerce to investigate whether the USA’s dependence on imported pharmaceuticals is a potential national security threat. If so, imposing tariffs would be a likely defence against imports. [Continued here.]…
Can the FDA fulfil its mission with a smaller workforce?
Volume 405, Issue 10488
26 April 2025
WORLD REPORT The US Food and Drug Administration’s new commissioner promises to restore public trust despite mass layoffs. Washington Correspondent Susan Jaffe reports.
Martin Makary fielded questions for nearly 2 h from a Senate committee last month before winning approval to take the helm as commissioner at the Food and Drug Administration (FDA). His early actions have provided some additional answers about how he will likely run an agency that impacts Americans’ daily lives but is depleted by the forced departure of at least 3500 scientists and other staff. [Continued here.]…
US transgender care providers face legal dilemma
Volume 405, Issue 10484
29 March 2025
WORLD REPORT Among the multitude of executive orders issued by President Donald Trump is one that creates a legal quandary for US health-care providers. Susan Jaffe reports from Washington, DC.[Continued here.]
…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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