Health
Health Programs Shutter Around the World After Trump Pauses Foreign Aid
Lifesaving health initiatives and medical research projects have shut down around the world in response to the Trump administration’s 90-day pause on foreign aid and stop-work orders.
In Uganda, the National Malaria Control Program has suspended spraying insecticide into village homes and ceased shipments of bed nets for distribution to pregnant women and young children, said Dr. Jimmy Opigo, the program’s director.
Medical supplies, including drugs to stop hemorrhages in pregnant women and rehydration salts that treat life-threatening diarrhea in toddlers, cannot reach villages in Zambia because the trucking companies transporting them were paid through a suspended supply project of the United States Agency for International Development, U.S.A.I.D.
Dozens of clinical trials in South Asia, Africa and Latin America have been suspended. Thousands of people enrolled in the studies have drugs, vaccines and medical devices in their bodies but no longer have access to continuing treatment or to the researchers who were supervising their care.
In interviews, more than 20 researchers and program managers described the upheaval in health systems in countries across the developing world. Most agreed to be interviewed on the condition that their names not be published, fearing that speaking to a reporter would jeopardize any possibility that their projects might be able to reopen.
Many of those interviewed broke down in tears as they described the rapid destruction of decades of work.
The programs that have frozen or folded over the past six days supported frontline care for infectious disease, providing treatments and preventive measures that help avert millions of deaths from AIDS, tuberculosis, malaria and other diseases. They also presented a compassionate, generous image of the United States in countries where China has increasingly competed for influence.
The State Department and U.S.A.I.D. did not respond to requests for comment.
There will now be no one to take custody of millions of dollars’ worth of supplies for vital oxygen systems, purchased for programs funded by U.S.A.I.D. that support health clinics in some of the world’s poorest countries. The shipments, now in transit, are scheduled to reach ports in the coming days, but employees of those programs have been ordered to stop work.
On Tuesday night, Secretary of State Marco Rubio issued an exemption to the funding freeze for “lifesaving humanitarian assistance,” including what a State Department memo called “core lifesaving medicine.” However, shuttered H.I.V. and tuberculosis treatment programs have been told by their contacts at U.S.A.I.D. that they cannot resume work until they receive written instruction that the waiver applies specifically to them.
Also on Tuesday, a federal judge blocked the freeze until Feb. 3. But in practice, most U.S.A.I.D. country offices and programs are proceeding as if the freeze remains in place.
They have been unable to obtain clarification on whether and when their work can continue because their assigned contacts at U.S.A.I.D. have either been fired or furloughed, or are under strict instructions to not talk to anyone.
Despite the court order, thousands of people have already lost their jobs as a result of the freeze. About 500 U.S.-based employees of U.S.A.I.D. were fired. In countries from India to Zimbabwe, staff members for health projects were immediately fired. An organization called the International Centre for Diarrhoeal Disease Research, Bangladesh, which does research on a top killer of children, laid off more than 1,000 employees this week.
If the waiver announced by Mr. Rubio does not apply to their work — as is likely because it is expected to exempt only a narrow scope of activities — many nonprofit groups will not have enough funds to pay their employees or maintain supplies. Already, organizations that rely on U.S.A.I.D. funds have not been able access any money, even for reimbursement of expenses already incurred.
Two-thirds of the staff of the President’s Malaria Initiative, an organization founded by former President George W. Bush that is the largest donor to anti-malaria programs and research worldwide, have been fired. Those employees were contract staff members, because the agency had longtime hiring freezes for permanent positions, and included some of the most senior and respected scientists working on malaria control in the world.
While the interruption of H.I.V. treatment has prompted an outcry, the suspension of malaria work also immediately jeopardizes lives, said a scientist who was a senior staff member at the President’s Malaria Initiative for a decade and was fired on Tuesday.
Malaria interventions in Africa are carefully planned around rainy seasons, the time of which varies by region. Houses are sprayed with insecticide, and children are treated with an antimalarial medication during peak malaria transmission times.
“You could open the funding floodgates again tomorrow and you will still have children dying months from now because of this pause,” the scientist said.
More than 50 million children received preventative drugs before the rainy season last year.
The delivery of rapid tests and malaria drugs into Myanmar, where cases of malaria increased nearly tenfold to 850,000 in 2023 (the most recent figures available) from 78,000 in 2019, has been frozen. Some organizations now have no workers left to distribute the supplies even if they were to arrive.
In some parts of the country, more than 40 percent of cases are of a type of malaria that is often deadly in children under the age of 5. Malaria drugs would seem to qualify under the stipulation of “lifesaving humanitarian assistance, including essential medicines” included in the waiver, but in the absence of certainty, no one has been bold enough to try to free the drugs now stuck at the Thai border.
Some 2.4 million anti-malaria bed nets are sitting in production facilities in Asia, manufactured to fulfill U.S.-funded orders and bound for countries across sub-Saharan Africa. Those contracts are now frozen, because the U.S.A.I.D. subcontractor that bought them is not allowed to talk to the manufacturer under the terms of the freeze. Contracts for eight million more nets are now in limbo, an executive with the manufacturer said.
U.S.A.I.D.’s largest project is called the global health supply chain, an effort to streamline procurement of supplies for H.I.V., malaria, maternal health and other key areas, to make the system more efficient and save money. It operates in more than 55 countries where, in many cases, it supplies the bulk of key medicines. Now its global web of staff has been ordered to stop work except for essential tasks, like guarding commodities in warehouses.
In Zambia, U.S.A.I.D. supports the bulk distribution of public health products, using the private trucking industry to move medicines from a central supply depot to seven regional hubs, from which they are taken by truck, motorbike and boat to rural health centers. It’s part of the extensive U.S. support of the health system in Zambia, one of the world’s poorest countries, and over time it has been working to build up the supply chain capacity of the government.
Since the stop-work order was issued last Saturday, all of the vehicles transporting health products have been stopped. “They have effectively paralyzed the Zambian public health sector by pulling out so abruptly,” said one consultant who worked with the program. Similar U.S.-funded systems, now frozen, also moved a major share of basic medical supplies in Mozambique, Nigeria, Malawi and Haiti.
In East Africa, medical researchers working on projects to find ways to stop transmission of H.I.V. and develop more effective contraception have found themselves floundering for explanations to give to participants in their clinical trials.
“We have women testing vaginal rings, they already have the rings in them, people who got an injectable for H.I.V. prevention — when you say ‘stop,’ what happens to them?” said an H.I.V. researcher who is an investigator on a number of clinical trials. “We have an ethical obligation to people who volunteer for trials.”
Apoorva Mandavilli contributed reporting.
Health
Brain Health Challenge: Workouts to Strengthen Your Brain
Today, you’re going to do perhaps the single best thing for your brain.
When I asked neurologists about their top behaviors for brain health, they all stressed the importance of physical activity.
“Exercise is top, No. 1, when we’re thinking about the biggest bang for your buck,” said Dr. Gregg Day, a neurologist at the Mayo Clinic.
Numerous studies have shown that people who exercise regularly tend to perform better on attention, memory and executive functioning tests. There can be a small cognitive boost immediately after a workout, and the effects are sustained if people exercise consistently. And while staying active can’t guarantee you won’t develop dementia, over the long term, it is associated with a lower risk of it.
Researchers think that moving your muscles benefits your brain in part because of special signaling molecules called exerkines. During and after a workout, your muscles, fat and other organs release these molecules into the bloodstream, some of which make their way up to the brain. There, those exerkines go to work, helping to facilitate the growth of new connections between neurons, the repair of brain cells and, possibly, the birth of new neurons.
Exercise also appears to improve blood flow in the brain. That ramps up the delivery of good things to brain cells, like oxygen, glucose and those amazing exerkines. And it helps remove more bad things, namely toxic proteins, like amyloid, that can build up and damage brain cells, increasing the risk for Alzheimer’s.
All of the changes brought on by exercise are “essentially allowing your brain to age more slowly than if you’re physically inactive,” said Kirk Erickson, the chair of neuroscience at the AdventHealth Research Institute.
The benefits are particularly pronounced in the hippocampus, a region critical for learning and memory. In older adults, the hippocampus shrinks 1 to 2 percent a year, and it is one of the main areas affected by Alzheimer’s. Researchers think physical activity helps to offset some of that loss.
The best exercise you can do for your brain is the one you’ll do consistently, so find something that you enjoy and that fits easily into your life.
Walking is one option; two neurologists I spoke to said they got their exercise in by walking at least part of the way to their offices. Recent research suggests that just a few thousand steps a day can reduce the risk of dementia. It’s important to get your heart rate up, though, so “walk as though you’re trying to get somewhere on time,” said Dr. Linda Selwa, a clinical professor of neurology at the University of Michigan Medical School.
Or you could try swimming, cycling, Pilates, weight lifting, yoga, pickleball, dancing, gardening — any type of physical exertion can be beneficial.
If the thought of working out feels like a drag, try pairing it with something else you enjoy doing, like listening to an audiobook. This is a trick that Katherine Milkman, a professor who studies habits at The Wharton School of the University of Pennsylvania, calls “temptation bundling.”
For Day 3, we’re asking you to spend at least 20 minutes exercising for your brain. Go for a walk with your accountability partner if they’re nearby. (If not, call them and do a walk-and-talk.) Or let us find you a new workout to try, using the tool below. As usual, we can all meet in the comments to catch up and check in.
Health
Little-known prescription pill is helping Americans drink less alcohol
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Recent studies continue to support a decades-old drug as an alternative means of reducing alcohol consumption.
The prescription opioid pill, called naltrexone, was first approved by the FDA to treat opioid dependence in 1984. A decade later, it was approved for alcohol use disorder.
In addition to the daily pill version, naltrexone is also available as a monthly injectable therapy, which was approved for alcohol use disorder in 2006 and opioid use disorder in 2010.
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How it works
Naltrexone works by blocking opioid receptors in the brain. For those dependent on opioids, it blocks the “euphoric” effects of the drugs and also curbs cravings for alcohol, according to experts.
The prescription opioid pill, called naltrexone, was first approved by the FDA to treat opioid dependence in 1984. A decade later, it was approved for alcohol use disorder. (iStock)
“Naltrexone can be used to assist with reducing alcohol cravings and reduce the pleasurable effects from alcohol ingestion, which can help those prone to binge-drinking to consume less volume,” Dr. David Campbell, clinical director and program director at Recover Together, a behavioral health and addiction treatment facility in Bend, Oregon, told Fox News Digital.
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The medication is useful for people who experience strong cravings, often drink to excess once they start, or drink primarily due to reward or relief as opposed to habit, according to Campbell.
“Naltrexone affects the rewards center of the brain, which blocks the rewarding effects of alcohol.”
Jessica Steinman, chief clinical officer at No Matter What Recovery in Los Angeles, calls naltrexone “an incredibly helpful and life-saving tool” for people who struggle with alcohol use disorder.
“Currently, in our society, many people are looking to get medication-assisted help from overconsumption of certain things or behaviors, including food, cigarettes and now alcohol,” she told Fox News Digital.
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“Naltrexone affects the rewards center of the brain, which blocks the rewarding effects of alcohol and cravings to be minimized. It can assist in telling the brain that alcohol isn’t wanted.”
The drug can also help if someone has a “healthy” relationship with alcohol and is looking to cut back on their drinking behaviors, Steinman added.
“We do not suggest moderation in any way for people struggling with alcohol use disorder or any type of dependence to alcohol or other substances,” she noted. “We do not believe drinking ‘less’ is a solution.”
Side effects
Common side effects of naltrexone can include nausea and vomiting, headache, sleep disturbances, dizziness, fatigue, anxiety, loss of appetite, and joint or muscle pain, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
These effects are generally mild and may improve as the body adjusts to the medication.
The medication is useful for people who experience strong cravings, often drink to excess once they start, or drink primarily due to reward or relief as opposed to habit. (iStock)
In rare cases, patients may experience more severe effects, such as liver issues, allergic reactions, trouble breathing and mental health effects.
“The most important thing when taking naltrexone for alcohol use is to ensure that there is no concurrent use of opioids, as taking naltrexone when using opioids can induce precipitated withdrawal, a very uncomfortable event,” Campbell cautioned.
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More than 50% of U.S. adults drink alcohol, about 17% are classified as binge-drinkers and about 6% drink heavily, according to CDC data.
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Each year, around 178,000 deaths in the country are linked to excessive alcohol use.
“Heavy alcohol consumption and binge-drinking can lead to many health problems and make chronic health conditions worse, so reducing alcohol intake can really improve health,” Donita Robinson, Ph.D., an associate professor of psychiatry at the UNC School of Medicine in North Carolina, told Fox News Digital.
More than 50% of U.S. adults drink alcohol, about 17% are classified as binge-drinkers and about 6% drink heavily. (iStock)
“Naltrexone helps many people reduce their drinking – it’s an effective medication to reduce alcohol craving and heavy drinking, and it works best in combination with counseling or other therapy.”
Robinson reiterated that people who are on opioid medications, including some painkillers, shouldn’t take naltrexone, as it can block their effectiveness and cause opioid withdrawal.
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Naltrexone is available with a prescription from a licensed healthcare provider, such as a primary care doctor, addiction medicine specialist or psychiatrist.
Health officials warn against purchasing the drug online or without a prescription, as it may be counterfeit and unsafe.
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Those interested in exploring whether naltrexone is an option for them should see a doctor, who can assess the safety of the drug based on the patient’s medical status and history.
They should also “make sure they have their goals and intentions in line before using a medication like this,” according to Steinman.
Health
Brain Health Challenge: Try the MIND Diet
Welcome to Day 2 of the Brain Health Challenge. Today, we’re talking about food.
Your brain is an energy hog. Despite comprising about 2 percent of the average person’s body mass, it consumes roughly 20 percent of the body’s energy. In other words, what you use to fuel yourself matters for brain health.
So what foods are best for your brain?
In a nine-year study of nearly 1,000 older adults, researchers at Rush University in Chicago found that people who ate more of nine particular types of food — berries, leafy greens, other vegetables, whole grains, beans, nuts, fish, poultry and olive oil — and who ate less red meat, butter and margarine, cheese, sweet treats and fried food had slower cognitive decline.
Based on these findings, the researchers developed the MIND diet.
Large studies encompassing thousands of people have since shown that following the MIND diet corresponds with better cognitive functioning, a lower risk of dementia and slower disease progression in people with Alzheimer’s. People benefit from the diet regardless of whether they start it in midlife or late life.
Experts think the foods included in the MIND diet are especially good for the brain because they contain certain macro and micronutrients.
Berries and leafy greens, for example, are rich in polyphenols and other antioxidants, said Jennifer Ventrelle, a dietitian at Rush and a co-author of “The Official Mind Diet.” Many of these compounds can cross the blood-brain barrier and help to fight inflammation and oxidative stress, both of which can damage cells and are linked to dementia.
Nuts and fatty fishes, like salmon and sardines, contain omega-3 fatty acids, which are important for building the insulating sheaths that surround the nerve fibers that carry information from one brain cell to another.
Whole grains and beans both contain a hefty dose of fiber, which feeds the good microbes in the gut. Those microbes produce byproducts called short-chain fatty acids that experts think can influence brain health via the gut-brain axis.
You don’t have to revamp your whole diet to get these nutrients. Instead, think about “MIND-ifying” whatever you already tend to eat, said Dr. Joel Salinas, a neurologist at NYU Langone Health and the founder and chief medical officer of the telehealth platform Isaac Health. For instance, add a handful of nuts or berries to your breakfast.
Today’s activity will help you MIND-ify your own meals. Share your choices with your accountability partner and in the comments, and I’ll discuss the ways I’m adjusting my diet, too. For added inspiration, check out these MIND-approved recipes from New York Times Cooking.
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