Health
State Department Permits Distribution of H.I.V. Medications to Resume — for Now
The Trump administration on Tuesday issued a waiver for lifesaving medicines and medical services, offering a reprieve for a worldwide H.I.V. treatment program that was halted last week.
The waiver, announced by Secretary of State Marco Rubio, seemed to allow for the distribution of H.I.V. medications, but whether the waiver extended to preventive drugs or other services offered by the program, the President’s Emergency Plan for AIDS Relief, was not immediately clear.
Still, PEPFAR’s future remains in jeopardy, with potential consequences for more than 20 million people — including 500,000 children — who could lose access to lifesaving medications. Without treatment, millions of people with H.I.V. in low-income countries would be at risk of full-blown AIDS and of premature death.
“We can very rapidly return to where the pandemic is exploding, like it was back in the 1980s,” said Dr. Steve Deeks, an H.I.V. expert at the University of California, San Francisco.
“This really cannot happen,” he said.
On Monday, the Trump administration ordered health organizations in other countries to immediately stop distributing H.I.V. medications purchased with U.S. aid. The directive stemmed from a freeze — which may become permanent — in the activities of PEPFAR, a $7.5 billion program overseen by the State Department.
Since it started in 2003, PEPFAR is estimated to have saved more than 25 million lives; more than 5.5 million children have been born free of H.I.V. who otherwise would have been infected.
In South Africa alone, PEPFAR’s shutdown would add more than a half million new H.I.V. infections and more than 600,000 related deaths over the next decade, according to one estimate.
The organization employs 270,000 doctors, nurses, pharmacists and other health workers. They had been told not to report to work or to serve patients.
PEPFAR’s end would “create instability and potentially collapse several countries’s AIDS programs that will be difficult to repair, if and when PEPFAR funding becomes available again,” said Dr. Salim Abdool Karim, an infectious disease epidemiologist at the University of KwaZulu-Natal in Durban, South Africa.
Dr. Abdool Karim said countries should stop relying on PEPFAR and support their own citizens, a goal that the program’s staff and partners had been working toward. But ideally that shift would happen gradually, over years during which PEPFAR would train local health workers and prepare them for the transition, he said.
“This is not a bad opportunity for countries to take greater responsibility,” he said. “But I think they can’t do it if it’s done in this kind of haphazard and unplanned way.”
Here’s what he and others expect from PEPFAR’s unexpected pause.
Sudden stops to H.I.V. treatment can quickly turn dangerous.
Every day, more than 220,000 people pick up H.I.V. medications at clinics funded by PEPFAR; the number included more than 7,400 children under 15, according to data published on Tuesday by AMFAR, The Foundation for AIDS Research.
The drugs work by suppressing H.I.V. in the body. When patients go off the drugs, the virus grabs the opportunity to rebound — and quickly. Within a week, H.I.V. levels will skyrocket from undetectable levels to more than 100,000 copies per milliliter of blood.
“That may be a time where you are very much at risk of passing the virus on to others,” Dr. Sallie Permar, a pediatrician and H.I.V. expert at Weill Cornell Medicine, said.
Then, the virus will start attacking a certain type of immune cell, crippling the body’s ability to fend off other infections, including tuberculosis, which frequently accompanies H.I.V. infection.
Spiking H.I.V. levels at first may cause flulike symptoms, including sore throat, swollen glands and fatigue. The immune system will likely marshal enough force to suppress the virus temporarily, but H.I.V. is adept at hiding until it finds the right opportunity to re-emerge.
When that occasion arises, “they can develop AIDS and progress,” Dr. Deeks said.
Children may be among the hardest hit.
PEPFAR is best known for financing H.I.V. treatment programs, but its funds also go to drugs for prevention, outreach and testing, and to support for orphans and women experiencing gender-based violence.
The loss of resources for each of these efforts will derail the fight against AIDS, said Dr. Glenda Gray, a pediatric H.I.V. expert at Wits University in South Africa.
“If H.I.V. testing falls by the wayside, it’s unlikely that we will be able to even diagnose people who need to go into treatment,” she said.
If a pregnant or breastfeeding woman has H.IV. but is not tested and not treated, she may pass the virus to her child. The higher her viral load, the more likely this is to occur.
Children with H.I.V. are less likely to be diagnosed than adults, and may not be treated till the virus makes them visibly very sick. This progression can be much more rapid in children than in adults, Dr. Gray said, “and obviously, children who are untreated are likely to die.”
Inconsistent treatment drives drug resistance.
As people lose access to medications, they may try to spread out their supplies by alternating days or to share their pills with others. If the virus replicates in people with only partial protection, it can learn to evade those defenses and become resistant to the medications.
People living with the virus may then pass the resistant virus on to others.
“That becomes a big problem, because now, suddenly, our cheap first-line drugs might not work when we have to restart them on treatment,” Dr. Abdool Karim said.
A virus that is resistant to treatments will also be better at evading vaccine candidates being tested.
“Not only are we looking at more drug resistance, but we’re looking at losing whatever ability we had to make an effective vaccine,” Dr. Permar said.
PEPFAR’s end may affect Americans, too.
More than one million Americans are living with the virus, and more than 30,000 become infected each year. If H.I.V. becomes resistant to available medications, it isn’t likely to remain in low-income countries. Americans, too, will be at risk.
They may also face indirect harms from ending PEPFAR. Creating huge populations of immunocompromised people may mean that other pathogens have an opportunity to spread. For example, dangerous Covid variants, including Omicron, are thought to have evolved in immunocompromised people with H.I.V.
At the same time, people worldwide have benefited from trials conducted under PEPFAR’s auspices, showing the importance of treating H.I.V. early, demonstrating that pregnant women can safely breastfeed as long as they are treated and that H.I.V. infections can be prevented with long-acting drugs.
“America has gotten an amazing amount of love around the world because of what it’s done,” Dr. Deeks said.
“From a humanitarian perspective, I can’t imagine anyone really wants to go along this pathway,” he added. “This doesn’t make any sense on any level.”
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Health
Relationship coach blames Oprah for pushing family estrangement ‘for decades’
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Oprah Winfrey is shining a light on family estrangement, which she calls “one of the fastest-growing cultural shifts of our time” — but one expert says the media mogul helped fuel that very culture.
“A Cornell University study now shows that almost one-third of Americans are actively estranged from a family member,” Winfrey said on a recent episode of “The Oprah Podcast,” referring to adult children going “no-contact” with parents, siblings or entire family systems.
Winfrey said the trend is a “silent epidemic” that can be especially relevant during the holidays.
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But family and relationship coach Tania Khazaal, who focuses on fighting “cutoff culture,” took to social media to criticize Winfrey for acting as if the estrangement crisis appeared “out of thin air.”
“Now Oprah is shocked by the aftermath of estrangement, after being one of the biggest voices pushing it for decades,” Canada-based Khazaal said in an Instagram video, which drew more than 27,000 likes and 3,000 comments.
Oprah Winfrey recently discussed what she called a “silent epidemic” of family estrangement on her podcast. (Theo Wargo/Getty Images)
Khazaal claimed that Winfrey’s messaging started in the 1990s and has contributed to a cultural shift where walking away became the first resort, not the last.
According to the relationship coach, millennials, some of whom grew up watching Oprah, are the leading demographic cutting off family members — and even if it wasn’t intentional, “the effect has absolutely been harmful,” Khazaal told Fox News Digital.
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The coach, who has her own history with estrangement, questioned why Winfrey is now treating the issue as a surprising crisis.
“Now she hosts a discussion with estranged parents and estranged kids, speaking on estrangement like it’s some hidden, sudden, heartbreaking epidemic that she had no hand in,” she said in her video.
Nearly one-third of Americans are estranged from a family member, research shows. (iStock)
Khazaal said she believes discussions about estrangement are necessary, but insists that people shouldn’t “rewrite history.”
“Estrangement isn’t entertainment or a trending conversation piece,” she added. “It’s real families, real grief, parents dying without hearing their child’s voice.”
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Winfrey reportedly responded in the comments, writing, “Happy to have a conversation about it — but not on a reel. Will have my producer contact you if you’re interested.” But the comment was later deleted due to the backlash it received, Khazaal told Fox News Digital.
“I would still be open to that discussion,” Khazaal said. “The first thing I’d want her to understand is simple: Setting aside cases of abuse or danger, the family unit is the most sacred structure we have.”
Experts emphasize that estrangement should be a last resort. (iStock)
“When children lose their sense of belonging at home, they search for it in the outside world,” she added. “That’s contributing to the emotional fragility we’re seeing today.”
Her critique ignited a debate online, with some social media users saying Khazaal is voicing a long-overdue concern.
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“The first time I heard, ‘You can love them from a distance’ was from Oprah … in the ’90s,” one woman said.
“My son estranged himself from us for five years,” one mother commented. “The pain, hurt and damage never goes away.”
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Others, however, argued that Winfrey’s podcast episode was empathetic and that estrangement shouldn’t be oversimplified.
Mental health experts say the conversation around estrangement is more complex than any single celebrity influence, and reflects broader cultural shifts.
Experts say today’s focus on boundaries and emotional well-being has reshaped family expectations. (iStock)
In the episode with Winfrey, Joshua Coleman, a California-based psychologist, said, “The old days of ‘honor thy mother and thy father,’ ‘respect thy elders’ and ‘family is forever’ has given way to much more of an emphasis on personal happiness, personal growth, my identity, my political beliefs, my mental health.”
Coleman noted that therapists sometimes become “detachment brokers” by unintentionally green-lighting estrangement.
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Jillian Amodio, a licensed master’s social worker at the Maryland-based Waypoint Wellness Center, told Fox News Digital that while public figures like Winfrey help normalize these conversations, estrangement might just be a more openly discussed topic now.
“Estrangement used to be handled privately and quietly,” she said.
Winfrey’s take on family estrangement is prompting a broader discussion amid the holiday season. (iStock)
But even strained relationships can be fixed with the right support, experts say.
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Susan Foosness, a North Carolina-based clinical director of patient programs at Rula Health, said families can strengthen their relationships by working with a mental health professional to improve communication, learn healthier conflict-resolution skills, and build trust and empathy through quality time together.
“No family is perfect,” Foosness told Fox News Digital.
Khazaal agreed, saying, “Parents need to learn how to listen without slipping into justification, and children need help speaking about their pain without defaulting to blame or avoidance.”
Fox News Digital reached out to Winfrey for comment.
Health
Major measles outbreak leads to hundreds quarantined in US county, officials say
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South Carolina is facing a major measles outbreak, resulting in the quarantine of hundreds of residents.
The South Carolina Department of Health (DPH) reported in a media briefing on Wednesday that the current number of measles cases has reached 111 as part of the current Spartanburg County outbreak.
DPH first reported a measles outbreak in the Upstate region on Oct. 2.
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The health department confirmed that 254 people are currently in quarantine and 16 are in isolation to prevent further spread.
The health department confirmed that 254 people are currently in quarantine in the upstate region. (Getty Images)
“This significant jump in cases is unfortunate,” a DPH spokesperson commented on the outbreak.
Public exposure was identified at Inman Intermediate School, with 43 of their students in quarantine.
“This significant jump in cases is unfortunate.”
Eight other intermediate and middle schools in the area are also reportedly undergoing quarantine. The DPH said multiple students have had to quarantine twice due to repeat exposure.
“Vaccination continues to be the best way to prevent the disruption that measles is causing to people’s education, to employment and other factors in people’s lives and our communities,” the spokesperson said.
“This significant jump in cases is unfortunate,” a DPH spokesperson commented on the current outbreak. (iStock)
Out of the 111 confirmed cases, 105 were unvaccinated. Receiving a vaccination within 72 hours has been shown to prevent measles infection, the DPH spokesperson noted.
Some cases are related to travel exposure, while others are from an unknown source, suggesting that measles is circulating in the community, the DPH noted.
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Connecticut has also reported its first measles case in four years, according to the Connecticut Department of Public Health.
The department confirmed on Thursday that an unvaccinated child in Fairfield County, under the age of 10, was diagnosed with measles after recently traveling internationally.
“Vaccination continues to be the best way to prevent the disruption that measles is causing,” a DPH spokesperson said. (iStock)
The child began to show symptoms several days later, including a runny nose, cough, congestion, fever and a rash starting at the head and spreading to the rest of the body.
The Connecticut DPH noted that measles is “highly contagious” and can spread quickly through the air via coughing or sneezing. The CDC has estimated that nine out of 10 unvaccinated individuals who encounter an infected person will develop the measles virus.
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According to the International Vaccine Access Center, more than 1,800 cases of measles have been reported in 2025, which is the most since the U.S. declared the virus eliminated in 2000. It is also the most cases recorded in three decades.
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“The single best way to protect your children and yourself from measles is to be vaccinated,” DPH Commissioner Manisha Juthani, M.D., wrote in a statement. “One dose of measles vaccine is about 93% effective, while two doses are about 97% effective.”
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