In the United States, thousands of people are marching and rallying in defence of science and to protest the Trump Administration’s assaults on research and evidence-based policy.
In her latest column, Dr Lesley Russell investigates infectious diseases outbreaks, vaccination issues, the final push for a pandemic treaty, and also brings wide-ranging updates on women’s health.
The quotable?
The Centers for Disease Control and Prevention (CDC) will study whether vaccines cause autism, despite numerous existing studies already showing there is no link.”
Lesley Russell writes:
Greetings from Colorado where a succession of snowstorms is providing us with great skiing and snowshoeing.
I’m making a concerted effort not to include too much Trump Sturm und Drang in this edition of The Health Wrap.
But – as seems to be increasingly the case – there is lots of news about infectious diseases.
I am constantly amazed at the extent to which infectious diseases dominate public health, science and medical news (and even climate change news) these days.
Trump’s America
Life here is endlessly dominated by Trump news; some days it seems each hour brings a new horror.
There was no comfort to be found in Trump’s speech to the United States Congress. This was best described as providing red meat for his MAGA fans and deep concerns for those who care about the Constitution, national values and ethics, and America’s international standing as a leader in the free world.
I wrote about some of the specific issues that are affecting Colorado in a recent article for Croakey.
In recent days the local news is increasingly dominated by stories that reflect the impact of the actions of Trump and Musk and their acolytes:
- people who have lost their federal jobs
- the implications of decisions around Diversity, Equity and Inclusion (DEI) on businesses and universities
- raids by Immigration and Customs Enforcement (ICE) that have literally scooped people who cannot document their immigration status off the streets
- interviews with car dealers about the increased cost of vehicles and parts due to tariffs imposed on Canada and Mexico.
Here are some great interviews with former federal workers who were recently part of mass firings by Trump and Musk about their take on Trump’s speech to the Congress.
The Mayor of Denver, along with the mayors from three other so-called sanctuary cities, was interrogated by Republicans on the House of Representatives Committee on Oversight and Government Reform about policies that provide shelter and food for immigrants and the degree of cooperation with ICE.
The Justice Department has said it plans to be aggressive against Democratic-led sanctuary cities and has threatened to withhold federal funds from cities that refuse to cooperate on immigration enforcement. The mayors have been threatened with criminal charges.
Read more about this congressional hearing and the likely consequences here.
There is also a good article from Professor Lawrence Gostin at Georgetown University and his colleague Sarah Wetter on the legality of Trump’s Executive orders on health here. They argue that it’s clear the United States is failing to protect public and global health.
Public anger is festering in many parts of the country.
Republican Members of Congress are being advised not to hold in-person town halls after several instances of lawmakers being berated by attendees went viral.
Democratic State Attorneys General are capitalising on this and will hold a series of Community Impact Town Halls around the nation.
Perhaps the biggest and most controversial issue that lies ahead is the congressional action that is needed on the federal budget. The US Government is currently operating under a continuing resolution (CR) set to expire on March 14.
If a budget solution is not reached (or at least another short-term CR), the federal government will shut down.
Funding the government is a tricky business for Republicans these days. Conservative Republicans typically favour deep cuts to federal programs and they want to push Trump’s agenda forward, especially his tax cuts.
Republicans cannot reach their budget goal of slashing at least US$1.5 trillion in spending over the next decade to fund Trump’s tax cuts and immigration crackdown without cutting healthcare programs like Medicare and Medicaid and maybe even Social Security (the very popular program relied on by most retirees that Musk has called a Ponzi scheme) . Those cuts would affect tens of millions and leave voters very angry.
On 12 March, Reuters reported that the House of Representatives on Tuesday passed a stopgap bill to keep federal agencies funded past Friday, averting a partial shutdown beginning this weekend.
The bill passed in a nearly party-line 217-213 vote, with one Republican voting no and one Democrat yes.
Republicans will need at least seven Democrats to vote for this for it to pass in the Senate.
See more details here.
Measles
There is now evidence that the measles outbreak (still uncontained) in Texas and New Mexico is spreading, with cases reported in New York City, New Jersey, Georgia, Kentucky, California and Alaska.
This is a real test for Robert F Kennedy Jr as Secretary for Health and Human Services (HHS).
So far his response has not been proportionate to the size of the problem (although perhaps we should be grateful there has even been a response!).
As pointed out in a recent article in The Washington Post, if Kennedy doesn’t quickly show more leadership, a deadly measles epidemic could be the Trump Administration’s first major domestic failure.
After initially downplaying the outbreak as “not unusual”, Kennedy then said that ending the measles outbreak is a top priority.
It’s a relief to see both that Texas (a very Republican state) has asked for help with the pandemic and that HHS has approved assistance from the Centers for Disease Control and Prevention (CDC). HHS has also sent MMR vaccines to Texas.
In an opinion piece published on Fox News Digital, Kennedy asked parents to consult with healthcare providers “to understand their options to get the MMR vaccine” for their children.
But he described this as a personal decision and did not explicitly recommend the vaccine.
Instead, he is worrying public health experts with his focus on vitamin A.
“Studies have found that vitamin A can dramatically reduce measles mortality”, he wrote in the article, and it’s disturbing to note that CDC has recently updated its guidance on measles to include vitamin A as a treatment. And it turns out that the government is shipping doses of vitamin A to Gaines County in Texas, at the heart of the measles outbreak.
The study Kennedy cites in support of this position is here.
The American Academy of Pediatrics cites a World Health Organization recommendation that two doses of vitamin A be administered by a health care professional 24 hours apart for children and adults with measles. The supplement restores low vitamin A levels (common where there is malnutrition) and can help prevent eye damage and blindness. But it can also cause liver problems.
Here’s what infectious disease expert Professor Peter Hotez has to say about the value of vitamin A in the treatment and prevention of measles in developed countries:
In an interview aired in Fox News this week, Kennedy claimed that doctors had seen “very, very good results” treating measles cases in Texas with a steroid (budesonide), an antibiotic ( clarithromycin) and cod liver oil, which he said had high levels of vitamin A and vitamin D. He did not mention vaccination.
There is no specific antiviral treatment for measles. Medications like antibiotics and steroids are used to treat bacterial infections such as pneumonia and encephalitis that are associated with measles.
The chair of the American Academy of Pediatrics Committee on Infectious Diseases says that cod liver oil is “by no means” an evidence-based treatment.
In comments that seemed directed against conventional safeguards against measles, Kennedy said:
“We’re going to be honest with the American people for the first time in history about what actually – about all of the tests and all of the studies, about what we know, what we don’t know. We’re going to tell them, and that’s going to anger some people who want an ideological approach to public health.”
It probably says something about this new approach to honesty that the top HHS spokesperson has quit his position, after just two weeks in the job, over disagreements with Kennedy and his approach to the measles outbreak.
How worried should Australians be?
The national averages for immunisation rates for young children in Australia come close to meeting the goals of 95 percent. It’s pleasing to see that immunisation rates for Aboriginal and Torres Strait Islander five-year olds are better than that.
But childhood vaccination rates are falling and parts of Australia are now vulnerable to disease. For example, vaccination rates for children in Richmond Valley, the Gold Coast Hinterland and Noosa are as low as 74.72 percent.
Australia has eliminated local transmission of measles, but cases continue to occur in people who have travelled overseas. See, for example, this report from last December.
The interim Australian Centre for Disease Control monitors and reports on measles cases in Australia. The ACDC webpage on surveillance activities is here.
Vaccination in focus
Vaccination issues are top of mind here in the United States.
MedPage Today has posted an excellent discussion about these issues with Dr Paul Offit, Director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, and one of the inventors of the rotavirus vaccine.
A thoughtful article in The Washington Post makes the point that Kennedy’s denialism over the measles outbreak – downplaying the threat instead of tackling it head-on – means the loss of precious time that could be used to contain it.
It also means that an assessment of vaccine availability is essential, for the following reasons:
- Headlines about the first death are already leading to a surge in demand for vaccines in Texas, even among formerly sceptical parents.
- In 2022 it was estimated that nine million American children and teenagers were not fully protected against measles.
- All over the country, adults are asking whether they need boosters. Many Americans who got the early versions of measles vaccine need a booster, as the 75 million Americans born between 1968 and 1989 who only got one measles shot as children.
- Doctors and nurses treating measles cases need a booster shot.
Already there are reports of MMR vaccine shortages in Texas.
The Merck and GSK vaccines that are approved for use in the United States are also approved in many other countries (including Australia). Shipments meant for export could, in theory – if Trump institute his America First policy – be diverted for US use.
MMR vaccine is made in Australia by Sequirus (CSL) but it’s not clear how much of the market this represents.
Australia might also want to do an audit of MMR vaccine supply and demand.
Bird flu
As concerns rise about the potential for an H5N1 pandemic, Kennedy has asked HHS to re-evaluate a US$590 million contract with Moderna.
The contract, signed in the final days of the Biden administration, is designed to help Moderna develop and test the safety and efficacy of mRNA vaccines to protect against five subtypes of influenza that could prompt pandemics, including H5N1.
The rationale provided by HHS is that: “Four years of the Biden Administration’s failed oversight have made it necessary to review agreements for vaccine production.”
But given Kennedy’s distrust of vaccines and the companies that make them, there are concerns this could be a prelude for cancelling a contract experts believe is critical to the country’s efforts to be ready for a bird flu pandemic.
The work on mRNA vaccines is especially important for bird flu because currently most flu vaccines are made using a decades-old approach where viruses are grown in hen’s eggs, then inactivated.
Production is slow and reliant on huge quantities of eggs – the supply of which is now threatened by outbreaks of H5N1 and other bird flu viruses.
As an aside, the Trump Administration has been considering poultry vaccination as it seeks to combat the H5N1 outbreak that has decimated poultry stocks and fuelled a record surge in egg prices. Kennedy has spoken out against this, saying that this would amount to “turning those birds into mutant factories”.
While there is apparently some truth in this, especially if the poultry vaccine does not completely prevent infections, experts believe that vaccination combined with strict biosecurity can help contain outbreaks in poultry stocks.
You can read more here about these issues and what the US Department of Agriculture is doing (and not doing) to address the H5N1 outbreak that has currently resulted in more than 160 million farmed birds being euthanised and outbreaks in at least 972 dairy herds across 16 states. (Livestock are generally not culled as they can recover from the virus, but milk from infected animals is not permitted to enter the food supply.)
CDC study
No-one who works in public health seriously thought that, as Secretary of HHS, Kennedy would abandon his long-held stance on the dangers of childhood vaccines (yes, the very vaccines he made sure his children received).
Last week it was announced that the CDC is planning a large study looking into potential connections between vaccines and autism, despite significant research showing vaccines and autism are not linked.
It is unclear whether or how Kennedy is involved in the planned CDC study or how it would be carried out. Trump’s nominee to head the CDC, Dr Dave Weldon, has yet to be confirmed by the Senate.
In a media release announcing the study, HHS and CDC cited what they described as skyrocketing autism rates.
“CDC will leave no stone unturned in its mission to figure out what exactly is happening,” the statement said. “The American people expect high quality research and transparency and that is what CDC is delivering.”
Since at least 2014, Trump has also floated a theory that vaccines are behind the rise in autism cases.
He mentioned the increase in his speech to Congress, saying, “so we’re going to find out what it is,” adding there is “nobody better” than Kennedy to “figure out what’s going on.”
Since the publication of the discredited and retracted Wakefield study in 1998, a series of studies has found no epidemiological evidence for a causal association between autism and the MMR vaccine.
One of the largest was a retrospective analysis of 537,000 Danish children (every child born in Denmark in the years 1991-1998).
In the past two decades, autism diagnoses among children in the US have seen a fourfold increase. This may be due to a changing definition of autism, better awareness and ascertainment, and increased screening and surveillance.
Roughly $419 million is spent on autism research in the US each year.
We might ask how much of this research has been interrupted and/or defunded by Trump and DOGE.
Final push for pandemic treaty
In May and early June of 2024, World Health Organization (WHO) members struggled and then failed to meet a deadline to reach a consensus on a pandemic treaty that would address the weaknesses exposed by the COVID-19 pandemic.
See my report in the 10 April, 2024 edition of The Health Wrap.
Negotiations have continued and now the 2025 World Health Assembly looms on 19-27 May. Will there be something to put on the table for discussion and can an international treaty be signed?
There’s an excellent article on the issues confronting negotiators in Think Global Health.
As outlined in this article, the treaty has two goals – making future pandemics less deadly and having fewer pandemics altogether.
But there’s a tension between these and a fear that high-income countries may not agree to the creation of the proposed Pathogen Access and Benefit-Sharing (PABS) System – which would allow the WHO to share small quantities of vaccines, drugs, and diagnostics on the basis of public health needs – unless the treaty takes clearer and bolder action on prevention.
This includes mitigating the ecological drivers of zoonotic spillover – the movement of infectious agents between species – (primary prevention) and improving outbreak detection and response (secondary prevention).
The latest draft of the pandemic agreement reflects that PBAS and prevention remain sticking points.
Five days of talks were scheduled for the week of 17 February and another five days are scheduled in April. There is no report of the substantive negotiating sessions from February.
“It’s now or never,” WHO Director General Dr Tedros Adhanom Ghebreyussus told the start of these talks.
Apparently the United States has informed the WHO that it would not take part in the Intergovernmental Negotiating Body (INB) overseeing the talks on the pandemic treaty.
Focus on women’s health
International Women’s Day was 8 March this year.
An opinion piece in the BMJ makes the case that Trump’s attacks on women’s health are embedded in a global right wing agenda and urges advocates of women’s health and gender equality to ramp up the fight and strengthen global alliances and partnerships.
It also states that it is necessary to focus as much on what he and his Administration are creating as on what they are defunding and destroying.
Somewhat poignantly, given Trump’s attitude to women’s health and research in general, the US National Academies of Sciences, Engineering and Medicine has just published A New Vision for Women’s Health Research, calling for transformative change at the National Institutes of Health.
Meanwhile the Trump Administration is now requiring that research grants are screened for the use of words such as “women”, inclusion” and “equity”.
It is good to see the extent to which the Albanese Government has listened to women’s voices on their health needs and responded, and the initiatives that have been funded to address women’s equality.
There is much more that needs to be done, specifically around the five priority areas of the National Women’s Health Strategy 2020-2030 – half the lifetime of this Strategy has already elapsed.
Some recent papers that caught my attention have focused on women’s brains and how they affect women’s health and ageing.
And there’s a good article here about why the study of sex-based brain differences is important. This research could help provide answers to the question of why women live longer than men.
Here’s a quick summary of some recent brain research.
A research study that looked at why, in typical aging, women have a brain that looks younger, with fewer cognitive deficits compared to men, has attributed this to genes carried on women’s second X chromosome.
These researchers found a gene in mice that rejuvenates female brains – and humans have the same gene.
In the same edition of the journal Science Advances as this paper, there were two other studies on women’s brains, one on the effect of hormone therapy on the brain and another on how age at the onset of menopause shapes the risk of getting Alzheimer’s Disease.
These findings are well-summarised in The New York Times.
And try to read all of the 7 March 2025 edition of Science Advances, which is devoted to advancing the science of women’s health.
There was also an interesting article in The Sydney Morning Herald that outlined how women’s brains change during pregnancy and afterwards.
A 2024 paper that mapped these changes can be accessed here.
In case you missed it
NIH terminates active research grants
In an unprecedented move, the US National Institutes of Health (NIH) has begun a mass termination of research grants that fund active scientific projects because they no longer meet “agency priorities”.
NIH staff members have been instructed to identify grants for projects studying transgender populations, gender identity, diversity, equity and inclusion (DEI) in the scientific workforce, environmental justice and any other research that might be perceived to discriminate on the basis of race or ethnicity.
Grants that provide funding to universities in China and those relating to climate change are also under scrutiny.
It’s possible that some Australian research projects might be affected, although I have heard no reports on this.
Protests grow
Researchers are organising protests and making their voices heard as Trump officials slash funding and lay off federal scientists.
#StandUpForScience rallies are taking places around the nation.
Onshore manufacturing of IV saline fluids
On 5 March, Health and Aged Care Minister Mark Butler announced that the Albanese Government has committed $20 million to the expansion of Baxter Healthcare’s production facilities, with the company matching the spend with its own $20 million investment.
This should address the issue of critical saline shortages that was experienced last year by Australian healthcare facilities. Further reaction to this announcement is in the latest edition of The Zap.
Tattoos linked to increased risk of cancer
A report from Denmark suggests that tattoo ink, which accumulates in regional lymph nodes is associated with chronic inflammation and an increased risk of abnormal cell proliferation, especially skin cancer and lymphoma.
The risk rises with larger tattoos.
Extreme heat can accelerate biological ageing
A recent paper suggests greater exposure to extreme heat may accelerate biological aging in older adults, raising new concerns about how climate change and heat waves could affect long-term health and aging at the molecular level.
Exposure to extreme heat has long been associated with negative health outcomes, including increased risk of death, but this research shows that it can increase biological aging ageing.
People living in areas where heat days, as defined as Extreme Caution or higher levels (≥90°F), occur half the year, such as Phoenix, Arizona, experienced up to 14 months of additional biological aging compared to those living in areas with fewer than 10 heat days per year.
Australians should be worried!
Workplace friendships improve mental health
A recent article in The Sydney Morning Herald looked at the importance of women’s workplace friendships and how they differ from men’s friendships.
These findings were first reported in the KPMG Friends at Work survey report, released in November 2024.
The survey has insights into the impact of friendship (and alternatively, loneliness) on both mental well-being and professional success and the barriers and opportunities for fostering connection in today’s technology-driven work environment.
Indigenous health news
As part of his Closing the Gap speech to Parliament last month, Prime Minister Anthony Albanese announced funding for twelve new or upgraded remote laundries in the Northern Territory and Central Australia.
The Remote Laundries Project was launched in 2019 and is part of the Aboriginal Investment Group.
It improves the health and quality of life for people in remote communities and provides sustainable Indigenous employment opportunities. A specific purpose of the project is to ensure clean bedding and the prevention of children’s scabies infection which can lead to rheumatic fever and heart disease.
The expansion of the Project has been welcomed by Aboriginal communities and the Heart Foundation.
The best of Croakey
My colleagues are publishing a series of articles investigating how to tackle misinformation and disinformation. These are the latest, with more to come:
- We need a strategic national effort to tackle misinformation and disinformation
- A call for tough legislation to curb misinformation and disinformation
- Experts make wide-ranging recommendations for tackling misinformation and disinformation.
The good news story
In the 17 July 2024 edition of The Health Wrap, I reported how Colorado was improving mountain trail access for people in wheelchairs and the increasing availability of all-terrain wheelchairs.
The Colorado Outdoor Recreational Industry Office has produced a report on how to elevate all Coloradans’ health through access to the outdoors. And there is a guidebook with information about accessible trails in the state.
Now I’m delighted to see that the Albanese Government has announced funding of $17.1 million to work in partnership with the States and Territories to improve the accessibility of national parks, beaches and play spaces around Australia.
Looking this gift horse in the mouth, I’m not sure how far $17.1 million will go – but it’s a beginning and I hope there will be more investments (for that is surely what this is) to come.
On this topic, researchers at the University of Melbourne have produced a report, Sun, Sand and Surf: Benefits, Elements and Pathways to Accessible Beaches, that looks at what must be done to make beaches more accessible, and the value in undertaking this work.
A number of beaches around the nation’s coastline have introduced initiatives to improve access. See, for example, this story about Sydney’s norther beaches.
Automobility has produced a guide to the top wheelchair accessible national parks and trails in Australia.
Clearly, the impact of Alfred upon east coast beaches raises some significant issues for accessibility, in the short and longer term.
Croakey thanks and acknowledges Dr Lesley Russell for providing this column as a probono service to our readers. Follow her on Twitter at @LRussellWolpe. Russell is Adjunct Associate Professor at the Leeder Centre for Health Policy, Economics and Data, University of Sydney.
Previous editions of The Health Wrap can be read here.
