What's happening with health research?

Health research in the United States is changing dramatically. The current administration is gutting funding, programs, and departments. What will be left? Oversight of federal research funding has intensified, including grants from agencies like the National Science Foundation. This raises concerns among researchers about potential limitations on academic freedom and the politicization of scientific research. 

Elite institutions, such as Harvard University, are facing financial challenges due to proposed increases in endowment taxes and threats to their tax-exempt status. These measures could lead to reduced funding for research programs and student aid, potentially impacting the broader landscape of academic research. 

There are now changes in vaccine approval processes. RFK Jr. has mandated placebo-controlled safety trials for all new vaccines. While intended to enhance transparency, public health experts warn that this requirement could delay vaccine availability and increase development costs. 

The administration has implemented significant cuts to public health programs, including the elimination of thousands of jobs at the Department of Health and Human Services and the cancellation of numerous immunization clinics. This raises concerns about the nation's preparedness for disease outbreaks and the overall strength of its public health infrastructure.

State-level fluoride bans have started. Florida is poised to become the second state to ban fluoride in public drinking water, following Utah. This move, supported by RFK Jr. has alarmed dental health experts who argue that fluoridation is a proven method to prevent tooth decay. The ban reflects a broader federal effort to reevaluate and, in some cases, dismantle existing oral health initiatives. 

Public Health Service and CDC long advocated for and funded studies supporting water fluoridation as a key public health measure. Studies from institutions like Harvard and University of Michigan helped establish fluoride's safety and effectiveness. 

Trump has signed an executive order to establish the "Make America Healthy Again Commission," tasked with developing strategies to address childhood chronic diseases. The commission aims to restructure federal responses to these health challenges, although specific policy details and funding allocations are still forthcoming.

The administration's decision to slash U.S. foreign aid has significantly impacted global health programs. Organizations are reporting increased emergencies and service closures in crisis zones due to the withdrawal of U.S. support, highlighting the broader implications of domestic policy decisions on international health efforts. 

Did you know that with the current administration's policies and plans, the development of HIV treatment and prevention would likely have been undercut. The development of antiretroviral therapy (ART) was led by NIH and CDC-backed studies. Dr. David Ho, an immigrant born in Taiwan, became a leader in HIV/AIDS research and Time's 1996 "Man of the Year." U.S. foreign aid funded PEPFAR, saving millions worldwide. This is currently being threatened by aid cuts. 

An executive order issued in January 2025 imposed a 90-day freeze on nearly all U.S. foreign aid, including PEPFAR. This abrupt halt disrupted HIV treatment and prevention services worldwide, particularly in sub-Saharan Africa, where two-thirds of the global HIV burden exists. Additionally, funding has halted ART access, suspension of healthcare worker salaries, and potential resurgence of AIDS-related deaths. Children are particularly at risk, with projections estimating up to 500,000 child deaths in sub-Saharan Africa over five years if funding isn't restored. This disruption not only threatens individual lives but also undermines decades of progress in global HIV/AIDS prevention and treatment efforts. 

The CDC is responsible for 91% of all HIV prevention funding in the U.S. Proposals to eliminate or drastically reduce this division's budget would severely impact PrEP access by cutting funding to state and local health departments and community-based organizations that provide testing, education, and prescriptions. Also, the Supreme Court is reviewing a case (Kennedy v. Braidwood Management) that challenges the Affordable Care Act's mandate requiring insurers to cover preventative services, including PrEP, at no cost. A ruling against this mandate could lead to insurers dropping PrEP from their coverage, making it unaffordable for many. 

Side bar - some HIV/AIDS info:

• It is not a "gay disease"
• Gay and bisexual men still face the highest risk - especially young black and Latino men. In 2022, 68% of new HIV diagnoses were among gay and bisexual men. 26% were black men, though they are a small percentage of the population. 
• In 2022, 22% of new HIV diagnoses were from heterosexual contact. 15% were among heterosexual women, and 7% among heterosexual men. 
• It is worth noting that according to the CDC's National Health and Nutrition Examination Survey (NHANES, 2015-2018) about 6.2% of men aged 18-44 reported having had sex with another man at some point in their lives. The National Survey of Family Growth (NSFG, 2015-2019) found that roughly 4.5% of self-identified heterosexual men reported having had at lease one same-sex sexual experience. In 2019, the CDC conducted a Youth Risk Behavior Surveys. Among high school males who identified as heterosexual, 5.7% reported having sexual contact with someone of the same sex. 
• Why did I say this was worth noting? Many men who identify as straight may still engage in same-sex behavior for multiple reasons. This means risk factors - not labels - drive HIV and STI transmission. Health messaging needs to be inclusive of behavior, not just identity. 
• In the U.S., Black women account for mare than half of all new HIV diagnoses among women, despite making up only about 13% of the female population.
• Globally, most people living with HIV are heterosexual. In sub-Saharan Africa, the epidemic is overwhelmingly heterosexual. 
• Women and girls are at higher biological and societal risk in many regions.
• Heterosexual transmission is increasing in some U.S. regions, particularly in rural and southern states, where access to education, testing, and PrEP is lower. 
• Social conditions - like poverty, racism, stigma and lack of healthcare - often determine who gets affected the most. 

Another life-saving drug is also under threat as the Trump administration has proposed ending a $56 million annual grant program that distributes Narcan to first responders across the country. This funding cut could lead to increased overdose deaths, particularly in areas heavily affected by the opioid crisis. Reducing access to Narcan (naloxone) could reverse the progress made in decreasing opioid-related deaths, as evidenced by a nearly 24% decline in U.S. drug overdose deaths reported by the CDC for the 12 months ending in September 2024. 

Info regarding drug overdose deaths in 2022:

• Approximately 107,941 individuals died from drug overdoses - age-adjusted rate of 32.6 deaths per 100,000 people
• 76% of all overdose fatalities were opioid related deaths
• Between 2022 and 2023, overdose death rated decreased for individuals aged 15-54 but increased for those aged 55 and older
• Males accounted for 70% of overdose deaths
• American Indians and Alaska Natives had the highest overdose death rate in 2022 at 65.2 per 100,000
• States with the highest overdose death rates (2023): West Virginia - 81.9 deaths per 100,000 and District of Columbia - 60.7 deaths per 100,000
• States with the lowest overdose death rates (2023): Nebraska - 9 deaths per 100,000 and South Dakota - 11.2 deaths per 100,000

When I started writing tonight, I wanted to dig in to scientific research and what health related issues were going to be focused on by the current administration. Maybe look into the qualifications of different individuals making decisions on policies, etc. compared to scholars and scientists that have already been working on things. However, once I learned that things like HIV/AIDS medication and Narcan were being threatened, I kind of got distracted. That's pretty common these days. Maybe I'll look into that tomorrow - unless there's other breaking news that I decide to focus my attention on. 

Have a great night and stay safe. 

Ashley