Morning Briefing
Summaries of health policy coverage from major news organizations
Viewpoints: It Takes Much More Than A SOTU Pledge To End HIV; Lessons On The Shortcomings Of Precision Medicine
For days preceding Tuesday night鈥檚 State of the Union address, word was that President Trump intended to roll out plans to end forever the HIV/AIDS epidemic in America. What he said in his address was terse. He observed the 鈥渞emarkable progress鈥 that had been made in recent years in the fight against the disease. He promised, 鈥淢y budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years.鈥 And he ended with a flourish, 鈥淭ogether we will defeat AIDS in America.鈥 Not much in the way of plans, but as Samuel Johnson said of a dog walking on its hind legs: 鈥淚t is not done well; but you are surprised to find it done at all.鈥 (Lillian Faderman, 2/6)
President Trump says he has a plan to end the HIV epidemic in America. During his State of the Union address, he noted that 鈥渟cientific breakthroughs have brought a once distant dream within reach鈥 and that he would request funding from Congress 鈥渢o eliminate the HIV epidemic in the United States within 10 years.鈥 We don鈥檛 yet know the details of the strategy, but reports indicate that it is modelled after the administration鈥檚 approach for ending the opioid epidemic and will target communities where rates of HIV infection are highest. (Sean Cahill, 2/6)
Watching President Trump鈥檚 State of the Union address Tuesday night, my mind raced back to one of my patients, panting as she strung together a few words. 鈥淢y difficulty breathing,鈥 she paused, 鈥渉as gotten worse in the last few weeks.鈥 In her hospital bed, she looked gaunt and tired. She was struggling with homelessness and had stopped taking her HIV medications months ago, as she did not have insurance and could not afford the cost of her medications. As her doctor, I feared that she had a life-threatening lung infection, an unfortunate but preventable complication of her HIV. (Robert Bonacci, 2/6)
This emphasis on reducing biomedical explanations to genetic pathways, known as genetic reductionism, comes at the expense of all other molecular, cellular, physiological, and epidemiological approaches. The dissenters have made their voices heard in the popular press and medical journals, such as Viewpoints in JAMA. Most recently, a special edition of the journal Perspectives in Biology and Medicine, titled 鈥淭he Precision Medicine Bubble,鈥 includes contributions questioning genetic reductionism by well-established investigators from genetics, cell biology, immunology, microbiology, pharmacology, physiology, anthropology, epidemiology, public health, and law. (Michael J. Joyner and Nigel Paneth, 2/7)
The American people face a broad range of challenges these days, some of which can genuinely be considered crises. An opioid-fueled overdose epidemic, for instance, that killed some 70,000 people in each of the last two years. Soaring healthcare costs and an insufficient safety net to keep those who fall ill from also falling into bankruptcy. Massive federal debt from ill-conceived tax cuts. Ongoing wars. Not included on that list are illegal immigration and border security. Do we have problems on those fronts? Definitely. Are they crises? Not even close. Yet that is how the president sought to portray them Tuesday during his State of the Union speech. (2/6)
Surprise turns to shock and then outrage. That鈥檚 the theme of 鈥淭hree Identical Strangers,鈥 a documentary film released last summer and now being screened by CNN. The film also has a less well-known precursor, 鈥淭he Twinning Reaction.鈥 Both chronicle twins and triplets born in the 1960s who were separated as infants and adopted by different families who had no idea of the other siblings鈥 existence. The separation and secrecy were unethical aspects of an experiment that sought to examine the contributions of genetics and environment to child development. The children (who are now adults), their families, and the public deserve answers to many unanswered questions. (Karen Glanz and Holly Fernandez, 2/7)
The UN鈥檚 Office of Drugs and Crime (UNODC) has tracked the explosive growth in synthetic opioids, present in 111 countries and territories around the world, so that policies can be better designed to meet the evolving challenge. The World Health Organization (WHO) recommends the precursor chemicals and opioid 鈥渁nalogues鈥 that are placed on international watch lists. Together the UNODC and the WHO set international standards for prevention and treatment. As you work within your communities to reduce demand and increase treatment options, understand that the story of supply playing out across the globe will impact your hometown. 聽Addressing problems 鈥渙ver there鈥 benefits Americans here. (Former Sen. Mark Kirk (R-Ill.) and Former Rep. Ander Crenshaw (R-Fla.)
This week on 鈥淭he Argument,鈥 the columnists debate abortion. Michelle Goldberg picks apart conservatives鈥 response to efforts in New York and Virginia to expand access and argues that even ostensibly limited restrictions are part of a broader quest to criminalize the practice. Ross Douthat thinks that in most cases abortion is too abhorrent to remain legal and teases out the various arguments within the wider anti-abortion movement. And David Leonhardt notes that abortion ranks among the political issues on which Americans appear to be genuinely split. (Ross Douthat, Michelle Goldberg and David Leonhardt, 2/7)
鈥淣o doctor has ever reminded me that I am black before,鈥 the patient said, laughing and nodding his head to let me know he appreciated my advice. Just as he was startled by my open recognition of his race, so too was I startled by his reaction. (Monica Maalouf, 2/6)
Children鈥檚 hospitals in Texas are facing a dire future鈥攖heir collective Medicaid losses, across the eight nonprofit institutions statewide in less than ten years, are a breathtaking three-quarters of a billion dollars. The population served by these hospitals include Texas鈥 poorest and most at-risk children. (Stacy Wilson, 2/6)
As President Donald Trump highlighted his administration鈥檚 successes during Tuesday鈥檚 State of the Union address, U.S. citizen Ali Hassan and his wife, Shaima Swileh, were in attendance to remind the nation of one of Trump鈥檚 greatest failures: The separation of families, including the families of U.S. citizens. Just a month earlier, the couple had buried their two-year-old son, Abdullah, only days after Swileh was finally reunited with her family after a months-long separation due to Trump鈥檚 travel ban. As Abdullah lay dying in a hospital bed in Oakland, he was denied 鈥 by his own government 鈥 the comfort and affection of his mother. (Saad Sweilem, 2/7)