“The national security might be something worth paying for,” Sen. Bill Cassidy of Louisiana, chairman of the Senate Health, Education, Labor, and Pensions Committee, said July 22 in an exclusive interview with Ñî¹óåú´«Ã½Ò•îl Health News.

The U.S., which has grappled with drug shortages in recent years, relies primarily on China to produce the active ingredients in many antibiotics, according to in JAMA Health Forum. Domestic facilities have closed or shifted to producing other drugs.

“Do we want China to have that sort of leverage for these drugs to be produced principally, maybe 99%, over there, and we don’t have access to them if tension rises between the two countries?” said Cassidy, who is a physician.

On July 21, Trump said in a that he would give generic drug companies two years to move production back to the U.S., after which he would impose 100% tariffs on imported products, rising to 200% the following year. Generic drugs make up an estimated 90% of all prescriptions filled in the U.S.

Cassidy, who has served in Congress , lost his bid for reelection in May after Trump endorsed a Republican primary challenger, Rep. Julia Letlow.

Last month, more than 16 months after his vote to confirm Robert F. Kennedy Jr. as head of the Department of Health and Human Services, on CBS News’ Face the Nation that the secretary broke promises he made to the senator, including that he would not change the federal recommendations for childhood vaccines.

Asked whether he would summon Kennedy again to discuss those promises, Cassidy said he had asked for him to appear before his committee but had not heard back about whether he would do so. Kennedy in April to discuss the Trump administration’s fiscal 2027 budget request for HHS.

Cassidy told Ñî¹óåú´«Ã½Ò•îl Health News that when he agreed to vote to advance Kennedy’s nomination, he trusted that Kennedy would keep his word about not disparaging vaccines.

“If they agree to guardrails and disregard those guardrails, you can judge me,” Cassidy said. “You may decide my judgment wasn’t very good, but I don’t think you can say I acted in bad faith.”

Regardless, Cassidy added, Kennedy was going to exert influence in the administration, and he thought it would be better for Kennedy to be in an official post, where his work would be subject to oversight.

“I’m pretty sure that RFK was going to have the president’s ear whether he was in office or not,” he said.

While Kennedy’s efforts to roll back federal vaccine recommendations are being blocked by courts, this week reported that the number of measles cases confirmed in the U.S. so far in 2026 has exceeded the total for 2025 — making it the highest number of cases in 35 years.

Cassidy, a principal author of the 2020 No Surprises Act targeting surprise medical bills, also said he doesn’t think Congress needs to make modifications to the law in the wake of reports that doctors and other healthcare providers are winning huge payouts under the arbitration system the law created. The No Surprises Act was intended to shield patients from receiving big bills for receiving medical care they didn’t know was outside their health plan’s network.

An analysis by this week found that providers were awarded nearly $15 billion in disputed claims in 2025, more than triple the 2024 figure of $4.08 billion.

“The initial step to make sure that people are getting their best deal is price transparency,” Cassidy said.

The HELP Committee on July 22 overwhelmingly approved advancing the Patients Deserve Price Tags Act, a bipartisan bill that would further expand the requirements that hospitals, insurers, and other healthcare providers make prices public and available to patients and employers. A House committee advanced a similar bill this week, also with bipartisan support, but it remains unclear whether either measure will be approved by the full House and Senate.

The interview — in which Cassidy also discussed his — was part of the “How Would You Fix It?” series featuring Julie Rovner, Ñî¹óåú´«Ã½Ò•îl Health News’ chief Washington correspondent and host of the What the Health? podcast.

An abbreviated version of this interview aired July 23 in Episode 456 of What the Health? From Ñî¹óåú´«Ã½Ò•îl Health News: “A Shrinking Safety Net.”

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .

For the first time in a quarter century, the U.S. no longer meets a main criterion for having eliminated measles as a public health threat. That status hinges on sporadic outbreaks fizzling out within a year. Utah’s outbreak has lasted for longer, since .

Nearly 400 people have been hospitalized with measles in the U.S. this year and last, three people have died, and at least three suffered with .

This month, the Centers for Disease Control and Prevention is set to finalize a comprehensive study of the nation’s measles situation, examining data from January 2025 through June 2026.

“I don’t think we could say with a straight face that there hasn’t been transmission over the past 12 months,” said a CDC scientist with knowledge of the agency’s measles report. (Ñî¹óåú´«Ã½Ò•îl Health News agreed not to name the researcher, who is concerned about retaliation.) The researcher said a national committee of measles specialists will review the CDC’s internal report, which then goes to the Pan American Health Organization, a group that evaluates the measles elimination status of countries throughout North, South, and Central America and the Caribbean.

PAHO will make at an annual meeting this fall, but scientists say the writing is on the wall. “The assessment for elimination isn’t until November, but that is a scheduling issue, basically,” said Anne Schuchat, who led the CDC’s immunization and respiratory disease group from 2006 to 2015.

“It’s just so sad, because some people will get brutally ill,” she said of measles’ return. “This is a wake-up call.”

Pediatricians in Utah have been on the front lines as measles and other vaccine-preventable ailments have returned to the U.S. In interviews with Ñî¹óåú´«Ã½Ò•îl Health News, six doctors shared insights on this new era of vaccine hesitancy — and what could be done to turn the situation around.

The conversations have been edited for clarity.

On Unvaccinated Children Hospitalized With Measles Complications

Emilie Morris, a hospital pediatrician in Salt Lake County and Utah County: When children come in, they’re often bent over. We call it tripoding, which is particular to upper respiratory infections and airway swelling. They have a rash — viruses cause rashes all the time — but in this context, the kid is hunched over, mouth open, drooling, crying, maybe not even producing tears, because they’re so dehydrated. Really labored breathing, kind of tugging in their belly, tugging between their ribs. Their eyes look kind of glazed over. It’s like they’re seeing through you.

Nathan Money, a hospital pediatrician in Salt Lake County and Utah County: If the child has a fever or trouble breathing, and they’re unvaccinated, I have to be way more aggressive from a medical standpoint, because they are at higher risk of having life-threatening illnesses. I have to do more blood work, or lumbar punctures to rule out meningitis. I have to do things which are painful, and it’s traumatic for the families.

I tell them, “Because your child doesn’t have vaccines, I have to be more worried about conditions like sepsis or meningitis, so therefore I need to do more workup.” The last thing I want to do is miss something. These are parents who love their children. They always tell me, “Do what you need to do to make sure my child is safe.”

On Treating Unvaccinated Children Hospitalized for Measles

Trahern W. Jones, a pediatric infectious disease specialist based in Salt Lake City: So I’m coming into a room and just hearing the most awful barking cough, just a cough and a high-pitch stridor as the child is trying to breathe. And he’s just coughing so hard it just makes you feel short of breath. He looks like he’s been beaten down for days, but he can’t rest, because the cough keeps him awake.

The parents tell me they’re not anti-vaccine, but in the past, somebody they know had a reaction to a vaccine — or something they thought was a reaction to a vaccine — and so they paused vaccines when the child was a baby. They were planning to catch up later.

In another case, the parent was stunned by how awful it was. I asked them what they knew about measles before their child was sick, and they said the only person who’d ever taught them anything about measles was their grandmother who had taken care of her kids with measles ages ago. That’s something I’ve heard from other parents. It’s such an awful illness. Even the best possible course is going to be one of the worst diseases most children ever go through.

There are multiple facets to it. Physically, the child has been beat down for multiple days by this virus. The parents don’t get to sleep, because they’re nursing their child. Then there’s the emotional component because the parent is regretting not getting the vaccine, not realizing how bad this was, and then feeling deeply ashamed, trying to reconcile with family members who are really upset at them for not getting their child vaccinated.

Morris: One child was from a family that was uninsured because they didn’t feel that they would need to use the medical system. They were faced with the high burden of cost of our healthcare system. The cost was playing into the parents’ decision on whether or not their child should receive necessary medical care. I said something like: “Please don’t go home. Your child needs oxygen. She has pneumonia. We will figure out a way to pay for this, because we acknowledge what we do is expensive.”

On top of that, the parent had several other children in the home who weren’t vaccinated. It was past the period where we could intervene with vaccines to try to prevent infection, so then our recommendation was to quarantine their children at home for 21 days: “Don’t interact with anybody else in your community. Don’t go to the grocery store, even with a mask. Please take this seriously.”

It takes time for parents to understand the level of concern I have, even when their child is physically ill in the hospital requiring ongoing care. It’s pretty indicative of the breakdown of trust between physicians and families. I say, “This is the gravity or severity of your child’s situation and how serious we need to be about protecting other people.”

It’s frustrating. How can I make people understand I have a very genuine concern for their child? And I know they share that concern, but maybe it’s not the same degree of concern, because they don’t understand the illness and how severe it can become.

Money: It’s heartbreaking to see these children struggling to survive when measles could have been easily prevented by a safe mechanism that is readily available and well studied. These are well-meaning parents who love their children, who have gotten bad information from federal leadership or from online sources. The saddest part to me is when I am caring for a child and the parent says, “I didn’t know that this could get so bad.”

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On Conversations With Parents Who Don’t Vaccinate Their Children

Tim Duffy, a pediatrician in Salt Lake County: A lot of families aren’t aggressively anti-vax, but they’re hesitant. Younger parents who grew up in the digital age have done their research — “research” in quotation marks — for months. And they keep getting confirmation of their concerns on social media. They think they’re doing what’s best for their child.

I’ve told families: “You could do nothing I say as a pediatrician. You could sleep your child on their stomach. You could not put them in a car seat or, when they’re older, not use seat belts. You could do nothing I say, and for your individual child, they will probably be OK. But from my standpoint, where I’m taking care of thousands of kids, within a system that takes care of hundreds of thousands of kids, we will have bad outcomes. These children will show up at our facilities, and it’s so sad.”

Pediatrician in southern Utah whom Ñî¹óåú´«Ã½Ò•îl Health News agreed not to name, because of concerns about harassment after being targeted by anti-vaccine activists in the past: A lot of parents are concerned about autism. I’ve told them that I’d be very concerned if there was any evidence that what we’re doing is causing autism. But if vaccines were causing autism, we should see more cases of autism in vaccinated kids compared to unvaccinated kids, and we’re just not seeing that.

I’ve also had families who say they want to be natural, or that they’re concerned about what is in the shots. A frequently asked question is: “Did you vaccinate your children?” I say that knowing what I know, I’m confident giving this to my kids. They’re all vaccinated.

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On the Influence of Politics on Vaccine Hesitancy

Jones: Vaccines have become a political football. That wasn’t true 20 years ago. But now it’s used to drive a wedge between groups of people, which is unfortunate. Vaccines are one of the main reasons why we don’t have to worry about losing our kids.

Southern Utah pediatrician: People don’t know who to believe. If politics comes up, I tell parents that my messaging on vaccines is not politically motivated. When parents ask about changes to the vaccine schedule, I’m transparent. [In January, the Department of Health and Human Services reducing the number of vaccines given to children. A few months later, a federal judge blocked those changes.]

I’ve said there was a process for the approval of immunizations through ACIP [the Advisory Committee on Immunization Practices], which is made up of scientists, public health experts, and doctors, and all those people were let go, and a new panel was selected. A couple of individuals changed the recommendation outside of the time-tested, evidence-based process for evaluating vaccines. That raises concerns for me as a doctor. I tell parents that the American Academy of Pediatrics, the American Academy of Family Physicians, and several other professional organizations have issued statements saying that these changes are not based on evidence.

Ellie Brownstein, pediatrician in Salt Lake County and president-elect of the Utah chapter of the American Academy of Pediatrics: I avoid talking about politics, but what’s being said has added another layer to our work. One family asked me about changes to vaccine recommendations, so instead of just telling them what immunizations are due, I talk with them about why physicians and researchers have followed a different schedule for years, about the reasoning and the science behind it. I explain that I trust these experts over someone without a lot of experience.

Money: People are not vaccinated, because they’ve lost trust in the medical community. They’re placing trust elsewhere. Rebuilding trust is a complicated process, but it comes from consistent messaging at every level, from the pediatrician to local health departments to community leaders, city leadership, district leadership, religious leadership, educational leadership.

We need consistent messaging from state leadership, which has been pretty absent. I want to see commercials on TV about the safety of the MMR [measles, mumps, and rubella] vaccine and the dangers of the measles, sponsored by my state leadership. I’d like to see this on billboards and in schools, in public buildings and grocery stores. I want to go to a sports event and see messages about the measles and the MMR vaccine. Right now, people have to go out of their way to find information from reputable sources.

We also need policy changes to support vaccination. This train is going in the wrong direction, and it can feel like a helpless situation, because we’re just not seeing the public messaging and leadership that’s needed to turn this around.

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Advice on Talking With Parents Who Don’t Vaccinate Their Children

Jones: Approach them with as much compassion as you possibly can. Ask open-ended questions to learn about their experiences that led them to have these concerns. I think it’s really important to not come down on them, citing facts and figures and pointing to guidelines on why they need to get their kids vaccinated. But try to direct their attention to the fact that you’re a real person with your own real experiences and knowledge. I point out to families that I have my own kids, and I would never recommend something for your kids that I wouldn’t do for mine.

Southern Utah pediatrician: I’ve learned that if you come down hard, you’re going to lose people who need care. My number one goal now is to build bridges and maintain a relationship with families, because that’s what’s going to allow me to convince some of them.

I approach people differently depending on where they are. Parents who are very skeptical or anti-vax will say no when I tell them their child is due for immunizations. I’ll say: “Fine. You guys get to choose. You’re the parents. But I’m curious to know what your reasoning is.” Sometimes they’re just like, “It’s something I’ve decided.” They don’t want to have a conversation.

It’s a good day if I can have a conversation with someone who doesn’t want to vaccinate, even if I don’t convince them. I try to help them think through things rather than shoving anything down their throat. When they’re done talking, I’ll ask, “Can I share my perspectives on this?” Some will say yes enthusiastically, and others will say yes because they’re being polite.

A lot of parents aren’t sure what to do, and those are the people I focus most of my time on. I focus our conversation on their specific concerns, and I’m open about specific side effects that different immunizations can have. For example, I’ll tell them that some children get a fever after a vaccine, which is OK. The fever is not harmful, but it can make babies feel crummy as their body is building up antibodies against viruses and bacteria.

Brownstein: I don’t like the idea of excluding unvaccinated kids from my practice. I know some do that. But what that does is it ends any future discussion. I can’t keep talking with parents about vaccines if I kick them out of my practice, and if these parents find like-minded doctors, this situation will get worse.

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On Being on the Front Lines of Measles’ Comeback in the U.S.

Money: I wish that people could see what I see. Everyone else sees what people post on Instagram. Or they think, “Someone I know had measles when they were a kid and they were fine.” But as a hospital-based pediatrician, I see what happens when things go poorly. I see what happens when children with measles aren’t able to breathe on their own, and they’re in a hospital bed with a cannula in their nose, struggling to breathe, an IV in their arm because they can’t drink on their own. And the child is terrified, and the parents are scared that their child might die.

It’s heartbreaking as a pediatrician and as a father to know that the entire situation could have been easily prevented.

Duffy: Even though parents say vaccination is their choice, I still feel personally responsible if something bad happens that’s preventable, because I feel like I didn’t say the right thing, I didn’t ask the right questions. Maybe I let it drop because of the look on a parent’s face.

Morris: Every pediatrician I know cares so deeply about what they do. Sometimes people forget that we are human beings practicing this discipline, and we bring all our concerns for our community into this space. I’m trying to navigate a lot of complex human emotions, like how it feels to hold grief with a family when something bad happens that was preventable — which is the worst situation, because you think, “Could I have done something differently?”

Jones: I think we’ll see more diseases start coming back that we thought we had gotten rid of. I think it’s going to take dramatic changes to actually prevent those outcomes. I’m not necessarily seeing those changes being done by those in power.

I think of that quote from The Lord of the Rings. It’s something like, you don’t get to choose the time that you’re born into, but you get to choose what you’re going to do about it. And if there’s any comfort that I have, it’s in knowing that there are right decisions to make and that I’m going to make them, and I’m going to help others make them, too.

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .

Julie Rovner Ñî¹óåú´«Ã½Ò•îl Health News Read Julie's stories. Julie Rovner is chief Washington correspondent and host of Ñî¹óåú´«Ã½Ò•îl Health News’ weekly health policy news podcast, "What the Health?" A noted expert on health policy issues, Julie is the author of the critically praised reference book "Health Care Politics and Policy A to Z," now in its third edition.

Enrollment in the federal food stamp program — the Supplemental Nutrition Assistance Program, known as SNAP — is down by more than 10% nationally, according to a new report, and in some states by as much as half. Those numbers are falling as states enact changes ordered by the GOP budget bill passed in 2025. The drop is much steeper than was predicted and could portend a similar fate for those on Medicaid, as states prepare to implement many of the same changes ordered for SNAP. 

Meanwhile, amid a rise in reported cases of the gastrointestinal ailment caused by the parasite cyclospora, federal public health officials once again struggle to explain to a confused populace how to stay safe. 

This week’s panelists are Julie Rovner of Ñî¹óåú´«Ã½Ò•îl Health News, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, Alice Miranda Ollstein of Politico, and Margot Sanger-Katz of The New York Times.

Panelists

Joanne Kenen Johns Hopkins University and Politico

Alice Miranda Ollstein Politico

Margot Sanger-Katz The New York Times

Among the takeaways from this week’s episode:

• Participation in the nation’s food stamp program is down, with children representing nearly half of those losing benefits, according to a recent analysis. Some states are showing much larger drops than others. The GOP-passed budget law imposes penalties for errors, leaving states spooked about the possibility of losing funding — and suggesting problems ahead for the full rollout of Medicaid work requirements next year.
• President Donald Trump’s immigration crackdown is increasing pressure on the health system, in particular on the availability of home-based and long-term care workers — including those who fill critical roles such as serving food and driving patients to medical appointments. Research has shown that the presence of immigrant workers has a protective effect on the health of their charges.
• Responding to revelations that doctors are reaping large payouts from the surprise-billing arbitration process, the Trump administration this week released information showing a spike in such payments and noted the need for changes to the law — without specifying what kind of changes. That law, the No Surprises Act, took effect in 2022 with the primary intention of shielding patients from big bills when they unknowingly receive out-of-network medical care.
• In other news, the Pentagon is imposing testosterone tests for many service members. The cyclospora outbreak continues. And the Trump administration announced plans to withhold Medicaid funding from California and Minnesota over accusations of fraud.

Also this week, Rovner interviews Sen. Bill Cassidy (R-La.), chairman of the Senate Health, Education, Labor, and Pensions Committee, as part of the “How Would You Fix It?” series.

Plus, for “extra credit,” the panelists suggest health policy stories they read this week that they think you should read, too: 

Julie Rovner: The New York Times’ “,” by Arijeta Lajka, Isabelle Niu, Mark Boyer, James Surdam, and Dan T. Peters.

Joanne Kenen: Stat’s “,” by Adam Feuerstein.

Margot Sanger-Katz: NPR’s “,” by Andrea Hsu.

Alice Miranda Ollstein: Roll Call’s “,” by Ariel Cohen.

Also mentioned in this week’s podcast:

• Ñî¹óåú´«Ã½Ò•îl Health News’ “Doctors ‘Cringe’ at Possibility of Documenting Which Medicaid Enrollees Too Sick To Work,” by Sam Whitehead.
• Ñî¹óåú´«Ã½Ò•îl Health News’ “A Deloitte-Run System Denied Medicaid Benefits for Michigan’s Disabled. Now Trump’s Law Piles On,” by Rachana Pradhan, Samantha Liss, and Kate Wells.
• The New York Times’ “,” by Miriam Jordan.
• The Wall Street Journal’s “” by Anna Wilde Mathews and Tom McGinty.

Credits

Click here to find all our podcasts.

And subscribe to “What the Health? From Ñî¹óåú´«Ã½Ò•îl Health News” on , , , , , or wherever you listen to podcasts.

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .

Homes that once belonged to friends, family, and neighbors had siding covered in mold. Some were boarded up. Others had holes in their roofs.

Black churches once used Oquina Creek, which runs along the border of the neighborhood, to baptize their congregants. Today, fecal bacteria and other contaminants have made the water unsafe due to an aging wastewater system.

“Sometimes you get the feeling like you’re in a Third World country,” Williams said. After three decades in Washington, D.C., he returned four years ago with a mission to revitalize communities such as Dewey City, which he said are “part of what makes Thomasville, Thomasville.”

A $19.8 million Community Change Grant from the Environmental Protection Agency was supposed to shift the tides of the neighborhood Williams grew up in.

The city and the , where Williams formerly served as community development director, applied for the grant in 2024. It was part of a $2 billion effort to help disadvantaged communities address environmental health risks and create clean energy and climate resiliency projects.

But three months after winning the grant, Thomasville became one of across the country — from to to — to see the funding stripped as priorities shifted in Donald Trump’s second presidency.

On the first day of his second term, Trump signed an executive order titled “.” It stated that the Biden administration “forced illegal and immoral discrimination” through diversity, equity, and inclusion programs.

In an emailed statement, EPA spokesperson Mike Bastasch said the administration is “fully committed to being a great steward of taxpayer dollars.” He added that the “radical agenda” of DEI and environmental justice “preferencing” are not within the agency’s core mission of protecting human health and the environment.

Environmental health advocates argue, though, that the decision to cut the grants was not rooted in science. They say that equating environmental justice to DEI is an act of bad faith and that withholding the money forces disenfranchised communities to delay long-overdue updates needed to protect public health for marginalized populations.

“I unfortunately believe we’re going to see a reversal in the health profile of this country,” said , an associate professor at the University of Michigan who served in the Biden administration as the first federal chief environmental justice officer.

“This current federal regime has decided that humanity and public health and justice don’t mean anything,” she said.

‘Why Us?’

Thomasville, near Georgia’s southwestern border, is home to just over 18,600 people.

The city had hoped to improve health outcomes in neighborhoods on its southern and western sides where, according to the grant proposal, “historical redlining created a legacy of disinvestment.”

Those areas have a deep history: Dewey City, for example, was the first neighborhood in the city where Blacks could build homes after the Civil War. It’s also home to the closed Douglass High School — the first public school for Blacks in Thomasville, established in 1902.

“This place has been neglected,” said Williams, who occasionally hosts historical walks through the community. “But it’s worth bringing it back online.”

The proposed “Restoring Resiliency” project featured a plan to remove toxic substances such as mold, lead paint, and asbestos from homes, repair a nearly 82-year-old wastewater system, and convert part of a shuttered high school band room into a health clinic.

“This was a long and storied attempt to bend the arc of justice closer,” said Jeremy Rich, a Thomas County commissioner and the pastor at First Missionary Baptist Church. “Justice in healthcare. Justice in environmental impact.”

Having a clinic in the community would be a “game changer,” Rich said. During the covid pandemic, he said, older residents who rely on public transit were reluctant to go to the nearby hospital or the county health department to get vaccinated. When his church offered shots from Black nurses, he said, vaccination rates improved.

Many residents don’t have the financial means to remove mold, lead paint, and other toxic materials, said Thomasville Mayor Pro Tem Lucinda Brown. “They just have money to live with every day. That’s it,” she said. “If they can make that happen.”

The grant meant hope, and its reversal left many asking, “Why us?” Williams said.

In the EPA’s May 2025 letter announcing the grant termination, it said Thomasville’s project promoted “initiatives that conflict with the Agency’s policy of prioritizing merit, fairness, and excellence.” The grant was “inconsistent with, and no longer effectuates, Agency priorities,” the letter said.

Environmental justice projects are rooted in science, not DEI, said Jillian Blanchard, the senior vice president of climate change and environmental justice at , a national nonprofit that provides pro bono legal assistance in focus areas such as health equity, immigration, and environmental health.

“Where is the water dirty? Where is the air unclean?” she said. “That is where the money should go.”

In June of last year, nearly two dozen communities and organizations around the country filed a to get the Community Change Grants reinstated. The lawsuit argued that the projects — such as efforts to create energy-efficient housing in Kalamazoo, Michigan, and empower Houston residents in the pollution permitting process — were vital.

The case was dismissed by a federal district judge in 2025 but is being appealed.

Thomasville was not named in that lawsuit. But the city did appeal the EPA’s decision on its project with the support of Blanchard’s group. The city and the EPA continue to dispute the issue.

This March, the EPA’s deputy inspector general, which serves as an independent watchdog for the agency, concluding that the process for determining the awardees was fair.

Such federal funding is needed because large-scale change is difficult for small municipalities to achieve without getting stuck with high-interest loans, Blanchard said.

“It’s next to impossible,” she said. “That’s one of the reasons the things haven’t been done.”

‘It’s Not Over’

The city of Thomasville has found other ways to make some improvements in the meantime. With the help of a nearly $3 million federal Community Development Block Grant from the Department of Housing and Urban Development, it made repairs to portions of Dewey City’s sewer, water, and drainage systems.

The Thomasville Community Development Corp. has begun building affordable housing in Dewey City and intends to convert a portion of the closed Douglass school into apartments for seniors.

The corporation has also applied for $764,000 in through the office of Sen. Jon Ossoff (D-Ga.) that it hopes to use to construct a community health clinic in Dewey City. Decisions on these funding requests will be made this fall.

“It’s not over,” said Williams, whose legacy in Thomasville runs deep. At the center of what locals call The Bottom — a two-block stretch of downtown where independent Black and other minority-owned businesses once thrived — is a plaque honoring his father, Earl Williams Jr., the city’s first Black mayor.

As he peered at his father’s memorial on a muggy afternoon, he reaffirmed his intentions.

“There’s more work to be done, and I’m able,” he said. “I like pouring into the community.”

But he has little hope the initial grant will be restored under the current administration.

“That was our shot. We didn’t do anything to miss it,” he said. “We just did it during the wrong period of time.”

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .

On that rainy Friday afternoon, hundreds of such mourners gathered to honor the man who went to the police department for help and didn’t come back.

“Stay woke. Stay guarded,” his daughter Lania Gilmore told the church full of mourners in this city of fewer than 16,000 with a long, troubled history of racial violence. “Be there for your family and love on one another.”

Her father, a 44-year-old Sikeston resident, died in police custody on June 10. During a quick, physical altercation involving seven Sikeston police officers, he was shocked with a Taser and put into hobble restraints, which allow officers to hogtie a person’s feet and hands, according to a through a public records request. Two autopsies were performed, but they — and Gilmore’s cause of death — had not been released as of mid-July while the result of a toxicology report remained pending.

Gilmore had approached an officer in the parking lot of the police station, according to the report, speaking words the officer said he could not understand. Lania Gilmore said that her dad, who had mental health issues, had asked her to call the police department and that he ran there seeking help.

“I kind of trusted the fact that he was OK because he was at the police station,” she told Ñî¹óåú´«Ã½Ò•îl Health News.

At his funeral, hardly anyone spoke of the police — and, at the family’s request, the funeral home declined to ask police to provide traffic assistance as they usually would. A preacher did his best to comfort Gilmore’s family. “Sometimes we need not talk,” the Rev. Tommy Robinson Jr. told the crowd. “We just need to listen.”

But after years of expressing concerns of racial bias within the city’s police department, some Black Sikeston residents wonder if anyone is listening at all anymore. They want justice even as the national reckoning over police brutality has faded from public view.

“We need the police. We just need them to do their jobs correctly and leave Black people alone,” said Mark Wiggins, president of Sikeston’s NAACP branch. “They know it. We know it. The truth of the matter is there’s a lot of unwarranted cop killings of Black men in America.”

But despite worldwide protests in 2020 in the wake of high-profile police-involved killings of Black people, the public paid little attention when a prestigious group released a report last year about deaths in custody, said Roger Mitchell Jr., a forensic pathologist finishing his term as president of the , which represents African American physicians. The urged Congress to require states to collect and report data on all in-custody deaths, a problem that Mitchell said disproportionately affects Black men.

“We are in an anti-diversity environment,” Mitchell said. “We’re in a war.”

Upon returning to the White House last year, President Donald Trump that targeted diversity, equity, and inclusion programs. As a result of that and other measures, funding for racial equity has dwindled, researchers who once studied violence as a public health issue have redirected their work to less politically charged topics, and a growing fear of professional and political retaliation has made it increasingly difficult to sustain the momentum.

Kevin Myles, a civil rights leader based in Georgia who has trained tens of thousands of activists around the country, said he saw a shift in priorities around racial equity before Trump was reelected. Since then, it has escalated, he said, and he has lost at least half his funding for his work on equity, child welfare, and mass incarceration.

“I don’t think we really were prepared. It’s not that we didn’t take it seriously. I don’t think we were psychologically prepared for what this means,” Myles said. “Everything we have done before now was practice. The game has just started.”

Sikeston, located in the rural area of southeastern Missouri known as the Bootheel, has a history of racial violence, including the brutal lynching of a Black man named Cleo Wright in 1942. Another Black man, Undraus Nabors, was found dead in a grain silo months after heading out to pick up his white girlfriend in 1999. In April 2020, less than a month before George Floyd’s murder in Minneapolis, an unarmed Black man, Denzel Taylor, was shot at least 18 times by Sikeston police officers. The city was the subject of the 2024 “Silence in Sikeston” documentary film and podcast by Ñî¹óåú´«Ã½Ò•îl Health News, Retro Report, and WORLD.

Silence in Sikeston

Watch: New Documentary Film Explores a Lynching and a Police Killing 78 Years Apart

The “Silence in Sikeston” documentary film explores how the nation’s first federally investigated lynching and a police killing 78 years apart haunt the same rural Missouri community. The film from Ñî¹óåú´«Ã½Ò•îl Health News and Retro Report explores the lasting impact of such trauma — and what it means to speak out about it.

Larry McClellon, a longtime Sikeston resident who founded a civil rights group called And Justice for All, has expressed concerns about the integrity of his city’s police department for decades. He’s also convinced that being vocal about racism in Sikeston comes with a price.

“It’s a dark side of Sikeston that a lot of people do not know and don’t prefer to know,” McClellon told Ñî¹óåú´«Ã½Ò•îl Health News in 2021 after police fatally shot Denzel Taylor. “But I’ve walked the streets.”

He believes someone burned down the headquarters of And Justice for All in 2019. A said the fire was “suspicious in nature.” The electricity in his building wasn’t on when flames erupted, he said, so he wasn’t satisfied when an investigator called it an electrical fire. He asked the department to take another look. No one was charged.

James McMillen, the city’s police chief, told Ñî¹óåú´«Ã½Ò•îl Health News in 2021 that he had plans to improve policing before Taylor died. At the time, McMillen, who is white, said he and his department had “a poor relationship” with Black residents in the city. He started some community meetings after Taylor’s death, but he said in 2024 that people had stopped showing up.

“We have tried,” the chief said during a this month. “But, as my daddy would say, a relationship is a two-way street. And so I don’t know what else I can do.”

During the meeting, Lania Gilmore pleaded with the city to release more information about her father’s case. Other residents wanted to know why the officers involved were not placed on administrative leave immediately after Gilmore died.

“It depends on the circumstances. It does,” McMillen told them. “You’re assuming a certain set of details that you don’t know.”

Another resident asked the city about training for officers. McMillen said his officers are trained. Nationwide, many communities have to assist people in crisis.

“Chief does not want anybody to be mistreated at all. Period,” Sikeston Mayor Greg Turnbow, who is white, said at the meeting. “And I guarantee you, I put my life in his hands. I’d do it today.”

McMillen declined to comment on Ñî¹óåú´«Ã½Ò•îl Health News’ questions about Gilmore’s case and the community’s concerns about the department. The Missouri State Highway Patrol investigated the death and planned to refer the results to the Cape Girardeau County prosecuting attorney, Sgt. Bradley Germann said.

The day Gilmore died, his daughter said, he had been anxious and was looking for a “safe space.” So, she said, he had spent much of the day watching her braid hair at the salon where she works, then he went with her to her eyelash extension appointment. Lania Gilmore said he was still feeling undone, but she needed some space, so he asked her to call the police instead. She said she did, then she watched him run toward the police station.

The rest unfolded within 30 minutes, according to the police report and . The police report said that, amid an ensuing scuffle, Gilmore bit one officer’s hand — “but did not break the skin.”

After the police stunned and restrained Gilmore, a paramedic gave him a sedative, and the emergency medical services took him to a hospital, according to the police report. The report listed five victims — all police — and accused Gilmore of third-degree assault and resisting arrest.

Lania Gilmore said police told her that her father overdosed. But she said she doesn’t understand how that would have been possible, given the short time between when he left her and an ambulance was called.

The city’s police force knew Gilmore had mental health issues, his daughter said. Police officers in a neighboring community “excessively tased” and beat him in 2020, . He received a $65,000 settlement five years later, and she said that experience left a mark.

After Gilmore died, Louis Houston, a longtime Sikeston resident, said he decided to move 30 minutes outside the city to a neighboring community, where he feels safer. He said hearing about other Black Sikeston residents being harassed by the police department had started to affect his mental health.

“I got on away from here,” said Houston, who returned to Sikeston for the funeral.

Houston’s already thinking about the conversations he will have with his young children about how to respond if they ever interact with a police officer. He has a script in mind.

“Be careful,” Houston plans to tell them. “They can help you, but they also can kill you.”

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Related Article

No One Wants To Talk About Racial Trauma. Why My Family Broke Our Silence.

Every family has secrets. I spent the past few years reporting about racial violence in Sikeston, Missouri. Interviewing Black families there helped me uncover my family’s traumatic past, too.

By Cara Anthony Sept. 13, 2024

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .

In June, Vincent Munster, an infectious disease researcher at the National Institutes of Health, was charged with bringing biological specimens into the U.S. without proper documents. Weeks later, Sen. Rand Paul (R-Ky.) ordered Anthony Fauci, Munster’s former boss, to appear before a Senate committee, alleging that he’d lied to Congress about the covid-19 pandemic’s origins. This spring, the FBI detained a former aide to Fauci, and federal officials banned a virus researcher in North Carolina from receiving federal funding.

In each case, senior U.S. officials and members of Congress have leaned into unproven theories that arrogant scientists damaged rather than protected public health by recklessly experimenting with covid and other killer viruses, including in China.

Conservative groups and social influencers have amplified that view through a whirlwind of covid conspiracy theories, bioterrorism fearmongering, and anti-immigration sentiment. The recent charges stirred long-held mistrust of the high-security Rocky Mountain Laboratories, where Munster works, among residents of this blue-collar mountain town in Montana built on logging.

A dozen scientists interviewed for this article said that any crimes or errors committed by Munster, who was transporting vials of inactivated mpox for research purposes, seemed to be over paperwork and posed no threat to the public. Nonetheless, some colleagues in Montana said, the alleged improprieties needlessly bat a hornet’s nest.

“This just gives ammunition to the people that are trying to stop this valuable research,” said Kim Hasenkrug, a scientist emeritus at the NIH who worked at Rocky Mountain Labs for 31 years. “Even people who have trusted us in the past, this sows seeds of distrust. How could it not?”

Cuts to U.S. foreign aid and research funding have left tens of millions of dollars in gaps in the fight against spreading Ebola and mpox outbreaks, scientists told Ñî¹óåú´«Ã½Ò•îl Health News. “When the next pandemic comes around and we need vaccines to protect ourselves, the chances are that China will develop them before we do,” said Kristian Andersen, an evolutionary biologist at Scripps Research. Andersen co-authored studies that stoked the ire of proponents of the theory that a lab leak started the covid pandemic.

Emily Hilliard, a spokesperson for the Department of Health and Human Services, which includes the NIH, said the federal government “remains fully equipped to protect Americans and respond to emerging public health threats.” She said the Centers for Disease Control and Prevention had deployed experts domestically and internationally to respond to Ebola.

Scientists like Munster are indispensable for figuring out the source of pandemic viruses, whether bats, pigs, rats, or some other animal, Andersen said. Munster “is the person who goes out to Africa to get samples of bad viruses from people,” said Stanley Perlman, a virologist at the University of Iowa and a longtime member of the FDA’s vaccine advisory panel. “He’s done lots of things that needed to be done, and he does them well.”

Authorities arrested Munster and Claude Kwe, a research fellow at Rocky Mountain Labs, June 2 on charges of conspiracy to smuggle mpox into the United States and lying to border agents. They had been stopped Jan. 25 at the Detroit airport after returning from the Republic of Congo.

The announcing the charges said FBI testing had confirmed the viruses were inactivated — Munster helped — but that the scientists jeopardized Americans’ safety.

“These NIH experts apparently broke our laws by smuggling viral pathogens on a packed commercial airplane from an outbreak in the Republic of Congo. Let that sink in,” said Jerome Gorgon, U.S. attorney for the Eastern District of Michigan.

The says Munster and Kwe falsely told customs agents the mpox specimens they brought back were for diagnostic use. Yet several scientists told Ñî¹óåú´«Ã½Ò•îl Health News that the specimens most likely were indeed for use in developing mpox diagnostic tests.

The complaint also states that the scientists lacked the appropriate documents. requires researchers to register and certify inactivated viruses.

“He is presumed innocent and we will have to await future proceedings before commenting,” Kwe’s federal community defender, Benton Martin, said of his client.

In Montana, Marshall Bloom, an associate director at Rocky Mountain Labs, told the Ravalli County Board of Health in a July meeting that the scientists have been suspended and aren’t allowed on campus amid an internal NIH investigation. “These are not trivial accusations,” Bloom said.

It is not illegal or unheard of to take an inactivated virus on a plane. If the samples were inactive, “the risk is zero,” said Daniel Jernigan, who worked for 26 years at the CDC and led its National Center for Emerging and Zoonotic Infectious Diseases until retiring last August.

“But you have to have the documentation available,” he added.

Jernigan recalled reprimands issued for this sort of lapse but knew of no arrests.

“In this climate,” Perlman said, “you’d want to make sure you talk to people at your institution to make sure any i’s are dotted and t’s are crossed.”

Munster’s attorney didn’t respond to multiple interview requests.

Skeptical Neighbors

Conservative politicians and others skeptical of the nation’s covid response have had Munster and Rocky Mountain Labs on their radar for years.

The facility is in Hamilton, a town of 5,000 in rural Ravalli County, which gave President Donald Trump 69% of its vote in 2024. The lab got its start with studies of Rocky Mountain spotted fever in the 1900s, when ranchers and cattle were dying from the then-unknown disease.

Today it is a Biosafety Level 4 facility, one of only several dozen labs in the world to employ the highest level of safety controls that enable scientists to study the deadliest pathogens.

Munster and his laboratory of viral ecology are known as the “go-to group for highly dangerous viruses” such as Middle East respiratory syndrome, Nipah, Ebola, and bird flu, said zoologist Peter Daszak, whose work has also been targeted in recent years. Munster “goes into red zones,” gets samples from sick people, and makes diagnostic tests that help assess an outbreak and how to stop it, Daszak said.

Munster and his colleagues contributed to studies of , , and — work that put the lab in the crosshairs of people warning about the dangers of biomedical research.

In April, the White Coat Waste Project, a self-described government watchdog group to stop tax-funded animal testing, paid for billboards across seven cities with NIH-funded labs, including Hamilton.

The next month, about the investigation into Munster, citing an anonymous letter. That caught the attention of Laura Loomer, a far-right activist known as a loyalty enforcer for Trump who has the president’s ear. She posted about it to her 1.9 million followers on the social platform X.

“Fauci Holdovers at @NIH and @HHSGov are about to unleash Ebola in America,” Loomer posted on May 17, asking why Munster, who is Dutch, and Kwe, from Cameroon, weren’t imprisoned or deported.

Little more than a week later, Montana Republican U.S. Sen. Tim Sheehy sent a letter to HHS calling for an investigation, saying the alleged improper behavior by the scientists could threaten national security.

Munster and Kwe were charged days later. U.S. Rep. Paul Gosar, an Arizona Republican, in mid-July as a reason to close the Hamilton facility, part of his ongoing “Fauci-era programs.”

The arrests added to local apprehensions about the facility.

 “You can’t pick and choose which rules you follow when you’re dealing with this stuff,” County Commissioner Jeff Burrows said at a June meeting. “And I know he’s innocent until proven guilty, but for God’s sakes, this is a big deal.”

The Ongoing Push To Blame Fauci

About two weeks after the charges, departing Director of National Intelligence Tulsi Gabbard released declassified documents that she said proved Fauci had lied to Congress about NIH-funded research at the Wuhan Institute of Virology, the lab that, in her words, “sparked covid.” The documents, however, provide no new evidence that the lab launched the covid virus. Most, though not all, virus experts think the best evidence indicates the virus jumped from bats to other animals, and then to humans at a Wuhan market.

of the lab-leak theory have issued fresh calls to punish Fauci, 85, and scientists his institute funded. Fauci declined to comment for this article.

Shortly after Gabbard’s report, Paul, who chairs the Senate Homeland Security and Governmental Affairs Committee, subpoenaed Fauci to testify before the committee.

Fauci “was Dr. Frankenstein of the modern era” and “has the blood of millions of people on his hands,” Peter Navarro, a senior adviser to Trump, on June 25. “You idiot! … You need to come clean, Fauci.”

The administration’s mistrust of the federal bureaucracy and the scientific work it has funded has led to broad cuts and staffing losses, including in .

A May 2025 suspended research on many risky viruses, and HHS later halted an $82 million, that funded research into emerging viruses by 10 labs across the world. In late May this year, the White House that would give political appointees sweeping power over all federally funded science.

Prominent covid experts and scientists close to Fauci have been called before congressional committees, barred from receiving government grants, or arrested.

In April, heavily armed FBI agents of David Morens, Fauci’s 78-year-old former aide. They forced him to strip to his underwear and drove him in handcuffs 40 miles to a federal courthouse, where he was briefly jailed, according to Science magazine. Morens’ case is pending.

In May, HHS told Ralph Baric, a University of North Carolina coronavirus expert, that it was halting his federal funding because of a “pattern of deception” in his communications with the NIH. .

In some ways, the arrests of Munster and Kwe felt unsurprising, said Philip Stewart, a recently retired Rocky Mountain Labs researcher focused on tick-borne diseases.

“There is an anti-science movement,” Stewart said. “We are targets, and if it hadn’t been Vincent, it would have been someone else.”

Most Americans believe in the lab-leak theory, according to surveys, and several U.S. intelligence agencies lean in that direction. That makes targeting scientists who do that kind of work politically expedient, said Daszak, whose NIH-funded nonprofit worked with Chinese virologists in Wuhan and has been under scrutiny since April 2020, when Trump his funding ended.

Animal viruses jump to humans in the wild a year, usually producing negligible infections, occasionally sparking an outbreak. The Ebola virus causing the current African epidemic may have originated in bats, which seem to carry it without getting sick.

Doctors on the ground in the Democratic Republic of Congo lacked diagnostic tests . Munster, who has extensively researched Ebola, was locked out of his lab soon after the January detention.

“While we sit around removing pandemic preparedness grants, arresting scientists, locking them up in some cases,” Daszak said, “viruses are out there evolving.”

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .

Nearly half of that money is , to be distributed by county commissioners and city councilors. The idea is that local leaders know their communities best and can do justice to these payouts, often described as “blood money” by people who’ve lost loved ones to an overdose.

But many local leaders have little to no training in addiction policy and may lack robust local health departments and policy guardrails to assist them.

That has resulted in spending decisions that many clinicians, researchers, and addiction recovery advocates say are unlikely to save lives or treat substance use disorders.

In New York, where is directly controlled by local governments, counties have spent tens of thousands of dollars on surveillance cameras, technology to help police access data on locked cellphones, and goggles that simulate being drunk, according to public records obtained by the nonprofit advocacy group and shared exclusively with Ñî¹óåú´«Ã½Ò•îl Health News. Though the purchases were likely legal, many people consider them a slap in the face because they don’t directly help people struggling with addiction or their families.

Without oversight, counties have the chance “to go rogue” with this money, said , director of drug policy at VOCAL-NY, an advocacy organization that is tracking settlement money as part of its mission to serve people affected by the war on drugs.

When advocates and families of overdose victims raise concerns to the various state agencies that could hold localities accountable, those agencies often punt to one another, Budnella and other local advocates said.

It feels “like the where it’s like everybody’s pointing at each other,” Budnella said. “Somebody needs to be able to have the stick and slam their hand on the table and be like, ‘You’re doing this wrong and this is the consequence.’”

The experience in New York provides a microcosm of regulators evading oversight responsibility nationwide while varied interests vie for the financial windfall.

Years of data collected by Ñî¹óåú´«Ã½Ò•îl Health News, the Johns Hopkins Bloomberg School of Public Health, and the addiction nonprofit Shatterproof have found that settlement money was spent on law enforcement gear, such as night-vision goggles and bulletproof vests; unproven prevention initiatives, such as a drug-awareness magician for kids; and budget stopgaps.

It’s unclear who should — or will — take action on such expenditures that many people harmed by the crisis consider questionable.

In each state, control of the money is split among various entities, creating a leadership vacuum. The federal government . Advocates and families who’ve lost loved ones have pushed for accountability but have limited power. A few states have passed new laws, but change is slow and uneven.

The require the majority of the money to be spent on “opioid remediation,” with . But the list is broad and open to interpretation. Further complicating the issue, many states — including New York — designate some portion of the settlement dollars as unrestricted, which allows for general spending.

Meanwhile, federal budget cuts have threatened addiction-related services and created more demand for funding. And though overdose deaths have decreased since , they still claim about 186 lives per day.

“We really are wasting this opportunity to use these funds to turn the epidemic around,” said , a Binghamton, New York, resident, whose 28-year-old son, Jeff Dugon, died of a heroin overdose in 2014.

He was a chef who loved to rib Pleus about her bad knife skills. She thinks of him and smiles every time she peels garlic the way he taught her. If the money could spare other families such heartache, that would give her solace.

“We need oversight,” said Pleus, who runs a nonprofit that is receiving opioid settlement cash from her county to serve people who use drugs and provide support groups for families.

In New York, there are three prime watchdog contenders: the Office of Addiction Services and Supports, the attorney general, and the comptroller.

The Lead State Agency

New York’s opioid settlement documents designate the as the “.”

It distributes a portion of settlement dollars via grants, according to recommendations from the state’s . It also has the power to “engage in oversight and audits of projects and programs” funded by settlement cash and “may withhold future funds” from local governments that do not comply with certain requirements, according to the agreement.

Agency spokesperson Jerry Gretzinger told Ñî¹óåú´«Ã½Ò•îl Health News the office has not yet exercised its power to withhold funds but understands its oversight role.

“OASAS has a duty to ensure these funds are used responsibly and strategically to build programs that will have a lasting impact in reversing this crisis,” Gretzinger wrote in a statement.

The office is currently auditing 19 local governments’ use of the money to ensure compliance with “reporting and recordkeeping requirements,” he said. However, that may not encompass the broader question of whether money was spent on appropriate uses, which many advocates want addressed.

Some people are frustrated with the narrow role OASAS has carved out.

For example, required local governments for the first time to publicly report how they spent settlement money. OASAS on its site. But it does not review the accuracy or detail of that data, instead relying on “the information as it is provided” by localities, Gretzinger said.

“That doesn’t feel like oversight,” said , a deputy director at the Legal Action Center, which obtained public records about local spending in New York.

Members of the state’s Opioid Settlement Fund Advisory Board have also to provide more data and evaluation of how dollars are being used. But at a , OASAS Commissioner Chinazo Cunningham deflected.

“OASAS has no oversight over these portions of dollars,” she said of the 46% of settlement money that goes directly to counties and cities. “In terms of what kind of data each county collects,” she added, “we cannot dictate exactly what that information is.”

Click for Examples of spending decisions Local Spending That’s Fueling Calls for Oversight in New York

To uncover how opioid settlement cash is being spent, the nonprofit advocacy group filed public records requests with 56 New York counties and New York City, all of which are to disburse as they see fit.

Many of the responses showed spending on addiction treatment, recovery, and prevention initiatives that researchers and clinicians agree are a good use of money. Others surfaced questionable expenditures.

, for example, showed $150,000 in settlement cash directed to “Sheriff Jail” with no further description. The county did not respond to repeated inquiries for more details.

Sullivan County spent more than $30,000 on Cellebrite technology, used to extract data from cellphones, and more than $37,000 on Tasers. Though county officials didn’t respond to requests for comment, explained that those purchases came from unrestricted funds.

Such justifications rankle some families affected by the crisis, who say even if there aren’t legal restrictions on those dollars, there should be moral ones.

“Anything that is not directly tied to people who are struggling with opioid addiction or the loss of someone is a poor use of funds,” said , who lost a son to an overdose and now runs a nonprofit aimed at helping families dealing with addiction. Her organization has received settlement funds from Broome County, New York.

Records also revealed that many jurisdictions have yet to spend a significant portion of their money — a other .

Local officials say thoughtful planning takes time. But some advocates suspect ulterior motives. Millions of settlement dollars in bank accounts can generate sizable interest.

In March, it came to light that Nassau County had in interest accrued from unused opioid settlement funds to the county’s general fund, where it could be used for any purpose. County officials didn’t respond to requests for comment. The money was following public backlash.

Advocates suspect such attempts are happening elsewhere but are difficult to identify within complex budgeting documents.

It feels like “it’s up to us all — the organizers, the advocates, the service providers” — to be constantly watching, said , director of drug policy at the advocacy organization VOCAL-NY. “It’s frustrating.”

That’s why state agencies are being called on to step into an oversight role.

The Top Law Enforcement Officer

New York has been one of the leading national voices on prosecuting pharmaceutical companies that fueled the overdose crisis. Her office has issued on the topic, touting her role in securing billions of opioid settlement dollars for the state.

But when asked about the attorney general’s role in ensuring this windfall is spent appropriately, her office passed the buck to other agencies.

“While our partners in state and local governments distribute and oversee these funds, we will continue our work to hold accountable the companies responsible for fueling the spread of addictions and overdoses,” spokesperson Grant Fox wrote in a statement.

That stance contrasts starkly with many people’s views of the office’s responsibility.

A state senator, a member of the opioid settlement advisory board, and several advocates named the attorney general’s office as a key enforcement entity.

“The money is here because of their efforts,” said Democratic state , who chairs the committee on alcoholism and substance use disorders and has introduced of related to settlement funds. “I believe it is under the Office of the Attorney General to enforce.”

Budnella, the advocate with VOCAL-NY, agreed, saying, “It would be a shame for all of their work that they have done to secure all this funding for it to be misspent.”

Attorneys general in and have taken more active roles, issuing lists of ways opioid settlement money cannot be spent. The lists include many law enforcement expenditures that have raised concerns for advocates in New York.

James’ office did not respond to a specific question about whether she’d consider creating a similar list.

The Fiscal Watchdog

Some people have suggested that the state comptroller, as a steward of New York’s finances, could play an oversight role, perhaps by conducting or requiring audits.

Early this year, the Reason Foundation, a libertarian think tank, that would create audit requirements for organizations receiving settlement cash. The blueprint suggests recipients of more than $1 million in opioid settlements be required to undergo an independent review of financial statements and transaction testing to determine whether funds were used for their intended purpose. Smaller grantees, receiving less than $1 million, could simply provide an unaudited accounting of the funds.

It’s “not telling states what is and what isn’t an appropriate use,” said , a co-author of the Reason Foundation plan. “We’re simply trying to ensure recipients follow through with their promises.”

No state has adopted the model law yet. But the office of New York told Ñî¹óåú´«Ã½Ò•îl Health News it is already conducting an audit.

The process, which began in February, “is looking at OASAS’ oversight” of the opioid settlement money, said spokesperson Mary Mueller. It includes settlement money controlled by the state and local governments.

Mueller said any future enforcement action “will depend on the results of our current work and our ongoing monitoring.”

The office is following in the footsteps of comptrollers and auditors in , , and , Tennessee, who have taken action on settlement cash.

These initial steps have given some advocates and researchers hope for the future of opioid settlement dollars, which are expected to flow for more than a decade.

“We’re already years in and we’ve seen the craziest stories” of this money and a , said , a co-author of the Reason Foundation’s model law. “If we can prevent that at least a little and have these funds be a bit more focused, I don’t think it’s too late.”

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .

“I have been vaccinating people throughout my entire career in uniformed services. I believe in vaccines,” Schwartz said at the hearing. “I do believe that mRNA technology is safe and effective.”

Her position contrasts with that of Health and Human Services Secretary Robert F. Kennedy Jr., who ousted Trump’s previous CDC director, Susan Monarez, after she sparred with him over vaccines. Kennedy, a longtime anti-vaccine activist, has baselessly called mRNA vaccines the deadliest ever made.

Schwartz “has dedicated her career to protecting the health of the American people.” Emily Hilliard, an HHS spokesperson, said in an emailed statement. “The president nominated her because of that exemplary record, and Secretary Kennedy looks forward to working with her to advance the Administration’s public health priorities.”

The CDC has had a Senate-confirmed leader for only about one month during Trump’s second term, and the agency has been roiled over the administration’s cuts to public health funding, firings of scientists and other career employees, and efforts to scale back childhood vaccines and access to covid shots.

Schwartz, who was deputy surgeon general in Trump’s first administration and is a former chief medical officer for the Coast Guard, has support in the public health community, where it’s hoped she can restore credibility at the agency she would lead.

“I will follow the science wherever it leads,” Schwartz told senators. “My first priority will be restoring trust in public health institutions.”

Democrats and some Republicans have expressed doubt that Schwartz will maintain any more independence from Kennedy than Monarez, who has said she was fired in August after refusing to sign off on changes Kennedy demanded to vaccine recommendations and personnel cuts. In a released by Sen. Bernie Sanders (I-Vt.), it was revealed Kennedy had pressured Monarez to change CDC guidance regarding the universal childhood flu vaccine.

Monarez “refused to act as a rubber stamp for Secretary Kennedy’s very dangerous agenda,” Sanders said July 15 at the Health, Education, Labor and Pensions Committee’s confirmation hearing for Schwartz. “Frankly, she stood up for protecting the well-being of the American people.”

The chairman of the HELP Committee, Sen. Bill Cassidy (R-La.), pressed Schwartz on whether she would push back against rhetoric or policies not based in science.

“We need unbiased leaders who make decisions based upon science, not politics or ideology,” Cassidy said. “This is not a theoretical.”

Cassidy, a physician, has also quarreled with Kennedy over vaccines. He lost a Republican primary for reelection in May after Trump endorsed one of his opponents. Despite his rupture with the White House, Schwartz almost certainly needs Cassidy’s support to win confirmation. That requires publicly committing to support vaccination and mainstream science.

Schwartz told the committee she would “never compromise” on science.

“The president would never ask me to not follow the law,” she said. “But I will always follow the law.”

Many Democrats on the committee raised concerns about the administration’s politicization of public health. Sen. Tammy Baldwin (D-Wis.) asked about the “political scrubbing” of research grants. Trump officials have canceled many research grants under the CDC and the National Institutes of Health for political reasons, including targeting diversity, equity, and inclusion efforts.

“Restoring trust to the CDC is my No. 1 priority,” Schwartz said. “Scientific integrity is core.”

The American Public Health Association’s CEO, Georges Benjamin, , saying she “possesses the medical background and public health knowledge to understand that the Centers for Disease Control and Prevention must be guided by evidence-based science.”

The APHA has fought many of Trump’s initiatives on public health. After Monarez’s resignation, the organization titled “Kennedy’s attack on public health must be stopped.”

Schwartz told the committee that if she is confirmed, she is committed to “radical transparency” and modernization.

Schwartz expressed support for one Kennedy initiative: She told senators she believes nutrition education and physical fitness assessments are important.

“I am all in on the Make America Healthy Again agenda,” she said.

At the July 15 hearing, Schwartz faced questioning alongside Trump’s pick for HHS assistant secretary for preparedness and response, Sean Kaufman.

Cassidy called out Kaufman for past comments casting doubt on the efficacy of vaccines. The senator raised his voice as he accused Kaufman of spreading “those damn lies.”

Kaufman was conciliatory. “Let me be clear: Vaccines save lives,” he said. “They are safe and effective.”

If confirmed by the Senate, Schwartz will replace Jay Bhattacharya, who is performing the duties of CDC director but is not officially the acting director. Bhattacharya is also the director of the NIH.

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .

Ñî¹óåú´«Ã½Ò•îl Health News senior correspondent Julie Appleby discussed the high cost of healthcare and the political fallout on WAMU’s 1A on June 30.

• .

Ñî¹óåú´«Ã½Ò•îl Health News senior correspondent Renuka Rayasam discussed the public health concerns around a planned immigration detention center in Georgia on WUGA’s The Georgia Health Report on June 26.

• .
• Read Rayasam’s “A Trump Stronghold Grapples With Health Risks of ICE Detention Sites.”

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .

Researchers this spring discovered in water in several coastal locations across New York’s Long Island, and town officials in the Hamptons vacation destination about the findings. in Florida have been infected this year, and in June urged people to take precautions.

About 1 in 5 people infected by the bacteria die, sometimes within a day or two of becoming ill, according to a Centers for Disease Control and Prevention . The bacteria, Vibrio vulnificus, can enter open wounds and cause tissue death and systemic sepsis.

“Many people with Vibrio vulnificus infection can get seriously ill and need intensive care or limb amputation,” the CDC says.

The risk of such public threats is mounting because climate change is expanding the territory of certain pathogens, but researchers say there’s another concern. The Trump administration has cut investments in programs and agencies that prevent, track, and respond to health hazards the federal government is now confronting.

Consider the , which can infest and kill livestock, in the U.S. in June. The U.S. Department of Agriculture lost in the first six months of 2025, according to a report from the USDA’s Office of Inspector General, and the agency’s winnowed-down inspection service is helping lead the response to the parasite.

Or malaria. A freeze on foreign aid disrupted international malaria prevention efforts, and warned that the U.S. is vulnerable to the reintroduction of the infectious disease.

And when it comes to Vibrio, the Trump administration began removing hundreds of deep-sea instruments that and yield data that helps that can allow the bacteria to flourish. the data to study Vibrio, which can when water temperatures and .

“It is important to track coastal temperatures, and that will relate to the distributions of Vibrio,” said Christopher Gobler, a professor in the School of Marine and Atmospheric Sciences at New York’s Stony Brook University, though he added that there are also other sources of data for researchers.

The Trump administration to dismantle the ocean monitoring system following bipartisan opposition to the effort in Congress.

But it’s still curtailing Vibrio surveillance. The life-threatening species that’s found in water can also sicken or kill people who eat contaminated seafood, such as infected with the bacteria. And infections from Vibrio vulnificus linked to consuming raw or undercooked shellfish as the presence of other pathogens in food decrease.

Since 1995, 10 states have participated in a federal program called the Foodborne Disease Active Disease Surveillance Network, or FoodNet. The program, with the CDC, monitors and track cases of foodborne illness caused by eight specific pathogens, including Vibrio. But last year the Trump administration to report on all but two pathogens, which means states no longer must report cases to the CDC.

Federal officials deny the moves are putting Americans at risk, saying the CDC continues to monitor these pathogens through other national surveillance systems to ensure ongoing visibility into disease trends and outbreaks.

Meanwhile, some former health leaders say the ramifications of sweeping cuts to health agencies and global prevention programs are becoming more apparent, undermining U.S. response efforts and initiatives that aim to safeguard the country from diseases.

“We are letting down defenses that were necessary to protect against microbial threats,” said Tom Frieden, a former CDC director who is now president and chief executive of Resolve to Save Lives, which works to stop preventable disease. “Instead of protecting, we’re doing the opposite.”

Do Limited Resources Mean Higher Risks?

The administration defends its actions, including massive layoffs at government health agencies, as necessary to eliminate wasteful spending.

The Department of Health and Human Services “is advancing the most significant public health reforms in a generation focused on prevention, accountability, scientific transparency, and better health outcomes,” agency spokesperson Emily Hilliard said in an email. “The Department is putting American families at the center of public health decision-making.”

Evidence suggests health risks are rising even as the Trump administration pulls back on resources for research, detection, and response.

Early in his administration, President Donald Trump opted to freeze and review work on global health programs. Trump’s cost-reduction effort, led by billionaire Elon Musk, also dismantled the U.S. Agency for International Development.

As a result, work was disrupted on the President’s Malaria Initiative, a George W. Bush-era program aimed at combating malaria in hard-hit countries that is credited with saving more than . USAID had in the program since 2005.

In addition, for global malaria programs were targeted for termination, , an independent research group that includes Ñî¹óåú´«Ã½Ò•îl Health News. The report didn’t include data on the total value of those specific malaria grants.

And the spending freeze halted research for more effective . The administration dissolved the CDC’s , shuffling staffers to other divisions and on the disease. HHS didn’t respond to an email asking how many staff members had been moved.

The life-threatening infectious disease spread by mosquitos was in 1951. But the CDC’s updated guidance on investigating domestic cases that “the country remains susceptible to malaria reintroduction.”

resulted in 10 people in Arkansas, Florida, Maryland, and Texas becoming infected locally, and mosquitoes capable of transmitting malaria are found throughout most of the country.

“The majority of U.S. residents lack protective immunity against malaria, rendering persons susceptible to severe illness and death if infected,” the CDC said in the May report.

HHS declined to comment on any of the specific cuts but said the CDC works with domestic and international partners to reduce the burden of malaria and prevent its reestablishment in the U.S.

It’s not just cuts to funding that are raising health risks, say researchers and former health officials. Significant staffing cuts mean there are fewer people working on preventing or tracking diseases, they say.

“Yes, the programs have been cut in terms of reduction in staff, but I would say, equally important, you have reductions in expertise,” said Jeanne Marrazzo, CEO of the Infectious Diseases Society of America. “It’s irreplaceable.”

Screwworm is a species of parasitic blowfly producing larvae that can enter open wounds and devour tissue, infecting people and animals. Like malaria, it has long been eliminated in the U.S., and disease monitoring efforts have been key to keeping it out.

The cuts at USAID stripped from the United Nations’ , which focuses on global food security and the such as screwworm.

In the wake of the administration’s cost-cutting initiatives, more than 20,000 employees are gone from the USDA, which develops and implements agriculture policy and provides resources to producers of livestock vulnerable to the parasite.

On June 3, the first new case of screwworm in the U.S. was confirmed, and there have now been infected with parasite. An expanding outbreak could devastate the cattle industry.

Agriculture Secretary Brooke Rollins during the Trump administration have led to screwworm’s return. Instead, she has , saying it didn’t do enough to prevent reintroduction into the U.S. Rollins said on X that “” under the previous Biden administration was partly to blame, providing no evidence.

The USDA did not respond to an email seeking comment.

Ashish Jha, a doctor who served as the White House covid response coordinator during the Biden administration, said there’s no truth to the claim that immigrants lacking legal status have brought screwworm into the U.S.

Investments in tracking and combating diseases have suffered, he said, because HHS Secretary Robert F. Kennedy Jr. is prioritizing the prevention of chronic disease at the expense of efforts to curtail infectious disease.

“Who doesn’t want a healthier country? It sounds great, but it’s kind of a bait and switch,” Jha said. “They’re doing the opposite. They’re letting down our defenses that are necessary to protect us against microbial threats.”

HHS’ Hilliard disagreed, saying Kennedy’s actions are making the agency more effective.

“Secretary Kennedy is delivering that reform by streamlining operations, reducing redundancies, and returning HHS to pre-pandemic staffing levels,” she said. “At the same time, he is dismantling policies and incentives that contributed to a nationwide chronic disease epidemic.”

Surveillance Gaps

Jha pointed to Trump’s decision to withdraw the U.S. from the World Health Organization, which coordinates global responses to public health issues and crises, and to the dismantling of USAID.

The pullback has had implications for the Ebola outbreak in the Democratic Republic of Congo, aid workers say.

Without the same amount of funding from USAID, the International Rescue Committee, which partners to deliver front-line health, surveillance, and outbreak preparedness activities in Congo, .

“Funding cuts have left the region dangerously exposed,” Heather Reoch Kerr, IRC’s country director for Congo, said .

The outbreak is roughly 7,000 miles away, but its spread has the , with stepped-up surveillance and entry restrictions on airline travelers. Federal officials have said that the dismantling of USAID hasn’t hampered detection or response.

“The U.S. government continues to move aggressively to contain the Ebola outbreak at its source in order to protect the American people and prevent further international spread,” the State Department said .

Trump’s decision to disengage with the WHO was criticized by following a hantavirus outbreak this spring on a cruise ship that had set sail from Argentina. the , and they questioned why the president suggested creating a costly new rather than sticking with the WHO — especially, they say, when the U.S. is cutting back on the surveillance programs it already has.

The federal government has tracked Vibrio cases as part of the FoodNet program, which aims in part to identify and curtail outbreaks. Reporting on cases of Vibrio is now optional.

Close to half of the cases of foodborne illness caused by Vibrio vulnificus have , and some within 24 hours after consumption of tainted shellfish such as raw oysters. The bacteria can multiply rapidly, leading to septic shock and blistering skin lesions. The pathogen is becoming to antibiotics.

The CDC estimates that of Vibrio infection occur annually, with infections from the most severe species, Vibrio vulnificus, steadily rising. , that species has led to 429 cases due to infections of open wounds and 135 cases from contaminated food.

“The more surveillance you get, you can connect the dots,” said Bill Marler, a Seattle-area food safety lawyer. “If a tree falls in the woods and you don’t hear it, did the tree fall? It’s easier not to report diseases. Then they can say, ‘Look at how safe our food supply is.’”

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .