This Week in Congress

House and Senate

Lawmakers have left town for the August recess. The Senate will return on  September 5, and the House will be back in session on September 12.

Supplemental for Disaster Assistance

The Biden administration plans to submit an emergency spending request for disaster relief “sometime this month” for congressional action in September.  Federal Emergency Management Agency (FEMA) Administrator Criswell told a House panel that she expected the Disaster Relief Fund to run dry by late August.

Federal News

New Director of the National Institute of Allergy and Infectious Diseases (NIAID)

Dr. Lawrence A. Tabak, D.D.S., Ph.D., Acting Director for the National Institutes of Health, has named Jeanne M. Marrazzo, M.D., as Director of the NIAID.  Dr. Marrazzo is currently the Director of the Division of Infectious Diseases at the University of Alabama at Birmingham. She is expected to begin her role as NIAID Director in the fall. Dr. Marrazzo’s research in discovery and implementation science has focused on the human microbiome, specifically as it relates to female reproductive tract infections and hormonal contraception; prevention of HIV infection using biomedical interventions, including PrEP and microbicides; and the pathogenesis and management of bacterial vaginosis, sexually transmitted diseases in HIV-infected persons and management of antibiotic resistance in gonorrhea. Dr. Marrazzo was the recipient of the American Sexually Transmitted Diseases Association’s Distinguished Career Award, the highest recognition of contributions to research in the field. The announcement can be found here

David Harvey, Director of NCSD stated for STIs, “we need better therapeutics, vaccines, and point-of-care diagnostics.” “These are all things that Dr. Marrazzo happens to be an absolute expert at, and we’re very excited and hopeful that more resources will be put into these priorities.” I expect Dr. Marrazzo will face some tough questions from Congress, “she is a force to reckon with in her own right and one of the best communicators I’ve ever seen.” “In this area, she is like Fauci, she can take complex clinical issues and translate them for a lay audience, as we saw her do that day after day in Covid.” I would love to see Marrazzo’s leadership “help speed the development of STI tests that give immediate results.” “That kind of progress would reduce the number of infected people who go untreated because they don’t come back to a clinic when their test turns positive after a couple of days.” I am also excited about the possibility “her appointment could lead to alternative treatments for syphilis — we’re still currently relying on penicillin, the standard of care since the 1940s that’s currently in short supply in the US.” The article can be found here

New CDC Director’s Focus on Building Trust with the Public

The pandemic was a chance for the CDC to do what it does best. Instead, that public health crisis left the CDC marred by political interference and criticism of confusing messaging — and the agency lost trust among Americans. Trust is clearly one issue on the mind of the agency’s new director, Dr. Mandy Cohen.  Cohen stated that “Beyond COVID, the CDC has so many issues it could focus on: obesity, opioids, rising numbers of STDs, shortage of public health workers, fighting conspiracy theories.”  The article can be found here

Fitch Downgrade Fuels Funding Fight

Fitch Ratings has downgraded the United States of America’s Long-Term Foreign-Currency Issuer Default Rating to ‘AA+’ from ‘AAA’. In Fitch’s view the repeated debt-limit political standoffs and last-minute resolutions have eroded confidence in fiscal management. Democrats and Republicans traded blame for the downgrade, with hard-right conservatives promising to dig in during the fight over spending limits on the FY’24 appropriations bills that could result in a shut down the federal government when the current fiscal year ends of September 30.

New Bureau of Global Health Security and Diplomacy

This week the State Department launched a new bureau focused on the battle against global outbreaks, a lasting priority of U.S. foreign policy, even as one of its key elements – a widely acclaimed HIV program – has become caught up in the political battle over abortion. The bureau is to include the 20-year-old initiative known as the President’s Emergency Program for AIDS Relief, or PEPFAR. Secretary of State Blinken, in a ceremony for the new Bureau of Global Health Security and Diplomacy, made only a passing reference to the abortion fight threatening PEPFAR’s normally assured support from lawmakers, saying he hoped Congress approved the program for another five years, without amendments. The announcement can be found here

Other Legislation and Happenings Around the Nation

Abortion

Alabama

Healthcare providers and an abortion rights group sued Alabama in an effort to block the state from criminally prosecuting people who help others travel out of state to get abortions. In a lawsuit filed in Montgomery, Alabama federal court, the West Alabama Women’s Center, the Alabama Women’s Center, and its medical director said any such prosecutions would violate a basic right to travel between states under the U.S. Constitution.

Florida

The campaign to secure abortion rights in Florida and create a haven for access in the South is facing a tough road to success. A proposed ballot measure, backed by a coalition of reproductive rights groups under the banner Floridians Protecting Freedom, would guarantee the right to an abortion until fetal viability. Backers are racing against time to get a million Florida voters to sign a petition to say they want it on the ballot. Then they must rally 60 percent of the vote in the November 2024 elections — the threshold to change the state constitution.

Guam

People seeking medication abortions on the U.S. Territory of Guam must first have an in-person consultation with a doctor, a federal appeals court ruled, even though the nearest physician willing to prescribe the medication is 3,800 miles, an 8-hour flight. The ruling handed down by a unanimous three-judge panel on the 9th U.S. Circuit Court of Appeals could make it even more difficult for pregnant people to access abortions on the remote island where 85% of residents are Catholic and about 1 in 5 live below the poverty line. The last doctor to provide abortions in Guam retired in 2018, leaving people seeking the procedure without local options.

Idaho

A U.S. judge has temporarily blocked the state of Idaho from prosecuting doctors who refer patients out of state to get an abortion, finding that it would violate a medical provider’s right to free speech. A District Court agreed with a challenge led by Planned Parenthood that the State’s Republican Attorney General’s interpretation of the state’s criminal abortion law was “chilling” to providers’ First Amendment rights.

Indiana

The American Civil Liberties Union of Indiana asked the state’s high court to keep Indiana’s near-total abortion ban on hold while it pursues a narrower preliminary injunction in a trial court to address the scope of the ban’s exemption allowing women facing serious health risks to obtain abortions. The petition seeking a rehearing will delay the ban from taking effect, as soon as this week, while the Indiana Supreme Court considers the matter. The ACLU of Indiana’s request comes after the high court ruled on June 30 that Indiana’s Republican-backed ban doesn’t violate the state constitution.

Ohio

After an abortion rights amendment qualified to appear on the November ballot in Ohio, a new lawsuit from Republicans asks the Ohio Supreme Court to block the measure. The challenge argues that the abortion rights petition did not identify which state laws would have to be repealed if the constitutional amendment were to be adopted. Ohio is likely the only state this year to have a measure on the ballot to enshrine abortion access into the state constitution, setting up a test case for how the issue may drive voters ahead of the 2024 presidential election. A poll released found 58% of Ohioans support a constitutional amendment.

Texas

Texas is one of 14 states that banned abortion after the U.S. Supreme Court struck down Roe v. Wade. The Texas ban includes an exception that allows physicians to end a pregnancy if it could result in the death of the woman or a “substantial impairment of a major bodily function.” But the plaintiffs in the case, more than a dozen Texas women, argue that doctors and hospitals denied them necessary care because the providers were afraid to run afoul of the law. Those who violate the ban could face up to 99 years in prison, a $100,000 fine and loss of their medical license.

LBGTQ

American Academy of Pediatrics

This week the American Academy of Pediatrics backed gender-related treatments for children, reaffirming its position from 2018 on a medical approach that has since been banned in 19 states. But the influential group of doctors also took an extra step of commissioning a systematic review of medical research on the treatments, following similar efforts in Europe that found uncertain evidence for their effectiveness in adolescents.

Florida

This week Florida superintendents were advised by the state to nix their Advanced Placement Psychology classes unless they exclude any topics related to gender or sexuality, according to The College Board, which oversees the AP program. “We are sad to have learned that today the Florida Department of Education has effectively banned AP Psychology in the state by instructing Florida superintendents that teaching foundational content on sexual orientation and gender identity is illegal under state law,” the College Board said. “The state has said districts are free to teach AP Psychology only if it excludes any mention of these essential topics.”

Gender Affirming Care

The Human Rights Campaign, Planned Parenthood, and others are urging the Department of Health and Human Services to expand a proposal protecting reproductive health information from law enforcement to also shield information related to gender-affirming care. If finalized, the proposed rule would modify privacy standards for identifiable health information under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and stop Health insurance plans, medical providers, and others from sharing protected health information connected to reproductive services obtained in states where they are legal. The suggestions to expand the reach of the proposal come as tensions over reproductive services and LGBTQ rights continue across the US. The rule can be found here

Kentucky

A federal appeals court is allowing Kentucky to enforce a recently enacted ban on gender-affirming care for young transgender people while the issue is being litigated. The 2-1 decision from the Sixth U.S. Circuit Court of Appeals in Cincinnati is not unexpected. The same three-judge panel ruled the same way earlier this month on a similar case in Tennessee.

Mpox

China

The World Health Organization reports China is currently experiencing the world’s fastest increase in cases of mpox, and the country needs to act fast to contain the spread. While the Americas and Europe have mostly contained the mpox outbreak that started in mid-2022, Asia has emerged as the disease’s new hot spot. Japan, South Korea, and Thailand, which all saw sporadic imported cases last year, have reported weekly new case numbers in the double digits in 2023, meaning the virus has been spreading in the domestic population. But according to the latest data reported to the WHO, China has surpassed all other countries in the world, with 315 confirmed cases in just the past three months—though irregular case reporting from Beijing means it’s impossible to know the true scale of the disease at this point.

Proctitis

According to a new study in Clinical Microbiology and Infection, proctitis was the was the strongest predictor of clinically confirmed mpox in thousands of patients with suspected illness who presented for testing.

Vaccine

Bavarian Nordic has received a US government contract for $120 million to manufacture more of its Jynneos smallpox/mpox vaccine. The order comes from the US Biomedical Advanced Research and Development Authority (BARDA), part of the Administration for Strategic Preparedness and Response at the Department of Health and Human Services.

COVID-19 Vaccines

The FDA will likely issue approval for Pfizer’s updated COVID-19 booster vaccines by the end of this month. A subvariant of the coronavirus is now the predominant strain in the US, displacing the most common subvariant, but the new vaccine is expected to be effective against both.