Louisiana Legislature examines proposal to offer TOPS to some medical students
Kaniya Pierre Louis, left, is a third-year medical student shadowing family medicine physician Dr. Zita Magloire. (Sarah Jane Tribble/KFF Health News)
Louisiana students who qualify for TOPS tuition awards but attend college out of state could still get that money if they decide to return home for medical or dental school. The legislature is considering a measure to lure them back home, but with conditions.
House Bill 275 by Rep. Stephanie Berault, R-Slidell, would require those students to pay back the aid unless they work full time in their field in Louisiana for at least three consecutive years after graduation.
The proposal is aimed at addressing a physician shortage in Louisiana, where the Cicero Institute reports 60 out of 64 parishes have a shortage of health care professionals.
The bill has the support of Gov. Jeff Landry and was unanimously approved Wednesday by the House Education Committee.
TOPS, short for the Taylor Opportunity Program for Students, is a merit-based scholarship program that helps Louisiana students attend in-state colleges and universities.
About 34 new medical and dental school students each year will qualify for TOPS under the legislation, according to a cost estimate for the bill. The cost will gradually increase over four years, when it is forecasted to level out at about $1.3 million annually.
Berault has also proposed House Bill 539, which would create a student loan repayment program for doctors who practice in Louisiana's rural areas. It has not yet been scheduled for a hearing.
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In axing mRNA contract, Trump delivers another blow to US biosecurity, former officials say
This is a KFF Health News story. The Trump administration's cancellation of $766 million in contracts to develop mRNA vaccines against potential pandemic flu viruses is the latest blow to national defense, former health security officials said. They warned that the U.S. could be at the mercy of other countries in the next pandemic. "The administration's actions are gutting our deterrence from biological threats," said Beth Cameron, a senior adviser to the Brown University Pandemic Center and a former director at the White House National Security Council. "Canceling this investment is a signal that we are changing our posture on pandemic preparedness," she added, "and that is not good for the American people." Flu pandemics killed up to 103 million people worldwide last century, researchers estimate. MORE: Bird flu is continuing to spread in animals across the US. Here's what you need to know In anticipation of the next big one, the U.S. government began bolstering the nation's pandemic flu defenses during the George W. Bush administration. These strategies were designed by the security council and the Biomedical Advanced Research and Development Authority at the Department of Health and Human Services, among other agencies. The plans rely on rolling out vaccines rapidly in a pandemic. Moving fast hinges on producing vaccines domestically, ensuring their safety and getting them into arms across the nation through the public health system. The Trump administration is undermining each of these steps as it guts health agencies, cuts research and health budgets and issues perplexing policy changes, health security experts said. Since President Donald Trump took office, at least half of the security council's staff have been laid off or left, and the future of BARDA is murky. The nation's top vaccine adviser, Peter Marks, resigned under pressure in March, citing "the unprecedented assault on scientific truth." Most recently, Trump's clawback of funds for mRNA vaccine development put Americans on shakier ground in the next pandemic. "When the need hits and we aren't ready, no other country will come to our rescue and we will suffer greatly," said Rick Bright, an immunologist and a former BARDA director. Countries that produced their own vaccines in the COVID-19 pandemic had first dibs on the shots. While the United States, home to Moderna and Pfizer, rolled out second doses of mRNA vaccines in 2021, hundreds of thousands of people in countries that didn't manufacture vaccines died waiting for them. The most pertinent pandemic threat today is the bird flu virus H5N1. Researchers around the world were alarmed when it began spreading among cattle in the U.S. last year. Cows are closer to humans biologically than birds, indicating that the virus had evolved to thrive in cells like our own. As hundreds of herds and dozens of people were infected in the U.S., the Biden administration funded Moderna to develop bird flu vaccines using mRNA technology. As part of the agreement, the U.S. government stipulated it could purchase doses in advance of a pandemic. That no longer stands. Researchers can make bird flu vaccines in other ways, but mRNA vaccines are developed much more quickly because they don't rely on finicky biological processes, such as growing elements of vaccines in chicken eggs or cells kept alive in laboratory tanks. Time matters because flu viruses mutate constantly, and vaccines work better when they match whatever variant is circulating. MORE: 2nd bird flu virus detected in western US. What does this mean for prevention? Developing vaccines within eggs or cells can take 10 months after the genetic sequence of a variant is known, Bright said. And relying on eggs presents an additional risk when it comes to bird flu because a pandemic could wipe out billions of chickens, crashing egg supplies. Decades-old methods that rely on inactivated flu viruses are riskier for researchers and time-consuming. Still the Trump administration invested $500 million into this approach, which was largely abandoned by the 1980s after it caused seizures in children. "This politicized regression is baffling," Bright said. A bird flu pandemic may begin quietly in the U.S. if the virus evolves to spread between people but no one is tested at first. Indeed, the Centers for Disease Control and Prevention's dashboard suggests that only 10 farmworkers have been tested for the bird flu since March. Because of their close contact with cattle and poultry, farmworkers are at highest risk of infection. As with many diseases, only a fraction of people with the bird flu become severely sick. So the first sign that the virus is widespread might be a surge in hospital cases. "We'd need to immediately make vaccines," said Angela Rasmussen, a virologist at the University of Saskatchewan in Canada. The U.S. government could scale up production of existing bird flu vaccines developed in eggs or cells. However, these vaccines target an older strain of H5N1 and their efficacy against the virus circulating now is unknown. In addition to the months it takes to develop an updated version within eggs or cells, Rasmussen questioned the ability of the government to rapidly test and license updated shots, with a quarter of HHS staff gone. If the Senate approves Trump's proposed budget, the agency faces about $32 billion in cuts. Further, the Trump administration's cuts to biomedical research and its push to slash grant money for overhead costs could undermine academic hospitals, rendering them unable to conduct large clinical trials. And its cuts to the CDC and to public health funds to states mean that fewer health officials will be available in an emergency. "You can't just turn this all back on," Rasmussen said. "The longer it takes to respond, the more people die." Researchers suggest other countries would produce bird flu vaccines first. "The U.S. may be on the receiving end like India was, where everyone -- rich people, too -- got vaccines late," said Achal Prabhala, a public health researcher in India at medicines access group AccessIBSA. He sits on the board of a World Health Organization initiative to improve access to mRNA vaccines in the next pandemic. A member of the initiative, the company Sinergium Biotech in Argentina, is testing an mRNA vaccine against the bird flu. If it works, Sinergium will share the intellectual property behind the vaccine with about a dozen other groups in the program from middle-income countries so they can produce it. MORE: 12 months and 70 cases since the first human bird flu infection: Are we any safer? The Coalition for Epidemic Preparedness Innovations, an international partnership headquartered in Norway, is providing funds to research groups developing rapid-response vaccine technology, including mRNA, in South Korea, Singapore and France. And CEPI committed up to $20 million to efforts to prepare for a bird flu pandemic. This year, the Indian government issued a call for grant applications to develop mRNA vaccines for the bird flu, warning it "poses a grave public health risk." Pharmaceutical companies are investing in mRNA vaccines for the bird flu as well. However, Prabhala says private capital isn't sufficient to bring early-stage vaccines through clinical trials and large-scale manufacturing. That's because there's no market for bird flu vaccines until a pandemic hits. Limited supplies means the United States would have to wait in line for mRNA vaccines made abroad. States and cities may compete against one another for deals with outside governments and companies, like they did for medical equipment at the peak of the covid pandemic. "I fear we will once again see the kind of hunger games we saw in 2020," Cameron said. In an email response to queries, HHS communications director Andrew Nixon said, "We concluded that continued investment in Moderna's H5N1 mRNA vaccine was not scientifically or ethically justifiable." He added, "The decision reflects broader concerns about the use of mRNA platforms -- particularly in light of mounting evidence of adverse events associated with COVID-19 mRNA vaccines." Nixon did not back up the claim by citing analyses published in scientific journals. In dozens of published studies, researchers have found that mRNA vaccines against COVID are safe. For example, a placebo-controlled trial of more than 30,000 people in the U.S. found that adverse effects of Moderna's vaccine were rare and transient, whereas 30 participants in the placebo group suffered severe cases of COVID and one died. More recently, a study revealed that three of nearly 20,000 people who got Moderna's vaccines and booster had significant adverse effects related to the vaccine, which resolved within a few months. COVID, on the other hand, killed four people during the course of the study. As for concerns about the heart issue, myocarditis, a study of 2.5 million people who got at least one dose of Pfizer's mRNA vaccine revealed about two cases per 100,000 people. COVID causes 10 to 105 myocarditis cases per 100,000. Nonetheless, HHS Secretary Robert F. Kennedy Jr., who founded an anti-vaccine organization, has falsely called COVID shots "the deadliest vaccine ever made." And without providing evidence, he said the 1918 flu pandemic "came from vaccine research." Politicized mistrust in vaccines has grown. Far more Republicans said they trust Kennedy to provide reliable information on vaccines than their local health department or the CDC in a recent KFF poll: 73% versus about half. Should the bird flu become a pandemic in the next few years, Rasmussen said, "we will be screwed on multiple levels." In axing mRNA contract, Trump delivers another blow to US biosecurity, former officials say originally appeared on
2 days ago
In axing mRNA contract, Trump delivers another blow to US biosecurity, former officials say
This is a KFF Health News story. The Trump administration's cancellation of $766 million in contracts to develop mRNA vaccines against potential pandemic flu viruses is the latest blow to national defense, former health security officials said. They warned that the U.S. could be at the mercy of other countries in the next pandemic. "The administration's actions are gutting our deterrence from biological threats," said Beth Cameron, a senior adviser to the Brown University Pandemic Center and a former director at the White House National Security Council. "Canceling this investment is a signal that we are changing our posture on pandemic preparedness," she added, "and that is not good for the American people." Flu pandemics killed up to 103 million people worldwide last century, researchers estimate. In anticipation of the next big one, the U.S. government began bolstering the nation's pandemic flu defenses during the George W. Bush administration. These strategies were designed by the security council and the Biomedical Advanced Research and Development Authority at the Department of Health and Human Services, among other agencies. The plans rely on rolling out vaccines rapidly in a pandemic. Moving fast hinges on producing vaccines domestically, ensuring their safety and getting them into arms across the nation through the public health system. The Trump administration is undermining each of these steps as it guts health agencies, cuts research and health budgets and issues perplexing policy changes, health security experts said. Since President Donald Trump took office, at least half of the security council's staff have been laid off or left, and the future of BARDA is murky. The nation's top vaccine adviser, Peter Marks, resigned under pressure in March, citing "the unprecedented assault on scientific truth." Most recently, Trump's clawback of funds for mRNA vaccine development put Americans on shakier ground in the next pandemic. "When the need hits and we aren't ready, no other country will come to our rescue and we will suffer greatly," said Rick Bright, an immunologist and a former BARDA director. Countries that produced their own vaccines in the COVID-19 pandemic had first dibs on the shots. While the United States, home to Moderna and Pfizer, rolled out second doses of mRNA vaccines in 2021, hundreds of thousands of people in countries that didn't manufacture vaccines died waiting for them. The most pertinent pandemic threat today is the bird flu virus H5N1. Researchers around the world were alarmed when it began spreading among cattle in the U.S. last year. Cows are closer to humans biologically than birds, indicating that the virus had evolved to thrive in cells like our own. As hundreds of herds and dozens of people were infected in the U.S., the Biden administration funded Moderna to develop bird flu vaccines using mRNA technology. As part of the agreement, the U.S. government stipulated it could purchase doses in advance of a pandemic. That no longer stands. Researchers can make bird flu vaccines in other ways, but mRNA vaccines are developed much more quickly because they don't rely on finicky biological processes, such as growing elements of vaccines in chicken eggs or cells kept alive in laboratory tanks. Time matters because flu viruses mutate constantly, and vaccines work better when they match whatever variant is circulating. Developing vaccines within eggs or cells can take 10 months after the genetic sequence of a variant is known, Bright said. And relying on eggs presents an additional risk when it comes to bird flu because a pandemic could wipe out billions of chickens, crashing egg supplies. Decades-old methods that rely on inactivated flu viruses are riskier for researchers and time-consuming. Still the Trump administration invested $500 million into this approach, which was largely abandoned by the 1980s after it caused seizures in children. "This politicized regression is baffling," Bright said. A bird flu pandemic may begin quietly in the U.S. if the virus evolves to spread between people but no one is tested at first. Indeed, the Centers for Disease Control and Prevention's dashboard suggests that only 10 farmworkers have been tested for the bird flu since March. Because of their close contact with cattle and poultry, farmworkers are at highest risk of infection. As with many diseases, only a fraction of people with the bird flu become severely sick. So the first sign that the virus is widespread might be a surge in hospital cases. "We'd need to immediately make vaccines," said Angela Rasmussen, a virologist at the University of Saskatchewan in Canada. The U.S. government could scale up production of existing bird flu vaccines developed in eggs or cells. However, these vaccines target an older strain of H5N1 and their efficacy against the virus circulating now is unknown. In addition to the months it takes to develop an updated version within eggs or cells, Rasmussen questioned the ability of the government to rapidly test and license updated shots, with a quarter of HHS staff gone. If the Senate approves Trump's proposed budget, the agency faces about $32 billion in cuts. Further, the Trump administration's cuts to biomedical research and its push to slash grant money for overhead costs could undermine academic hospitals, rendering them unable to conduct large clinical trials. And its cuts to the CDC and to public health funds to states mean that fewer health officials will be available in an emergency. "You can't just turn this all back on," Rasmussen said. "The longer it takes to respond, the more people die." Researchers suggest other countries would produce bird flu vaccines first. "The U.S. may be on the receiving end like India was, where everyone -- rich people, too -- got vaccines late," said Achal Prabhala, a public health researcher in India at medicines access group AccessIBSA. He sits on the board of a World Health Organization initiative to improve access to mRNA vaccines in the next pandemic. A member of the initiative, the company Sinergium Biotech in Argentina, is testing an mRNA vaccine against the bird flu. If it works, Sinergium will share the intellectual property behind the vaccine with about a dozen other groups in the program from middle-income countries so they can produce it. The Coalition for Epidemic Preparedness Innovations, an international partnership headquartered in Norway, is providing funds to research groups developing rapid-response vaccine technology, including mRNA, in South Korea, Singapore and France. And CEPI committed up to $20 million to efforts to prepare for a bird flu pandemic. This year, the Indian government issued a call for grant applications to develop mRNA vaccines for the bird flu, warning it "poses a grave public health risk." Pharmaceutical companies are investing in mRNA vaccines for the bird flu as well. However, Prabhala says private capital isn't sufficient to bring early-stage vaccines through clinical trials and large-scale manufacturing. That's because there's no market for bird flu vaccines until a pandemic hits. Limited supplies means the United States would have to wait in line for mRNA vaccines made abroad. States and cities may compete against one another for deals with outside governments and companies, like they did for medical equipment at the peak of the covid pandemic. "I fear we will once again see the kind of hunger games we saw in 2020," Cameron said. In an email response to queries, HHS communications director Andrew Nixon said, "We concluded that continued investment in Moderna's H5N1 mRNA vaccine was not scientifically or ethically justifiable." He added, "The decision reflects broader concerns about the use of mRNA platforms -- particularly in light of mounting evidence of adverse events associated with COVID-19 mRNA vaccines." Nixon did not back up the claim by citing analyses published in scientific journals. In dozens of published studies, researchers have found that mRNA vaccines against COVID are safe. For example, a placebo-controlled trial of more than 30,000 people in the U.S. found that adverse effects of Moderna's vaccine were rare and transient, whereas 30 participants in the placebo group suffered severe cases of COVID and one died. More recently, a study revealed that three of nearly 20,000 people who got Moderna's vaccines and booster had significant adverse effects related to the vaccine, which resolved within a few months. COVID, on the other hand, killed four people during the course of the study. As for concerns about the heart issue, myocarditis, a study of 2.5 million people who got at least one dose of Pfizer's mRNA vaccine revealed about two cases per 100,000 people. COVID causes 10 to 105 myocarditis cases per 100,000. Nonetheless, HHS Secretary Robert F. Kennedy Jr., who founded an anti-vaccine organization, has falsely called COVID shots"the deadliest vaccine ever made." And without providing evidence, he said the 1918 flu pandemic "came from vaccine research." Politicized mistrust in vaccines has grown. Far more Republicans said they trust Kennedy to provide reliable information on vaccines than their local health department or the CDC in a recent KFF poll: 73% versus about half. Should the bird flu become a pandemic in the next few years, Rasmussen said, "we will be screwed on multiple levels."
Yahoo
4 days ago
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American Doctors Are Moving to Canada To Escape the Trump Administration
Illustration credit: Oona Zenda/KFF Health News Earlier this year, as President Donald Trump was beginning to reshape the American government, Michael, an emergency room doctor who was born, raised, and trained in the United States, packed up his family and got out. Michael now works in a small-town hospital in Canada. KFF Health News and NPR granted him anonymity because of fears he might face reprisal from the Trump administration if he returns to the U.S. He said he feels some guilt that he did not stay to resist the Trump agenda but is assured in his decision to leave. Too much of America has simply grown too comfortable with violence and cruelty, he said. 'Part of being a physician is being kind to people who are in their weakest place,' Michael said. 'And I feel like our country is devolving to really step on people who are weak and vulnerable.' Michael is among a new wave of doctors who are leaving the United States to escape the Trump administration. In the months since Trump was reelected and returned to the White House, American doctors have shown skyrocketing interest in becoming licensed in Canada, where dozens more than normal have already been cleared to practice, according to Canadian licensing officials and recruiting businesses. The Medical Council of Canada said in an email statement that the number of American doctors creating accounts on which is 'typically the first step' to being licensed in Canada, has increased more than 750% over the past seven months compared with the same time period last year — from 71 applicants to 615. Separately, medical licensing organizations in Canada's most populous provinces reported a rise in Americans either applying for or receiving Canadian licenses, with at least some doctors disclosing they were moving specifically because of Trump. 'The doctors that we are talking to are embarrassed to say they're Americans,' said John Philpott, CEO of CanAm Physician Recruiting, which recruits doctors into Canada. 'They state that right out of the gate: 'I have to leave this country. It is not what it used to be.'' Canada, which has universal publicly funded health care, has long been an option for U.S.-trained doctors seeking an alternative to the American health care system. While it was once more difficult for American doctors to practice in Canada due to discrepancies in medical education standards, Canadian provinces have relaxed some licensing regulations in recent years, and some are expediting licensing for U.S.-trained physicians. In mere months, the Trump administration has jeopardized the economy with tariffs, ignored court orders and due process, and threatened the sovereignty of U.S. allies, including Canada. The administration has also taken steps that may unnerve doctors specifically, including appointing Robert F. Kennedy Jr. to lead federal health agencies, shifting money away from pandemic preparedness, discouraging gender-affirming care, demonizing fluoride, and supporting deep cuts to Medicaid. The Trump administration did not provide any comment for this article. When asked to respond to doctors' leaving the U.S. for Canada, White House spokesperson Kush Desai asked whether KFF Health News knew the precise number of doctors and their 'citizenship status,' then provided no further comment. KFF Health News did not have or provide this information. Philpott, who founded CanAm Physician Recruiting in the 1990s, said the cross-border movement of American and Canadian doctors has for decades ebbed and flowed in reaction to political and economic fluctuations, but that the pull toward Canada has never been as strong as now. Philpott said CanAm had seen a 65% increase in American doctors looking for Canadian jobs from January to April, and that the company has been contacted by as many as 15 American doctors a day. Rohini Patel, a CanAm recruiter and doctor, said some consider pay cuts to move quickly. 'They're ready to move to Canada tomorrow,' she said. 'They are not concerned about what their income is.' The College of Physicians and Surgeons of Ontario, which handles licensing in Canada's most populous province, said in a statement that it registered 116 U.S.-trained doctors in the first quarter of 2025 — an increase of at least 50% over the prior two quarters. Ontario also received license applications from about 260 U.S.-trained doctors in the first quarter of this year, the organization said. British Columbia, another populous province, saw a surge of licensure applications from U.S.-trained doctors after Election Day, according to an email statement from the College of Physicians and Surgeons of British Columbia. The statement also said the organization licensed 28 such doctors in the fiscal year that ended in February — triple the total of the prior year. Quebec's College of Physicians said applications from U.S.-trained doctors have increased, along with the number of Canadian doctors returning from America to practice within the province, but it did not provide specifics. In a statement, the organization said some applicants were trying to get permitted to practice in Canada 'specifically because of the actual presidential administration.' Michael, the physician who moved to Canada this year, said he had long been wary of what he described as escalating right-ring political rhetoric and unchecked gun violence in the United States, the latter of which he witnessed firsthand during a decade working in American emergency rooms. Michael said he began considering the move as Trump was running for reelection in 2020. His breaking point came on Jan. 6, 2021, when a violent mob of Trump supporters besieged the U.S. Capitol in an attempt to stop the certification of the election of Joe Biden as president. 'Civil discourse was falling apart,' he said. 'I had a conversation with my family about how Biden was going to be a one-term president and we were still headed in a direction of being increasingly radicalized toward the right and an acceptance of vigilantism.' It then took about a year for Michael to become licensed in Canada, then longer for him to finalize his job and move, he said. While the licensing process was 'not difficult,' he said, it did require him to obtain certified documents from his medical school and residency program. 'The process wasn't any harder than getting your first license in the United States, which is also very bureaucratic,' Michael said. 'The difference is, I think most people practicing in the U.S. have got so much administrative fatigue that they don't want to go through that process again.' Michael said he now receives near-daily emails or texts from American doctors who are seeking advice about moving to Canada. This desire to leave has also been striking to Hippocratic Adventures, a small business that helps American doctors practice medicine in other countries. The company was co-founded by Ashwini Bapat, a Yale-educated doctor who moved to Portugal in 2020 in part because she was 'terrified that Trump would win again.' For years, Hippocratic Adventures catered to physicians with wanderlust, guiding them through the bureaucracy of getting licensed in foreign nations or conducting telemedicine from afar, Bapat said. But after Trump was reelected, customers were no longer seeking grand travels across the globe, Bapat said. Now they were searching for the nearest emergency exit, she said. 'Previously it had been about adventure,' Bapat said. 'But the biggest spike that we saw, for sure, hands down, was when Trump won reelection in November. And then Inauguration Day. And basically every single day since then.' At least one Canadian province is actively marketing itself to American doctors. Doctors Manitoba, which represents physicians in the rural province that struggles with one of Canada's worst doctor shortages, launched a recruiting campaign after the election to capitalize on Trump and the rise of far-right politics in the U.S. The campaign focuses on Florida and North and South Dakota and advertises 'zero political interference in physician patient relationship' as a selling point. Alison Carleton, a family medicine doctor who moved from Iowa to Manitoba in 2017, said she left to escape the daily grind of America's for-profit health care system and because she was appalled that Trump was elected the first time. Carleton said she now runs a small-town clinic with low stress, less paperwork, and no fear of burying her patients in medical debt. She dropped her American citizenship last year. 'People I know have said, 'You left just in time,'' Carleton said. 'I tell people, 'I know. When are you going to move?'' KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF. Subscribe to KFF Health News' free Morning Briefing. This article first appeared on KFF Health News and is republished here under a Creative Commons license.
