Trump administration to cut vaccine support to developing countries: report
The decision was included in a 281-page spreadsheet that the severely downsized United States Agency for International Development (USAID) sent to Congress on Monday night.
The document details which grants the agency intends to continue and which it will terminate, according to the New York Times, which obtained a copy.
The United States will also significantly scale back support for malaria programs but will maintain some funding streams for treating HIV, tuberculosis, and providing food aid in countries facing conflict and natural disasters.
Only 869 of more than 6,000 USAID employees remain on active duty, according to the Times. The administration has decided to continue about 900 grants while ending over 5,340.
The newspaper estimated a $40 billion reduction in the annual budget of the agency, which has since been absorbed by its parent department, the State Department.
"#USA support for @Gavi is vital. With US support, we can save over 8 million lives over the next 5 years and give millions of children a better chance at a healthy, prosperous future," Gavi, a public-private partnership headquartered in Geneva, wrote on X in response to the report.
"The withdrawal of US financial support for Gavi would severely threaten the tremendous progress made in reducing deaths due to vaccine-preventable diseases and would increase the risk of outbreaks here in the United States," added William Moss, executive director of the international vaccines access center at Johns Hopkins Bloomberg School of Public Health.
It estimated that US support over the past 25 years has helped save 18 million lives and enabled 19 countries to transition away from Gavi's support, with some becoming donors themselves. The United States provides around a quarter of the organization's budget.
ia/md

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles


Medscape
29 minutes ago
- Medscape
Younger, Smaller Children Show Less Success With ART
Younger children living with HIV with low BMI for their age were more likely than older children to fail first-line antiretroviral therapy (ART), based on new data from the ODYSSEY trial presented at the International AIDS Society Conference on HIV Science. Although the ODYSSEY trial showed superior efficacy of dolutegravir (DTG)-based treatment than standard of care, data on predictors of treatment failure in children starting ART on DTG-based regimens are limited, wrote James Wyncoll, PhD, medical statistician at University College London, London, England, and colleagues in their abstract. The researchers reviewed data on 381 children who started first-line ART: 189 with DTG and 192 with standard of care. Most of the children (82%) were in Africa, 13% were in Thailand, and 5% were in Europe. At baseline, the median age of the children was 10.5 years, and the median CD4 percentage was 20%. The median BMI-for-age z-score was -0.58, and 19% of the participants met the World Health Organization (WHO) criteria for stage III/IV disease. The researchers considered the predictive values of baseline characteristics across four domains (anthropometrics, HIV indicators, hematology, and demographics) for treatment failure after 96 weeks. Overall, 75 children experienced treatment failure by 96 weeks, including 24 in the DTG group and 51 in the standard-of-care group. Fewer children treated with DTG experienced treatment failure and the risk declined with increasing age, the researchers wrote. However, predictors of treatment failure were not significantly different between treatment groups, they said. In the domain-specific models, after adjustment for weight and trial arm, independent and significant predictors of treatment failure included low BMI-for-age, low CD4%, WHO stage III/IV events, high neutrophils, and care at a location in Africa. In a multivariate analysis, DTG treatment, lower weight, CD4%, ongoing WHO stage III/IV events, and African region remained as significant predictors of treatment failure ( P < .1). Neutrophils were no longer significant after adjustment for ongoing WHO stage III/IV events, and BMI-for-age was no longer a significant predictor after adjustment for CD4% and region. 'The findings of this study can help clinicians by identifying characteristics at ART initiation which predict a child's risk of treatment failure,' Wyncoll told Medscape Medical News . This study provides information on predictors of treatment failure in children starting ART for the first time, including those starting DTG regimens, he said. Outside of clinical trials, adolescents receiving ART reportedly fared worse than younger children, but the current study showed that the risk for treatment failure declined with increasing age, Wyncoll said. 'We think it's likely that in trials, where participants have increased support, adolescents have good responses to treatment, and it is the youngest children who are at highest risk of treatment failure,' he noted. Reasons for greater treatment failure in younger children may include the need for different formulations, as well as the reliance on caregivers to administer the drugs, which can be difficult, he added. Both CD4% and BMI-for-age are previously recognized predictors of treatment failure. Takeaways and Next Steps The study's findings support previous research showing young age as a strong risk factor for treatment failure with ART, Wyncoll told Medscape Medical News. 'Even with early diagnosis and ART, other studies like the EARTH cohort and the LIFE trial show high mortality in the first 2 years of life, especially within the first 6 months,' he said. 'The EARTH study found that an adverse maternal social environment was linked to poorer outcomes and higher treatment failure in young children, emphasizing the need for strong, sustained support for mothers during pregnancy and early life of infants, including emotional and adherence support,' he noted. Screening for and preventing opportunistic infections such as tuberculosis and giving nutritional support is essential to promote treatment success, and baseline CD4 percentage can help identify children at highest risk for treatment failure, he said. The final model in the current study provides the basis for an online risk prediction tool for treatment failure, Wyncoll explained. Clinicians would enter a child's characteristics (such as treatment type, age, CD4%, and BMI for age) at ART initiation. 'Children are currently left behind when we consider novel treatment regimens,' Wyncoll said. 'Our work highlights the need for innovative approaches and more research into improved treatment for vulnerable children, such as different ART delivery methods or enhanced therapeutics,' he added. Although the researchers concluded that predictors of treatment failure for children in the DTG and SOC groups were the same, the findings were limited by the low rates of treatment failure for the children on DTG, Wyncoll told Medscape Medical News . 'Further research is needed using real-world data from children starting dolutegravir to consolidate these findings,' he said. Don't Discount DTG for Children Relatively few studies have examined risk factors for virologic failure in children with HIV, especially those on DTG, said Monica Gandhi, MD, director of the University of California San Francisco (UCSF) Bay Area Center for AIDS Research and professor of medicine at UCSF, in an interview. The current study findings showing a lower CD4 count when initiating ART or ongoing advanced HIV (as represented by the WHO stage III/IV events) or lower weight when starting ART were all risk factors for failure and were not unexpected, Gandhi told Medscape Medical News . 'What was surprising was to see DTG-based ART more associated with failure than standard-of-care (SoC) ART, since DTG is more potent and durable in adults,' she said. The clinical takeaway is to try to start ART in children as soon as possible to avoid low CD4 counts or more advanced HIV on ART, both of which are risk factors for failure, Gandhi said. DTG-based ART should still be the standard of care among children, but additional research is need to determine into what kind of formulations work best younger ages, such as a dispersible tablet for oral suspension, she added.


Hamilton Spectator
8 hours ago
- Hamilton Spectator
What to know about soda sweeteners as sugar returns to American Coke
President Donald Trump teased the announcement last week, but the Coca-Cola Co. confirmed it Tuesday: a cane sugar-sweetened version of the beverage maker's trademark soda will be released in the U.S. this fall. For decades, Coke and the makers of other soft drinks have generally used high fructose corn syrup or artificial sweeteners in their products manufactured in the U.S. But American consumers are increasingly looking for food and drinks with fewer and more natural ingredients , and beverage companies are responding. PepsiCo and Dr Pepper have sold versions of their flagship sodas sweetened with cane sugar since 2009. Coca-Cola has sold Mexican Coke — which uses cane sugar — in the U.S. since 2005, but it's positioned a trendy alternative and sold in glass bottles. Coke with cane sugar will likely be more widely available. Here are some frequently asked questions about the sweeteners in U.S. sodas: What's the difference between cane sugar and high fructose corn syrup? Many consumers know that consuming too many sweets can negatively affect their health, but soda drinkers sometimes debate if either cane sugar or high fructose corn syrup is better (or worse) than the other. The short answer is that it doesn't make a difference, said Marion Nestle, one of the nation's top nutrition experts and professor emeritus at New York University. High fructose corn syrup is made of the simple sugars glucose and fructose in liquid form. Cane sugar, also known as sucrose, is made of glucose and fructose bonded, but quickly split, Nestle explained. Both are still sugars, with about the same amount of calories. Whether a can of Coca-Cola contains one or the other, it will still be a sugary drink with about the same amount of calories and the same potential to increase well-documented health problems from obesity and diabetes to tooth decay. Why did soda companies switch from using sugar to high fructose corn syrup? High fructose corn syrup costs less. According to price data from the U.S. Department of Agriculture, the wholesale price of HFCS-55, the type of corn syrup most commonly used in beverages, averaged 49.4 cents per pound last year. The average wholesale price of refined cane sugar was 60.1 cents per pound, while the average wholesale price of refined beet sugar was 51.7 cents per pound. But high fructose corn syrup has advantages beyond price. According to a 2008 paper in the American Journal of Clinical Nutrition, high fructose corn syrup is more stable than sugar when added to acidic beverages, and it can be pumped directly from delivery trucks into storage and mixing tanks. Why is high fructose corn syrup less expensive that sugar? Tariffs are one reason. The U.S. has had barriers on sugar imports almost back to its founding; the first went into place in 1789, according to the Cato Institute, a think tank that advocates free markets. Since the passage of the Farm Bill in 1981, the U.S. has had a system in place that raises duties on sugar once a certain amount has been imported. The U.S. also has domestic production controls that limit supplies, keeping prices higher. But high fructose corn syrup is also cheaper because of the federal government's billions of dollars in subsidies for corn farmers. Loans, direct payments, insurance premium subsidies and surplus crop purchases all lower farmers' costs – and the price of the corn they grow. Are sugar replacements used in diet sodas safe? While cutting back on added sugars has documented benefits, replacing them with artificial sweeteners is complicated, too. Coca-Cola Zero Sugar, introduced in 2017, uses the artificial sweetener aspartame and the natural sweetener stevia in its recipe. But research suggests that aspartame may be linked to cancer. In 2023, a committee for the World Health Organization determined that aspartame should be categorized 'as possibly carcinogenic to humans.' While that doesn't mean that diet soda causes cancer, the scientific committee concluded that there may be a possible link between aspartame and liver cancer, and that the issue should be studied further. The U.S. Food and Drug administration disagreed with the WHO panel, citing 'significant shortcomings' in the research that backed the conclusion. FDA officials noted that aspartame is one of the most studied food additives and said 'FDA scientists do not have safety concerns' when it is used under approved conditions. Stevia, a plant-based sweetener, appears to be 'a safe choice,' according to the Center for Science in the Public Interest, an advocacy group. ___ Durbin reported from Detroit. Aleccia reported from Los Angeles.

Wall Street Journal
11 hours ago
- Wall Street Journal
U.S. Global Health Aid Is an Exemplar of Efficiency
It's good that in the end Senate Republicans saved some global health aid. As Bill Gates highlights in his op-ed, 'U.S. Aid for Global Health Is Saving Lives' (July 15), American health aid is remarkably efficient. My organization, the Copenhagen Consensus, has for decades worked with hundreds of the world's top economists and many Nobel laureates to identify the most cost-effective solutions to global challenges. Several American global health initiatives deliver amazing benefits for every dollar spent. Consider Gavi, the Vaccine Alliance. Our research shows that the childhood vaccinations Gavi funds currently save nearly four million lives a year. Each dollar spent delivers an astounding $286 in policy benefits. Other countries and philanthropists help achieve this, but the 13% of Gavi's budget that the U.S. contributed last year matters. That $400 million in American outlays alone will help protect 75 million additional children and prevent over 1.2 million deaths in the next five years.