Using Big Tobacco’s Playbook

As a youth tobacco control advocate in the Caribbean, I see glaring similarities between the tactics of the tobacco industry and those of the food and beverage industry. The tobacco industry asserts itself as a stakeholder in policy development. They often lobby against comprehensive tobacco control policies under the guise of protecting jobs and economic interests, disregarding the toll of tobacco-related diseases on our communities.

They attempt to influence scientific research to cast doubt on the harms of their products. By funding studies that downplay the health risks of tobacco use or promote misleading claims, they seek to undermine the evidence base for tobacco control measures. The tobacco industry strategically targets youth by marketing flavoured vapes with attractive packaging while engaging in corporate social responsibility activities, such as sponsorships and scholarships, which improves their public image.

The food and beverage industry is clearly mimicking Big Tobacco’s playbook, evident in their persistent marketing to children and resistance to the Octagonal Warning Label. However, Caribbean youth won’t be silent bystanders. We demand transparent, evidence-based public health policies that prioritize our well-being, not corporate profits.

Dorial Quintyne
(Public Health Practitioner, Barbados)

Breastmilk Substitutes

A troubling trend in their marketing strategy involves portraying formula as a cure-all for common infant issues like fussiness and colic, which are natural developmental processes ideally addressed through breastfeeding. This not only fuels unwarranted anxiety around breastfeeding and infant care but also establishes a misleading equivalence between formula and breastfeeding. This narrative undermines women’s confidence in exclusively breastfeeding, potentially contributing to lower breastfeeding rates globally.

Here in CARICOM, implementation of the International Code of Marketing of Breast Milk Substitutes from the WHO is abysmal with only one country reported as having implemented any provisions – a critical measure to counteract the powerful breast milk substitutes lobby. For advocates, like myself, a first step is a call for full implementation of the Code supported by widespread transformations such as universal paid maternity leave. Governments, workplaces, and healthcare providers must collaborate to ensure unwavering support, offering unbiased information about infant feeding.
Additionally, implementing clear front-of package warning labels is crucial for empowering parents to make informed decisions about their children’s nutrition. Breast milk remains the paramount source of infant nutrition, and these labels can counteract the oversimplified messaging of formula marketing, emphasizing the unequivocal benefits of breastfeeding. This concerted effort aims to create a more informed and supportive global environment for parents and caregivers.

Rhianna Smith
Breastfeeding Advocate, Barbados

How can governments protect policies from industry interference – highlighting the CROSQ report

Being involved in the development of the newly published (March 2024) report, ‘Public health decision-making in CARICOM: Strengthening the Front-of-Package Nutrition Labelling Standardisation Programme’, which analyses and seeks to inform the strengthening of that standardisation programme, has underscored for me the importance of governments in protecting public policies.

The report highlights, for example, the labyrinth of actors involved and the multiple potential entry points for inordinate industry interference in the process to revise the CARICOM Regional Standard specification for the labelling of pre-packaged foods to include octagonal ‘high in’ warning labels as defined by the PAHO Nutrient Profile Model. From the lack of standardisation in the approach to commenting, voting and accepting evidence, to variations in committees’ composition, among other factors, it is evident that weak or absent rules to govern multisectoral engagement in policymaking create opportunities for commercial and other vested interests to usurp public health interests.

I am convinced that our CARICOM Governments must not only sit in the driver’s seat of the policymaking process but must also establish clear rules for legitimate stakeholders to navigate the policymaking space in ways that do not undermine the public interests at stake. As such, governments must adopt, implement and consistently monitor a suite of governance mechanisms, such as conflict of interest policies and access to information laws.

Kimberley Benjamin
Attorney-at-law, Barbados

The Jamaican FOPWL voting process

The 2023 Jamaican voting process for the Final Draft CARICOM Regional Standard–5, which included the Octagonal Warning Label and the PAHO Nutrient Profile Model, was marred by significant irregularities, suggesting interference from the food and beverage industry. As a member of the National Consumers League (NCL), I participated in this process, motivated by my expertise as a global health lawyer.

The process was supervised by the Bureau of Standards Jamaica (BSJ). Per BSJ standards, a 75% affirmative vote was required to approve the standard. However, the five stakeholder groups’ votes resulted in a deadlock: 40% in favour (NGOs and academia), 40% against (industry and government), and 20% undecided—both members of the consumer group (Consumer Affairs Commission-CAC and National Consumer League of Jamaica-NCLJ) could not reach a consensus.

Instead of reporting this deadlock to CROSQ and recording an abstention, NCL was invited to meetings under the guise of having the consumer stakeholder group (NCL and CAC) come to a definite decision i.e. consensus. NCL had originally voted in favour of the standard. This approach was inappropriate, as reaching the 75% requirement for approval was impossible at this stage. The only other objective would have been to secure a firm opposing vote as the national position. The interventions constitute significant irregularities, reflecting a pattern of industry interference seen in regulatory processes globally.

Urgent steps must be taken to improve public health governance such that standards-making/ policymaking processes such as these are safeguarded from undue influence by industry actors with conflicting interests.

Shajoe Lake
Global Health Lawyer, Jamaica

FOPWL 

As a major industrial hub in the Caribbean, Trinidad and Tobago guarantees a lucrative market for processed or ultra-processed products, crippling health systems. As a youth advocate in the healthy food policy space, there has been a lack of transparency in T&T’s consultative and voting processes around the hotly debated ‘high-in’ octagonal front of package warning label (FOPWL) standard. Food and beverage manufacturers and distributors continue to resist the adoption of the FOPWL standard, which reflects their willingness to sacrifice consumers’ health in pursuit of profits.

Even more concerning, is the shift of a public health strategy in combating obesogenic environments to a trade-focused debate. Under the guise of concerns over costs to consumers and manufacturers associated with mass reformulation or relabeling requirements, private sector has conducted studies to determine an appropriate FOPL scheme, hoping to undermine the scientific evidence highlighting octagonal warning label’s FOPL’s efficacy.

It is evident that food and beverage industries are well-connected politically, capitalizing on their resources to provoke fear and ignorance amidst the region’s economic vulnerabilities. We must keep pushing for the regional adoption of the FOPWL standard and unmask industry interference. We call on our governments to safeguard the region’s economic development but not at the cost to consumers’ health and wellbeing.

Simone Bishop Matthews
Public Health Practitioner, Trinidad and Tobago

The importance of COI free public health research in informing healthy food policies

As a public health researcher, it is important to scrutinise all aspects of research, including: the connections of the researcher(s), the funding source(s), the event(s) under observation, the overall research design, questions asked, how they’re asked, as well as the communities and individuals one speaks to.

Consider these two example questions:

• Do you think that the government should place restrictions on what you eat and drink?
• Can you describe ways in which the government could promote healthy eating practices?

One question is leading and biased, the other is objective. These questions may seem similar in focus, but the outcomes will be very different.

Too often, we see misleading research from ‘industry actors’ who produce, promote and distribute unhealthy food and beverages. These reports create a distinct conflict-of-interest. Instead of truly prioritizing the health and wellbeing of society, they downplay the health-harming effects of their products and distract the consumer with other focuses.
Octagonal Front-of-Package Warning Labels (FOPWL) are an effective solution to this issue. The Pan American Health Organization notes that the ‘High-In’ Octagonal label, modelled in countries like Chile and Mexico, is the best and most readily understood nutrition label. Consumers using this system can easily and accurately identify products high in nutrients of concern like salt, sugar and fats.

Despite this clear public health evidence, we see industry promoting other, less efficient and less effective labelling standards. Policy makers must avoid such research as it often prioritises the profitability of the business over the health and wellbeing of people.

Christopher Laurie
Public Health Researcher, Barbados

Marketing to Children

As the Advocacy Officer for Childhood Obesity Prevention and Healthy Food Policy at the Healthy Caribbean Coalition, I am responsible for monitoring conflicts of interest and industry interference in policy-making across the region. During the COVID-19 pandemic, I observed a troubling trend: the increased marketing of ultra-processed brands and products directly to children. This strategy, aimed at acquiring and retaining customers from a young age, disregards the well-documented physical and mental health risks associated with product consumption.

This insidious unhealthy food marketing, particularly when targeting children across the Caribbean and globally, takes various forms, from branded school sponsored events and the distribution of branded school items, to donations of ultra-processed products to vulnerable children by numerous food/beverage manufacturers and entities. These are deflective activities aimed at gaining public and policymaker favor while promoting products for profit.

By cultivating this collective favour, actors in the ultra-processed product industry gain privileged access to policymakers, entering “closed-door meetings” and policymaking spaces that lack clear guidelines for managing conflicts of interest and fostering transparency. Their gained public support and respect also discourages questioning of their presence in these influential spaces.

It is crucial to urgently address what may seem like innocent tactics as they evolve to threaten the development of mechanisms, like healthy food policies, that are designed to protect the region’s health.

Danielle Walwyn
Advocacy Officer, Antigua and Barbuda

SEE THE TRUTH: SOME FOOD INDUSTRY ACTORS WORKING AGAINST OCTAGONAL WARNING LABELS

There is an urgent need to protect our public health policy-making processes.

Since the start of consultations around the front-of-package labelling Regional Standard for pre-packaged food products in 2018, the ultra-processed food and beverage industry — supported by the wider private sector industry in the Caribbean — has become an overpowering actor in healthy food policy discussions.

Visit the campaign webpage

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The Host

Julie Rovner
KFF Health News

@jrovner

Read Julie's stories.

Julie Rovner is chief Washington correspondent and host of KFF 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.

The Affordable Care Act was signed into law 14 years ago this week, and Health and Human Services Secretary Xavier Becerra joined KFF Health News’ Julie Rovner on this week’s “What the Health?” podcast to discuss its accomplishments so far — and the challenges that remain for the health law.

Meanwhile, Congress appears on its way to, finally, finishing the fiscal 2024 spending bills, including funding for HHS — without many of the reproductive or gender-affirming health care restrictions Republicans had sought.

This week’s panelists are Julie Rovner of KFF Health News, Mary Agnes Carey of KFF Health News, Tami Luhby of CNN, and Alice Miranda Ollstein of Politico.

Panelists

Mary Agnes Carey
KFF Health News

@maryagnescarey

Read Mary Agnes' stories.

Tami Luhby
CNN

@Luhby

Read Tami's stories.

Alice Miranda Ollstein
Politico

@AliceOllstein

Read Alice's stories.

Among the takeaways from this week’s episode:

• The Supreme Court will hear oral arguments next week in a case that could decide whether the abortion pill mifepristone will remain easily accessible. The case itself deals with national restrictions rather than an outright ban. But, depending on how the court rules, it could have far-reaching results — for instance, preventing people from getting the pills in the mail and limiting how far into pregnancy the treatment can be used.
• The case is about more than abortion. Drug companies and medical groups are concerned about the precedent it would set for courts to substitute their judgment for that of the FDA regarding drug approvals.
• Abortion-related ballot questions are in play in several states. The total number ultimately depends on the success of citizen-led efforts to collect signatures to gain a spot. Such efforts face opposition from anti-abortion groups and elected officials who don’t want the questions to reach the ballot box. Their fear, based on precedents, is that abortion protections tend to pass.
• The Biden administration issued an executive order this week to improve research on women’s health across the federal government. It has multiple components, including provisions intended to increase research on illnesses and diseases associated with postmenopausal women. It also aims to increase the number of women participating in clinical trials.
• This Week in Medical Misinformation: The Supreme Court heard oral arguments in the case Murthy v. Missouri. At issue is whether Biden administration officials overstepped their authority when asking companies like Meta, Google, and X to remove or downgrade content flagged as covid-19 misinformation.

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

Julie Rovner: The Washington Post’s “Arizona Lawmaker Tells Her Abortion Story to Show ‘Reality’ of Restrictions,” by Praveena Somasundaram. (Full speech here.)

Alice Miranda Ollstein: CNN’s “Why Your Doctor’s Office Is Spamming You With Appointment Reminders,” by Nathaniel Meyersohn.

Tami Luhby: KFF Health News’ “Georgia’s Medicaid Work Requirement Costing Taxpayers Millions Despite Low Enrollment,” by Andy Miller and Renuka Rayasam.

Mary Agnes Carey: The New York Times’ “When Medicaid Comes After the Family Home,” by Paula Span, and The AP’s “State Medicaid Offices Target Dead People’s Homes to Recoup Their Health Care Costs,” by Amanda Seitz.

Also mentioned on this week’s podcast:

• NPR’s “Standard Pregnancy Care Is Now Dangerously Disrupted in Louisiana, Report Reveals,” by Rosemary Westwood.
• The Washington Post’s “As the Cost of Storing Frozen Eggs Rises, Some Families Opt to Destroy Them,” by Amber Ferguson.

Click to open the transcript

Transcript: The ACA Turns 14

[Editor’s note: This transcript was generated using both transcription software and a human’s light touch. It has been edited for style and clarity.]

Julie Rovner: Hello, and welcome back to “What the Health?” I’m Julie Rovner, chief Washington correspondent for KFF Health News, and I’m joined by some of the best and smartest health reporters in Washington. We’re taping this week on Thursday, March 21, at 10 a.m. As always, news happens fast and things might have changed by the time you hear this. So here we go.

We are joined today via video conference by Alice Miranda Ollstein of Politico.

Alice Miranda Ollstein: Hello.

Rovner: Tami Luhby of CNN.

Tami Luhby: Hello.

Rovner: And my KFF Health News colleague Mary Agnes Carey.

Mary Agnes Carey: It’s great to be here.

Rovner: Later in this episode to mark the 14th anniversary of the Affordable Care Act, we’ll have my interview with Health and Human Services Secretary Xavier Becerra, but first, this week’s news. So it appears our long national nightmare following the progress of the fiscal 2024 spending bill for the Department of Health and Human Services is nearly over, nearly halfway through the fiscal year. The White House, House, and Senate have, as far as we can tell, reached a compromise on the last tranche of spending bills, which is a good thing because the latest temporary spending bill runs out at midnight Friday. Funding for the Department of Health and Human Services, from what I’ve seen so far, is basically flat, which is a win for the Democrats because the Republicans had fought for a cut of something in the neighborhood of 22%.

Now, assuming this all happens, the House is scheduled to vote, as we speak now, on Friday at 11 a.m., leaving the Senate not very much time to avert a possible partial shutdown. Democrats seem also to have avoided adding all manner of new restrictions on reproductive and gender-affirming health care to the HHS part of the bill. It’s the last big train leaving the station likely until after the election. So Alice, we’ll get to the add-ons in a minute, but have you seen anything in the HHS funding worthy of note or did they manage to fend off everything that would’ve been significantly newsworthy?

Ollstein: Like you said, it is basically flat. It’s a small increase, less than 1% overall for HHS, and then a lot of individual programs are just completely flat, which advocacy groups argue is really a cut when you factor in inflation. The cost of providing services and buying medications and running programs and whatnot goes up. So flat funding is a cut in practice. I’m hearing that particularly from the Title X family planning folks that have had flat funding for a decade now even as demand for services and costs have gone up.

So I think that in the current environment, Democrats are ready to vote for this. They don’t want to see a shutdown. And in the House, the bill passage will depend on those Democratic votes because they are likely to lose a lot of Republicans. Republicans are mad that there weren’t deeper cuts to spending and, as you alluded to, they’re mad that they didn’t get these policy rider wins they were banking on.

Rovner: As I’ve mentioned, since this is a must-pass bill, there are always the efforts to add non-spending things to it. And on health care, apparently, the effort to add the PBM, pharmacy benefit regulation bill we’ve talked about so much failed, but lawmakers did finally get a one-year deal to extend PEPFAR, the international AIDS/HIV program. Alice, you’ve been dutifully following this since it expired last year. Remind us why it got held up and what they finally get.

Ollstein: What happened in the end is it is a one-year reauthorization that’s a so-called clean reauthorization, meaning they are not adding new anti-abortion restrictions and provisions that the Republicans wanted. So what we reported this week is, like any compromise, no one’s happy. So Republicans are upset that they didn’t get the anti-abortion restrictions they wanted, and I’ll explain more on that in a second, and Democrats are upset that this is just a one-year reauthorization. It’s the first reauthorization that’s this sort of short-term stopgap length. In the program’s decades of history, it’s always been a full five-year reauthorization up until now. But the fight over abortion and accusations that program funds were flowing to abortion providers really split Congress on this.

Even though you had mainstream leadership Republicans who were saying, “Look, we just want to reauthorize this as-is,” you had a small but very vocal contingent of hard-line anti-abortion lawmakers backed by some really influential groups like the Heritage Foundation and SBA [Susan B. Anthony Pro-Life America] who were saying, “No, we have to insist on a shorter-term reauthorization,” so that they hope Trump will be in office next year and can impose these exact same anti-abortion restrictions through executive action. So they’re basically trying to punt control of the program into what they hope is a more favorable environment, where either they’ll have the votes in Congress to make these changes and restrictions to the program or they can do it through the White House.

Rovner: So basically, the fight over PEPFAR, not over. So as I already mentioned, Saturday is the 14th anniversary of the Affordable Care Act, which you’ll hear more about in my interview with HHS Secretary Becerra, but I wanted to pose to you guys one of the questions that I posed to him. As Nancy Pelosi famously predicted, at least according to public opinion polls, the more people learned about the health law, indeed, the more they are liking it. But it still lacks the popularity and branding of big government health programs, like Medicare and Medicaid, and I think lots of people still don’t know that lots of the provisions that they like, things like letting your adult children stay on your health plan until they’re 26 or banning preexisting condition exclusions, those were things that came from the Affordable Care Act. Any theories as to why it is still so polarizing? Republicans didn’t love Medicare and Medicaid at the beginning either, so I don’t think it’s just that Republicans still talk about it.

Luhby: Part of it I think is because there are so many provisions and they’re not labeled the Affordable Care Act like Medicare is. Actually to some extent, Medicaid may not be as well known in some states because states have different Medicaid programs and different names and so do the ACA exchanges. So that’s part of it, but also, things like why do you get a free mammogram and why you get to go for a routine checkup every year; that’s not labeled as an Affordable Care Act provision, that’s just the preventive services. So I think that it would be difficult now after 14 years to bring all of that into the everyday branding by doctors and health providers. But that’s certainly what the administration and advocates are trying to do by sending out a lot of messages that list all of the benefits of the ACA.

Rovner: I will say this is the biggest full-court press I’ve seen an administration do on the ACA in quite a while. Obviously, it’s a presidential election year and it’s something that the Biden administration is proud of, but at least I would think that maybe just all the publicity might be part of their strategy. Mac, you wanted to say something.

Carey: No, absolutely. It’s going to be part of the Biden reelection campaign. They’re going to be pushing it, talking a lot about it. We have to remember we’ve had this ringside seat to all the Republican opposition to the Affordable Care Act. All the conversation about we’re going to repeal it and put something better in, former President Trump is still sending that message out to the electorate. I don’t know how much confusion, if any confusion, it creates, but to Tami’s point, you’ve got millions of people that have gotten coverage under the Affordable Care Act but millions more have benefited by all these provisions we’re talking about: the preventive care provisions, leaving adult kids up to 26 on your health insurance plan, that kind of thing.

Also, give it time. Fourteen years is a long time, but it’s not the time of Medicare, which was created in 1965, and Medicaid. So I think over time, the Affordable Care Act is part of the fabric and it will continue to be. But absolutely, for sure, President Biden is going to run on this, like you said, Julie, full-court press, talk extensively about it in the reelection campaign.

Ollstein: It makes sense that they’re leaning really hard on Obamacare as a message because, even if everyone isn’t familiar with it, a lot more people are familiar with it and like it than, polling shows, on the Biden administration’s other big health care accomplishment, which is drug price negotiation, which polling shows that most people, and even most seniors, who are the ones who are set to benefit the most, aren’t aware that it exists. And that makes sense because they’re not feeling the impact of the lower prices yet because this whole thing just started and it won’t be until 2026 that they’ll really actually experience cheaper medications. But people are already feeling the direct impact of Obamacare on their lives, and so it does make sense that they’re going to lean really hard on this.

Rovner: Of course, we went through the same thing with Obamacare, which also didn’t take full effect until, really, this is really the 10th anniversary of the full effect of the Affordable Care Act because it didn’t take effect until 2014. Tami, you wanted to add something.

Luhby: No, I was going to say it’s also the seventh anniversary of the Trump administration and congressional Republicans trying to tear apart the Affordable Care Act and repeal and replace it, which is the messaging that you’re seeing now is very similar to what you saw in 2017. It’s just surprising to me that with very intensive messaging on both sides at that time about what the Republicans saying what the problems are and the Democrats saying what all of the benefits are, — including the protections for people with preexisting conditions and the other things we’ve mentioned — that more people don’t associate those provisions with the ACA now. But the Biden administration is trying to revive all of that and remind people, as they did in 2018 in the successful midterm elections for the Democrats, that the ACA does provide a lot of the benefits that they are taking advantage of and appreciate.

Rovner: I think, in some ways, the 2017 fight was one of the best things that ever happened to the ACA in terms of helping people understand what actually was in it, because the Democrats managed to frighten people about things that they liked being taken away. Here we go again. All right, let us turn to abortion. There’s a new report out from the Guttmacher Institute that finds a dramatic jump in the use of medication abortion in 2023, the first full year since the Supreme Court reversed the nationwide right to abortion in the Dobbs [v. Jackson Women’s Health Organization] case, more than 60% of abortions use medication rather than a procedure last year. This news comes as the Supreme Court next week prepares to hear oral arguments in a case that could dramatically restrict availability of the abortion pill mifepristone. Alice, remind us what’s at stake in this case. It’s no longer whether they’re going to just outright cancel the approval.

Ollstein: That’s right. So the Supreme Court is taking up the narrowed version of this from the 5th Circuit. So what’s at stake are national restrictions on abortion pills, but not a national outright ban like you mentioned. But those restrictions could be really sweeping and really impactful. It would prevent people from getting the pills through the mail like they currently do. It would prevent people from potentially getting them in any other way other than directly from a doctor. So this would apply to red states and blue states alike. It would override abortion rights provisions in blue states that have done a lot to increase access to the pills. And it would also restrict their use back to the first seven weeks of pregnancy instead of 10, which is a big deal because people don’t often find out they’re pregnant until getting close to that line or beyond.

So this is a really big deal, and I think you can really see, especially from the flurry of amicus briefs have been filed, that anxiety about this case in the medical community and the pharmaceutical community, the scientific community, it goes way beyond the impact just on abortion. People are really worried about setting a precedent where the FDA’s scientific judgment is second-guessed by courts, and they worry that a win for the anti-abortion groups in this case would open the door to people challenging all kinds of other medications that they have an issue with: contraception, covid vaccines, HIV drugs, the list goes on and on, gender-affirming care medications, all sorts of things. So there are the bucket of potential impacts on abortion specifically, which are certainly significant, and then there’s the bigger slippery slope fears as well.

Rovner: Also, this is obviously still way political. More than just the abortion pill. It’s been a while since we’ve talked about state ballot measures. We, I think, feel like we spent all of last year talking about abortion state ballot measures. Alice, catch us up real quick on where we are. How many states have them? And what is this campaign against, by the anti-abortion people, to try to prevent them from getting on the ballot?

Ollstein: Check me if I’m wrong, but I don’t believe we know for sure about, especially the states that have citizen-led ballot initiatives where people are gathering signatures. So Florida had one of the earliest deadlines and they did meet their signature threshold. But they are now waiting on the state Supreme Court to say whether or not they have a green light to go forward this fall. A lot of other states are still collecting signatures. I think the only states we know for sure are the ones where the state legislature is the one that is ordering it to be put on the ballot, not regular citizens gathering signatures.

We still don’t know, but things are moving forward. I was just in Arizona reporting on their efforts. Things are moving forward there. Things are moving forward in Montana. They just got a court ruling in their favor to put something on the ballot. And things are moving forward in Missouri, a lot of places. So this could be really huge. Of course, like you mentioned, anti-abortion groups and anti-abortion elected officials are doing a lot of different things to try to prevent this from going on the ballot.

It’s interesting, you heard arguments over the last couple years against this being more along the lines of, “Oh, this is allowing these out-of-state big-money groups to swoop in and mislead and tell us what to do,” and those were the anti-abortion arguments against allowing people to vote on this directly. Now, you’re hearing, I’m hearing, more arguments along the lines of, “This shouldn’t be something subject to a popular vote at all. We shouldn’t put this up for a vote at all.” They consider this a human rights issue, and so I think that’s a really interesting evolution as well, particularly when the fall of Roe [v. Wade] was celebrated for returning the question of abortion access to the people, but maybe not these people specifically.

Rovner: I’ve been interested in seeing some of these anti-abortion groups trying to launch campaigns to get people not to put signatures on petitions. That’s moving it back a step I don’t think I’d ever seen. I don’t think I’ve ever seen a campaign to say, “Don’t sign the petition that would put this on the ballot to let people vote on it.” But that’s what we’re seeing, right?

Ollstein: Well, that’s what I went to Arizona to see firsthand is how that’s working, and it’s fascinating. They really worry that if it gets on the ballot, it’ll pass. It has in every state so far, so it’s reasonable for them to assume that. So they’re trying to prevent it from getting on the ballot. The way they’re doing that is they’re tracking the locations of signature gatherers and trying to go where they are and trying to intervene and hold up signs. I saw this firsthand. I saw it at a street fair. People were gathering signatures and several anti-abortion demonstrators were standing right in front of them with big signs and trying to argue with people and deter them from signing. It was not working, from what I observed. And from the overall signature count statewide, it was not working in Arizona. But it’s fascinating that they’re trying this.

Carey: I was going to say just our reporting from our KFF Health News colleagues found that 13 states are weighing abortion-related ballot measures, most of which would protect abortion rights. To your point, the scope is pretty extensive. And for all the reasons Alice just discussed, it’s quite the issue.

Rovner: Yeah, and we will obviously talk more about this as the election gets closer. I know we talk about Texas a lot on this podcast, but this week, I want to highlight a study from next door in Louisiana, also a very strong anti-abortion state. A new report from three groups, all of which support abortion rights, charges that, as in Texas, women with pregnancy complications are being forced to wait for care until their conditions become critical. And in some cases, women with nonviable pregnancies are being forced to have C-section surgery because their doctors don’t dare use medication or other less-risky procedures in case they could be accused of performing an abortion.

At some point, you have to think that somebody is going to have a malpractice case. Having a C-section because your doctor is afraid to terminate a nonviable pregnancy seems like pretty dangerous and rather aggressive way to go. This is the first I’ve ever heard of this. Alice, have you heard anything about this?

Ollstein: Not the C-section statistics specifically, but definitely the delays in care and some of the other impacts described in that report have absolutely been reported in other states and in legal challenges that have come up in Texas, in Oklahoma, in Tennessee, in Idaho by people who were denied abortions and experienced medical harms because of it. So I think that fits into the broader pattern. And it’s just more evidence about how this is having a chilling effect on doctors. And the exact letter of the law may be one thing, and you have elected officials pointing to exemptions and provisions in the law, but the chilling effect, the fear and the confusion in the medical community, is something in addition to that.

Rovner: As we put it out before, doctors have legitimate fears even if they don’t want to get dragged into court and have to hire lawyers and take time off — even if they’re innocent, even if they have what they consider to be pretty strong evidence that whatever it was that they did was legitimate under the law in terms of taking care of pregnant women. A lot of them, they don’t want to come under scrutiny, let’s put it that way, and it is hard to blame them about that.

Meanwhile, the backlash over the Alabama Supreme Court decision that fertilized embryos for IVF have legal rights is continuing as blue states that made themselves safe spaces for those seeking abortion are now trying to welcome those seeking IVF. Anybody think this is going to be as big a voting issue as abortion this fall? It’s certainly looking like those who support IVF, including some Republicans, are trying to push it.

Carey: I would think yes, it absolutely will be because it has been brought into the abortion debate. The actual Alabama issue is about an Alabama law and whether or not this particular, the litigants who sued were … it was germane and covered by the law, but it’s been brought into the abortion issue. The whole IVF thing is so compelling, about storage of the embryos and what people have to pay and all the restrictions around it and some of the choices they’re making. I guess that you could say more people have been touched by IVF perhaps than the actual abortion issue. So now, it’s very personal to them and it’s been elevated, and Republicans have tried to get around it by saying they support it, but then there’s arguments that whether or not that’s a toothless protection of IVF. It came out of nowhere I think for a lot of politicians and they’ve been scrambling and trying to figure it out. But to your point, Julie, I do wonder if it will be elevated in the election. And it was something they didn’t think they’d have to contend with, rather, and now they do.

Rovner: Obviously, it’s an issue that splits the anti-abortion community because now we’ve had all these very strong pro-lifers like Mike Pence saying, “I created my family using IVF.” Nikki Haley. There are a lot of very strong anti-abortion Republicans who have used IVF. So you’ve got some on the far … saying, “No, no, no, you can’t create embryos and then destroy them,” and then you’ve got those who are saying, “But we need to make sure that IVF is still available to people. If we’re going to call ourselves pro-life, we should be in favor of people getting pregnant and having babies, which is what IVF is for.” Alice, I see you nodding your head.

Ollstein: Yeah. So we’re having sort of a frustrating discourse around this right now because Democrats are saying, “Republicans want to ban IVF.” And Republicans are saying, “No, we don’t. We support IVF. We love IVF. IVF is awesome.” And neither is totally accurate. It’s just missing a lot of nuance. Republicans who say they support IVF also support a lot of different kinds of restrictions on the way it’s currently practiced. So they might correctly argue that they don’t want to ban it entirely, but they do want it practiced in a different way than it is now, such as the production of many embryos, some of which are discarded. So I think people are just not being asked the right questions right now. I think you got to get beyond, “Do you support IVF?” That gives people a way to dodge. I think you really have to drill into, “OK. How specifically do you want this regulated and what would that mean for people?”

Carey: Right, and the whole debate with some of the abortion rights opponents, some of them want the federal government to regulate it. Mike Johnson, speaker of the House, has come out and said, “No, no, that can be done at the state level.” So they’ve got this whole split internally in the party that is, again, a fight they didn’t anticipate.

Rovner: Well, Mac, something that you alluded to that I was struck by was a piece in The Washington Post this week about couples facing increasing costs to store their IVF embryos, often hundreds of dollars a year, which is forcing them to choose between letting the embryos go or losing a chance to possibly have another child. It’s obviously a big issue. I’m wondering what the anti-IVF forces think about that. As we’ve seen in Alabama, it’s not like you can just pick your embryos up in a cooler and move them someplace else. Moving them is actually a very big deal.

I don’t wish to minimize this, but I remember you have storage units for things, not obviously for embryos. One of the ways that they make money is that they just keep raising the cost because they think you won’t bother to move your things, so that you’ll just keep paying the increased cost. It feels like that’s a little bit of what’s happening here with these stored embryos, and at some point, it just gets prohibitively expensive for people to keep them in storage. I didn’t realize how expensive it was.

Carey: They’re all over the place. In preparing for this discussion, I’ve read things about people are paying $600 a year, other people are paying $1,200 a year. There’s big jumps from year to year. It can be an extremely expensive proposition. Oh, my goodness.

Rovner: IVF itself, I think as we’ve mentioned, is also extremely expensive and time-consuming, and emotionally expensive. It is not something that people enter into lightly. So I think we will definitely see more as we go. There’s also women’s health news this week that doesn’t have to do with reproduction. That’s new. Earlier this week, President Biden issued an executive order attempting to ensure that women are better represented in medical research. Tami, what does this order do and why was it needed?

Luhby: Well, it’s another attempt by the Biden administration, as we’ve discussed, to focus on reproductive health and reproductive rights. During the State of the Union address earlier this month, Biden asked Congress to invest $12 billion in new funding for women’s health research. And there are actually multiple components to the executive order, but the big ones are that it calls for supporting research into health and diseases that are more likely to occur midlife for women after menopause, such as rheumatoid arthritis, heart attacks, osteoporosis, and as well as ways to improve the management of menopause-related issues.

We are definitely seeing that menopause care is of increasing focus in a multitude of areas including employer health insurance, but the executive order also aims to increase the number of women participating in clinical trials since they’re poorly represented now. We know that certain medications and certain treatments have different effects on women than men, but we don’t really know that that well because they’re not as represented in these clinical trials. Then it also directs agencies to develop and strengthen research and data standards on women’s health across all of the relevant research and funding opportunities in the government.

Rovner: I’ll say that this is an issue I have very strong feelings about because I covered the debate in 1992 about including women in medical research. At the time, doctors didn’t want to have women in clinical trials because they were worried about hormones, and they might get pregnant, and we wouldn’t really know what that meant for whatever it was that we were testing. Someone suggested that “If you’re going to use these treatments and drugs on women, maybe you should test them on women too.” Then I won an award in 2015 for a story about how they still weren’t doing it, even though it was required by laws.

Carey: And here we are, 2024.

Rovner: Yeah, here we are. It just continues, but at least they’re trying. All right, finally, this week in medical misinformation, we travel to the Supreme Court, where the justices heard oral arguments in a case brought by two Republican state attorneys general charging that the Biden administration, quote, “coerced” social media platforms, Google, Meta, and X, into downgrading or taking down what public health officials deemed covid disinformation. I didn’t listen to the arguments, but all the coverage I saw suggested that the justices were not buying what the attorneys general were selling.

Yet another public-health-adjacent case to watch for a decision later this spring, but I think this is really going to be an important one in terms of what public officials can and cannot do using their authority as public health officials. We’re obviously in a bit of a public health trust crisis, so we will see how that goes.

All right, that is the news for this week. Now, we will play my interview with HHS Secretary Xavier Becerra, then we will be back with our extra credits.

I am so pleased to welcome back to the podcast Health and Human Services Secretary Xavier Becerra. I’ve asked him to join us to talk about the Affordable Care Act, which was signed into law 14 years ago this weekend. Mr. Secretary, thanks so much for coming back.

Xavier Becerra: Julie, great to be with you on a great week.

Rovner: So the Affordable Care Act has come a long way, not just in the 14 years since President Obama signed it into law, but in the 10 years since the healthcare.gov website so spectacularly failed to launch, but this year’s enrollment setting a record, right?

Becerra: That’s right, and you should have said, “You’ve come a long way, baby.”

Rovner: So what do we know about this year’s enrollment numbers?

Becerra: Another record breaker. Julie, every year that President Biden has been in office, we have broken records. Today, more Americans have health insurance than ever in the history of the country. More than 300 million people can now go to a doctor, leave their child in a hospital and know they won’t go bankrupt because they have their own health insurance. That’s the kind of peace of mind you can’t buy. Some 21.5 million Americans today look to the marketplace on the Affordable Care Act to get their coverage. By the way, the Affordable Care Act overall, some 45 million Americans today count on the ACA for their health care insurance, whether it’s through the marketplace, through Medicaid, or some of these basic plans that were also permitted under the ACA.

Rovner: Obviously, one of the reasons for such a big uptake is the expanded subsidies that were extended by the Inflation Reduction Act in 2022, but those expire at the end of next year, the end of 2025. What do you think would happen to enrollment if they’re not renewed?

Becerra: Well, and that’s the big question. The fact that the president made health care affordable was the big news. Because having the Affordable Care Act was great, but if people still felt it was unaffordable, they wouldn’t sign on. They now know that this is the best deal in town and people are signing up. When you can get health insurance coverage for $10 or less a month in your premiums, that’s a great deal. You can’t even go see a movie at a theater today for under $10. Now, you can get health care coverage for a full month, Julie. Again, as I always tell people, that doesn’t even include the popcorn and the refreshment at the movie theater, and so it’s a big deal. But without the subsidies, some people would still say, “Ah, it’s still too expensive.” So that’s why the president in his budget calls for extending those subsidies permanently.

Rovner: So there are still 10 states that haven’t taken up the federal government’s offer to pay 90% of the costs to expand Medicaid to all low-income adults in their states. I know Mississippi is considering a bill right now. Are there other states that you expect could join them sometime in the near future? Or are any of those 10 states likely to join the other 40?

Becerra: We’re hoping that the other 10 states join the 40 that have come on board where millions of Americans today have coverage. They are forsaking quite a bit of money. I was in North Carolina recently where Gov. [Roy] Cooper successfully navigated the passage of expansion for Medicaid. Not only was he able to help some 600,000-plus North Carolinians get health coverage, but he also got a check for $1.6 billion as a bonus. Not bad.

Rovner: No, not bad at all. So many years into this law, I feel like people now understand a lot of what it did: let adult children stay on their parents’ health plans until the age of 26; banning most preexisting condition exclusions in health coverage. Yet most people still don’t know that those provisions that they support were actually created by Obamacare or even that Obamacare and the Affordable Care Act are the same thing. Medicare has had such great branding success over the years. Why hasn’t the ACA?

Becerra: Actually, Julie, I think that’s changing. Today, about two-thirds of Americans tell you that they support the marketplaces in the Affordable Care Act. I think we’re actually now beginning an era where it’s no longer the big three, where you had Social Security, Medicare, and Medicaid and everyone protects those. Today, I think it’s the big four, the cleanup hitter being marketplace. Today, you would find tens of millions of Americans who would say, “Keep your dirty, stinking hands off of my marketplace.”

Rovner: Well, we will see as that goes forward. Obviously, President Biden was heavily involved in the development of the Affordable Care Act as vice president, as were you as a member of the House Ways and Means Committee at the time. What do you hope is this administration’s biggest legacy to leave to the health law?

Becerra: Julie, I think it’s making it affordable. The president made a commitment when he was first running to be president. He said on health care he was going to make it more affordable for more Americans with better benefits, and that’s what he’s done. The ACA is perfect proof. And Americans are signing up and signaling they agree by the millions. To go from 12 million people on the Affordable Care Act marketplace to 21.5 million in three years, that’s big news.

Rovner: So if I may, one question on another topic. Next week, the Supreme Court’s oral arguments occur in the case it could substantially restrict the availability of the abortion pill mifepristone. Obviously, this is something that’s being handled by the Justice Department, but what is it about this case that worries you most as HHS secretary, about the potential impact if the court rolls back FDA approval to the 2016 regulations?

Becerra: Well, Julie, as you well know from your years of covering health care, today there are Americans who have less protection, fewer rights, than many of us growing up. My daughters, my three daughters today, have fewer protections and access to health care than my wife had when she was their age. That’s not the America most of us know. To see another case where, now, medication abortion, which is used by millions of Americans — in fact, it’s the most common form of care that is received by a woman who needs to have abortion services — that is now at stake. But we believe that if the Supreme Court believes in science and it believes in the facts, because mifepristone has been used safely and effectively publicly for more than 20 years, that we’re going to be fine.

The thing that worries me as much, not just in the reduction of access to care for women in America, is the fact that mifepristone went through a process at the FDA similar to scores and scores of other medications that Americans rely on, that have nothing to do with abortion. And if the process is shut down by the Supreme Court for mifepristone, then it’s probably now at risk for all those other drugs, and therefore those other drugs that Americans rely on for diabetes, for cancer, who knows what, might also be challenged as not having gone through the right process.

Rovner: I know the drug industry is very, very worried about this case and watching it closely, and so will we. Mr. Secretary, thank you so much for joining us.

Becerra: Always good to be with you, Julie.

Rovner: OK, we are back. It’s time for our extra-credit segment. That’s when we each recommend a story we read this week we think you should read, too. As always, don’t worry if you miss it. We will post the links on the podcast page at kffhealthnews.org and in our show notes on your phone or other mobile device. Tami, why don’t you go first this week?

Luhby: OK, my extra credit this week is an article about Georgia’s unique Medicaid program from KFF Health News’ Andy Miller and Renuka Rayasam. It’s titled “Georgia’s Medicaid Work Requirement Costing Taxpayers Millions Despite Low Enrollment.” And I’m really glad they did this story. I and many others wrote about Georgia launching this program initially but haven’t done follow-up. So I was very happy to see this story.

As many of our listeners probably know, the Trump administration allowed multiple states to impose work requirements in Medicaid for the first time in the program’s history in 2018. But the efforts were eventually stopped by the courts in all states except Georgia. Georgia was allowed to proceed with adding its work requirement to Medicaid because it was actually going to expand coverage to allowing adults with incomes up to 100% of the poverty line to qualify. So the Georgia Pathways to Coverage initiative began last June.

Andy and Renuka took a look at how it’s faring, and the answer is actually not so well. Only about 3,500 people have signed up, far short of the 25,000 that the state projected for the first year. What’s more, the program has cost taxpayers at least $26 million so far, with more than 90% of that going towards administrative and consulting costs rather than actual medical care for low-income people.

By contrast, expanding Medicaid under the Affordable Care Act to people with 138% of the poverty line would make at least 359,000 uninsured Georgia residents newly eligible for coverage and reduce state spending by $710 million over two years. That’s what the advocates are pushing. So we’ll see what happens in coming months. One thing that’s also noted in the story is that about 45% of Pathways applications were still waiting to be processed.

Rovner: I will point out that we did talk a couple of weeks ago about the low enrollment in the Georgia program. What we had not seen was how much it’s actually costing the states per enrollee. So it is really good story. Alice, why don’t you go next?

Ollstein: Yeah, so I have some very relatable news from CNN. It’s called “Why Your Doctor’s Office Is Spamming You With Appointment Reminders.” It’s about why we all get so many obnoxious repeat reminders for every medical appointment. It both explains why medical practices that operate on such a tiny profit margin are so anxious about no-shows and last-minute cancellations, and so that’s part of it. But also part of it is that there are all these different systems that don’t communicate with one another. So the prescription drug system and the electronic medical records system and the doctor’s office’s own system are all operating in parallel and not coordinating with one another, and that’s why you get all these annoying multiple reminders. The medical community is becoming aware that it’s backfiring because the more you get, the more you start tuning them out and you don’t pay attention to which ones might be important. So they are working on it. So a somewhat hopeful piece of news.

Rovner: Raise your hand if you have multiple patient portals that you have to deal with for your multiple …

Ollstein: Oh, my God, yes.

Rovner: I will note that everybody’s hands go up. Mac?

Carey: I have not one but two stories on a very important issue: Medicaid estate recovery. The first is from Paula Span at The New York Times. The headline says it all, “When Medicaid Comes After the Family Home.” And the second story is an AP piece by Amanda Seitz, and that’s titled “State Medicaid Offices Target Dead People’s Homes to Recoup Their Health Care Costs.” Now, these stories are both about a program that’s been around since 1993. That’s when Congress mandated Medicaid beneficiaries over the age of 55 that have used long-term care services, and I’m talking about nursing homes or home care, that states must try to recover those expenses from the beneficiaries’ estates after their deaths.

As you can imagine, this might be a problem for the beneficiaries. They might have to sell a family home, try to find other ways to pay a big bill from Medicaid. Rep. Jan Schakowsky, she’s a Democrat of Illinois, has reintroduced her bill. It’s called the Stop Unfair Medicaid Recoveries Act. She’s trying to end the practice. She thinks it’s cruel and harmful, and her argument is, in fact, the federal and state governments spend way more than what they collect, and these collections often go after low-income families that can’t afford the bill anyway.

So even though it’s been around, it’s important to read up on this. A critical point in the stories was do states properly warn people that assets were going to be recovered if they enroll a loved one in Medicaid for long-term care and so on. So great reading, people should bone up on that.

Rovner: This is one of those issues that just keeps resurfacing and doesn’t ever seem to get dealt with. Well, my story this week is from The Washington Post, although I will say it was covered widely in dozens of outlets. It’s called “Arizona Lawmaker Tells Her Abortion Story to Show ‘Reality’ of Restrictions.” On Monday, Arizona State Sen. Eva Birch stood up on the Senate floor and gave a speech unlike anything I have ever seen. She’s a former nurse at a women’s health clinic. She’s also had fertility issues of her own for at least a decade, having both had a miscarriage and an abortion for a nonviable pregnancy in between successfully delivering her two sons.

Now, she’s pregnant again, but with another nonviable pregnancy, which she plans to terminate. Her point in telling her story in public on the Senate floor, she said, was to underscore how cruel — her words — Arizona’s abortion restrictions are. She’s been subject to a waiting period, required to undergo an invasive transvaginal ultrasound to obtain information she and her doctor already knew about her pregnancy, and to listen to a lecture on abortion, quote, “alternatives,” like adoption, which clearly don’t apply in her case.

While she gave the speech on the floor, several of her Democratic colleagues stood in the camera shot behind her, while many of the Republicans reportedly walked out of the chamber. I will link to the story, but I will also link to the entire speech for those who want to hear it.

OK, that is our show. As always, if you enjoy the podcast, you can subscribe wherever you get your podcasts. We’d appreciate it if you left us a review; that helps other people find us, too. Special thanks as always to our technical guru, Francis Ying, and our fill-in editor for today, Stephanie Stapleton. As always, you can email us your comments or questions. We’re at whatthehealth@kff.org, or you can still find me at X, @jrovner, or @julierovner at Bluesky and @julie.rovner at Threads. Mary Agnes, where are you hanging out these days?

Carey: I’m hanging out on X, @MaryAgnesCarey.

Rovner: Alice?

Ollstein: @AliceOllstein on X, and @alicemiranda on Bluesky.

Rovner: Tami?

Luhby: The best place to find me is at cnn.com.

Rovner: There you go. We will be back in your feed next week. Until then, be healthy.

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View the full post Grenada among 7 countries meeting WHO air quality guidelines for 2023 on NOW Grenada.

However, the HC Division bench of Justices Sanjay Dwivedi and Achal Kumar Paliwal clarified that this arrangement and benefit would be given only as a one-time measure and if the students fail to clear the exam, no further benefit would be given to them.

"These applications are allowed to the extent that not only the students, who are before this Court, but other students of unsuited colleges shall be allowed to participate in the examination as set-forth," the bench further added.

These concerned colleges were depicted as 'deficient' in the report of the Central Bureau of Investigation (CBI) submitted in deference to the order of the High Court.

Meanwhile, by filing an interim application, these 'deficient' colleges expressed their grievances regarding the Court order directing the constitution of three-member expert committee and shifting of students of deficient colleges to other colleges with an intent to evade academic loss to the students.

While considering their plea, the HC observed that shifting the students to other colleges would cause them hardship as contended by the intervenor deficient colleges. It had been contended that the students would lose 3-4 years if they were not allowed to participate in the examination.

Also Read: High Court directs State to close 70 Bogus Nursing Colleges

Responding to their pleas, the Court ordered, "We find it but obvious that shifting of students of colleges which cured the defects, would necessarily add to their hardship. Ergo, we modify the order to the extent that the students of colleges enlisted as deficient shall be allowed to participate in the examination. At the same time, the Committee will see whether the colleges have cured the deficiencies to get the recognition and affiliation for future years or not. It is made clear that this order would not only govern the students of deficient colleges categorised by CBI, but would also be available for the colleges which have not come to threshold of this Court so as to truncate the exercise of filing more applications for the same purpose. These applications are accordingly allowed with the above modification in the order dated 13.02.2024."

As per the latest media report by Live Law, previously while considering the pleas challenging the legality of granting recognition and affiliation to nursing colleges in the State, the HC bench had set up a three-member committee headed by Retired Justice Rajendra Kumar Shrivastava. The panel was tasked with supervising the progress of 74 colleges found to be deficient with minimal curable deficiency.

The Central Bureau of Investigation (CBI) inspected 308 colleges out of 364 colleges in compliance with the court order, barring 66 nursing colleges having interim protection from the inspection by the Apex Court. Among these 308 colleges, 65 colleges were found to be 'unsuitable' and 74 colleges were found to possess curable deficiencies. Accordingly, CBI submitted its report in a closed envelope on 17.01.2024.

Previously, the Court on 08.02.2024 had clarified that none of the students who got admitted to these 'unsuitable' colleges were entitled to re-accommodation in other colleges. Back then, the court had reasoned that it was the duty of the students to ensure that the colleges met the minimum standards of medical education by relying on the order in the case of Re Committee of Management Anuragi Devi Degree College & Anr. v. State of Uttar Pradesh & Anr.

Thereafter, the students of these unsuitable colleges filed interim applications before the HC bench and argued that they could not be compared to the graduate students who were aggrieved in the case of Re Committee of Management Anurag Devi.

Agreeing with this argument, the court noted "...these students are not graduates and their mental status cannot be equated with the students who are graduate nor are they come in the circumference of students whom the Supreme Court had repelled to favour."

Modifying its order, the bench granted relief to the students allowing them to appear in the exam and observed,

"Thus, we are of the opinion that the order dated 08.02.2024 is modified to the extent that students of unsuited colleges shall also be permitted to participate in the examination, but this arrangement and benefit would be a one-time-measure and if they do not clear the examination, no further benefit shall be given to them. These applications are allowed to the extent that not only the students, who are before this Court, but other students of unsuited colleges shall be allowed to participate in the examination as set-forth."

In their plea, the students also highlighted that they provided their services in the Government Health Centres during the COVID-19 outbreak. Acknowledging their contribution, the court noted, "On careful consideration of the documents made appendage to this application, it transpires that these students had borne the brunt of the responsibility when regular government staff took to their heels."

Further, the Court modified its previous order mentioning that the regularisation of Session 2023-24 mentioned in the order dated 13.02.2024 year shall be read as Session 2022-23 instead.

Emphasizing that the State Government will have the discretion to determine whether the academic session 2023-2024 must be declared as zero-year or not, the bench ordered, "Albeit, MPMSU has sent such proposal to the State Government but the State Government has not yet acted thereupon and now it is for the State to decide whether declaration of Session 2023-24 as zero-year is proper or not and if yes, then further sessions could be regularised or not. He accentuates that Nursing Council has already given its approval that last date of admission can be extended and as such declaration of zero-year would also cause great loss to the colleges which are otherwise found suitable."

"Thus, we deem it proper to keep the ball in the court of State Government to take decision eitherway on the proposal of MPMSU and accordingly, this court will give its verdict. For the present, Session 2023-24 mentioned in the order dated 13.02.2024 shall be read as Session 2022-23. Thus, we allow the suited colleges to start enrollment of students for the Session 2022-23. The decision with regard to Session 2023-24 shall be taken by this Court after the decision is taken by the State Government on the proposal made by MPMSU," it further mentioned.

Medical Dialogues had reported last year how the Madhya Pradesh Nursing Council, Bhopal had cancelled the affiliation of 19 nursing colleges for several allegations of irregularities including the appointment of fake teachers.

Last year, the CBI submitted its report on the alleged Nursing Colleges scam case to the Gwalior bench of the Madhya Pradesh High Court. Submitting the report, CBI mentioned that 50 per cent of the colleges were found to be operating fraudulently.

Further, the report also contained information about 140 out of 271 Nursing Colleges in the State. Taking note of the report, the HC bench had directed the Indian Nursing Council (INC) to match its data with CBI's data and present its report. Back then, the Court had also warned INC and the officials of medical colleges of an FIR in case of any tampering of data.

The issue of nursing colleges running without adhering to the prescribed norms was earlier being considered by the Gwalior bench of Madhya Pradesh High Court as well. Previously, taking stringent action against such nursing colleges, the Madhya Pradesh HC had directed the State and the Nursing Council to shut down 70 such bogus Nursing Colleges belonging to Gwalior-Chambal region.

To view the latest order by the MP HC, click on the link below:

https://medicaldialogues.in/pdf_upload/madhya-pradesh-high-court-234685.pdf

Also Read: Madhya Pradesh Nursing Council Cancels Affiliation of 19 Nursing Colleges

PAHO and the Korea International Cooperation Agency join forces to improve access to health for migrants in Peru

Cristina Mitchell

20 Mar 2024

Hyderabad: Dr Reddy's Laboratories Ltd., a global pharmaceutical
company, has announced the launch of Versavo (bevacizumab) in the United Kingdom (UK).

Dr Reddy’s
Versavo is a (bevacizumab) biosimilar of Avastin and indicated for the treatment of several types of
cancers, including metastatic colorectal cancer, advanced non-squamous non-small cell lung cancer,
recurrent glioblastoma, metastatic renal cell carcinoma, advanced cervical cancer, ovarian cancer and
metastatic breast cancer.

Bevacizumab is the first antiangiogenic therapy proven to slow metastatic disease progression in patients with cancer. It is a humanized recombinant antibody that targets human vascular endothelial growth factor (VEGF), leading to deterred angiogenesis and tumor growth.

Versavo is the first Dr. Reddy’s biosimilar product to be approved and launched in the UK. It is available
in strengths of 100mg and 400mg single use vials.

Dr Reddy’s launched Versavo in India in 2019. Subsequently, Versavo was introduced in other
markets such as Thailand, Ukraine, Nepal, and Jamaica under the same brand name. In Colombia, the
product was launched under the brand name Persivia.

Dr Jayanth Sridhar, Global Head of Biologics at Dr Reddy’s, said, “The launch of Versavo in a
highly regulated market underscores our capability for global clinical development of high-quality
biosimilar products. Versavo is a potential treatment option for patients with different types of cancers.
This launch reinforces our commitment to bring more biosimilar and other critical biological products to
meet the unmet needs of patients, and strengthens our focus on oncology.”

Established in 1984, Dr Reddy’s Laboratories Ltd. is a global
pharmaceutical company headquartered in Hyderabad, India. Dr Reddys offers a portfolio of products and services
including APIs, generics, branded generics, biosimilars and OTC. Its major therapeutic areas of focus are gastrointestinal,
cardiovascular, diabetology, oncology, pain management and dermatology. Dr Reddys major markets include – USA, India, Russia & CIS
countries, China, Brazil and Europe. 

Read also: Dr. Reddy's gets CDSCO panel Nod To market Omeprazole Delayed-release orally disintegrating tablets

SCREENING TESTS can help find cancer at an early stage, before symptoms appear. When abnormal tissue or cancer is found early, it may be easier to treat or cure. By the time symptoms appear, the cancer may have grown and spread and this can make...

This research was conducted across multiple Canadian rheumatology clinics and enrolled a total of 102 adults with active PsA. They were prescribed apremilast between July 2018 and March 2020 and were followed for 12 months with visits recommended every four months to monitor the progress. The primary outcome measure focused on achieving remission or low disease activity defined by a Clinical Disease Activity Index for Psoriatic Arthritis (cDAPSA) score of 13 or less. 

The results from this study revealed significant improvements in various markers of disease activity despite 44.1% of the patients discontinuing this study within 12 months. Importantly, 63.7%, 67.2%, and 53.8% of patients achieved cDAPSA remission or low disease activity at 4 months, 8 months, and 12 months, respectively.

The patients who continued the study expressed reduced joint inflammation, pain and psoriasis symptoms. Improvement in treatment satisfaction and patient-reported outcomes, including physical and mental well-being, were obvious over the 12-month period. Safety data indicated that apremilast was well-tolerated, with diarrhea, nausea, and migraine being the most common adverse events leading to discontinuation. 

This study expressed positive outcomes of apremilast in real-world settings, by providing patients with effective relief from PsA symptoms and enhancing their overall quality of life. Overall, these findings contribute to the growing body of evidence that support the clinical effectiveness of apremilast in PsA management.

Reference:

Chandran, V., Bessette, L., Thorne, C., Sheriff, M., Rahman, P., Gladman, D. D., Anwar, S., Jelley, J., Gaudreau, A.-J., Chohan, M., & Sampalis, J. S. (2024). Use of Apremilast to Achieve Psoriatic Arthritis Treatment Goals and Satisfaction at 1 Year in the Canadian Real-World APPRAISE Study. In Rheumatology and Therapy (Vol. 11, Issue 2, pp. 443–455). Springer Science and Business Media LLC. https://doi.org/10.1007/s40744-024-00641-w

Santo Domingo.- The Ministry of Public Health (MSP) and the Pan American Health Organization (PAHO) jointly announced the establishment of a toxicological center in the country on Monday. The primary objective of this center is to provide specialized assistance and management for cases of poisoning.

According to a statement released by Public Health, the center will offer information, guidance, and specialized care for diagnosing and treating cases of poisoning. Additionally, it will conduct toxicological laboratory tests, develop programs for poisoning prevention and toxicovigilance, promote research on poisoning prevention and management, and manage mass poisonings by alerting health authorities for prompt decision-making and effective health responses in incidents involving chemical substances.

To initiate this initiative, an inter-institutional commission was formed by the Ministry of Public Health in collaboration with PAHO advisors. This commission analyzed the feasibility of implementing the center.

Health Minister Víctor Atallah met with PAHO representative Alba María Ropero to validate specific details for the immediate commencement of installation work. As part of the preparation process, visits were conducted to pre-selected institutions to assess their physical, technological, and personnel capabilities. This assessment aimed to develop a roadmap and define the stages for the center’s development.

Minister Atallah described the establishment of a poison center as an unprecedented milestone for the country. He emphasized the necessity of having tools to mitigate health damage resulting from various causes, including improper handling of chemicals and food.

Ropero Álvarez underscored the significance of the initiative in reducing poisoning incidents. He noted that toxicological centers have been established across Latin America and the Caribbean to address similar situations of exposure to chemical substances. While a previous attempt was made in the Dominican Republic in 2009, Ropero Álvarez expressed confidence that the current endeavor would succeed.