red and green silhouette illustration of women having a conversation.

The Not-So-Sacred Human Genome: What South Africans Think About Heritable Human Genome Editing

By Donrich Thaldar

South Africans have issued a clarion call for research to move ahead on health-related applications of heritable human genome editing (HHGE), finds my research group’s new public engagement study — the first of its kind in Africa.

The study engaged a diverse group of 30 South Africans in three evenings of deliberations on the governance of HHGE. The methodology entailed (a) facilitated deliberation between the participants with the aim of finding consensus, although consensus was not forced; and (b) ensuring well-informed deliberations by providing participants with balanced, internationally peer-reviewed information about HHGE and the ethical arguments relating to it. The results of these deliberations are summarized briefly below.

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Person in protective yellow hazmat suit and mask holds pills in hands.

Book Review: ‘The Truth Pill: The Myth of Drug Regulation in India’

By Aparajita Lath

The Truth Pill, authored by Dinesh Thakur and Prashant Reddy, is a monumental work that convincingly shows that drug regulation is but a myth in India.

In their investigative style, the authors explain drug regulation in India through the lens of history, both Indian and global. The book’s combination of history and contemporary issues makes for an immersive and compelling read. It may, however, leave you feeling frightened, given the dysfunctional regulatory system in India and the impact this can have on patients around the world. However, the book not only highlights problems but also offers several well-thought-out and actionable paths to reform.

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FDA approved concept. Rubber stamp with FDA and pills on craft paper. 3d illustration.

Book Review: ‘Drugs and the FDA: Safety, Efficacy, and the Public’s Trust’ by Mikkael A. Sekeres

By Matthew Chun

In Drugs and the FDA: Safety, Efficacy, and the Public’s Trust, oncologist Mikkael A. Sekeres tells a captivating story of how the U.S. Food and Drug Administration became the agency it is today and how it makes some of its toughest decisions regarding the regulation of potent drugs.

Sekeres centers his narrative on the controversial 2011 Avastin hearings, in which the FDA reconsidered and ultimately withdrew the breast cancer indication for Genentech’s Avastin drug. Having served on the Oncologic Drugs Advisory Committee (ODAC) tasked with making a recommendation to the FDA based on the hearings and clinical data, Sekeres provides a relatable personal account of the emotion-filled proceedings and the agonizing decision to withdraw approval of a beloved treatment option that never lived up to its promising initial results.

As he recounts his experience as an ODAC member, Sekeres skillfully weaves in historical references to various regulatory failures, including poisoned vaccines, opioid deaths, thalidomide-induced birth defects, and the woefully inadequate response to HIV/AIDS, which shaped the role of the FDA since its inception in 1930. Upon describing how the FDA developed its modern system of checks and balances to ensure drug safety, efficacy, and accessibility, Sekeres then illustrates how the Avastin hearings put all of these processes and values to the test. Among other things, Drugs and the FDA encourages readers to grapple with several important themes that pervade the agency’s decision-making process, including (1) the tension between drug safety and accessibility, (2) the relative weight of expert opinion versus patient autonomy, and (3) the role of democracy and transparency in drug regulation.

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Blue biohazard sign in front of columns of binary code.

The International Weaponization of Health Data

By Matthew Chun

International collaboration through the sharing of health data is crucial for advancing human health. But it also comes with risks — risks that countries around the world seem increasingly unwilling to take.

On the one hand, the international sharing of health-related data sets has paved the way for important advances such as mapping the human genome, tracking global health outcomes, and fighting the rise of multidrug-resistant superbugs. On the other hand, it can pose serious risks for a nation’s citizens, including re-identification, exploitation of genetic vulnerabilities by foreign parties, and unauthorized data usage. As countries aim to strike a difficult balance between furthering research and protecting national interests, recent trends indicate a shift toward tighter controls that could chill international collaborations.

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Technician holding tube of blood for testing in the research laboratory.

Fighting Diagnostic Discrimination and Stigma in Monkeypox

By Katie Gu

History recently repeated itself when technicians from two major laboratories refused to accept blood samples from patients testing for monkeypox. 

This August, the U.S. saw the largest increase in monkeypox cases in the world. In the midst of a nearly 80% increase in U.S. cases, phlebotomists from Labcorp and Quest Diagnostics reportedly turned away potential monkeypox samples. Such refusals dangerously parallel instances of diagnostic discrimination against HIV/AIDS patients in the 1980s and 1990s. 

Within both eras, such actions have fueled stigma, propagated misinformation, and encouraged scapegoating in the middle of public health crises. 

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Protesters holding signs that read My Body My Choice, Human right, Bans Off Our Bodies, Abortion Is Healthcare.

Dobbs v. Jackson Women’s Health and Its Devastating Implications for Immigrants’ Rights

By Asees Bhasin

While reproductive injustice against immigrants is not new, they are now even more vulnerable to reproductive oppression in light of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization overturning the constitutional right to abortion.

Immigrant reproduction has long been vilified and opposed, with immigrant parents facing accusations of being hyper-fertile and giving birth to “anchor babies.” Additionally, pregnant immigrants have faced additional structural barriers to accessing necessary abortion care. This article explains how these injustices are likely to be exacerbated by the Dobbs ruling.

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Empty hospital bed.

Do No Harm: A Call for Decarceration in Hospitals

By Zainab Ahmed

In an era of mass suffering, some still suffer more than others. What’s worse, there is nothing natural about it. It is human made.

As an emergency medicine resident at a large academic hospital in Los Angeles, I see how incarcerated patients’ suffering is sanctioned by hospitals and medical professionals, despite their pledge to do no harm.

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A stethoscope tied around a pile of cash, with a pill bottle nearby. The pill bottle has cash and pills inside.

We Haven’t ‘Learned the Lessons of COVID’ Until We Remake the Political Economy of Health

By Beatrice Adler-Bolton and Artie Vierkant

Over the course of the pandemic it has been popular to claim that we have “learned lessons from COVID,” as though this plague has spurred a revolution in how we treat illness, debility, and death under capitalism.

Management consulting firm McKinsey, for example, writes that COVID has taught us that “infectious diseases are a whole-of-society issue.” A Yale Medicine bulletin tells us that we successfully learned “everyone is not treated equally, especially in a pandemic.” These bromides reflect the Biden administration’s evaluation of its own efforts; a recent White House report professes to have “successfully put equity at the center of a public health response for the first time in the nation’s history.”

We have learned nothing from COVID. The ongoing death, debility, disability, and immiseration of the pandemic are testament only to a failed political economy that pretends at magnanimity.

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WASHINGTON MAY 21: Pro-choice activists rally to stop states’ abortion bans in front of the Supreme Court in Washington, DC on May 21, 2019.

Restricting Reproductive Rights During the War on Drugs: Intersectional Regimes of Surveillance and Criminalization That Harm Us All

By Taleed El-Sabawi, Jennifer J. Carroll, and Bayla Ostrach

Health law and policy in the United States are, in many senses, driven by a desire to control. When that control is enacted to impose anti-scientific but deeply moralized social norms, suffering always follows. Consider, for example, the decision in Dobbs v. Jackson Women’s Health Organization, which ended a constitutionally recognized right to abortion. This decision allows states to exert near-total control over pregnant people and their bodies — and many are already experiencing physical and emotional harm as a result.

This suffering at the hands of the state is compounded by existing drug law and policies, which also prioritize control over bodies above personal wellbeing and autonomy. Pregnant people who use drugs (including alcohol) are often subject to both of these coercive regimes, facing head-on the harmful synergism between drug criminalization and the criminalization of abortion.

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NEW YORK, NY - MAY 24, 2020: New York Times newspaper with "U.S. Deaths Near 100,000, An Incalculable Loss" front-page article delivered to front door in Manhattan.

Pandemic Nihilism, Social Murder, and the Banality of Evil

­­By Nate Holdren

Lire en français.

Every day in the pandemic, many people’s lives end, and others are made irrevocably worse.[1]

These daily losses matter inestimably at a human level, yet they do not matter in any meaningful way at all to the public and private institutions that govern our lives. Our suffering is inconsequential to the machinery of power and to those who compose and operate that machinery. This has been the case all along, but in this phase of the pandemic, our suffering has been nihilistically recast as not just inconsequential, but inevitable by the administration and the voices it has cultivated as its proxies. Consider, for example, White House Press Secretary Karine Jean-Pierre’s remarks during President Biden’s July 2022 COVID-19 infection: “As we have said, almost everyone is going to get COVID.”

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