File folders in a filing cabinet.

Strengthening the Freedom of Information Act in 2023

By Mitchell Berger, MPH

While the Freedom of Information Act (FOIA) (5 U.S.C. § 552) and agency implementing regulations generally are fairly concise, FOIA still has led to considerable litigation.

What is an agency record? Should contractors be covered by FOIA? How and under what circumstances should a given FOIA exemption apply? How should FOIA search and duplication fees be charged by agencies, and what level of fees are reasonable? Debate continues about these and many other issues, but even amidst this debate opportunities abound to support FOIA implementation in the year ahead.

Read More

Bill of Health - Globe and vaccine, covid vaccine

Biotech Companies Are Opening Manufacturing Sites in Africa: Will This Help Vaccine Equity?

By Sarah Gabriele

Two pharmaceutical giants of the pandemic, Moderna and BioNTech, are taking steps for increasing the manufacturing capacity for the COVID-19 vaccine in Africa. Last March, Moderna announced its plan to set up a manufacturing facility in Kenya to produce messenger RNA (mRNA) vaccines, including COVID-19 shots. Similarly, in 2021, BioNTech started planning its own manufacturing plant in Africa, which will be composed of modular shipping containers.

Measures to address global vaccine inequity could not come sooner. As of December 15, 2022, only 34% of the population in Africa has received at least one dose of the COVID-19 vaccine, with Moderna and BioNTech having provided fewer doses compared to Oxford-AstraZeneca and Johnson & Johnson. After failing to successfully deliver vaccines equitably during the first two years of the pandemic, Moderna and BioNTech appear now to be taking steps to shoulder greater responsibility for vaccine equity.

However, if companies are ethically required to address the availability of vaccines, these well-intended efforts might still fail to fulfill their moral obligations. Indeed, while the construction of these new sites might sound like great news for fostering the delivery of vaccines in low- and middle-income countries, we should be aware that these manufacturing sites, as well as the existence of manufacturing capacity, might not be enough to achieve desired outcomes.

Read More

Stethoscope with blue suitcase on a table with American flag as background.

Is a Federal Medical License Constitutional?

By Timothy Bonis

Although three in four doctors support scrapping state medical boards in favor of a single federal license, such sweeping reform is likely far off. It is not just state boards’ political obstructionism standing in the way. Basic constitutional federalism limits Congress’s ability to assume powers traditionally held by the states, leaving medical licensure (a state matter since its 19th-century inception) difficult to federalize.

This post will explore potential constitutional arguments for and against federal licensure, investigate the constitutionality of more moderate legislative approaches, and speculate on how the late Roberts Court might respond to reform attempts.

Read More

Boston, MA, US-June 25, 2022: Protests holding pro-abortion signs at demonstration in response to the Supreme Court ruling overturning Roe v. Wade.

Physician-Led Advocacy for the Future of Reproductive Health Care

By Katie Gu

The American Medical Association (AMA) recently adopted new policies aimed at protecting access to reproductive health care and reducing government interference in medical practice. As the nation’s most prominent professional medical association, the AMA’s unified stance brings a stronger physician-led voice in reproductive health care advocacy in the aftermath of Dobbs v. Jackson Women’s Health Care Organization.   

Read More

Medical armored personnel carrier. Medical cross on the armor of an armored vehicle against the background of the flag of Ukraine at exhibition ARMS AND SECURITY - 2021. Kiev. Ukraine - June 18, 2021.

Sutures for Ukraine: The Medical Case for City Diplomacy

By Vrushab Gowda, Leslie Appleton, and Jesse Ehrenfeld

The war in Ukraine has brought nothing less than an unmitigated humanitarian catastrophe. Health care infrastructure has been deliberately — and systematically — targeted by Russian forces since the very outset of the invasion. Hospitals have been bombed, internal displacement has uprooted providers from their communities, and rail lines have come under sustained bombardment from cruise missiles, hindering the resupply of frontline towns. All of this has exacerbated the demands on an already fragile health care system, which strains to keep up. The Ukrainian people urgently need practical solutions.

Enter city diplomacy. In parallel to official channels of federal aid, American cities can play a decisive role in supporting their Ukrainian counterparts under threat. An “Adopt-a-City” campaign could leverage preexisting ties within a sister cities context (like Los Angeles and Kiev, if approved), which can be bolstered and intensified. Where these relationships do not exist, they can be created. New York could “adopt” Odessa. Atlanta, Kharkiv. Houston, Dnipro.

City departments of health would take center stage throughout all of this. Unlike howitzers, ammunition, electrical grids, and water supplies, medical aid is readily portable across international lines and can be concentrated in urban settings. An “Adopt-a-City” platform would provide a unified vehicle for channeling it, permitting American cities to render material and infrastructural assistance alike.

Read More

see saw with earth as fulcrum and a pile of vaccines weighing down one side with nothing on the other side.

What Happened to the COVID-19 Vaccine Patent Waiver?

By Sarah Gabriele

In June 2022, after almost two years of debate over a potential COVID-19 vaccine patent waiver, the World Trade Organization adopted the Ministerial Decision on the TRIPS Agreement (“WTO Decision”), which provided for a partial waiver of intellectual property rights.

More specifically, the WTO Decision waived patent rights on vaccines and allowed for the use of protected clinical trial data for regulatory approval of vaccines. However, after almost four months since the adoption of the WTO Decision, there is still a large gap in vaccination rates worldwide.

Read More

Pile of envelopes with overdue utility bills on the floor.

The Unfurling Crisis of Unfunded Isolation, Testing, and Treatment of Infectious Disease in the US

By Steven W. Thrasher

For many politicians in the United States, the summer of 2022 was a time of trying not to think about the coronavirus pandemic—though, if they were concerned about the risk that they, their neighbors, and their constituents were facing, they should have been paying very close attention. By August, there were about 500 to 600 COVID deaths a day, accounting for more than a “9/11’s worth” every week, a level of death twice what it had been in the summer of 2021.

But for gay men in the United States, the summer of 2022 was a time of worrying about a whole new viral epidemic: monkeypox. The variant of the MPX orthopoxvirus circulating globally in 2022 has behaved very differently than it had in previous outbreak, acting as a sexually transmitted infection and moving almost exclusively through the bodies of gay men.

Read More

SAINT LOUIS, MO. - August 2, 2021: A protestor holds a sign reading "Evictions Are Violence" at a protest held days after the federal eviction moratorium expired.

U.S. Eviction Policy is Harming Children: The Case for Sustainable Eviction Prevention to Promote Health Equity

By Emily A. Benfer

Without a nationwide commitment to sustainable eviction prevention, the United States will fail the rising number of renter households at risk of eviction. Worse still, the country will set millions of children on the path of long-term scarring and health inequity.

A staggering 14.8% of all children and 28.9% of children in families living below the poverty line experience an eviction by the time they are 15. For children, eviction functions as a major life event that has damaging effects long after they are forced to leave their home. It negatively affects emotional and physical well-being; increases the likelihood of emotional trauma, lead poisoning, and food insecurity; leads to academic decline and delays; and could increase all-cause mortality risk.

Read More

Grassy field with white picket fence encircling it.

Accessing COVID-19 mRNA Vaccines for Research: The Re-emergence of the Tragedy of the ‘Anticommons’

By Aparajita Lath

Some COVID-19 vaccine manufacturers in the US have refused to share vaccine samples for research purposes, creating an access issue with the potential to delay comparator studies, follow-on research, and new vaccine / drug development.

This issue may be the latest example of the tragedy of the “anticommons” in biomedical research.

Read More