President Joe Biden on Wednesday signed an executive order that the White House said would protect access to abortion care, part of the continuing fallout from a June Supreme Court reversal of its landmark 1973 ruling establishing a right to abortion.

With each of the 50 states now free to write abortion laws as it sees fit, an early test came Tuesday when voters in the Midwestern state of Kansas voted decisively to keep that state’s right to abortion. But several states now outlaw the practice, sometimes even in the case of rape or incest.

“This is just extreme,” Biden said before signing the order, which aims to help people seeking abortions travel to a state where it remains legal. “You know, even the life of the mother is in question in some case — in some states.

“Republicans in Congress and their extreme MAGA ideology are determined to go even further, talking about nationwide bans that would outlaw abortion in every state, under every circumstance, going after the broader right to privacy as well. But as I said before, this fight is not over. And we saw that last night in Kansas.”

This was the second abortion-related executive order that Biden had signed since the Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision. The first executive order, last month, aimed to guarantee access to emergency contraception and abortion medication.

Critics said these White House actions were too vague, and too slow.

“What we’re seeing is the federal government figuring out how they can support abortion patients without violating federal law,” said Elizabeth Nash, state policy analyst at the Guttmacher Institute, a research and policy organization that supports abortion rights.

“And so that’s why some of this is so piecemeal,” she said. “And we’re seeing what agencies are going to come up with. And frankly, this is the sort of announcement that we really needed to hear right when Dobbs came down. And so I’m hoping that these agencies can be kick-started into action so that they can catch up. Because we are seeing states ban abortion.”

On Wednesday, White House press secretary Karine Jean-Pierre said the Biden administration is working as fast as it can, but “there’s steps and processes that we have to take in order to take actions as big as these.

“But look, there has been an urgency from this president from day one when — when the Supreme Court made this extreme decision to take away a constitutional right,” she said.

Thirteen states immediately banned abortion right after the Supreme Court ruling. In the coming months, four states — California, Kentucky, Michigan and Vermont — will vote on abortion, as Kansas did.

Kansans on Tuesday voted in large numbers, and nearly 59% voted against a proposal to amend the state constitution to remove abortion protections. In this respect, the conservative state echoed national trends: A recent Pew poll found that 61% of U.S. adults say abortion should be legal in all or most cases.

Anti-abortion groups decried the Kansas vote and Biden’s actions.

“Biden and the Democrats make a serious error in assuming Americans nationwide agree with their radical agenda — using the full weight of the federal government to impose abortion on demand up to the moment of birth, illegally forcing taxpayers to fund it, ‘cracking down’ on nonprofits that provide life-affirming alternatives, and threatening to destroy any guardrails of democracy that stand in their way,” said Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America.

No state allows abortion at birth. Most abortions — about 91% of them — happen before the 13-week mark, said the U.S. Centers for Disease Control and Prevention.

Research from the Kaiser Family Foundation found that abortions at or after 21 weeks of pregnancy represent just 1% of all U.S. abortions. Those cases, it said, are often the result of serious health risks to the fetus or the pregnant person.

Since the ruling, Biden and Vice President Kamala Harris have urged Congress to enshrine abortion access into federal law. Harris has spent the past few weeks crisscrossing the country to speak about the issue with legislators, health care providers, faith leaders and others.

She said the Biden administration’s policy is clear.

“We trust the judgment of the women of America to make decisions based on what they know is in their best interests,” she said.

“We trust the women of America to make those decisions, if she chooses, in consultation with her faith leader, with her physician, with her loved one. But we understand fully the government should not be making that decision for her.”
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Two invasive species — the brown tree snake and the American bullfrog — cost the world more than $16 billion between 1986 and 2020, according to a study. 

Researchers say the already-hefty price tag should be seen as a lower limit on the true cost of invasive reptiles and amphibians, especially in under-studied regions such as Africa and South America. The study results were published in the online journal Scientific Reports. 

Invasive species are animals, plants or other living things that aren’t native to the places where they live and damage their new environments. Humans spread many of the more than 340 invasive reptile and amphibian species — as stowaways in cargo or through the exotic pet trade, for instance. 

Invasive reptiles and amphibians can damage crops, destroy infrastructure, spread disease and upset ecosystems. The damage is costly, but scientists still don’t fully understand the extent of the economic impact wrought by invasive species. 

For the study, biologist and study author Ismael Soto of the University of South Bohemia, and Ceske Budejovice in the Czech Republic, and his colleagues, estimated the global cost of invasive reptiles and amphibians using a database called InvaCost. The database collects the results of thousands of studies, reports and other documents produced by scientists, governments and non-governmental organizations. 

The data revealed that invasive reptiles and amphibians have cost at least $17 billion worldwide between 1986 and 2020.  

“But this cost mostly focused on two species — the brown tree snake [and] the American bullfrog,” Soto told VOA in an interview via Zoom. “But there are almost 300 invasive species of reptiles [and] amphibians. So, this means that our cost is really underestimated.”  

The two species have received a disproportionate amount of attention from researchers, said economist Shana McDermott of Trinity University, who was not involved in the study. 

“When you talk about invasives, people immediately will probably say, ‘Oh, the brown tree snake,’ just because its impacts are so wide-ranging,” she said via Zoom. “It’s got ecosystem biodiversity impacts. It’s got impacts to human health — it sends people to the hospital every year with bites. It takes down energy infrastructure. … And so, of course, people are like, ‘Oh God! That’s an incredibly dangerous invasive! Let’s understand it better.'”  

The research bias toward a few well-known species also skews the distribution of costs worldwide. For instance, 99.6% of the $10.4 billion in costs from reptile invasions were in Oceania and the Pacific Islands, largely reflecting damage dealt by the brown tree snake in Hawaii, Guam and Northern Mariana Islands. Likewise, most damage from amphibians was in Europe.  

But that doesn’t mean invasive reptiles and amphibians aren’t problematic elsewhere. Soto said there are many invasive amphibians in Africa, but their costs probably haven’t been quantified.  

“There’s not enough research in these countries [to] detect the economic costs,” he said. 

Soto also noted that the current cost estimate only includes costs that are easily quantified. Destroyed crops or property are easier to count than reduced quality of life or indirect damage to human health and assigning dollar values to ecological damage is trickier still, McDermott said. 

“We’re still in this very early stage of trying to understand the economic costs, and trying to understand how invasive species impact ecosystems, how they impact people’s quality of life,” she said, adding that she wants to include the price of biodiversity losses in future cost estimates. 

Soto and McDermott agreed that future studies should not only quantify the costs of more species in more regions but also project how the costs will evolve with time, especially as climate change continues to facilitate the spread of more invasive species. 

“There is a lot still left to be determined. … I do think that quantifying it is the first step, though,” said McDermott. “Unless you can put a dollar value on it, unfortunately, you don’t get [policymakers’] attention for policy. So, this is an incredibly important topic. … We really shouldn’t be waiting on more studies to act.” 

 
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A bill enhancing health care and disability benefits for millions of veterans exposed to toxic burn pits won final approval in the Senate on Tuesday, ending a brief stalemate over the measure that had infuriated advocates and inspired some to camp outside the Capitol.

The Senate approved the bill by a vote of 86-11. It now goes to President Joe Biden’s desk to be signed into law. Biden described the legislation as the biggest expansion of benefits for service-connected health issues in 30 years and the largest single bill ever to comprehensively address exposure to burn pits.

“I look forward to signing this bill, so that veterans and their families and caregivers impacted by toxic exposures finally get the benefits and comprehensive health care they earned and deserve,” Biden said.

The Senate had overwhelming approved the legislation back in June, but a do-over was required to make a technical fix. That process derailed when Republicans made a late attempt to change another aspect of the bill last week and blocked it from advancing.

The abrupt delay outraged veterans groups and advocates, including comedian Jon Stewart. It also placed GOP senators in the uncomfortable position of delaying the top legislative priority of service organizations this session of Congress.

A group of veterans and their families have been camping out at the Capitol since that vote. They had endured thunderstorms and Washington’s notorious summer humidity, but they were in the galleries as senators cast their votes.

“You can go home knowing the good and great thing you have done and accomplished for the United States of America,” Senate Majority Leader Chuck Schumer told them.

The legislation expands access to health care through the Department of Veterans Affairs for millions who served near burn pits. It also directs the VA to presume that certain respiratory illnesses and cancers were related to burn pit exposure, allowing veterans to obtain disability payments to compensate for their injury without having to prove the illness was a result of their service.

Roughly 70% of disability claims related to burn pit exposure are denied by the VA due to lack of evidence, scientific data and information from the Defense Department.

The military used burn pits to dispose of such things as chemicals, cans, tires, plastics and medical and human waste.

Hundreds of thousands of Vietnam War era veterans and survivors also stand to benefit from the legislation. The bill adds hypertension, or high blood pressure, as a presumptive disease associated with Agent Orange exposure.

The Congressional Budget Office projected that about 600,000 of 1.6 million living Vietnam vets would be eligible for increased compensation, though only about half would have severe enough diagnoses to warrant more compensation.

Also, veterans who served in Thailand, Cambodia, Laos, Guam, American Samoa and Johnston Atoll will be presumed to have been exposed to Agent Orange. That’s another 50,000 veterans and survivors of deceased veterans who would get compensation for illnesses presumed to have been caused by their exposure to the herbicide, the CBO projected.

The bill is projected to increase federal deficits by about $277 billion over 10 years.

The bill has been a years-long effort begun by veterans and their families after they had returned from the fighting in Iraq and Afghanistan and experienced maladies that they suspected were caused by their close proximity to burn pits. It was named after Sgt. First Class Heath Robinson from Ohio, who died in 2020 from cancer he attributed to prolonged exposure to burn pits. His widow, Danielle Robinson, was first lady Jill Biden’s guest at the president’s State of the Union address earlier this year.

Stewart, the former host of Comedy Central’s The Daily Show, also brought increased exposure to the burn pit maladies veterans were facing. He also was in the gallery watching the vote Tuesday. He wept and held his head in his hand as the final vote began.

“I’m not sure I’ve ever seen a situation where people who have already given so much had to fight so hard to get so little,” he said after the vote. “And I hope we learn a lesson.”

The House was the first to act on the burn pits legislation. An earlier version the House approved in March was expected to increase spending by more than $320 billion over 10 years, but senators trimmed some of the costs early on by phasing in certain benefit enhancements. They also added funds for staffing to help the VA keep up with the expected increase in demand for health care and an increase in disability claims.

Some GOP senators are still concerned that the bill will increase delays at the VA because of an increased demand for veterans seeking care or disability compensation.

“What we have learned is that the VA cannot deliver what is promised because it does not have the capacity to handle the increase,” said Sen. Marsha Blackburn, R-Tenn.

Sens. Jon Tester, D-Mont., and Jerry Moran, R-Kan., led the effort to get the bill passed in the Senate. After passage, Tester told reporters he received a call from Biden, thanking him for “taking a big weight” off his shoulder.

Moran said that when the bill failed to pass last week, he was disappointed but remembered the strength of the protesters who had sat outside in the scorching heat for days.

“Thanks to the United States Senate for demonstrating when there’s something good and a good cause, this place still works,” Moran said. 
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The United States sued Idaho on Tuesday over a state law that it says imposes a “near-absolute ban” on abortion and also sought to block the Western state from prosecuting or disciplining doctors, according to a court filing.

The lawsuit, filed in U.S. District Court for Idaho, seeks a preliminary and permanent injunction against the state prohibiting enforcement of the law and asked the court to rule that the state law violates federal statutes.

The lawsuit also alleges the state law interferes with the United States’ pre-existing agreements with hospitals under Medicare, referring to the federal health care program for seniors.

“Today, the Justice Department’s message is clear … if a patient comes into the emergency room with a medical emergency jeopardizing the patient’s life or health, the hospital must provide the treatment necessary to stabilize that patient,” U.S. Attorney General Merrick Garland said at a news conference in Washington announcing the filing.

“This includes abortion, when that is the necessary treatment,” Garland added.

Tuesday’s lawsuit marks the Justice Department’s first legal battle over reproductive rights since the Supreme Court in June overturned the landmark 1973 Roe v. Wade ruling that recognized women’s constitutional right to abortion.

Idaho in March became the first state to enact a six-week abortion ban modeled on a Texas law that empowers private citizens to sue abortion providers. The law bans abortion before many women know they are pregnant.
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India is accelerating action against the monkeypox virus after reporting its first death due to monkeypox in the southern state of Kerala, that of a 22-year-old man who had recently returned from the United Arab Emirates.

The death of the young man is the first due to monkeypox in Asia, where several countries have reported outbreaks of the viral infection that has been declared a global public health emergency by the World Health Organization.

Kerala health authorities announced the death on Monday after it was confirmed that the man had monkeypox. He had died in a hospital on Saturday, about a week after returning from the UAE, where his family said he had tested positive for the infection. By the time doctors were informed, he was already critical.

Samples from the man that were tested in India also detected the virus, according to Kerala Health Minister, Veena George.

This is the fourth monkeypox death reported globally outside Africa. So far there have been two monkeypox related fatalities in Spain and one in Brazil.

Kerala health authorities said that about 20 persons, who had been in contact with the 22-year-old, are being monitored. Passengers who were on the flight with him from UAE to Kerala have also been contacted and authorities have urged people with symptoms to inform doctors.

After the death was reported in Kerala, the federal government said it is setting up a task force to monitor the outbreak in the country.

Fifteen laboratories have been designated to diagnose monkeypox while some states, including the capital, New Delhi, have set up isolation wards.

India has so far detected six cases of the viral disease – four in Kerala and two in New Delhi.

Meanwhile the government has invited domestic vaccine makers to consider making shots against monkeypox after the country reported some cases of infection.

The Indian Council of Medical Research, the federal medical research organization, said last week that it is willing to share the monkeypox virus strain it has isolated to aid the process of developing a vaccine. India is a major vaccine producer.

Vaccines already exist for monkeypox, including those used to eradicate smallpox. Experts have said that unlike COVID 19, mass vaccinations against monkey pox will not be necessary.

Monkeypox, which was first discovered in a monkey, is related to the smallpox virus, which was eradicated in 1980, but is far less severe.

The disease has been found in more than 70 countries where it is not endemic. According to The U.S. Centers for Disease Control and Prevention more than 23,000 monkeypox cases have been detected since January in these countries.

In a statement last week, the World Health Organization’s regional director in South East Asia, Poonam K. Singh, said the risk of a monkeypox outbreak in the region was “moderate but the potential of its further international spread is real.” She said that “We need to stay alert and be prepared to roll out an intense response to curtail the spread of monkeypox.”
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The public health response to the outbreak of monkeypox in the United States has so far failed to prevent significant community spread of the disease, leading to a call for a reassessment of the strategy for containing it.

Since the first reported U.S. case of the outbreak on May 17, the number of infections has soared to more than 5,000, with the majority found among men who have sex with men.

Although reporting of case numbers is scattered across different agencies, the U.S. appears to account for more than 25% of global cases identified during the current outbreak, which the World Health Organization has identified as a “public health emergency of international concern.”

‘You have to act fast’

Infectious disease experts have been dismayed by what they saw as a lack of urgency on the part of U.S. public health agencies in the early weeks of the outbreak.

“What I expected to see would have been a more vigorous kind of a response based on lessons that we’ve learned from … COVID-19, as well as lessons we’ve learned from the HIV response,” Dr. Wafaa El-Sadr, founder and director of ICAP at Columbia University Mailman School of Public Health, told VOA.

“When you have an outbreak, the most important thing is you have to act fast, you have to mobilize, and … you have to rally all your assets to work together really quickly to be able to do what’s needed,” El-Sadr said.

Facing criticism at the end of June, the White House announced what it called the “first phase” of a national monkeypox vaccine strategy designed to “help immediately address the spread of the virus by providing vaccines across the country to individuals at high risk.” The administration said that it would “rapidly deploy vaccines in the most affected communities and mitigate the spread of the disease.”

Similar to smallpox

The monkeypox virus comes from the same family as the deadly smallpox virus, but infections with the disease tend to be far less severe and are rarely fatal.

The disease typically presents with a fever and body aches, followed by the eruption of skin lesions, which can occur all over the body but which are often found on the face and hands.

Though the disease is rarely fatal, the skin lesions can cause severe pain lingering over several weeks.

International scope

According to data collected by the World Health Organization, diagnosed new cases of monkeypox have been concentrated in Europe and North America during the latest outbreak, with more than 14,000 reported in the WHO’s European Region and nearly 6,800 in North America.

By contrast, there are far fewer cases in other regions tracked by WHO. The agency’s African Region has reported only 328 cases, and numbers are far lower in the Western Pacific Region (65), the Eastern Mediterranean Region (26) and the South-East Asia Region (6.)

It should be noted that case numbers are affected by countries’ capacity to test and report active cases of monkeypox, meaning that in some developing countries, the numbers reported to the WHO may represent an undercount.

More manageable than COVID

Monkeypox is the sort of disease that the U.S. public health infrastructure ought to be able to combat effectively.

First, because it spreads primarily through close skin-to-skin contact, it is far less contagious than the virus that causes COVID-19, which can be transmitted through the air.

In addition, effective tests to diagnose the disease are available, as is a vaccine to prevent infection. There is also a highly effective treatment available for infected people.

However, the public health response in the U.S. has so far failed to take full advantage of the opportunity to counter monkeypox.

In a July 15 letter to senior public health officials, including Secretary of Health and Human Services Xavier Beccera and CDC Director Rochelle Walensky, a group of physicians and activists complained, “Multiple unnecessary regulatory barriers to treatments, diagnostics, and vaccines have prevented people in the United States from accessing medical countermeasures necessary to protecting their health, allowing the continued spread of monkeypox virus.”

Delays and confusion

While tests exist that can reliably identify cases of monkeypox, in the early weeks of the outbreak only labs affiliated with the Centers for Disease Control were authorized to administer them, creating significant backlogs in testing. They have since been made available to several large commercial laboratory chains, but the initial delay may have contributed to the early spread of the disease.

Even though there is an effective vaccine against monkeypox, U.S. officials failed to order new doses to add to the country’s limited stockpile until June, the month after the disease began spreading. In addition, U.S. regulators did not approve the use of a facility in Denmark, where the vaccine is manufactured, until the middle of July.

While the medication tecovirimat is known to be highly effective against smallpox and has shown success against monkeypox as well, at the beginning of the outbreak, the CDC required doctors to go through an onerous application process for each patient, greatly slowing the distribution of the medication.

‘Public health failure’

In a blistering op-ed published in the New York Times on Saturday, former Food and Drug Administration commissioner Dr. Scott Gottlieb wrote, “Our country’s response to monkeypox has been plagued by the same shortcomings we had with Covid-19. Now if monkeypox gains a permanent foothold in the United States and becomes an endemic virus that joins our circulating repertoire of pathogens, it will be one of the worst public health failures in modern times not only because of the pain and peril of the disease but also because it was so avoidable.”

He continued, “Our lapses extend beyond political decision making to the agencies tasked with protecting us from these threats. We don’t have a federal infrastructure capable of dealing with these emergencies.”

CDC Director Rochelle Walensky has challenged criticisms from Gottlieb in the past. Earlier in July, she said in a statement to CNN, “It is true that we have work to do — here and internationally — and are likely to see more monkeypox cases in the near term, but it is possible to significantly decrease the number of cases and contain the current monkeypox outbreak through education and increased testing and access to vaccines – all priorities we’ve made dramatic progress on.”

The CDC has launched an effort to support case identification and contact tracing nationwide, as well as support for testing and “case confirmation.” In addition, the agency has expanded outreach to medical professionals to help them identify cases of monkeypox and has expanded its efforts to communicate information about the disease to the public, particularly to the populations most at risk.

CDC researchers are also investigating the nature of the disease, including precisely how it is transmitted and what course the illness typically takes once a person is infected.

At a global level, the CDC reports that it is sharing information with other countries to help coordinate a global response to the virus. This includes close cooperation with the government of Nigeria in an effort to sequence the DNA of the virus, in order to better understand its evolution.

Window is closing

El-Sadr, of Columbia University, told VOA that while she is concerned about the response to the disease this far, she believes there is still an opportunity to bring it under control.

“We have enough tools already,” she said. “If we could just mobilize and communicate and utilize those tools, I think we have a shot at stopping this outbreak. But the window of opportunity closes very fast when it comes to outbreaks and that’s the reason why there’s a profound need for urgency.”

Failure, she said, could leave the U.S. facing the prospect of monkeypox becoming endemic in the country, meaning that it would persist at a fixed level in the country even if no additional infected people arrive from other countries.
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New York City Mayor Eric Adams declared a state of emergency Monday over the spread of monkeypox.

“This order will bolster our existing efforts to educate, vaccinate, test, and treat as many New Yorkers as possible and ensure a whole-of-government response to this outbreak,” Adams said in a statement released with the executive order.

The order allows Adams to suspend local laws and temporarily impose new rules to control the spread of the outbreak.

Similarly, Gov. Kathy Hochul declared a state disaster emergency last Friday. She previously announced that over the next four to six weeks, the federal government would distribute 110,000 vaccine doses to the state in addition to the 60,000 already distributed.

As of Monday, New York City has reported 1,472 cases, according to monkeypox data on the NYC Health website. Most cases worldwide have affected men who have sex with men.

In an announcement Saturday declaring a public health emergency in the city, Adams and Health Commissioner Ashwin Vasan estimated that about 150,000 New Yorkers may be at risk of monkeypox infection.

Cases are continuing to rise across the country. New York currently has the highest number of recorded monkeypox cases among the 50 states, followed by California with 799 cases as of Friday, the CDC reports. San Francisco Mayor London Breed declared a state of emergency on Thursday.

Though California has distributed more than 25,000 vaccine doses, Gov. Gavin Newsom said in a KTVU-TV interview last week that the state is “not even close to where we need to be.”

The rapid spread of monkeypox worldwide has sparked alarm over the past few months. Since May, more than 22,000 cases have been reported in 80 countries, despite the virus naturally occurring only in Central and West Africa.

The World Health Organization declared a global health emergency over monkeypox on July 23.
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