The Biden administration is preparing for a worst-case scenario if a conservative federal judge rules in favor of a lawsuit seeking to restrict access to one of the two drugs typically used to induce a medicated abortion.

Two drugs, mifepristone and misoprostol, can be taken by women at home and are used for just over half of U.S. abortions. But that could be quickly changed by a lawsuit filed by an anti-abortion group in Texas that claims the Food and Drug Administration wrongly approved mifepristone for use more than 23 years ago.

The case is before a federal judge appointed by former President Donald Trump. A ruling in favor of the abortion opponents could immediately shut down the sale of the drug, but women would still have access to medicated abortions with a regimen of misoprostol.

Vice President Kamala Harris promised on Friday that the White House would push back on efforts to ban the drug, as she gathered a group of nearly a dozen doctors and abortion rights advocates to discuss a plan for responding to the looming threat to access to medical abortions.

“There are now partisan and political attacks attempting to question the legitimacy of a group of scientists and doctors who have studied the significance of this drug,” Harris said. “There is now an attempt by politicians to remove it from the ability of doctors to prescribe and the ability of people to receive.”

The lawsuit against mifepristone was filed by the Alliance for Defending Freedom, which was also involved in the Mississippi case that led to Roe v. Wade being overturned. It’s the latest fallout in the struggle over reproductive care that the Democratic administration must grapple with since the Supreme Court overturned the constitutional right to an abortion last year.

Harris did not publicly lay out how the administration plans to respond if a ruling that halts the sale of the drug nationwide comes down on Friday.

‘Medication abortion is not going away’

Health and Human Services Secretary Xavier Becerra, meanwhile, was in California on Friday to meet leaders from Planned Parenthood to talk about access to the abortion drugs.

Dr. Kristyn Brandi said she told the vice president on Friday that the ruling could trigger widespread confusion over the accessibility of medicated abortion in the U.S. Brandi, who is chair of the Physicians for Reproductive Health, said she already fields calls at her New Jersey clinic from women asking if medicated abortion is legal in the state.

“It’s a really important thing to communicate with people: medication abortion is not going away,” Brandi said.

She added that Harris expressed support for immediately challenging the ruling if it shuts down access to mifepristone.

Clinics and telehealth providers have been preparing for a ruling that shuts down access to mifepristone, ordering more doses of misoprostol so they can offer medication abortions with just that one drug. They will have to change the way they counsel patients, telling them that misoprostol-only abortions are slightly less effective and sometimes more painful than abortions done with both drugs.

Abortions using both drugs “can be as effective as 98% or more,” while misoprostol-only abortions are up to about 95% effective, Melissa Grant, chief operating officer of the Carafem abortion clinic, told The Associated Press.

Mifepristone dilates the cervix and blocks the action of the hormone progesterone, which enables a pregnancy to continue. Misoprostol causes contractions that empty the uterus. Typically, mifepristone is taken by mouth first, followed by misoprostol a day or two later.

Studies show medication abortions are safe and effective, though with a slightly lower success rate than ones done by procedure in a clinic.

Another lawsuit filed

With the Texas decision pending, a dozen Democratic-controlled states filed their own lawsuit in federal court against the FDA on Thursday in Washington. The lawsuit seeks to make it easier for woman to access the drug and alleges that several FDA requirements for prescribing and dispensing it are “burdensome, harmful and unnecessary.”

When the FDA approved mifepristone in 2000 it placed several safety restrictions on its use, including limiting dispensing to specialty clinics and requiring women to pick up the drug in person. The Biden administration had sought to expand access to medicated abortions in light of the Supreme Court’s ruling, with an FDA announcement this year that broadened the pill’s access through retail and mail-order pharmacies.

But several limitations remain, such as one that doctors must be specially certified to prescribe the drug.

Several medical groups have long opposed those requirements, pointing to the low rate of side effects seen with mifepristone compared with other medications that don’t carry any certification requirements.
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The trickle-down effects of Russia’s war in Ukraine are still being felt on food prices in vulnerable places, nearly one year after Moscow invaded the neighboring country.
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Federal wildlife officials on Wednesday announced a proposal to classify one of two dwindling California spotted owl populations as endangered after a lawsuit by conservation groups required the government to reassess a Trump administration decision not to protect the brown and white birds.

The U.S. Fish and Wildlife Service proposed that California spotted owls that have their habitats in coastal and Southern California be protected under the Endangered Species Act.

That population “does not have a strong ability to withstand normal variations in environmental conditions, persist through catastrophic events, or adapt to new environmental conditions throughout its range,” which led the agency to propose listing it as endangered, wildlife officials said.

The other California spotted owl population, which lives in Sierra Nevada forests in California and western Nevada, would be classified as threatened, the agency said.

The habitat of the medium-sized brown owl with white spots on its head and chest and a barred tail is under serious threat from current logging practices and climate change, including increased drought, disease and more extreme wildfires.

Most California spotted owls live on land overseen by the Bureau of Land Management and the U.S. Forest Service.

How much the population has declined since conservation groups started their effort to protect it more than 20 years ago is unclear.

The only available demographic data on spotted owls living in coastal and Southern California was collected in San Bernardino National Forest and shows a decline of 9%, the federal wildlife service said.

The Sierra Nevada population shows declines ranging from 50% to 31% percent in some areas, the agency said.

The federal agency’s decision follows an agreement reached in November between the U.S. Fish and Wildlife Service and several conservation groups that sued the federal agency in 2020 over its decision not to protect the California spotted owl population.

Justin Augustine, a senior attorney at the Center for Biological Diversity, one of the groups that sued, applauded the agency’s decision and said he was happy to see the California spotted owls could finally get the safeguards they need.

Augustine said he planned to use the 60-day public comment period to push for more protections for the California spotted population in the Sierra Nevada.

“One of the things I’ll be addressing is the issue of how to make sure that (Sierra Nevada) spotted owls are actually protected under their threatened status rather than potentially allowing some logging to occur that would be harmful,” he said.

The California spotted owl is one of three spotted owl subspecies and the last to be protected under the Endangered Species Act, Augustine said.

The other two subspecies are the northern spotted owl and the Mexican spotted owl.

The northern spotted owl habitat is in Oregon, Washington state and Northern California. The tiny owl was listed as threatened under the Endangered Species Act in 1990, sparking an intense battle over logging in the region. In 2020, the Trump Administration refused to upgrade it to endangered status despite losing nearly 4% of its population annually.

The Mexican spotted owl was first listed as threatened in the U.S. in 1993. It is found in Arizona, New Mexico, Colorado, Utah, parts of West Texas and Mexico.

The species is in danger of extinction due to lose of habitat to logging, development, mining and wildfires.
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A new report by four leading United Nations agencies and the World Bank estimates every two minutes, one woman dies during pregnancy or childbirth, mostly from preventable causes.

The report, “Trends in maternal mortality 2000 to 2020,” was produced by WHO, UNICEF, and the UNFPA, along with the World Bank Group and UNDESA/Population Division.

Health officials say the data presented in the report should be a wakeup call for world leaders to take action to end maternal deaths by investing in health care systems and closing the widening social and economic inequities that contribute to these deaths.

“While pregnancy should be a time of immense hope and a positive experience for all women, it is tragically still a shockingly dangerous experience for millions around the world,” said Tedros Adhanom Ghebreyesus, the World Health Organization’s director-general.

“These new statistics reveal the urgent need to ensure every woman and girl has access to critical health services before, during and after childbirth,” he said, “And that they can fully exercise their reproductive rights.”

The report finds an estimated 287,000 women around the world died from a maternal cause in 2020.  That is equivalent to 800 deaths a day, or one death every two minutes.

“These numbers show persistent inequities between countries which are undermining women’s rights.,” said Anshu Banerjee, assistant director general for universal health coverage at WHO. 

“There is over a hundred-fold risk of dying depending on where a woman delivers her baby, particularly in low-income countries compared to high income countries,” he said.

The statistics bear this out. While some significant progress in reducing maternal deaths was made between 2000 and 2015, the report notes this progress has largely stalled, and in some cases been reversed.

For example, between 2016 and 2020, it says the maternal mortality rate increased in Europe, Northern America, Latin America and the Caribbean.

While the number of deaths has gone up, the report says the regions have among the lowest maternal mortality rates in the world.

During this same period, the report says two regions, Australia and New Zealand, and Central and Southern Asia, reduced maternal deaths significantly. The picture is quite different in sub-Saharan Africa, which has the highest rate of maternal mortality, accounting for 70 percent of maternal deaths worldwide.

Jenny Cresswell, an epidemiologist at WHO and author of the report, said the maternal mortality ratio per 100,000 live births in sub-Saharan Africa in 2020 is estimated to be 545 maternal deaths for every 100,000 live births.

“This number is 136 times bigger than MMR (maternal mortality ratio) in Australia and New Zealand, the lowest region,” Cresswell said.

She adds, “A 15-year-old girl in Chad in 2020 has a one in 15 chance of dying from a maternal cause during her lifetime, and that is 4,000 times greater than the probability in Belarus.”

In 2020, Belarus had one MMR per 100,000 live births compared to Chad, which had 1,063 MMRs per 100,000 live births.

Leading causes

The leading causes of maternal deaths include severe bleeding, high blood pressure, pregnancy-related infections, complications from unsafe abortions, and underlying conditions such as HIV/AIDS and malaria.

Banerjee said nearly all these maternal deaths are preventable.

“Nearly half of all pregnancies are unintended, which is highlighting the lack of access of some 270 million women globally to modern family planning methods —meaning they are unable to choose how and when to plan their families,” he says.” Many lack access to safe abortion, which increases risk of complications, including deaths associated with unsafe procedures,” said Banerjee.

Natalia Kanem, executive director of the U.N. Population Fund, said it is unacceptable that so many women continue to die needlessly during pregnancy and childbirth.

She said, “We can and must do better by urgently investing in family planning and filling the global shortage of 900,000 midwives so that every woman can get the lifesaving care she needs. 

“We have the tools, knowledge, and resources to end preventable maternal deaths,” she said. “What we need now is the political will.”
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To address the relatively high cost of health care in Africa, a Kenyan mobile application lets users pay for medical services by selling their personal data through blockchain technology. Officials say Snark Health’s Hippocratic Coins have attracted more than 300 doctors and 4,000 users.  Victoria Amunga reports from Nairobi, Kenya. Camera: Jimmy Makhulo.
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An organization that trains young people for conservation jobs is recycling dead trees and replacing them with new ones, salvaging valuable lumber in the process. Mike O’Sullivan reports from Long Beach, California.
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A controversial Chinese biophysicist, who had been imprisoned after creating the world’s first gene-edited babies, had his Hong Kong work visa revoked after immigration officials suspected he lied on an application form for a talent scheme.

He Jiankui, who sparked an international scientific and ethical debate in 2018 when he revealed he had created the world’s first “gene-edited” babies resistant to HIV, said at the time at an international conference in Hong Kong that he had modified two embryos before they were placed in their mother’s womb.

The scientist said he used a technology known as CRISPR-Cas9 to alter the embryonic genes of twin girls before birth. He said he had targeted a gene known as CCR5 and edited it in a way he believed would protect the girls from infection with HIV, the virus that causes AIDS. It later emerged that a third gene-edited baby had been born.

The former associate professor at the Southern University of Science and Technology — who has since been fired — was later accused of having forged approval documents from ethics boards. He was sentenced by a Chinese court to three years in prison in late 2019 for illegally carrying out human embryo gene-editing intended for reproduction. He was released in April 2022.

The scientist posted on the Chinese social media platform WeChat on Saturday that he had been granted the visa on February 11 under the talent scheme. It was aimed at attracting people with rich work experience and good academic qualifications from all over the world to explore opportunities in Hong Kong.

He said he would conduct gene-editing research using artificial intelligence and was “optimistic about [the future of] Hong Kong,” reported the South China Morning Post. His original post cannot be found.

“We plan to use artificial intelligence tools to evolve the adeno-associated virus (AAV) capsids to improve the efficiency of gene therapy and promote affordable gene therapy for rare diseases,” he was quoted by the paper as saying. AAV is a small virus that has emerged as the most promising platform for gene therapy.

Scientists engineer the outer protein shell of AAV, known as capsid, to improve targeting and efficacy.

In response to the furor, the Hong Kong government issued a late-night statement on Tuesday, saying the visa of an individual who “made false representation” has been rescinded and a criminal investigation launched. Officials did not name He but made reference to media reports regarding an applicant being granted a visa “despite having been imprisoned for illegal medical practice.”

“After reviewing the application, the Immigration Department suspected the visa/entry permit was obtained by false representation, and the Director of Immigration had declared the visa/entry permits invalid in accordance with the law, and would conduct a criminal investigation to follow up,” said the statement.

The statement also warned that applicants who give false information face a maximum sentence of 14 years in prison and a fine of $17,842 upon conviction. The government has also issued a new requirement that future applicants under the visa scheme must declare whether they have any criminal records.

Since his prison release 10 months ago, He has established a laboratory in Beijing dedicated to developing affordable drugs for rare genetic diseases. Although He insisted that his work was to help people, international medical experts have criticized his gene-editing procedure as risky, ethically contentious and medically unjustified with inadequate consent from the families involved.

In a study published in the journal Nature Medicine in June 2019, scientists found that people who have two copies of a so-called “Delta 32” mutation of CCR5 — which protects against HIV infection in some people — also have a significantly higher risk of premature death.

He told The Guardian newspaper early this month that he moved “too quickly” by pressing ahead with the gene-editing procedure but stopped short of apologizing. He declined to elaborate on what measures should have been taken but said he would give further details at a scheduled talk on the use of CRISPR gene-editing technology at the University of Oxford next month.

He then said in a Twitter message on February 10 that he was “not ready to talk about my experience in the past three years, so I decided that I will not visit Oxford in March.”
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Researchers in Kenya say they’ve detected an invasive mosquito that can transmit malaria in different climates, threatening progress to fight the parasitic disease. Kenya’s Medical Research Institute this week urged the public to use mosquito nets and clean up areas where mosquitos can breed.

Kenya has detected the presence of a new malaria carrier, which was first discovered in the region in Djibouti in 2012.

The new carrier, the Anopheles stephensi mosquito, transmits plasmodium vivax, the parasite the causes the deadliest type of malaria.

Bernhards Ogutu is a chief researcher at Kenya Medical Research Institute. He says it was only a matter of time before the mosquito was discovered in the country after it appeared in Ethiopia and South Sudan.

“We’ve not been able to pick plasmodium vivax which is found in Asia and Kenya. It’s there in Ethiopia and this vector can also transmit it,” said Ogutu. “So that will also look at whether we might have plasmodium vivax in coming up with this new vector showing in our place. Vivax is more difficult to treat in that you can get treated and real up because it keeps staying in the body and the liver.”

Malaria affects over 229 million people each year and kills over 400,000 people, according to the World Health Organization.

More than a quarter of a million children die in Africa each year as a result of the mosquito-borne disease, including over 10,000 in Kenya.

Ogutu expresses concern for urban residents, saying that the new carrier may feed on poor environmental management systems.

“So the fact that this can survive in urban areas where water is not clean and that can transmit, that’s the worry people are having. For the time being its to monitor and see to what extent we are going to have its spreading and what impact it will be having,” said Ogutu.

Redentho Dabelen is a public officer in the Marsabit County town of Laisamis, where the vector was discovered.

He says experts are going to communities to teach people how to protect themselves from the disease.

“To sensitize them and teach them how to prevent themselves from the vector bites. We are trying to spray the houses,” said Dabelen. “We are trying to tell them about the disease through the community health volunteers and if they get infected they go to the hospital.”

According to the researchers, the population should continue to use malaria control tools such as sleeping under mosquito nets and practicing good environmental management and sanitation.

In 2021, the WHO approved a malaria vaccine for children aged five months to two years that has been shown to reduce child deaths.
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Decades of violence and humanitarian crises have left many Somali people traumatized, according to a health study by the U.N. and Somali organizations. Harun Maruf reported from Washington and Abdulkadir Zubeyr in Mogadishu spoke to mental health doctors and patients in the country. They have this report narrated by Salem Solomon. Camera: Abdulkadir Zubeyr. Video editor Betty Ayoub.
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