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public health
Health Aid Cuts in Secret Trump Deals Will Inflict 'Preventable' Death, Disease on Global South: Report
"It will be patients who will pay the ultimate price," said one global health advocate.
Aug 31, 2026
The US Congress has pushed back against President Donald Trump's efforts to slash foreign aid, which has long been supported by Democrats and Republicans alike—but a new report on more than a dozen Memoranda of Understanding that the White House has reached with countries that have long relied heavily on healthcare assistance shows that the administration is underspending "congressionally appropriated global health funds by potentially billions of dollars," as it pushes its "America First Global Health Strategy."
That's according to Public Citizen, which on Sunday joined Partners In Health in releasing an analysis of documents that the two nonprofits obtained after suing the Trump administration and filing a Freedom of Information Act (FOIA) request.
The groups reviewed the MOUs that have been signed for 18 out of 34 countries whose agreements have been negotiated by the US State Department, including Rwanda, Liberia, Burundi, and Madagascar.
Although Congress has voted to keep foreign aid levels relatively constant—rejecting a budget that called to slash global health spending by $6.2 billion before approving one that proposed a $615 million decrease in spending—the report finds that the MOUs cut foreign health aid by about $2 billion by 2030, compared to 2024 levels.
“These documents suggest that the Trump administration is on course to underspend on global health by billions of dollars compared to what Congress has ordered, risking lives and allowing diseases to spread,” said Peter Maybarduk, director of the Access to Medicines program at Public Citizen. “The administration must answer how and when it intends to invest the missing billions for health.”
Overall, funding for programs that aim to prevent the spread of diseases including HIV/AIDS, tuberculosis, and Ebola—which is currently spreading in the Democratic Republic of Congo's fastest-spreading outbreak on record—is set to be reduced by 59% from historical spending, according to the MOUs viewed by Public Citizen and Partners in Health.
Some countries would see their health assistance from the US plummet even more, with Rwanda's MOU stipulating a 97% reduction in US health aid. Liberia is set to receive 84% less funding for health initiatives by 2030, and Burundi is set to lose 78% of its aid.
"Partners In Health provides direct care in Rwanda, Liberia, and Sierra Leone, along with seven other countries, and expects under-spending of these funds to impact patients’ access to care," said Public Citizen.
The MOUs also demand that the countries meet strict co-financing requirements to make up for their lost funding, and governments in poor countries across Africa could face penalties "which could worsen funding cuts" if they miss the co-financing targets.
"The planned decreases in US funding are larger for several countries than the funding increases from partner governments," reads the report. "For more than half of countries (11 out of 18), co-financing commitments fall short of the US government’s cuts over five years compared to baseline US government funding."
Countries are likely to struggle to meet the co-financing requirements in the MOUs, warned Public Citizen and Partners In Health.
Malawi would be required to secure new healthcare funding equal to 56% of the country's total health expenditure, the report found. With Uganda also facing co-financing requirements from international health organizations including the Global Fund and Gavi, the East African country would be required to mobilize funds equal to 44% of its total health budget.
"These funding cuts will cause death and disease that is preventable,” said Vincent Lin, associate director of health policy and advocacy for Partners In Health. “The State Department is setting up other countries for failure with the co-financing requirements outlined in these agreements, but it will be patients who will pay the ultimate price.”
Maybarduk told The Washington Post that Sierra Leone will be required under its MOU to fill a 71% health funding gap by 2030.
“It’s going to be very difficult, and if a country like that falls behind, and then is punished for that, then of course the health problems compound," said Maybarduk.
The State Department denied to the Post that the Trump administration will not spend all the foreign health assistance funds appropriated by Congress; it suggested that more of the money than usual may go to religious organizations as well as an "innovation fund" to support US technology that aims to fight disease.
Last week, Public Citizen sued the Trump administration under FOIA to obtain the rest of the MOUs that remain hidden from the public.
The White House, said the group, "has kept the public in the dark about the full details of its plans for the future of US support for global health."
"The State Department has negotiated these bilateral agreements," the group said, "on rushed timelines with limited participation from civil society and affected communities."
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Opioid Settlement Funds Belong to the Public: Communities Want Healing, Not Punishment
This money was won because communities suffered extraordinary harm and hundreds of thousands of people lost their lives, so funds should build and expand capacity of much-needed health infrastructure and create lasting systems of care.
Aug 31, 2026
Nearly $58 billion is now flowing into states and local governments after the recent settlement with Purdue Pharma and other companies whose actions fueled the overdose epidemic, one of the deadliest public health crises in American history. For the first time in a generation, local communities have a critical opportunity to decide how this money is spent and allocate funding to build systems on their own terms, systems that actually save lives and provide care rooted in dignity.
The question is whether state, county, and municipal officials will actually take that chance.
The settlement money belongs to the people that paid the price. It is restitution for those lives lost, for families devastated, and for communities harmed not only by addiction and overdose, but by decades of failed punitive policies that criminalized suffering instead of treating it. It doesn’t belong to politicians, hospital systems, police departments, or consultants.
That means people directly impacted by overdose, addiction, incarceration, homelessness, and family separation should help decide how these dollars are spent. Too often, they are shut out of that decision entirely. In many states, opioid settlement decisions are made in private meetings with little public awareness, minimal reporting requirements, and limited opportunities for ordinary residents to participate. Some local governments still have no meaningful public process at all.
As federal health and social service funding faces growing cuts, many states and localities are quietly eyeing opioid settlement dollars to backfill budget gaps or prop up systems that should already be publicly funded.
When people get involved, the results improve. More states are passing legislation requiring reports on opioid settlement spending. In Hancock County, Maine, there was initially no public framework for opioid settlement spending. After a local advocate stepped forward to engage county officials, authorities created a committee of community stakeholders, including people with firsthand lived experience, to help advise how to spend those funds. In Buffalo, New York, public scrutiny and press attention around the use of settlement spending on things like police equipment and snowblowers pushed local leaders toward better investments, such as recovery coaches and treatment clinic upgrades, in later funding rounds. We can see how public engagement changes outcomes.
New Jersey committed nearly $119 million to expand harm reduction centers offering naloxone distribution, syringe access, mobile outreach, and connections to care. Kentucky continues to invest in a network of legal aid providers helping people impacted by drug use expunge their criminal records. Portland, Maine spreads its opioid funds across three efforts: a needle buyback program that removes used syringes from public spaces; a housing first program that gets people into stable housing without requiring sobriety first; and contingency management, which rewards people with incentives like gift cards for staying off stimulants such as meth and cocaine.
We also know what does not work. Nevertheless, across the country, settlement dollars are still being spent on police equipment, surveillance technology, jail expansions, and outmoded treatment programs that forbid modern medications, and ineffective "just say no" style prevention campaigns. Some jurisdictions have purchased drones, tasers, license plate readers, police dogs, and narcotics detection equipment using funds that were supposed to heal communities harmed by overdose.
The most insidious trend may be one the public cannot easily see: supplantation. According to best practice guidance from Johns Hopkins University and endorsed by more than 60 organizations including my own, supplantation advises that opioid settlement funds must not replace existing funding sources. But as federal health and social service funding faces growing cuts, many states and localities are quietly eyeing opioid settlement dollars to backfill budget gaps or prop up systems that should already be publicly funded. Settlement dollars should not replace Medicaid; they should not compensate for cuts to public health infrastructure. They were never meant to become a government slush fund.
This money was won because communities suffered extraordinary harm and hundreds of thousands of people lost their lives. Funds should build and expand capacity of much-needed health infrastructure and create lasting systems of care, not patch holes created by shifting political priorities. It’s not that settlement funds should never stabilize existing programs; in some cases, communities may need to use these dollars temporarily to sustain lifesaving services that would otherwise disappear. But those decisions must happen transparently, with public input, and with a clear understanding of the trade-offs involved. Advocates have issued guidelines that can help jurisdictions think through these challenging decisions.
There is reason for cautious optimism. Advocates, impacted families, and community organizations across the country are building models for transparency, accountability, and evidence-based investment. A new National Roadmap for Spending Opioid Settlement Funds can help communities understand their local processes and push for smarter spending. It also documents problematic and promising spending across the country. Advocates in Maine, New York, and New Jersey have created websites to help community members get involved in directing opioid settlement funds. The Maine Recovery Action Project has created a national toolkit that anyone can use to start organizing residents to have a say in spending decisions.
Residents should ask simple but critical questions, such as: Where is the money going? Who benefits? What evidence supports these investments? Who was consulted?
The overdose crisis was perpetrated by decisions, made over the course of decades, that never faced accountability. We cannot afford to repeat that mistake now with resources made available to repair the damage.
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The Nuclear Regulatory Commission: Bringing Cancer Potential to a Community Near You
Under pressure to expand nuclear energy production, the commission has proposed weakening standards protecting workers and communities from radiation exposure.
Aug 27, 2026
The Nuclear Regulatory Commission, or NRC, whose mission is to protect public health and safety regarding nuclear energy, has now transformed into an agency, as so many have under the current administration, to support the nuclear industry and its billionaire backers. Following other captured federal agencies like the Department of Energy, which is variably led by individuals from the very industries it is intended to regulate, the NRC is under pressure from the president to facilitate the quadrupling of nuclear energy production by 2050. This is to be accomplished by fast-tracking the licensure and building of reactors while discarding the nuclear radiation exposure safety measures in place for decades as these are seen to be onerous and financially burdensome to the industry.
The current safety standard for nuclear exposure comes from the BEIR VII (Biologic Effects of Ionizing Radiation) study. This was produced by the National Academies of Sciences, Engineering, and Medicine and concluded that there is no safe level of ionizing radiation exposure above background, noting that any excess exposure above background increases the risk to human health of cancer, and other diseases associated with nuclear exposure. This is the so-called Linear No Threshold, LNT, theory. This theory is the basis for the core precautionary safety principle and risk management approach used in the fields of ionizing radiation exposure from medicine and dentistry to nuclear energy referred to as “ALARA,” or "As Low As Reasonably Achievable.”
The problem that exists, even with current standards of radiation exposure allowance, is that they are based on the “Reference Man,” which is a 25-to-30-year-old 70 kilogram man. This androcentric standard totally disregards the fact that the majority of humanity is not represented by this standard, and that children, females, pregnant women, and the elderly are more sensitive to radioactivity exposure. In addition workers involved throughout the entire nuclear cycle are at increased risk from exposure. Furthermore, a recent Harvard study demonstrated increased cancer rates in the communities surrounding nuclear power plants within ~18.5 miles.
The current NRC proposal plans to do away with ALARA while purportedly supporting the LNT. This flies in the face of reason and is duplicitous as LNT is the basis of ALARA. Their plan is to substitute an unproven “graded approach” allowing workers to be exposed to near the regulatory limits and then taking added measures so as not to exceed it. They propose allowing the exceeding of exposure limits under “certain circumstances” setting up a banking system from subsequent year allowances amortizing over five years. They have even invoked the controversial unproven hypothesis of “Radiation Hormesis,” which proposes that a small amount of radiation causing cellular damage will stimulate cellular repair, as though to say what does not kill you, is good for you. Remember LNT.
The current proposal does just the opposite unless we stop it from moving forward. The NRC is providing a limited public comment period on this proposal which ends at midnight on August 31.
Furthermore, when implemented, these new regulations will most likely be used to reduce the already weak cleanup standards, further increasing the health risks to impacted communities contaminated from our nuclear legacy and history. These include communities such as the South Carolina Savannah River Site and New Mexico Los Alamos Nuclear Lab and Trinity Test Site to the Navajo Nation mining sites, Hanford Washington site, Nevada Test Site, St Louis Cold Water Creek, Parks Township (Pennsylvani), Rocky Flats Site near Denver, and the Santa Susana Field Lab near Los Angeles, among others.
The rationale for this current proposal is to facilitate the fast-tracking of nuclear power for the uncontrolled growth of data centers (with 1,500 new data centers currently in development), artificial intelligence, additional large commercial nuclear power plants, and new plutonium pits that are the nuclear trigger of nuclear weapons, reminding us that nuclear power remains the cover story for nuclear weapons.
The potential health risks of cancer, heart disease, birth defects, cognitive defects, thyroid and endocrine disorders, genetic mutations, and infertility are all related to ionizing radiation exposure. These are risks lasting for generations, passed on from one generation to the next. Yet, these health effects do not have to be and can be prevented if we demand the strengthening of current radiation exposure guidelines. The current proposal does just the opposite unless we stop it from moving forward. The NRC is providing a limited public comment period on this proposal which ends at midnight on August 31. Your comment is critical and can be submitted at federalregister.gov. More information can be found at www.protectbetter.org.
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The Current Medicaid Fight Is in the Rulemaking
The Centers for Medicare and Medicaid Services' implementation of the One Big Beautiful Bill narrows the very protections Congress included to prevent vulnerable people nationwide from losing the health coverage they need.
Aug 26, 2026
The biggest Medicaid fight today isn't happening in Congress—it's happening inside the Centers for Medicare and Medicaid Services.
Now, a year after H.R. 1’s passage (the 2025 federal reconciliation bill enacting significant cuts and changes to Medicaid), CMS’ recently issued interim final rule (IFR) implementing the law’s work-reporting requirements in the program narrows the very protections Congress included to prevent vulnerable people nationwide from losing the health coverage they need.
The Congressional Budget Office previously estimated that more than 5 million people will lose Medicaid coverage because of these requirements. Already a conservative estimate as other organizations estimated over 10 million people are at risk of losing coverage, the number will surely be higher given CMS' IFR goes beyond the statutory language of the law.
The clearest example of this is the IFR's treatment of the medically frail exemption.
If the goal is really healthier communities and greater workforce participation, making it harder for medically vulnerable people to keep their health insurance is exactly the wrong approach.
Congress recognized that people living with complex medical conditions, disabilities, and chronic illnesses, including substance use disorder (SUD), should be protected from burdensome work-reporting requirements. As such, H.R. 1 specifically includes “medically frail” individuals among those exempt from the new requirements.
Yet CMS has added a new hurdle, putting millions of eligible Americans at dire risk of losing access to essential healthcare.
Under the IFR, people with SUD and other qualifying health conditions must also demonstrate that their condition "significantly impairs" their ability to satisfy the requirement before they can qualify for the exemption. This additional standard does not appear in the statute and will inevitably reduce the number of people who can secure the exemption.
For people living with SUD, the consequences could be profound.
While SUD is a chronic but treatable medical condition, pervasive stigma and discriminatory barriers have led to fewer than 1 in 5 people who need treatment actually receiving it. Amid persistent addiction and overdose crises, we should be making it easier for people to access the services and supports they need to become and stay well, not erecting additional barriers to lifesaving care.
Moreover, while CMS' rule relies heavily on Medicaid claims data and provider documentation to identify individuals who qualify as medically frail, the administration’s approach overlooks the reality that many people with SUD have never entered treatment due to the above-mentioned stigma and discrimination. Requiring additional documentation will not "motivate" people to seek care, as CMS suggests. Instead, it creates yet another barrier for people who are already among the hardest to reach.
When people are deprived of Medicaid access, their ability to engage in preventive care, behavioral health services, medications, and treatment that keep chronic conditions under control is also lost. And it doesn’t take a rocket scientist to understand how untreated health conditions can not just impede a person’s capacity to work but quickly lead to costly emergency services.
These are not only personal tragedies—they are costly public policy failures.
Taking away health coverage does not eliminate health needs. It just shifts and raises costs while undermining public health and safety. Access to healthcare is precisely what enables many people to work, care for their families, and be productive community members, so why are we erecting so many barriers?
If the goal is really healthier communities and greater workforce participation, making it harder for medically vulnerable people to keep their health insurance is exactly the wrong approach.
Last month, both our organizations, along with many other leading advocates nationwide, explicitly articulated these concerns and submitted comments urging the agency to reverse course and faithfully reinforce the protections Congress included in the law. While CMS' public comment period on the IFR is now closed, all those who share the same perspective can still take action by calling their members of Congress to share their concerns about the impact of H.R. 1 and specifically, how the administration is planning to implement the law.
A year after H.R. 1’s passage, the question is no longer simply about what Congress enacted—it is whether the regulations that make the law real will preserve purposeful protections or quietly erode them through administrative action.
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Diarrhea Summer: Brought to You by Trump, Big Ag, and the Climate Crisis
This cyclosporiasis outbreak is a bright red, flashing warning light: Without quick action and systemic changes to our food system, the next outbreak could be much, much worse.
Aug 23, 2026
For many, summer is a time for refreshing salads, burgers with lettuce, and fresh berries. But multiple growing outbreaks of cyclosporiasis are draining that summer fun, forcing people to look at fresh produce and wonder, “Will this give me explosive diarrhea?”
These outbreaks, now making up the biggest in US history, weren’t inevitable. They’re linked to President Donald Trump’s funding cuts, Big Ag’s control of our food supply, and yes, even climate change.
This cyclosporiasis outbreak is a bright red, flashing warning light. Without quick action and systemic changes to our food system, the next outbreak could be much, much worse.
What Brought This Sh*t On?
Cyclosporiasis is an intestinal infection caused by the parasite Cyclospora cayetanensis. It contaminates and lays eggs on produce including leafy greens, raspberries, snow peas, basil, and other herbs. Eating those eggs can cause us intestinal pain, low-grade fever, explosive diarrhea, and other medical problems.
Cyclospora is sending us a dire warning that our leaders must heed: We need to invest in public health, climate change response, and a sustainable, diverse food system that bucks corporate control.
From May 1 to August 4, the Centers for Disease Control and Prevention (CDC) confirmed over 10,000 lab-tested cases of cyclosporiasis and 517 hospitalizations. Forty-seven states are reporting cases, with the largest outbreak spanning 15 states. Michigan health officials have reported over 12,000 cases in that state alone. In August, Michigan reported the first and second deaths from this outbreak.
Handwashing and washing produce aren’t entirely effective in eliminating Cyclospora—only cooking produce to at least 158°F can kill the parasites. That, plus the ongoing confusion on where these outbreaks originated, has contributed to this summer’s continuing unease around leafy greens and other produce.
Overwhelming evidence for the Midwest outbreaks points to shredded iceberg lettuce from Taylor Farms de Mexico. Taylor Farms is not a new name in food safety headlines. In fact, from 2009 to 2026, its products have been implicated in more than a dozen foodborne illness outbreaks, ranging from deadly E. coli outbreaks to Listeria, Cyclospora, and Salmonella.
Just this month, in addition to their connection to the historic Cyclospora outbreak, Taylor Farms is now involved in a Salmonella outbreak affecting 27 states and about 345 people. This summer of sickness highlights the role Taylor Farms has played in sickening thousands of individuals across the United States over the years, with little to no significant repercussions from the federal government.
How Trump’s Cuts Made This CyclosporaOutbreak Worse
The US has established programs designed to study, track, and help contain foodborne illnesses. But in recent years, funding for these programs has failed to keep up with the need. And the Trump administration has only made things worse by slashing staff and funding.
The Trump administration cut key grant and funding programs that state health departments rely on to track foodborne illnesses. Last year, due to staffing cuts, the Administration paused a quality control program conducted through the FDA’s Food Emergency Response Network (FERN) at least through September 2025. This program included quality control work on lab testing for Cyclospora in spinach. It’s unclear whether the program is back up and running today.
Rather than Make America Healthy Again, Trump’s cuts show blatant disregard for food safety and public health.
FERN’s system of federal, state, and local laboratories defends and responds to contamination in the food supply. It tests food samples during large-scale outbreaks to help identify the source of contamination.
Meanwhile, at the CDC, Trump’s budget and staffing cuts have led to downgrades to the FoodNet program. FoodNet tracks long-term trends in foodborne illness rates across 10 states. But with Trump’s cuts, FoodNet was forced to stop tracking 6 of the 8 pathogens it has historically tracked. Cyclospora was 1 of the 6 on the chopping block.
Collectively, those six pathogens cause an estimated 111,000 hospitalizations and 418 deaths each year. One of them, Campylobacter, causes up to $6.8 billion in economic damages every year.
Rather than Make America Healthy Again, Trump’s cuts show blatant disregard for food safety and public health. Quick and comprehensive data collection is an essential line of defense in detecting and containing foodborne illness outbreaks—without it, we’re left fighting in the dark.
Big Ag’s Dominance = More Foodborne Illness
This Cyclospora outbreak also highlights the dangers of our corporate-controlled, highly consolidated food system. Lettuce and leafy greens are common causes of foodborne illness because most are irrigated using polluting substances, or they’re produced near disastrously polluting factory farms.
Factory farms are a huge culprit of this contamination problem. These facilities exist to make raising livestock as cheap as possible for the sake of corporate profits, storing up to a million animals in tight confines. Leafy greens grown near factory farms are regularly exposed to pathogens in the waste that these facilities produce in abundance.
Cyclosporasis in particular spreads via human waste, and Big Ag has long spread sludge from human sewage on agricultural land as fertilizer.
In short, our profit-at-any-cost, highly consolidated food system trades public health for corporate gain.
Moreover, as the industry searches for more water sources, it’s increasingly turned to “recycled” wastewater. While this water moves through treatment plants before it hits fields, that’s often not enough to make it totally pathogen-free. Studies have shown that bacteria and pathogens persist in wastewater after treatment, and research suggests that “using treated wastewater for agricultural irrigation may cause food chain contamination.”
These dangerous business practices aren’t the only way Big Ag is driving more foodborne illness. Taylor Farms, the corporation at the heart of today’s largest Cyclospora outbreaks, has acquired or invested in 10 other companies in just eight years. It runs 22 production facilities in North America and sells 40% of “value-added salads” in the United States.
This consolidation—fewer and bigger companies controlling more of our food—makes our food system even more vulnerable to shocks. Now, Cyclospora shows us the outsized influence a single company can have because of its massive reach. A single corporation can send an illness across the country.
In short, our profit-at-any-cost, highly consolidated food system trades public health for corporate gain.
Climate Change Makes Everything Worse, Including Cyclospora
Since the 1990s, cyclosporiasis outbreaks have occurred each year, typically from May through August. As climate change makes summers hotter and longer, the window for Cyclospora to spread also widens, as the parasite thrives in warm, humid conditions.
Studies also show that climate change and climate disasters will cause more food spoilage and foodborne illnesses. Hotter temperatures promote the growth of pathogens such as Listeria, Campylobacter, and Salmonella, while floods can contaminate food supplies with sewage and agricultural runoff.
Right now, our corporate-dominated food system is utterly unprepared for how climate change will impact our food.
Moreover, as climate change drives more and longer droughts, the US Department of Agriculture will likely encourage farms to turn to wastewater as a solution. The agency has called treated wastewater “the irrigation wave of the future.”
Right now, our corporate-dominated food system is utterly unprepared for how climate change will impact our food. While government agencies recommend we irrigate our crops with wastewater, Trump is demolishing climate and public health programs and funding.
Cyclospora is sending us a dire warning that our leaders must heed: We need to invest in public health, climate change response, and a sustainable, diverse food system that bucks corporate control. Or they’ll guarantee another foodborne illness outbreak, rather than making Americans healthy.
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Overflowing Bins in Bethlehem Tell a Bigger Story
They are telling the story of a city under pressure, a story of institutions struggling to maintain essential services, a story of workers trying to do their jobs under increasingly difficult circumstances.
Aug 23, 2026
The world knows Bethlehem as the city of the Nativity. It is a city of churches, olive groves, ancient stone streets, and a history that attracts pilgrims and visitors from across the globe. For many, Bethlehem symbolizes peace, hope, and human resilience.
Yet in recent weeks, another image has emerged. Overflowing garbage containers. Piles of waste left uncollected for days. Unpleasant odors drifting through neighborhoods. Stray dogs searching through torn plastic bags. Flies, rodents, and growing public concern about health and sanitation.
For residents, these scenes are disturbing. For visitors, they are difficult to reconcile with the image of one of the world's most recognized and beloved cities. But the garbage accumulating in Bethlehem's streets is not the real story. It is merely the most visible symptom of a much larger crisis. The question is not why a container is overflowing. The question is what happened to the system behind it.
At first glance, it may seem like a simple municipal problem. A shortage of fuel. A broken truck. Workers on strike. Delayed collection rounds. The reality is far more complicated.
The environment does not understand politics. It understands only what we do—or fail to do—to protect it.
Waste management depends on an entire chain of institutions, workers, vehicles, roads, fuel supplies, disposal facilities, municipal revenues, and public cooperation. When enough pressure is placed on that chain, it begins to break. And in Bethlehem, pressure has been building for years.
The city has suffered repeated economic shocks. The tourism sector, once a major source of income, was devastated by the Covid-19 pandemic. Before it could fully recover, the war and the broader economic crisis brought new hardships. Businesses struggled. Workers lost jobs. Household incomes declined. Many families found themselves prioritizing food, rent, and basic necessities over municipal fees.
As revenues declined, local institutions found it increasingly difficult to sustain essential services. At the same time, operational costs continued to rise. Fuel became more expensive and, at times, harder to secure. Vehicles required maintenance. Equipment aged. Service providers struggled to balance growing needs with shrinking resources.
The crisis does not stop there.
Road closures, military gates, and movement restrictions have increasingly complicated daily life throughout Bethlehem Governorate. What should be a routine collection route can suddenly become longer, slower, or more expensive. A delayed truck today may become an overflowing container tomorrow.
Even the final destination of the waste is not immune from these pressures.
The Al-Minya landfill, which serves communities in southern parts of the West Bank, represents a critical component of the region's waste management system. Any disruption affecting access, transportation, security, or operations along this chain eventually reaches the streets of Bethlehem and surrounding communities.
The result is a problem that residents experience every day. A container left uncollected. A street corner filled with waste. A smell that lingers in the summer heat. A growing sense that something is no longer working as it should.
When waste accumulates, the consequences extend beyond appearance.
Overflowing garbage attracts stray dogs, insects, rodents, and other disease vectors. It increases environmental risks and can create fire hazards during hot weather. It affects public health, community well-being, and the quality of life in neighborhoods already facing multiple challenges.
This is why waste management should never be viewed as a secondary service. It is not simply about removing garbage from the street. It is about protecting public health. It is about preserving human dignity. It is about maintaining the environmental quality of cities and communities. It is also about protecting the people who perform this difficult work.
One night, at around 2:00 am in the morning, I drove into Bethlehem to take my wife to catch an early bus to Allenby Bridge Boarder with Jordan. While most of the city slept, sanitation workers were already on the streets. Wearing reflective orange uniforms, they swept roads, emptied containers, and loaded waste onto trucks. Few residents would ever see them. By sunrise, most traces of their work would have disappeared.
Their presence reminded me that waste management is not an abstract system. It depends on real people working under difficult conditions, often exposed to hazards that most citizens never think about.
But workers alone cannot solve this crisis, neither can municipalities, nor can citizens. Responsibility is shared.
Citizens must reduce the waste they generate, support cleaner public spaces, and contribute to the sustainability of essential services whenever possible.
Municipalities and service providers need stronger planning, better resource management, and long-term financial stability.
National institutions must support local governments struggling under extraordinary economic and political pressures.
And international partners should recognize that environmental services are not luxuries. They are fundamental to public health, social stability, and human dignity.
There is another reason this issue deserves greater attention. Pollution does not recognize borders. Smoke from burning waste does not stop at a checkpoint. Contaminated water does not respect political divisions. Air pollution travels wherever the wind takes it.
The environment does not understand politics. It understands only what we do—or fail to do—to protect it. That is why environmental protection requires cooperation, shared responsibility, and long-term vision.
Bethlehem does not simply need more garbage trucks or more containers. It needs investment in sustainable solutions. It needs stronger institutions. It needs public awareness. It needs serious efforts to reduce waste generation, expand reuse and recycling, and create economic opportunities through a circular economy approach.
Most importantly, it needs recognition that environmental challenges are not isolated technical problems. They are deeply connected to economic conditions, governance, public services, and the daily lives of ordinary people.
The overflowing containers seen today across Bethlehem are telling a much bigger story. They are telling the story of a city under pressure, a story of institutions struggling to maintain essential services, a story of workers trying to do their jobs under increasingly difficult circumstances, a story of economic hardship, environmental vulnerability, and a community searching for sustainable solutions.
And perhaps they are also reminding us of something simple: Garbage does not appear overnight. Neither do environmental crises. Both are the result of problems left unresolved for too long.
If Bethlehem is to remain the beautiful city that the world knows and cherishes, addressing those problems can no longer wait.
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Congo's Ebola Outbreak 'Growing Exponentially,' Warns UN Official
In just under 100 days, the epidemic has killed over 2,500 people and is "now covering an area that is bigger than France."
Aug 21, 2026
It's been nearly 100 days since authorities in the Democratic Republic of Congo declared the Ebola outbreak and, as a key United Nations humanitarian official said Friday, the disease has now killed over 2,500 people and continues to rapidly spread.
"The Ebola outbreak is growing exponentially," said the UN's senior Ebola coordinator, Julien Harneis. "In the last three months, 2,500 people have died, and half of those in the last 20 days."
"The epidemic is spreading widely," he continued. "It's now covering an area that is bigger than France."
Harneis acknowledged the outbreak's toll on healthcare providers, with 160 having contracted Ebola—43 of whom have died. He said that "apart from the threat from the virus, healthcare workers and frontline workers have been attacked by youths, ambulances have been burned and stoned, and the healthcare facilities have been attacked."
"Conditions on the ground are extremely difficult," the official said, "but we will continue deploying all the humanitarian and medical assistance needed until the job is done."
"We're only covered for the next weeks, and very soon funding will run out," he noted. "Every delay in funding and implementation makes this epidemic more deadly, more difficult to stop and more expensive. So, we need that international support immediately."
As the outbreak has worsened, US President Donald Trump has faced renewed global criticism for withdrawing from the World Health Organization (WHO), dismantling the US Agency for International Development, and cutting public health funds.
Harneis nodded to those moves on Friday, according to UN News:
Although the United States has contributed $80 million to the DRC government to boost bed capacity and safe burial practices, among other support, cuts to aid work—especially in the last two years—have reduced the capacity of humanitarian organizations by more than 30%, he added.
Despite these challenges, multiple specialist UN agencies continue to work alongside the DRC authorities to push back Ebola. They include the World Health Organization, the World Food Program, the UN Children's Fund (UNICEF), the UN migration agency (IOM) and partners including Médecins Sans Frontières.
"This epidemic continues to spread, moving faster than the response can keep up," Dr. Javid Abdelmoneim, international president of Médecins Sans Frontières (MSF), also known as Doctors Without Borders, said in a Friday statement. "Treatment centers remain essential for saving lives, but this response needs more than extra beds."
"It needs better detection, safe isolation for sick people and their contacts, and support to health workers," Abdelmoneim said. "People seeking care in existing health facilities also need to be protected from infection. Crucially, the response must be built with communities, not around them."
Trish Newport, the group's emergency program manager in Ituri province, said that UN agencies, humanitarian organizations, and the Congolese Ministry of Health "must urgently expand" training and support so that workers and community leaders can "help detect cases early, refer people safely, reinforce infection prevention and control, and protect themselves and others from infection."
WHO said Thursday that "Ituri province remains the epicenter, but ongoing transmission, spread to new areas, a high case fatality ratio (47%), and increasing infections among healthcare workers indicate that the outbreak remains severe and difficult to control."
"Imported cases have been reported in Uganda, France, and Germany, demonstrating the potential for international spread, although no sustained transmission has occurred outside the DRC," the agency continued. "The overall risk remains very high in the DRC, high for neighboring countries, particularly those sharing land borders with the DRC, and low at the regional and global levels, where preparedness and rapid detection measures are helping to prevent wider spread."
While the DRC infections are being caused by the Bundibugyo virus, the government recently requested a release of Ervebo vaccines from the global stockpile, given that, as WHO explained Thursday, "early laboratory and animal data suggest it may provide some protection."
The UN agency said that the International Coordinating Group on Vaccine Provision, which manages the stockpile, informed the DRC of an immediate initial release of 70,000 doses, including 50,000 for frontline and health workers, and 20,000 "for a Phase 3 clinical trial to understand the impact of the vaccine on the Bundibugyo virus."
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Critics Slam Trump FDA Pick Heidi Overton as 'Anti-Reproductive Rights, Anti-Vax, Anti-Science'
"The American people deserve someone who will put science and facts FIRST, not another Trump sycophant who will make it their mission to attack medication abortion," said one Democratic senator.
Aug 19, 2026
President Donald Trump on Wednesday tapped White House health policy adviser Dr. Heidi Overton to lead the Food and Drug Administration, a move that drew fierce opposition from Democratic lawmakers, reproductive rights advocates, and public health experts, who pointed to her opposition to abortion rights and support for controversial changes to federal vaccine policy as cause for alarm.
Trump took to his Truth Social network to announce his pick of Overton, a physician and deputy director of the White House Domestic Policy Council, to replace former FDA Commissioner Marty Makary, who resigned in May following months of turmoil at the agency. The president described Overton as a "ROCKSTAR" in his administration who will "deliver on the MOST TRANSFORMATIVE Health Agenda in History."
"Heidi is 'ALWAYS RIGHT,' Secretary Kennedy recently said in the Oval Office!" Trump continued, referring to Health and Human Services chief Robert F. Kennedy Jr. "We need her leadership at the FDA now to ensure that the US remains the WORLD LEADER for Scientific Discovery and CURES."
The president also said Overton would work with Centers for Medicare & Medicaid Services Administrator Mehmet Oz to advance his agenda of faster drug approvals, increased innovation, clinical trial reforms, and lower prescription drug prices.
However, skeptics argue that Overton’s policy record raises serious questions about whether she would maintain the FDA’s scientific and regulatory independence in an administration in which critics say loyalty to Trump is of paramount importance.
Reproductive Freedom for All—formerly the National Association for the Repeal of Abortion Laws and NARAL Pro-Choice America—noted that "Overton has an extensive anti-abortion record."
The group continued:
She celebrated the overturning of Roe v. Wade as a “huge victory,” and has advocated for the politicization of government agencies to help advance a nationwide anti-abortion agenda. She previously worked at America First Policy Institute, an extreme conservative think tank made up of former Trump administration officials, where she authored a brief pushing disinformation about the safety of medication abortion and calling for additional, medically unnecessary restrictions on access to mifepristone.
“Donald Trump is trying to put an anti-abortion extremist in charge of any agency that could seriously undermine reproductive healthcare—including the agency that could roll back access to mifepristone nationwide," Reproductive Freedom for All president and CEO Mini Timmaraju said. "Her nomination is another alarming step in Trump’s plan to weaponize every part of the federal government to restrict abortion nationwide.”
Overton's shifting stance on vaccines also raised eyebrows.
Endpoints News senior senior reporter Max Bayer highlighted how, while working at AFPI, Overton "and others praised Operation Warp Speed, the massive government initiative to expedite development and manufacturing of the Covid-19 vaccines" during Trump's first administration.
But less than a year later, Bayer said, Overton "advocated against Covid-19 school vaccine mandates, writing in an editorial the data supported more parental choice in the decision."
"Overton stood by Trump earlier in August as he announced a sweeping and contentious new executive order amending the childhood vaccine schedule and advising that the [measles, mumps, and rubella] vaccine be broken up into individual components," he added. "Makers of the vaccine pushed back on the directive, but now with Overton in line to lead the FDA, there could be enhanced pressure for drugmakers to follow through on the request."
Democratic US lawmakers also voiced opposition to Overton's nomination.
"Heidi Overton is a far-right, anti-abortion extremist who has no business leading the FDA," Sen. Patty Murray (D-Wash.) said on social media. "The American people deserve someone who will put science and facts FIRST, not another Trump sycophant who will make it their mission to attack medication abortion. I will vote NO."
At least one Republican lawmaker—who chairs the Senate Health, Education, Labor, and Pensions Committee—also questioned Trump's pick.
"While I respect Dr. Overton’s experience as a physician, I have strong concerns about her nomination to be FDA commissioner," Sen. Bill Cassidy (R-La.), a gastroenterologist, said on X. "Her lack of managerial experience does not prepare her well for leading a large organization that is already dealing with staffing and morale issues."
"Additionally, Dr. Overton’s active role in last week’s nonsensical vaccine executive order calls into question her commitment to standing up for sound science and protecting children’s health. That alone is almost disqualifying," added Casisdy, who earlier this year lost a primary race to a Trump-backed challenger.
Overton's nomination comes amid turmoil at an agency that has seen thousands of employees fired by Kennedy since last year amid Trump administration efforts to shrink the government in line with Project 2025, the Heritage Foundation-led framework for a far-right federal overhaul.
Chris Meekins, a former Trump health official who is now an analyst at the investment bank Raymond James, told clients that Overton would be "like Makary, but probably worse."
“Being seemingly inexperienced and unqualified is fine if you have self-awareness and humility and a strong team around you,” Meekins wrote. “Based off of our DC channel checks, she does not seem to have either."
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Federal Judge Blocks Trump and RFK Effort to Get More Teens Pregnant
The ruling, said the government watchdog Public Citizen, is "a win for young Americans' well-being."
Aug 19, 2026
The Teen Pregnancy Prevention program, first authorized through bipartisan legislation in 2009, has been credited with helping to dramatically reduce the number of American teenagers who have experienced unwanted pregnancies in the past decade and a half, dropping by more than 65% over 16 years, according to one congressional report.
Despite the best efforts of President Donald Trump and Health and Human Services Secretary Robert F. Kennedy Jr., a federal judge's ruling on Wednesday sent the message that the push to reduce teen pregnancy in the US will continue, with the administration's limits on the program's federal grants paused.
Judge Christopher Cooper of the US District Court for the District of Columbia granted a preliminary injunction in the case of Hennepin County, Minnesota v. US Department of Health and Human Services, in which officials joined King County in Washingtin state, Planned Parenthood of the Heartland, and the Sexuality Information and Education Council of the United States (SIECUS) in challenging HHS's changes to the program's grant policy. The plaintiffs were represented by Public Citizen and Democracy Forward.
The changes, said Cooper, were “likely arbitrary and capricious.”
The new policy, announced in June, canceled 53 of 66 active grants that had gone to public universities, health departments, and nonprofits for programming related to sex education, including information that was given to teens on contraception and communication with sexual partners.
In Trump's 2027 budget, the grants are described as promoting "radical leftist ideology," and officials claim there is no evidence that teen pregnancy prevention programs that go beyond educating young people about abstinence have "contributed to the historic decline in teen pregnancy, which is now at an all-time low."
Under new guidance issued in June, Teen Pregnancy Prevention (TPP) program grantees are required to focus lessons on abstinence, deemphasize contraception, and teach teens about fertility and "body literacy."
“HHS is perfectly entitled to formulate its own views about how to stem teen pregnancy—or even whether it is worth preventing at all—and to pursue policy initiatives consistent with its viewpoint. But it is not at liberty, under the Administrative Procedure Act (APA), to impose conditions on grant recipients that Congress did not intend or that are unreasonable or unexplained. The preliminary record suggests that HHS has done just that,” wrote Cooper in the ruling.
"Through the TPP, Congress sought to fund a range of evidence-based teen pregnancy prevention strategies, not just abstinence. According to unrebutted record evidence, programs that teach abstinence to the exclusion of all other approaches are ineffective in delaying sexual initiation and reducing adolescent pregnancy, at least as a general matter," Cooper continued.
The judge took aim at the administration's promotion of "body literacy," which he called “a nebulous concept that appears to elevate fertility and marital procreation over well-tested forms of contraception and pregnancy prevention.”
Cooper also suggested that HHS had not bothered to find genuine evidence of its claims about "body literacy," instead "remarkably" referencing "public health studies that appear either not to exist or not to support the propositions for which they are cited—a hallmark of AI-generated citations.”
The judge stopped short of reinstating the dozens of grants, amounting to about $67 million, that have been terminated, saying it was unclear whether he had the authority to do so.
The plaintiffs and other advocates of comprehensive sex education have called for a permanent injunction; Cooper called on both parties in the case to propose a schedule for next steps by September 1.
Callie Simon, executive director of SIECUS, said the group was "encouraged that the court has halted implementation of the new harmful policy" but emphasized that "the impacts of terminating existing grants remain."
“Today’s decision sends a clear message that the Trump-Vance administration cannot replace the proven, bipartisan Teen Pregnancy Prevention program with an ideologically driven alternative that harms young people,” said Simon. "Communities across the country are still without the evidence-based programs they relied on, and we will continue fighting to ensure young people have access to the sex education they deserve.”
Sandra J. Valenciano, director and health officer for public health in Seattle and King counties, said local communities were facing a measurable loss due to HHS' stripping of TPP grants
“This federal action threatened our ability to complete a study on a new science-based, community-informed sex education curriculum specifically for young men and boys,” said Valenciano. “This ruling gives us hope that we may still be able to get to the finish line with this study and ultimately empower more young people to build healthy families if, when, and how they choose.”
Ruth Richardson, president and CEO of Planned Parenthood North Central States, said the ruling "reaffirms the value of trusted, evidence-based education programs that help youth make informed choices and plan for their futures."
"Attacks on the Teen Pregnancy Prevention program not only put young people at risk, they also risk increasing costs for taxpayers," said Richardson. "No one benefits from these politically motivated attacks. It’s time for them to end.”
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Amnesty Calls for 'Global Solidarity' as Ebola Outbreak Becomes Worst in DRC's History
"The people of the DRC deserve the world’s attention, resources, care, and solidarity," said one advocate.
Aug 17, 2026
As the Ebola crisis that was first detected in the Democratic Republic of Congo in May became the deadliest outbreak of the disease in the country's history on Monday, one global public health expert in the United Kingdom pointed to the key difference between the 2014 epidemic in West Africa and the one that has now killed at least 2,325 people in the DRC.
In 2014, wrote Devi Sridhar, chair of global public health at the University of Edinburgh, in The Guardian, the US and other wealthy countries "worked with the World Health Organization (WHO) to escalate a response, bringing military-like coordination, necessary resources, logistics, and trained personnel."
Now, said Sridhar, "we’ve had two 'America-First'" terms of President Donald Trump.
"The US is no longer part of the WHO or working multilaterally, favoring a 'go-it-alone' response," she wrote.
In Trump's second term, the president cut tens of billions of dollars in foreign aid spending. Data released by the Organization for Economic Cooperation and Development in April showed the US spent 56.9% less on foreign assistance last year after Trump dismantled the US Agency for International Development (USAID), cut smaller programs, and demanded that Congress rescind billions that had already been appropriated for countries and programs in need.
Ebola has become the DRC's worst-ever outbreak in just three months, wrote Sridhar, "in the context of the defunding of foreign aid, the censorship of scientists, the closure of USAID, the implosion of the Centers for Disease Control and Prevention, and a 'Make America Healthy Again' movement."
By the time officials announced that the outbreak had been detected in May, they had already recorded 246 suspected cases and 80 suspected deaths in Ituri province—suggesting that US aid and public health cuts had "undermined some of the surveillance and detection initiatives that might have helped to catch this earlier," as Jeremy Konyndyk of Refugees International said at the time.
Months after getting a significant head start in spreading throughout the population, Ebola has now been detected in six of the DRC's 26 provinces, and the country's public health institute has recorded at least 4,945 cases, with 101 detected in the 24 hours preceding Monday's announcement.
Ebola "is winning in the Democratic Republic of the Congo,” said the United Nations last Friday, noting that the epidemic was killing one person every 30 minutes.
Amnesty International called on the globa; community to urgently try to make up for the surveillance failures that happened earlier this year and mobilize to slow the outbreak.
"We call for global solidarity as eastern DRC faces its deadliest Ebola outbreak in the country's history," said Amnesty. "Human rights must continue to be prioritized as health workers treat the disease across the region."
The US State Department said earlier this month that it has provided $512 million in direct assistance to help respond to the outbreak—far less than the $5.4 billion the US enacted in December 2014 to fight the epidemic in West Africa.
US spending is lagging as the outbreak has become the fastest-growing in the history of the virus, as The Guardian reported Monday. The 2014 outbreak took five months to reach 1,000 deaths, but more than 2,000 people have died of Ebola in less than three months since the disease was detected.
Thomas Parisch, a public health specialist with Doctors Without Borders in the DRC, told The Guardian that the country still appears to be struggling with the limits imposed by aid cuts.
"Normally, as an outbreak progresses, the case fatality ratio should fall as contact tracing improves and patients are identified and treated earlier," said Parisch. "Instead, we’re still seeing many cases detected very late, when treatment is less likely to succeed, with many identified only after they die in the community.”
The outbreak also differs from previous epidemics in that the current Ebola infections are being caused by the rare Bundibugyo virus. There are no approved vaccines or treatments for the strain, but WHO Director-General Tedros Adhanom Ghebreyesus said recently that two new vaccines were being tested on people.
Lawyer and advocate Bernice King urged the public to "refuse to look away."
"Nonviolence is an active commitment to protect life," said King. "The people of the DRC deserve the world’s attention, resources, care, and solidarity."
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