The last mile challenge is a common phenomenon in global health… treating the hardest to reach cases, & achieving disease eradication, requires the highest amount of resources per individual. The overnight disruption of USAID programs last year is expected to lead to NTD resurgence across the globe.

Karnataka state legislature building (Vidhana Soudha) in Bengaluru, India. Constructed in 1956. The inscription above the columns reads: "Government work is God's Work"

1 year on from the brutal, overnight termination of USAID programs, @timhirschelburns.bsky.social evaluates the consequences and brings names and stories to the statistics. With vital health programs shuttered overnight, without any plan for a safe transition… cruelty was the point.

I don’t think people realize how monstrous the destruction of USAID was. It was stuff like locking warehouses of medicines the US had ALREADY paid for. Discharging sick people from hospital. Cutting HIV meds w/ no notice. They were warned people would die, and we know the names of people who did

"There is no antiviral drug to treat measles. The best protection against the disease is vaccination with the measles, mumps, and rubella (MMR) vaccine. Among the 646 cases in South Carolina, 563 are unvaccinated..."

Every dollar invested in global and domestic climate-resilience measures yields between $2 and $10 in avoided losses. Cutting these programs is a false economy that will cost far more in natural disasters, forced migration, and other global powers filling the void we leave behind.

“Fraternity, being together in harmony, is an act of resistance.” -Georges Collinet (Afropop Worldwide @prx.org)

PSA for flu and COVID season: If someone dressed like this tells you to wash your hands, you should probably listen.

Via @thehill.com: Approaching 1 year since the dismantling of USAID with devastating consequences: 700K+ deaths, loss of outbreak surveillance systems, and the end of ag. research that benefitted US farmers... all for <1% of the federal budget. @thelastmileusaid.bsky.social | @altusaid.altgov.info

Area People Amazed At Discovery That Watching TV While Driving Is Distracting

Via @matthewkavanagh.bsky.social on new negotiated agreements with former USAID partner countries: "...what is being sold as autonomy is, in practice, a more transactional and conditional model of engagement that mirrors rather than reduces the colonial relationships critics have long decried."

📡 The January 2026 Apothek Dispatch is live: Reflecting on one year since USAID's dissolution, insights from Kenya on financing Africa's health frontline, & 50+ opportunities spanning internships to senior roles. Plus: WHO withdrawal, exposomics, quantum computing, & what's next for global health.

We've long known about how viral infections can exacerbate CVD- or even increase the likelihood of new onset CVD. Influenza is a well-studied example. bsky.app/profile/amit...

Despicable and unconscionable: In 2024, the copper smelter in AZ emitted more than 11.6 tons of lead and 2.5 tons of arsenic. In 2025, Trump & Zeldin said to the mine owner, essentially: no worries, carry on. The people of AZ and everywhere down wind should be furious. @docsforclimate.bsky.social

"Climate change is also exposing and accelerating long-standing weaknesses in healthcare infrastructure. The regions that are most vulnerable to climate extremes, such as heatwaves, floods and prolonged drought, often coincide with areas that already face fragile medical provision." #planetaryhealth

APHA mourns the loss of Dr. William H. Foege, a titan of public health whose life and work made people around the world healthier and safer. Dr. Foege consistently applied science, innovation and moral clarity to address the most pressing public health challenges of his time. vist.ly/4p4z2

Pete Epanchin's key points, 1 year since the freeze on US foreign assistance: 1) the benefits of foreign assistance did not stop with partner countries; 2) Americans gained as well; 3) trust is far easier to break than it is to rebuild; and 4) unmanaged risks abroad do not stay abroad.

Landmark glyphosate safety study retracted in December, leading to a "...crisis of confidence in the science behind a weedkiller that has become the backbone of American food production. It is used on soybeans, corn and wheat, on specialty crops like almonds, and on cotton and in home gardens."

Interview with an ex-USAID entomologist who worked to prevent malaria around the world: "As a scientist, being able to use scientific data to make decisions that are going to impact people’s lives — that is the best thing you can do." #USAIDForever #MedSky #GlobalHealth

Via @petersinger.bsky.social in @thinkglobalhealth.org: www.thinkglobalhealth.org/article/the-...

"There is no antiviral drug to treat measles. The best protection against the disease is vaccination with the measles, mumps, and rubella (MMR) vaccine. Among the 646 cases in South Carolina, 563 are unvaccinated..."

The cruelty is the point... #USAIDForever

Seriously - no reason to spread ANY germs, no matter which virus or bacteria are causing your symptoms. It's never "just a cold" for a lot of people so keep it to yourself, stay home, wear a mask and open a window if you possibly can.

Great explainer via @lseblogs.bsky.social: Moore's Law gave us 50 years of exponential classical computing growth, but it's hitting physical limits. Quantum computing could provide a horizon of future growth. Perhaps solving problems that old computers never could? Think climate change, cancer, ...

Every dollar invested in global and domestic climate-resilience measures yields between $2 and $10 in avoided losses. Cutting these programs is a false economy that will cost far more in natural disasters, forced migration, and other global powers filling the void we leave behind.

Via @krutikakuppalli.bsky.social: The rise of anti-science rhetoric "...has made routine preventive care feel like walking into an ideological minefield. Increasingly, it is making it harder and sometimes nearly impossible to protect patients’ health."

Remember when pregnant women were being told not to take Tylenol? A new Lancet review a finds no causal link between prenatal acetaminophen use and autism or ADHD. What does matter during pregnancy: high fevers. Source: www.thelancet.com/journals/lan...

The visual “new food pyramid” and written guidance in RFK Jr.’s latest edition of the Dietary Guidelines for America do not match. “It’s a confusing message for Americans” says Dr. Cheryl Anderson of the American Heart Association. My latest. www.theguardian.com/us-news/2026...

I've been thinking about this short story by Andy Weir lately: “Every time you victimized someone... you were victimizing yourself. Every act of kindness you’ve done, you’ve done to yourself. Every happy and sad moment ever experienced by any human was, or will be, experienced by you.”

Via @pauloffit.bsky.social from 2023: Worth a read. The author recounts his conversation with RFK Jr. twenty years ago and the lies that followed. “…RFK Jr. has said that he has taped our conversation. Great. Release the tape. Let’s hear what really happened.” #MedSky

“Fraternity, being together in harmony, is an act of resistance.” -Georges Collinet (Afropop Worldwide @prx.org)

A family from South Carolina brought their measles infections to airports, ferries and various locations in Washington state. The health department says that they didn’t know they had measles. But this is why unvaccinated people are a danger to communities, not just themselves.

"Certain aspects of the new guidelines are laudable and backed by science, but other aspects that are neither evidence-based nor likely achievable within the context of the recommendations are highly concerning."

We're closing the gates to global talent and turning off the taps for scientific research right when we need it most. Climate change, next-gen cancer therapies, quantum computing, AI... all of these challenges require the world's best minds and bold investment. #Science 🧪

U.S. Cuts Health Aid and Ties it to Funding Pledges by African Governments by the inimitable @stephanienolen.bsky.social www.nytimes.com/2026/01/15/h...

Thankfully, my mom trusted the experts and got me vaccinated against polio. My children’s mom trusted the experts and got our kids vaccinated against polio and many other dread diseases. I ❤️ real experts.

PSA for flu and COVID season: If someone dressed like this tells you to wash your hands, you should probably listen.

Via @thehill.com: Approaching 1 year since the dismantling of USAID with devastating consequences: 700K+ deaths, loss of outbreak surveillance systems, and the end of ag. research that benefitted US farmers... all for <1% of the federal budget. @thelastmileusaid.bsky.social | @altusaid.altgov.info

"The proposed revisions to the assessment, released Wednesday, nearly double the amount of formaldehyde considered safe to inhale... Even that older assessment significantly underestimated the dangers posed by formaldehyde..."

From Andy ..."bacterial meningitis that transformed me overnight from a perfectly healthy 22-year-old college student, working at the school newspaper and playing just about every intramural sport, to a comatose ICU patient, fighting for my life on a ventilator." www.thebulwark.com/p/my-life-sh...

Texas A&M decided to publicly cancel my Ethics class, and share a false statement that I declined to provide information, which made it impossible for [them ] to request an exemption. See for yourself, if this statement is true. They are getting creative!

Via @kffhealthnews.org: "Healthy older adults vaccinated against flu have substantially lower risks of hospitalization for heart failure, as well as for pneumonia and other respiratory infections. Vaccination against influenza has also been associated with lower risks of heart attack and stroke."

Short answer: Short of testing, you can't tell! Key takeaway: "Just as both illnesses look alike, you can prevent their spread in similar ways: frequent hand-washing, sticking to places with good ventilation, avoiding crowds, masking, staying home when you’re sick and getting vaccinated."

The climate crisis in Americans’ lives. “The animals and plants that he marveled at throughout the years are fading. He hasn’t seen a bluebird in years. There are far fewer butterflies”. “I do feel a sense of loss and a feeling of mourning,” www.theguardian.com/us-news/2025...

"The most intuitive number in the report is how many people in the world lack access to essential health services. In the 2023 report that number was 4.5 billion and now it’s 4.6 billion."

Via @christahasenkopf.bsky.social: "Air pollution quietly erases around 6% of global gross domestic product each year, far outweighing the annual growth expected from artificial intelligence, yet receives less than 0.1% of global philanthropy." www.weforum.org/stories/2025...

“And has reducing the number of diseases all children are advised to be vaccinated against to 11 from 18 brought the United States in line with most other affluent countries? Two words. No and no” www.statnews.com/2026/01/09/c...

With expanded authority & funding, the Development Finance Corporation (DFC) can be a vital tool for US engagement in global health. 👇 Some ideas on how it can simultaneously advance US health security & improve health outcomes where most needed. @cfr.org www.thinkglobalhealth.org/article/what...

I wrote a personal essay about what the destruction of USAID means for me. My grandfather worked for decades as a USAID economist and my mom grew up in Afghanistan, Pakistan and Nigeria. The end of USAID marks the end of a subculture and way of life that I think is basically good.

My latest publication explores “digital therapeutics” and their potential to address global health challenges. Can these scale exponentially like other digital products, or is their growth more like traditional biopharma treatments? Read via the link below for my take: