Viewpoints: It Takes Much More Than A SOTU Pledge To End HIV; Lessons On The Shortcomings Of Precision Medicine

The Washington Post: Trump Says He Wants To End AIDS. His Party’s History Tells A Different Story.
For days preceding Tuesday night’s State of the Union address, word was that President Trump intended to roll out plans to end forever the HIV/AIDS epidemic in America. What he said in his address was terse. He observed the “remarkable progress” that had been made in recent years in the fight against the disease. He promised, “My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years.” And he ended with a flourish, “Together we will defeat AIDS in America.” Not much in the way of plans, but as Samuel Johnson said of a dog walking on its hind legs: “It is not done well; but you are surprised to find it done at all.” (Lillian Faderman, 2/6)

Boston Globe: Trump’s Dubious Promise About Ending HIV
President Trump says he has a plan to end the HIV epidemic in America. During his State of the Union address, he noted that “scientific breakthroughs have brought a once distant dream within reach” and that he would request funding from Congress “to eliminate the HIV epidemic in the United States within 10 years.” We don’t yet know the details of the strategy, but reports indicate that it is modelled after the administration’s approach for ending the opioid epidemic and will target communities where rates of HIV infection are highest. (Sean Cahill, 2/6)

The Washington Post: Trump Can’t Eliminate HIV Without Protecting Obamacare
Watching President Trump’s State of the Union address Tuesday night, my mind raced back to one of my patients, panting as she strung together a few words. “My difficulty breathing,” she paused, “has gotten worse in the last few weeks.” In her hospital bed, she looked gaunt and tired. She was struggling with homelessness and had stopped taking her HIV medications months ago, as she did not have insurance and could not afford the cost of her medications. As her doctor, I feared that she had a life-threatening lung infection, an unfortunate but preventable complication of her HIV. (Robert Bonacci, 2/6)

Stat: Is Precision Medicine Really The Best Approach To Improving Health?
This emphasis on reducing biomedical explanations to genetic pathways, known as genetic reductionism, comes at the expense of all other molecular, cellular, physiological, and epidemiological approaches. The dissenters have made their voices heard in the popular press and medical journals, such as Viewpoints in JAMA. Most recently, a special edition of the journal Perspectives in Biology and Medicine, titled “The Precision Medicine Bubble,” includes contributions questioning genetic reductionism by well-established investigators from genetics, cell biology, immunology, microbiology, pharmacology, physiology, anthropology, epidemiology, public health, and law. (Michael J. Joyner and Nigel Paneth, 2/7)

Los Angeles Times: The Nation Faces Many Problems. A Crisis At The Border Isn’t One Of Them
The American people face a broad range of challenges these days, some of which can genuinely be considered crises. An opioid-fueled overdose epidemic, for instance, that killed some 70,000 people in each of the last two years. Soaring healthcare costs and an insufficient safety net to keep those who fall ill from also falling into bankruptcy. Massive federal debt from ill-conceived tax cuts. Ongoing wars. Not included on that list are illegal immigration and border security. Do we have problems on those fronts? Definitely. Are they crises? Not even close. Yet that is how the president sought to portray them Tuesday during his State of the Union speech. (2/6)

Stat: Address The Ethical Violations That Led To ‘Three Identical Strangers’
Surprise turns to shock and then outrage. That’s the theme of “Three Identical Strangers,” a documentary film released last summer and now being screened by CNN. The film also has a less well-known precursor, “The Twinning Reaction.” Both chronicle twins and triplets born in the 1960s who were separated as infants and adopted by different families who had no idea of the other siblings’ existence. The separation and secrecy were unethical aspects of an experiment that sought to examine the contributions of genetics and environment to child development. The children (who are now adults), their families, and the public deserve answers to many unanswered questions. (Karen Glanz and Holly Fernandez, 2/7)

The Hill: Addressing Drug Problems Abroad Benefits Americans Here
The UN’s Office of Drugs and Crime (UNODC) has tracked the explosive growth in synthetic opioids, present in 111 countries and territories around the world, so that policies can be better designed to meet the evolving challenge. The World Health Organization (WHO) recommends the precursor chemicals and opioid “analogues” that are placed on international watch lists. Together the UNODC and the WHO set international standards for prevention and treatment. As you work within your communities to reduce demand and increase treatment options, understand that the story of supply playing out across the globe will impact your hometown.  Addressing problems “over there” benefits Americans here. (Former Sen. Mark Kirk (R-Ill.) and Former Rep. Ander Crenshaw (R-Fla.)

The New York Times: The Abortion Argument
This week on “The Argument,” the columnists debate abortion. Michelle Goldberg picks apart conservatives’ response to efforts in New York and Virginia to expand access and argues that even ostensibly limited restrictions are part of a broader quest to criminalize the practice. Ross Douthat thinks that in most cases abortion is too abhorrent to remain legal and teases out the various arguments within the wider anti-abortion movement. And David Leonhardt notes that abortion ranks among the political issues on which Americans appear to be genuinely split. (Ross Douthat, Michelle Goldberg and David Leonhardt, 2/7)

Chicago Tribune: Racial Bias Influences Health Care — And It Starts In The Exam Room
“No doctor has ever reminded me that I am black before,” the patient said, laughing and nodding his head to let me know he appreciated my advice. Just as he was startled by my open recognition of his race, so too was I startled by his reaction. (Monica Maalouf, 2/6)

Austin American-Statesman: Legislature Must Ensure Funding For State’s Children’s Hospitals
Children’s hospitals in Texas are facing a dire future—their collective Medicaid losses, across the eight nonprofit institutions statewide in less than ten years, are a breathtaking three-quarters of a billion dollars. The population served by these hospitals include Texas’ poorest and most at-risk children. (Stacy Wilson, 2/6)

Sacramento Bee: What 2-Year-Old American Boy’s Death Exposes About Muslim Ban
As President Donald Trump highlighted his administration’s successes during Tuesday’s State of the Union address, U.S. citizen Ali Hassan and his wife, Shaima Swileh, were in attendance to remind the nation of one of Trump’s greatest failures: The separation of families, including the families of U.S. citizens. Just a month earlier, the couple had buried their two-year-old son, Abdullah, only days after Swileh was finally reunited with her family after a months-long separation due to Trump’s travel ban. As Abdullah lay dying in a hospital bed in Oakland, he was denied — by his own government — the comfort and affection of his mother. (Saad Sweilem, 2/7)