Michelle Goldberg on Mark Dybul's departure; stem cell transplant appears to free patient of HIV; condom sales going up; Office of Faith-Based and Neighborhood Partnerships inspires skepticism; Utah House approves anti-abortion legal fund.
Michelle Goldberg on Mark Dybul’s Departure
Michelle Goldberg offers a rich account of Mark Dybul’s departure from the Office of Global AIDS Coordinator on The American Prospect.
Goldberg examines the differences between Secretary of State Hillary
Clinton’s and President Barack Obama’s leadership styles and how that could affect PEPFAR and the US’s stance on global HIV prevention:
Obama, after all, has, like Dybul, made working with faith-based groups
a major priority. He’s eager for bipartisan support, even if it means
sacrificing parts of his own agenda. Clinton, seared by many years of
ideological warfare, is less concerned with placating her opponents.
She thrilled feminists worldwide at the 1995 Beijing conference when
she proclaimed, "Women’s rights are human rights, once and for all." As
secretary of state, she’s promised to foreground women’s issues,
including sexual and reproductive health, which is one reason that,
while foreign-policy conservatives were sanguine about her
confirmation, social conservatives largely were not.
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The recent uproar over family-planning provisions in the stimulus
bill have shown how eager the right is to demagogue on sexual issues.
Should Clinton push forward with more effective prevention policies,
the consensus that has sustained the massive American commitment to
AIDS relief could fray. So far, though, keeping that consensus together
has come at the cost of some women’s lives.
Stem Cell Transplant Appears to Free Patient of HIV
CNN reports: "A 42-year-old HIV patient with leukemia appears to have no detectable
HIV in his blood and no symptoms after a stem cell transplant from a
donor carrying a gene mutation that confers natural resistance to the
virus that causes AIDS, according to a report published Wednesday in
the New England Journal of Medicine."
Hutter and a team of medical professionals performed the stem cell
transplant on the patient, an American living in Germany, to treat the
man’s leukemia, not the HIV itself.
However, the team deliberately chose a compatible donor who has a
naturally occurring gene mutation that confers resistance to HIV. The
mutation cripples a receptor known as CCR5, which is normally found on
the surface of T cells, the type of immune system cells attacked by HIV.
But while successful, the treatment likely won’t be widely applicable:
"About a third of the people die [during such transplants], so it’s
just too much of a risk," Dr. Jay Levy, professor at UC San Francisco. "To perform a stem cell
transplant, doctors intentionally destroy a patient’s immune system,
leaving the patient vulnerable to infection, and then reintroduce a
donor’s stem cells (which are from either bone marrow or blood) in an
effort to establish a new, healthy immune system."
Condom Sales Going Up
William Saletan observes that condom sales are increasing, and he
theorizes that’s because Americans want to "control the family
payroll." "I’d like to think that when times are tough, people become increasingly
rational and careful about limiting their financial commitments,
especially when the welfare of existing children is at stake," writes Saletan. But: "the
part about condoms being a ‘relatively inexpensive form of birth
control’ worries me. Including a barrier method is generally a good
idea. But if people are cutting back on more foolproof contraception
and relying entirely on condoms, there’s always a risk that one
screw-up will lead to pregnancy." True. I wish Congresss and Obama had thought of that when the jettisoned the family planning
provision from the stimulus package.
Office of Faith-Based and Neighborhood Partnerships Inspires Skepticism
On The American Prospect, Sarah Posner is more than skeptical about the newly-reconstituted Office of Faith-Based and Neighborhood Partnerships:
Despite Obama’s own lip service to nonbelievers in his Inaugural
Address, the inclusion of leaders from nonreligious organizations on
this advisory council, and the presence of the word "neighborhood"
alongside "faith based" in his new partnership between government and
community, this is without a doubt a religious endeavor. Why else would
he have chosen the venue of the National Prayer Breakfast
— an event whose origins and true agenda Obama either chose to
overlook, doesn’t understand, or does understand but nonetheless
embraced in the long-standing spirit of phony bipartisanship that the
prayer breakfast represents — to make his first public announcement
about the office, followed by a private signing of the executive order
at the White House?
[Obama] did not, as many had hoped he’d do, reverse two Bush-era executive
orders that permitted employment discrimination by federally funded
religious organizations and the direct funding of houses of worship.
Instead, the executive order he did sign authorizes the director of the
Office of Faith-Based and Neighborhood Partnerships and the advisory
council to refer particular cases to White House counsel and the
Department of Justice for legal review.
Utah House Approves Anti-Abortion Legal Fund
One of the reasons Utah lawmakers have not moved forward on an
abortion ban in the state has been awareness of the cost of defending
the ban in court. Now, the House has approved a proposal that would
set up a "legal defense fund" to fund a challenge Roe with a state abortion ban, the AP reports. "House Bill 114 would create a fund that
accepts private donations to help offset any legal fees the state would
incur if it were to pass an abortion ban by 2014. Defending a law that
bans abortion in most cases would likely cost the state millions of
dollars." But the last similar efforts raised on $13,000. The Senate votes next on the proposal.
My life’s work has been to transform the conversation about abortion, so I am overcome with joy at the Supreme Court ruling in Whole Woman’s Health v. Hellerstedt. Abortion providers have been living under a very dark cloud since the 2010 elections, and this ruling represents a new day.
Abortion providers can finally begin to turn our attention from the idiocy and frustration of dealing with legislation whose only intention is to prevent all legal abortion. We can apply our energy and creativity fully to the work we love and the people we serve.
My work has been with independent providers who have always proudly delivered most of the abortion care in our country. It is thrilling that the Court recognized their unique contribution. In his opinion, after taking note of the $26 million facility that Planned Parenthood built in Houston, Justice Stephen Breyer wrote:
More fundamentally, in the face of no threat to women’s health, Texas seeks to force women to travel long distances to get abortions in crammed-to-capacity superfacilities. Patients seeking these services are less likely to get the kind of individualized attention, serious conversation, and emotional support that doctors at less taxed facilities may have offered.
This is a critical time to build on the burgeoning recognition that independent clinics are essential and, at their best, create a sanctuary for women. And it’s also a critical time for independent providers as a field to share, learn from, and adopt each other’s best practices while inventing bold new strategies to meet these new times. New generations expect and demand a more open and just society. Access to all kinds of health care for all people, including excellent, affordable, and state-of-the-art abortion care is an essential part of this.
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We’ve been under attack and hanging by a thread for so long—with our financial, emotional, and psychic energies drained by relentless, unconstitutional anti-abortion legislation—it’s been almost impossible to create and carry out our highest vision of abortion care.
Clearly 20-week bans don’t pass the undue burden test, imposed by the Court under Planned Parenthood v. Casey, because they take place before viability and abortion at 20 weeks is safer than childbirth. The federal Hyde Amendment, a restriction on Medicaid coverage of abortion, obviously represents an undue burden because it places additional risk on poor women who can’t access care as early as women with resources. Whatever the benefit was to late Rep. Henry Hyde (R-IL) it can’t possibly outweigh that burden.
Some of these have already been rejected by the Court and, in Alabama’s case, an attorney general, in the wake of the Whole Woman’s Health ruling. Others will require the kind of bold action already planned by the Center for Reproductive Rights and other organizations. The Renaissance involves raising an even more powerful voice against these regulations, and being firm in our unwillingness to spend taxpayer dollars harming women.
I’d like to entertain the idea that we simply ignore regulations like these that impose burdens and do not improve health and safety. Of course I know that this wouldn’t be possible in many places because abortion providers don’t have much political leverage. This may just be the part of me that wants reproductive rights to warrant the many risks of civil disobedience. In my mind is the man who stood in front of moving tanks in Tiananmen Square. I am yearning for all the ways to stand in front of those tanks, both legal and extralegal.
Early abortion is a community public health service, and a Renaissance goal could be to have early abortion care accessible within one hour of every woman in the country. There are more than 3,000 fake clinics in this country, many of them supported by tax dollars. Surely we can find a way to make actual services as widely available to people who need them. Of course many areas couldn’t support a clinic, but we can find ways to create satellite or even mobile clinics using telemedicine to serve women in rural areas. We can use technology to check in with patients during medication abortions, and we can provide ways to simplify after-care and empower women to be partners with us in their care. Later abortion would be available in larger cities, just as more complex medical procedures are.
In this brave new world, we can invent new ways to involve the families and partners of our patients in abortion care when it is appropriate. This is likely to improve health outcomes and also general satisfaction. And it can increase the number of people who are grateful for and support independent abortion care providers and who are able to talk openly about abortion.
We can tailor our services to learn which women may benefit from additional time or counseling and give them what they need. And we can provide abortion services for women who own their choices. When a woman tells us that she doesn’t believe in abortion, or that it is “murder” but she has to have one, we can see that as a need for deeper counseling. If the conflict is not resolved, we may decide that it doesn’t benefit the patient, the clinic, or our society to perform an abortion on a woman who is asking the clinic to do something she doesn’t believe in.
I am aware that this last idea may be controversial. But I have spent 40 years counseling with representatives of the very small, but real, percentage of women who are in emotional turmoil after their abortions. My experience with these women and reading online “testimonies” from women who say they regret their abortions and see themselves as victimized, including the ones cited by Justice Kennedy in the Casey decision, have reinforced my belief that when a woman doesn’t own her abortion decision she will suffer and find someone to blame for it.
We can transform the conversation about abortion. As an abortion counselor I know that love is at the base of women’s choices—love for the children they already have; love for their partners; love for the potential child; and even sometimes love for themselves. It is this that the anti-abortion movement will never understand because they believe women are essentially irresponsible whores. These are the accusations protesters scream at women day after day outside abortion clinics.
Of course there are obstacles to our brave new world.
The most obvious obstacles are political. As long as more than 20 states are run by Republican supermajorities, legislatures will continue to find new ways to undermine access to abortion. The Republican Party has become an arm of the militant anti-choice movement. As with any fundamentalist sect, they constantly attack women’s rights and dignity starting with the most intimate aspects of their lives. A society’s view of abortion is closely linked to and mirrors its regard for women, so it is time to boldly assert the full humanity of women.
Anti-choice LifeNews.com contends that there have been approximately 58,586,256 abortions in this country since 1973. That means that 58,586,256 men have been personally involved in abortion, and the friends and family members of at least 58,586,256 people having abortions have been too. So more than 180 million Americans have had a personal experience with abortion. There is no way a small cadre of bitter men with gory signs could stand up to all of them. So they have, very successfully so far, imposed and reinforced shame and stigma to keep many of that 180 million silent. Yet in the time leading up to the Whole Woman’s Health case we have seen a new opening of conversation—with thousands of women telling their personal stories—and the recognition that safe abortion is an essential and normal part of health care. If we can build on that and continue to talk openly and honestly about the most uncomfortable aspects of pregnancy and abortion, we can heal the shame and stigma that have been the most successful weapons of anti-abortion zealots.
A second obstacle is money. There are manyextraordinary organizations dedicated to raising funds to assist poor women who have been betrayed by the Hyde Amendment. They can never raise enough to make up for the abandonment of the government, and that has to be fixed. However most people don’t realize that many clinics are themselves in financial distress. Most abortion providers have kept their fees ridiculously and perilously low in order to be within reach of their patients.
Consider this: In 1975 when I had my first job as an abortion counselor, an abortion within the first 12 weeks cost $150. Today an average price for the same abortion is around $550. That is an increase of less than $10 a year! Even in the 15 states that provide funding for abortion, the reimbursement to clinics is so low that providers could go out of business serving those in most need of care.
Over the years a higher percent of the women seeking abortion care are poor women, women of color, and immigrant and undocumented women largely due to the gap in sexual healtheducation and resources. That means that a clinic can’t subsidize care through larger fees for those with more resources. While Hyde must be repealed, perhaps it is also time to invent some new approaches to funding abortion so that the fees can be sustainable.
Women are often very much on their own to find the funds needed for an abortion, and as the time goes by both the costs and the risk to them increases. Since patients bear 100 percent of the medical risk and physical experience of pregnancy, and the lioness’ share of the emotional experience, it makes sense to me that the partner involved be responsible for 100 percent of the cost of an abortion. And why not codify this into law, just as paternal responsibilities have been? Perhaps such laws, coupled with new technology to make DNA testing as quick and inexpensive as pregnancy testing, would shift the balance of responsibility so that men would be responsible for paying abortion fees, and exercise care as to when and where they release their sperm!
In spite of the millions of women who have chosen abortion through the ages, many women still feel alone. I wonder if it could make a difference if women having abortions, including those who received assistance from abortion funds, were asked to “pay it forward”—to give something in the future if they can, to help another woman? What if they also wrote a letter—not a bread-and-butter “thank you” note—but a letter of love and support to a woman connected to them by the web of this individual, intimate, yet universal experience? This certainly wouldn’t solve the economic crisis, but it could help transform some women’s experience of isolation and shame.
One in three women will have an abortion, yet many are still afraid to talk about it. Now that there is safe medication for abortion, more and more women will be accessing abortion through the internet in some DIY fashion. What if we could teach everyone how to be excellent abortion counselors—give them accurate information; teach them to listen with nonjudgmental compassion, and to help women look deeper into their own feelings and beliefs so that they can come to a sense of confidence and resolution about their decision before they have an abortion?
There are so many brilliant, caring, and amazing people who provide abortion care—and room for many more to establish new clinics where they are needed. When we turn our sights to what can be, there is no limit to what we can create.
Being frustrated and helpless is exhausting and can burn us out. So here’s a glass of champagne to being able to dream again, and to dreaming big. From my own past clinic work:
At this clinic we do sacred work
That honors women
And the circle of life and death.
This is the second article in a two-part series on the effect Rep. Marsha Blackburn’s Select Investigative Panel on Infant Lives is having on the research community. You can read the first piece in the series here.
The anti-choice front group that triggered Rep. Marsha Blackburn (R-TN)’s investigation into widely discredited allegations of fetal tissue trafficking first revealed the identities of researchers who have used fetal tissue in their work more than a year ago.
In May 2015, the Center for Medical Progress (CMP) published unredacted documents naming the researchers that are identical to those used by the so-called Select Investigative Panel on Infant Lives, according to a publicly available online directory discovered by Rewire. In June 2016, CMP added to its database unredacted Planned Parenthood contracts, which appeared verbatim among the documents that Blackburn sent over to the Obama administration as part of her request for a federal abortion inquiry.
CMP’s heavily edited videos alleging that Planned Parenthood profited from fetal tissue donations led to three congressional investigations that yielded no evidence of wrongdoing and the creation of the current panel, seemingly intent on proving otherwise. David Daleiden, the group’s leader, remains under criminal indictment in Texas for fraud in connection with his production and release of the videos. This month, Arizona became the 13th state to find no substance to his allegations.
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One of the at least 14 researchers named in the documents agreed to an interview with Rewire, some of which appeared in part one of this series, on the condition of anonymity. The researcher wasn’t aware that such a prominent anti-choice group had previously revealed the names and contact information for individuals typically found in laboratories, not abortion clinics. Neither did Eugene Gu, a second researcher that spoke with Rewire on the record. The select panel subpoenaed Gu’s company, Ganogen, Inc., in March.
Gu said that by releasing the names and delaying the redactions, Republicans on the U.S. House of Representatives select panel allowed anti-choice groups to get their hands on the researchers’ personal and professional information. The documents were available online for two days before the belated redactions. Links to the unredacted documents sent to reporters remained live for at least five days.
“I was actually hoping that they corrected it fast enough that it wouldn’t be re-circulated, but I guess that was just wishful thinking,” Gu said.
Relationship Raises Eyebrows on Capitol Hill
Gu didn’t realize that CMP had circulated the researchers’ names in 2015. No matter which came first, the underlying fact remains the same: CMP and Blackburn are using many of the same documents to try and prove the existence of fetal tissue trafficking.
The connection, at a minimum, raises a chicken-or-egg scenario. Is CMP feeding information to Blackburn, is it the other way around—or is it a combination of the two?
Congressional Democrats have few doubts that it’s all of the above.
“That relationship is clearly very close,” Rep. Jan Schakowsky (D-IL), the panel’s ranking member, said in an interview with Rewire. “It certainly appears that the Republicans may be receiving documents and information directly from Daleiden or someone associated with him.”
StemExpress, the tissue procurement company targeted in the CMP videos, raised the same objections over Blackburn’s exhibits for the hearing looking into the allegations of fetal tissue “pricing.”
“While some of these illegally obtained documents are posted to the CMP website, some of the Majority’s exhibits have never appeared publicly, suggesting that perhaps the Select Panel may be receiving so-called ‘evidence’ directly from Mr. Daleiden and/or his associates,” the company’s counsel wrote in a letter to the select panel.
Blackburn’s select panel did not respond for comment by publication time.
Fetal tissue research plays an important role in understanding the causes of diseases, particularly Zika and others that strike in utero, according to the researcher. Such research could also lead to major developments in the area of regenerative medicine, potentially replacing lost neurons as a result of Parkinson’s disease and spinal cord injuries.
The researcher that requested anonymity sought to correct the record on Blackburn’s assertions about the processes governing such research.
“It’s important for the public to understand the way research works,” the researcher said. Biologists “will do absolutely everything that they can” in the initial stages to use human cultured cells or animal models, turning to fetal tissue specimens only for final, confirmatory experiments. The researcher described a multistep process that involved senior-level reviews to determine whether experiments had advanced to that stage and, if so, establish reputable sources from which to place orders.
“I would want to reassure people who don’t support the use of fetal tissue for research that researchers take the weight of the responsibility of using this material very seriously,” the researcher said. The research community approaches fetal tissue “with the utmost respect” and reserves use “for the most important experiments when there is no other possible scientifically valid way to address the question that needs to be addressed.”
Frustrations, Fears Run High Amid Slowing Research
Gu echoed similar ethical considerations in his use of fetal tissue. Through Ganogen, he’s set an ambitious goal: End the organ donor shortage, starting with pediatric patients, by growing human fetal organs in animals. He credits fetal tissue with the potential to greatly accelerate the clinical trial process.
“There’s no alternative to having human tissue, and this is human tissue that would be incinerated and thrown away. We’re not encouraging abortions in any shape or form,” Gu said. “A transplant surgeon doesn’t encourage traffic fatalities so they have organs to transplant into their patients.”
The research community, nevertheless, is suffering as a direct result of the investigation and the anti-choice sentiment fueling it. The New York Times reported a downturn in the availability of fetal tissue for research and the willingness of institutions to proceed with what remains. One neurologist delayed his multiple sclerosis research until 2019, according to the Washington Post.
Separately, the reproductive health-care community is facing its own set of consequences—in the form of unprecedented violence that researchers fear could head their way and ultimately, dissuade them from participating in fetal tissue research.
The researcher that requested anonymity recognized the cessation of research as the investigation’s “intended,” if misguided, goal.
“To my mind, it doesn’t help the overall cause of improving humanity by curing disease, and finding new remedies for conditions that plague all of us, to intimidate researchers in this way, especially in an instance like this where it is not the researchers themselves that are accused of doing anything wrong,” the researcher said.
The way Gu sees it, the select panel isn’t just putting his own life, and research, at risk. It’s endangering widespread medical advancements. And it’s frustrating for him.
“That’s why we went to medical school in the first place—to help patients, not to be subpoenaed by Congress,” Gu said.