| | | | |  | | By Daniel Payne and Chelsea Cirruzzo | Presented by The Pharmaceutical Reform Alliance | With Carmen Paun
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President Donald Trump's executive orders to overhaul some agency policies have some federal workers worried. | Mark Schiefelbein/AP | WATCH AND WAIT — Federal workers are facing fresh anxieties with President Donald Trump’s first week of actions targeting agencies, including those that lead the federal government’s health policies. Some workers keeping the government running are thinking about quitting, POLITICO’s Liz Crampton, Nick Niedzwiadek, Kevin Bogardus, Nahal Toosi and Alice Miranda Ollstein report. Others are preparing to file grievances with their unions, moving communications to encrypted platforms or strategizing. Within hours of returning to power, Trump issued a slew of executive orders seeking to overhaul how the federal government operates, from removing job protections to ending remote work to implementing a hiring freeze. But his order to remove diversity, equity and inclusion programs has been especially worrisome. For many federal workers, watching and waiting are the best courses of action until they have more clarity about what comes next. That’s partly because not all of Trump’s executive orders are what they seem … A number of the incoming administration’s orders have more muscle than they did in the first Trump administration — but some are just posturing, POLITICO’s Irie Senter and Megan Messerly report. Removing diversity, equity and inclusion programs, freezing spending from the Inflation Reduction Act, withdrawing from the World Health Organization and pulling the plug on the U.S.’ commitment to the Paris climate agreement have real consequences across the country — and the globe. But Trump’s order defining gender as only male or female won’t automatically fulfill the president’s campaign-trail promises to stop transgender students from participating in sports. And the order targeted at ending the federal government’s efforts to pressure social media platforms to change their content comes after most of those activities have already ceased. Still, a number of the Week One policies, from allowing transgender troops to openly serve in the military to ending birthright citizenship, will likely be decided by the courts. WELCOME TO MONDAY PULSE. I’m Daniel Payne, filling in for Chelsea today. Do you know something about Robert F. Kennedy Jr.’s upcoming confirmation hearing — or a tip about other health policy movement on the Hill? Reach out by email at dpayne@politico.com or by Signal @danielp.100 and ccirruzzo@politico.com and @ChelseaCirruzzo.
| | | | A message from The Pharmaceutical Reform Alliance: Big Pharma continues to profit at the expense of American consumers, pricing the same drug nearly 10x higher in the U.S. than in other countries. Let's take action to curb skyrocketing medication costs and bring relief to American families. Learn more. | | | | | | 
Democrats are waging an all-out ad fight to prevent Robert F. Kennedy Jr. from becoming secretary of HHS. | Pool photo by Julia Demaree Nikhinson | FIRST IN PULSE: SENATORS IN THE CROSSHAIRS OF ANTI-RFK PUSH — Protect Our Care’s Stop RFK War Room is out with a new ad campaign urging senators to reject his confirmation. The campaign from the Democratically aligned health group leads up to Robert F. Kennedy Jr.’s HHS secretary confirmation hearing before the Senate Finance Committee on Wednesday. Kennedy will appear before the Senate Health, Education, Labor and Pensions Committee on Thursday. The group, which is putting more than a million dollars into its monthslong campaign against Kennedy, plans to target senators it believes could be open to voting against Kennedy: Sens. Bill Cassidy (R-La.), Susan Collins (R-Maine), John Curtis (R-Utah), Joni Ernst (R-Iowa), Mitch McConnell (R-Ky.), Lisa Murkowski (R-Alaska), Mike Rounds (R-S.D.) and Thom Tillis(R-N.C.). Another group is targeting the same senators. 314 Action, which works to boost scientists’ voices in policymaking, will launch $250,000 in digital ads Monday. Both groups will call attention to Kennedy’s history of anti-vaccine rhetoric as a reason to reject him.
| | | | Power shifts, razor-thin margins, and a high-stakes agenda. We’ve transformed our coverage—more reporters, more timely insights, and unmatched policy scoops. From leadership offices to committee rooms, caucus meetings, and beyond, our expert reporting keeps you ahead of the decisions that matter. Subscribe to our Inside Congress newsletter today. | | | | | | | CIA LEANS TOWARD LAB LEAK — Several Republican lawmakers and others who have supported the theory that a lab leak in China triggered the Covid-19 pandemic feel vindicated after the CIA said Saturday it’s more likely that was the pandemic’s origins than an infected animal that spread the virus to people, Carmen reports. This comes after the CIA has been saying for years that it couldn’t conclude with certainty how the pandemic started. A U.S. official granted anonymity to share private details about the assessment said former CIA Director William Burns had told analysts that they needed to take a position on the Covid pandemic’s origins but he was agnostic on potential theories. A new CIA analysis of the intelligence it had on the virus’ origin was completed and published internally before the arrival of former Republican congressmember John Ratcliffe, who became the CIA’s new director Thursday. Why it matters: Congressional Republicans have embraced the unproven lab leak theory, pointing to how the first cases of Covid were reported in Wuhan where a virology lab was researching coronaviruses at the time. Background: Neither theory about how the pandemic started has been proven.
| | | | A message from The Pharmaceutical Reform Alliance:  
| | | | | GLOBAL HEALTH PROGRAMS’ SPENDING FREEZE — A Secretary of State Marco Rubio order freezing foreign aid spending for 90 days Friday alarmed global health activists, some members of Congress and former global health officials, who warned it would lead to deaths among people depending on it for lifesaving treatment. The President’s Emergency Plan for AIDS Relief — better known as PEPFAR — which funds treatment for people living with HIV in many countries, mostly in Africa, is one example. “This stop-work order is cruel and deadly,” said Asia Russell, the executive director of Health GAP, a nonprofit that advocates for access to treatment in people with HIV. “It will snatch HIV medicines, prevention services and support from the hands of adults, babies and young people across PEPFAR-supported countries,” she said. Russell argued that the global program, credited with saving 25 million lives since President George W. Bush started it in 2003, makes America safer, more prosperous and more secure, in line with President Donald Trump’s foreign policy tenets. The program has received about $5 billion in funding annually in recent years. Dems react: Reps. Gregory Meeks (D-N.Y.), top Democrat in the House Foreign Affairs Committee, and Lois Frankel (D-Fla.), ranking member in the House Appropriations Subcommittee on National Security, Department of State and Related Programs, also warned in a letter to Rubio on Friday that the freeze will cost lives, referring to PEPFAR and the President’s Malaria Initiative, which they wrote “provides 37 million mosquito nets and malaria medicines to 63 million people to prevent further spread of one of the world’s deadliest diseases. These lives depend on an uninterrupted supply of medicines.” Dr. Atul Gawande, who ran global health programs at the U.S. Agency for International Development during the Biden administration, warned in a post on X on Saturday that the order also stops work battling a deadly outbreak of Marburg — a virus similar to Ebola, known to cause more deaths — in Tanzania and “stops monitoring of bird flu in 49 countries, a disease which has already killed an American on home soil.”
| | | | New Year. New Washington. New Playbook. With intensified congressional coverage and even faster delivery of policy scoops, POLITICO’s reimagined Playbook Newsletter ensures you’re always ahead of the conversation. Sign up today. | | | | | | | MEXICO CITY POLICY IS BACK — Trump signed an executive order Friday reinstating the so-called Mexico City Policy — named for the city where it was first announced — restricting foreign organizations receiving U.S. global health funding from providing and promoting abortion with other sources of financing. In doing so, Trump is follows a Republican presidential tradition that started with Ronald Reagan in 1984. Democratic presidents have rescinded the policy. The Trump administration renamed it Protecting Life in Global Health Assistance during his first term. Anti-abortion advocates, including members of Congress, celebrated the return of the policy. “By redirecting taxpayer dollars away from the abortion industry, President Trump has reinstituted a life-affirming protection consistent with the political consensus that taxpayer dollars should not fund abortion and the abortion industry,” said Rep. Chris Smith (R-N.J.), who chairs the House Foreign Affairs global health subcommittee. Organizations that work to prevent infectious disease and provide abortions and those that advocate for abortion rights warned that the policy would ultimately cost lives. “The cost of reimposing this rule will be paid in hardship, human lives and a reversal of some of the most important gains in the HIV response,” said Beatriz Grinsztejn, president of the International AIDS Society. She argued the policy will cause “severe disruption to health services, including HIV and reproductive and sexual health, particularly in areas of the world most affected by HIV.” And so is the Geneva Consensus Declaration: The Trump administration Friday made another anti-abortion move on the global stage: The State Department informed signatories of the Geneva Consensus Declaration of the U.S. intent to rejoin immediately. Background: The declaration, signed during the first Trump administration, was a joint initiative with Brazil, Egypt, Hungary, Indonesia, and Uganda. The coalition of countries sought to curb global access and support for abortions by stating that no international right to abortion exists, and thus countries don’t have any obligation to finance or facilitate it. Former President Joe Biden withdrew the U.S. from it when he took office. Brazil and Colombia have also since withdrawn from it, as progressive heads of state took over in both countries.
| | The New York Times reports on the reasons some vaccines contain aluminum. The Washington Post reports on why Covid rates weren’t as bad as expected this winter — but flu rates were worse. The Atlantic’s Faith Hill questions the narrative of the modern loneliness epidemic.
| | | | A message from The Pharmaceutical Reform Alliance: Big Pharma boosts drug prices year in and year out, often without clinical justification and at a pace exceeding inflation. This pads Big Pharma's profits while hurting American patients who already struggle to afford healthcare costs. Over the past decade, the price of some life-saving medications have increased astronomically, with some drug prices increasing up to 5,000%. Learn more. | | | | | | | Follow us on Twitter | | | | Follow us | | | | |
