Happy Thursday everyone! It’s your researcher McKenzie back to write today’s top. Welcome to The Health 202, where we’re planning our best outfits because D.C.’s after-hour museum parties are officially back.
Unintended pregnancies will likely be one consequence of Russia's invasion
One potential lasting consequence of the Russian invasion for Ukraine is more unintended pregnancies, which could have ripple effects for years to come.
Just look at estimates for Afghanistan. A new United Nations report estimates that the Afghanistan war may lead to 4.8 million unintended pregnancies by 2025 — an effect that could also show up among Ukrainian women and girls who are being uprooted from their homes.
When Russia first invaded Ukraine, officials involved in relief efforts said their priority was to deliver lifesaving trauma supplies to hospitals to stave off immediate deaths.
But now Ukraine’s health system is under tremendous stress as it struggles to meet the needs of almost 6.5 million people displaced within its borders, more than half of whom are women, according to a study by the International Organization for Migration. Five weeks into the war, relief workers are scrambling to meet ongoing health needs — and for women, that includes reproductive health care.
- “When we are in the center of this, of course the first thought is how to survive,” Halyna Skipalska, director of Ukraine for HealthRight International, told The Health 202. “Two weeks ago, reproductive health was not a main focus, but now [organizations of relief efforts] are thinking of it.”
The U.N. Population Fund (UNFPA), a sexual and reproductive health agency, estimates that at least 265,000 Ukrainian women were pregnant when the invasion began, and up to 1,000 will give birth weekly over the next three months. Besides helping these women deliver safely amid active combat, challenges include delivering contraceptives in the war zone and giving assistance to women who become pregnant due to rape.
- Ukraine has already begun its investigation into reports of sexual violence against women involving Russian soldiers, which began to emerge almost immediately after the invasion began, the New York Times reports.
- “If you had 15 minutes to leave your house, what would you take? Would you remember your contraception?” said Natalia Kanem, executive director of UNFPA, which spearheaded the report. “In the days, weeks and months after a crisis starts, sexual and reproductive health and protection services save lives, shield women and girls from harm, and prevent unintended pregnancies. They are as vital as food, water and shelter.”
The challenges will likely be exacerbated by a rise in unintended pregnancies due to an expected spike in sexual violence.
Looking at the past: According to the U.N. report, roughly 20 percent of women in humanitarian emergencies, like the ongoing conflict in Ukraine, will face sexual violence — and more than 1 in 3 of them will become pregnant as a result of forced or pressured sex.
Kanem said the active war zone in Ukraine could also exacerbate preexisting human trafficking problems in the region as women flee the country.
HealthRight, a global health organization, is rushing to develop a safe way to deliver supplies to survivors within 72 hours of their attack, which Skipalska said is a critical intervention period to screen for sexually transmitted infections, collect evidence and administer emergency contraceptives to prevent unintended pregnancy.
Ukrainians will need midwives and medical teams that speak the language, are trained to work in a combat zone and are willing to enter areas with active fighting. There will also be demand for abortion pills, a variety of birth control methods and drugs for people with preexisting conditions, like HIV.
Kanem added that while the international aid community has pivoted its attention to “put women and girls at the center” of their efforts, “the resources do not match up with that aspiration.”
But the direction of aid is changing, and more funds are on their way.
- Some of the funds will go toward producing and distributing dignity kits to refugees, which include basics like soap, hygiene products and information about sexual violence.
The International Planned Parenthood Federation (IPPF) told The Health 202 there’s also a critical need for obstetrics tools to perform deliveries in makeshift underground maternity wards.
- The World Health Organization estimates that 15 percent of pregnancies — regardless of whether the women are in a war zone — will require skilled medical care for potentially lifesaving complications.
- “Babies don't wait,” said Caroline Hickson, European regional director for IPPF. “Women giving birth are a group who are at risk if things go wrong and they can’t access the support they need.”
And yet, areas of Ukraine are short on safe places to seek out care. The WHO has verified at least 82 attacks on health care since the onset of the Russian invasion. At least 68 incidents affected medical facilities and 18 affected health-care workers. There have been approximately 72 deaths.
UNFPA emergency supply distribution site:
Pregnant women in #Ukraine urgently need #ReproHealth medicines and equipment to deliver safely.— UNFPA Eastern Europe & Central Asia (@unfpaeecaro) March 29, 2022
@UNFPA is delivering over 13 tons of supplies to cover the most urgent needs. pic.twitter.com/L308DbJ3aL
White House rolls out ‘one-stop shop’ website
President Biden announced yesterday the launch of covid.gov, where Americans can find vaccines, tests, treatments and masks. The new website also includes information on local spread of the virus, guidance on travel rules and a new tool to help Americans find places to quickly get antiviral treatments if they have covid-19, our colleague Dan Diamond reports.
And Congress pushes on more covid-19 funds
Biden also pushed Congress to end its weeks-long stalemate on more coronavirus aid. There may be some traction here.
Last night, Sen. John Thune (S.D.), the chief Republican vote counter, told The Hill that the size of the potential deal could shrink to $10 billion. That’s because the negotiators would drop roughly $5 billion in aid to fight the coronavirus abroad because not enough funding could be agreed upon to finance it.
- A Senate GOP aide told The Health 202 the same, adding that $5 billion could be for therapeutics, and the other $5 billion for therapeutics, vaccines or testing.
- The caveat: An agreement has not been announced as of early this morning. Spokespeople for Democrats didn’t immediately return a request for comment late last night.
Meanwhile, Biden gets a boost
The president received his second booster on camera just a day after federal health officials signed off on another dose for those 50 and older. The move comes as some experts say Biden faces a heightened risk of contracting covid-19. Over the last two weeks, the coronavirus has crept closer to the president, with the second gentleman and two high-profile White House staffers recently getting infected.
Biden to lift pandemic border restrictions
The Biden administration is planning to lift a Trump-era pandemic order that let authorities rapidly expel border crossers, The Post’s Maria Sacchetti and Nick Miroff report.
The restrictions won’t end immediately. The administration is expanding border facilities and migrant processing capacity, aiming to fully halt the measures in May. Biden officials have maintained they’ll defer to the Centers for Disease Control and Prevention, the agency completing a review of the Title 42 order. An official announcement is expected this week.
The backstory: The Trump administration implemented the measure in March 2020, characterizing it as a way of preventing the coronavirus from spreading inside detention cells, border stations and other crowded spaces. Some Democratic leaders have been urging Biden to end the program, while Republicans have been pushing for it to stay.
From our notebook
It’s the prices …
Americans really want lawmakers to curb the cost of health care. That’s according to a new poll from the Kaiser Family Foundation, which asked adults how they would rank a slew of health policies.
Here’s what the public says should be a top priority for Congress:
- Limiting price increases for medicines to the rate of inflation (61 percent)
- Capping out-of-pocket costs for insulin at $35 per month (53 percent)
- Placing a limit on seniors’ out-of-pocket health costs (52 percent)
- Allowing Medicare to negotiate the price of prescription drugs (48 percent)
But who’s to blame if Congress can’t pass drug pricing legislation? About half say either Biden (23 percent) or congressional Democrats (29 percent) deserve the most blame, while 44 percent say Republicans should be responsible.
A regional Planned Parenthood affiliate filed a lawsuit seeking to block Idaho’s new ban on nearly all abortions.
The details: Last week, Idaho became the first state to enact a law modeled after Texas, which bans abortions after fetal cardiac activity is detected and deputizes private citizens to enforce the law. Planned Parenthood filed a petition with the state Supreme Court yesterday seeking to stop the measure from going into effect next month.
In other news … the Department of Health and Human Services awarded over $256 million in grants for the federal family planning program, including some to Planned Parenthood. Last year, the Biden administration reversed a Trump-era rule barring clinics from receiving Title X funds if they refer patients for abortions.
And Arizona Gov. Doug Ducey (R) signed legislation barring abortions after 15 weeks, mirroring a Mississippi ban the Supreme Court seems inclined to uphold.
In other health news
- Pregnant women who are vaccinated are nearly twice as likely to get infected as those who aren’t pregnant, our colleagues Amy Goldstein and Dan Keating report.
- In a 54-to-44 vote, the Senate confirmed January Contreras to serve as assistant secretary at HHS’s children and families division.
- The CDC removed its pandemic-era travel warnings for cruises, per The Post’s Hannah Sampson.
- A panel of outside FDA advisers voted against approving an experimental medicine for ALS because the clinical study data failed to establish the drug’s effectiveness, Reuters reports.
- Thirteen groups — such as Amnesty International USA and Trade Justice Education Fund — are urging Biden to reject the recently-leaked provisional deal to waive patent rights for certain covid vaccines. They argue it “would not achieve any of the goals of the promised TRIPS waiver.” Adam Hodge, a spokesperson for the U.S. Trade Representative, told The Health 202 that no agreement on text has been reached, but that USTR had joined informal discussions “to try to break the deadlock.”
Biden’s new budget proposal pic.twitter.com/FKj7G3UToP— Washington Post TikTok Guy 🤹🏼♂️ (@davejorgenson) March 30, 2022
Thanks for reading! See y'all tomorrow.