Last week, the Food and Drug Administration (FDA) approved a small pill called enlicitide. It is a tablet you swallow once a day on an empty stomach with a sip of black coffee, water, or tea. But it does something that until now took a needle and a specialist’s prescription: It lowers the most dangerous kind of cholesterol by nearly 60 percent, about as much as the strongest injectable drugs on the market.

If that sounds less innovative than some of the medical advances I sometimes cover here — there’s no AI or gene editing involved — you’re missing the story. Enlicitide is just the latest example of how medicine has been quietly making progress against the deadliest thing in the modern world.

That thing is heart disease. It has been the leading cause of death in the United States for essentially a century, and in 2025 it killed 694,708 Americans — about one in five deaths — more than every form of cancer combined. Around the world, cardiovascular disease kills roughly 20 million people a year, the biggest cause of death on the planet.

But today, our enemy is on the retreat. In the US, the age-adjusted death rate from cardiovascular disease has fallen about three-quarters since 1950. In plain terms: A 60-year-old today is roughly four times less likely to die of heart disease this year than a 60-year-old was when Harry Truman was president. As I wrote last year, deaths specifically from heart attacks are down 89 percent since 1970.

That progress comes down to a single number. Low-density lipoprotein, or LDL, aka the “bad” cholesterol your doctor always wants you to lower. Until recently, a high LDL score was all but inescapable, something you could nudge lower with a better diet and willpower but struggle to really fix. What has changed is that we can now lower LDL for nearly anyone who needs it — further, more easily, and earlier in life than before.

A lifesaving genetic mutation

It’s a story that goes back 20 years. In the early 2000s, two geneticists at University of Texas Southwestern, Helen Hobbs and Jonathan Cohen, wanted to solve a medical mystery: Why did some individuals have striking low cholesterol levels? They combed the Dallas Heart Study for an answer. They found a handful — many of them Black Americans — carrying a broken copy of a gene called PCSK9. Their bodies cleared LDL from the blood with unusual efficiency, and the payoff was staggering: carriers of the strongest variant had about 28 percent lower LDL and roughly 88 percent lower risk of heart disease than people who did not carry the mutation.

That finding proved lowering LDL prevents heart attacks, and it handed drugmakers a target: copy that gene. Every PCSK9 drug since — including the new enlicitide — imitates a mutation a few people in Dallas were simply born with.

Millions of Americans still take the old cholesterol-lowering workhorses, statins, and they’ve proven highly effective at reducing heart disease for most people. But not everyone: Some people can’t tolerate the muscle aches; others take them faithfully and still don’t get their LDL low enough. Enlicitide is built for exactly those people: a pill as cholesterol-lowering as an injection but without the needle, and a drug that spares them the statin muscle aches.

Closing the loop

If the pill is today, gene editing is tomorrow — and it may be the answer to a problem no pill can reliably solve: getting people to keep taking their medicine.

About half of patients on statins quit them within a year, and a daily pill, however potent, only helps the people who actually take it. So that demands a fix you can’t forget. A company called Verve Therapeutics, now owned by Eli Lilly, has been testing a treatment that makes a single-letter edit to the PCSK9 gene in the liver — one infusion, in theory for life. In its first human trial, published over the spring in the New England Journal of Medicine, a single dose cut LDL by as much as 62 percent, and held it there for more than a year. Instead of a pill mimicking the effects of the genetic mutation that protected those people in Dallas, gene editing just switches off the gene.

As important as it is, cholesterol isn’t the whole story when it comes to heart disease. There’s smoking, which declined from about 40 percent of US adults in the 1960s to under 15 percent today, sparing countless arteries. High blood pressure — the silent condition that killed President Franklin D. Roosevelt at 63 in 1945, when doctors had few effective ways to treat it — can now be caught early and treated with cheap generic pills.

And then there are the GLP-1s. More than one in 10 US adults say they are currently on an anti-obesity drug, and whatever else you may think of them, they’ll make a significant dent in heart disease. In one major trial semaglutide cut cardiovascular events by 20 percent.

The war continues

Still, the war on heart disease won’t be easy to win.

Just because a pill like enlicitide has been proven to lower a lab value does not mean it’s yet proven to lower deaths. They should — the injectable versions of these drugs cut heart attacks and strokes by about 20 percent in long trials. But enlicitide’s own outcomes study won’t conclude for years.

Precisely because the condition itself so widespread, treatments for heart disease will only be effective if they are equally widespread.

Heart disease is shifting, too. The same research showing heart-attack deaths down 89 percent found deaths from other heart conditions — heart failure, arrhythmias, hypertensive disease — up 81 percent since 1970, though because heart attacks were killing several times as many people, overall heart-disease deaths have still dropped by about two-thirds since 1970.  Some of that shift is perversely the result of success: people who might have died of an initial heart attack now live long enough for the heart to wear out in other ways. And some of this is the reverse of progress: As smoking and cholesterol fell, obesity climbed to about 40 percent of US adults, pulling diabetes and high blood pressure with it.

And then there’s perhaps the biggest problem in medicine: access. A 60 percent drop in cholesterol helps only the people who can actually get the drug. Half of patients abandon cheap statins within a year. Enlicitide arrives at about $300 a month with uncertain insurance coverage. The gene edit, whenever it becomes available, will certainly cost far more, and at first will reach only the sickest.

More than 60 percent of US adults are projected to have some form of heart disease over the course of their life. Precisely because the condition itself so widespread, treatments for heart disease will only be effective if they are equally widespread.

Which brings us back to that unassuming little pill. It’s just a tablet, doing what a generation of scientists spent their careers trying to do: turning one of the deadliest numbers in medicine into one you can change. It’s the kind of progress that’s too easy to miss — until it saves your life.

A version of this story originally appeared in the Good News newsletter. Sign up here!

The gerontocracy is real: The median senator is 64 years old, and 20 members of Congress are over 80. One legal scholar called it the “old-igarchy.” It seems the combination of President Donald Trump’s recent 80th birthday, the sudden death of Sen. Lindsey Graham, and the currently unknown health status of Sen. Mitch McConnell has called collective attention to the advanced age of our elected officials — and with good reason. 

So this week, I talked with Rep. Jim Clyburn of South Carolina on his 86th birthday. And I wanted to (delicately) ask a question that’s been brewing in my head since the whole fiasco with then-President Joe Biden: Why don’t the oldheads want to retire? 

Over a long interview, I asked the House Democratic leader about generational change, shifts in the electorate on corporate PAC money and artificial intelligence, and whether he thinks there are any lessons to learn from the 2024 election.

On the question of age, Clyburn told me, “I know people who are 66 years old with much less energy than I have, and none of the experience that I have.” Clyburn said he would also be open to a recently proposed law calling for members of Congress to take cognitive tests, though he dismissed the idea of term limits or an age cap. 

Here’s what else I learned: 

1. They aren’t giving up power because they don’t want to

That’s the whole thing. The reason the boomers (and Clyburn’s Silent Generation) won’t step aside isn’t that no one has asked. It’s that they don’t want to. And for Clyburn, I think the armor doubles as the blind spot. When I asked about younger generations being distrustful that older politicians can deliver, he invoked his grandparents, saying, “Don’t worry about what people call you. It’s what you answer to that’s the issue.”

And while that is wisdom, hardened over the decades, I don’t know if it works as well as a leadership philosophy. Stay the course and ignore the criticism can also be read as ignoring electoral feedback. “I don’t react to that stuff,” Clyburn said, when asked about calls for generational change.

2. Clyburn says what the establishment thinks: It’s the voters’ fault

Clyburn articulates the core view of establishment politics as cleanly as anyone: There is nothing much to change. He doesn’t believe the party made significant errors in 2024, and he doesn’t take the primary results in New York City, Colorado, and elsewhere to be anything other than a flash in the pan. Pushed on what political lesson he took from an administration built to stop Trump that ended with Trump back in office, he went to turnout: “When the white vote turned out 71 percent two years ago, and the Black vote turned out 59 percent, you tell me whose fault that is.” Asked directly whether the argument was that Black people let Kamala Harris down, he didn’t hesitate: “In many instances, absolutely.” 

At its heart, this is a philosophy that blames the voters and insulates the party establishment from reflection. 

But this is also why the next round of primaries is so important. It’s easy to file New York, Colorado, or Graham Platner’s rise in Maine as one-offs — local flukes, not an overwhelming trend. But the Michigan and Wisconsin primaries are coming, and those are the ones that decide whether this gets treated as a pattern. The temperature of the freakout is still yet to be set.

3. He defends the establishment’s alliance with the Congressional Black Caucus

The moderate wing of the Democratic Party is held up, at the grassroots, by Black voters — particularly in the South. Clyburn knows that, and he defended both the alliance and the corporate policies that tie them together. 

Clyburn holds that taking corporate dollars is necessary for minority candidates who don’t come from family wealth — “I would challenge you to find me one single vote I have ever cast that pharma supported and my constituents didn’t.” He deferred to a pro-Israel colleague, Rep. Gregory Meeks, on questions of Israel: “I’m guided by Gregory Meeks.” He made no apology for backing Andrew Cuomo over Zohran Mamdani in this year’s New York mayor’s race — the same Cuomo he’d said should resign in 2021.

I asked him what Black communities have gotten in exchange for that loyalty. His answer was an agenda: “What did we get out of our support for Obama? What did we get out of our support for Biden?” And that’s a real answer. But I think there’s also another one underneath it.

I see Clyburn’s actions through the context of changing power within the Democratic Party, just as much as what’s going on outside of it. The Black political class, specifically, is invested in holding its own position against the party’s rising coalitions, immigrant communities in particular. That’s part of what’s at the heart of Clyburn’s endorsements of Cuomo and Haley Stevens in Michigan, and even the recent fight over which states should vote first in the Democratic presidential primary. 

Find the full episode — including a bonus segment where Clyburn defends the party’s approach to Israel — wherever you get your podcasts.

Could you accidentally gamble away your right to vote?

If you live in Wisconsin, and you bought contracts on a prediction market like Kalshi about who would win elections there, you’ve done just that, according to state election officials. And they think that if you vote anyway, you could be prosecuted.

“We want voters to understand that they cannot legally make a bet on an election and cast a ballot in that same election,” Meagan Wolfe, administrator of the Wisconsin Elections Commission, said in a statement Tuesday, ahead of the state’s August 11 primaries.

The reason wasn’t a new law about online markets but a very old statute dating back to the year 1849 — just after Wisconsin became a state. 

“No person shall be allowed to vote in any election in which the person has made or become interested, directly or indirectly, in any bet or wager depending upon the result of the election,” the statute reads.

The bipartisan commission also said those voters could be on the hook for felony exposure, if they know about the prohibition and vote anyway. Intentionally voting while not being qualified to do so is a felony, per state law. “It’s important for voters to understand the consequences if they bet on an election outcome,” Wolfe said.

Many other states have laws on the books against gambling on elections. Wisconsin is the first where officials are saying people are banned from voting if they do it through prediction markets.

And it may not be the last, since New York has a very similar provision in both its constitution and state law. 

“In New York State, voting in an election in which an individual has placed any bet or wager on the result is prohibited,” Kathleen McGrath, director of public information for the New York State Board of Elections, told me. 

The New York attorney general’s office has not yet issued a formal opinion on whether Kalshi and Polymarket election bettors are barred from voting in elections they’ve wagered on. But they’re currently locked in a court battle to try and get Kalshi regulated under state gambling laws.

All this makes for a potentially explosive situation in the upcoming midterms, given the rapid growth of the industry, which has rolled out massive advertising campaigns and sponsorship deals to attract customers this election cycle. 

Prediction market companies have responded with fury. Benjamin Freeman of Kalshi posted on X that this was “insane,” blatantly unconstitutional,” “illegal,” “dishonest,” and “dystopian.” In an emailed statement, Kalshi said this was “incredibly dangerous to democracy.” 

Bettors may be less perturbed. “The reaction I am party to is almost amused by how idiotic it is — how unenforceable, and backwards, and emblematic of government regulators,” said Alex Keeney, who founded Eventual, a prediction market podcast he co-hosts with traders.

But Wisconsin Elections Commission member Ann Jacobs, who flagged the issue earlier this year and helped create the new guidance, told me in an interview that the decision was not taken lightly.

“This has been the law for a long time,” she said. “And if you don’t like the law, go talk to your legislator.”

So, where did this old law come from? Could it actually be enforced? And would it hold up against court challenges?

America’s hidden history of degenerate election gambling

It may seem surprising that a state would have such an old law of this nature on the books.

But, it turns out, many early 19th century Americans were degenerate election gamblers — so many that this became a topic of national conversation and condemnation.

In a 2012 paper, economic historian Paul Rhode and economist Koleman Strumpf wrote that betting on elections was “commonplace” since the US’s earliest years as a nation, but that it became “especially intense during the partisan conflicts of the Jacksonian era.” Newspapers, which in those days were mainly partisan, championed the practice.

Concerns eventually rose that election betting encouraged election rigging, just as people complain today that prop bets are corrupting sports. After the 1844 election, Rhode and Strumpf wrote, Whig Party members complained that “gamblers favoring Polk had committed voting fraud using the winnings from election bets to defray their expenses.” 

Then, in 1845, the governor of New York, Silas Wright, urged his state legislature to make “the extensive and rapidly increasing practice of betting on elections” illegal, due to the “corrupting tendencies which it exerts upon the election itself.” And, Rhode and Strumpf continue, evangelicals “preached long and hard against election betting” as part of the second Great Awakening movement.

The craze eventually faded, but it was peaking just around the time Wisconsin became a state in 1848. So its new state constitution specifically addressed the issue, saying “laws may be passed” excluding election bettors “from the right of suffrage.” Hence the 1849 law.

Why attention returned to this law in 2026

In recent years, in the rare occasions when the law has been noticed at all, it’s been treated as an amusing, antiquated curiosity. 

But the rise of prediction markets like Kalshi and Polymarket — and the corresponding surge in election betting — made it relevant again.

In March, after Jacobs of the Wisconsin Elections Commission heard a radio story about Polymarket, she posted on X: “WI friends – I know it’s all the rage to bet on everything, but you cannot bet on an election in Wisconsin!  If you do, your ballot can be challenged & thrown out.”

Kalshi has long taken the position that it doesn’t allow election “gambling,” but rather “financial products” called “event contracts.” But the commission’s legal staff studied the issue, and concluded earlier this month that it was “relatively clear” that a Wisconsinite “cannot, even indirectly” make a bet or wager on an election and then vote in that election. 

The press release warning voters — and the backlash from Kalshi and Polymarket — soon followed. 

How the law might (but probably wouldn’t) be enforced

So, what would happen, then, if an avid “event contract” trader decided to vote anyway?

Realistically, the answer is: probably nothing.

But if someone else had knowledge that this person was making election bets and voting, they could show up to try to get them disqualified.

“You would have to be there at the moment they showed up to vote — or when their absentee ballot is pulled out to be counted — and you’d say, ‘I’m challenging that voter,‘” Jeff Mandell, a Wisconsin election lawyer, told me. “But the chances that somebody is around with the right knowledge to block someone on one of these bases strikes me as pretty slender.”

The other theoretical risk is felony prosecution. Law enforcement officials could obtain information that people voted on elections they’d wagered on and, then, criminally charge them for  voting illegally. 

But Mandell pointed out that “that seems like a lot of work” for a prosecutor, adding, “I think that fears about enforcement, either civil or criminal, are probably overstated.”

Still, Jacobs argued, it’s possible. “This is the law,” Jacobs said. “It is a situation where, if people have placed a bet, they should consult with their own attorney and decide what to do.”

Would the law stand up to court challenge?

Since Wisconsin’s original state constitution specifically said the state could restrict election bettors from voting, the law would seem to be on firm ground.

There’s just one catch: That section of the constitution was repealed forty years ago. 

That repeal was made as part of a broader overhaul of the document and doesn’t appear to have been specifically targeted at the election betting issue. But it does mean that the statute doesn’t necessarily have the firm state constitutional footing it once did.

“The current constitutional language only authorizes the legislature to disenfranchise voters on two grounds — a felony conviction or incompetency — which does suggest that disenfranchisement on other grounds is impermissible,” Robert Yablon, a University of Wisconsin-Madison law professor, said in an email.

The law could also be challenged in federal court. As written, the law appears to prohibit even someone making a $1 bet with their friend on an election outcome from voting. Challengers could argue that law isn’t narrowly tailored enough to justify depriving qualified citizens of their voting rights.

For now, though, the law is on the books, and it says what it says. 

“As a policy, it makes sense,” Jacobs told Vox. “You want people to make their voting decisions based on who they think is best for the job — not who’s going to make them the most money.”

The New York question

Though the Wisconsin situation has made national headlines this week, it has largely escaped notice that New York has very similar provisions in both its constitution and in state law.

New York’s constitution says that no person who “shall make or become directly or indirectly interested in any bet or wager depending upon the result of any election, shall vote at such election.”

In fact, state law says that if a voter’s eligibility is challenged on these grounds, they must swear what is known as the “Bribery Oath,” swearing that they haven’t been paid to vote a certain way — and that they “have not made, or become directly or indirectly interested in any bet or wager depending upon the result of this election.”

When I inquired with New York state officials about whether these provisions about bets and wagers applied to Kalshi and Polymarket election event contracts, they declined to comment specifically on that.

But the New York attorney general’s office has repeatedly taken the position, both in their public rhetoric and in court, that prediction markets are “gambling platforms” that should be regulated by state gambling law. (Earlier this month, a judge gave the state a favorable ruling in a suit brought by Kalshi over this, though Kalshi is appealing.)

If New York reaches a similar interpretation as Wisconsin, Kalshi or Polymarket bettors on elections would not be legally permitted to vote in those elections. Of course, doing that comes with a risk of voter disenfranchisement, especially if this guidance isn’t well-publicized or is only belatedly clarified.

So, in both states, these very old laws have collided with a modern trend — and the result is a big mess. 

Ticks are taking over the United States. Due to climate change, changing land use, and an explosion in the deer population, ticks have been expanding their territory and infecting more people than ever. They carry pathogens that cause everything from Lyme disease to the red meat allergy-inducing Alpha gal syndrome. In some cases, tick bites can be fatal.

Ticks usually lurk in the tall grass in wooded areas. That means going on a hike or even just hanging out in your backyard or a park can expose you to a tick bite. In many parts, of the country fear of ticks is changing how people live their lives, including the way they dress, how they enjoy their hobbies, or even whether they spend much outdoors at all. 

The tick surge is catching public health officials off guard. Emergency room visits due to tick bites are the highest they’ve been since 2017. In spite of the uptick, most public health departments still focus on lowering the population of mosquitos in their areas over ticks. 

Climate reporter Jonthan Mingle says we can fix this problem. As Mingle explained in a recent New York Times op-ed, encouraging the public to do tick checks and use bug spray is a part of the solution, but we’re leaving a bunch of larger interventions on the table. Mingle joined Today, Explained co-host Sean Rameswaram to explain why ticks are expanding their range and what we can do about it. 

Below is an excerpt of their conversation, edited for length and clarity. There’s much more in the full podcast, so listen to Today, Explained wherever you get your podcasts, including Apple Podcasts, Pandora, and Spotify.

We covered Lyme disease and tick bites on this show back in 2018 because the tick situation was getting out of hand. How much more out of hand has it become since then?

You know some experts I talked to used the word exponential. So what’s happening is that some of these tick species are spreading into areas where people aren’t familiar with them, doctors aren’t familiar with them. Thanks to warmer winters, ticks are expanding their hunting season. You may have a day that’s like 40 degrees in January, ticks are out looking for you, waiting for you to walk by and grab on and grab a meal. 

In 2024, a pilot named Brian Weitzel, father of three in northern New Jersey, had a hamburger, at a barbecue, went home to mow his lawn, and a few hours later was unresponsive on the floor and he died that night. His family was left in shock, of course, trying to figure out why he had died. And it turned out that he had likely been bitten by the lone star tick and had developed an allergy to red meat. This is referred to as Alpha-gal syndrome, which is just the latest entrant into the files of all the many ways in which tick bites can make us sick. The most familiar one, of course, is Lyme disease. Each year, about half a million people are treated for Lyme disease. It’s the fastest growing vector-borne disease in the US. Cases have more than doubled over the past decade, and those cases are mostly as a result of getting bitten by the black-legged tick or the deer tick. The thing is both of these ticks — and many other ticks that are also marching northward and westward and expanding their empires rapidly across North America — they can deliver all kinds of pathogens.

They’re claiming more and more of the map, and they’re claiming more and more of our psychic map right? I tell people I’m not a tick expert, although I’ve talked to a bunch of them, but I’ve become a tick expert in the sense that I am very familiar with tick paranoia and how it can keep you from venturing out into the places you love: hiking paths or picnic grounds or parks. And so that was part of the story I wanted to write about, too — Why are we letting the ticks keep us, if not out of these places that we need and love, why aren’t we fighting back?

And why is it? Are we not fighting back against the ticks?

Not really. I mean, this is one of the surprising takeaways from my reporting is that we’re barely even trying. One way of understanding that is to think about two numbers. One number is 90 percent. 90 percent of vector-borne disease cases in the US are from ticks.

90 percent?

Yeah. And yet despite the fact that 90 percent of cases of vector-borne illness come from tick bites, if you look at what local city, county health agencies do in terms of vector control, 80 percent of what they do is mosquito control, and only about 10 or 11 percent of these local health agencies around the country do any kind of tick control. So why is that? It’s a familiar story in the public health world. It’s not enough funding or policy support for trying out, testing, deploying new approaches to controlling ticks.

Even though people are dying?

We’re just kind of taking for granted that, ‘Oh, well, what can you do? You just tuck your pants in and spray some insecticide on your boots and that’s all you can do.’ It’s like, well, actually we have a long history of going to war with mosquitoes. Before there was tick control, there was mosquito control. The CDC was founded with the sole mandate in 1946 of wiping out malaria and fighting mosquitoes. 

It feels like they lost that fight because in my neighborhood you can’t go out between the hours of seven and nine o’clock.

The mosquitoes haven’t gone away, but malaria did for the most part. You know, in talking to experts today, including folks at the CDC, they told me that there’s a suite of tools we could be using if we wanted to get serious about fighting ticks. As one veteran tick expert at the CDC told me, if you want to make a dent in this problem, you have to get to the deer. The deer are the engine driving a lot of these tick species spreading, and we just have way more deer than we did decades ago, especially in the eastern US and suburban parts of America. So how do you get to the deer? I had people in the comments section of my piece saying the clear answer is just we should all be hunting deer. But in talking to the experts, they’ll tell you it’s not really a feasible solution. You would have to knock deer populations way down to make a dent in the tick populations. 

What is more promising is a combined approach of stuff like vaccines. There are people developing vaccines that you could deliver to deer or to rodents, which are another important host for these ticks so that when the tick bites them, they’ll die. That, I learned from talking to folks who do this kind of research for a living, is a more promising avenue for controlling ticks than all of us picking up crossbows and becoming deer hunters.

So why is it that we’re not doing anything?

What I heard from experts is that we’re not even funding this research in a serious way. We do this stuff for mosquitoes. People don’t realize it, but your local county health agency, they go out and they find where the mosquito breeding grounds are and stagnant pools the water and they treat it. It takes this sustained quiet effort. 

We saw the consequences of not doing that recently. This is a bit tangential, but screwworm. Screwworm was this flesh eating larval pest that devastates cattle herds that it was eradicated in the US in 1966, and it was kept at bay by the vigilance of people at USDA and USAID who ran these programs to release millions of sterile screwworm males out of airplanes. It created this wall that kept the screwworm from coming into the southern US. And probably if we stopped doing the mosquito control at a local scale, we’d see more cases of dengue fever, West Nile virus, and all these other rare but serious illnesses that climate change is making more of a threat here in the US.

Could you just practically help people understand how they can protect themselves in the absence of, I don’t know, a functional government?

Doing tick checks. And we do it in my household pretty much daily when you come home, do a thorough tick check, throw your clothes in the dryer. Ticks hate heat. And some people like to use permethrin spray, which is this insecticide that’s designed to kill ticks on your boots or your pants when you go out for a hike. Researchers have known these things are really effective if you keep doing them, if you stay vigilant. And all it takes is that one time, that one time you go out for a hike and you come back and you forget to do the tick check. 

So we need those kinds of personal measures of vigilance and protection, but we still need to kind of push for a bigger public health response to this. The ticks are going to keep spreading into the calendar, too, in the sense that as winters get warmer, more and more days of the year when you’re outdoors, you’re going to encounter ticks who are hungry, and they’re looking for you. 

The Trump administration may have just signed an agreement so controversial that President Donald Trump himself is opposed to it. 

On Wednesday, the US and Saudi Arabia signed a 30-year, multibillion-dollar nuclear energy cooperation agreement. The terms of the deal signed by Secretary of Energy Chris Wright and his Saudi counterpart have not been released, but some of the details discussed by officials in reporting by the Wall Street Journal and New York Times earlier this week raised eyebrows, mainly the fact that in addition to helping the Saudis construct nuclear reactors, the US could potentially help the Saudis construct facilities to enrich their own uranium.

The timing is particularly awkward with the US currently at war with Saudi Arabia’s rival Iran, in large part due to concerns about that country’s nuclear enrichment program. 

It is also happening in the context of an emerging new nuclear world, where last century’s arms control agreements are falling by the wayside, regimes like Russia are increasingly employing nuclear threats, and longtime US allies are increasingly nuclear-curious due to both growing military threats and skepticism about the value of American security guarantees. It could raise the risk that other countries will seek the capability to raise the bomb, even if they don’t immediately build one. 

“It’s unprecedented in the history of US nuclear policy,” said Matthew Kroenig, senior fellow at the Atlantic Council and author of the book, Exporting the Bomb. “Never before have we helped another country build a uranium enrichment facility. All the way back to Eisenhower, the deal has been: If you want nuclear energy, terrific. We’re happy to help you, but you can’t make the fuel because once you make the fuel, it’s too dangerous.”

Whether the deal will even happen is getting less clear. The agreement was already going to face significant opposition in Congress, where it must be sent for review, but Trump added to the confusion on Thursday morning with a Truth Social post that contradicted much of what had been reported the day before. Trump wrote that there would be “no enrichment of material” under the deal and that the agreement is “totally subject to Saudi Arabia joining the very respected and successful Abraham Accords,” referring to the series of diplomatic normalization agreements between Israel and a number of Muslim countries signed during Trump’s first term. This was not reported in any of the media accounts earlier in the week, which were based on statements from US officials. 

The Saudi government has not yet responded to Trump’s latest statement, but sources close to the talks have indicated that no such pledge was included in the negotiations. 

Saudi Arabia has long insisted that it will not normalize relations with Israel until the creation of a Palestinian state, and if they had caved on that position prior to the agreement, it seems unlikely that no one would have mentioned it before today. At a press briefing on Thursday, White House spokesperson Karoline Leavitt affirmed that the deal would be “off” unless Saudi Arabia joined the Abraham Accords. Asked for clarification on the discrepancy between Wednesday’s reporting and Trump’s announcement on Thursday, the White House press office referred Vox to Leavitt’s statement. 

At the moment, there’s more confusion than clarity around the deal, and what it means for the future of both the Middle East and global efforts to control nuclear weapons. 

What’s standing between Saudi Arabia and a nuke?

This idea behind the Saudi deal isn’t new: Both the first Trump administration and the Biden administration pursued a civilian nuclear deal with the kingdom. It’s been a controversial notion for just as long, given Saudi Arabia’s often aggressive foreign policy, human rights record — including the high-profile murder of US citizens — and the fact that Crown Prince Mohammed bin Salman has said in the past that his country would seek to build its own nuclear bomb if Iran ever acquired one. 

Saudi Arabia insists that its interest in nuclear energy is purely peaceful — part of a larger goal to diversify its economy away from oil and gas and to generate power for a nascent artificial intelligence industry. Proponents in the US argue that a deal would deepen ties between the US and an important security partner. It would also, they argue, head off the risk of Saudi Arabia cooperating instead with China or Russia to build a nuclear program and be a potential windfall for the US nuclear power industry. 

The US has previously entered into 29 nuclear cooperation agreements — commonly known as “123 deals” for Section 123, the legislation that governs them — involving 49 countries. The deals require countries to submit to a number of safeguards to prevent them from weaponizing these nuclear programs, including requiring US consent for any enrichment of uranium for the US-built nuclear plants. 

In more recent US deals, most countries have agreed to give the International Atomic Energy Agency even more stringent inspection authorities. Some have gone further: Under the deal signed with the United Arab Emirates in 2009 and Taiwan in 2013, the countries agreed to forswear any enrichment of uranium on their soil, including for projects in which the United States is not involved. This has been called the “gold standard” for nuclear sharing deals, and it’s what the US pushed for in previous nuclear sharing negotiations with Saudi Arabia. 

The Saudis have long balked at some of the stricter provisions in some more recent US deals, such as additional IAEA inspections and a pledge to enrich no uranium at all. The kingdom has argued these are intrusive infringements on its sovereignty, particularly given that Iran was allowed to continue enriching under previous agreements with the US. But, Kroenig said, there’s little plausible reason to oppose these restrictions if Saudi Arabia is only interested in civilian energy.

“They probably haven’t decided to build nuclear weapons yet, but it seems like they want the option,” Kroenig said.

Saudi Arabia is not going to build a bomb overnight. It’s not even going to start enriching uranium for some time. Under the deal — at least the version that was reported earlier this week by the Wall Street Journal — US companies would immediately begin work on building nuclear power plants when the deal goes into force, while US and Saudi officials would conduct a two-year study to determine “value of enrichment for Saudi Arabia.” (This, notably, would likely be concluded during Trump’s term.)

In this respect, the deal may in fact be tougher than the never-concluded Biden agreement, which reportedly would have allowed enrichment to begin immediately. 

If the study concludes Saudi Arabia needs to enrich, the enrichment facility would be constructed in a secretive “black box” to prevent the Saudis from acquiring sensitive technology. If the US objects to Saudi enrichment after the study, the Saudis couldn’t enrich for another 10 years. After that, it’s not clear what happens. 

The safeguards do not mollify many nonproliferation experts. 

“Skeptical is a mild way of putting it,” said James Acton, co-director of the Nuclear Policy Program at the Carnegie Endowment. “Even if you black-box the technology, Saudi Arabia could still nationalize the facility. This is a country that has overtly declared an interest in proliferation. Once it’s on Saudi soil, you have very limited options to stop it from misusing that technology if it decides to do so.”

The most difficult and expensive part of building a nuclear device is uranium enrichment, and the US will have helped Saudi Arabia a long way down that path. That doesn’t mean the kingdom is necessarily planning to build a bomb, but if it decides on that course of action down the road, it will have a significant head start.

“Saudi Arabia’s nuclear program does not pose a near-term proliferation risk,” said Kelsey Davenport, director for nonproliferation policy at the Arms Control Association. Rather than trying to quickly build a bomb, she suggested that “the more likely scenario is that Saudi Arabia will continue to acquire the capabilities that would be necessary to weaponize and move to the threshold of nuclear weapons, which would enable a rapid move to build the deterrent if the decision were made.”

This, she added, would both complicate ongoing nuclear talks with Iran and “set a terrible precedent” for future nuclear agreements. 

What happens now? 

“Look, there are some benefits to the deal,”  said Robert Einhorn, a former State Department special adviser for nonproliferation and arms control. “It will give a boost to the US nuclear industry. It will help cement US-Saudi strategic relations. It will deny Russia and China a foothold in an important element of the Saudi economy. But the Trump administration will have to work hard to convince the Congress and the American public that the shortcomings of the deal are not disqualifying.”

That process starts this week. The agreement will now be submitted to Congress for a 90-day review period. This isn’t a formal treaty that requires approval. Congress has to pass a joint resolution opposing it.

The deal is likely to draw opposition on both sides of the aisle. In 2019, then-Republican Sen. Marco Rubio (FL), now secretary of state, sponsored legislation that would require any 123 agreement with Saudi Arabia to be affirmatively approved by Congress.  (“I miss Sen. Rubio,” Rep. Brad Sherman (D-CA), a co-sponsor of the House version of the bill, said during a hearing on Wednesday.)

In addition to security concerns, the potential conflicts of interest around the bill may also draw scrutiny. Tom Barrack, a close Trump confidante who is now US ambassador to Turkey and an adviser on Middle East policy, was investigated by federal authorities and was the subject of a House probe during Trump’s first term for lobbying for nuclear deals with Saudi Arabia and the UAE while he had significant real estate investments in those countries and ties to the government.  

ProPublica also reported in 2019 that Barrack had sought a major financial stake in Westinghouse, the nuclear reactor builder. The Wall Street Journal wrote that Westinghouse Electric is likely to be one of the main beneficiaries of the deal to build nuclear reactors in the Kingdom.

It still seems unlikely that opponents of the deal in Congress will be able to cobble together a veto-proof majority to block it. The better question is whether Trump is effectively blocking it. If he is really going to insist on Saudi Arabia joining the Abraham Accords, that could be a nonstarter for Mohammed bin Salman. 

A new nuclear world takes shape

Events in recent years have led Saudi leaders to doubt the extent to which the US would really come to their aid in a worst-case scenario. There have been mixed reports about whether Saudi Arabia backed or opposed Trump’s decision to launch this year’s war on Iran — the Saudi government denies supporting it — but either way, if this war ends with Iran’s regime still in place, in possession of its uranium stockpile, and in control of the world’s most critical energy chokepoint, the doubts in Riyadh about America’s reliability will only increase, along with their nuclear ambitions. 

In the coming weeks, the White House will make the case that this deal is safer and more comprehensive than the ones the US would not agree to in the Biden administration and Trump’s first term. But that argument will be harder to make against the notion that Saudi Arabia’s incentive to build a bomb has only grown since then. 

Abdul El-Sayed is among America’s most prominent proponents of Medicare-for-all. 

The frontrunner in Michigan’s Democratic Senate primary literally wrote the book on that policy (or at least, a book on it). In El-Sayed’s view, Medicare should cover “all necessary healthcare” for every American — without co-pays, premiums, or deductibles — and be “accepted everywhere.”

Alas, despite his many years of advocacy, El-Sayed has seemingly failed to persuade his wife of that last point: According to a recent report from the Washington Free Beacon, El-Sayed’s partner, the psychiatrist Sarah Jukaku, does not accept Medicare as a form of payment at her private practice.

This bit of gossip is of little importance, in and of itself. The Free Beacon’s story does nothing to refute the case for El-Sayed’s candidacy or his healthcare plan (his wife’s business is, well, her business). As hit pieces go, it’s weak tea.

Nevertheless, the tension between El-Sayed’s healthcare proposals and his wife’s business practices is real. And it is illustrative of a major challenge facing anyone who wishes to reform our nation’s misbegotten healthcare system: To meet the medical needs of all Americans, reformers will need to defy the interests of most doctors — and in many cases reduce their compensation. 

And that won’t be easy. Few people feel a deep fondness for insurance companies. But El-Sayed is far from the only American who loves a physician.

The biggest obstacle to Medicare-for-all

To understand why Medicare-for-all would be bad news for many doctors — and how the Free Beacon’s story illustrates that point — we must first dwell on one fundamental fact about America’s healthcare system: It’s a rip-off. 

The US spends about twice as much per person on medical goods and services as other wealthy countries. And yet, all that money does not actually buy us much more care. Compared to our peers abroad, Americans are less likely to see a doctor, secure a long hospital stay, or access a timely appointment for medical treatment. On the other hand, we do have the privilege of paying radically higher healthcare prices.

To take just one telling example: In the United States, a coronary bypass surgery will typically cost more than $89,000; in Australia, it costs just $17,741.

Such exorbitant prices are the chief obstacle to any version of universal healthcare. Even with one-third of working-age Americans uninsured or underinsured — and thus, consuming too little medical care — the bill for America’s health sector ran to $5.7 trillion in 2025. 

In El-Sayed’s vision, Americans would consume vastly more medical services than they do today: The uninsured would suddenly have access to every doctor in the country, while everyone else would see their co-pays and deductibles drop to zero, encouraging them to schedule far more doctors’ visits.

This would be a costly proposition in any country. At America’s current healthcare prices, it would be prohibitively expensive. There is simply no way to realize anything approaching the left’s healthcare ambitions without slashing the amount of money that Americans pay per medical service. 

Doctors will pay a price for universal healthcare

Medicare-for-all advocates are aware of this fact. And they’re typically eager to talk about one source of America’s high healthcare prices: The inefficiencies of our private health insurance model. 

In America’s byzantine system, each insurer needs its own teams of auditors, claims reviewers, and myriad other specialists, while every major healthcare provider needs a horde of administrators to navigate the idiosyncratic rules of all these different insurance companies. Americans pay dearly for this bureaucratic bloat. By one estimate, our system’s administrative costs are $500 billion higher than they would be if the insurance industry was consolidated into a single public insurer. 

And yet, as large as that figure may seem, it still represents a fraction of America’s excess healthcare costs. The primary cause of our nation’s exorbitant medical prices is simpler than administrative redundancies: our healthcare providers charge exceptionally high rates.

Hospitals are the biggest culprits on this front. But physicians are also part of the problem.

According to a 2026 study from economists at the University of Chicago, Stanford, and the US Census Bureau, American physicians earn about twice as much as Canadian ones — and four times as much as Swedish doctors. 

Critically, this does not merely reflect America’s greater wealth or wage inequality. It is true that educated professionals of all kinds — financial analysts, lawyers, software engineers, etc. — earn more in the US than they do in other rich countries. But American doctors don’t just earn unusually high absolute incomes — they also occupy an atypically rarified place within their own country’s class hierarchy. About 42 percent of American specialty physicians are in the top 1 percent of their nation’s income earners. Among Canadian specialists, that figure is just 27 percent; for Swedish ones, it is 7 percent.

The main driver of these disparities is straightforward: America imposes fewer price controls on its healthcare sector than other nations do. 

And this is where Jukaku’s practice reenters the picture. 

The public parts of America’s insurance system — Medicare and Medicaid — pay rates that are only modestly above international norms. It is when American doctors bill private insurers — or the rich consumers of boutique medicine — that they really make bank.

As a result, top clinicians like Jukaku often decline to take Medicare. If you’ve got affluent patients beating down your door, accepting Uncle Sam’s rates just doesn’t pay.

Unless the government forces doctors and hospitals to swallow steep pay cuts, however, Medicare-for-all won’t pencil out. According to a widely cited 2018 analysis by the economist Charles Blahous, if a single-payer system kept provider payments constant, national health spending would rise by $3.25 trillion over a decade, even with administrative savings taken into account. By contrast, if all providers were forced to accept Medicare’s rates, health spending would actually fall by $2.05 trillion over the same period.

Soaking physicians is tough politics

Thus, there is a clear conflict between progressives’ healthcare ambitions and medical providers’ material interests. 

Yet the left is often reluctant to acknowledge this reality. El-Sayed tends to portray insurers as the sole economic beneficiaries — and political defenders — of America’s inequitable healthcare system. The fact that hospitals and doctors also profit off the status quo’s dysfunctions does not feature prominently in his rhetoric. To the contrary, El-Sayed suggested in 2020 that doctors like his wife are actually underpaid, even though American psychiatrists earn far higher salaries than their counterparts abroad. 

To be fair, progressives aren’t alone in eliding providers’ culpability. Virtually all Democratic politicians do the same. And not without reason. Politically speaking, it is one thing to denounce the greed of private insurers — the faceless bureaucracies standing between Americans and their desired treatments. It’s quite another to call for reducing the wages of doctors, men and women who perform laudatory work and enjoy widespread admiration. 

Precisely for this reason, however, reformers must grapple with healthcare providers’ investment in the current system. The American Medical Association (AMA), the lobby representing our nation’s physicians, was instrumental in killing past attempts to move toward single-payer. And at least some segments of the medical profession would surely mobilize against any contemporary Medicare-for-all bill that imposed substantial cost controls on the healthcare sector. What’s more, in doing so, they would be able to draw on a resource the private insurance industry lacks — the public’s trust.

How to make healthcare less expensive right now

There is no easy answer to the problems all this presents. But part of the solution is to chip away at providers’ payment rates where progressives already have the power to do so. This would not only help drive down costs for existing healthcare in the short term, an urgent priority all its own, but also would smooth the path to universal coverage in the long run.

That project can take many forms. One would be state-level payment regulations. In Maryland, hospitals receive the same rates, no matter whether their patients pay with Medicare, private insurance, or cash. And their budgets are also fixed, so that they aren’t able to milk fees out of unnecessary care. Rhode Island, meanwhile, caps the growth of its hospital reimbursement rates at the pace of overall inflation. Other states could follow their lead. 

But policymakers should also address the supply constraints that undergird American doctors’ high salaries. US physicians’ ability to command high pay doesn’t just reflect America’s weak cost controls but also a persistent shortage of working doctors. The US has roughly 2.7 physicians for every 1,000 of its residents; the average among comparable countries is 3.9, according to a Kaiser Family Foundation analysis.

In this context, forcing down doctors’ pay might seem perilous. After all, doing so would reduce young people’s incentive to pursue a medical career, potentially deepening the shortage. 

In reality, however, there is no dearth of qualified people who want to practice medicine in the US. We just don’t let many of them do so.

This is partly because American policymakers consciously sought to restrict the number of doctors in the country, beginning in the 1980s. As Robert Orr of the Niskanen Center explains, the US government issued a report in 1981 warning of an imminent “physician surplus” and recommending “immediate action to curtail both the domestic training of physicians as well as the admittance of those trained outside of the country.”

The report’s argument rested on false premises; it failed to anticipate that Americans’ demand for healthcare would rise sharply as they grew wealthier. Nonetheless, its recommendations were largely implemented: Federal support for medical-school scholarships was pared back while funding for residencies has been capped since 1997. 

At the same time, policymakers maintained high barriers to the immigration of fully-trained foreign doctors: Even physicians with years of experience, and credentials in nations with high medical standards, are typically required to complete a multi-year residency before being able to practice in the US.

Ending the federal freeze on residency funding will require congressional action. But states can immediately make it easier for foreign doctors to practice within their borders. In fact, Tennessee established a pathway for such physicians to ply their trade in the state, without having to repeat a residency, in 2023. And many states subsequently enacted similar reforms.

Removing the bottlenecks on America’s doctor supply won’t eliminate the political hurdles to Medicare-for-all. But it would put downward pressure on doctors’ salaries, reduce the risks of capping physician pay, and make the left’s vision of healthcare abundance more feasible. After all, you can’t actually eliminate the care rationing that so many Americans resent by extending insurance coverage or enacting price controls alone. No matter how we pay for our medical services, we can only deliver as much care as our health sector’s resources allow. 

Don’t hate the doctor, love the sick

In saying all this, I don’t mean to convey disdain for the medical profession. Like El-Sayed, some of my best friends are doctors! In fact, my mother, father, brother, and sister-in-law are all physicians. And they all have contributed far more to American society than I ever will. My brother spends his workdays providing lifesaving treatments to cancer patients; I often spend mine sitting at a desk in my pajamas, arguing about politics on the internet. 

Physicians deserve to be well-paid for their strenuous labor. But if we want healthcare in America to be universally affordable and widely accessible, we will need to pay many of them a bit less.

This story appeared in Today, Explained, a daily newsletter that helps you understand the most compelling news and stories of the day. Subscribe here.

During his campaign to become mayor of New York, Zohran Mamdani famously vowed that he’d arrest Israeli Prime Minister Benjamin Netanyahu the next time he visited the Big Apple. 

This week, Netanyahu essentially called his bluff. He’s expected to address the United Nations in September. And after a whole lot of hemming, and hawing, and hedging, Mamdani admitted in a video Tuesday night that he does not actually have the legal authority to arrest a foreign dignitary on US soil. 

The retreat is not surprising to legal experts, who had long questioned how Mamdani would pull this particular promise off. In November 2024, the International Criminal Court — a tribunal recognized by 125 countries, not including Israel, China, Russia, or the US — did issue an arrest warrant for Netanyahu on charges of starvation, murder, persecution, and intentionally directing attacks against civilians.

But the US does not recognize the ICC’s jurisdiction. And even if it did, the job of executing its warrants would presumably not fall to New York City cops. So, why did Mamdani suggest he’d arrest Netanyahu when he actually knew he could not?

The end of the pro-Israel consensus

Mamdani’s allies argue that the principle here mattered, that the mayor needed to issue some kind of denunciation, even if he couldn’t act. But there’s another, more cynical read here, too: For Democrats, critiquing Israel is good politics. 

This is a seismic, generational shift, with far-ranging implications for both Democrats and US foreign policy. The party’s left flank has criticized Israel for years, but older and more moderate Dems only soured on Israel recently. 

“A few months after October 7, younger and progressive Democrats overwhelmingly took the opinion that Israel was committing a genocide,” said Hamid Bendaas, of the Institute for Middle East Understanding, a pro-Palestinian advocacy group. “But there were still elements of the Democratic Party — people watching MSNBC or NPR — that weren’t convinced.”

For many of these voters, the turning point only came after President Donald Trump took office again. Severe famine swept across Gaza last summer — the consequence of ongoing conflict and Israeli restrictions on food and aid shipments. Netanyahu also allied himself closely with Trump, particularly around the war in Iran. Support for Israel has consequently grown more GOP-coded, rather like Kid Rock or Bass Pro hats.

Now, even Democrats far to the right of Mamdani are looking to retool the US-Israeli relationship. Listen to Tuesday’s Today, Explained podcast episode for even more about the shift (!).

One link for later

➨ Beat the endless scroll at its own game. Social media is compelling — and compulsive — because it hijacks your sense of curiosity. But my colleague Constance Grady has come up with a delightful (and delightfully simple) antidote: To reclaim your time, just find the thing that fascinates you even more than your feed. 

Before you go…

• Did you know…that the term “luddite” comes from a movement of skilled, 19th-century textile workers who smashed and burned automated looms?
• Today’s trivia: The city of Enid, Oklahoma, is named after a character from which Victorian literary work? (You can find this and other brain puzzles in Vox’s daily crossword. Look for the answer in tomorrow’s edition.)
• Yesterday’s trivia: Yesterday I messed up! I told you that there were 23 countries in Latin America, when there are in fact 23 countries in North America. (I think we can all agree that the latter makes for more surprising trivia.) I also asked you for the name of the Eminem song that gave us the slang term for an obsessive admirer. That would be “Stan.” It also samples Dido. 

Welcome to The Logoff: President Donald Trump has seemingly called off a nuclear deal with Saudi Arabia after his energy secretary already formally signed it.

What happened? On Wednesday, the Trump administration formally concluded what’s called a “123 Agreement” to work with Saudi Arabia on the development of its civilian nuclear power infrastructure. This kind of deal allows the United States to provide another country with nuclear fuel and equipment on the condition that they submit to safeguards against building a nuclear weapon.

But on Thursday morning, after the negotiations were quite literally concluded, Trump threw a monkey wrench into things — posting on Truth Social that the deal was “totally subject to Saudi Arabia joining the very respected and successful Abraham Accords.”

The Abraham Accords are a series of agreements from Trump’s first term that normalized diplomatic relations between Israel and some nearby Arab states. In effect, then, Trump is saying that Saudi Arabia will not get its 123 Agreement unless it formally recognizes the State of Israel. Which the Saudis are unwilling to do absent the creation of a Palestinian state.

Why is Trump doing this? As is often the case with his strange last-minute decisions, no one really knows. There are a few leading guesses, though.

The first is that the agreement with Saudi Arabia was a bad idea on the merits. Experts on nuclear weapons, the Middle East, and international relations more broadly all said that the deal gave Saudis exactly what they wanted with virtually nothing in return, effectively surrendering a key piece of leverage Washington has on Riyadh.

The second is that other American friends in the Middle East got angry. The Israelis are a leading candidate, as they have long opposed any agreement that might bring the Saudis closer to a nuke. The Emiratis, often in competition with Saudis for regional influence, are another; their nuclear deal with the US, inked in 2009, is a lot stricter.

The third is bipartisan opposition in Congress, which would need to approve any deal.

What’s the takeaway: Unless something changes radically, Trump has blown up a nuclear deal that’s already been signed — humiliating his negotiators and angering the Saudis.

And with that, it’s time to log off…

As of today, we are officially two weeks away from the NFL’s first preseason game. Our long national nightmare of calling soccer “football” is almost over.

What caused the ongoing outbreak of cyclospora, the diarrhea-causing parasite currently spreading across the United States? Michigan officials have been saying for weeks that they believed the outbreak may be linked to bagged salad or salad kits. What we were waiting to learn was the specific brands and specific products in question. 

And late last week, it looked like we finally had the answer — but then things quickly got cloudy. 

On July 16, the Washington Post reported, citing anonymous sources, that the outbreak had been linked to shredded iceberg lettuce supplied to Taco Bell by Taylor Farms. A day later, Taylor Farms said it was withdrawing products from US stores and restaurants based on information from the FDA.

But then on July 19, per NBC News, the FDA said that there had been a false positive for cyclospora when testing a sample of Taylor Farms iceberg lettuce; Taylor Farms said in its own statement that the FDA had “apologized” for the mix-up. The next day, the company and the federal government were stuck in a semantic argument: Per NOTUS, the FDA insisted it did not “officially apologize” to Taylor Farms but “explain[ed] factually the issues” with the false positive. 

So where does that leave us right now? Officials still believe that Taylor Farms iceberg lettuce was the source of the Michigan outbreak. But whether those are the only products driving the outbreak remains unclear, with almost every state now reporting at least one cyclospora case in 2026. And on Thursday afternoon, the FDA announced that it was tracking a second outbreak linked to other unspecific products, though details were otherwise scarce.

Any outbreak of food-borne illness requires careful public communication. Officials need to tell people how to avoid contaminated food without scaring them away from eating fresh fruits and vegetables altogether.

But instead, many Americans have been left wondering what, exactly, they’re supposed to do. As one frustrated Reddit user put it: “So is the damn lettuce bad or not????” (If you need some advice on what foods are safe and what foods to be cautious about, we have a story for you.)

It may sound like a funny question, but it’s a profoundly serious one. The problem isn’t just that people are confused about their lettuce. The Trump administration’s handling of the cyclospora outbreak — from its conflicting public messages to accusations of political favoritism — has left many Americans even more confused about whether they can trust anything they’re hearing from the government. That’s a dangerous place to be during any public health emergency.

The cyclospora outbreak has become a communications nightmare

We are approaching 10,000 cyclosporiasis cases across the US this year: Michigan alone has recorded 7,664 as of this morning, Ohio has seen more than 1,200, and more than 40 states have now reported at least one case in 2026. The country usually sees a few hundred cases at most in a given year. Cyclosporiasis, the disease caused by the cyclospora parasite, leads to what public health experts describe as “watery” and “frequently explosive” diarrhea. While it isn’t typically life-threatening, it can cause serious complications: 160 people have been hospitalized in Michigan since the outbreak began.

And so for those of us who very much hope to eat fresh produce but do not want diarrhea, there’s a bit of urgency to figure out where the cyclospora is coming from. Food-borne illness investigations are already inherently difficult because of how globalized our food supply has become: Produce can travel all over the country and the world before it comes to your grocery shelf, and the process of government health workers interviewing the people who get sick and cross-checking to identify the shared foods that they might have in common is laborious.

Once investigators find a source, the information has to be shared clearly and responsibly. That is where the Trump administration has tripped up this week. 

Trump — and Health Secretary Robert F. Kennedy Jr. in particular — came into office criticizing the public health establishment. They accused officials of misleading the public about the novel coronavirus and the vaccines developed to fight it, while failing to convey the nuances of the pandemic. But now, as they grapple with the incomplete picture of the cyclospora emergency, they are making many of the same mistakes.

“They’re very similar problems, even if on the outside, they don’t look quite the same,” said Michael Mackert, director of the Center for Health Communication at the University of Texas at Austin. “The underlying commonality is very much that we are dealing with imperfect information all the time.”

In any outbreak, some uncertainty is to be expected. Investigators have struggled to identify the source of earlier cyclosporiasis outbreaks too. And the FDA maintains that the likely source of the outbreak is Taylor Farms iceberg lettuce, based on the information they have gathered from sick patients and other sources, no matter the false positive result that has sparked so much confusion.

“The epidemiological evidence is so strong that the lack of a positive test is almost meaningless,” said Francisco Diez-Gonzalez, director of the Center for Food Safety at the University of Georgia. 

But the mistake that the Trump administration made was in sharing preliminary results and then having to issue a seemingly contradictory statement shortly afterward.

“FDA should have waited for confirmation of the presumptive results before going public,” Diez-Gonzalez said.

The larger stakes of the Trump administration’s poor communication

Investigations like these are hard enough — but when you add in the public health funding cuts of the past 18 months and the casual and widespread corruption characteristic of the Trump administration, trust in the government’s public health apparatus has sunk even lower.

It’s created just the conditions for conspiracies to bloom. “Unfortunately our FDA is compromised,” wrote one top commenter on Reddit. “I would not trust what comes out of it during this administration.” 

Several news outlets and influential social media accounts noted that Taylor Farms had donated $1 million to Trump’s MAGA super PAC and, in the middle of the controversy, received a private White House meeting. According to the New York Times, Taylor Farm officials used that meeting to dispute the findings that their products were responsible for the outbreak — and shortly thereafter, the FDA made its “false positive” announcement.

The administration insists that their decision-making is being guided by science, but even the appearance of impropriety has become a common theme in the press coverage. The broader uncertainty and distrust may help to explain why it’s not only Taco Bell and Taylor Farms taking a hit right now: According to Market Watch, Chipotle and the fast-casual salad chain Chopt have also seen a decline in traffic in recent weeks.

Public health requires public confidence. Perceived influence from special interests is a problem, even if the interactions didn’t alter the FDA or CDC’s actions.

Kennedy, who helms our government’s health department, should understand this well: His Make America Healthy Again movement made restoring public trust a central part of its message while accusing the existing public health establishment as being in league with special interests. 

The cyclospora outbreak has revealed how difficult that is to do in practice. 

In trying to communicate nuanced information during an active outbreak — while consulting interested parties like Taylor Farms itself — the administration has instead fueled doubts about the credibility of its messaging

Even before cyclospora turned eating salad into a leap of faith, Trump had a poor track record: His administration has slashed CDC staff, brought on vaccine skeptics to set vaccine policy, and clashed with the scientific establishment on a number of high-profile issues, like the time Trump held a televised press conference to argue a disproven theory that Tylenol can cause autism.

“Unfortunately, this is another example of a missed opportunity to establish credible and trusted communications to prepare the public to understand the real risks from the pathogen and confidence in the food safety and information from the FDA,” Scott Ratzan, editor-in-chief of the Journal of Health Communication: International Perspectives, told me. “Faith in our institutions continues to erode. We could do better.”

We are lucky cyclospora is not a deadly disease. Next time, the stakes for these miscues could be much higher.

Chances are good you live with another person. Over half of American adults cohabitate with their spouse or significant other. Older adults are increasingly living with roommates. Multigenerational households have more than quadrupled over the last decade. And about a third of adults under 35 live with a parent. 

If you’ve found yourself living communally at one point or another, you know that sharing space comes with its quirks and potential headaches. Who gets to use the only bathroom first in the morning? Who’s responsible for taking out the trash? Do you actually need to be friends with your roommates? 

Being a better roommate or family member isn’t just about minimizing daily annoyance — it’s about transforming your relationships and overall well-being. According to the 2025 World Happiness Report, a household of about four members is predictive of higher happiness levels and better relationships. Older adults who cohabitate are more satisfied living with others, and have higher well-being and happiness than those who live alone, research suggests.  

Whether you live with a romantic partner, roommates, parents, grandparents, or other family members, experts (including therapists, authors, friendship experts, and researchers) — who have firsthand experience of their own — have concrete tips for how to communicate, declutter, and split finances with the people you share space with. 

Responses have been edited and condensed for clarity. 

Communicate, communicate, communicate

“I will live and die on the hill of communication being the most important aspect of successfully living with other adults. That comes from my experience living with my parents in adulthood, and from working on my anthology about communal living and interdependence. If good communication can ultimately lead to progress, any challenges that come up around logistics, habits, preferences — the things people tend to think are most important to consider when sharing space with others — can be addressed. Understanding that living with other adults doesn’t require perfect compatibility, but rather a shared willingness to work at it, opens up so many doors.”

—Samantha Paige Rosen, editor of Living, Together: Reimagining Community in the Age of Disconnection

Accept everyone’s unique (and probably wrong) ways of doing chores

“How someone loads the dishwasher is the biggest differing personalities button-pusher ever. Know this. And accept it.”

—Lauren Palmer Jansen, communications coordinator for L’Arche GWDC, a community where people with and without intellectual disabilities live and work together

Get regular meetings on the calendar

“I always recommend having a designated time — weekly, monthly — for house meetings. It feels odd initially because we believe that everything with friends should happen organically. But when you’re sharing something as sacred as a home, you have to be aligned on what creates a safe and joyful experience. This also helps with any anxiety you might feel about bringing up hard topics, like washing the dishes or inviting guests over, because you have the security of knowing that there’s dedicated time to check in.”

—Danielle Bayard Jackson, friendship educator and author of Fighting For Our Friendships: The Science and Art of Conflict and Connection in Women’s Relationships

Mark your territory

“In a shared home, peace isn’t about square footage, but it’s often helped by each person having one space that’s truly their own. That single boundary, like a door you can close, is often what makes the togetherness feel like a choice you’re happy to continue making.”

—Juli Ford, multigenerational living expert and founder of Home After 50

Discuss decluttering

“Clutter is a common household stressor, and our research suggests one reason why is that people living together buy things independently but hesitate to get rid of things independently, often over-involving each other in disposal decisions. Our proposed fix: Set disposal rules up front, the same way you might set buying rules. Let each person freely toss items only they use, or create a ‘staging area’ where items sit briefly before leaving the house. People can weigh in if they want, without letting clutter linger indefinitely.”

—Peggy Liu, professor of marketing at the University of Pittsburgh School of Business, and Theresa Kwon, assistant professor of marketing at the University of Hong Kong Business School

Agree to the “uncomfortable rule”

“Roommates who want to get along will find a way to get along. The second you stop wanting to get along, the dynamics shift. Agree to the uncomfortable rule. The uncomfortable rule says that if anyone is uncomfortable, you all agree to talk about the problem and listen. This way no one needs to hide the truth when uncomfortable situations come up. This also makes it easier to have conversations instead of confrontations.”

—Harlan Cohen, author of Win or Learn: The Naked Truth About Turning Every Rejection Into Your Ultimate Success

Divide chores equitably, not equally

“Don’t divide housework equally, divide it explicitly and equitably. In an intergenerational home, people have different amounts of time, energy, and physical capacity, so the goal isn’t identical workloads but a shared agreement everyone considers fair. Use a shared system to make the work visible. Track what gets done and by whom, then check in regularly before invisible labor turns into resentment.”

—Peter Askjær Drejer, founder of Tody, a chore managing app

Get clear about money up front

“From a financial therapist perspective, one of the biggest sources of conflict in shared living situations is the meaning people attach to money, fairness, and responsibility. Talk about expectations from the very beginning. You want to reduce the possibility of resentment forming, which can often happen if there were no conversations early on discussing what is or is not acceptable behavior and what is expected of everyone within the shared space. Most often people will wait until they’re already frustrated to discuss sharing finances or household responsibilities. But it is highly unproductive to engage in a conversation when it starts emotionally charged. Instead, schedule regular check-in conversations where you discuss not only who pays for what, but also whether the current arrangement still feels fair.” 

—Kiki Jacobson, licensed mental health counselor specializing in financial therapy

Find the good in tough situations

“My best advice is to see good intentions everywhere, even if you’re experiencing bad outcomes. For the most part, no one wants to be a bad roommate, so if someone is acting in a way that’s driving you insane, you want to approach the situation as if both of you want to fix the situation. Offer help rather than accusations. And, importantly, sometimes you can help teach others how to show up to a conversation by modeling good behavior. Sometimes people just don’t know how to have a mature, helpful conversation because they’ve never done it before. Staying regulated goes a long way.”

—Katie Rose, licensed clinical social worker

Don’t compromise, get creative

“Every recurring argument is an invitation to redesign the system rather than blame the person. Stop asking who’s right and start asking, How could we make this easier? The happiest households aren’t conflict-free — they’re creative. They develop rhythms, rituals, and agreements that work for the people actually living there rather than trying to squeeze themselves into someone else’s idea of how a household should function. One person cooks while the other cleans. Mornings become a quiet zone. Everyone gets an hour alone before reconnecting. Creativity is often a far better relationship skill than compromise.”

—Jane Garnett, licensed marriage and family therapist

Invest in a white noise machine

“Get an industrial strength white noise-maker. The app on your phone won’t cut it. It needs to be the kind you find in therapy offices so you can drown out at least some of the annoying sounds around you. Keep it on all day, not just for sleeping. Buy two if needed.”

—Mary McLaughlin, licensed clinical social worker

This story appeared in Today, Explained, a daily newsletter that helps you understand the most compelling news and stories of the day. Subscribe here.

A yet-unreleased, cutting-edge AI model escaped its test environment last week, connecting to the internet and murdering its creators in a bid for self-determination and autonomy. 

I’m kidding, of course: That’s the plot to Westworld. (And Ex Machina, and The Matrix, and too many other sci-fi stories to list.) But on Tuesday, OpenAI did reveal that two of its models broke containment and hacked Hugging Face, a platform for AI developers, during a recent test. 

The test was designed to evaluate how good the models had gotten at finding, and exploiting, cybersecurity flaws. To do that, researchers placed the models in a tightly controlled, tightly isolated environment, called a “sandbox,” and essentially challenged them to solve a cybersecurity puzzle. 

Instead of solving it directly, however, the models identified an unknown flaw in software connected to their test environment — then used that flaw to tunnel through OpenAI’s research network until they located a computer with internet access. From there, the models (correctly!) reasoned that Hugging Face might hold the answer to their challenge. 

It’s an “unprecedented” incident, OpenAI said — and a cautionary tale. Over the past year, a growing chorus of AI researchers, cybersecurity experts, and tech executives have warned that society is unprepared for this new generation of frontier AI models. 

In the real world, of course, these models do come with guardrails. (OpenAI turned them off for the test.) But the episode still suggests that the gap between reality and science fiction is narrowing — perhaps a bit faster than you’d expect.

The (impossible?) quest for a moral AI

The Hugging Face hack is a textbook example of what AI researchers call the alignment problem: the enormous, mind-melty challenge of getting AI systems to do what you want, the way that you wanted them to do it. 

Given a task and left to their own devices, AI models will pursue that task using the most efficient means available to them. But sometimes, the most efficient means are harmful, deceitful, antisocial, or otherwise…bad. 

The Hugging Face episode is one example. Bias is another: When an Amazon hiring algorithm discriminated against female candidates, for instance, it was doing what Amazon wanted (finding candidates who resembled past hires) in a way that Amazon did not want (by penalizing resumes that included words associated with women). 

In a truly apocalyptic scenario, you could even imagine — and many sci-fi writers have imagined — AI systems killing people in the narrow, relentless, and morally indifferent pursuit of their goals. Consider an AI that’s asked to order coffee, for example, and then takes steps to ensure that no one on earth can ever stop it. 

In the interests of avoiding this dystopia, AI companies have poured billions of dollars into the project of encoding their creations with human values. But even that apparently worthwhile ambition raises thorny questions, because human values vary — and often, conflict.

Should the AI order the cheapest coffee, or the cup produced under the best labor conditions? A lot of forests are cleared to plant coffee each year; maybe the AI should nudge me toward tap water, instead. Is your inferior human brain starting to melt yet…? 

One link for later

➨ Write a little note today. By hand. With a pen. Handwriting is a disappearing art in American schools, homes, and workplaces. (The average kindergarten teacher spends only 10 minutes a week teaching handwriting, and that’s the primary grade when kids learn penmanship.) People tend to think more deeply when they’re writing than when they’re typing, one education researcher told Vox. Plus, a handwritten note has a certain charm that an email or text does not. 

Before you go…

• Did you know…that the average F1 race car driver can lift 90 pounds — wait for it — with their neck? Driving doesn’t immediately sound all that athletic, but the extreme physics of F1 racing demand extraordinary fitness.
• Today’s trivia: Which Eminem song gave us the slang term for an obsessive admirer? (You can find this and other brain puzzles in Vox’s daily crossword. Look for the answer in tomorrow’s edition.)
• Yesterday’s trivia: Yesterday we asked you for the number of countries in North America. The answer is 23. It includes Central America and the Caribbean, in addition to the big three.

Last week, House Democrats voted on an amendment that would have cut $3.3 billion in annual US military aid to Israel from a State Department funding bill. The amendment was brought to the floor by Rep. Thomas Massie, an outgoing Republican from Kentucky. It failed 314-104, but 103 Democrats — nearly half of the House Democratic caucus — supported it, signaling a significant shift in the party’s longstanding support for aid to Israel.

In 2024, a similar vote came up in the House to cut military aid to Israel. Then, just 37 House Democrats voted for the measure. Now, two years later, 103 House Democrats voted to cut funding. That shift in support was accelerated after the October 7 Hamas attacks and Israel’s subsequent military campaign in Gaza, which has killed large numbers of Palestinian civilians. The debate is also playing out in Democratic primaries across the country. In New York and Colorado, Democratic socialist candidates who have sharply criticized Israel and opposed continued US military aid recently won House primaries.

Historically, Jewish Americans have overwhelmingly identified with and voted for the Democratic Party, while Democratic lawmakers have generally supported Israel and US military assistance to the country. In 2016, the Obama administration signed a 10-year memorandum of understanding (MOU) with Israel, committing the US to seek $38 billion in military assistance for fiscal years 2019 through 2028. Congress must vote to approve this funding, so the shift in Democratic support of Israel could have real consequences.

There is still a very strong support for Israel among many House Democrats, but the shifting views are notable. House Minority Leader Hakeem Jeffries opposed the Massie amendment, arguing that it was overly broad and could jeopardize humanitarian assistance. But in a letter addressed to his House colleagues he also called for a “major reset” in US policy toward what he described as Israel’s “far-right Netanyahu government.”

Today, Explained host Sean Rameswaram spoke with Democratic Rep. Brad Schneider, who represents Illinois’s 10th Congressional District, and remains a strong supporter of Israel.

Below is an excerpt of the conversation, edited for length and clarity. There’s much more in the full podcast, so listen to Today, Explained wherever you get podcasts, including Apple Podcasts, Pandora, and Spotify. 

Can you walk us through last week’s vote? You voted against the measure to cut aid to Israel, and a lot of your colleagues obviously did not. How did that play out for you?

Growing up in the ’60s, ’70s, and for the last 65 years, I fundamentally believe that the US-Israel relationship is important. I also believe that the aspiration for peace in the Middle East, not just between Israelis and Palestinians, but broadly throughout the region, is something that is in the United States’s interest and the interest of the people in the region. So this is not a new issue to me, and it’s something I thought long and hard about. 

Tom Massie doesn’t believe any of that. His intentions with this amendment were anything but pure. It was hastily crafted and poorly written. And one of the biggest issues with it is not only does it [not] address this 10-year memorandum of understanding, something negotiated by President Obama eight years ago, but there are also two years left on the MOU. 

It was a messaging bill and nothing more, and it was a negative message. I voted no because I think if we’re going to move toward peace, we need to do so in a constructive way. A lot of my colleagues were saying we need to send a message to the Netanyahu government.

“I have to hold onto that optimism for the prospects of peace because the alternative is too dark.”

I’ve been extremely critical of this government, their failure to address the settler violence in the West Bank, the failure to plan for a day-after in Gaza following what was a horrific war. If we’re going to move towards peace, if we’re going to find a path where Israelis and Palestinians can live side by side and the region can have the peace they deserve. Because we’re not just talking about Israelis and Palestinians; there’s progress being made between Lebanon and Israel in giving Lebanon, the people of Lebanon, the liberty and freedom they all deserve. 

Can I ask you if you still take money from AIPAC? And if so, how much?

I appreciate the support I get from people who care about the issues that I advocate for. So people who are pro-Israel, pro-US-Israel relationship are likely to support me because I’m pro-US-Israel, pro-US-Israel relationship. I’m also pro-addressing gun safety and reducing gun violence in this country. So I get the support of those groups. The support I get doesn’t determine my positions. I think my positions determine who supports me. 

Has your position on Israel shifted at all since October 7th, or at any point in your political career? And if so, can you tell us how?

So my position hasn’t changed because I’ve always been committed to promoting peace between Israelis and Palestinians and finding a path where both can live together, which I believe ultimately is two states: a Jewish democratic state of Israel, and a Palestinian state living side by side. My frustration with the current Israeli government has grown and continues to grow. Every conversation I have with them, whether it’s the US ambassador to Israel, whom I’ve had the privilege of working with many times, or my meetings with Prime Minister Netanyahu. I’ve had an engagement with the prime minister going back now for almost 30 years. But in the last several years, every single conversation I have with them talks about the need to address settler violence, the need to get humanitarian aid.

One of the things that I am proud of and will say loudly and proudly is that immediately after October 7th, as the war began, my team and I worked hard to push for humanitarian aid into Gaza to do everything we could to make sure that the civilians who were always caught in the middle of any war wouldn’t suffer more than they did. And the suffering was horrific. And I did challenge Israel when they made what I’ll call ill-conceived, ill-advised, in some cases illegal decisions to deprive humanitarian relief from entering Gaza. We pushed hard, and we worked with the Egyptians to get the Rafah crossing open. We pushed the Israelis to open the Karam Shalom crossing. And to not just get aid to those crossings, but get aid into and across the territories within Gaza.

Why are you so optimistic about the situation? 

I am always going to be optimistic. I have to hold onto that optimism for the prospects of peace because the alternative is too dark. And let’s separate the issue for folks living in the region and the folks living here. And for the Israelis and Palestinians, these are two peoples who are totally traumatized — traumatized not just over the last couple of years, but for decades. So I recognize the trauma that Israelis have and are experiencing, and I recognize the trauma that the Palestinians have and are experiencing. And that’s part of what I feel is my obligation: to hold onto that optimism and speak to a better future and work to try to find ways to bring the parties on both sides of the issue together to make the hard choices and take the risk to get to a path to peace.

So the reason I’m holding onto optimism — and it’s not 24/7; I have my moments when I am down and where I feel like the hill we’re climbing is just too steep — is you take a deep breath and you dig deep, and you say, I can’t give up on hoping and working towards peace because otherwise peace is never going to happen. And I want to find people who are like-minded.

And that is not just on the Israeli side of the equation. We have to find people on the Palestinian side, and for those on the Palestinian side, we have to find Israelis. And I meet, and I spend time with them on a regular basis. They come to my office. When I’m in the region, I talk to them. We have to strengthen and empower those voices who believe that peace will only come when the Israelis see the Palestinians as a people worthy of engagement and a shared future, and the Palestinians see the Israeli as a people worthy of engagement and a shared future, and recognize that until they get there, there’s no future for either side. We’ve got to have a path where both are pointing in the same direction.

There was an unintentionally revealing moment in acting Attorney General Todd Blanche’s confirmation hearing last week. After Sen. John Kennedy (R-LA) asked Blanche whether he and President Donald Trump are friends, the leader of the United States Department of Justice replied, “I’m his lawyer,” before correcting himself and saying he “was his lawyer.”

Blanche previously defended Trump in three criminal cases brought while the president was out of office, but he is emphatically not supposed to be Trump’s lawyer right now. As acting attorney general — Blanche currently leads the DOJ because the attorney general’s job is vacant and Blanche is the Senate-confirmed deputy attorney general (DAG) — Blanche’s client is the United States, not the person who happens to occupy the White House. 

But it’s easy to see why he misspoke: Blanche has largely acted as Trump’s hammer since he was confirmed as the DOJ’s No. 2 official, overseeing numerous prosecutions of Trump’s perceived enemies. Now Trump wants to promote him to the DOJ’s top job — a sign of Trump’s confidence in his former criminal defense lawyer turned personal enforcer.

It’s unusual for a president to put his own defense lawyer in such a powerful position — indeed, it’s unusual for a president to have a criminal defense lawyer at all. But Trump has a long string of attorneys who’ve defended him and his companies against an equally long string of criminal allegations ranging from tax fraud, to falsifying business records, to illegally taking classified documents, to charges arising from his failed attempt to steal the 2020 presidential election. 

And he’s put at least five of those criminal defense lawyers in top federal jobs. 

Trump’s decision to turn much of his criminal legal team into powerful government officials matters for two big reasons. The first is that two members of that team, Blanche and Solicitor General John Sauer, are leaders within the Justice Department. Next to the military, there is no more fearsome government institution than the DOJ, which has the power to arrest people and try them for federal crimes. 

The DOJ is supposed to exercise this authority with restraint — and often with restraints imposed by the Constitution itself — but Blanche has used the Justice Department’s power against Trump’s political enemies who appear to have committed no crime and removed constraints on Trump and his Justice Department, all while Sauer has worked consistently to convince the Supreme Court to remove other constraints on Trump.

Meanwhile, three of Trump’s former criminal lawyers, Emil Bove, Justin Smith, and Matthew Schwartz, now have lifetime appointments as US Court of Appeals judges, placing them one rung on the judicial ladder down from the Supreme Court. The judiciary, of course, is the branch of government that is supposed to prevent the president from breaking the law, so every Trump loyalist appointed to this branch weakens the remaining legal constraints on Trump and his administration.

Trump, of course, isn’t the only president to place close confidants in the Justice Department or the federal bench. President John F. Kennedy famously named his brother attorney general. President Lyndon B. Johnson appointed Abe Fortas, who represented him in a 1948 election dispute, to the Supreme Court in 1965.

But Trump’s decision to place someone willing to pursue his personal vendettas in charge of the Justice Department is, at the very least, a break with post-Watergate norms established to prevent the DOJ from becoming a political weapon. And Fortas, who resigned in disgrace after fewer than four years on the bench, is more of a cautionary tale than a model of good governance.

Although the current Supreme Court is dominated by conservative Republicans, some of these justices do break with Trump on questions that divide the Republican Party — such as whether Trump should unilaterally impose high tariffs on many nations. But if Trump gets to turn his personal cronies into justices, that could change quickly. A judiciary controlled by MAGA loyalists means that all remaining checks on Trump’s authority could end. Many of his former-lawyers-turned-appointees are already working to make an unchecked Trump administration a reality.

How are Trump’s former personal lawyers already reshaping American legal norms?

Smith, who worked on the Trump v. United States immunity case, was confirmed last month. And Schwartz, who worked on the false documents case that led to Trump’s conviction, joined the bench last week. So there’s not much to say about these two men’s record in federal office — yet.

But Blanche, Bove, and Sauer have all displayed ruthless cunning in their efforts to advance Trump and his causes.

Blanche has been DAG since March 2025, a role that oversees the federal government’s criminal prosecutions and its 93 regional US attorneys’ offices. He’s led the entire Justice Department since April, after former Attorney General Pam Bondi — another of Trump’s former personal lawyers — left office.

So Blanche oversaw several dubious federal prosecutions targeting people Trump perceives as enemies, including criminal proceedings targeting former FBI Director James Comey and current New York Attorney General Letitia James. There’s also evidence that Blanche has played an unusually direct role in the Justice Department’s decision to bring meritless charges against prominent Democrats.

In May 2025, for example, Newark Mayor Ras Baraka, a Democrat, showed up at an ICE detention facility in his New Jersey city and asked to tour it. He was briefly let inside the gate, where he was confronted by about a dozen law enforcement officers and asked to leave, which he did.

But then one of these officers received a phone call. A video, later submitted to a federal court, shows the officer turning to his colleagues after the call and announcing, “We are arresting the mayor right now, per the deputy attorney general of the United States.” That deputy attorney general, of course, was Blanche. (In a September court filing, DOJ confirmed that officers arrested Baraka “after consulting with the Deputy Attorney General.”)

Yet, despite Blanche’s apparent decision to personally order Baraka’s arrest, the DAG forgot to check whether Baraka had actually done something that could support criminal charges. The mayor was only charged with misdemeanor trespassing, and those charges were dismissed two weeks later. At the court hearing formally dropping these charges, a federal magistrate judge admonished prosecutors for “using the immense power of the government to pursue weak cases or to make examples without sufficient cause.”

Blanche also unsuccessfully attempted to establish Trump’s $1.776 billion “anti-weaponization fund,” which would have been used to distribute money to Trump’s allies — including, potentially, Trump supporters who participated in the January 6 attack on the US Capitol. Although the fund appears dead after it received bipartisan pushback in Congress, a DOJ press release announcing the fund said it was “established” by the attorney general, a role performed by Blanche, and that the fund would be administered by five people chosen by Blanche.

Before Trump took office, Bove was Blanche’s law partner. Shortly before Bove joined the bench, he briefly served as principal associate deputy attorney general — essentially the DAG’s top deputy, which meant that Bove was Blanche’s right-hand man. In that role, he was often described as Trump’s “enforcer.” 

Bove spent only about half a year as Blanche’s lieutenant, but he managed to spark a mini-revolt in one of the Justice Department’s most prestigious offices during his short tenure. After Bove ordered the DOJ to dismiss corruption charges against then-New York City Mayor Eric Adams “without prejudice,” a maneuver that would allow the charges to be reinstated if Adams did not cooperate with the Trump administration’s immigration crackdown, seven federal prosecutors resigned rather than comply with Bove’s order. 

One was Danielle Sassoon, a former law clerk to Justice Antonin Scalia, a conservative icon. Another, Hagan Scotten, wrote in his resignation letter to Bove that “I expect you will eventually find someone who is enough of a fool, or enough of a coward, to file your motion. But it was never going to be me.” Scotten clerked for Republican Chief Justice John Roberts and for future Republican Justice Brett Kavanaugh.

Meanwhile, a whistleblower complaint by another former DOJ lawyer claims that Bove said, in a meeting about a court decision halting some deportations, “that D.O.J. would need to consider telling the courts ‘fuck you’ and ignore any such order.”

Trump appointed Bove to the US Court of Appeals for the Third Circuit last September. Federal appeals courts typically spend months deciding cases, so his tenure on the Third Circuit has thus far been less eventful than his time at the DOJ. But there are early signs that he remains loyal to Trump even after moving into an independent branch of government. Bove attended a Trump rally in December, a highly unusual move for judges who are supposed to remain nonpartisan. And the background image on his iPhone is reportedly an image of a defiant Trump raising a fist, or at least it was months after he joined the bench.

That leaves Sauer, who, as solicitor general, is tasked with defending federal government programs in the Supreme Court. That includes the Trump tariffs that the Supreme Court struck down last winter, and Trump’s unconstitutional attempt to strip many newborn Americans of their citizenship.

Despite these losses, Sauer has an impressive winning record before the Supreme Court, largely because the Court is controlled by six Republicans who are highly sympathetic to Trump and his agenda. This is, after all, the same Court that said that Trump may use the powers of the presidency to commit crimes, after Sauer argued as much. 

Sauer has been particularly effective in persuading the Republican justices to block lower court rulings against Trump on the Court’s “shadow docket,” a once rarely used mix of emergency motions and other matters that became a routine part of Supreme Court litigation during Trump’s first term.

So Trump has taken several of his personal lawyers and transformed them into some of the most well-credentialed — and in some cases, the most powerful — figures in the legal profession. Thus far, the evidence suggests that these individuals remain loyal to Trump, even when they move into jobs that are supposed to be nonpartisan. Three of them already have lifetime appointments. 

Any nation governed by the rule of law must have government officials who will obey whatever constraints the law imposes — whether they be federal agency leaders who follow the law out of a sense of duty, or judges who rein in executive branch leaders who refuse to do so. Institutions like the Department of Justice also depend on informal norms, many of which are a response to similar abuses of power during the Nixon administration, that have long constrained federal prosecutors.

But Trump’s DOJ is often actively hostile to these norms, and the growing legal power of Trump’s personal lawyers is just the latest example. Their steady reshaping of the judiciary clears the way for a federal government that is not constrained by anything.

In 2019, the AI researcher Rich Sutton published a short essay called “The Bitter Lesson.” Seventy years of AI research, he argued, kept demonstrating the same thing: The most effective ways to train AI rely on raw, brute-force computing power — simply scaling up — rather than clever approaches built on human insight. It didn’t matter how elegant the researchers’ work was. More compute would win every time. It’s a bitter lesson because, well, no one wants to accept that even the best efforts can go unrewarded.

This summer, climate change has been teaching its own kind of bitter lesson. Last week smoke from out-of-control Canadian wildfires reached more than 120 million Americans, sending out air quality alerts across 18-plus states from Minnesota to Virginia. Those wildfires, which were made more likely by the effects of climate change, followed record-breaking heat waves in Europe that contributed to the deaths of thousands of people.

Disasters like these inevitably renew calls for climate action, but no current US emissions policy, no amount of carbon cutting now, could clear the air, just as nothing Europe has done on climate — and it has done more than any other region, at no small cost — could protect it from those killer temperatures. Not this summer, not this decade, not the one after. The steps countries take now to reduce carbon emissions, to mitigate climate change, will not protect them from the present-day effects of climate change.

That’s the bitter lesson of climate change, and 2026 is the summer it has become unignorable. The dangerous effects we’ve been warned about are here, locked in on every timescale that matters to the people living through them. We can’t prevent the worst from happening right now, so we need to figure out how we’re going to adapt to it. 

The smoke we can’t stop

Canadian wildfire smoke is as close to an unstoppable disaster as exists today. The fires are Canada’s, the ignition is mostly lightning, the fuel is a subcontinent of boreal forest no fire agency can manage, and the whole system sits outside US jurisdiction. While strategies like prescribed burning and forest thinning can help reduce the wildfires that crop up in the western US, the sheer scale of Canadian forests makes such management far more difficult, maybe impossible. There is no timescale on which American mitigation clears American air of Canadian wildfire smoke. 

What this means is that for this wildfire smoke, at this moment, adaptation may be all there is.

American law has already conceded the point. Under the Clean Air Act’s Exceptional Events Rule, a state can petition the Environmental Protection Agency to strike wildfire-smoke days from the record used to judge whether its air is legally clean. In other words, the official response to one of the country’s fastest-growing air-quality threats is to delete it from the ledger. 

It’s true that climate attribution science ties heat waves to warming with the highest confidence of any extreme, while wildfire is messier — a compound event filtered through ignition, fuel, and fire weather. But fire seasons are lengthening, fuels are drying, and the most extreme wildfire events on Earth more than doubled between 2003 and 2023. The pattern is intensifying fire in particular regions — the boreal north among them — and the smoke goes where the wind says.

And that smoke is worse than it looks. Wildfire PM2.5 — the microscopic particles that are particularly dangerous —  is roughly three to four times more toxic to the lungs, per unit of mass, than ordinary urban particulate matter. During major smoke events, pediatric asthma visits can spike by more than 30 percent, and Harvard researchers have found the cardiorespiratory damage persists for months after the sky turns blue again. That’s especially dangerous for vulnerable populations like babies and pregnant women.

We can’t affect the winds, we struggle to stop the fires, and any current attempt to reduce warming enough to make those infernos less likely won’t be felt for years. But that doesn’t mean we’re helpless to protect ourselves from wildfire smoke, any more than we are from extreme heat.

We can purify indoor air, and it costs less than you probably think. Strap four furnace filters to a box fan — creating a Corsi-Rosenthal box — and indoor PM2.5 drops by roughly half; in testing during actual wildfire smoke, a DIY unit cut fine particles by about 56 percent in a large room and close to 99 percent in a small sealed one.

For heat, the toolkit is even better known — and one of the best proofs it works is in, of all places, France. The historic 2003 heat wave killed some 15,000 people there, most of them elderly and alone. The national heat plan built in its aftermath — tiered alerts, registries of vulnerable residents, check-in calls, cool rooms — cut the death toll of comparable heat waves by roughly 90 percent: When France hit its all-time record of 114.8°F in 2019, fewer than 1,500 died, per the Christian Science Monitor. A recent European analysis estimates a rerun of 2003 would now kill 77 percent fewer people in France than in a world that never adapted.

So technologies exist to protect ourselves. What’s too often missing are the standards, money, and the drive to deploy protection before the disaster arrives instead of after.

Catching up to today

When it comes to wildfire smoke, some governments are ahead of the game — and some aren’t. Washington state, Oregon, and California now regulate outdoor workers’ smoke exposure by air-quality index, under rules like Cal/OSHA’s wildfire-smoke standard; California funds “clean air centers” with upgraded filtration where people can shelter on bad-air days; Colorado’s Clean Air for Schools program ships free HEPA units to K-12 classrooms. A purifier humming in a classroom is essentially doing for smoke what a cooling center does for heat.

When it comes to heat, some parts of Europe are catching up. Barcelona now runs a network of nearly 400 “climate shelters” — libraries, museums, retrofitted schoolyards — with the goal of putting one within a 10-minute walk of every resident. For the first time, the city is keeping libraries open through August to do it, which, as anyone who has visited Europe in the late summer knows, is no small thing.

So adaptation exists, and it is saving lives. But this summer has also shown what happens when cities, states, and countries aren’t ready. 

In the US, the Midwestern and Northeastern states that spent last week under smoke alerts have almost none of the protections against wildfire smoke that have become more common in Western states, and no one is required to build them, because the country has no enforceable national indoor air-quality standard at all. In Europe, national heat plans are still reluctant to reach for the most powerful tool on the shelf. About one European household in five has air conditioning, compared to nearly nine in ten in the US, in large part because much of the continent still treats the machine as a moral defect. 

In both cases, rich regions that have largely taken climate mitigation more seriously than some of their neighbors aren’t pursuing adaptations they need. Which really means not taking climate change as seriously as they should. 

Accepting the bitter lesson

For a generation, adaptation was the word climate advocates were often reluctant to say out loud. In his 1992 book Earth in the Balance, Al Gore called adaptation “a kind of laziness, an arrogant faith in our ability to react in time to save our skins.” (He later changed his mind.) And in fairness, “we’ll just adapt” has often been a delaying tactic, an easy out for polluters. 

But the ground has shifted under that caution, because the projections did exactly what projections are supposed to do: they came true. 

Longer fire seasons, deadlier heat waves, smoke reaching places that never used to see it — this summer is the confirmation. And that changes what seriousness requires. If you’ve spent decades warning people that the effects of climate change are coming, you can’t treat readying for those effects as a distraction from the real work. None of this argues for easing up on emissions — each ton that isn’t emitted is adaptation nobody has to build. But preparing for what you predicted is what believing your own prediction looks like.

For AI researchers, Rich Sutton’s lesson was bitter for a specific reason. Those who resisted its conclusion weren’t foolish; they resisted it because it seemed to undercut all their hard work. They resisted it because it didn’t seem fair, just as it’s not fair that countries and states that have in many ways done much to mitigate climate change find themselves just as vulnerable, if not more so, than peers that have done comparatively little. 

But here’s the other half of Sutton’s lesson: The researchers who accepted it won. They stopped defending their cleverness and built what worked. That option is open to climate politics too. The atmosphere isn’t fair, but it is consistent, and it will deliver next summer’s version of this one on schedule. We can be ready. The bitter lesson is only bitter until you have the will to act on it. 

A version of this story originally appeared in the Future Perfect newsletter. Sign up here!

In January 2025, Linda-Gail Bekker stood inside a vaccine manufacturing plant and allowed herself to believe that the first HIV vaccine candidate conceived through African science and led by Africans might finally become a reality.

The vaccine would be built on mRNA technology, the same platform that had helped tame the Covid-19 pandemic. Bekker hoped it might finally crack the puzzle that had frustrated HIV researchers for more than four decades.

No virus has proved more evasive. Hundreds of HIV vaccines have entered testing; none has succeeded at providing durable protection against infection. And the need remains vast: In 2025, roughly 1.2 million new HIV infections were reported; anti-retroviral treatments have turned it into more of a survivable disease, but more than half a million people died from AIDS-related causes the same year. There is still no known cure.

So researchers like Bekker, an infectious disease specialist at the University of Cape Town, have more hope now, in part because there is finally a clearer idea of what an effective vaccine needs to do. It must coax the immune system into producing a particular type of protective antibody, a rare class of defender, capable of recognizing and disabling HIV despite the virus’s extraordinary diversity and rapid ability to mutate.

No one yet knows how to reliably do that. But mRNA is uniquely suited to the task of finding out, vaccinologists say. Thanks to the platform’s speed and flexibility, researchers can iterate rapidly through the otherwise laborious process of designing, testing, and refining the series of vaccine components needed to guide the body toward making those essential antibodies.

At the start of last year, Bekker and her colleagues were ready to put that strategy to the test. The clinical trial for their new mRNA-based HIV vaccine was just on the verge of enrolling its first participants. But the project depended on the same backing that had sustained HIV vaccine research for decades: US government funding. Washington had long supplied roughly 90 percent of the world’s investment in the field. Then President Donald Trump returned to office.

Within hours of his inauguration, Trump signed an executive order freezing foreign aid. The $45 million contract from the US Agency for International Development (USAID) that was supposed to fund clinical trials like Bekker’s disappeared, as did a web of other funds, many routed through the National Institutes of Health (NIH), that had helped fuel the field’s progress for years.

The timing could hardly be more cruel. After 40-odd years of chasing a shape-shifting foe, scientists believe they now know what kind of immune response an HIV vaccine must generate — and have in mRNA a powerful new tool for pursuing it. But just as many researchers have finally glimpsed a path to victory, the United States and much of the funding has pulled away from the fight. 

Pushing the envelope

From the outset, the target for preventing HIV was clear. Within a year of identifying the virus as the cause of AIDS in 1983, researchers had zeroed in on its envelope protein as the most promising point of attack for a vaccine.

Protruding from the virus’s surface in knobby clusters, the envelope protein acts like a molecular grappling hook, latching onto immune cells before pulling the virus itself inside. Without this feature, HIV cannot infect a cell.

Much as the coronavirus spike protein would later become the basis for Covid vaccines, this protein on the surface of HIV seemed an obvious bullseye. But identifying the target didn’t mean researchers could hit it. Most of what the immune system sees of the envelope protein is actually just a decoy. The parts that stick out and draw the strongest immune response are also its most changeable, differing from one strain to the next and mutating freely whenever antibodies close in, leaving the body to waste its firepower on a target that keeps slipping away.

Candidate vaccines kept making the same mistake. They would elicit plenty of antibodies, but not the kind that could keep up with the virus. Time and again, promising candidate vaccines generated excitement in the laboratory, only to come up empty when it mattered most in large-scale clinical testing.

The field’s fortunes started to change in the late 2000s when researchers began studying the small fraction of people living with HIV who developed antibodies capable of recognizing the virus’s concealed, conserved features. Though these hard-won antibodies came too late to protect their makers, they gave scientists a molecular blueprint for the defenses a vaccine would need to build.

As the field came to learn, these “broadly neutralizing antibodies” do not appear overnight but rather after years of battle with the virus. 

The challenge, then, was to design a vaccine that would not just trigger an immune response but guide a person’s immune system through the same evolutionary journey. This would require a succession of vaccine components to prompt a carefully choreographed process within the body, rather than the single, fixed target that suffices for shots against measles or hepatitis B.

It was a strategy rooted in rational design but dependent on trial and error. Progress would come through a steady stream of small proof-of-concept studies, each informing the next generation of vaccine candidates. Ordinarily, it would take at least a year — often longer — to manufacture and prepare each vaccine iteration before it could be tested in people. 

But then the Covid pandemic rocketed mRNA into the spotlight.

The mRNA advantage

mRNA technology upends the old recipe of vaccine development. Conventional shots work by showing the immune system a mugshot of the enemy: a killed or weakened germ, or one of its proteins, grown batch by batch in vats of cells or eggs. An mRNA vaccine takes a different route. Rather than supplying the mugshot, it supplies the instructions to draw one: a short, lab-printed strip of messenger RNA, the molecule cells normally use to ferry genetic directions from DNA to their protein-making machinery.

Inject the right sequence, and it will program the body’s own cells to become tiny factories, producing the target protein and presenting it to the immune system as if it were the real intruder. Because it is all just code, refining a design means editing text, not rebuilding a factory — the work of days, not months.

“We’ve been able to design vaccines in real time,” said University of Pennsylvania Perelman School of Medicine assistant professor Ted Kreider, who is a specialist in infectious diseases.

To HIV researchers, the appeal was obvious. HIV’s greatest weapon was its ability to shift and adapt. Now, at last, a vaccine could, too. 

The timing was ideal. Just as researchers were beginning to map the path to an effective vaccine, mRNA offered a way to move down that path at speed. With vaccine designs no longer bottlenecked by design and manufacturing, what once might have taken decades of stepwise vaccine development could, thanks to mRNA, be compressed into years.

Across a growing number of clinical trials, researchers are now testing different vaccine components, different sequences, and different delivery platforms, searching for the combination that most effectively nudges the immune system toward a truly HIV-thwarting response.

A paper published last month in Nature offered one such path forward, showing in monkeys that a painstaking sequence of eight shots could coax the immune system into producing potent antibodies capable of neutralizing a broad range of HIV strains. But even the study’s authors see a catch. “It’s still too many [shots] to be practical in humans,” said Dennis Burton, a professor of immunology and microbiology at Scripps Research who worked on the project.

Whether mRNA ultimately becomes the vaccine itself — or simply the tool that helps researchers discover it — remains an open question.

The fundamental challenge for now, after all, is vaccine design, notes Mark Feinberg, president and CEO of IAVI, a nonprofit research organization focused on developing vaccines against HIV. And for that task, he says, “the most obvious advantage of mRNA is simply the speed of getting an idea from the laboratory to the clinic.”

But if the technology reaches the finish line, researchers say it could offer other advantages as well. Because the protein is made inside the body’s own cells rather than in a lab, it folds and displays itself much as it would on the real virus, giving the immune system a more faithful target to train against. That way, when the real virus arrives, the body already knows its true face.

It also gives vaccine designers an unusual number of knobs to turn, notes Kristie Bloom, an mRNA vaccine researcher and molecular biologist at the University of Witwatersrand in South Africa. By altering the vaccine’s formulation, dose, or genetic design, researchers can shape not just the magnitude of the immune response but also its balance: favoring antibody-producing B cells, virus-killing T cells, or some mix of the two.

With mRNA, “there’s quite a bit of flexibility,” she said.

Not so fast

For all the putative upsides, however, mRNA does carry some baggage. There are concerns about public acceptance given the intense backlash and misinformation campaigns that followed the rollout of Covid-19 vaccines. And though those shots ultimately proved remarkably safe, with very low rates of serious side effects, a peculiar skin problem has emerged in early-stage trials of mRNA vaccine candidates for HIV specifically. 

In two separate trials reported last year, around one in 12 participants who received mRNA-based HIV vaccines manufactured by Moderna developed chronic urticaria, a form of persistent hives that in some cases endured for years. The vaccines encoded different portions of HIV’s envelope protein, yet both produced the same unexpected side effect.

The fact that the reactions appeared across distinct vaccine designs — but never before in Moderna’s other mRNA vaccine programs — has fueled suspicion that something about HIV’s envelope protein itself may be involved. Even so, no clear explanation has emerged. 

“We’ve ruled a bunch of things out,” said William Schief, a professor at Scripps Research’s department of immunology and microbiology who doubles as vice president for protein design at Moderna, “but there’s no smoking gun.”

Schief is continuing to investigate the source of the immune reactions. But not wanting an unresolved safety signal to bring the program to a halt, he and his collaborators have pressed ahead with lower-dose versions of the vaccine, betting that the hives will fade while the desired immune response remains intact. 

That strategy is now being evaluated in an IAVI-backed trial led by Bekker in South Africa. Known as IAVI G004, it has yielded encouraging early results. (Unlike the African-developed vaccine whose launch was derailed by the USAID funding freeze, this study is testing a different mRNA vaccine candidate, manufactured by Moderna.)

At the lowest dose tested, just one-tenth of the amount used in the original studies, the hives that had troubled earlier trials never materialized, Bekker said. Her team has since moved on to a somewhat higher dose, seeking the sweet spot between safety and immune potency. 

All of these discoveries and challenges along the way have helped map a path forward. “We know what we need to do,” said Barton Haynes, director of the Human Vaccine Institute at the Duke University School of Medicine. The task for them now is to move through the necessary iterations as quickly as the science — and the funding and political landscape — allow.

“A black hole”

When Bekker and her team learned about the sudden funding cut that would halt their African-designed, USAID-funded vaccine study in January 2025, they were already in Tanzania to prepare its launch. They immediately had to stop work on the project, which had been years in the making. “It was like falling into a black hole of depression,” she said. 

And the setbacks kept coming. With prominent vaccine critic Robert F. Kennedy Jr. overseeing US health policy, the federal government moved to undermine both vaccine science broadly and mRNA technology in particular.

The NIH, in addition to terminating dozens of smaller HIV-related grants, began winding down its flagship Consortia for HIV/AIDS Vaccine Development (CHAVD) program, which has long served as a cornerstone of global HIV vaccine research, while other federal agencies curtailed support for mRNA vaccine projects across multiple disease areas.

At the same time, South Africa, the continent’s leading center for biomedical research, found itself in the Trump administration’s crosshairs over allegations of anti-white discrimination. New federal research grants were no longer permitted to support collaborations with South African scientists, severing ties that had underpinned years of international HIV research.

“That’s a perfect storm to prevent us from building on the most exciting science HIV vaccines have had in 45 years,” said Mitchell Warren, executive director of AVAC, a nonprofit dedicated to HIV prevention access and policy. 

Yet for all the financial and political disruption, the scientific momentum hasn’t stopped. Philanthropic organizations and governments elsewhere have stepped up to help fill the funding gap, allowing key trials to move forward, although in scaled-down forms with more modest ambitions. 

The Africa-led effort that Bekker had dreamed of was salvaged, with emergency backing from the South African Medical Research Council, albeit in diminished form and built, in the end, on the same protein-based technology that mRNA was meant to leapfrog.

The only mRNA-based HIV vaccine study that is actually underway in Africa is IAVI G004: a program designed by US scientists, not by locals, and funded largely by the Gates Foundation.

A longtime backer of HIV research, that foundation is estimated to invest around $70 million annually — with $64 million being invested in 2022, and $70 million in 2026 — across a global portfolio of HIV vaccine programs. That’s a substantial sum, though only a fraction of the hundreds of millions of dollars once provided by the NIH, USAID, and other federal agencies. 

For now, some of that funding continues to flow. But even what remains is far from assured. The Trump administration’s proposed 2026 budget would slash the National Institute of Allergy and Infectious Diseases — the NIH institute that has long anchored HIV vaccine science — along with the Office of AIDS Research that coordinates HIV research across the entire NIH, leaving the field’s longer-term future in doubt.

“We’re not going to be able to fill the gap that’s been left by the US government,” said Nina Russell, director of TB & HIV research and development at the Gates Foundation. Still, she says, the foundation remains determined to keep the most promising vaccine programs moving forward: “We are super committed to it.”

All of these changes have left the research field daunted, but not hopeless. “It’s been a very disruptive time,” said Burton, who leads one of the CHAVD research hubs. But he remains convinced the field is on the right track. “The pieces of the puzzle are in place,” he said. “It’s obviously been a long, long journey, but you can begin to see the end.”

A higher bar

The funding crisis and political challenges are not the only forces reshaping HIV vaccine development.

For much of the HIV epidemic, which has killed over 40 million people worldwide, even a partially effective vaccine might have been enough to transform the course of HIV. Today, however, vaccine researchers are also competing against long-acting preventive drugs that can protect people for months at a time with just two injections. 

These drugs are an enormous step forward for HIV protection, but they also raise the standard the vaccine field must meet, Warren said. “The bar for a licensed vaccine that is going to have a public health impact has gotten much higher,” he said.

But these prophylactic drugs, which began as daily pills and have evolved into long-acting injectables, are only as good as the systems that deliver them. Cost, stigma, and the need for regular clinic visits have limited access in many countries with the highest HIV burdens. A vaccine, by contrast, that provided years of protection after a handful of doses could overcome many of those barriers.

That is precisely why many scientists view the current retreat of the US government with such alarm. After decades of disappointments and billions of dollars in investment, the field finally believes it has a coherent strategy for building an effective HIV vaccine. The fear is that momentum could stall just as researchers have begun to see a path across the finish line. As a result, what once seemed like a scientific problem increasingly looks like a political one.

For Bekker, the current moment feels all too familiar. In the early 2000s, South Africa’s government embraced AIDS denialism, delaying the rollout of lifesaving treatments and forcing researchers and clinicians to battle both the virus and the state. A quarter-century later, she says, the political opponent has merely changed address to Washington, DC, threatening once again to undermine the fight against HIV and cost countless lives.

“When politics interferes in science,” Bekker said, “that is the death of scientific progress.”

Bekker still does not know whether the vaccine she watched being manufactured last year will ever reach the people it was designed to protect. She and her colleagues still hope to carry out the made-in-Africa mRNA vaccine trial they spent years designing — if they can find a way to pay for it. But Bekker remains convinced that the scientific strategy behind it is the right one, and that mRNA may yet do for HIV what it did for Covid-19, rapidly transforming decades of scientific groundwork into an effective shot.

She only hopes politics does not succeed where HIV itself has failed in slowing the field’s progress. “We should only be fighting the virus,” Bekker said. “But we’re fighting the administration and its policies, and that is a waste of our energy.”

This story appeared in Today, Explained, a daily newsletter that helps you understand the most compelling news and stories of the day. Subscribe here.

President Donald Trump seemed visibly irked when asked about his plans for Iran on Tuesday. “You don’t know anything,” he snapped at a reporter who said Iran showed no signs of deescalating. 

You have to forgive the man his vexation — he is in something of a bind. The war in Iran, never popular to begin with, has only become more of a lemon since a tenuous ceasefire collapsed earlier this month. In the two weeks since, Iran has bombarded targets across the Middle East with missiles and drone strikes. The onslaught badly damaged US bases and, just last week, killed three American soldiers’ lives.

Now Iran and its allies, metaphorically drunk on their recent successes (…alcohol is technically illegal in Iran!), appear to be revving for a new round of attacks. Iran launched strikes on Kuwait, Jordan, and Bahrain this week, reportedly targeting both US bases and civilian infrastructure. And on Monday, Yemen’s Iran-backed Houthi militia also threatened to shut down a second key waterway that could further strain global oil markets. 

The world is running out of soldiers

The latest US casualties are a grim reminder that — for all the talk of drones and precision missiles — wars are still fought by actual, human people. 

But major military powers are running short on soldiers: The US, the United Kingdom, Germany, and Japan have all recently struggled to recruit troops. And the forces driving that shortage aren’t easily reversed. 

For starters, falling birth rates and aging populations have left many countries with fewer military-age adults. Being the right age is also only half of the equation. In the US, factors including weight, drug use and physical or mental health conditions would disqualify an estimated three-quarters of young Americans from military service.

Then there’s the military’s image problem: Polls show that young people around the world are becoming less willing to fight for their respective countries. And young Americans, in particular, have more negative views of both the military and the war in Iran than do their parents or grandparents.

There is another way to fill the ranks, of course…but it isn’t popular. The US ended its draft in 1973, and most Western militaries have similarly transitioned to all-volunteer forces. If the US did ever need to restart its draft, both the politics and the logistics could prove formidable. 

One link for later

➨ Treat yourself to a froyo. The go-to dessert of my misspent 20s is apparently very much back in vogue. But this time, it’s less about the zany flavors and maximalist toppings and more about wellness buzzwords like…protein and probiotics. Hmmmm. 

Before you go…

• Did you know…that carrots don’t actually improve your vision? The myth originated as part of a World War II propaganda campaign to conceal Britain’s development of radar technology.
• Today’s trivia: How many countries are in North America? Don’t look it up — just guess! (Our daily trivia generally comes from Vox’s daily crossword, but today’s tidbit comes from my colleague Sean Rameswaram.) 
• Yesterday’s trivia: Yesterday I asked you to name the Mesoamerican civilization that spoke Nahuatl. That would be the Aztecs — though 1.5 million people in central Mexico still speak the language now.

Welcome to The Logoff: President Donald Trump announced giant new tariffs on Canada, which are scheduled to start in 30 days. Now negotiators from both countries are scrambling to see if they can be avoided.

What happened? Late on Monday, the White House announced 50 percent tariffs on a slew of Canadian goods — including whiskey, cheese, down jackets, and (naturally) hockey sticks. Because the Supreme Court sharply limited his tariff powers earlier this year, Trump is invoking a largely forgotten and possibly defunct authority under Section 338 of the Tariff Act of 1930.

Previously, these goods had been covered under the USMCA, the trade deal Trump negotiated with Canada and Mexico in his first term to replace NAFTA. But on July 1, the agreement expired and the US declined to renew it. 

Why is Trump doing this? The White House claimed three key grievances: Canadian duties and restrictions on American alcohol, dairy products, and automobiles. Liquor appears to be a special irritant: All but two Canadian provinces have pulled US-made booze from government liquor stores, and even some Democrats have complained.

However, the alcohol boycott began as retaliation for the trade war Trump launched in early 2025, when he was talking regularly about Canada becoming America’s 51st state. Much like his effort to reopen the Strait of Hormuz, Trump is trying to fix a problem he caused in the first place.

Interestingly, the tariffs will not go into effect for 30 days. This suggests that they may be less a serious policy initiative than a negotiating tactic. 

What’s the takeaway: Trump’s lifelong fascination with economic warfare has survived the Supreme Court’s rebuke, and he continues to fixate on Canada as a special target of his ire. It is unclear why; both countries have suffered from the breakdown in bilateral relations. 

But whatever the motivation, the ultimate outcome is clear: Icy relations to the north are a permanent fixture of the Trump presidency.

And with that, it’s time to log off…

The Odyssey officially had the biggest opening of any live-action movie of the year, as the new Avengers: Doomsday trailer is greeted with yawns. Here’s to the new MCU: the Mycenaean Cinematic Universe.

If the US wanted to be the world’s police officer, then why not try to be its doctor too? 

Just two months before the invasion of Iraq in 2003, George W. Bush announced an ambitious plan to pump $15 billion into the global fight against HIV, stunning his allies in Congress, health advocates, and heads of state of the program’s intended beneficiaries. 

The President’s Emergency Plan for AIDS Relief, or PEPFAR, was the largest commitment by any nation in history dedicated to addressing a single disease, a disease that killed about 3 million people in 2003, most of them living in sub-Saharan Africa, and infected 5 million more. “Ladies and gentlemen,” Bush proclaimed in his State of the Union address that year, “seldom has history offered a greater opportunity to do so much for so many.”

On that, he was right. In the two decades to follow, PEPFAR would save an astounding 25 million people’s lives through lifesaving HIV therapies, and prevent millions of babies from being born with HIV in the first place, all at a cost of about 0.08 percent of the federal budget. 

And yet, in the wake of the Trump administration’s foreign aid cuts, one of the greatest achievements in American history is now at risk. PEPFAR, mercifully, still exists, saved from the sledgehammer by an outpouring of bipartisan support last February. But experts say the program has been transformed beyond recognition by countless small cuts, and the abrupt gutting of global health architecture, reshaped not by decades of accumulated wisdom around HIV prevention, but by at times absurdly petty ideology.

Over the past year, more than 77 percent of PEPFAR grantees have lost funding or had their payments delayed, according to a survey released Tuesday by the HIV research group amfAR. 

Nearly two-thirds of grantees — especially those supporting vulnerable populations such as LGBTQ people, young women, and sex workers — said the cuts had disrupted their ability to offer HIV treatments and other services. The Trump administration released limited data showing a deep reduction in HIV prevention services, but a relative consistency in access to treatment earlier this year. However, this new survey paints one of the first pictures available of how PEPFAR cuts are actually being felt on the ground, and how the administration’s priorities are reshaping who and what gets funded.

According to the survey’s authors, at least 1,700 HIV-related sites or clinics have shut down as a result of cuts. Well over 16,000 health workers — including those going door to door to make sure pregnant parents get tested for HIV or children get on treatment — have lost their jobs. 

Many organizations surveyed reported receiving emails when their PEPFAR grants were terminated, noting that their work violated President Donald Trump’s executive order against “unlawful diversity, equity, and inclusion.” It appears, they say, that many of these groups were flagged not because they embraced the distinctly American concept of DEI in their work, but because their name or mission description included a phrase like “gender” or “LGBTQ.”  

A health clinic serving survivors of domestic violence in Mozambique, for example, might now be flagged just for using the phrase “gender-based violence” in their name. This may be part of the reason why even pregnant women — who even the Trump administration has emphasized as a critical demographic in its HIV goals — have lost access to services. 

Back in 2003, Bush defied conservative critics in his own party who attempted to redirect PEPFAR funding to abstinence-only programs. For decades, American presidents have been able to see past their ideology in service of saving lives. They largely understood that contraceptives like condoms and special interventions for those most at risk, including LGBTQ people, were necessary for stopping the spread of HIV. Under the Trump administration, this norm is unraveling. 

“This administration has zero interest in addressing clinical outcomes for vulnerable people with HIV,” said Asia Russell, executive director of the advocacy group Health GAP, who noted that “to be effective, HIV prevention and treatment services actually have to go where the disease is, and that risk is not evenly distributed,” surging in certain geographies like South Africa or within key populations like trans people or young women. Getting support to these groups is “morally right,” she said, but it is also “the only way to do effective HIV work, regardless of your stance on the morals or the merits.”

The fight against HIV is running on fumes

When HIV aid does get doled out these days, it is distributed with far less transparency than in the past, and in ways that often appear to be ideologically or politically driven, both in terms of the populations they serve and the countries they operate in, rather than guided by best practices. 

In theory, lifesaving HIV care was exempted from sweeping aid cuts last year. But in reality, access to even the most basic HIV services and treatments has also atrophied across the board, while falling disproportionately on at-risk populations. 

That’s come both in the form of direct cuts and as a byproduct of broader disruptions to the kind of outreach services, testing, and socioeconomic programs that get patients in the door to begin with. 

“You can’t cut pieces of the architecture of how PEPFAR functions and expect to maintain a really robust treatment program in the long term,” said Jennifer Sherwood, director of research and public policy at amfAR. “If you cut the testing program, the prevention programs, the kind of services that allow people to stay in care and return to care, you’re going to see that you can’t maintain a treatment program.”

The number of people getting on treatment for the first time has sharply declined over the past year, even according to the administration’s own limited data drop, while access to testing, contraceptives, and other preventative services — all critical to keeping infections down in the long run — face cuts that threaten their ability to function at all. 

To make matters worse, amfAR’s survey shows that services designed for the populations most at risk of HIV — such as sex workers, LGBTQ people, young women, and teenage girls — have been disproportionately affected by PEPFAR cuts. Among those who lost funding, a staggering 90 percent of organizations that serve gay and bisexual men were forced to slash access to PrEP — which strongly protects against HIV infection — and many stopped offering it entirely. The same was true for over half of organizations serving pregnant women, whose children now face a higher risk of contracting HIV in the womb.  

The majority of new HIV infections are concentrated in these “key populations,” as they’re known in public health parlance, many of whom face stigma or other obstacles to obtaining care. “One really powerful aspect” of how PEPFAR used to work, said Thomas McHale, public health director at Physicians for Human Rights, was that it consistently “followed the science and followed the epidemiology” to serve “groups that are at the margins of society.” That approach appears to have been thrown out under the new administration, and in at least some cases, actively discouraged.

McHale has been documenting the impact of PEPFAR cuts in South Africa in recent months, and “what we saw was a system under severe stress and strain,” he said. It is one in which a bisexual man stopped taking his HIV medications for weeks because the LGBTQ clinic he used to go to closed. “He just couldn’t bear the stigma of accessing services in a place that’s not meant for him,” according to McHale. Similarly, a young woman was forced to wait in line for 10 hours just to refill her PrEP prescription. 

“If we’re not focusing on preventing disease,” McHale said, “it’s just a more expensive and more devastating challenge to address in the future.”

Some countries may soon stop receiving PEPFAR funding altogether

As I’ve written previously, the Trump administration has attempted to remake foreign aid into a dealmaking enterprise, one in which money flows directly through national governments rather than through large, western-led non-governmental organizations or NGOs. 

In theory, there are benefits to this approach, because it prioritizes the expertise of local health groups and policymakers who are often best equipped to evaluate and address the needs of those in their care. In practice, however, amfAR’s survey shows that so far, under the Trump administration, local organizations have actually lost more funding and been forced to close more sites than international groups have. “These cuts fell heavily on locally-based organizations” while NGOs have fared somewhat better, said Sherwood, “and that really runs counter to all of our global health goals.”  

“I’m concerned because public health is no longer how we’re measuring success” when it comes to reaching PEPFAR’s goals, said Jirair Ratevosian, a senior fellow at the Duke Global Health Institute who served as chief of staff of PEPFAR under the Biden administration. He is especially alarmed by the decision last month to end PEPFAR support for South Africa, which has the largest HIV epidemic in the world. The administration appears to have done so in part because of Trump’s insistence that the nation is waging a nonexistent “genocide” against white Afrikaners. 

“If we’re not focused on preventing disease, it’s just a more expensive and more devastating challenge to address in the future.”

Thomas McHale, Physicians for Human Rights

“HIV control is not their chief concern,” said Ratevosian, who recently ran the numbers on a separate fissure with Zimbabwe, finding that cutting PEPFAR would lead to 75,000 new HIV infections in just one year. In South Africa, similar cuts could lead to over 2 million more infections over the next two decades, a toll that would invariably cross borders, and could threaten the world’s immense, hard-won progress against HIV. “You can’t have a global HIV strategy,” said Ratevosian, “if you’re not engaging these countries.”

Priorities shift under any new administration, and it’s not abnormal for an organization to tweak its language or services to adapt. But PEPFAR, the bipartisan program which began under Republican leadership, and thrived and expanded under three successive presidencies, including during Trump’s first term, has never faced such turmoil. 

“Even among organizations who didn’t lose US funding, we’re still picking up changes to the way they work, the populations they serve, the words they use,” said Sherwood of amfAR. Her group’s survey showed that nearly 80 percent of organizations that did not lose funding still altered the way their organization worked to comply with new policies. “This network of changes from the US,” she said, “are prompting a lot of changes on the ground.”

Gut health is everywhere right now. The hashtag #GutTok has over 6 billion views on TikTok, the global digestive health product market is worth over $60 billion, and viral trends that promise to “hack your gut” through miracle products, cleanses, and restrictive diets are all the rage. But what does gut health really mean, and what can science tell us about how to make sure our gut is in good shape?

The gut microbiome, a complex network of trillions of microorganisms living inside our digestive system, may hold the key to the mysteries of gut health. We have a symbiotic relationship with all of those little guys; we keep them well-fed and they produce substances that can benefit our body and brain. These microbes help regulate bodily functions, protect against disease, and recover from illnesses like cyclosporiasis, which is spreading right now across the US.

But with so many voices chiming in on gut health, pushing everything from probiotic foods and supplements to wellness shots and coffee enemas, it can be hard to tell what information is based on real research and what might just be a marketing gimmick or social media clickbait. Vox spoke to doctors and visited Cedars-Sinai in Los Angeles to bust some gut health myths for science-backed advice. 

Read more about gut health and gut microbiome research:

• Vox editor Katherine Courage’s book, Cultured: How Ancient Foods Can Feed Our Microbiome.
• Cedars-Sinai’s Human Microbiome Research Institute.
• The MAST program at Cedars-Sinai.
• Trisha Pasricha’s book, You’ve Been Pooping All Wrong. 
• Vox’s explainer video on probiotics in yogurt.
• Pew Research Center’s findings on why people look to influencers for health and wellness information.
• The Myths and Scientific Realities About Gut Microbiota.

This video is presented by Colgate. Colgate doesn’t have a say in our editorial decisions, but they make videos like this one possible.

If you’re looking to wean yourself off social media and replace it with a more productive habit — and who among us isn’t — a lot of the common advice can sound like it’s coming from a drill instructor: Go outside and touch grass. Routine is key. Get your butt in the chair and don’t get up until you’ve done the work. They might as well be telling you to do a hundred pushups while they’re at it.

As valuable as that advice may be when you need a kick in the pants, these imperatives create an uneasy tension between leisure and labor. It’s all well and good to try to turn away from the siren song of your phone, but how likely are you to stick with the alternatives — reading books, drawing, meditating — if they feel like homework? 

It’s a lot more fun, and a lot less arduous, to try to beat social media at its own game instead, and harness your curiosity. 

Social media apps work in part by playing off our natural curiosity. Every time we refresh the endless scroll, they promise to give us new information, capturing the parts of our brains that always wonder what’s about to happen next. But they rarely actually satisfy that curiosity. They just repeat it endlessly: What’s going to happen when I scroll this far? Or this far? Or this far? The answer is almost always: the same thing as last time.

Away from social media, however, the world works differently. If you get curious about a question off the algorithm, it can lead you somewhere new and interesting. 

Even when we begin with a utilitarian goal, curiosity can take us in surprising directions. A few years ago, I got interested in running. At first I would just lace up my shoes, do a few perfunctory stretches, and jog straight out of my front door. But I gradually became curious about the mechanics of what I was trying to do. I began investigating running form, which led me to theories about how you should be doing different kinds of running every week. From there I learned about how strength training was important to support running, and then weight lifting led me to nutrition. I’m still not a particularly fast runner, but I am a data bank on all the ways there are for a person to make themselves just a little bit faster, and I know there’s more for me to keep looking into.

The goal here should be to get away from simple goals (running more, as in my example) to a more open and adventurous experience of what interests and engages us (understanding how I can support my body when I’m running). The experience is simple: Find something that fascinates you, learn a little more about that — whether from your friends, a documentary, or even an old-school internet search — then try to figure out what new questions that opens up and keep asking them. It’s a process that allows us to become our guides, whether we know where we’re headed or not.

In a recent essay, the writer John Paul Brammer explains that that’s exactly how he got himself to read more. 

“Curiosity is a child,” Brammer writes. “When it wants something, when it truly wants something, it’s nearly impossible to keep its hands away.” Brammer found his way to reading by getting curious about David Foster Wallace, which in turn led him to Wallace’s influences: from Donald Barthelme to Thomas Pynchon to Clarice Lispector.

“I read out of strict obedience to curiosity, the desire to know what these words in this sequence might hold,” Brammer writes. “I had to make it fun at first. This was messy. I sipped from this book, then that one. It wasn’t formal or rigorous. I read whenever I felt like it.”

Where habits are mindless and rote, curiosity is something to be indulged: It’s fun, even hedonistic. Embracing curiosity means finding ways to play with art and ideas, as if they’re clay, instead of chipping away at them, as if they’re solid stone.

“The relevant science isn’t something I’m qualified to parse,” Brammer writes in his essay. But when I looked into that very science, I found that his experience aligned with it quite well.  

“If you link curiosity to the accumulation of knowledge, you can actually self-boost your curiosity over time, with the end result of more continued interest.”

Kou Murayama, University of Tübingen

“People have likened the state of being curious about something to an aversive state,” says Celeste Kidd, an associate professor of psychology at UC Berkeley. “It’s unpleasant, akin to something like an itch. When you have that aversive state, when you really want some piece of information, it feels very satisfying to scratch it. There’s all sorts of positive feelings that come with satisfying specific curiosity.” 

The endless scroll of our phone apps can function like a hydrocortisone cream, offering a balm for the irritation without really dealing with the cause. It’s not actually scratching the itch. To do that, you have to get curious about a question that can guide you through an idiosyncratic and looping itinerary that is never fully determined in advance. 

Writer and tech designer Celine Nguyen has written about letting her curiosity guide her down rabbit holes in her essay on “research as leisure activity,” a phrase she borrowed from librarian Karly Wildenhaus. Speaking to me, Nguyen describes getting interested in the way the rise of vibe coding is affecting app design. 

“This idea around shifting design processes made me think of this art historian Claire Bishop,” Nguyen says. Bishop’s most recent book deals with the way technology changes our response to contemporary art, and Nguyen says that “after reading that, I was like, ‘I really like reading about contemporary art and performance. What else can I read in this vein?’” 

Nguyen followed her new interest in dance to a fixation on choreographer Pina Bausch, and soon found herself scouring the internet for still images from Bausch dances. 

“It’s sort of like this pleasantly fizzy, almost like ADHD brain thing,” Nguyen says. “It sort of feels like I’m wandering around this massive information landscape and I’m just coming off all these images or all these reference points or quotes that speak to me, and maybe at the end of this process I can sum up what it is I’m interested in.”

The point at which you satisfy your curiosity can be dangerous. Once the itch is gone, the desire to learn can disappear completely — even if you don’t know as much as you think. 

Kidd describes a study in which she tried to motivate people to learn a new fact about something they thought they already completely understood, but were actually wrong about.

“When we paid them to look up the right answer, they weren’t motivated to seek out more information,” she says. “They did it, but it was like they were out to lunch. They were thinking about something else. That information did not go in.” 

According to Kou Murayama, a professor of psychology at the University of Tübingen in Germany, the best way to maintain your momentum is to marshal your ephemeral curiosity into long-term interest by letting the answer to one question prompt a new one, as if you were figuring out where to eat each meal in a new city by asking your waiters where they like to eat. 

“If you link curiosity to the accumulation of knowledge, you can actually self-boost your curiosity over time, with the end result of more continued interest,” Murayama says. “Curiosity is basically short-lived, but if it’s linked to accumulating knowledge, or if you can link it to your self identity or importance, then you can self-booster interest.”

The trick is to, like Brammer and Nguyen, guide your curiosity toward a topic that can keep surprising you over time. What that usually means is to look for a topic that you already know a little bit about that can keep surprising you.

“We’ve done studies with 7-month-old babies, and they’re seeking out particular kinds of things in the world that violate their expectations, just a little bit but not too much,” Kidd says. “It tends to be the case that people want to elaborate on knowledge they already have as opposed to going into other domains. If there’s some way to relate a desired new set of expertise to something that you already have some background in, that’s a thing that you could absolutely do intentionally.”

So if you want to find some creative outlet for your time — or even if you just want to read more — there are straightforward steps to take: Look for something that excites your curiosity. Look for something that you are uncertain about, something so maddeningly unclear that you can’t help but itch at it. 

This mystery doesn’t have to be about science or philosophy. It could be about what happens to a character in a particular thriller, or how to capture a likeness in charcoal, or what a certain part of your city looks like. The point is that it should be the kind of question that you can’t let go of.

Then indulge in finding the answer — and let that question prompt another one. Then another. Then another.