A push to stay at the VA

The ideas and innovators shaping health care

Jan 09, 2025 View in browser   By Erin Schumaker and Carmen Paun THE NEXT CURES Veterans and psychedelics advocates are lobbying to keep Dr. Shereef Elnahal at the VA. | Erin Schumaker/POLITICO Dr. Shereef Elnahal wants to keep his job as undersecretary for health at the Department of Veterans Affairs. An advocate of psychedelics as a mental health treatment, he’s making the case that his own interest in the drugs dovetails with that of President-elect Donald Trump’s pick to lead the Department of Health and Human Services, Robert F. Kennedy Jr. Elnahal's popular among veterans and psychedelics advocates, who are making calls this week to encourage lawmakers to lobby Trump to keep Elnahal on. The odds of that are long. Elnahal is a Biden administration appointee and Trump has largely tapped loyalists and celebrities to staff his administration. "I haven't been asked to stay, but if I am asked, I would stay," Elnahal told POLITICO. "I'd be honored to continue on and advance the agenda for veterans." While Trump hasn't publicly commented on psychedelics, Elnahal is heartened by what he's heard from Kennedy, who has openly criticized the Food and Drug Administration's approach to regulating the mind-altering drugs. The FDA this summer rejected a drugmaker’s application to offer the psychedelic drug MDMA, alongside therapy, as a post-traumatic stress disorder treatment. "The public statements from Bobby Kennedy on this have been very encouraging," Elnahal said. Kennedy said his mind was open “to the idea of psychedelics for treatment,” in a post to X in September, adding that “People ought to have the freedom and the liberty to experiment with these hallucinogens to overcome debilitating disorders.” "I really appreciate Bobby Kennedy's approach to trying to instill wellness as a bigger part of American life — I think veterans would benefit from that," Elnahal said, adding, "When it comes to breakthrough therapies for mental health and tackling veteran suicide, psychedelics fall straight into that agenda." Still, some are skeptical that the hype around psychedelic medicine has outpaced the science behind it, and worry that the drugs could be misused or could put patients at risk. Why it matters: A year ago, the VA announced it would fund psychedelic research on post-traumatic stress disorder and depression for the first time since the 1960s. Thousands of veterans, many of whom have PTSD or depression, travel to other countries to seek psychedelic-assisted therapy each year. Given that, Elnahal thinks the United States should be offering those therapies in well-controlled settings. "The only way to do that is to boldly approach this with more research and to give veterans access to this kind of therapy here at home," he said. "You shouldn't have to travel to Mexico. You shouldn't have to travel to Costa Rica. We really need a line of sight into this type of therapy to make sure that it's effective." "I think the incoming administration has the right mindset on developing that evidence and delivering it safely to veterans." WELCOME TO FUTURE PULSE West Mountain, N.Y. | Tymm Schumaker This is where we explore the ideas and innovators shaping health care. Your desk job may be keeping you up at night. People with highly sedentary jobs are at much higher risk for insomnia symptoms, according to a new study from the University of South Florida. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Ruth Reader at rreader@politico.com, or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp.  THE LAB An AI tool that analyzes placentas could help doctors spot infections in infants after childbirth. | AP Photo Researchers are developing an artificial intelligence-backed tool to help doctors quickly spot infections in infants after childbirth. How so? Using a large, diverse dataset containing 12 years’ worth of photos and medical reports, researchers used AI to teach a computer program to analyze pictures of the placenta, an organ that forms in the uterus during pregnancy, and to make predictions based on those images. The model, PlacentaCLIP+, can accurately identify health risks, like neonatal sepsis, a life-threatening infection, by analyzing photos of the placenta after birth. Researchers also taught the model to make predictions in different photo-taking conditions, so that it could contend with motion blur, blood stains on the placenta and lighting variations like glare and shadows. The model was validated cross-nationally to ensure it works on different populations of patients. The study was published in the journal Patterns in December. Why it matters: Neonatal infections result in 550,000 deaths worldwide annually, according to the World Health Organization. Identifying infections faster could help mothers and babies get antibiotic treatment more quickly. But in the U.S., doctors perform only a quick examination of the placenta after delivery, the researchers note, and only about 20 percent of placentas undergo testing — a process that can take up to four days. Placentas not tested are discarded. In less-resourced countries, like Uganda, health care facilities often lack any placental testing capabilities. “Discarding the placenta without examination is a common but often overlooked problem,” Alison Gernand, principal investigator on the project and associate professor in Penn State College’s health and human development department, said in a statement. “It is a missed opportunity to identify concerns and provide early intervention that can reduce complications and improve outcomes for both the mother and the baby,” Gernand said. What’s next: Developing a simple-to-use smartphone app or integrating the model into medical record software. The goal: To allow medical professionals with limited training to photograph placentas after birth and get immediate feedback they can use to treat their patients. WASHINGTON WATCH In his parting speech, USAID’s Dr. Atul Gawande said the U.S. should keep its international alliances strong. | USAID/Ghana America’s public health efforts abroad keep its international alliances strong and improve its security at a time when many threats the U.S. faces, such as emerging pathogens, come from beyond its borders. That’s the parting message from Dr. Atul Gawande, assistant administrator for Global Health at the U.S. Agency for International Development. A renowned surgeon and writer, Gawande called the position he’s held for the past four years “the best health job in government that you’ve never heard of,” in a farewell speech at the agency Wednesday. He cited a Russian disinformation effort that falsely portrayed U.S. health activities in Africa as an example of how meaningful USAID’s global health work is geopolitically. He said a new Russian information agency, African Initiative, “repeatedly publishes baseless claims that our programs are covertly carrying out nefarious biological testing on African communities,” Gawande said. African Initiative states on its website that it aims “to mutually expand the knowledge of Russians and Africans about each other.” Gawande, citing a speech by USAID Administrator Samantha Power last month in which she mentioned Russia’s effort, said “the propaganda reveals how America’s competitors understand the enormous power of our work.” Why it matters: Gawande’s warning comes as the incoming Trump administration is expected to pull back from some of America’s public health efforts abroad. Global health advocates fear President-elect Donald Trump may seek to hold flat or cut America’s global health funding of at least $10 billion a year, which has made it the biggest global health donor. Trump is also expected to withdraw the U.S. from the World Health Organization.   Follow us on Twitter Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker   Follow us

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