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White House Budget Chief Says Issue Of Abortion Coverage In Health Reform Still Under Debate
In an appearance on "Fox News Sunday," White House Office of Management and Budget Director Peter Orszag said that he is "not prepared to say explicitly" whether health care reform legislation would prohibit the use of federal tax revenue to fund abortion coverage, the New York Times reports. Orszag"s statement came in reply to a question asking whether he was prepared to say that "no taxpayer money will go to pay for abortions." Orszag said, "It"s obviously a controversial issue, and it"s one of the questions that is playing out in the debate" (Pear/Liptak, New York Times, 7/20).Sen. Judd Gregg (R-N.H.), who also appeared on "Fox News Sunday," said, "No matter what your views are on abortion, you shouldn"t ask people to use their tax dollars if they think that abortion is taking a life." Gregg added, "I would hate to see the health care debate go down over that issue. We do really need health care reform, and it has to be substantive. ... So hopefully we won"t get ourselves wrapped around the wheel of abortion in this debate" (FoxNews.com, 7/19). According to the Times, there is an ongoing behind-the-scenes debate over handling abortion coverage in health overhaul legislation. The debate affects both the public insurance plan the legislation would create and private insurers, who would receive tens of billions of dollars in federal subsidies to expand coverage for low- and moderate-income U.S. residents. A provision in the House health reform bill (HR 3200) calls for a federal advisory committee to advise the HHS secretary on an "essential benefits package" that most insurers would be required to provide. Abortion-rights opponents want abortion coverage excluded from the package, while abortion-rights advocates say the decision should be left to medical professionals. House committees working on health reform legislation have rejected Republican amendments that would have restricted abortion coverage. The Hyde Amendment, first enacted in 1976, prohibits the use of federal Medicaid money for abortion services. However, abortion-rights opponents argue that federally subsidized coverage of the uninsured would not be subject to the existing restrictions. The National Right to Life Committee issued an analysis of the House bill, stating, "There is no doubt that coverage of abortion will be mandated, unless Congress explicitly excludes abortion from the scope of federal authority to define "essential benefits."" According to the group, even if the HHS secretary did not require abortion coverage, "federal courts would interpret the broadly worded mandatory categories of coverage to include abortion" (New York Times, 7/20).

H1N1 Flu Update: U.S. Flu Funds; South Africa Confirms First Case; EU Encouraged To Coordinate Pandemic Vaccine Policy
Senate Passes Bill Including Flu Funds
News of the day
New Phone Number To Make Urgent Care Easier To Access, UK
A consultation on a new national three-digit number - 111 - that will make it easier for patients to access urgent care wherever they are was launched by Ofcom.
Cardiovascular

DNA Deletion Makes Swedish Chlamydia 'Invisible'

New sequencing and analysis of six strains of Chlamydia will result in improved diagnosis of the sexually transmitted infection. This study provides remarkable insights into a new strain of Chlamydia that was identified in Sweden in 2006 after spreading rapidly across the country by evading most established diagnostic tests. The results also reveal more about the evolution of the Chlamydia trachomatis bacterium, which is the most common cause of sexually transmitted infections (STIs) globally. The long-term effects of an undetected Chlamydia infection include infertility and ectopic pregnancy. Long-term eye infection by Chlamydia is also the leading cause of preventable blindness in the developing world. As part of a long-standing collaboration between the Wellcome Trust Sanger Institute and University of Southampton, the team of researchers focused on six strains of Chlamydia. Of particular interest to the team was the new Swedish strain provided by collaborators at Malmo University Hospital, Sweden. The genome of the Swedish strain features an evolutionary "hiccup" that allowed it to go undetected in Sweden for several months. Indeed, doctors thought that the numbers of cases of Chlamydia were falling, when the opposite was true. Through non-diagnosis, this version of Chlamydia spread silently. The reason: a deletion of the region of genetic information used to diagnose the presence of Chlamydia. "The medical and research communities need to heed this warning," says Dr Helena Seth-Smith, investigator at the Sanger Institute and lead author on the study. "Chlamydia infections appeared to be in decline in Sweden, but this could not have been further from the truth. The loss of a segment of genetic code made the tests completely powerless to detect this particular strain of Chlamydia. This type of evolution to evade diagnosis could occur in other infectious bacteria." "We have found more stable genetic targets - these should be the regions against which we design diagnostic tests." The deletion - 377 letters of genetic code - occurred on the plasmid of the bacterium. Plasmids are small, circular molecules of DNA that are located outside the chromosome. Chlamydial plasmids have been shown to vary little between different strains of Chlamydia, and are present in larger quantities than the chromosome. This makes them ideal candidate targets for diagnostic tools. Clinical tests have focused on one region of the bacterial plasmid - a gene of unknown function which is largely deleted in the new Swedish strain. "We have confidently placed great reliance on nucleic acid based diagnostic tests for many years," explains Professor Ian Clarke, University of Southampton, senior author on the study, "but we must always be alert to changes in the biology of this organism. Chlamydia are notoriously difficult to study in the laboratory and genomics can make a vital contribution to adding to our understanding of this insidious parasite." After careful analysis of the newly sequenced plasmids of these strains, the team have identified the regions of the plasmid that vary least between strains. "These are thought to be important in the stability of the plasmid, and so tests on these regions should prove more reliable," explained co author Dr. Pete Marsh from the Southampton Health Protection Agency." "This is a truly remarkable turn of events," explains Dr Nicholas Thomson, principal investigator at the Sanger Institute. "It is an example today of evolution in action: we believe that diagnostic tests that target one region of the Chlamydial plasmid have allowed the Swedish strain, very quickly, to become the dominant strain in that country." "Paradoxically, the efforts of humans to control the spread of the disease may well have been the cause that shaped the development and spread of this new strain." Chlamydia is a bacterial parasite that only grows within human cells: as a result there is not a great deal of exchange of genetic material between strains. The stability of the link between the bacterial chromosome and the plasmid DNA was also established in this study, reinforcing confidence in the plasmid as the target for diagnostic tests. Publication Details Seth-Smith H. et al. (2009) Co-evolution of genomes and plasmids within Chlamydia trachomatis and the emergence in Sweden of a new variant strain. BMC Genomics Published online before print as doi: Funding This work was supported by the Wellcome Trust and the MRC sexual health and HIV grant scheme. Participating Centres * Molecular Microbiology Group, University Medical School, Southampton General Hospital, Southampton, UK * The Pathogen Sequencing Unit, The Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK * Department of Clinical Microbiology, Malmo University Hospital, Malmo, Sweden * Health Protection Agency South East, Southampton General Hospital, Southampton, UK * Department of Obstetrics and Gynaecology, Malmo University Hospital, malmo, Sweden * Viral Diseases Programme, Medical Research Council, Banjul, The Gambia/Clinical Research Unit, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine London, UK Don Powell Wellcome Trust Sanger Institute


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