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Policy Considerations for Defining Essential Health Systems
This policy brief outlines how an essential health system designation relates to existing designations and discusses policy considerations for developing measures to identify essential health systems.
E-bike safety; lung cancer treatment and prevention; keeping CMA Festival attendees safe; plus other stories with Vanderbilt Health sources
WKRN News 2 interviewed Jeffrey Upperman, MD, FACS, Professor and Chair of the Department of Pediatric Surgery and Surgeon-in-Chief of Monroe Carell Jr. Children’s Hospital at Vanderbilt, about e-bike related injuries following the recent death of a Brentwood High student and a proposal to require safety training before students could ride a bike on a school campus in Williamson County. Fabien Maldonado, MD, MSc,Professor of Medicine and Thoracic Surgery, was on WTVF News Channel 5‘s live studio show, “Openline,” with host Ben Hall, to discuss lung cancer, treatment and prevention. WSMV’s “Today In Nashville” program hosted Vanderbilt LifeFlight paramedic/flight nurse practitioner Tony Smith to talk about safety for the CMA Festival. The New York Times reporter Carl Zimmer interviewed James Crowe, MD, Director of the Vanderbilt Center for Antibody Therapeutics, for a story about the race to find vaccines and treatments as Ebola spreads. The Vanderbilt Health News release about the pilot clinical trial conducted by Vanderbilt Health and Cumberland Pharmaceuticals Inc., that confirms the safety of ifetroban and supports the further development of the drug to prevent cancer metastasis, was picked up by Reuters, Stock Titan,and others. Women We Admire has named Lee Ann Liska, President and Chief Operating Officer, to its list of top women leaders of Nashville for 2026. Radiology Business, Aunt Minnie, Bioengineer, and Imaging Technology News covered the study from Consuelo Wilkins, MD, MSCI, the Mildred Thornton Stahlman Professor in Rural Health and professor of Medicine in the Division of Geriatric Medicine, that found Black and Hispanic people, while known to be far more apt to have dementia, are significantly less apt than other racial and ethnic groups to show Alzheimer’s pathology on brain scans. STAT News interviewed Deva Sharma, MD, Transfusion Medicine & Hematology-Oncology, for a story about more patients requesting unvaccinated blood and what it means for the medical system at large. Yahoo! Health reporter Korin Miller interviewed Gitanjali Srivastava, MD, Director of Obesity Medicine, for a story about how semaglutide and tirzepatide compare. William Schaffner, MD, Professor of Preventive Medicine, was quoted by several news outlets about public health issues, including: NBC News (new COVID vaccinations); Medscape (pneumonia and sepsis); and CNN (protection from contagious viruses). Shelbyville Times-Gazette is repurposing Jessica Pasley’s July 2025 Vanderbilt Health News story on tick-borne illnesses as a front-page story.
Morning Preview: A Jobs Report Surprise, Immigration Showdown and Rising Heat Risks
Today, economists and consumers are reacting to a better-than-expected job report and regulators are rethinking how schools spend billions on internet access and classroom technology. At the same time, the first major heat waves of the season are putting pressure on public health systems as summer ...
How climate services for health protects lives and economies
Climate-smart investments and smart tools will become increasingly vital to keep health systems running as extreme weather events become more frequent.
Minor league update for 6/4/26
The minor league action in the Rangers’ system from Thursday
VIEW Strong May jobs number sends yields, rate expectations higher
The U.S. economy posted another month of strong employment gains in May, confirming that the labor market was gaining traction after stumbling last year and sending short-term interest rates higher on Friday morning in the face of inflation stemming from the war with Iran.
MISS shifts the ecosystem of shark science
The program creates a space where women of color thrive as they dive into marine research.
Dr. Elisabeth Rosenthal on health care
Dr. Elisabeth Rosenthal sits down with Lester Holt to discuss the challenge of reforming the American health care system.
WellSpan Health strikes strategic partnership with Philips to deploy, co-develop new healthcare tech
Community health system WellSpan Health inked a seven-year strategic alliance with Philips to drive advanced imaging technology across its network and co-develop new AI and tech tools. | WellSpan Health inked a seven-year strategic alliance with Philips to drive advanced imaging technology across its network and co-develop new healthcare technology.
Health Care Roundup: Market Talk
Find insight on AstraZeneca, TD Cowen, EBR Systems and more in the latest Market Talks covering Health Care.
Youth mental health system in NJ hurts kids, frustrates parents, study says
Lawmakers proposed fixes to NJ's child mental health system in response to a report saying it frustrates parents, leaves kids waiting for care
Scientists warn Trump plan to axe US ocean monitoring system will leave world ‘flying blind’
Experts say dismantling the ocean observation system will ‘severely degrade’ the accuracy of weather predictions
How living and practicing medicine abroad complicated my beliefs about universal health care systems
“I believe deeply in universal health care. But universal care must also mean universal safety and accountability, not merely universal access.”
‘A calling’: Paid foster parents are changing outcomes for NC children
Crossnore President Brett Loftis, CEO Sarah Norris discuss professional foster parenting and its role in reforming NC’s child welfare system.
Hospitals Are Leading Efforts to Make Health Care More Affordable
Affordability is front and center in conversations across the country, as Americans feel pressure from the rising cost of living and policymakers search for solutions. Hospitals and health systems share their concerns because we see the impact of high costs every day on the patients and families we serve. Hospitals are not waiting to do their part. Across the nation, they are already implementing efforts to make healthcare more affordable and accessible, as well as providing solutions that could lower costs across the entire health care system.
City of Detroit preparing lawsuit against Riverview Health as neighbors report ongoing noise problems
Detroit neighbors in West Village are once again complaining about noise they say is coming from a Riverview Health rehab center on Jefferson Avenue, this time from the facility’s HVAC system.
Exclusive: South Korea labour minister calls on tech firms to share excess AI profits with suppliers, staff
South Korea's labour minister called on the country's major tech firms to share the spoils of their massive windfall profits, warning that unprecedented chip-sector gains stemming from the AI boom risked widening a gap in inequality.
The science of Bluey
Bluey quietly incorporates scientifically accurate STEM concepts into stories of childhood and family life,
The evolution of in-vehicle entertainment
High-end and flashy infotainment systems on new vehicles are a big draw for modern drivers.
Building a One Health workforce to protect people from zoonotic disease and foodborne illness
From zoonotic pathogens that move between animals, humans and their shared environment to antimicrobial resistance (AMR), driven by antimicrobial use across sectors, to chemical contaminants, food safety is at the centre of the One Health approach. On World Food Safety Day, we highlight those using the approach to address risks to human, animal and environmental health. WHO, together with partners, is committed to strengthening the One Health workforce, including professions such as veterinarians, epidemiologists and food safety officers. However, the approach is only as strong as the systems behind it and the people who implement it – across sectors, services and borders.
Science is HERE All Summer at The Tech Interactive
San Jose’s Science Center Announces Packed Lineup Headlined by Summer Camp, Tech Topple, DOME Series, Workshops, and Tech at Nite The Tech Interactive is bringing a summer full of hands-on science experiences to downtown San Jose, featuring STEM camps, immersive dome shows, interactive exhibits, workshops, and family-friendly activities designed for visitors of all ages. Learn more at https://www.thetech.org San Jose, CA, June 04, 2026 (GLOBE NEWSWIRE) -- Summer is HERE at The Tech Interactive,
UW-Oshkosh adds MBA in Business Analytics; program will launch in fall - UW-Oshkosh Today
The University of Wisconsin–Oshkosh is adding a new STEM-designated Master of Business Administration (MBA) in Business Analytics—designed to prepare the next generation of professionals to turn data into action.
Meta Silently Added Face-Recognition Code for Its Smart Glasses to Millions of Phones
Code reviewed by WIRED uncovered an unreleased face-recognition system embedded in Meta’s smart glasses platform. It’s designed to identify people via biometric data stored on users’ phones.
Decoding the Complex Science of Obesity
GLP-1. GIP. Amylin. Incretins. Peptides. NuSH. It’s not hard to see why the language surrounding modern obesity research sometimes feels like an alphabet soup of scientific terms. But behind each is a growing understanding of how the body regulates hunger, metabolism, energy use, and weight. It’s shaping what we know about how those systems might contribute to obesity.
Black businesses as community anchors: History, economic power, and the fight to reserve it
Black-owned businesses play a vital role in building community wealth, jobs, and opportunity. Join Brookings for a discussion on new research, business ownership parity, and strategies to strengthen Black business ecosystems.
ECU Health Beaufort Hospital now offers MISHA Knee System
ECU Health Beaufort Hospital now offers the MISHA Knee System for patients suffering from medial knee osteoarthritis.
How Funding Cuts Left the World Vulnerable to Ebola
A strain with no known treatment or vaccine is spreading fast, and the international system built to contain outbreaks is in crisis.
Public Policy Cornerstones of America’s Financialized Health Care System
I’ve been examining how public policies have facilitated the transformation of America’s health and medical care systems into today’s financialized and commercialized realities.
WVU Health System takes next step toward buying Independence Health
An acquisition of Independence would further expand West Virginia University Health System into southwestern Pennsylvania.
New Philadelphia Science Camp 2026 set for July 13-17 at Camp Tuscazoar
Science Camp 2026 will be held at Camp Tuscazoar for students entering grades two-eight, with STEM activities and scholarships available.
Melinda French Gates on Menopause, Midlife, and the Women's Health Gap
Melinda French Gates talks menopause, mental health, and the systemic gaps in women's care.
RFK Jr. Seeks To Peek at Americans’ Medical Records for Clues on Autism and Vaccines
To collect and scrutinize millions of Americans’ health data, U.S. health secretary Robert F. Kennedy Jr. aims to work with state organizations that help health systems share medical records. In Nebraska, millions in federal dollars has flowed into one nonprofit cooperating with Kennedy’s project.
Trump took a hair-loss drug for years. It’s no longer on his medical records.
The president's past doctors said he used Propecia, a drug to stem hair loss. The White House has been pointedly silent on whether he is still taking it — a reflection of the gaps in Trump's recent health reports.
Opinion | Alleged fraud by United Healthcare undermines trust in health system
Insurer accused of making patients appear sicker to inflate payments.
Minister dismisses ‘two-tier justice’ claim in light of Henry Nowak tragedy as ‘slur’ on police
Politicians on the right have politicised Novak’s death and suggested there is a ‘two-tier’ policing system that victimises white people
AIRM Sets a New Standard for Brand Reputation Management in AI Search
SINGAPORE, June 04, 2026 (GLOBE NEWSWIRE) -- Rankpage has launched AIRM, an AI Reputation Management system developed to help businesses monitor...
Scientists will lose critical climate record as ocean observatory goes dark under Trump funding cuts
The National Science Foundation announced it would dismantle most of the ocean monitoring system, pulling instruments from waters off Oregon, Washington, Alaska, North Carolina and Greenland by 2027.
Cancer’s favorite escape trick may actually make it easier to kill
Scientists have uncovered a surprising new way the immune system fights cancer, overturning a core belief that has guided immunology for decades. The research found that when cancer cells shut down a key immune-recognition molecule called MHC I—a common trick used to hide from “killer” T cells—they can actually become more vulnerable to attack by a different group of immune cells known as CD4+ “helper” T cells.
Beluga whales keep switching mates and it may be saving their species
Hidden beneath Arctic waters, beluga whales have long kept their family lives a mystery. By analyzing DNA from more than 600 belugas in Alaska’s Bristol Bay over 13 years, researchers uncovered a surprisingly flexible mating system: both males and females regularly have offspring with different partners over their lifetimes.
Around the MHS
This edition of news from around the Military Health System for the week of June 1-5, 2026, includes more coverage from the 2026 MHS Conference: awards for exceptional military medical professionals, Uniformed Services University’s spotlight on readiness, and inspirational words from a heroic Medal of Honor recipient.
Countries unite at WHA79 to advance refugee and migrant health through stronger national systems
At a high-level event held on the margins of the Seventy-ninth World Health Assembly (WHA79), countries and partners reaffirmed the urgent need to strengthen refugee and migrant health through inclusive national health systems and shared practical experiences for turning global commitments into action.
WHO Health Emergencies EPI-WIN webinar: Hantavirus in focus III: reflections from a Border Health and Point of Entry perspective
The complex multi-country response to the hantavirus outbreak linked to cruise ship travel is an unprecedented test of the global border health system. This EPI‑WIN webinar will provide an opportunity to hear from key border health stakeholders on their involvement in and initial reflections about this particular multi-country response, as well as their routine collaborative work for the management of public health events across borders, at points of entry, and onboard conveyances.
Radio scans find no evidence of alien tech from interstellar comet 3I/Atlas
The SETI Institute said Wednesday that extensive radio scans by its telescope in Northern California found no signs of otherworldly technology from our solar system’s latest interstellar visitor.
Why AI is not the magic fix for healthcare
AI can improve healthcare efficiency, but systemic barriers and misaligned incentives remain the real problem.
Cooper University Health Care plans new medical campus in Gloucester County
The $300 million project adds to the health system's hospital expansion in Camden, where 3 new towers are under construction.
Trump’s Medicaid Work Rules Force States To Scrap Plans and Rework Systems
By Rachana Pradhan and Samantha Liss | KFF Health News The Trump administration’s rollout of a federal mandate that millions of Americans on Medicaid must work or risk losing health benefits will force states to scrap months of preparation, according to advocates for Medicaid enrollees and ...
Scientists warn Oregon could lose critical ocean data under federal cuts
A federal decision to dismantle ocean monitoring systems off Oregon's coast could impact forecasting, fisheries, and climate science.
Scientists warn Oregon could lose critical ocean data under federal cuts
A federal decision to dismantle ocean monitoring systems off Oregon's coast could impact forecasting, fisheries, and climate science.
WorkSource Fulton, Grady Health System partner for healthcare worker training investment
The funding is aimed at providing more skilled workers for industries in Fulton County, meeting the needs of businesses and residents alike.
College Professors Say Incoming Students No Longer Understand Middle School Math and Science
Professors at the University of California want to reinstate entrance exams, claiming many students don't have a basic understanding of STEM subjects.
Health system's ‘Heads Up’ series supports young people’s mental well-being
The series includes short videos, online materials and community discussions on topics highlighted in the survey.
Senators urge quick action to halt college sports decay
Senators and college officials on Wednesday urged swift action on a bipartisan measure that aims to overhaul college athletics system they say hemorrhages money and hinders student-athletes — even as two powerful conferences said they would seek changes. During a much-anticipated Senate Commerce Committee hearing, both the bill’s authors — Chair Ted Cruz, R-Texas, and […]
Ultrahuman says hackers accessed customers' wellness data via internal tool
The breach at wearable ring makaer Ultrahuman stemmed from credentials stolen from a malware-infected employee laptop.
AHA to celebrate Community Health Improvement Week, June 8-12
The AHA and health care organizations across the country will celebrate Community Health Improvement Week, June 8-12. CHI Week honors those working in partnership to improve the health and well-being of individuals and communities throughout the country. Hospitals and health systems are encouraged to plan in-person or virtual events to highlight and increase awareness of their work. LEARN MORE
Nick Saban asks Congress to 'bring order' via college sports bill
Nick Saban appeared in Congress to support the bipartisan Protect College Sports Act, which aims to "bring order to a system that badly needs fixing" in the NIL and transfer portal era.
Families push CES to expand science curriculum
A group of 13 families has expressed concerns over the quality of STEM (science, technology, engineering, and math) education at Conners Emerson Elementary School, claiming that the current structure of
Why ocean science is still one of the worst-funded scientific fields worldwide
For a planet that is 71% ocean, humanity spends a surprisingly small amount of time (and money) trying to understand it. Ocean science sits in a strange place in the research ecosystem. It underpin…
Algal blooms explained: How scientists are helping spot them sooner
Algal blooms can seem to appear overnight. A stretch of ocean that looked clear days earlier can suddenly appear discolored and sometimes pose risks to ecosystems and human health. But scientists say ...
California voters feel increasingly disillusioned with political system
“Many residents feel abandoned by a political system that asks for their vote but rarely their voice.”
Catholic Health CEO Patrick O'Shaughnessy Steps Down
Dr. Patrick O'Shaughnessy, who has served as president and CEO of Catholic Health since 2021, has stepped down from the Rockville Centre-based health system. Gary Havican, previously executive vice president and chief operating officer, has assumed the roles of president, CEO and chief operating officer, according to the health system. It was not immediately clear
Texas universities show sharp differences in health insurance premiums, Baker Institute report finds
Annual health insurance premiums for faculty and staff vary by more than $5,000 per employee across Texas universities, according to a new report from Rice’s Baker Institute for Public Policy. For PPO (or POS plans) — the only plan type offered at every institution in the sample — the report finds that the total annual cost of individual coverage, combining employer and employee contributions, ranges from $8,095 for Texas universities belonging to Employees Retirement System of Texas (such as the University of Houston) to $15,742 at Trinity University.
Elections to top science bodies test Croatia’s gender equality in research
Croatia’s track-record on gender equality in science has been both questioned and lauded in recent months, following both bad and good news on the topic. On the one hand, a senior awards committee was announced without a single woman researcher included. On the other, the national science academy welcomed its first cohort of fellows with more women than men.Members of the committee, which gives national awards recognising scientific achievement, are proposed by the ministry of science and endorsed by the parliament. The current line-up does include a woman, but she is culture minister Nina Obuljen Koržinek rather than a researcher. Even then, she didn’t make it into the photograph released to announce the appointments on April 16. “The image speaks a thousand words,” says Tanja Rudež, a science journalist for Jutarnji List newspaper. “I am surprised that none of these men, all well-known scientists, saw a problem with the fact that there was not a single successful female scientist on the committee,” she told Science|Business.Ivan Đikić, a prominent Croatian biochemist based at Goethe University Medical School, commented on LinkedIn that the news illustrated a “sad truth” about the state of science in Croatia.“It [. . .] reveals a system where women, despite contributing a substantial share of high-quality, internationally competitive science, are systematically excluded from the very processes that determine recognition and influence,” he wrote. Some 60% of researchers in Croatia are women, according to the Croatian Bureau of Statistics, and they perform well in international competitions. For example, of the 12 European Research Council (ERC) grants awarded to Croatian researchers, seven went to women.“So how is it possible that decision-making bodies are still dominated by men over 60, while not a single female ERC laureate is involved in the selection process?” asked Đikić. “This is not a marginal oversight; it is a structural failure.” The ministry of science did not reply to a request for comment. The awards committee is not unusual. For example, a scientific advisory body announced by the ministry of demographics in April comprises 35 men and five women. The board of the Croatian Science Foundation, newly appointed by the parliament, is a little better, with five men and two women, but still unequal. “This is especially significant because such bodies do not merely distribute prestige. They shape research priorities, funding allocation and long-term scientific development,” Marija Lugarić, chair of the parliament’s committee on gender equality, told Science|Business. “Representation here matters not only symbolically, but materially.”Referring to the awards committee and the board of the science foundation, Lugarić says that while both bodies were appointed by parliament, neither met the minimum 40% gender balance threshold that Croatian law and EU guidelines expressly recommend for public bodies.Đikić wants to see EU institutions put pressure on the government to ensure basic standards of fairness, transparency and democratic governance in science policy are met. “Meaningful change will not come without pressure,” he wrote. “It must intensify both within Croatia and at the level of European institutions. Anything less undermines the credibility of Europe’s commitment to excellence and inclusion in science.”Rudež also underlined the importance of talking and writing about this topic, “because public opinion in Croatia does influence changes in the status and visibility of women in science.”The European Commission has not yet responded to a request for comment.Good news from the academyA more positive story came from the Croatian Academy of Sciences and Arts on 21 May, with the announcement of seven new women fellows and five men. This is the first time in the academy’s 165-year history that women have outnumbered men in a new intake.One of the new fellows, two-time ERC grantee Iva Tolić, credits the academy leadership with trying to be more modern and inclusive, representing the whole community better. “The academy is really aware that so far, before this election, there were very few women,” she told Science|Business. “So, they are actively trying to make this more equal.”Related articlesExplained: How the MSCA is close to achieving gender balanceCall for EU to leverage academic freedom in global talent raceRudež is more cautious, noting that despite the academy’s “breakthrough this year [. . .] it is still a predominantly male institution, with only 18% women.”This reflects a wider imbalance in Croatia’s research landscape. “The key levers of power in science are still in the hands of men,” she went on. “For example, all 14 rectors of private and public universities are men.”Similarly, Lugarić says a structural glass ceiling still exists in Croatian science, which is “most visible precisely where power is exercised.”She cites data from the Commission’s She Figures 2024 report, which shows that Croatia ranks second in the EU for gender equality in research and innovation overall, with an equality index of 79.6 out of 100. It is in the top five for women’s career advancement, participation in research; representation across all research sectors and for scientific publications.In stark contrast, it ranks second to last when it comes to women in decision-making positions in science. “This is not a coincidence,” Lugarić says. “It is a structural pattern.”Informal barriersThe persistent under-representation of women in the highest structures of Croatia’s academies, boards, award committees and leadership positions is not down to formal barriers, Lugarić says, but arises from more subtle obstacles such as “informal networks, persistent expectations regarding traditional gender roles and the unequal distribution of care responsibilities.”Tolić would like to see more support for young women in terms of affordable housing and child support, and higher salaries. Currently, she says, salaries in science stay low for the first 10-15 years, while housing and spaces in kindergarten are limited and expensive. “You have to work a lot, you get very little money, so it’s not great to have a family in this situation,” she says.But despite the challenges, Tolić is optimistic, saying that gender equality in research in Croatia is “definitely improving and going in the right direction.” The situation is particularly promising in biology, she adds, where most full professors, heads of department and deans of faculties are women. Lugarić, too, see the glass ceiling “very slowly, cracking,” and cites the academy election as an example that structural change is possible. Yet the situation in the national awards committee is a “stark reminder that without a conscious, systemic commitment to gender balance, progress will remain slow and uneven.”
The cult of objectivity has broken consciousness science
With 22 competing theories and no consensus in sight, the science of consciousness is lost. In this exclusive IAI interview, Berkeley psychedelics researcher and bestselling author of a new book on consciousness Michael Pollan insists that even though consciousness lies beyond traditional forms of scientific investigation, we should resist becoming dualists who see it as something radically different from ordinary stuff in the world. Instead, he makes the case for reimagining science itself: it must stop reaching for objective descriptions of physical reality, and instead embrace subjectivity as the indispensable core of all inquiry. Alasdair Craig: How did your experiences with psychedelics get you interested in consciousness?Michael Pollan: One of the things that happens on psychedelics is that they foreground consciousness. What formerly seemed perfectly transparent and ever present—and yet, non-existent, as water is to fish—suddenly you see it. The metaphor I use in the book is that psychedelics sponge the windscreen. Suddenly you realize: wow, there’s a windscreen, there is this phenomenon that’s mediating my relationship to reality. This is not an unusual realization on psychedelics. I think a lot of people are called to think about consciousness after psychedelic experiences. So that was the proximate inspiration for A World Appears: A Journey Into Consciousness (2026).And then there was a more specific way in which psychedelics influence the book. That was a particular experience I had on psilocybin. I had the sensation that the plants in my garden were conscious and returning my gaze, with their own point of view and agency, and I got curious as to how to evaluate an insight like that. I mean, what’s the truth quotient of insights you have on psychedelics? And I was reading William James—who, of course, wrote beautifully about mystical experience—and he said, we can’t judge the metaphysics here, but we should pay attention to two criteria: (1) How useful is it to think this is true? He was a pragmatist, of course. And (2) can we subject it to other ways of knowing to validate it? Because maybe we should treat these insights as hypotheses. And that’s kind of how I approach psychedelics, as a great generator of hypotheses, but they need to be tested against other ways of knowing. And so that led me down this long path exploring the science of plant intelligence and plant sentience.AC: I love your phrase, “smudging the windowpane of conscious experience.” So do you now start to think, actually, even when I’m not on psychedelics, I’m just seeing a screen all the time, which is not reality, but rather is my conscious experience, behind which reality is hidden?MP: Well, you know, not when I’m brushing my teeth and making breakfast! But yes, in meditation, certainly. I mean, one of the things you realize is that my experience happens to be this way now, but it could be another way. And many things can affect it. My morning coffee changes the screen in various ways, sharpens certain things.___The only tool we have to understand consciousness is consciousness.___There’s this wonderful metaphor in Aldous Huxley’s book, The Doors of Perception, where he thinks we channel consciousness, and that what the brain does is edit it, and there’s a reducing valve. And psychedelics open the reducing valve wider. I don’t know that I’m ready to buy into the idea that consciousness exists outside brains, but I do love that metaphor because there are times when you are more conscious than others. I know I’ve switched from window pane to valve, but you know, a camera aperture can open wider or narrower. And I do have a sense of that. I have a sense of when I’m being less conscious, and when I’m being more conscious, by which I mean, you know, more present, taking in more sensory information. So when you start thinking about consciousness as a matter of degree, that changes things also.I think when we scroll on social media, obviously, we’re conscious. But minimally so, because we don’t have to generate our own thoughts. We’re basically taking these little hits from other people and thinking their thoughts.The process of writing this book made me kind of relativize everyday consciousness as just one type, which is exactly what William James said. Normal consciousness is one type, separated by the flimsiest of screens from the other types.AC: If we stick with the metaphor of the smudge on the window that you get when you take psychedelics, it seems like we’re saying that consciousness has become like an object that you’re looking at, right? You’re looking at the smudge and that just is consciousness. But sometimes we’ll talk about consciousness as a state that you’re in, rather than an object you can perceive. You’re either conscious or you’re not conscious. So it’s difficult to really know what sort of thing we’re talking about when we talk about consciousness, right?MP: Yeah. When you say that consciousness is an object, what’s the subject? Consciousness also? The only tool we have to understand consciousness is consciousness. So we’re in a closed loop and when we get a perspective on consciousness, we’re not achieving any distance from it. That’s one of the problems with studying consciousness. Science is predicated on an objective, God’s eye view of things, and you never get that. There’s no such thing. SUGGESTED VIEWING The brain filters consciousness With Àlex Gómez-Marín But, yeah, there is this sense, I think, that consciousness is something you can approach. Certainly, when you’re writing and trying to recreate a conscious experience, it’s a fiction, but you’re standing back from it, and looking at it. But there’s no real subject-object distinction.AC: That’s so interesting, because when philosophers start talking about consciousness, they often talk about what they call “qualia”, which is their word for the felt experience of, say, the color red. And I think that way of speaking often makes us think of the qualia as an object, which you can see out there: the redness of red. But, as you say, we also want to collapse the subject-object distinction when we talk about consciousness. So there’s something strange going on here…MP: Oh, yeah, there are many strange things going on! *AC: Let’s talk about the varieties of consciousness. Apart from perceptions, there are, pains, emotions, thoughts, and so on. What is it that holds all this diversity together so that they all count as instances of consciousness? What is it that they all have in common?MP: Yeah, that’s a really good question. I mean, there is sensory information, right? Which we perceive coming from the world outside ourselves. And then there’s internal information, which is what’s called interoception. And this is very important too. This is where feelings come from—what are sometimes called homeostatic feelings—that are intended to get the brain to keep us in these narrow ranges of temperature and glucose and so on. That’s a very important part of consciousness. And according to some researchers, who I think are probably right, this is where consciousness begins, with these very primal feelings, like hunger and thirst and warmth and itch, and things like that. And then there’s this third thing, which is our thinking about thinking.And what holds all this together is, I think, the sense of self. Consciousness generates a self: it is probably an organizing principle. All this stuff is happening to the self. It’s a construct, I think, but it is very useful. It can connect all these different streams of consciousness to a single being or a place, metaphorically speaking.* AC: The first half of your book is about the science of consciousness. Is consciousness just another thing, like black holes or the origin of life, which we don’t yet understand, but which we should have every hope that science will one day get to the bottom of, or is there something special about consciousness that makes this unlikely?MP: It depends how you define science. As we define science now, it’s going be very difficult. Science since Galileo has had a set of rules or assumptions, which is that the proper remit of science is to deal with the objective, quantifiable, third-person world. And the physical sciences have done amazing work under that set of limitations. Galileo—for tactical reasons, not for philosophical reasons—said science should not deal with the soul, which at the time was what consciousness was considered to be. So what is subjective, what is qualitative, what is first person, we’re going to leave to the church, he said. And this was a good agreement, and it probably kept many scientists from getting burned at the stake. But it leaves science in an awkward spot, now that it wants to venture into that territory of qualities, of first-person experience. And I don’t think it has the proper tools. I think it will have to add to its toolkit in some way, and find a way to bring in phenomenology, or lived experience and introspection, which science is usually dismissive of.The challenge—we alluded to it earlier—is that the only tool you have to study consciousness with is consciousness. And what I mean by that is, the whole scientific enterprise is a manifestation of consciousness. As much as scientists like to flatter themselves with this idea that they attain a godlike perspective on what they study, when it comes to consciousness, there’s no such thing. And it’s fine for all the things you can step outside of and study from that perspective. But two areas it won’t work are consciousness and cosmology.___It could be that we live in this anomaly of not believing nature is conscious. And maybe psychedelics are teaching us something we’ve forgotten.___With cosmology, too, you have to study the universe from inside the universe. It’s not that cosmologists haven’t made progress. We know a lot about the age of the universe and expansion and things like that. But we can’t penetrate what happened before the Big Bang. We just don’t have the tools because we can’t stand outside.The fact that there are 22 full-scale theories of consciousness tells you all you need to know: we’re kind of lost. And I was surprised to find that we are more lost than I thought we were when I started this. I thought that there’d be leading theories, or that we had experiments that we could conduct that would nail some of this down. And the fact is, we don’t.So, I don’t know if science can solve it. But, of course, we can change the rules of science. A really influential book for me was a book called The Blind Spot, by two physicists, Marcello Gleiser and Adam Frank, and a philosopher, Evan Thompson. It’s a reminder that science is a social practice. It’s organized in a certain way and it can be organized in a different way. But it has this huge blind spot at the center of it, which is its failure to recognize that it is a form of consciousness itself, and it doesn’t have a good way of taking account of lived experience.AC: On the one hand, I think you want to resist traditional dualism, which would say that consciousness is something magical, something supernatural, right? But on the other hand, you’re accepting that there is this division in reality between the stuff that you can investigate objectively and measure, and so on—the stuff that science has been good at finding out about—and consciousness, which, for some reason, you can’t objectively measure. Some would take this to suggest that the dualism is actually right. Is there a way of reconciling these two strands of your thinking?MP: To call it magical is full of value judgement. I mean, you could just say immaterial. The interesting thing is, I think, that intuitively we’re all dualists. And I don’t know whether that’s because we’re children of Descartes and other cultures are less dualist than we are. Or it may be because that’s how consciousness feels. It feels different than the body. It feels separate from the body. But I don’t think we should trust that intuition.AC: So let’s think about ways that science might be changed to get at consciousness. I suppose the starting point would be the way that you begin the second half of your book. You have this nice line from William James, where he says, “We now begin our study of the mind from within.” Could you give us some sense of the ways of studying the mind from within? What does this involve?MP: I don’t know what that science looks like. But one of the points I’m making is that it depends on the humanities. I found that I learned as much, if not more, about consciousness, from reading novels and poetry. There is a sense of the fullness and complexity of consciousness that you don’t get in any scientific account. I interviewed this stream-of-consciousness writer and I approached her as an expert on consciousness, and she is. So I think that dialogue is really important.I’m reading Ben Lerner’s new novel, Transcription. Just read the first page of this novel: it’s a man falling asleep on a train, going to conduct an interview, and there is the experience of being in the train, facing backwards, there’s the view outside, but there’s a reflection of himself through which he’s seeing outside. There’s the memory of dropping his kids off at school. All this is going on in one moment of consciousness. Scientists aren’t going anywhere near that. But I think it’s useful for them to think about. That’s where we’re trying to go: like, how does such a layered experience happen? You know, it also makes you wonder, could a computer ever do this? And it gives you some doubt.*AC: Before we get to computers, perhaps we could talk briefly about plants. How did you come to feel that they are sentient?MP: Well, it was a psychedelic experience, and it’s not unusual on psychedelics. In fact, there’ve been studies about how people become animists during psychedelic experience. Their belief in animism arises after a single psychedelic experience.You know, most scientists would say this is all a myth. But we have only 400 years of the age of enlightenment and science. Before that, we were animists, and if you go around the world, most indigenous cultures are still animists, and children are animists, by and large, until they go to school. So it could be that we live in this anomaly of not believing nature is conscious. And maybe psychedelics are teaching us something we’ve forgotten.As I said, I wanted to test this idea, and see whether there was conventional scientific evidence for it. And there’s fascinating work going on in a field that calls itself—in a rather cheeky way—plant neurobiology. These are people who fully realize there are no neurons in plants, but they’re trolling conventional botanists! And they’re doing experiments that are demonstrating that plants can learn and remember, which is kind of amazing: how do you store a memory without neurons? They’re finding plants that can solve problems, that can hear and see. In fact, they have 20 senses to our five or six. For example, a bean plant looking for something to twine, and given a pole within eight inches or so of it, knows where that pole is and will aim its spiraling reach at that pole. What is that about? Is it bouncing signals off of it?One of the spookiest things is the fact that the same anesthetics that put us out put plants out. You might think that plants are already out, but they’re not. They’re just slow. If you take a plant with a fast behavior, like a Venus flytrap, and give it an anesthetic, it will stop reacting. So you have to ask yourself, what is lost when the plant is anaesthetized? Some state of alertness, of awareness, of its environment, of reactivity. I’m not prepared to call that consciousness, but maybe it’s sentience—which is a simpler form of consciousness, and involves the ability to sense what’s going on in your environment and assess what’s good and bad for you and act appropriately. That may be a universal quality of life.AC: Let’s turn from plants to AI. You point out that LLMs are trained on the internet rather than direct interactions with reality. You put this really nicely when you say the internet is not the world so much as a shadow cast by the world. So LLMs are living in this kind of shadow world, or in Plato’s cave, as you put it. What’s the significance of this for AI consciousness and moral consideration? And, to recall the beginning of our conversation, if we’re stuck behind a veil or screen of consciousness, are we also stuck in a kind of shadow world?MP: I don’t think they’re the same shadow worlds because our world includes nature and other people. And even if it’s mediated in some ways... There is a reality out there, and we are in relation to it, through consciousness. There’s friction with it. What’s missing from the LLMs is that friction with the real world. There’s more to the world than human representation, which is what they’re dealing with. And that means that so far, AI is a cultural technology for combining thoughts we’ve already had. SUGGESTED VIEWING Cracking the code for thought With Roger Penrose, Sabrina Gonzalez Pasterski, Max Tegmark, Güneş Taylor Genuine creativity is more than collage. A lot of what AI does now is tantamount to collage, putting this with that and you know, that’s part of art, certainly. But there are also genuinely new ideas that come into the world that don’t come in through manipulating the representations we already have. So it remains to be seen whether AIs can be truly creative in that more radical sense.But my arguments against AI becoming conscious have to do with the fact that the idea of AI consciousness is based on this faulty metaphor that the brain is a computer. There are dimensions in which the brain is like a computer—it certainly does its share of computation. But computers have this sharp distinction between hardware and software, and brains don’t. In a brain, hardware and software are identical. Every memory is a physical change to the brain. Brains are not interchangeable in the way computers are. So this idea that you could take the consciousness out and somehow run it on another substrate, a silicon substrate, seems foolhardy.Anyway, it’s a more extended argument, and I may be wrong. And when we move to computers that aren’t based on silicon—neuromorphic computers and things like that—all bets may be off.AC: Regarding your point about LLMs being stuck in the world of our representations—the internet or whatever—and not being able to interact with reality, are these representations, the world of the internet, themselves part of reality? We’ve created the internet, but it’s still a real thing that exists. And so while the LLMs may be trapped within that part of reality, they’re nevertheless within reality and interacting with it and so on. So it’s not obvious that there’s a barrier there to them becoming conscious and being creative.MP: Yeah, I mean, if our consciousness is built out of human culture, which is what we’re talking about with all those representations. But I tend to think consciousness comes a bit more out of nature and friction with the natural world, but...AC: So there’s a fundamental divide between the natural world and human artefacts?MP: And we lose track of that, and especially people in this computer world. You know, the people who are creating these AI systems, my guess is they’ve been into video games since the age of three, and they didn’t go outside a lot. And their own contact with nature is somewhat limited. I could be wrong, it’d be a very interesting thing to ask, all the wizards of AI, whether they like to go fishing and hiking and do things like that. Or were they on computers from a very early age? I interviewed Blake Lemoine, the Google engineer who came to believe that LaMDA, the Google LLM out at the time, was conscious and deserved personhood. It was very clear that he didn’t see a distinction between this bubble in which he lived and the real world. And I think we’ve all been distanced from the natural world, and this is taking us even further away. But it’s still there, you know, and we still have bodies, and we’re still mortal, and we don’t live in a simulation.AC: I think that’s a great place to finish. Michael Pollan, thank you very much!
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How Science Works
The 2nd Weather and Climate Livestream is now underway. It is organized by a group of early-career researchers concerned about declining funding for the field and eager to demonstrate how weather and climate research makes a difference in our lives. Last year’s event was a great success, drawing terrific press coverage including a piece in the NY Times. This year features a strong lineup of talks aimed at a general audience — I highly recommend tuning in. Share I gave a talk yesterday about How Science Works in Three Steps. You can see the short presentation here (I’ve appended a transcript below): And please tune into the livestream here. It runs through tomorrow at 6 pm ET. Thanks for reading The Climate Brink! Subscribe for free to receive new posts and support our work. Subscribe Cleaned up transcript: Thank you, and thanks to everyone tuning in. I want to talk about something I think a lot of people don’t really understand: how science actually works. Arguments over any scientific topic — climate change, vaccines, you name it — revolve around competing claims. For climate change, the claims are: Is the Earth warming? Are humans to blame? What will the impacts be? Over the last 150 years, the scientific community has developed a remarkably robust method for sorting out which claims are true and which aren’t. That method is what I want to walk through. So how does science generate knowledge? If you ask a high schooler, they’ll give you the version they learned in ninth grade: an individual scientist forms a hypothesis, runs an experiment, and draws a conclusion. That’s more or less what happens at the individual level, though in practice it’s more iterative — you design, test, and refine all at once, landing on a slightly different idea each time until you reach a conclusion about whatever hypothesis you’ve ended up with. But this isn’t science. It’s only step one. Any individual scientist can make mistakes — scientists are human. Maybe there’s a bug in the code, maybe there’s an error in the experiment. Just because someone ran an experiment and reached a conclusion doesn’t mean it’s right, and scientists don’t treat a single result as settled truth. Step two is peer review, the first layer of quality control. The scientist writes up what they did and submits it to a journal, which sends the paper to other experts in the field. Those experts judge whether the methods are sound, whether it properly references prior work, and whether the conclusions actually follow from the data. Ask any scientist and they’ll tell you peer review is miserable — the comments come back brutal, often harsh, and you have to revise and resubmit, sometimes multiple times, before an editor finally accepts the paper. Peer review catches an immense amount of bad science, but it can’t catch all of it. Reviewers get sloppy or overworked, they miss obvious mistakes, and they can’t catch hidden errors — a bug in the code, a misread instrument. So a peer-reviewed paper making it into a journal doesn’t mean the paper is right. Nobody treats a single paper as the final word. That’s where step three comes in: the crucible of science. Important results get retested by the broader community. If you publish something interesting, it gets dissected. Sometimes people try to reproduce your work directly but more often they test its implications. If someone claims X is true, and that implies that Y is also true, then scientists will go check Y. If a claim survives this gauntlet long enough, it becomes accepted. That’s how we generate knowledge. Let me give an example: the ozone hole. In 1985 — and I doubt many people watching were around then, but I remember it well — Joe Farman and his colleagues published observations from Antarctica showing that a huge chunk of ozone was disappearing every year. This was shocking because most atmospheric chemists had expected ozone loss to occur at mid-latitudes and high altitudes, not over the South Pole. When scientists see something they don’t understand, they rush to explain it, and several competing hypotheses quickly appeared in the peer-reviewed literature. One pointed to chlorine chemistry from chlorofluorocarbons. A second blamed nitrogen chemistry, possibly driven by solar proton events — meaning the sun was responsible. A third argued it wasn’t chemistry at all but dynamics: winds were carrying naturally low-ozone air from the lower atmosphere up into the stratosphere. Then the community went to work testing which theory could survive the crucible. Aircraft flew into the ozone hole and found no nitrogen, ruling out the nitrogen theory. Measurements showed the air in the polar vortex was descending, not rising — which would bring high-ozone air down, eliminating the dynamics theory. Meanwhile, those same flights measured enormous amounts of chlorine, strongly correlated with exactly the regions where ozone was being destroyed. That became known as the “smoking gun” paper, and it established that chlorine chemistry was the cause. Through this process, a consensus emerged. And it’s worth being clear that this consensus is organic. There’s no vote, no poll, no meeting where it gets decided. Scientists go to conferences, talk to one another, and independently arrived at the same answer. It’s the ultimate free market of ideas. After the consensus was established, the peer-reviewed literature doesn’t even mention the rival theories — it simply takes chlorine chemistry as given. That’s what a consensus looks like. It doesn’t mean every single scientist agrees, but it does mean there’s no longer any legitimate debate. So where can you see what scientists actually think? It’s all in the peer-reviewed literature, which contains the entire historical record of the argument: the discovery, the competing theories, the debate, the testing, and finally the community coalescing around one answer. But there’s a lot of room for misrepresentation. You can dig up an old paper claiming the ozone hole was caused by dynamics and wave it around as if there still was a debate about the cause of the ozone hole — without mentioning that the idea was disproven long ago and that even its own authors no longer believe it. There’s a bigger problem, though: the peer-reviewed literature is written in a language I call “nerd.” It’s extremely hard to read — honestly, some of it is hard for me to follow. It takes graduate students years to work through the literature in a single field, so we can’t expect policymakers or ordinary people to do it. This is where scientific assessments come in. The most famous is the IPCC — the Intergovernmental Panel on Climate Change. The job of an assessment is to read and summarize the peer-reviewed literature, synthesizing what’s settled, what’s been disproven, and what remains genuinely debated. To ensure the assessments accurately summarize the peer-reviewed literature, assessments are written by large teams, which are far less prone to bias than individuals and which dilute the influence of any one scientist with an axe to grind. The teams are deliberately assembled to avoid stacking the deck, and the reports themselves go through multiple rounds of peer review. That rigorous process is exactly why you can trust them and why people consider the IPCC to be the gold standard of what we know about the climate system. An assessment produced through a different process may well not be credible. You can even watch the consensus evolve across assessments. Take the attribution of warming. The 1990 IPCC report said the observed warming was broadly consistent with model predictions but also comparable to natural variability — in other words, we don’t know whether humans are responsible. By 1995, it concluded that the balance of evidence suggested a discernible human influence — a sentence only a committee could write, and one that barely commits to anything. By 2001, most of the warming over the previous 50 years was judged “likely” due to greenhouse gases; by 2007, “very likely”; by 2013, “extremely likely.” The 2023 report says essentially the same as 2013 — there’s not much stronger language available. So, to wrap up: science is our ultimate tool for deciphering the universe — the most successful method we’ve ever developed for determining what’s true and what isn’t. Our understanding is written into the peer-reviewed literature, so if you want to know what scientists think, that’s where to look. And for those of us who don’t speak nerd, scientific assessments are the Rosetta Stone — they translate nerd into English. Let me open the floor to questions. Thank you.
The work you can't always see: Beer is political, part 2
Recently I published a piece about beer, politics, and the question of who speaks up and who doesn’t. I meant every word of it. I still do. And then my inbox opened up. Cleveland Prost is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe I’ve been writing about beer since 2014. For most of that time, I kept things deliberately light — taproom profiles, new releases, the people behind the pints. Gradually, over years of building this thing, you gave me something I didn’t expect: permission. Permission to go deeper. To say what I actually saw in this industry and what I actually believed about it. That trust isn’t something I take lightly. It’s why that piece existed at all, and it’s why this one does too. I’m not walking anything back. But I want to go further. In that piece, I wrote that beer has never existed outside the system. That immigration policy affects who staffs breweries and harvests ingredients. That labor policy affects taproom workers. That civil rights policy affects who feels safe walking into a taproom. That “beer does not exist in a vacuum. The idea that it does is comforting. It is also false.” I believe that as much now as I did when I wrote it. But one idea came back at me, in different forms, over and over (from reader emails, comments, and conversations): that beer itself isn’t political — that it only becomes political when someone decides to make it that way. That what we’re really seeing is a choice by individuals to inject division into something that doesn’t inherently require it. It’s a comforting idea. It’s also wrong — and I think it’s worth being precise about why. That framing assumes that breweries operate outside the conditions shaping everything else. That politics is something you choose to bring into a room that was, until then, clean and neutral. That if you stay quiet, you stay clear of it. But the room was never neutral. It was never clean. Politics is already in the room. It’s in who walks through the door comfortably and who hesitates. It’s in whether a space can be used for organizing without fear. It’s in whether helping someone quietly might carry consequences you have to think carefully about in advance. It’s in who staffed the brewery, who harvested the grain, who can afford to be a regular. The idea that you opt out of all that by staying quiet is an illusion. You only change how visible your response to it is. This is, I realize, a hard thing to hear if you came to a beer newsletter for something lighter. I wrote recently that “beer, for me, has always felt like a refuge — a third place in an increasingly fractured world.” I meant that. I still do. But a refuge is not an escape from reality. It’s a place to gather strength to face it. Here’s what I actually missed — and what I want to correct. Multiple people in the industry reached out to me. I’m not naming them and I’m not identifying their businesses, because that’s not my call. If and when they want to be loud about what they’re doing, that agency belongs to them. What I can share is the substance of what they said, because it complicated something I presented too cleanly. The overall message: *You don’t know what we all are doing.* And they’re right. I don’t. One example involved a collaboration brewed quietly to support another business facing serious challenges in a whole different region, with proceeds directed toward solidarity, community, and keeping operations afloat. No announcement. It could have been broadcast widely. The point was never publicity. Another example involved logistical support for community efforts: organizing safe transportation, providing space for meetings on otherwise closed days, facilitating gatherings under difficult conditions. All of it happening while balancing real financial pressure and genuine concern for personal safety. None of what they described is a brewer “deciding to make beer political.” It’s people responding to the conditions around them — conditions that are already shaping who feels safe, who has access, who can gather, who needs help, and who has the capacity to offer it. Politics, again, already in the room. Already shaping choices. Whether anyone announced it or not. I’ve spent decades in taprooms, at barrel releases, at festivals, in back offices and brewing floors, talking to the people who built this industry from nothing. I know how much happens that never makes it onto social media. I know the owner who quietly comp’d a tab for someone having a crisis. The brewer who drove an hour to pick up a stranger who needed a safe ride. The taproom that stayed dark on a Tuesday so a community group could use the space without it becoming A Whole Thing. None of that gets a post. Most of it never will. So when I wrote recently about silence — when I said that “silence right now doesn’t feel neutral, it feels like complicity” — I was writing about what I could see. And I was right about what I saw. The public silence of breweries that have the platform, the stability, and frankly the safety to say something and choose not to? That still troubles me. I’m not softening that. But some of what I read as silence is actually something else entirely. It’s people doing the work with their hands instead of their phones. It’s people who are genuinely afraid — not of being canceled, but of real consequences for their families, their employees, their ability to keep the doors open at all. That deserves more than a footnote. It deserves to be named clearly. Here’s the tension I want to sit with honestly: public statements matter. They matter because people can’t rally around something they can’t see. Visibility creates awareness and solidarity. It helps people find each other. It tells someone standing outside your taproom door, uncertain whether they’ll be welcomed inside, something they need to know — or whether it’s even safe for them to be in public at all. That’s not performative. I wrote recently that the craft beer movement “was built on collective defiance. It was built on rejecting consolidation. On pushing back against homogeneity.” I believe that too. And I’ll extend it: breweries should be at least as loud about their values as they are when they drop a new seasonal. Your hazy IPA gets a full rollout — the label art, the tap handle photo, the countdown post. Human dignity deserves the same energy. Be as loud about human rights as you are about your beer. There is no reason those two things should require different levels of courage from you. But visibility isn’t the only form of courage. And not everyone can be visible right now without real consequences — financial, personal, sometimes physical. There are people in this industry doing hard, unglamorous, sometimes risky work in the background, and announcing it would compromise it or paint a target on someone who’s already stretched thin. That’s not silence as complicity. That’s operational discipline under pressure. What I want to push back on — clearly, not gently — is the idea that behind-the-scenes action and public visibility are in competition with each other. The person organizing quietly in the back room and the person posting a statement of solidarity on a Tuesday morning are both doing something real. We need both. We need the quiet infrastructure and we need the visible signal. We need people to know that this industry — at its best, at its most independent, and human — gives a fuck. I closed that piece with a question: “Reactive and fearful? Or clear and values-driven?” That question still stands. But having heard from you, I’d add a corollary: the values-driven path isn’t always the loudest one. Sometimes it’s a phone call and a recipe. Sometimes it’s a room made available on a closed Tuesday. Sometimes it’s a drive across town for someone who needed a safe ride home. All of it is political. All of it was always political. You don’t get to opt out of that — you only get to decide what you do with it. I’ve spent more than a decade writing about this industry because I believe it can be exactly that. I’ve been lucky enough to build an audience that lets me say so plainly. That’s a privilege I intend to use. The work is happening. Some of it you’ll see. Some of it you won’t. Support it either way. Cleveland Prost is a reader-supported publication covering beer and brewing across New York state. To receive new posts and support this work, consider becoming a free or paid subscriber. Cleveland Prost is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
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Astronomers have finally cracked the mystery behind a strange class of repeating cosmic signals that has baffled scientists for years. Using Australia’s ASKAP radio telescope, researchers traced the bursts to a rare stellar duo in which a dense white dwarf is relentlessly siphoning material from a nearby red dwarf companion. As the stolen matter spirals inward, the system unleashes powerful radio waves and X-rays every 1.4 hours.
Towards a responsive health system and equitable access to quality RMNCAH services
Indonesia’s vast geography and sociocultural diversity shape the delivery of reproductive, maternal, newborn, child and adolescent health (RMNCAH) services in ways that are both enabling and challenging. Across provinces, significant variation has been observed in how services are planned, resourced, and delivered. These variations in service standards and quality are felt daily in the lives of women, newborns and adolescents. Despite these challenges, progress is visible. National estimates show a drop in maternal mortality ratio, from 331 to 140 per 100 000 live births since 2000, signaling improvements in care quality and access. Fertility has stabilised and contraceptive use has grown, yet unmet reproductive health needs persist, and adolescent pregnancies continue to reflect early marriage and limited access to youth-friendly services.To better understand how Indonesia’s health system has evolved under decentralisation, the Ministry of Health, supported by World Health Organization (WHO), United Nations Population Fund (UNFPA), the United Nations Children’s Fund (UNICEF), IPAS and the Asian Development Bank (ADB), conducted a joint external review of RMNCAH programmes. This review draws on multiple sources of evidence, including existing literature, policy documents, national health system data, as well as field visits to six selected provinces to represent Indonesia’s geographic and administrative diversity. During the field visits, review teams observed service delivery in health facilities, spoke with health workers and local leaders and met mothers and families to understand how RMNCAH policies are operationalised. One of the challenges identified was the management of low birthweight (LBW) infants, a major contributor to neonatal deaths, under resource constraints. One midwife described a severe case of extremely LBW twins, one stillborn and the other died after three days of care. She recalled how the surviving infant struggled to swallow and may not have received breast milk, while simultaneous emergencies required the team’s attention, affecting the care provided to the infant.A subsequent review of the case by the district health office revealed insufficient antenatal care, fragmented maternal medical history due to population mobility, referral delays, limited provider capacity in neonatal intravenous access and a heavy workload that constrained proper newborn monitoring. These insights informed recommendations to strengthen both system-wide and service-level responses. Since the early 2000s, Indonesia’s decentralisation initiative has given much of the responsibility for funding, staffing and managing health services to regional governments. While the Ministry of Health sets national clinical standards, daily management of public health facilities falls under regional authorities through the Ministry of Internal Affairs. While this arrangement allows services to be tailored to local needs, it also depends heavily on local capacity for planning, budgeting and management. Health facilities and district health offices are better positioned to translate national priorities into local action when they have access to consistent technical support, helping health workers manage resource constraints and infrastructure gaps.The complexity of Indonesia’s health system governance is no easy feat to navigate. Understanding these dynamics is essential to strengthening policy, improving coordination and ensuring more equitable access to services across Indonesia. Under the leadership of Ministry of Health, recommendations from this exercise will be key in guiding the nation’s roadmap to an equitable and quality health system for RMNCAH.Written by Edit Oktavia Manuama, National Professional Officer (Maternal, Newborn, and Child Health), and Jessie Yunus, National Professional Officer (Gender, Rights, Equity, and Disability Inclusion)