Category: Washington Post

  • In northwest Nigeria, U.S. confronts a growing terrorist threat

    In northwest Nigeria, U.S. confronts a growing terrorist threat

    BAIDI, Nigeria — There are still bloodstains and bullet holes in the mud-brick alcove where villagers took shelter last month after militants overran their community, opening fire on residents who had gathered to drink tea in the town square.

    Six people, ages 18 to 60, were killed in Baidi that night, locals said, gunned down without warning by men whose faces were obscured by the darkness. The attack was the latest in Nigeria’s northwestern Sokoto state, carried out by what Nigerian and U.S. officials believe is the newest African affiliate of the Islamic State.

    On Christmas night, President Donald Trump announced that United States had launched airstrikes against the group, known here as Lakurawa, part of what the White House and its allies have described as a campaign to put a stop to the “slaughter of Christians” in Nigeria. But the U.S. strikes were largely ineffective, Nigerian officials, analysts and residents said, and there are very few Christians in Sokoto to protect. The state, once part of a 19th-century caliphate, remains overwhelmingly Islamic, and it is Muslims in villages like this one who have borne most of the violence in Sokoto.

    Yet no one here denies there is a real and growing security crisis. Islamist militants from several different groups have wrought havoc in Mali, Burkina Faso and Niger in recent years while quietly extending their reach into northern Nigeria. Most researchers see Lakurawa as an extension of the Islamic State Sahel Province (ISSP), which is strongest along the borderlands between Mali and Niger but has shown the ability to strike high-profile targets. Its fighters kidnapped an American missionary in central Niamey, Niger’s capital, late last year and, just last week, executed a large-scale attack on Niger’s international airport.

    Now, according to five Nigerian and U.S. officials, ISSP is sharing intelligence and coordinating logistics with the more established Islamic State West Africa Province (ISWAP), which is based hundreds of miles to the east on the islands of Lake Chad. Together, officials fear, the two groups could destabilize vast stretches of northern Nigeria, home to an estimated 130 million people, where authorities have long struggled to contain insurgent violence.

    “This is not just a Nigeria problem,” said one of the Nigerian security officials, speaking like others in this story on the condition of anonymity to discuss sensitive and ongoing operations. “It affects the entire region.”

    Men handle donkeys at the market in Tangaza, Nigeria, on Jan. 26. Many kidnappings and attacks occur in this area.

    The U.S. has ramped up cooperation with Nigeria’s military in recent months, according to four of the officials, running daily surveillance flights over northern Nigeria with drones launched from Ghana. Officials said the flights have provided actionable intelligence used in additional strikes by the Nigerian military.

    What, if anything, the U.S. and Nigerian strikes have achieved against militants in the northwest remains difficult to discern. Both nations are playing catch-up on a threat that analysts say has been building for years and is still poorly understood. Attacks by Lakurawa have not been officially claimed by the Islamic State, and researchers and officials have competing theories about the group’s origins and allegiances.

    What was clear over the course of more than 20 interviews across Sokoto state is that the militants are on the offensive. Residents in multiple front line villages say armed men are increasingly imposing an extreme version of Islamic law on their communities, demanding they pay taxes known as zakat and punishing those who refuse.

    Fighters often announce their arrival by barging into mosques and dictating the rules communities must live by. Most of the villages around Baidi, residents said, have already fallen under Lakurawa’s control. Western schools, already rare in this impoverished region, have been shuttered. Music, cigarettes, and traditional celebrations, including weddings and naming ceremonies, have been banned. Drinking and drugs are forbidden and strict dress codes are enforced.

    Musa Sani next to blood and bullet holes where Lakurawa shot during a recent attack that killed several people in Baidi, Nigeria, on Jan. 26.

    A few weeks before the attack in Baidi, residents said, militants approached members of a local vigilante group that had formed to defend the community, demanding they urge local leaders to submit to their rule. The leaders refused.

    “We understood there would be retaliation,” said Musa Sani, 47, one of the vigilantes. “But we did not want to live under a terrorist regime.”

    Men hang out in Silame, Nigeria, where Lakurawa pass through, on Jan. 25. Lakurawa have been known to punish people for having cell phones. Many kidnappings and attacks occur in this area.

    ‘Under the radar’

    In November, U.N. secretary-general António Guterres told the U.N. Security Council that Africa’s Sahel region, spanning the breadth of the continent from the Atlantic Ocean to the Red Sea, now accounts for more than half of all terrorism deaths worldwide and warned of a “disastrous domino effect across the entire region.”

    A dizzying array of armed groups thrive across a succession of weak states with porous borders. JNIM, a powerful al-Qaeda affiliate, and ISSP compete for influence in Mali, Burkina Faso, and Niger (JNIM also claimed its first attack in Nigeria in late October). ISWAP and the remnants of the Boko Haram jihadist movement are dominant in northeast Nigeria and around Lake Chad.

    Boko Haram’s rampage in northeast Nigeria captured the world’s attention more than a decade ago when fighters kidnapped nearly 300 schoolgirls from their dormitories in Chibok. But the arrival of Sahelian militants in the northwest a few years later flew largely under the radar and has been a source of growing alarm for Nigerian officials.

    Hakimi Maikudi, community leader, stands in the road where Lakurawa came through during the attack in Baidi, Nigeria, on Jan. 26.

    In early November, when Trump suddenly threatened to go “guns-a-blazing” into Nigeria to protect embattled Christmas, officials here were surprised and angry. Nigeria’s population of 230 million is roughly split between Christians and Muslims, and people of both faiths have been targeted by extremists.

    But Nigeria’s military was watching the militant violence, especially in the northwest, with growing concern, acknowledged Daniel Bwala, a senior adviser to President Bola Tinubu. “We had always viewed the United States as a senior brother,” said Bwala. “We needed to find a way to work with [them].”

    Bwala and a delegation of top officials made the rounds in Washington, appealing for help in addressing a security crisis they said impacted all Nigerians. Their efforts paid off: When the U.S. launched strikes on Dec. 25, it was against Lakurawa targets provided by Nigerian officials.

    Although Trump and other U.S. officials have publicly claimed the strikes were a success, they have provided no evidence to support their claims. At least four of the 16 Tomahawk missiles failed to explode, the Washington Post found, landing in open fields and a residential area far from where the militants are known to operate. Nigeria’s government has said three dozen suspected militants were arrested while attempting to flee Sokoto state following the strikes. Mohammed Idris, the country’s information minister, told the Post that a “comprehensive evaluation” was still underway.

    A senior Nigerian intelligence official who deployed a team to the sites where missiles reached their targets told the Post that while Lakurawa camps were destroyed, there was no indication that militants were killed. Three other Nigerian officials conceded that the sheer number of armed groups operating in the northwest, and shifting alliances among them, have made it difficult to obtain accurate intelligence.

    That lack of clarity presents “a real operational challenge vis-à-vis targeting,” said James Barnett, a Nigeria specialist based between Lagos and Britain. “Intelligence has to be precise and fresh for it to be effective.”

    Barnett also cautioned that Lakurawa may not be a single coherent group, but rather a catchall term for Sahelian Islamist militants. Allied criminal bandits, he added, may be exploiting the confusion and operating under its name.

    As officials try to make sense of the situation, fighters loyal to ISSP have “entrenched themselves in the Niger-Nigeria borderland and are advancing toward Benin,” said Héni Nsaibia, the senior West Africa analyst for the Armed Conflict Location & Event Data project.

    “They have decided to run their operations covertly,” he said, “to try to stay under the radar.”

    Children leave their home in Silame, Nigeria, where Lakurawa pass through, on Jan. 25.

    Rule of the gun

    Driving north from the bustling city of Sokoto, the regional capital, toward the border with Niger, the roads are largely devoid of traffic. Rolling brushland is interrupted only by the occasional farm.

    It is in these remote, ungoverned spaces that Lakurawa established a foothold, officials say, and is now expanding.

    Residents in four towns and villages described armed men arriving here more than five years ago from Mali and Niger, traveling on motorbikes and speaking languages they didn’t understand.

    At first, they presented themselves as peacemakers — mediating disputes between herders and farmers, which sometimes turned violent, and protecting communities from roving bandits. But it was not long before they showed their true colors, residents said, issuing draconian decrees at gunpoint.

    Over the last year, according to experts, residents and officials, the militants have widened their reach, bringing more villages under their control and using violence against those who resist.

    Residents in Dankale recalled being crowded into the village meeting place last year by 10 men with AK-47s, their faces mostly hidden by turbans. Through an interpreter, the Islamists demanded that locals disarm and adhere to their rules, said Awal, one of the men present that day.

    “We knew that if we spoke,” he said, “we would be killed.”

    Habiba, left, and Bashariya, carrying baby Awaisu, grind cornmeal in Dankale, Nigeria, where Lakurawa pass through, on Jan. 25.

    In nearby Karadal, imam Sirajo Lawal said that virtually everyone in his village tries to live by the Quran. But the Islam that he preaches, and that his father preached before him, gives people the freedom to choose their own path, he said.

    With the militants, however‚ “they say, ‘You must do this, otherwise, hellfire,’” said Lawal, 55. “This is the point of difference.”

    He spoke to the Post at a school in Tangaza, about six miles from his village, now solidly under the control of Lakurawa. Interviewing him there would have been too dangerous. Men in the community who listen to music or refuse to grow beards are beaten or fined by the militants, he said. Gunmen have also burst into traditional ceremonies, which are no longer permitted, and fired into the air.

    Imam Sirajo Lawal in Tangaza, Nigeria, on Jan. 26.

    In Karadal, and dozens of communities like it, the group rules by extortion: forcing locals to pay taxes in exchange for safety. Lawal said he had put aside eight bags of grain for his next payment to the group.

    Kingsley L. Madueke, the Nigeria research coordinator for the Global Initiative Against Transnational Organized Crime, said much of Lakurawa’s funding is believed to come from tax collection, though the group also carries out kidnappings for ransom and steals cattle from herders. Often, he added, they cooperate with local bandits who know the terrain.

    Most analysts believe Lakurawa is part of, or affiliated with, the Islamic State Sahel Province, which first emerged in 2015, killed four U.S. soldiers in an ambush in rural Niger in 2017 and was officially recognized as a “province” by the Islamic State in 2022. How much support Lakurawa receives from the Islamic State’s hub in northern Somalia is unclear — one of many things researchers are still trying to pin down.

    Lawal said the militants came straight to him when they wanted to enter his village. He acquiesced to their demands, he said, knowing the Nigerian government would not protect them.

    “We are not comfortable at all, but we cannot do otherwise,” he said. “They could kill us at any time.”

    In the wake of U.S. strikes, Lakurawa have apparently moved their camps, Madueke said, but their attacks have continued. Dislodging them from the northwest would require a clear strategy and sustained commitment from an administration that has not prioritized Africa, said retired U.S. Air Force Maj. Gen. Kenneth Ekman.

    “A dozen cruise missiles does not a counterterrorism mission make,” he said. “We’ve learned time and again that success requires consistent presence with sufficient capability and will alongside our partners.”

    Men walk with camels in Baidi, Nigeria, on Jan. 26. A recent attack by Lakurawa here killed several people.

    Sani, the vigilante in Baidi, was initially hopeful the U.S. strikes would wipe out so many militants that they would abandon the area. He knew he was mistaken when he heard the gunfire in the town square.

    He found his grandfather among the dead, his stomach perforated with bullets. Through his tears, he tried to help two men with critical injuries, he said, but neither made it. He expects more violence is coming.

    “We’re more scared than ever before,” he said. “It feels like they’ve dispersed and are everywhere.”

  • Trump launches TrumpRx.gov, branding his push to lower prescription prices

    Trump launches TrumpRx.gov, branding his push to lower prescription prices

    NEW YORK — The Trump administration on Thursday launched TrumpRx, a website it says will help patients buy prescription drugs directly at a discounted rate at a time when health care and the cost of living are growing concerns for Americans.

    “You’re going to save a fortune,” President Donald Trump said at the site’s unveiling. “And this is also so good for overall health care.”

    The government-hosted website is not a platform for buying medications. Instead, it’s set up as a facilitator, pointing Americans to drugmakers’ direct-to-consumer websites, where they can make purchases. It also provides coupons to use at pharmacies. The site launches with over 40 medications, including weight-loss drugs such as Ozempic and Wegovy.

    The site is part of a larger effort by the Trump administration to show it’s tacking the challenges of high costs. Affordability has emerged as a political vulnerability for Trump and his Republican allies going into November’s midterm elections, as Americans remain concerned about the cost of housing, groceries, utilities and other staples of middle-class identity.

    Trump stressed that the lower prices were made possible by his pressuring of pharmaceutical companies on prices, saying he demanded that they charge the same costs in the U.S. as in other nations. He said prescription drug costs will increase in foreign countries as a result.

    “We’re tired of subsidizing the world,” Trump said at the event on the White House campus that lasted roughly 20 minutes.

    The president first teased TrumpRx in September while announcing the first of his more than 15 deals with pharmaceutical companies to lower drug prices to match the lowest price offered in other developed nations. He said in December the website would provide “massive discounts to all consumers” — though it’s unclear whether the prices available on drugmakers’ websites will routinely be any lower than what many consumers could get through their insurance coverage.

    The website’s Thursday release came after it faced multiple delays, for reasons the administration hasn’t publicly shared. Last fall, Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, told Trump the site would share prices for consumers before the end of the year. An expected launch in late January was also pushed back.

    The president has spent the past several months seeking to spotlight his efforts to lower drug prices for Americans. He’s done that through deals with major pharmaceutical companies, including some of the biggest drugmakers like Pfizer, Eli Lilly and Merck, which have agreed to lower prices of their Medicaid drugs to so-called “most favored nations” pricing. As part of the deals, many of the companies’ new drugs are also to be launched at discounted rates for consumer markets through TrumpRx.

    Many of the details of Trump’s deals with manufacturers remain unclear, and drug prices for patients in the U.S. can depend on many factors, including the competition a treatment faces and insurance coverage. Most people have coverage through work, the individual insurance market or government programs like Medicaid and Medicare, which shield them from much of the cost.

    Trump’s administration also has negotiated lower prices for several prescription drugs for Medicare enrollees, through a direct negotiation program created by a 2022 law.

  • As West goes after Russia’s oil fleet, Moscow fears for its war funding

    As West goes after Russia’s oil fleet, Moscow fears for its war funding

    Europe is tightening the net on Russian oil being shipped through its waters, squeezing Moscow’s ability to fund its war even as officials and business executives in Russia fear the window is narrowing to reach a peace deal before the economy deteriorates.

    The European Union is considering imposing an outright maritime ban on services needed to ship Russian oil, such as insurance and transportation, as part of a new sanctions package marking four years of Russia’s war.

    The ban would significantly ratchet up the sanctions imposed on Russian oil, replacing the current oil price cap system, and comes as 14 European nations — including Britain, France, and Germany — warned last week they could intercept the shadowy fleet of tankers Russia created to help it evade sanctions operating in breach of international maritime law.

    Russian oil revenue plummeted by 50 percent in January compared with the same month the previous year after tough new sanctions imposed by the U.S. Treasury on Russian oil majors Rosneft and Lukoil in October. The penalties forced Moscow to accept ever-steeper discounts of more than $20 per barrel for its oil. Combined with India’s apparent agreement to halt Russian oil purchases in favor of increased imports from the United States and potentially Venezuela, the measures threaten to further strain the resources Moscow needs to fuel its war machine, risking crisis as nonpayments grow across the economy.

    Inspired by the seizure last month by U.S. forces of the Marinera tanker after a weeks-long pursuit despite a Russian submarine escort, the French navy briefly captured another suspected Russian shadow fleet tanker, the Grinch, which had been traveling from the Russian Arctic port of Murmansk across the Mediterranean carrying 730,000 barrels of oil under the flag of Comoros.

    French President Emmanuel Macron said the vessel was subject to international sanctions and suspected of flying a false flag.

    After Russia launched its full-scale invasion of Ukraine in February 2022, the Kremlin used intermediaries to buy up aging tankers and created what became known as the shadow fleet, to lessen its dependency on Western shipping services and reduce sanctions risks. Instead of being insured through Western companies, these tankers often receive insurance from Russia, backed by the country’s central bank, and sail under the flags of less stringent jurisdictions such as Sierra Leone and Cameroon, to conceal the origin of the oil.

    If enforced, the proposed measures could impact nearly a half of Russia’s oil exports, or about 3.5 million barrels per day, which head through European waters via the Baltic and Black seas, with crude shipments mostly bound for refineries in India, China, and Turkey.

    It’s not yet clear if the proposed EU maritime services ban, which requires a unanimous vote by member states, will be passed. But with the risk on the shadow vessels increasing from interceptions as well as attacks by Ukrainian drones, the costs are rising for shipments through Europe.

    “Russian oil exports are highly sensitive to disruptions in shipping. It is an Achilles’ heel,” said Janis Kluge, an economist at Germany’s Institute for International and Security Affairs. “If I were in Russia’s shoes, I would be very worried about the developments both with regards to a stricter policy against the shadow fleet and the Ukrainian drone attacks against tankers. Because both create significant risks. It is critical for Russia to have these shipping lanes open for its oil, or it will really run into big trouble.”

    A Russian academic close to senior Moscow diplomats said any European ban on maritime services for Russian oil and any further interceptions of shadow fleet tankers were “serious threats for Russia.”

    “This is a threat not just for the economy, but also it’s a political question about whether Russia can allow such actions without losing its political reputation,” the academic said.

    Even without the further risk to oil exports, Russian finance officials have been writing with increasing urgency to President Vladimir Putin to warn of a potential crisis by the summer, according to a person in contact with these officials and who spoke on the condition of anonymity because of the sensitivity of the subject.

    The officials have warned falling revenue means the budget deficit is only set to grow without further tax hikes while pressure is mounting on the Russian banking system due to high interest rates and a corporate borrowing spree to fund the war.

    One Moscow business executive said the crisis could hit in “three or four months” as signs appear that real inflation is spiraling far beyond the officially declared 6 percent despite interest rates being held at a high 16 percent. Signs of growing strain in the economy are the biggest numbers of closures of restaurants in Moscow since the pandemic and the forced layoffs of thousands of workers as costs grow, the executive said, also on the condition of anonymity.

    But there is little sign that Putin is set to change his calculus and step back from the Kremlin’s maximalist war demands. Last week, Foreign Minister Sergei Lavrov dismissed the Western security guarantees Ukraine says it needs for any deal, calling instead for an end to the regime in Kyiv.

    “We have no understanding about when the war will end,” the business executive added.

    The growing economic pressures are nevertheless weighing on Moscow as it seeks to keep the Trump administration on its side during negotiations to end the war. “If Trump comes to the conclusion that Russia is sabotaging the negotiation process then it’s possible there could be new sanctions including on the energy sector, and this is a serious challenge for Russia,” the Russian academic said.

    If anything, Russia is only growing more vulnerable to economic pressure, said Craig Kennedy, a former vice president at Bank of America Merrill Lynch now at Harvard University.

    “Oil revenues are sliding, credit is overextended. And Moscow knows things are only likely to get worse in 2026,” he said.

    Not all of Russia’s oil is under sanction, and Western companies can ship this oil as long as it is sold under the price cap first imposed by the European Union in December 2022. The EU had hesitated over imposing a full ban over fears it could cause a counterproductive oil price spike.

    But when the U.S. sanctioned Russia’s two biggest oil majors, Rosneft and Lukoil, in October last year, it sharply increased the share of Russia’s total oil output under U.S. sanctions to 80 percent. Moscow became even more reliant on its shadow fleet to transport its oil through the Baltic and Black seas to refineries in India, Turkey, and China.

    “The amount of unsanctioned oil now produced in Russia is a lot lower,” Kennedy said. “If shipping compliance gets tightened, it could put even more pressure on Russian export revenue.”

    Ukraine has also been stepping up its own efforts to target the shadow fleet, further increasing the risks and costs of shipping Russian oil. Since late November its forces have attacked at least nine Russia-linked tankers, deploying naval and aerial drones, as well as mines.

    European officials will likely still face a game of cat and mouse in targeting the illicit Russian oil. Already since the U.S. imposed sanctions on Rosneft and Lukoil, two mysterious new intermediary companies — Redwood Global Supply FZE LLC and Alghaf Marine DMCC — emerged out of nowhere to become major exporters of Russian oil, according to data from Kpler, a global commodities intelligence firm, compiled by the Kyiv School of Economics.

    Redwood sold 757,000 barrels per day in December, and Alghaf sold 174,000 barrels per day after trading zero amounts of oil previously, according to the data. “What we observed is that volumes traded by these new companies skyrocketed,” said Borys Dodonov, head of the Center for Energy and Climate Studies at the Kyiv School of Economics.

    European governments also argue that many of the Russian shadow fleet vessels flying flags of convenience from nations such as Cameroon and Sierra Leone are not compliant with international maritime safety standards, while those that sail under more than one flag during a voyage — as the Marinera did — can be treated as “stateless” under international maritime law allowing them to be boarded and searched.

    Amid the crackdown, Russia could be forced to register more of its shadow fleet under Russian flags, making them easier targets for sanctions, analysts said, especially if they are de-registered by other flag states.

    Any such move however could also increase the possibility of conflict over attempts to board Russian-flagged vessels with Moscow seeking to intimidate Europe out of taking any action. Russia’s Maritime Board, overseen by hawkish former Security Council chief Nikolai Patrushev, warned late last month that measures would be taken to protect Russian shipping interests against actions by “unfriendly states.”

    “It’s a question of whether these actions will be taken by the Europeans by themselves without the participation of the U.S.,” the Russian academic said. “Then there could be some measures in response like protection by a military convoy.”

  • Demise of U.S.-Russia nuclear pact sparks fears of new arms race

    Demise of U.S.-Russia nuclear pact sparks fears of new arms race

    The last major arms-control agreement between the U.S. and Russia expired Thursday, increasing the risk of a new arms race between the world’s two largest nuclear powers amid growing global instability.

    The 2011 Strategic Arms Reduction Treaty, or New START, limited the size of the Russian and U.S. nuclear arsenals and allowed for inspections and exchanges of information. Its demise leaves Moscow and Washington without a framework to regulate their strategic stockpiles for the first time since the depths of the Cold War in the 1980s.

    The end of the accord “definitely doesn’t make the world safer,” said Pavel Podvig, a senior researcher at the United Nations Institute for Disarmament Research in Geneva. “The real loss will be a loss of transparency and it will increase political risks.”

    START is expiring as relations between Russia and Europe have spiraled to their worst in decades over the war in Ukraine and with uncertainty among U.S. allies about its longterm commitment to the NATO military alliance. China is bolstering its strategic forces and other nations are eyeing the need for nuclear weapons to safeguard themselves as major powers increasingly jostle for dominance in their regions.

    The treaty had been due to expire in 2021 before the two sides agreed to a five-year extension, though Russian President Vladimir Putin suspended formal participation in 2023, halting inspections and information exchanges as confrontation with the U.S. surged over his full-scale invasion of Ukraine. Still, he pledged to uphold the pact, which restricts each side to 1,550 deployed strategic warheads.

    “The immediate danger is that, in the absence of legal constraints and verification measures, both countries will revert to worst-case planning and begin uploading hundreds more warheads to their deployed forces out of fear that the other is doing so,” said Mackenzie Knight-Boyle, a senior research associate for the Nuclear Information Project at the Federation of American Scientists. “The United States and Russia have significant upload capacity that would allow them to drastically increase their numbers of deployed nuclear warheads in a short amount of time.”

    In September, Putin said he’d be ready to adhere to the terms of the treaty for another year after it expired if the U.S. did the same. President Donald Trump didn’t formally respond to that idea.

    Trump will decide the path forward on nuclear arms control and will clarify it in his own timeline, a White House official said. The president has spoken repeatedly of addressing the threat from nuclear weapons and indicated that he wants to involve China in arms control talks, the official added.

    “China’s nuclear strength is by no means at the same level with that of the U.S.,” Lin Jian, a Chinese Foreign Ministry spokesperson, told reporters at a Feb. 3 briefing. “It is neither fair nor reasonable to ask China to join the nuclear disarmament negotiations at this stage.”

    China hopes the U.S. will respond to Russia’s “constructive” proposal for extending START’s terms and “truly uphold global strategic stability,” the spokesman added.

    Russia now assumes the two sides “are no longer bound by any obligations or symmetrical declarations within the context of the treaty” and are “free to choose their next steps,” the Foreign Ministry in Moscow said in a statement late Wednesday. Still, Moscow “remains open to the search for political and diplomatic ways to comprehensively stabilize the strategic situation,” it said.

    Some Republican lawmakers privately urged Trump not to entertain Putin’s proposal, according to a person familiar with the matter, in light of the risk it would end up constraining the U.S.’s ability to maneuver without doing much to limit Moscow’s actions.

    In particular, the treaty only regulated strategic weapons and didn’t place limits on tactical nuclear weapons for either side. Former CIA Director Bill Burns has said there was a genuine risk of Russia resorting to those shorter-range and lower-yield weapons in Ukraine in the fall of 2022.

    At a Senate hearing on Tuesday, retired admiral Charles A. Richard, a former commander of United States Strategic Command, told lawmakers that “simply extending the New Start Treaty for one year does not constrain Russia to the same way that it constrains us,” and that doing so would prevent the U.S. from meeting the challenge posed by China’s own rapid buildup.

    Rose Gottemoeller, a former undersecretary of State for arms control in the Obama administration who was the chief U.S. negotiator of the New START treaty, advocated for an extension, saying it would be better to “keep them limited at least for another year while we continue to plan and prepare for the Chinese threat.”

    China has been growing its nuclear forces to catch up with Russia and the U.S.. In its 2025 annual report to Congress on military developments in China, the Pentagon said Beijing had “continued its massive nuclear expansion” as part of its goal of achieving “strategic counterbalance” against the U.S. by 2027.

    The People’s Liberation Army is on track to have more than 1,000 warheads by 2030 from a stockpile in the low 200s at the start of this decade, according to the Pentagon report. While Beijing adheres to a no-first-use policy on nuclear weapons, China “has not demonstrated a willingness to advance discussions on nuclear risk reduction measures, bilaterally or multilaterally,” it said.

    Russia may indicate “a willingness to refrain from buildups until the United States increases its strategic arsenal,” said Dmitry Stefanovich, a research fellow at the Center for International Security at the Institute of World Economy and International Relations in Moscow. Still, the absence of binding agreements between the nuclear powers creates “the foundation for an increase in strategic offensive weapons in the medium term,” he said.

    An unconstrained nuclear era that led to increases in Russian and U.S. weapons would likely prompt other states from the UK and France to North Korea and Pakistan to seek to increase their strategic arsenals, according to Knight-Boyle of the Federation of American Scientists.

    Putin boasts that Russia has developed a new range of strategic weapons in recent years that are capable of evading existing defenses. They include the nuclear-powered Burevestnik cruise missile and Poseidon torpedo drone, as well as the Kinzhal hypersonic ballistic missile that’s claimed to be capable of traveling at up to 10 times the speed of sound.

    Russia has also used the Oreshnik intermediate-range ballistic missile in strikes on Ukraine, a weapon that’s capable of carrying atomic warheads and has a range of 3,100 miles, putting most of Europe and the U.S. West Coast in striking distance.

    After Moscow conducted trials of the nuclear-capable Poseidon and Burevestnik, Trump threatened to resume atomic tests “on an equal basis” to other powers. That prompted Putin to order his officials to seek more information about Washington’s intentions and to set out proposals for “the possible commencement of work on nuclear weapons testing.”

    The last U.S. nuclear explosive test was in 1992, though it continues to test delivery systems. Russia’s last known nuclear detonation was in 1990, while China’s was in 1996.

    Russian officials say negotiations on a potential new agreement would also have to cover the issues of North Atlantic Treaty Organization expansion, the U.S. global missile-defense system and medium- and short-range missile deployments.

    A deal to settle the war in Ukraine “could open up a broader dialog with the Russians on strategic stability,” said Ankit Panda, Stanton Senior Fellow in the Nuclear Policy Program at the Carnegie Endowment for International Peace. “The Russians will be interested in engaging on arms control.”

  • When patients see the line between life and death, should we believe them?

    When patients see the line between life and death, should we believe them?

    After she dropped to her knees outside her home in Midlothian, Va., suffocating, after she was lifted into the ambulance and told herself, “I can’t die this way,” and after emergency workers at the hospital cut the clothes off her to assess her breathing, Miasha Gilliam-El, a 37-year-old nurse and mother of six, blacked out.

    What happened next has happened to thousands who’ve returned from the precipice of death with stories of strange visions and journeys that challenge what we know of science. Last year, a team of researchers from Belgium, the United States, and Denmark launched an ambitious effort to explain these experiences on a neurobiological level — work that is now being contested by a pair of researchers in Virginia.

    At stake are questions almost as old as humanity, concerning the possibility of an afterlife and the nature of scientific evidence — questions likely to take center stage at a conference of brain experts in Porto, Portugal, in April.

    “The next thing I knew, I was out of my body, above myself, looking at them work on me, doing chest compressions,” Gilliam-El said, recalling Feb. 27, 2012, the day she suffered a rare condition called peripartum cardiomyopathy. For reasons that aren’t fully understood, between the last month of pregnancy and five months after childbirth, a woman’s cardiac muscle weakens and enlarges, creating a risk of heart failure.

    Gilliam-El, who had given birth just three days earlier, recalled watching a doctor try to snake a tube down her throat to open an airway. She remembered staring at the machine showing the electrical activity in her heart and seeing herself flatline. Her breathing stopped.

    “And then it was kind of like I was transitioned to another place. I was kind of sucked back into a tunnel,” she said. “It is so peaceful in this tunnel. And I’m just walking and I’m holding someone’s hand. And all I’m hearing is the scripture, ‘Yea, though I walk through the valley of the shadow of death …’”

    While neuroscientists have discovered more and more about the inner workings of the brain in recent decades, a deep mystery still surrounds near-death experiences like Gilliam-El’s.

    Writing last year in the journal Nature Reviews Neurology, a research team led by Charlotte Martial, a neuroscientist at the University of Liège in Belgium, synthesized some 300 scientific papers focusing on commonalities across the following experiences: viewing one’s body from the outside, journeying through a tunnel toward a brilliant light, and experiencing a deep sense of peace. The authors linked these experiences to specific changes in the brain, creating a pioneering model called NEPTUNE (neurophysiological evolutionary psychological theory understanding near-death experience).

    Bruce Greyson and Marieta Pehlivanova, researchers at the University of Virginia School of Medicine, responded with a sweeping critique of the NEPTUNE model in the journal Psychology of Consciousness: Theory, Research, and Practice.

    While calling the model “an admirable strategy,” they wrote that aspects of such experiences cannot be explained solely by brain physiology, and they criticized the NEPTUNE authors for omitting evidence that did not support their ideas.

    Although this debate is taking place in the rarefied atmosphere of scientific journals and conferences, it is almost certainly one that has crossed the minds of most people.

    “This is not the digestive function of some lower life form we’re talking about here. These are implications that reach all of humanity,” said Jeffrey Long, a radiation oncologist and co-author of the 2011 book Evidence of the Afterlife: The Science of Near-Death Experiences.

    “Do we have some evidence?” he asked. “And how strong is that evidence that we have life after death, that our consciousness survives bodily death?” Long — who was not involved in either the NEPTUNE paper or the critique — said he has studied more than 4,000 near-death experiences.

    The NEPTUNE researchers cited several studies showing that about 10 to 23% of near-death experiences occur after a heart attack, 15% after a prolonged stay in intensive care and 3% after a traumatic brain injury. Others occur after electrocution, near drowning, and complications during childbirth.

    “For most of them, it’s a life-transforming experience,” Martial said. “Typically, they are less afraid to die [afterward].” They tend to develop greater interest in spirituality, she said, and can become more empathetic to others.

    To create the NEPTUNE model, scientists examined changes in gas concentrations in blood vessels in the brain: the decreased oxygen and increased carbon dioxide that occur just before and during a cardiac arrest.

    They cited studies suggesting that sensations resembling out-of-body experiences may be generated in the temporoparietal junction, a high-level hub for processing sensory information and helping distinguish the self from others. Studies indicate that applying electric stimulation to this area, located behind and just above the ear, could trigger an out-of-body experience, they wrote.

    Folded into their analysis were observations about brain chemistry, including the nerve cells and chemical messengers that regulate mood, sleep, and learning. Martial said the model is intended as a living document that can be revised as scientists learn more.

    But Greyson and Pehlivanova disputed key aspects of the model. They wrote that illusions triggered by electric stimulation are “nothing like the visions of deceased persons reported in [near-death experiences].” For example, one study reported inducing an illusion in which a patient felt the presence of a person behind them whom they could not see or hear.

    “This is not remotely comparable to the visions reported in many [near-death experiences] of identified deceased persons who are seen, heard, smelled, and touched,” wrote Greyson and Pehlivanova, who are, respectively, a professor emeritus of psychiatry and neurobehavioral sciences and a research assistant professor of psychiatry and neurobehavioral sciences.

    The two acknowledged that near-death experiences “are typically triggered by physiological events” but stressed that such events do not account fully for the experiences people have described. They faulted the NEPTUNE authors for dismissing evidence from patients’ near-death accounts and from hospital staff who have supported aspects of those accounts — for example, the number of people who were in the room during resuscitation.

    Scientists disagree on whether the stories patients tell constitute reliable scientific data.

    Near-death experiences have been described since antiquity, said Greyson. Researchers have been collecting and discussing accounts since at least 1892, when Swiss mountaineer and geologist Albert Heim discussed stories he’d collected since his own brush with death while climbing in the Alps.

    By their nature, these reports can be difficult to define and even harder to analyze with scientific rigor. In a 1983 paper, Greyson described a 16-item scale he developed for measuring accounts of near-death experiences and standardizing research into them.

    But the effort to impose rigor on the study of near-death experiences forces researchers into an uncomfortable zone that straddles the line between the scientific and the spiritual.

    “These stories are seductively powerful narratives that give hope to our deepest yearnings for consciousness beyond our death,” Kevin Nelson, an emeritus professor of neurology and retired chief of medical staff affairs at University of Kentucky HealthCare, wrote in an email. “I too have such hope, but with wax in my ears and science lashing me to the mast, I will not succumb to the siren’s song.” (Nelson was one of the authors of the NEPTUNE paper.)

    Greyson said the NEPTUNE researchers may dismiss the testimony of patients who have come close to dying “as not evidential, but the fact is that every scientific discovery begins with subjective observation that may eventually be corroborated by controlled experiment.”

    In addition to testing aspects of the NEPTUNE model, Greyson and Pehlivanova wrote that “it will also be important to remain open to other potential causes, whether currently unknown or not yet fully understood.”

    By necessity, most previous studies have involved researchers going back to patients after their near-death experiences to gather their accounts and medical records. But such retrospective studies are open to biases in how people remember such events after time has passed and how they have shared their accounts with others.

    However, Martial, the NEPTUNE researcher, said that she and three of her colleagues at the University Hospital of Liège are in the midst of a prospective study that involves tracking patients from the moment they are taken to the hospital’s resuscitation room. It will involve video footage recorded at the hospital as well as electroencephalograms that measure electrical activity in the brain.

    “When we die, this is a process — not just an event,” Martial said. “For example, during a cardiac arrest, we have a decrease of oxygen, which leads to a decrease of brain activity. But at some point, actually, we see an increase of electrical brain activity, and then we can observe a kind of flatline.”

    Gilliam-El, the nurse, remembered that her near-death experience ended when a powerful voice told her “Not yet,” and she felt herself return to her body. Everything looked blurry in the bright hospital room.

    She feared that if she told anyone what had happened, they wouldn’t believe her.

  • As cold-stunned invasive iguanas fall from trees, Floridians scoop them up for killing

    As cold-stunned invasive iguanas fall from trees, Floridians scoop them up for killing

    Ryan Izquierdo woke up on a recent morning groggy, cold and most of all ready — to go iguana hunting.

    Temperatures in Jupiter, Fla., where the 27-year-old social media star lives, had dipped well below 50 degrees, as a cold front swallowed much of the East Coast in snowfall and record-breaking low temperatures. As flurries fell on parts of the state, residents braced for the inevitable: Cold-stunned green iguanas — one of Floridians’ most reviled invasive pests — began to lose consciousness and fall out of trees.

    The dry, scaly deluge is a familiar forecast in those parts. These cold-blooded reptiles’ nervous systems shut down when temperatures dip into the 40s and below. They become paralyzed and fall from their leafy perches. This time, for some unlikely conservationists, as well as state officials, that meant killing season.

    In a first, officials capitalized on the paralyzed pests and told residents they could bring them in for disposal.

    “This is the first time we have organized a removal effort of invasive iguanas,” said Shannon Knowles, communications director for the Florida Fish and Wildlife Conservation Commission (FWC).

    “South Florida has not experienced this level of cold weather in many years,” she added. “So we used this opportunity to remove this invasive non-native species from the landscape.”

    The commission issued an executive order that allowed people without permits to gather and transport the iguanas to one of several offices to be humanely killed, “or, in some cases, transferred to permittees for live animal sales.”

    Typically people can themselves humanely or painlessly do away with green iguanas when they see them, but they’re not allowed to transport them. Knowles added that people lined up, cloth bags and bins brimming with the lizards, to drop them off Sunday and Monday. While she said the commission did not yet have an official estimate, Izquierdo was floored by what he saw.

    “It was a madhouse,” Izquierdo said of the FWC site near Fort Lauderdale where he deposited about 100 iguanas Monday. “There were iguanas that were pushing six to six-and-a-half feet long. They look like dragons, absolutely crazy.”

    Green iguanas are a scourge of South Florida. First documented in the 1960s, their population has since exploded to, by some estimates, more than 1 million. They’ve wreaked havoc on the region’s infrastructure, burrowing holes around homes, sidewalks and seawalls. They’ve chewed through some of the state’s most crucial native plants such as nickerbean, which helps sustain the endangered Miami Blue butterfly.

    Izquierdo has been catching iguanas since he was 10 years old. In his grandmother’s backyard, he found them to use as fishing bait for peacock bass.

    “I’ve always loved nature and the outdoors,” he said.

    Now, he makes a living out of it as a content creator, documenting his fishing excursions around the world. But as the dipping temperatures created a new opportunity last weekend, he decided to temporarily pivot to the quest he dubbed “a Florida man Easter egg hunt for dinosaurs.”

    He jumped into his pickup truck and began hunting.

    In warm temperatures, iguanas are almost impossible to nab. You need either a gun or a 15-foot-long pole with an invisible lasso attached to it, Izquierdo said.

    “If you want to do iguana management, this is a good time to do it because they’re very vulnerable to removal,” said Frank Mazzotti, a professor of wildlife ecology at the University of Florida.

    But in the cold, chase proved easy and bountiful. “This is the most I’ve ever found,” he said. “We were practically almost stepping on them.”

    Despite the fun and viral Instagram reels, he’s not immune to the difficult decisions that come with maintaining a balanced ecosystem.

    “They’re animals, so people do have a soft spot in their heart for them and so do I because they’re really cool, especially the little baby ones,” Izquierdo said. “But you have to look at the bigger picture of things.”

    He’s passionate about making the most of a dead green iguana. On Monday night, he and his friends baked an iguana pizza, (delicious, he said, they’re nicknamed “chicken of the trees”) and he plans to use the skin and some meat for fishing lures and bait.

    On Tuesday morning, as the temperatures in Florida finally began to creep up to milder levels, Izquierdo sat in his truck, filled with about a dozen stunned iguanas, knowing his hours of hunting were numbered.

    “As the temperature starts climbing back up, it’s going to get back to normal,” he said. Two motionless lizards, a male and a female, lay in his lap. “Yeah, these iguanas will be back about their business.”

  • Gavin Newsom sat by his mother during her assisted suicide, and came to terms with anger and grief

    Gavin Newsom sat by his mother during her assisted suicide, and came to terms with anger and grief

    It was the spring of 2002 when Gavin Newsom’s mother Tessa, dying of cancer, stunned him with a voicemail. If he wanted to see her again, she told him, it would need to be before the following Thursday, when she planned to end her life.

    Newsom, then a 34-year-old San Francisco supervisor, did not try to dissuade her, he recounted in an interview with the Washington Post. The fast-rising politician was wracked with guilt from being distant and busy as she dealt with the unbearable pain of the breast cancer spreading through her body.

    Newsom’s account of his mother’s death at the age of 55 by assisted suicide, and his feelings of grief and remorse toward a woman with whom he had a loving but complex relationship, is one of the most revealing and emotional passages in the California governor’s book, Young Man in a Hurry: A Memoir of Discovery, which will be published Feb. 24.

    Newsom, a potential Democratic candidate for president, has seldom spoken of the chapter in his family’s life, which is likely to generate controversy if he enters the race. Assisted suicide, at the time, was illegal in California and remains illegal in all but 12 states and the District of Columbia, according to the advocacy group Death with Dignity.

    When that Thursday in 2002 arrived, Newsom and his sister Hilary did as his mother asked and sat by her bedside in Pacific Heights, Newsom said in an interview this week. He wanted her suffering to end, he said, but it would be years before he could forgive her for asking him to be there.

    “I hated her for it — to be there for the last breath — for years,” he said in an interview in San Diego this week. “I want to say it was a beautiful experience. It was horrible.”

    Forty-five minutes before the “courageous doctor” arrived to administer the medicine that would end her life, Newsom and his sister gave their mother her regular dose of painkillers to keep her comfortable, he said.

    When the doctor arrived, Tessa Newsom lucidly answered his questions and told him she was sure of her decision, Gavin Newsom said. Her labored breathing and the gravity of the moment became too much for Newsom’s sister. She left the room. Newsom stayed.

    “Then I sat there with her for another 20 minutes after she was dead,” he said, his voice breaking briefly and his eyes welling as he told the story. “My head on her stomach, just crying, waiting for another breath.”

    Despite his painful memories, Newsom said that he believes assisted suicide should be legal nationally, that people should have “the freedom to make that decision themselves.” California legalized the practice in 2015 with the “End of Life Option Act.”

    Six years after voters approved the practice, and two years after he became governor in 2019, Newsom signed a second bill that reduced the waiting period for a drug-induced suicide from 15 days to 48 hours and eliminated a requirement for a formal written declaration of intent at the end of the process. Last year, Newsom signed a third bill that eliminated a sunset clause in the 2015 bill, making assisted suicide legal in California indefinitely.

    When the bill came up in the California legislature, Newsom heard objections not only from churches and religious groups, but also from “the old Irish Catholic side of my family.”

    They were “up in arms about that bill, and obviously, by extension, by what my mom did,” he recalled. But Newsom said his own experience with his mother strengthened his support for the bill.

    “I watched the physical deterioration, the mental deterioration, just the cries of pain,” he said this week. “She would have just suffered.”

    Last year in an interview on the Diary of a CEO podcast, Newsom said he had no regrets about his role — “If you want to come after me, come after me, she needed to do it,” he said.

    Tessa Newsom worked three jobs to support her two children after her husband left, Newsom wrote in the book. His father, William Newsom, an attorney who became a judge, was the best friend of the billionaire Gordon Getty — and had for a time helped manage the Getty Trust. Their father’s friendship with the Gettys, which began in high school, created what Newsom described as a “surreal” double life for the two Newsom children, who joined their father and the Gettys during summer vacations that involved private jets, resorts and limousines.

    Tessa Newsom, a quiet but dominant force who shaped his work ethic, he said, did not approve of Newsom’s political ambitions.

    She urged him to stay immersed in his business, the PlumpJack Group, a wine and hospitality company that he founded in 1992.

    “Get out before it’s too late,” Tessa Newsom told her son after he had become a San Francisco supervisor in 1997 and was considering a 2003 run for mayor of San Francisco, which had been his father’s dream.

    She never fully explained the admonition. But William Newsom had also harbored political ambitions for a time — running for San Francisco county supervisor and state senator. And the younger Newsom learned years later, through an oral history his father recorded, that his electoral failures and subsequent debt had led to the unraveling of his parents’ marriage, Newsom said in an interview with the Post and in his book.

    Newsom — a father of four who is married to Jen Siebel, a documentary filmmaker — said his mother’s warning still haunts him.

    “I think about it any time when things are really going down — that she was right,” he said with a laugh. And while many people don’t believe that Newsom is still wrestling with whether he will run for president, his mother’s warnings are part of the quandary, he said.

    “I don’t think people are taking me as literally as they should. We’ll see what happens,” he said of a potential presidential run. “Every day, I just try to get better, and be a better husband, be a better father. I’ve got to take care of them, and I can’t do what my father did.”

  • A self-collected test allowed me to finally get cervical cancer screening

    A self-collected test allowed me to finally get cervical cancer screening

    If you have a cervix you may have felt a surge of relief — joy, even — when the American Cancer Society (ACS) announced its updated guidelines for cervical cancer screening in December. I know I did.

    The organization now allows for a self-collection test for human papillomavirus, or HPV, a sexually transmitted infection that causes almost all cases of cervical cancer, as an alternative to a more traditional clinician-collected test. For some women — including me — this endorsement means that we can finally access this lifesaving screening.

    Over the last decade, there have been notable changes in how and when women are screened for cervical cancer. The go-to method used to be the Pap smear, which involves inserting a speculum so that a provider can collect cells from the cervix, the lowest end of the uterus that connects to the vagina. Eventually, in 2020, the ACS began recommending that all women at average risk of cervical cancer start screening at age 25 with a clinician-collected HPV test.

    For the patient, the experience was the same for a Pap or HPV test: Your provider would still have you lie on your back with your feet in stirrups, insert a speculum, and use a swab to collect a sample of cells from your cervix. As someone with vaginismus — a condition that causes my vaginal muscles to involuntarily contract — it would have been impossible for me to get these done.

    Then, in 2024, the Food and Drug Administration (FDA) approved self-collected HPV tests for use in healthcare facilities — meaning that women at average risk could opt to do a less-invasive self-swab of their vagina with their provider present. And in 2025, the FDA approved the first at-home tool, a wand made by Teal Health, to screen for cervical cancer, allowing women to collect the sample and mail it to a lab without even needing to visit their doctor. (If you have a personal history of cervical cancer or are at high risk, you may not be a candidate for self-collected testing).

    At 26, I was officially overdue for my first screen, so my doctor recommended I try the in-office self-collection test.

    What the self-collected HPV test was like

    Before self-collection became an option, I would lie on the exam table at my gynecologist’s office, put my legs in stirrups, and involuntarily clench at any touch. I was excited to try the self-collection test, but also skeptical that it would work for me.

    The self-swabs in the clinic looked manageable and controllable, something I could hold and insert myself. The handle was as narrow as a mascara wand, and the brush at the end was made of flexible plastic bristles that felt soft. Most importantly, it did not need to directly touch my cervix. It was less invasive, without the internal pressure that usually made my body tense. I inserted the swab about two inches into my vagina, rotated it for 30 seconds and then handed it to my doctor, who swirled it inside a vial with liquid solution.

    “That’s it?” I asked my doctor once she screwed the cap on the vial. “Is it for sure as accurate as a regular Pap smear?” Yes and yes, she assured me. I was in awe. There was a time earlier in life when my vaginismus made it feel impossible to even insert a tampon — I couldn’t believe I had completed an HPV test.

    My doctor mailed my sample to a lab, and I received the results in less than two weeks. My Pap smear came back normal with no signs of HPV. Even better, this meant I did not need to be tested again for another five years.

    Amy Banulis, an OB/GYN and associate medical director for Women’s and Maternal/Child Health at Kaiser Permanente in Virginia, said most women will be able to comfortably complete the self-collected test, even if they have vaginismus.

    “For those that still do have discomfort, there are relaxation techniques that can be utilized,” Banulis said. These could include progressive muscle relaxation, deep breathing, and imagery or visualization. If these tactics don’t make a difference, your OB/GYN can refer you to a pelvic floor physical therapist that may be able to help you with this, Banulis said.

    How effective it is compared to a traditional Pap

    The experience was so seamless that I actually worried something was wrong. What if I didn’t insert the swab high enough? I wondered when I got home. Would the results of the test still be reliable if, God forbid, I did not rotate it long enough? It almost felt too comfortable, so how effective was it really? Many women share the same concerns, but they don’t need to worry, said Jasmin Tiro, a professor of public health sciences at the University of Chicago.

    Many women who use the test say it’s easy to do and doesn’t hurt, Tiro said, adding: “It’s very hard to do it wrong.”

    It’s important to clarify that the self-collected HPV test is not the exact same test as a Pap smear or a clinician-collected HPV test, she said. The self-test collects vaginal cells, while the latter two tests use a sample of cervical cells. While a cervical sample can be tested for both HPV and abnormal cells (cancerous or precancerous), vaginal cells can only reveal if you have HPV, Tiro said.

    This means that a self-collected test may be only one part of the screening process, Tiro said. About 10% of women will screen positive for HPV, she said. If you get a positive HPV self-collected result, the next step may be a type of test or procedure that involves a pelvic exam to look for precancerous or cancerous cervical cells. That follow-up test is essential for the screening process to be effective, Tiro said.

    However, HPV does not always turn into cervical cancer; especially in people in their teens or early 20s, the virus often clears on its own without causing any health issues — which is why screening isn’t even recommended before 25. So depending on your age, your doctor may just want to retest you a few years later to see if you still have an HPV infection and determine then if that warrants further testing.

    My takeaway: We need to make screening more accessible

    I’m grateful for testing that is less invasive and painful, but I still find myself wondering why it took so long for us to arrive here. How many women would have been protected if our pain and concerns were not routinely diminished? In the past, I had doctors tell me, “Since you’ve had sex before, the speculum shouldn’t feel intimidating.” I became so used to people, including well-meaning physicians, questioning the validity of my pain. And I felt demoralized that I couldn’t even complete a test that was essential for detecting and preventing a disease that kills about 4,000 women in the U.S. each year.

    I also wonder what, if anything, can be done to ensure the new self-swab testing is accessible to all women who want or need it? When I asked Tiro, she told me that gathering more patient testimonials, developing patient-centered guidance for people who may still not want to complete the test, and devoting more research to the testing can all help. These are all things that physicians and researchers are actively working on.

    Personally, the self-collected HPV test has given me a sudden sense of agency, something I have rarely felt in a gynecologist’s office. My hope is that this alternative option can give other women greater control over their healthcare, too. Cervical cancer screening is an essential preventive care service. If you have trouble undergoing a Pap smear, ask for the alternative self-collection test. There is no shame, only power, in advocating for your health.

  • Lee Hamilton, foreign policy leader in Congress, has died at 94

    Lee Hamilton, foreign policy leader in Congress, has died at 94

    Lee H. Hamilton, a deliberative, soft-spoken Indiana Democrat who won bipartisan respect for his integrity and foreign policy expertise during 34 years in the U.S. House of Representatives, and who later helped steer high-profile inquiries into the 9/11 terrorist attacks and Iraq War strategy, died Feb. 3. He was 94.

    His son, Douglas Hamilton, confirmed the death but did not cite a specific cause.

    Mr. Hamilton, who was first elected to the House in 1964, became a prominent voice in some of the most contentious foreign policy debates of his era.

    The son of a pacifist Methodist minister, he helped lead an unsuccessful effort in 1991 to block President George H.W. Bush’s use of the military to drive Iraq from Kuwait. During the Reagan administration, the congressman had forcefully opposed military aid for the anti-communist Contra rebels fighting to overthrow Nicaragua’s left-wing Sandinista government.

    An all-state Hoosier high school basketball star, he maintained the lanky build and crew cut of his youth into his senior years. He also maintained a middle-of-the-road voting record that reflected the largely rural, small-town slice of southern Indiana he represented.

    He was measured in tone and language, almost professorial in manner — the antithesis of the stereotypical backslapping, lectern-thumping politician.

    “Lee Hamilton is a thinker, which makes him a little different,” political commentator Chris Matthews, then an aide to Speaker Thomas P. “Tip” O’Neill Jr. (D., Mass.), told the New York Times in 1984. “He makes his case logically, deductively. He’s not the kind of visceral politician you see around here.”

    At the time, Mr. Hamilton chaired the Europe and Middle East subcommittee of the House Foreign Affairs Committee and was O’Neill’s point man in pushing the Reagan administration to withdraw U.S. peacekeepers from Lebanon after the terrorist bombing in Beirut that killed 241 American service members. He later chaired the full Foreign Affairs and Intelligence committees.

    Mr. Hamilton advocated an activist role for Congress in shaping foreign policy and cautioned lawmakers against ceding all responsibility for military intervention to the president.

    The proper boundary between the executive and legislative branches was at the heart of the Iran-Contra affair, which raised Mr. Hamilton’s profile somewhat beyond Capitol Hill.

    After disclosures that the Reagan administration had diverted profits from the secret sale of weapons to Iran to fund the Nicaraguan rebels, then-Speaker Jim Wright (D., Texas) appointed Mr. Hamilton to head a special House committee to investigate the clandestine arrangement, which was designed to circumvent Congress’ ban on funding of the Contras.

    In 1987, Mr. Hamilton’s committee and a Senate panel chaired by Democrat Daniel K. Inouye of Hawaii held 41 days of televised hearings. The two key players, Vice Admiral John Poindexter, Reagan’s national security adviser, and an aide, Lt. Col. Oliver North, were unrepentant when they appeared, insisting that the covert program was in the national interest.

    Blaming the scandal at least in part on Congress’ “fickle, vacillating, unpredictable, on-again-off-again policy” toward the Contras, North told the committees: “The Congress of the United States left soldiers in the field unsupported and vulnerable to their communist enemies. . . . I am proud of the efforts that we made, and I am proud of the fight that we fought.”

    Mr. Hamilton’s reply was polite and stern. “I cannot agree,” he said, “that the end has justified these means, that the threat in Central America was so great that we had to do something even if it meant disregarding constitutional processes [and] deceiving the Congress and the American people.”

    He concluded: “Democracy has its frustrations. You’ve experienced some of them, but we — you and I — know of no better system of government. And when that democratic process is subverted, we risk all that we cherish.”

    In the end, the two committees found no conclusive evidence that Reagan was aware of the diversion. But their majority report concluded that laws had been disregarded and that the president “created or at least tolerated an environment where those who did know of the diversion believed with certainty that they were carrying out the President’s policies.”

    North and Poindexter were later found guilty of criminal charges stemming from the Iran-Contra affair, but their convictions were overturned on appeal.

    In an interview for this obituary in 2016, Norman Ornstein, a political scientist at the American Enterprise Institute, called Mr. Hamilton “one of the premier legislators of his time.”

    At least two Democratic presidential candidates, Michael Dukakis in 1988 and Bill Clinton in 1992, considered Mr. Hamilton as a running mate. His less-than-lively style and his record on some social issues — most noticeably, his opposition to federal funding of abortions except in cases of rape, incest or a threat to the mother’s life — may have hurt his chances.

    Mr. Hamilton did not seek reelection in 1998, but his career in elective politics proved to be only a first act. The second was a run of leadership roles in public policy and academic undertakings that cemented his standing as one of Washington’s elder statesmen.

    In 2002, he was named vice chairman of the 9/11 Commission, an independent, bipartisan panel created by Congress and the White House to examine the terrorist attacks a year earlier on the World Trade Center and the Pentagon.

    Chaired by former New Jersey Gov. Thomas Kean, a Republican, the 10-member group issued a unanimous report in 2004 identifying a raft of government shortcomings that contributed to the 9/11 disaster and 41 recommendations to prevent a recurrence. The report led to a number of changes in national security policies and organization, including the creation of a new position — director of national intelligence — to unify the intelligence community.

    Though the commission was not without critics, Kean and Mr. Hamilton, who worked essentially as co-chairs, got high marks for steering the investigation through a political minefield and producing a document that had the backing of all commission members, Republicans and Democrats.

    Mr. Hamilton returned to the limelight in 2006 as co-chair, with former secretary of state James A. Baker III, of the Iraq Study Group, a bipartisan panel organized by the U.S. Institute of Peace to propose strategies to stabilize Iraq, where sectarian violence was taking an increasing toll in American and Iraqi lives three years after the U.S.-led invasion.

    Among its 79 recommendations, the 10-member group called for boosting diplomatic efforts in the region, including engaging Syria and Iran, and increasing the number of American troops embedded in Iraqi units for training purposes while gradually decreasing the strength of U.S. combat forces.

    In part because of Baker’s close connection to the Bush family, the panel’s work drew significant media attention. But in January 2007 — in what then-Vice President Dick Cheney later described as a “repudiation of the Baker-Hamilton report” — President George W. Bush announced the deployment of more than 20,000 additional U.S. troops to Iraq to provide security, mainly in Baghdad. The surge would buy time for the Iraqi government to strengthen its military capacity, the administration argued.

    In 2015, President Barack Obama awarded Mr. Hamilton the Presidential Medal of Freedom, the nation’s highest civilian honor. The White House announcement called him “one of the most influential voices on international relations and American national security over the course of his more than 40-year career.”

    Lee Herbert Hamilton was born in Daytona Beach, Fla., on April 20, 1931, and as a child, he moved with his family to Evansville, Ind., where his father had a church assignment.

    He graduated in 1952 from DePauw University and completed a law degree at Indiana University in 1956. He was a lawyer in Columbus, Indiana, when he got involved in politics, and in 1964, he rode President Lyndon Johnson’s coattails to victory over an incumbent GOP congressman. Except for a close call in the GOP landslide of 1994, he repeatedly won reelection by comfortable margins.

    His wife of 57 years, Nancy Nelson, died in a car accident in 2012. In addition to his son, Douglas, survivors include two daughters, Tracy Souza and Deborah Kremer; five grandchildren; and a great-granddaughter.

    After leaving Congress, Mr. Hamilton was president for more than a decade of the Woodrow Wilson International Center for Scholars in Washington. He also directed what is now the Center on Representative Government at Indiana University in Bloomington and wrote books on Congress and international affairs.

    When Mr. Hamilton left the Wilson Center in 2010 and was preparing to move back to Indiana, an NPR interviewer asked him what he had learned over his many years in public life.

    “I think that you come filled with ambition and drive and energy and wanting to accomplish great things, and you find the system is very hard to move, to make it work,” Mr. Hamilton replied. “I think what has impressed me over the years is the sheer complexity and difficulty of governing this country.”

  • Myra MacPherson, trailblazing Washington Post journalist, has died at 91

    Myra MacPherson, trailblazing Washington Post journalist, has died at 91

    Myra MacPherson, a wide-ranging feature writer for the Washington Post’s Style section and an author whose books included a study of the competing demands of politics and marriage among power couples in Washington and a volume on the enduring traumas of the Vietnam War, died Feb. 2 in hospice in Washington. She was 91.

    The cause was congestive heart failure, said her son, Michael Siegel.

    When Ms. MacPherson applied for her first journalism job in 1956, with ambitions to cover major news stories, an editor at the Detroit Free Press informed her that he had no openings on the women’s page.

    “I said I wasn’t considering the women’s department,” she recalled, “and he looked at me as if I had said I just shot my mother or something. He said, ‘We have no women in the city room.’”

    She spent the early 1960s relegated to women’s issues and society coverage at the Washington Star and the New York Times before the Post’s top editor, Ben Bradlee, poached her in 1968 for a new features section called Style. She was promised a freewheeling mandate to cover contemporary affairs and personalities with the irreverent verve of a glossy magazine.

    Assigned to cover the New York Mets in 1969, the year the team won the World Series for the first time, Ms. MacPherson was denied the full access granted to her male colleagues, and she wrote a scathing story about “being treated like a non-eunuch in a harem.”

    As she recounted decades later in a letter to the Times, a columnist griped to her: “The next thing, you girls are going to want to get into the locker room.”

    “We don’t want to use the urinals,” Ms. MacPherson said she replied, “just the typewriters.”

    Her first book, The Power Lovers (1975), was an unblinking look at the pressures of Washington marriages. “I am his mistress,” Marian Javits, the wife of Sen. Jacob K. Javits (R., N.Y.) told her. “His work is his wife.”

    Ms. MacPherson conceived her book about Vietnam after watching the 1979 TV movie Friendly Fire. As a mother, she said, she was deeply moved by Carol Burnett’s performance as the grief-stricken parent of a dead Vietnam War soldier.

    “When I watched the show, I realized that I didn’t know anyone in Washington who had a son in combat,” she recalled in an interview with California’s Riverside Press-Enterprise. “The sons I knew were mostly those who had escaped to college, gone into the National Guard or who had protested the war.”

    The damage done by the Vietnam War was still fresh and in many circles was not a welcome subject for discussion when Ms. MacPherson began writing what became Long Time Passing: Vietnam and the Haunted Generation (1984).

    Long Time Passing examined the war and its aftermath through the lives of hundreds of people profoundly affected by the conflict.

    Ms. MacPherson included the perspectives of nurses, mothers, and wives as well as servicemen — some of whom said they were proud of what they did and some who said they were ashamed of it or traumatized by it. Some said they were deserters.

    She also interviewed historians and psychologists, and she helped bring the concept of posttraumatic stress disorder to wider attention. In its best passages, author Donald Knox wrote in his Times review, the book “sings, soars, explodes with feeling” and “shines a powerful light on the differences that divide this generation.”

    Myra Lea MacPherson was born in Marquette, Mich., on May 31, 1934, and grew up in Belleville, a town of 800 between Detroit and Ann Arbor. Her father worked for the camera company Argus, and her mother was a homemaker.

    Ms. MacPherson was editor in chief of her high school newspaper, and she became night city editor of the student newspaper at Michigan State University in East Lansing. She graduated in 1956 with a degree in journalism.

    After compiling the TV listings at the Free Press, she left for the Detroit News, where her professional experience improved, to a point. Assigned to cover the Indianapolis 500 in 1960, she said, she was the only female reporter at the race. She was denied access to the press box and the speedway’s Gasoline Alley, where drivers and their crews worked, and had to conduct interviews through chain-link fences along the track’s periphery.

    Her first marriage, to Washington sportswriter Morris Siegel, ended in divorce. In 1987, she married Jack Gordon, a liberal Democratic state senator from Miami Beach whom she met years earlier when covering an Equal Rights Amendment convention in Tallahassee. She and Gordon moved to Palm Springs, Calif., in 2001, but maintained a home in Washington. He died four years later after being struck by a car.

    Her daughter, Leah Siegel, a sports producer at ESPN, died of breast cancer in 2010. Survivors include her son, Michael Siegel, and three grandchildren.

    Ms. MacPherson, who left the Post in 1991, spent years contributing articles to Vanity Fair and other publications. Her books included She Came to Live Out Loud (1999), a look at dying and grief from the viewpoint of a woman diagnosed with breast cancer at 37; All Governments Lie (2006), a biography of the left-wing independent journalist I.F. Stone; and The Scarlet Sisters (2014), a dual biography of two fiercely independent 19th-century siblings, Victoria Woodhull and Tennessee Claflin.

    “I would definitely like to think I would have been out blazing a trail in Victorian times, probably in the liberal wing of the suffragist movement and also in journalism,” Ms. MacPherson told the website Edwardian Promenade, reflecting on her last book.

    “When I sought my first newspaper job, there were no women covering anything but society news, fashion,” she added. “I fought my way out of that niche and was one of the few women covering regular news. I don’t know if I could take the pummeling the sisters [Woodhull and Claflin] did, but in a much lesser way, women in the ’60s and ’70s were breaking new ground and I was among them.”