By Megan R. Wilson

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In today’s issue:

• Senators push the Trump administration to free up vaccine funds that Congress approved
• Supreme Court allows consumers to keep getting the abortion pill through the mail for now
• How we got here, and where we’re going with psychedelic drug regulation

Good afternoon, and welcome to the Health Brief newsletter. Congress is gone, and our amazing regular Health Brief writer Megan Wilson is finally getting a well-deserved vacation. We will publish today and Wednesday this week.

I’m Rebecca Adams, the lead health care analyst at WP Intelligence. Send your news tips and guesses about what drink Megan is enjoying at the beach my way at rebecca.adams@washpost.com, or on Signal at RA912.94.

Programming notes: WP Intelligence is at the Milken Institute’s Global Conference 2026 in Los Angeles held Sunday to Wednesday this week. You can watch the livestreams here. WPI Deputy Editor Yun-Hee Kim is moderating a discussion on the future of AI investments, which you can watch here.

And: WP Intelligence will be on stage at the AI+Expo conference in Washington, D.C., later this week. Come see us! You can register for free here. Catch me interviewing National Coordinator for Health IT Tom Keane, former Food and Drug Administration acting commissioner Janet Woodcock and CVS Health Chief Information Security Officer Alan Rosa in three fireside chats on Friday morning.

Other sessions my colleagues are moderating include one on the future of work, featuring WP Intelligence Editorial Director Luiza Savage and panelists including acting secretary of labor Keith Sonderling.

Health and Human Services Secretary Robert F. Kennedy Jr. testifies during a Senate committee hearing on April 22, 2026 in Washington, D.C. Senate appropriators raised concerns about Kennedy's refusal to send out congressionally approved vaccine funds. (Maxine Wallace/The Washington Post)

	The Lead Brief

Senate Appropriations Committee Chairwoman Susan Collins (R-Maine), supported by a group of other Republican and Democratic senators, is pressuring the Trump administration to stop blocking two years of global vaccine funding that Congress approved.

Lawmakers including former Senate majority leader Mitch McConnell (R-Kentucky), Lisa Murkowski (R-Alaska) and Patty Murray (D-Washington) asked in a letter to Secretary of State Marco Rubio why the department has not used a total of $600 million approved in fiscal years 2025 and 2026 for Gavi, the Vaccine Alliance.

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The vaccine alliance “plays a critical role in averting the spread of preventable diseases around the globe, and helps protect public health in our country by stopping outbreaks before they reach our borders,” the bipartisan group wrote. 

Senators said Gavi has prevented 20.6 million deaths since its inception in 2000. Congressional support endures “because of its proven success as a public-private partnership,” the letter said.

The lawmakers said that the vaccine funding supports American jobs since the alliance buys more than $12.5 billion in U.S. goods and services.

What’s next? Rubio is expected to testify before the House Appropriations Committee in the coming weeks before the panel plans to vote on its fiscal 2027 bill in June.

By the numbers: Gavi’s funding has not grown much in recent years. In the fiscal years 2018 through 2023, Congress provided $290 million per year.

In fiscal 2024, that grew to $300 million. Congress appropriated $300 million for the 2025 and 2026 fiscal years, but the administration did not send out that money, which expires on Sept. 30.

The House Appropriations Committee approved a bill that would give another $300 million in funds for fiscal 2027.

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Gavi’s funding to lower- and middle-income countries comes from governments, private organizations and individuals — including the United Kingdom, the United States, Norway and the Gates Foundation — according to the nonpartisan health policy news, polling, and policy organization KFF.

The U.S. pledged in 2024 to give almost $1.6 billion over five years, about 13 percent of the vaccine alliance’s funding through 2030.

The administration’s refusal to provide the vaccine funding that Congress approved stems from concerns by Health Secretary Robert F. Kennedy Jr., including over the use of vaccines containing thimerosal, a preservative that inhibits the growth of bacteria. 

The Centers for Disease Control and Prevention calls thimerosal safe, but it was largely phased out in U.S. vaccines.

Gavi still uses multidose vaccines containing thimerosal, in some cases for practical reasons in low-income nations: The multiple-dose vials require less refrigeration space.

• Kennedy’s perspective: Gavi has not provided “the specific data, studies, or detailed accounting of how U.S. funds are used, and has declined to develop a plan to phase out thimerosal-containing vaccines despite a formal request,” said HHS spokesman Andrew Nixon in a statement. “As a result, the United States will withhold new funding and pause access to [Development Finance Corporation] financing until these concerns are addressed … . The United States is calling on Gavi to address these issues and strengthen public trust; until then, U.S. financial contributions will remain paused.”
• The vaccine alliance’s view: It’s not easy to remove the vaccines, according to a Gavi spokesperson. “Any decision to remove vaccines from the portfolio would require a decision from Gavi’s board, which in the past the U.S. has always been represented on,” said Gavi spokesperson Olly Cann.

If the organization received the promised U.S. funding, Gavi would be able to invest in two new vaccines that offer greater protection and do not contain thimerosal, Cann said.

“Difficult decisions have had to be made” without the funds, Cann said. Cuts include funds for emergency vaccine stockpiles against diseases such as Ebola, cholera and meningitis. The group is also limiting prevention campaigns and vaccination against diseases such as malaria.

No conversations between Gavi and the administration are scheduled.

Packets of Mifepristone, the abortion pill. (Paul Ratje/For The Washington Post)

	Litigation Report

In the next round in the fight over the abortion pill, Supreme Court Justice Samuel A. Alito Jr. issued an order Monday temporarily allowing consumers to continue using the mail to get the pill through May 11, according to a story by Washington Post reporters Praveena Somasundaram, Justin Jouvenal and Julian Mark.

The decision came after two drugmakers filed emergency appeals to the high court on Saturday. They challenged a U.S. Court of Appeals for the 5th Circuit ruling that reinstated a requirement that the drug, mifepristone, can only be picked up in person.

Danco Laboratories, the maker of the drug, and GenBioPro, which makes a generic version, both asked the high court to pause the lower court’s ruling that made it harder for patients to access pills.

Danco called the 5th Circuit’s order “unprecedented.”

The state of Louisiana had sued the FDA after the agency allowed patients to access pills through telehealth and mail. Alito asked for a response by Thursday.

Also on Monday, officials from nearly two dozen states filed an amicus brief to the Supreme Court, asking for the 5th Circuit’s ruling to be stayed.

Pills are now the most common method of abortion in the U.S. Abortion opponents have been frustrated that the number of abortions did not decline after a 2022 Supreme Court ruling striking down the nationwide right to an abortion.

	Agency alert

The White House’s executive order on psychedelic drugs on a Saturday last month may have seemed abrupt and unlikely for the party that brought us the Nixon-era “war on drugs” and former first lady Nancy Reagan’s anti-drug Just Say No campaign.

Podcast host Joe Rogan had texted President Donald Trump about the benefits of a psychedelic known as ibogaine, and said the president responded right away: “Sounds great. Do you want FDA approval? Let’s do it.”

Standing in the Oval Office behind Trump weeks later, as the April 18 executive order was announced, Rogan said, “It was literally that quick.”

But the issue was discussed behind the scenes for months, reports my colleague Rachel Roubein in a new article out today. When announcing the changes, Trump clarified that he asked Kennedy to check out the suggestion. And traditional Republican allies, such as veterans, have been building support for years.

Rachel traced how the Republican Party, which traditionally viewed illicit drugs through a tough-on-crime lens, evolved in recent years as veterans that have clout with the GOP touted psychedelics as a way to mitigate post-traumatic stress disorder, depression and other mental health issues. 

Kennedy has said he became open to some psychedelic use because he believes the psychoactive ayahuasca plant mixture helped his son process his mother’s suicide.

Rachel’s story explores how Rogan’s request originated. Former Texas governor Rick Perry (R), who also was energy secretary during Trump’s first term, and ibogaine advocate W. Bryan Hubbard appeared on Rogan’s podcast in late March. Hubbard asked Rogan to arrange a White House meeting, and Rogan’s appeal then began.

• The details: Trump’s executive order tasks the Food and Drug Administration with granting certain psychedelics a fast review of about one to two months, and giving some patients the right to try them. It also provides at least $50 million in federal funds to states with programs using psychedelics for mental illness treatment.
• White House view: “A growing body of recent evidence suggests that psychedelics could have great potential to help veterans and patients,” White House spokesman Kush Desai said. “The president’s executive order did not endorse psychedelics but recognized this evidence to open the door to more research.”

Who wins? The multibillion-dollar psychedelic industry is growing rapidly. Following the executive order, three companies — two studying psilocybin (“magic mushrooms”) for depression and another studying methylone for PTSD — won vouchers from the FDA under the FDA Commissioner’s National Priority Voucher pilot that launched last year. That doesn’t ensure the drugs’ approval but rather expedites regulatory reviews. The companies are Compass Pathways, the Usona Institute and Transcend Therapeutics.

Looking ahead: The agencies are moving quickly.

Because the drugs are controlled substances, the Drug Enforcement Administration also has to sign off. Under a 2015 law speeding up agency action, scheduling changes move forward when the Health and Human Services Department tells DEA that an application for a new drug with the potential for abuse was submitted, and the HHS secretary recommends that DEA regulate it under a category that is not the most restrictive one.

How fast? The DEA has to act within 90 days following a two-part process. The clock starts either when DEA receives an HHS evaluation and scheduling recommendation, or when DEA receives notice that the drug was approved, whichever is later.

And that means: A psychedelic drug could be on the market by the end of the year or early next year, if there are no hiccups and manufacturers give the administration all the information needed to show that the drugs are safe and effective.

Ibogaine did not get a fast-track FDA voucher. But, for the first time, the FDA is allowing an early-phase study in the U.S. of an ibogaine derivative. The company behind it, DemeRx NB, is developing it as a potential alcohol use disorder treatment.

Industry-wide: Soon the FDA plans to release final clinical trial guidance to companies developing these products. The White House began reviewing the guidance on April 17.

	What We’re Reading

• “The Quest to Use AI to Help Find New Drugs” by the Wall Street Journal’s Peter Loftus.
• “Supreme Court turns down COVID-19 vaccine case brought by John Stockton” reports Amy Howe for SCOTUSblog.
• “Senators Urge Rubio to Restore Global Vaccine Campaign Support,” Bloomberg Government’s Zach C. Cohen reports.
• A Long, Strange Trip: How the G.O.P. Came to Embrace Psychedelic Drugs” writes Andrew Jacobs for The New York Times.

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