2026-03-13 19:00:00
This story was originally published by Grist and is reproduced here as part of the Climate Desk collaboration.
Up until the end of February, a steady flow of ships bound for destinations across the world would pass daily through the Strait of Hormuz. A narrow channel running between Oman and Iran, the waterway serves as the only natural maritime link between the Persian Gulf and the global economy. That all changed on March 2, when, after days of military strikes led by the US and Israel, Iran effectively closed the strait for the first time in history and warned that any ships passing through would be fired upon. Ever since, vessels moving through the channel have been attacked and set ablaze, and hundreds of tankers remain stranded. At least 1,800 people have been killed in the war, including Iran’s Supreme Leader Ayatollah Ali Khamenei and other top government officials.
The Persian Gulf is a linchpin of the planet’s oil and gas production; normally, roughly one-fifth of global oil and gas flows through the strait. Now, as it remains embattled, oil and gas prices have surged, and many experts warn an energy crisis is imminent. Restaurants across India are scaling back operations and warning of closures amid fuel shortages from the maritime blockade, while cooking gas prices are spiking in Sri Lanka.
Another world crisis sparked by the war in Iran may also be in the offing. That’s because the region’s oil and gas production has made it one of the world’s leading exporters of nitrogen fertilizers, which are indispensable to the global food system. To produce the chemicals used to grow much of the planet’s crops, natural gas is broken down to extract hydrogen, which is combined with nitrogen to make ammonia, and then mixed with carbon dioxide to make urea. All told, nearly a third of the global trade for nitrogen fertilizer passes through the Strait of Hormuz, while almost half of the world’s sulfur, essential in producing phosphate fertilizers, also travels through the corridor.
The waterway is a lifeline for food, too. Palm oil exports coming from Southeast Asia face potential major disruptions. Grain shipments headed to Gulf countries reliant on rice and wheat imports have been stalled.
“A worrying amount of food, or inputs into modern agriculture, are going through this very small channel,” said Ginni Braich, a data scientist who studies food insecurity at the University of Colorado Boulder’s Better Planet Laboratory. She estimates that the strait is in the top 20th percentile of all the world’s transportation corridors just based on the sheer volume of food that passes through it. The sudden and cascading effects of trade halting through the waterway, according to Braich, “really underscores how interconnected everything is, and how fragile … just any small amount of disruption can have huge aftershocks that reverberate all around the world.”
The timing, Braich said, could not be worse, as spring planting in the northern hemisphere — crop farmers’ biggest season — is approaching. “So, basically, vessels that were leaving the Middle East today would be arriving in mid-April,” she said. “Now, the fact that obviously nothing is leaving means that there’s going to be a large hole in the market for fertilizer.”
If the war persists, experts warn that the drop in supply and the increase of cargo insurance premiums and freight rates could raise prices for everyone along the supply chain. Unlike with oil, there is no meaningful strategic reserve for nitrogen-based fertilizer, so there’s no equivalent stockpile to help buffer the shocks. While the US does produce some of its own fertilizer, domestic producers cannot rapidly replace millions of tons of fertilizer supplies. Other countries more reliant on fertilizer imports from the Middle East, such as India, will be hit hard by the cessation of traffic on the strait. China, Indonesia, Morocco, and several sub-Saharan African nations are also expected to be affected by the global gridlock of sulfur exports flowing from the Gulf.
Moreover, Braich warned, any prolonged increase in shipping and inventory costs “is going to be felt by the consumer.”
For some, the impact is already here. Prices for key fertilizer products are up because of the war and are expected to squeeze growers’ profit margins — which could lead farmers to ration fertilizer use, reducing yields, or even to shift from planting input-intensive crops. US Agriculture Secretary Brooke Rollins told reporters in Atlanta, Georgia, on Tuesday that the Trump administration was “looking at every possible option” to address “skyrocketing” fertilizer costs for US farmers “based on actions on the other side of the world.”
About 4 billion people on the planet eat food grown with synthetic nitrogen fertilizers. Roughly half of the global population, in other words, is alive because of these chemicals converted into nutrients for plants, said Lorenzo Rosa, who researches sustainable energy, water, and food systems at the Carnegie Institution for Science at Stanford University.
Of course, the fact that natural gas is the key to mass-producing synthetic fertilizers carries its own terrible climate implications. Together, manufacturing and applying synthetic fertilizers to fields and farms accounts for over 2 percent of global greenhouse gas emissions — just about equal to the CO2 emissions from global aviation. There are low-emissions alternatives to this process, Rosa argued: Nitrogen could be recycled from waste, and natural gas plants could be powered by local or renewable energy sources and built closer to the farms that require fertilizer.
Normally, the fossil fuel-based, centralized — and, thus, fragile — supply chain for fertilizer and food is far cheaper than its alternative. But major shocks like the US-Israel war against Iran expose the dangerous vulnerability of that system, as efficient and financially sound as it may be. “At some point, a country will have to decide: ‘Do I want the cheap fertilizer, importing it from the Strait of Hormuz or another country? Or do I prefer to pay a green premium and have my own domestic production and energy and food security?’” said Rosa.
Rollins acknowledged this vulnerability in Tuesday’s press conference. “We are getting almost all of our urea, almost all of our phosphate, almost all of our nitrogen from other countries around the world, and that has to stop,” she said.
The catch, however, is that decentralizing this supply chain could inadvertently create a green divide — splitting the world between the nations and farmers who can afford domestically produced fertilizer and those who can’t. Many countries confronting widespread famine in Africa, for instance, already pay the highest fertilizer prices in the world and are unable to withstand further inflation.
“There are many stops along the way from closing the Strait of Hormuz to a child in Malawi being fed,” said Cary Fowler, president of the nonprofit Food Security Leadership Council and former US special envoy for global food security in the Biden administration. “The clear thing is that those two things are connected.”
The same countries that stand to face the most harmful food security effects because of the conflict in Iran are also the ones struggling to feed their citizens following the collapse of global food aid after President Donald Trump dissolved the US Agency for International Development, or USAID, last year. Emergencies like these are where the international community’s response becomes increasingly important, Fowler said.
Besides the dissolution of USAID, which halted international research efforts and initiatives to improve farming practices in lower-income nations, the UN’s World Food Programme has in recent months sounded the alarm over historically low donations from the US and other major Western donors.
“If we don’t invest in that sustainable productivity growth, then we put ourselves in a situation where we’re going to need a lot more humanitarian aid, particularly when there’s flare-ups like we’re experiencing now,” said Fowler. “And that gives us another choice — whether to provide that humanitarian aid or not. And that’s a choice of whether we want to, at least in the short term, solve the problem. Or do we want to watch children starve to death on TV?”
It’s not clear how long the strait will remain closed, although Trump has swung between stating the war with Iran could stretch on through April, if not longer, and declaring it nearly done. Last week, the president announced that the US might begin to escort oil tankers through the embattled channel. “No matter what, the United States will ensure the FREE FLOW of ENERGY to the WORLD,” Trump wrote on social media, before later declaring “death, fire, and fury” if Iran continues its shipping blockade. On Sunday, he told Fox News that ships holding there should “show some guts” and push through the strait.
The president made no mention of fertilizer — or food.
Rahul Bali of WABE, Atlanta’s NPR station and a Grist partner, contributed reporting.
2026-03-13 18:30:00
Think about the disease that worries you most — the one that runs in your family. Or maybe someone you love is living with it. Whether that’s cancer, Alzheimer’s, diabetes, or depression, odds are the US government has been funding the research to treat it.
That research is a big reason we have drugs that made fatal blood cancers survivable, treatments that turned HIV from a death sentence into something people live full lives with, and a vaccine that all but prevents cervical cancer.
But last year, the US funded dramatically fewer grants to do medical research that can lead to breakthroughs like those. New data released by the NIH this week shows how the damage from those cuts broke down.
The numbers are striking across the board.
New grants for Alzheimer’s and aging research were cut in half — from 369 in 2024 to 177, all while the US population is rapidly aging. Mental health research grants fell by 47 percent. And new grants for cancer research fell by 23 percent — even as cancer rates are rising sharply among Gen X and millennial Americans. Across all areas, the NIH went from funding roughly 5,000 new research grants in 2024 to just 3,900 in 2025.
“This is the worst year I’ve ever seen, probably going back to the 1980s,” said Jeremy Berg, who led the National Institute of General Medical Sciences, one of NIH’s largest institutes, from 2003 to 2011.
The NIH’s funding system was already under strain — too many researchers were chasing too few research dollars. That has always meant that the most ambitious and most unconventional ideas struggle to get funded.
But the Trump administration’s policy decisions have made that problem dramatically worse in just a single year.
The NIH funds research through federal grants. Scientists across the country submit their proposals, a panel of outside experts scores and ranks them, and then each NIH institute — each focused on a different area of medicine — funds as many top-scoring proposals as its budget allows. In a normal year, about 5,000 new grants get funded.
Last year, one policy change did more to shrink that number than almost anything else.
In July 2025, the White House Office of Management and Budget required NIH to start paying the full cost of approved grants upfront — all at once, instead of paying year by year, as it has for a very long time. In principle, funding grants upfront makes them less vulnerable to future budget cuts.
But here’s the problem: When NIH funds a research project, it’s typically a commitment that stretches three to five years. That means in any given year, about 80 percent of the agency’s budget is already spoken for — paying for grants it promised in previous years. Only the remaining 20 percent of the budget is available to fund new research.
When the agency has to pay the full cost of every multiyear grant up front, that means each new grant costs several times more than it used to. Michael Lauer, who oversaw NIH’s grant-making for nearly a decade before leaving the agency in early 2025, put it simply: “Instead of funding five grants, you now only fund one, and that means four other grants that would’ve been funded don’t get funded.”
Berg, the former NIH institute director, estimates this single change wiped out roughly 1,000 new grants.
But it wasn’t the only factor. The Trump administration also terminated thousands of existing grants over the past year — something Lauer said he had seen happen only twice in his entire 18-year tenure at the agency. The leftover money from those terminations went to the US Treasury, not back to NIH. Berg estimates that roughly $500 million left the system this way.
On top of that, about 12 percent more grant applications were submitted in 2025 than in 2024, all competing for the shrinking pool of funds.
The Trump administration has been open about wanting a smaller NIH; it proposed cutting the agency’s budget for 2026 by 40 percent, though Congress has not enacted that cut. At the same time, the White House has pushed policy changes it says are aimed at restoring accountability at NIH — but the effect of those changes has been to shrink the agency.
“I think it’s pretty easy to start to wonder if there is some connection between those two things,” Carrie Wolinetz, a former senior NIH official, told STAT News.
The NIH did not respond to specific questions about the institute-level declines, or what happened to the money from terminated grants.
With fewer grants to go around, you might think the system is just getting more selective — funding just the best ideas and cutting the rest. But that’s actually not how it works.
Philippe Aghion, the economist who shared last year’s Nobel Prize, found that past a certain point, more competition actually stifles innovation rather than spurs it. When NIH can only fund the top 5 or 6 percent of proposals, what survives is good but conservative science — established labs extending well-established research.
“The main thing you’re giving up there is new ideas,” Berg said.
Researchers in the UK recently discovered that people vaccinated against shingles had a roughly 20 percent lower risk of developing dementia seven years later. That finding came from a natural experiment in Wales, where people born before a certain date weren’t eligible for the vaccine and those born after were — and the group that got the vaccine had lower rates of dementia.
Understanding why a shingles vaccine works against dementia, and whether it could lead to new ways to prevent dementia, is the kind of exploratory research that would now struggle to get funded.
Katalin Karikó, who won the 2023 Nobel Prize in medicine for the mRNA work behind the Covid vaccines, had her grants repeatedly rejected long before the Trump cuts. The window for unconventional ideas was already narrow. Now it’s narrowing even further.
And much of the damage could prove permanent. When funding dries up, researchers leave — for other countries, for the private sector, for careers outside science altogether. “Researchers who leave the field or the country to work elsewhere are unlikely to return,” said Joshua Weitz, a University of Maryland professor who tracks science funding.
There are early signs that 2026 could get even worse for medical research. The White House budget office has delayed NIH from spending its 2026 funding, even after Congress approved it, and the NIH has made roughly a third as many new awards as it typically would by this point in the year.
The hardest thing to measure, Berg said, is the research that never got a chance to begin. “It’s much more like we set out across the ocean to see what we could discover and the voyage was canceled. There might be some beautiful island out there of incredibly important stuff, but we’re never going to know about it.”
2026-03-13 18:00:00
On Wednesday, the New York Times published the preliminary findings of a US investigation into the recent airstrike on Shajarah Tayyebeh, an elementary school for girls in the Iranian city of Minab. The investigation confirmed what all public evidence had pointed to: that an American Tomahawk missile destroyed the school, killing roughly 175 people per Iranian estimates — most of whom were children.
Alongside the article, the Times posted a verified video from the school in the hours following the bombing. You can see, on the remains of the building’s outer wall, a light blue mural depicting a child playing with a butterfly. You can hear, in the video’s audio, the inhuman wails of someone who had just lost a child dear to them.
The day after this damning news report, the White House released a video depicting the Iran war as a Nintendo game.
The video, set to jaunty childlike music, depicts the United States as a player in various Wii Sports games — tennis, golf, bowling, etc. When the player character hits a hole in one, or bowls a strike, it cuts to real-life footage of a US bomb hitting an Iranian target. “Hole in one!” the Nintendo announcer declares, as we watch human lives being erased.
The video’s overtly childish imagery would be appalling at any point. In the wake of the news about Sharajah Tayyebeh, it approximates a form of moral horror. Yet it is what we have come to expect from the Trump administration, which has been releasing this sort of trivializing propaganda throughout the war.
Various official X accounts have posted videos intercutting real bombings in Iran with clips from more violent video games, war films like Braveheart, sports highlights, and speeches from Secretary of Defense Pete Hegseth set to movie-trailer-style epic music.
War is not hell, for this White House — it is fun.
In some ways, this is not a surprise. The Trump administration is staffed, from top to bottom, by inveterate posters. They have turned everything — from the end of foreign aid to ICE raids — into memes. Why treat war any differently?
But war, and the school attack in particular, illustrate the pernicious function of this method of governance. Living online becomes a vehicle of moral trivialization, where tangible consequences of stakes of policy become secondary to the more immediately accessible world of likes and reposts. They are doing war for the chat.
In this world of Content, the meaning of a bombing raid is not the lives lost or strategic gains won but how good it looks when repackaged into a sizzle reel featuring Master Chief from Halo. Dozens of dead girls matter less to the White House than how Hegseth sounds when he says “lethality.”
This online war, lacking in any clear real-world justification, creates its own. And in doing so, it turns atrocity into afterthought: killing not with a clean conscience, but with no consciousness at all.
Historically, American wartime propaganda follows a fairly predictable script.
The president deliberately builds a case that war is a terrible necessary: that some grave American interest, or noble moral cause, requires the spilling of blood. Once the war begins, official government propaganda remains relatively restrained; the vicious stuff, like the racist depictions of Japanese during World War II, tends to come after some major event inciting the public against the enemy (like Pearl Harbor). And even then, the most lurid content gets outsourced to the press and or popular culture.
Nick Cull, a scholar of propaganda at USC’s Annenberg School of Communication, sees the current Iran war as a break with this pattern. The Trump administration not only failed to convince the public that the war is necessary, but it scarcely even tried. Once the war began, the administration almost immediately began publishing death and destruction fancams.
Previous administrations used “to talk carefully and regretfully about military actions,” Cull says. Under Trump the US “reduces American military activity to team talk — high school football cheering.”
This is, Cull theorizes, a function of the administration’s preoccupation with media imagery — for reasons that had been theorized about 35 years prior.
In 1991, the philosopher Jean Baudrillard wrote a famous essay series arguing that the Gulf War was, in essence, a kind of media fiction. Baudrillard was not denying that the United States was dropping bombs on Iraq, but rather that the visual spectacle of the war created on then-novel 24-hour cable news networks had constructed a public narrative that bore only questionable resemblance to the war actually being waged.
“All those journalists who set themselves up as bearers of the universal conscience, all those presenters who set themselves up as strategists, all the while overwhelming us with a flood of useless images,” Baudrillard wrote.
In this synthetic reality, war was imagined as a fireworks show of high-tech precision weapons over night-vision skies, and not the bodies piled up where they landed. While he was pessimistic about observers’ ability to establish the truth behind the broadcast — “we do not have the means,” he wrote — Baudrillard believed it was nonetheless important to “not be duped” by the “virtuality” of the war.
Much of this seemed overheated at the time — even paranoid. Coverage of the Gulf War was hardly perfect, but responsible journalists at outlets like CNN had strong professional incentives to avoid brazenly detaching their broadcasts from reality.
But by the time the second Iraq War rolled around, a moment when post-9/11 fear and jingoism pushed media in a more openly chauvinistic direction, Baudrillard’s critique of cable news stung harder. And in today’s social media environment — where responsible gatekeepers have been dethroned, our feeds are a continuous tide of unverified images and contextless short videos, and attention is a currency that spends regardless of underlying accuracy — it feels uncomfortably prescient.
As Baudrillard’s essay suggests, the US has been accused for decades of presenting its citizens a videogame version of war. What’s perhaps most different this time is the degree to which the government takes this criticism as a compliment: You’re damn right it’s a video game. Come over and let’s play!
Their motives for doing so are not as simple as conscious manipulation. The relevant policymakers are enthusiastic consumers of this type of propaganda just as much as they are producers.
The president is a former reality TV host and social media addict. The defense secretary is a former Fox News personality, as were at least 20 other high-level hires. The vice president is a poster, the FBI director a podcaster. The administration’s most influential private sector ally is, of course, Elon Musk — a near-trillionaire who owns the right’s leading social media outlet.
With this class of person calling the shots, there is a persistent tendency to treat the online as the real zone of political conflict — almost more real than actual reality. The line between lying, confusion, and performance becomes blurred, almost indistinguishable. What matters is not only whether the American military is truly beating Iran, but the extent to which they can convince themselves and their online supporters that they are.
The wartime sizzle reels fail as actual propaganda: No one who doesn’t already support the administration will be impressed by grainy bombing footage paired with a clip of Walter White growling, “I am the danger.” Yet if the audience is understood to be the right’s very online cadres, which now include the top policymakers in American government, it makes perfect sense: They believe they can meme the war they want into existence.
This reduction of real-world issues of life and death into a quest for likes has infected the White House at every turn. And the further away from people’s daily lives and experience the damage, the more thoughtless and triumphant the memes.
Consider roughly a year ago, back when Musk was in charge of DOGE. His signature accomplishment during that time was not making government more efficient or even reducing spending, which has since gone up. Rather, he and his team succeeded in one key objective: destroying USAID, the agency dedicated to providing lifesaving aid to the world’s poorest people.
The real human stakes of this decision were absolutely enormous: One estimate suggests that roughly 800,000 people may have already died as a result of Musk’s actions. Yet he destroyed USAID not based on any kind of serious evaluation of its policy, but rather on his social media obsessions.
DOGE agents first began scrutinizing the agency not because of its budget, which was tiny, but in order to find examples of “viral waste” they could easily mock on social media. In the hours before the agency’s destruction, Musk was chatting with right-wing influencers on X about how USAID was a “criminal organization” that needed to “die” based on a web of conspiracy theories shared back and forth between them. And after his precipitous decision to cut off its funds, which caused medicine and food supplies to literally rot in warehouses, he joked about the whole thing being an imposition on his social calendar.
“We spent the weekend feeding USAID into the wood chipper. Could gone to some great parties [sic]. Did that instead,” he wrote on X.
That post got 21,000 reposts and 159,000 likes. And there is no doubt that Musk experienced each and every one of those accolades as more meaningful than the life of every child who died from preventable cases of malaria or AIDS. The online world is more immediate to him, the polluted water in which he swims, what happens there shapes his actions and sense of self more than the ultimate consequences of his behavior.
The Trump administration’s communication strategy seems designed to cultivate this incuriosity among themselves as much as anyone else. The real-world pain of ICE deportations, communities upended and families ripped apart, is replaced with stylized footage of teched-out federal agents and AI-generated Miyazaki memes of crying migrants. The officials involved bathe in the online accolades from their supporters, immersing them in a cocoon where they do not truly have to consider what they have done.
And now, we are seeing what it looks like to run a war on these principles.
The mass murder at the Minab girls’ was, it appears, a targeting accident: Years ago, the school used to be part of a nearby Iranian navy facility. Yet this accident may well have been preventable; the Pentagon used to have dedicated offices designed to assess intelligence and targeting decisions that might lead to undue civilian casualties. Hegseth spent the past year demolishing them, describing military lawyers as “jagoffs” who got in the way of the “lethality” of America’s “warfighters.”
There is, in short, a plausible straight line between Hegseth’s bluster and atrocity. Yet the bluster will continue, with no self-reflection: A thoroughly mediated creation, Hegseth is nothing but his persona. He will not give it up.
Nor will Trump make him. The president has responded to the news in Minab with a mix of disinterest and risible lies — at one point, claiming that an Iranian Tomahawk missile blew the school (Iran does not have these American made-weapons). The actuality of events has not penetrated his bubble; he is dancing to YMCA as oil tankers burn and bodies cool.
The wartime sizzle reels are another manifestation of this ethos. Built not to persuade a neutral audience, but rather to appeal to those already-bought in, their primary service is thought-deadening: replacing any serious consideration of consequences with collective reveling in memes. “When you didn’t want the US involved with Iran but the submarine kill videos are sick,” one popular right-wing X account tweeted, with a GIF of an ambivalent Larry David posted below the text.
It thus is not just collective self-deception at work for the administration and its very online supporters: It is collective exculpation. The crimes at Minab, and anywhere else, pale in comparison to sick kills.
2026-03-13 04:00:00
Have you ever caught yourself squinting at the acronyms next to your health care provider’s name? MD, DO, NP, PA…
The medical workforce has changed. While the United States has long faced a doctor (MD or DO) shortage, there are now more nurse practitioners (NPs) and physician assistants (PAs) than ever before. More states are giving them a broad license to perform medical services on their own. A PA could prescribe you medication during a hospital stay. An NP could set up their own clinic in your area and run it like the family doctors of the last century.
If you’re looking for a primary care appointment, but have limited options (as many of us do), you may find more appointments with an NP next to the name than an MD. Or you might find an NP running the minute clinic at your local pharmacy.
Our political wellness landscape has shifted: new leaders, shady science, contradictory advice, broken trust, and overwhelming systems. How is anyone supposed to make sense of it all? Vox’s senior correspondent Dylan Scott has been on the health beat for a long time, and every week, he’ll wade into sticky debates, answer fair questions, and contextualize what’s happening in American health care policy. Sign up here.
What do all these letters mean? How should people think about these different credentials in different contexts? These are questions with major implications for both the US health system as a whole, and for each individual seeking care. Here’s what you need to know.
Though the rules can differ depending on where you live, here are the broad strokes of what these different certifications mean:
There are other acronyms (RNs, or registered nurses; LPNs, or licensed practical nurses) but NPs especially are increasingly practicing medicine autonomously, literally changing the face of health care for many Americans.
In 1999, there were just 44,000 NPs in the United States. Today, while estimates vary, there are in the neighborhood of 400,000. A real shift in the type of provider who offers general care — and even sometimes treatment in a more specialized setting — is underway in America.
The dramatic growth in NPs has coincided with reforms that have allowed them to practice more medicine on their own. In the 1990s, only a handful of states were allowing NPs to have full autonomy, including the ability to start and oversee their own clinic; today, more than half (27) grant them that freedom under state law (called “scope of practice” laws).
Why such a shift? The doctor shortage was the most commonly cited reason in my interviews with researchers in this field. It’s becoming harder and harder for patients to find a doctor, especially for basic primary care, because many doctors are opting for more lucrative specialties over becoming a general practitioner. Authorizing NPs specifically to do that work on their own is theoretically a way to get more providers into underserved communities. While doctors have often resisted these changes, large health systems are more supportive because it is cheaper to hire NPs than MDs.
“The health systems are experiencing shortages of workers everywhere. They just want warm bodies,” Monica O’Reilly-Jacob, a nurse practitioner and nursing health services researcher at Columbia School of Nursing, told me.
So, in theory, you can get more providers delivering the same basic medical services at a lower cost, often to patients who may not have any other options. Even if those benefits are limited, some experts still argue in favor of relaxing the rules and giving more discretion to the individual clinic or health system to decide how their providers practice medicine.
“It seems to me that these scope of practice questions are actually relatively well managed within the institution,” Martsolf said.
The theory seems sound — but the reality is a bit more complicated.
There is some evidence that giving NPs more freedom allows them to deliver care to more patients; one study in particular looked at prescribing for opioid overdose treatment after NP laws were liberalized in some states and found that more prescriptions were being written without appearing to replace the prescriptions already being given by MDs and DOs. That would suggest the NPs were playing a complementary role and addressing an unmet need.
“We see big increases in prescribing behavior in the states where [NPs] can participate in the market compared to states where they can’t, which we interpret as an increase in market access and lower costs,” Mindy Marks, a health economist at Northeastern University and co-author on that study, told me. “There was a need there that’s now being addressed.”
But there may be a limit to how much loosening rules for NPs expands access for the people who need it most. At the same time that more NPs are allowed to start and run their own practices, those NPs are being drawn away from primary care by the same financial incentives that are luring doctors away. They can make more money working with a specialist or in a hospital than they can running their own primary care clinic.
That can also lead to people working beyond what they’ve been trained to do, O’Reilly-Jacob said. While most NPs have received training specifically for primary care, more and more of them are working in acute care settings, like hospitals. While NPs could get certification for those services, not all of them do.
This disconnect between the idea of expanding scope of practice and how it actually plays out in the real world is one of the reasons that patients should still be diligent about who’s treating them.
Despite the caveats, all the experts I spoke to said yes, they would be comfortable with or even prefer getting treated by an NP, particularly for primary care.
“I will wait two months to see my primary care NP rather than the physician that she works with,” O’Reilly-Jacob said, adding that the NP has a longer waiting list but that she’s worth it. “I think NPs just look at the whole person. They focus on preventative care. They’re really patient-centered. They are great at communication. They’re not standing at the door with their hand on the knob waiting to leave. I notice a big difference between primary care in front of an NP and a physician.”
Still, there are some questions that you can ask if you’re looking for a new primary care provider and considering an NP. Ask how long they’ve been practicing and what kind of training they’ve received. If you find a NP who’s worked on their own for 10 years, you’re probably going to get as good of care as you would from a doctor, Martsolf said. Some states, like New York, actually require NPs to perform a certain number of hours with doctor oversight before an NP can practice on their own. But if they are a younger provider, it could be worth asking additional questions about their experience and education to make sure you’re comfortable with having them as your primary contact with the medical system.
Likewise, at a specialty clinic or a hospital, you could ask about how an NP coordinates with a doctor or what kind of specialized training they have received.
“If I was in the hospital, I would just say, ‘What’s your certification?’” O’Reilly-Jacob said. “And if they’re certified to be practicing where they are, I’m all on board.”
2026-03-13 01:03:49
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In the less than two weeks since the US and Israel began bombing Iran in late February, the war has already killed over 1,900 people across 11 countries and displaced up to 3.2 million people. It has destroyed schools, hospitals, and critical infrastructure across the region, and threatens to plunge countries near and far — many of which rely on now-disrupted shipping routes for fuel and fertilizer — into economic and humanitarian crises.
If the escalating conflict feels to you like one more in a long slog of painfully violent, complex global crises, then you are not wrong. There are indeed more wars and armed conflicts today than there have been at any time since the end of World War II. Over one-fifth of the world’s kids now live in places warped by conflict, which magnifies poverty and hunger. And conflict doesn’t just worsen conditions on the ground — it makes getting humanitarian aid flowing to those who need it most an extraordinarily difficult and dangerous task.
But difficult doesn’t mean impossible. Local aid workers across the region have been working nonstop to get civilians safely fed and cared for, while new methods of crisis response mean that the world may soon be able to move money much more quickly to the people and places that need it most. And while just how long this war will continue may only be known to President Donald Trump, these organizations will need support to fuel long-term recovery for those both directly and indirectly affected by the violence. The fighting has effectively closed the Strait of Hormuz, a narrow shipping lane between Iran and Oman that supplies about a quarter of the world’s seaborne oil trade and more than a third of the world’s fertilizer. A prolonged closure could quickly devolve into a major global food crisis, including a spike in hunger in the countries most vulnerable to it.
For the average person, thinking about how to help in a conflict like this can feel daunting, to say the least. It might even seem pointless against the sheer momentum of war. If you can’t solve everything — if the war has no end in sight — then why bother with Band-Aid solutions at all?
But people need help now, so they can make it to the day after. And with global aid cuts siphoning off support for humanitarian relief organizations even as conflict spikes, your donations are genuinely more important than ever. Here’s how to help.
One way to think about the complexities of getting aid to a conflict zone is to imagine a natural disaster that lasts not for hours or days, but for weeks, months, or years on end. “With a hurricane or flood, the hazard has likely passed” by the time aid starts pouring in, said Patricia McIlreavy, CEO of the Center for Disaster Philanthropy.
But when it comes to complex manmade humanitarian disasters like war, “that hazard is continuing,” she said, meaning that the damage and logistical challenges of coordinating relief in the fog of war can quickly compound as time goes on.
If you’re in the US, giving directly to organizations based in Iran is complicated by American sanctions on the country, though humanitarian projects are generally exempt. But you can donate to global relief organizations, like the International Committee of the Red Cross and the Norwegian Refugee Council, many of which do work in Iran and across the region.
Other groups, like Project HOPE, are actively monitoring the needs of many Iranian refugees, while focusing their relief efforts on the fallout among Iran’s most vulnerable neighbors.
In Lebanon, home to the world’s highest refugee population per capita, escalating hostilities have led to a mounting humanitarian crisis in a country still recovering from its last war with Israel, which technically ended in 2024. Even prior to the new hostilities, Lebanon was experiencing a severe economic collapse, with nearly 70 percent of the country in need of humanitarian assistance.
Many of these organizations are doing their best to actively deploy resources where they anticipate the greatest needs will be. “They don’t know how things are going to settle,” said McIlreavy. “They don’t know where they’re going to have access. And so they’re going to need to be flexible.”
That goes for their supporters as well.
The bulk of humanitarian aid still passes through established charities and agencies like the United Nations. But there’s also the increasingly popular idea of sending cash directly to people, something that has been done informally for centuries through remittances and mutual aid.
A growing body of research shows that even in fragile conflict zones, people often strongly prefer receiving cash — which they can then spend however they need to — over relief items like food parcels, hygiene kits, or blankets. The nonprofit GiveDirectly has pioneered the use of technology to get cash aid to people fast, and is actively exploring how to help those affected by this conflict through a newly launched emergency fund.
Historically, most of GiveDirectly’s work has focused on people living in extreme poverty, rather than specifically targeting those living in conflict zones. But the organization has also more recently expanded to providing emergency relief to families affected by conflicts like the Yemeni civil war and armed clashes in the Democratic Republic of the Congo.
One way the group works is through cellphone metadata, which can help identify people who are likely in need. In this case, that may include displaced people in Lebanon, Iranian refugees entering Turkey, or Malawians affected by rising fertilizer costs. GiveDirectly then screens those people for eligibility via text, and sends them cash through mobile payment platforms.
The process tends to be “cleaner, faster, more objective, and cheaper” than more traditional outreach methods like knocking door-to-door, said Leith Baker, who runs GiveDirectly’s emergency cash strategy. It’s a “really protective, dignified way to receive money” that “gives the recipient a lot of choice and protection.”
Once the group’s outreach system is in place, it also works exceptionally fast, which makes it an especially promising option for people in rapidly evolving conflict zones. You can help GiveDirectly with its plans to send cash to those affected by the conflict by donating here.
For other ways to send cash directly, plenty of local advocates in Lebanon and across the region have also begun creating and sharing mutual aid funds for local families and organizations, like Nation Station, a volunteer-led community kitchen in Beirut, Lebanon.
While those who live in range of the bombs are at the greatest risk, many of those most affected will include people who don’t live in the region at all. Those in already deeply impoverished countries will be the most vulnerable to the conflict’s economic ripple effects, which already include surging prices on food, fertilizer, and fuel. There are plenty of groups working to support communities in crisis both now and long after the news cycle fades.
Even prior to this escalating crisis, the world was already on the verge of a grim milestone. For the first time in decades, the number of people living in extreme poverty is projected to start increasing by 2030, with most of it highly concentrated in the poorest — and often most conflict-affected — countries.
Global aid cuts have been making a bad situation even worse. And now, for the most vulnerable countries, the Iran war could cause far more than just higher prices at the grocery store, but also prolonged, widespread food shortages. It’s more important than ever to dig deep now to support those suffering the worst fallout.
“Even if the conflict was to end tomorrow,” said McIlreavy, “the recovery will take a long time.”
Update, March 12, 1 pm ET: This story has been updated with information regarding the number of Iranian people who have been displaced by bombings.
2026-03-13 01:00:00
Bananas are one of the world’s most popular fruits. They’re a staple crop in Asia, Africa, and Latin America. In the US, the average person eats more than 25 pounds of bananas per year.
The banana found in nearly every lunch bag, smoothie, and cereal is likely a Cavendish banana — a single variety that accounts for 99 percent of global exports — despite there being over 1,000 different species of bananas. This kind of uniformity is what allows the beloved banana to be cheap, durable, and ubiquitous.
It also makes them extremely vulnerable.
A variant of Panama disease, a soil fungus that once wiped out the world’s most commercial banana, the Gros Michel, in the 1950s, is back. And this time, there’s no obvious replacement for it waiting around the corner. So, what will it take to save one of the world’s most beloved fruits?
This video explores how monocropping became both a blessing and a curse in the search for the most commercially viable banana, how this assumed ubiquity could lead to the end of the banana as we know it, and what scientists are doing to prevent the extinction of the Cavendish.
Read more about the future of bananas:
This video is presented by Stonyfield Organics. Stonyfield Organics doesn’t have a say in our editorial decisions, but they make videos like this one possible.