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Florida has become the second state in the nation to ban the addition of fluoride to public drinking water.

On Thursday, Gov. Ron DeSantis signed the Florida Farm Bill, which includes language banning the use of any additive in a public water system that does not meet the new definition of a “water quality additive”: a chemical or substance used in public water to specifically address drinking water standards, contaminants or quality.

“Yes, use fluoride for your teeth, that’s fine. But forcing it into the water supply is basically forced medication on people,” DeSantis said. “They don’t have a choice. You’re taking that away from them.”

More than 70% of Floridians who use community water systems receive fluoridated water, according to Florida Surgeon General Dr. Joseph Ladapo, who issued guidance in November recommending against community water fluoridation, citing its potential health effects.

The CDC reiterated its faith in the health benefits of fluoride in 2015, naming water fluoridation one of the “10 Greatest Public Health Achievements of the 21st Century.” The ADA has also emphasized that “eighty years of community water fluoridation at optimal levels has proven to be safe and effective at reducing tooth decay to improve oral health.”

However, research has showed that exposure to fluoridated water during pregnancy is associated with increased neurobehavioral problems in children, and a federal review concluded that higher levels are linked with lower IQ in kids.

With the future of her cancer treatment in limbo, Natalie Phelps doesn’t know how much longer she can wait.

Last month, after months of seeking treatment options for her colorectal cancer, the 43-year-old mother of two was accepted into an ongoing study at the National Institutes of Health. She thought the research would allow her to receive an experimental immunotherapy – but she now faces an excruciating wait and an equally excruciating choice.

First, her tumor must grow to at least 1 centimeter in size in order to receive treatment, she said. But even after she meets that criteria, an abrupt reduction in the NIH workforce means her treatment will take much longer to develop than initially expected. She’s worried that that extra time may make a huge difference in her health.

The Trump administration has been conducting a review of funding and a restructuring of the US Department of Health and Human Services, resulting in massive waves of job cuts across federal health agencies under HHS, including the NIH, the nation’s medical research agency.

Part of the HHS transformation involves decreasing the NIH workforce by about 1,200 “by centralizing procurement, human resources, and communications across its 27 institutes and centers,” according to the Trump administration. The administration announced in late March that the HHS restructuring would save taxpayers $1.8 billion per year through an overall reduction of about 10,000 full-time employees.

Tim Andrews knew that he needed dialysis to manage his end-stage kidney disease, but over months of treatment, he started to wonder whether it was worth it. He was exhausted and hopeless. He missed his grandkids.

It kept him alive, but it didn’t feel like living.

Desperate for another option, he found a surprising alternative: an organ from a pig.

Andrews, 67, is a pioneer of a new kind of medicine. In January, he had an experimental cross-species transplant of a kidney from a genetically modified pig. He is one of only a handful of patients who have undergone the experimental procedure. For now, he’s the lone person in the United States known to be living with a pig kidney.

Andrews knew that there was a risk to trying something so new, but if the kidney gave him just one more day free from dialysis, it was worth it — for him and for fellow patients.

‘Pick a box’

Andrews had been living with diabetes since the 1990s, managing the condition with insulin. About 2½ years ago, he went to the doctor feeling unusually tired. Tests showed that he had stage 3 kidney failure — his kidneys were still working but less efficiently than they should. He was relieved to learn that it was manageable with medication, monitoring and lifestyle changes.

But about a month later, a doctor delivered more bad news: Andrews’ kidney disease had rapidly progressed to end-stage disease. Dialysis was the only option to keep him alive until he could get an organ transplant.

The story of transplants has always been one of altruism. After all, organs can be neither sold nor purchased. They can only be donated as a gift of life.

It is a story that started in 1954, when Dr. Joseph Murray performed the world’s first successful organ transplant at Boston’s Peter Bent Brigham Hospital between identical twin brothers Ronald and Richard Herrick. Richard had been discharged from the US Coast Guard after being diagnosed with end-stage kidney disease, and his identical twin brother, Ronald, was a willing donor. Although they had no certainty it would work, the transplant resulted in eight more years of life for Richard, successful in part because they had the same DNA.

When Ronald died in 2010, Dr. Murray remembered him in a statement published in the American Journal of Transplantation, saying: “we should never forget that he not only saved his brother Richard’s life, but also paved the way for thousands of other transplant recipients throughout the world.”

It is this same ethos that is now pushing forward the burgeoning field of xenotransplantation – the practice of using animal organs for human transplant

For the past two years, I’ve spoken with surgeons, genetic engineers and patients who have all told me of the hope of using genetically engineered pig donors to help end the organ shortage crisis. In the United States alone, there are more than 100,000 people waiting for an organ at any given moment – most of them in need of a kidney. Every day, 17 people on that list will die, just waiting.

“This paradigm that someone has to die in order for somebody to live is, a broken paradigm. It just doesn’t work,” said Dr. Robert Montgomery, director of the NYU Langone Transplant Institute. As both a transplant surgeon and a heart transplant recipient himself, he knows how agonizing the wait can be. It’s why he’s relentlessly pushing for a new source of organs.

“Because less than 1% of the people who die every year die in a way that they could ever even be considered as organ donors, we need a sustainable, renewable source of organs from something else other than humans dying,” Dr. Montgomery told me.

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