US approval of the abortion medication mifepristone has been revoked, in a decision that could further disrupt reproductive healthcare for millions of people.
District Judge Matthew J Kacsmaryk, a Trump administration appointee in Amarillo, Texas, signed an injunction directing the Food and Drug Administration (FDA) to halt its approval while a lawsuit challenging its safety continues.
He sided, in part, with a conservative Christian group, Alliance Defending Freedom, who brought a lawsuit alleging the drug was not being regulated properly.
He did not go as far as the plaintiffs wanted, but he put a “stay” or hold on approval of the drug.
The judge’s decision does not come into effect for seven days. Meanwhile, the Department of Justice has announced it will appeal the ruling.
In a statement, President Joe Biden said: “My Administration will fight this ruling…
“Let’s be clear – the only way to stop those who are committed to taking away women’s rights and freedoms in every state is to elect a Congress who will pass a law restoring Roe versus Wade.
“Vice President Harris and I will continue to lead the fight to protect a woman’s right to an abortion, and to make her own decisions about her own health.”
Mifepristone blocks the hormone needed to maintain a pregnancy and has been approved in the US since 2000 for medical abortion and miscarriage management.
It is used safely in more than 60 countries worldwide and when taken together with the drug misoprostol, accounts for more than half of abortions in America.
Some abortion providers have said they will wait for guidance from the FDA before implementing the ban on mifepristone.
In a separate ruling in Washington state on Friday night, a judge said the FDA must keep medication abortion drugs available in at least 12 liberal states, creating a legal stand-off on the drug, which is likely to escalate to the Supreme Court.
‘Ludicrous’ to question drug ‘safer than ibuprofen’
The American College of Obstetricians and Gynaecologists say the Texas lawsuit disregards “decades of data” that support the efficacy of mifepristone, and is “exacerbating the current abortion care crisis in the US”.
Dr Razel Remen, an abortion provider in Michigan, told Sky News: “Mifepristone is literally one of the safest medications on the market – safer than ibuprofen, safer than Tylenol.
“People are more likely to have an adverse event happen to them driving in their car, or going through childbirth… The fact that it’s even being put into question is absolutely ludicrous.”
Angel, who is 24 and lives in Texas, had an abortion using the drug in February.
She was already a mother of three, and decided to terminate her recent pregnancy because she did not want any more children.
Angel says this attempted ban on mifepristone is “another attack on a woman’s right to choose”.
“You can do it at home… it’s convenient, it’s easy, it’s safe… I just don’t understand how something could be right for so many years. And then one day, all of a sudden, be wrong.”
Pills have become the new frontier in the battle for abortion access since the Supreme Court overturned Roe v Wade– the constitutional right to abortion – last June.
Many people trying to access abortion in severely restricted states are ordering pills in the post, or travelling across state lines to pick them up.
As abortion clinics have already been shuttered in Texas, Angel had to acquire the pills through underground methods.
“It’s nearly impossible to get an abortion here,” she said. “You can’t go to the pharmacy. You can’t go to a Planned Parenthood. No clinics… nothing… If you find it, it’s like a blessing.”
Now, with mifepristone access in jeopardy, pro-choice campaigners fear that getting an abortion in America has become even harder to navigate.
“What’s clear is that we need all forms of abortion in this country, and we need them all to be legal,” Elisa Wells, co-founder of the organisation Plan C, tells us.
Her organisation provides information and support to women searching for abortion access in every state.
“This injustice is being done by manipulating the court system to try and ban this medication… It’s really outrageous,” Ms Wells said.
“We are a modern democracy, and we need access to basic medical care in every part of our country, legally and without restriction – and that includes abortion.”
There are alternatives to mifepristone for those still trying to access medical abortion.
Some doctors have been anticipating the ruling, and plan to move to a misoprostol-only option. They say that method is still safe, but it has the potential for more side effects and increased discomfort.
This decision marks yet another controversial legal battle over abortion access in America, which has the potential to wind up back in the Supreme Court.
Eleven Thai civilians and a soldier have been killed in clashes between Thailand and Cambodia, officials have said, as long-standing tensions in disputed border areas boiled over into open conflict.
Among those killed was an eight-year-old boy, the army said in a statement.
It said most casualties occurred in Si Sa Ket province, where six people were killed after shots were fired at a fuel station.
Image: Smoke and fire in the Kantharalak district in Thailand amid clashes between Thailand and Cambodia. Pic: Army Region 2 via Facebook/Reuters
Another 14 people have been injured in three Thai border provinces.
Thailand’s health minister Somsak Thepsuthin confirmed the fatalities to reporters, adding Cambodia’s actions, including an attack on a hospital, should be considered war crimes.
Both countries accuse one another of starting the military clashes and have downgraded their diplomatic relations in the rapidly escalating dispute. Thailand has also sealed all land border crossings with Cambodia.
Early on Thursday, a Thai F-16 fighter jet bombed targets in Cambodia, according to Thailand’s army.
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“We have used air power against military targets as planned,” Thai army deputy spokesperson Richa Suksuwanon said.
Cambodia’s defence ministry said Thai jets had dropped bombs on a road near the ancient Preah Vihear temple, saying it “strongly condemns the reckless and brutal military aggression of the Kingdom of Thailand against the sovereignty and territorial integrity of Cambodia”.
Image: Thai people who fled clashes take shelter in Surin province. Pic: AP
Image: Fighting has taken place in disputed border areas
‘Civilian areas targeted’
Clashes are ongoing in at least six areas along the border, the Thai defence ministry said.
Thailand’s foreign ministry said Cambodian troops fired “heavy artillery” on a Thai military base on Thursday morning and also targeted civilian areas, including a hospital.
“The Royal Thai Government is prepared to intensify our self-defence measures if Cambodia persists in its armed attack and violations upon Thailand’s sovereignty,” the ministry said in a statement.
A livestream video from Thailand’s side showed people, including children and the elderly, running from their homes and hiding in a concrete bunker as explosions sounded.
The clash happened in an area where the ancient Prasat Ta Muen Thom temple stands along the border between Thailand’s Surin province and Cambodia’s Oddar Meanchey province.
Image: Thai people who fled clashes in Surin province, northeastern Thailand. Pic: AP
‘Conflict not spreading’
Thailand’s acting premier said fighting must first stop before peace talks can start.
Caretaker Prime Minister Phumtham Wechayachai told reporters there had been no declaration of war and conflict was not spreading into more provinces.
He said Cambodia had fired heavy weapons into Thailand without any specific targets, resulting in civilian deaths.
Earlier on Thursday, Cambodia downgraded diplomatic relations with Thailand to their lowest level, expelled the Thai ambassador and recalled all Cambodian staff from its embassy in Bangkok.
The day before, its neighbour withdrew its ambassador and expelled the top Cambodian diplomat in protest after five Thai soldiers were wounded in a land mine blast, one of whom lost part of a leg.
A week earlier, a land mine in a different contested area exploded and wounded three Thai soldiers, including one who lost a foot.
Relations between the southeast Asian neighbours have collapsed after a Cambodian soldier was killed in an armed confrontation in a disputed border area in May.
Nationalist passions on both sides have further inflamed the situation, and Thailand’s prime minister was suspended earlier this month as an investigation was opened into possible ethics violations over her handling of the border dispute.
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Border disputes are longstanding issues that have caused periodic tensions between the countries. The most prominent and violent conflicts have been around the 1,000-year-old Preah Vihear temple.
In 1962, the International Court of Justice recognised Cambodian sovereignty over the temple area.
In Nasser Hospital in southern Gaza, they have virtually nothing left to eat.
Warning: This article contains images that some readers may find distressing.
Huda has lost half her body weight since March, when Israel shut the crossings into Gaza, and imposed a blockade.
The 12-year-old girl knows she doesn’t look well.
“Before, I used to look like this,” Huda says, pointing to a picture on her tablet.
“The war changed me. Malnutrition has turned my hair yellow because I lack protein. You see here, this is how I was before the war.”
Her mother says her needs are simple: fresh fruit and vegetables, fish, maybe a little meat – but she won’t find it here.
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Huda can only wish for a brighter future now.
“Can you help me travel abroad for treatment? I want to be like you. I’m a child. I want to play and be like you,” she says.
Image: Huda wishes for a brighter future
Amir’s story
Three-year-old Amir was sitting in a tent together with his mother, father and his grandparents when it was hit by projectiles.
Medical staff carried out surgery on his intestines and were able to stop the bleeding – but they can’t feed him properly.
Instead, he’s given dextrose, a mixture of sugar and water which has no nutritional value.
Image: Amir’s mother and siblings were killed in an attack that also left his father ‘in a terrible state’
Image: Medical staff performed surgery on three-year-old Amir – but can’t feed him properly
Amir’s mother and his siblings were all killed in the attack and his father is no longer able to speak.
“His father is in a terrible state and won’t accept the reality. What did these children do? Tell me, what was their crime?” Amir’s aunt says.
The desperate scenes of hungry children in Gaza have not been caused by scarcity.
There’s plenty of food waiting at the crossings or held in warehouses within the territory. Israel claims the United Nations is failing to distribute it.
Image: Amir’s relative holds pictures of the toddler and his family before the war
Both Israel and the US have taken charge of the food distribution, with the UN’s hundreds of aid centres shut.
Instead, the UN tries to organise convoys but says it can’t obtain the necessary permits – and faces draconian restrictions on aid.
Sometimes food is made available at communal kitchens called ‘tikiya’.
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3:49
Malnourished girl: ‘The war changed me’
‘I want life to be how it was’
Everyone is desperate for whatever they can get – and many leave with nothing.
“It’s been two months since we’ve eaten bread,” one young girl says. “There’s no food, there’s no nutrition. I want life to go back to how it was, I want meat and flour to come in. I want the end of the tikiya.”
Dr Adil Husain, an American doctor who spent two weeks at Nasser Hospital, treated a three-year-old called Hasan while he was there.
Weighing just 6kg, Hasan should be 15kg at his age.
“He needs special feeds, and these feeds are literally miles away. They’re literally right there at the border, but it’s being blockaded by the forces, they’re not letting them in, so it’s intentional and deliberate starvation,” Dr Husain tells me.
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Military clashes have erupted between Thailand and Cambodia, killing at least 12 people, including 11 civilians.
A long-standing dispute over border areas escalated into an exchange of gunfire, shelling and rockets being launched on 24 July, with both sides accusing one another of initiating the violence.
Relations between the Southeast Asian neighbours deteriorated sharply after an armed confrontation in May that killed a Cambodian soldier. Nationalist passions on both sides have further inflamed the situation.
Here is all you need to know about the situation and how it got to this stage.
What is happening in Thailand and Cambodia?
Tensions first broke out on Thursday morning in an area near the ancient Ta Muen Thom temple along the border of Thailand’s Surin province and Cambodia’s Oddar Meanchey province.
The Thai army said that most casualties occurred in the Si Sa Ket province, where six people were killed after shots were fired at a fuel station. At least 14 people were injured in three other border provinces.
Image: Smoke and fire in the Kantharalak district in Thailand. Pic: Army Region 2 via Facebook/Reuters
An eight-year-old boy was among those killed, Thailand’s health minister Somsak Thepsuthin said.
Thailand’s foreign ministry said Cambodian troops fired “heavy artillery” on a Thai military base on Thursday morning and also targeted civilian areas, including a hospital.
Image: Fighting has taken place in disputed border areas
In response, the Thai army said a Thai F-16 fighter jet bombed military targets in Cambodia.
Cambodia’s defence ministry said Thai jets had dropped bombs on a road near the ancient Preah Vihear temple, saying it “strongly condemns the reckless and brutal military aggression of the Kingdom of Thailand against the sovereignty and territorial integrity of Cambodia”.
Clashes are now thought to be ongoing in at least six areas along the border, the Thai defence ministry said.
Image: Pic: TPBS/Reuters
What caused the escalation?
For more than a century, Thailand and Cambodia have laid claim to undisputed points along their 817-km (508-mile) land border. This has led to skirmishes over several years and at least a dozen deaths, including during a weeklong exchange of artillery in 2011.
Tensions were reignited in May after a Cambodian soldier was killed during a brief exchange of gunfire, which escalated into a full-blown diplomatic crisis and now has triggered recent armed clashes.
Both countries agreed to de-escalate tensions, but Cambodian and Thai authorities continued to implement or threaten restrictions on the other.
Image: Thai people who fled clashes between Thai and Cambodian soldiers in Surin province, northeastern Thailand. Pic: AP
Image: Pic: AP
Tighter restrictions on Thailand’s land border with Cambodia were implemented, stopping almost all crossings except for students, medical patients and others with essential needs. Thai authorities sealed the border entirely after Thursday’s escalation.
Meanwhile, Cambodia has banned Thai movies and TV shows, stopped the import of Thai fuel, fruits and vegetables and boycotted some of its neighbour’s international internet links and power supply.
Earlier on Thursday, Cambodia said it was downgrading diplomatic relations with Thailand to their lowest level, expelling the Thai ambassador and recalling all Cambodian staff from its embassy in Bangkok.
Image: A residential area in Surin Province shelled by Cambodia, according to Thailand. Pic: Royal Thai Army/AP
That was in response to Thailand withdrawing its ambassador and expelling the Cambodian ambassador a day earlier, in protest against a number of land mine blasts that injured a total of eight Thai soldiers.
Thai authorities alleged the mines were recently laid along paths that by mutual agreement were supposed to be safe. They said the mines were Russian-made and not of a type used by Thailand’s military.
Cambodia accused Thailand of making “baseless accusations”, pointing out that the unexploded mines could have been from previous periods of unrest.
Image: An injured Thai soldier who stepped on a land mine being airlifted to a hospital in Ubon Ratchathan, Thailand.
Pic: The Royal Thai Army/AP
Political fallout
Earlier this month, Thailand’s former prime minister Paetongtarn Shinawatra attempted to resolve tensions via a call with Cambodia’s influential former prime minister and current president of the senate, Hun Sen.
Image: Thailand’s suspended prime minister Paetongtarn Shinawatra. Pic: Reuters
Their conversation was later leaked, revealing Ms Shinawatra referred to Mr Sen – who stepped down as prime minister in favour of his son Hun Manet in 2023 – “uncle” and criticised Thai military leadership.
Her comments caused widespread outrage and protests and led to Ms Shinawatra being suspended from her position on 1 July after a court ruling.
Image: Hun Sen, Cambodia’s former prime minister. Pic: Reuters
Her ally, former defence minister Phumtham Wechayachai was appointed as acting prime minister.
Mr Wechayachai said on Thursday that fighting between Cambodia and Thailand must stop before negotiations between the two sides can begin.
Is it safe to travel there?
The neighbouring countries are both hugely popular with tourists, but since tensions escalated on the border on Thursday, the UK Foreign Office (FCDO) has updated its advice for individuals already in the area or planning to visit.
The FCDO website states: “There are reports of fighting including rocket and artillery fire on 24 July between Thailand and Cambodia at several locations along the border. Casualties have been reported, as well as evacuations of areas close to the border.”
Image: People wait in line to receive food at a shelter in Buriram, Thailand.
Pic: Reuters
It adds that British nationals should “exercise a high level of vigilance in border areas” and “follow the instructions of local authorities. There are also unexploded landmines in the border area”.
The US Embassy in Thailand also released new advice, telling US citizens to “follow direction from Thai security services and consult local government authorities for the latest information”.
Image: Pic: Reuters
Image: Pic: Reuters
Why is the border contested?
Tensions over the border largely stem back to a 1907 map drawn under French colonial rule that was used to separate Cambodia from Thailand.
Cambodia has used the map as a reference to claim territory, while Thailand has argued the map is inaccurate.
The most prominent and violent conflicts have been over the 1,000-year-old Preah Vihear temple.
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In 1962, the International Court of Justice awarded Cambodia sovereignty over the temple area, which caused irritation between the neighbouring countries.
Cambodia went back to the court in 2011, following several clashes between its army and Thai forces that killed about 20 people and displaced thousands. The court reaffirmed the ruling in Cambodia’s favour in 2013.
Cambodia has again turned to the international court to resolve the border disputes but Thailand has rejected the court’s jurisdiction.