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St. Louis therapist offers psychedelic-assisted therapy in Oregon and Colorado

4 weeks ago
Kate Schroeder’s journey began seven years ago when one of her therapy clients brought up the idea of using psilocybin — also known as magic mushrooms — to help treat post traumatic stress disorder.  “I had a pretty immediate, almost visceral ‘no’ inside of me to the thought of mixing psychedelics with therapy,” said Schroeder, […]
Rebecca Rivas

Shattered Science: The Research Lost as Trump Targets NIH Funding

4 weeks ago

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

The National Institutes of Health is responsible for more than 80% of the world’s grant investment in biomedical research. Its funding has sparked countless medical breakthroughs — on cancer, diabetes, strokes — and plays a fundamental role in the development of pharmaceutical drugs.

Scientists compete vigorously for a slice of the more than $30 billion that the agency doles out annually; they can spend years assembling grant applications that stretch thousands of pages in hopes of convincing peer reviewers of the promise of their projects. Only 1 in 5 gets chosen.

The NIH has rarely revoked funding once it has been awarded. Out of the tens of thousands of grants overseen by the institution since 2012, it terminated fewer than five for violations of the agency’s terms and conditions.

Then Donald Trump was reelected.

Since his January inauguration, his administration has terminated more than 1,450 grants, withholding more than $750 million in funds; officials have said they are curbing wasteful spending and “unscientific” research. The Department of Government Efficiency gave the agency direction on what to cut and why, ProPublica has previously found, bypassing the NIH’s established review process.

“The decision to terminate certain grants is part of a deliberate effort to ensure taxpayer dollars prioritize high-impact, urgent science,” said Andrew G. Nixon, the director of communications for the Department of Health and Human Services. He did not respond to questions about the terminated grants or how patients may be impacted, but he said, “Many discontinued projects were duplicative or misaligned with NIH’s core mission. NIH remains focused on supporting rigorous biomedical research that delivers real results — not radical ideology.”

Targeted projects, however, were seeking cures for future pandemics, examining the causes of dementia and trying to prevent HIV transmission.

The mass cancellation of grants in response to political policy shifts has no precedent, former and current NIH officials told ProPublica. It threatens the stability of the institution and the scientific enterprise of the nation at large. Hundreds of current and former NIH staffers published a declaration this week — cosigned by thousands of scientists across the world, including more than 20 Nobel laureates — decrying the politicization of science at the agency and urging its director to reinstate the canceled grants. Many researchers have appealed the terminations, and several lawsuits are underway challenging the cuts.

It has been difficult for scientists and journalists to convey the enormity of what has happened these past few months and what it portends for the years and decades to come. News organizations have chronicled cuts to individual projects and sought to quantify the effects of lost spending on broad fields of study. To gain a deeper understanding of the toll, ProPublica reached out to more than 500 researchers, scientists and investigators whose grants were terminated.

More than 150 responded to share their experiences, which reveal consequences that experts say run counter to scientific logic and even common sense.

They spoke of the tremendous waste generated by an effort intended to save money — years of government-funded research that may never be published, blood samples in danger of spoiling before they can be analyzed.

Work to address disparities in health, once considered so critical to medical advancement that it was mandated by Congress, is now being cut if the administration determines it has any connection to “diversity,” “equity” or “gender ideology.” Caught in this culling were projects to curb stillbirths, child suicides and infant brain damage.

Researchers catalogued many fears — about the questions they won’t get to answer, the cures they will fail to find and the colleagues they will lose to more supportive countries. But most of all, they said they worried about the people who, because of these cuts, will die.

Research Frozen

The NIH often awards funding in multiyear grants, giving scientists the time and intellectual freedom to pursue their work uninterrupted. They plan experiments, hire staff and make equipment purchases on long timelines.

Now, studies can’t be completed. Papers can’t be published. Years of research may be lost and millions of dollars wasted.

Grants Terminated:

A project to improve recruitment of participants in Alzheimer’s clinical trials.

A study to increase vaccine uptake in underserved populations.

A study investigating in-utero exposure to contaminants in public drinking water.

An examination of the consequences of abortion restrictions.

Diana Greene Foster, a reproductive health researcher and professor at the University of California, San Francisco

After the Supreme Court overturned the constitutional right to abortion, demographer Diana Greene Foster set out to study the outcomes of pregnant patients who showed up in emergency departments. She wanted to know whether state restrictions were causing delays in care.

“This needs to be answered for courts to consider the evidence,” said Foster, a professor at the University of California, San Francisco. “Every day that goes by, people are potentially at risk.”

Less than one year into a five-year NIH grant, she had arrived at some early findings: “Abortion bans don’t stop very many people from getting abortions,” she said. “Bans actually cause people to have their abortions later in pregnancy.” For those who live in states with bans, she found, second-trimester abortions increased from 8% of procedures to 17%, requiring more complex interventions to end their pregnancies and increasing their risk of complications.

But before the data could be published, the NIH informed her on March 21 that the grant was terminated. It was no longer in line with agency priorities, a letter stated, specifying that studies on “gender identity” “ignore, rather than seriously examine, biological realities.”

The termination left Foster confused. “They are wrong that studying gender minority populations is not important,” she said. “But my study is not about gender identity. It is relevant to anyone who is pregnant, regardless of how they identify.”

Foster had to pause her research while she searched for other funding. “This was clearly a politically motivated cut,” she said.

ProPublica heard from more than 70 researchers who said that they were unable to continue their projects due to the terminations.

“Two and a half years into a three-year grant, and to all of a sudden stop and not fully be able to answer the original questions, it’s just a waste.” —Ethan Moitra, associate professor at Brown University, who was researching whether brief therapy can improve mental health for LGBTQ+ people

“We are now scrambling to figure out if there are parts we can continue or salvage.” —Julia Marcus, associate professor at Harvard Medical School, who was researching whether HIV prevention medicine can be made available over the counter

“To build trust between health care providers, health researchers in communities takes decades of work, and scientists have already done the work. Now this is going to be depleted.” —Jesus Ramirez-Valles, professor at the University of California, San Francisco, who was examining how HIV impacts the physical and mental health of gay men as they age

Patient Studies Interrupted

Thousands of studies supported by the NIH involve human subjects. Some include clinical trials, in which researchers recruit participants, often with grave conditions from cancer to HIV, to test the value of novel treatments and protocols.

In addition to jeopardizing data, terminating a grant in the middle of an active study may worsen participants’ conditions and put them at higher risk of death.

Grants Terminated:

A study to prevent sexually transmitted infections with common antibiotics.

A study to increase access to kidney transplant evaluations.

A clinical trial to understand the effectiveness of flu and COVID-19 vaccine text message reminders.

A study to test a protocol to prevent HIV transmission.

Amy Nunn and Dr. Philip Chan, behavioral and social science professors at Brown University

A single daily pill can nearly eliminate the risk of contracting HIV — but only when taken as prescribed. Black and Latino men who have sex with men have more than a 1-in-4 chance of contracting HIV but sometimes struggle to get or stay in care.

Working with community clinics across Mississippi, Washington, D.C., and Rhode Island, Brown University professors Amy Nunn and Dr. Philip Chan set out to examine what happens when people are provided wraparound clinical services before they contract the disease. “This is about preventing people from getting HIV,” Nunn said.

The study provides aggressive case management to help patients navigate the health care system and stay on the treatment, known as pre-exposure prophylaxis or PrEP, which is available in both oral and injectable forms. Workers provide patients with reminders, help them get coverage and even pick up their medicine.

In 2023, the researchers received about $3.7 million in NIH funding for five years of work. Their team was just starting to gather data that showed the program’s efficacy when the grant was terminated. “This is science that had really great chances of having a huge impact, and all of a sudden, it’s cut off at the knee,” Nunn said.

Chan told ProPublica that he worries that the patients in their study could be harmed by the cut. “There’s no doubt that some of them are going to not stay on PrEP,” said Chan, “and that some of them are going to get HIV.”

At least 30 researchers told ProPublica that the termination of their grant forced them to end clinical research or a trial abruptly, leaving participants in limbo.

“We cannot assay the blood samples that we have collected and paid participants for. A total waste of the money and resources that went into collecting the data.” —Sarah Whitton, professor at the University of Cincinnati, who was identifying risk factors for mental illness and suicidality for young LGBTQ+ women

“We have also had to quickly scramble to keep the study going unfunded to avoid having to stop the treatment and clinical trial for those already enrolled.” —Tiffany Brown, assistant professor at Auburn University, who was developing an eating disorder treatment for LGBTQ+ patients

“With a clinical trial, if you can’t follow participants to the end, you have no information, because the whole point is to see whether there’s change from beginning to end.” —Katie Biello, professor and chair of epidemiology at Brown University’s School of Public Health, who was trying to improve adherence to medication protocols for adolescents with HIV in Brazil

Disparities Disregarded

(Edwin Tan/Getty Images)

The Trump administration has banned the NIH from funding grants with a perceived connection to “diversity, equity and inclusion,” alleging that such projects may be discriminatory.

Caught up in the wave of terminations is work seeking to understand why some populations — including women and sexual, racial or ethnic minorities — may be more at risk of certain disorders or diseases.

Grants Terminated:

A study investigating how discrimination affects the mental health of Latino youth.

Research examining maternal behavioral health conditions of Black women.

An examination of the effects of structural racism on people at risk of kidney disease.

A study investigating why women of color disproportionately die from cervical cancer.

Adana Llanos, an epidemiologist and health equity scholar at Columbia University

Despite preventative vaccines and improved screening, more than 4,000 women die every year from cervical cancer. Black and Hispanic women are more likely than their white peers to be diagnosed, and often at later stages.

After more than a decade of studying cancer care disparities, epidemiologist Adana Llanos found that the ZIP code in which a woman received care often plays a pivotal role in how she fares. And in 2023, Llanos and her colleagues were awarded a multiyear NIH grant to further examine inequities, specifically in cervical cancer care and who survives it.

Even though their work targets the women most at risk, Llanos said their research, like most health equity research, will increase our understanding of cervical cancer more broadly. “This work has the potential to improve cancer outcomes for everyone, no matter what you identify as, no matter what your characteristics are,” she said.

Last year, her team began to recruit a cohort of 960 women who had been diagnosed with cervical cancer to track their patterns of care and outcomes. But in March, after the researchers had enrolled about 200 participants, the NIH terminated the funding. Llanos paused enrollment.

The cancellation felt like a betrayal of her study’s participants, she said. Llanos had spent years developing relationships with community groups and cancer patients, gaining their trust so they would feel comfortable sharing their treatment experiences.

“We’ve made commitments to them,” she said.

More than 550 of the terminated grants were focused on health disparities or inequities, attempting to understand why some groups have different health outcomes.

“If you cannot identify groups that are higher risk, it seems like just really bad science. That’s sort of the basics of how you try to conquer a disease.” —Carl Latkin, professor at Johns Hopkins University’s Bloomberg School of Public Health, who was analyzing the comorbidities of people who have HIV and those at risk for getting it

“Health disparities are just going to get larger, and real folks are going to die.” —Marguerita Lightfoot, professor at the Oregon Health & Science University-Portland State University School of Public Health, who was studying the value of guaranteed income and financial mentoring to Black youth

“It’s a major principle of epidemiology to target work towards the people who are being disproportionately affected. Now we’re being told that we cannot mention them in our research.” —Dr. Matthew Spinelli, assistant professor at the University of California, San Francisco, who was working to prevent sexually transmitted infections with common antibiotics

LGBTQ+ People Targeted

(Jason Koxvold for ProPublica)

One of Trump’s first executive orders was a directive banning federal funds from being used to support or promote so-called “gender ideology.” Hundreds of grants focused on the health of LGBTQ+ populations have been terminated, including many studies focused on young people and those at risk of contracting HIV.

In response to a lawsuit, a federal judge issued an injunction barring the administration from fully enforcing the orders. It canceled the grants anyway, citing agency policy and scientific priorities.

Grants Terminated:

A study to improve the delivery of behavioral health care to LGBTQ+ youth.

Research to address substance use in young men who are at risk for or living with HIV.

An evaluation of disparities in mpox vaccination rates among men who have sex with men.

An investigation of why LGBTQ+ adults are dying by suicide.

Lauren Forrest, an assistant professor of psychology at the University of Oregon (Jason Koxvold for ProPublica)

Gay, lesbian and bisexual adults are over three times more likely to consider suicide than their heterosexual peers. Few studies have aimed to figure out how to prevent this.

Last year, Lauren Forrest, an assistant professor of psychology at the University of Oregon, received a multiyear grant to do so, focusing on LGBTQ+ people who live in rural areas where access to specialized care may be more limited.

She was planning to recruit dozens of participants. But on March 21, she received a notification from the NIH that her grant was terminated because it did not “effectuate” the agency’s priorities, citing its connection to “gender identity.”

“The way they’re going about deciding which grants will or won’t be terminated, it’s not about scientific rigor,” she said. “It’s about literally actively discriminating against health-disparity populations.”

Forrest has been forced to reduce the hours of her research staff, and she now risks losing key lab personnel who may have to seek other employment due to the cuts. “There is no way to recover the lost time, research continuity or training value once disrupted,” she said.

She worries most about the deaths that could have been prevented. “People are going to be harmed because of this,” she said.

More than 300 of the grants terminated by the NIH were focused on LGBTQ+ health care. About 40 of those grants were researching ways to prevent suicide in adults and youth.

“We have a paper that’s ready to go out that shows lesbian women are almost 3 times as likely to have a stillbirth compared to their heterosexual peers. That’s such an avoidable, horrible outcome to happen, and that paper may never be published.” —Brittany Charlton, associate professor at Harvard Medical School, who was quantifying obstetrical outcomes for lesbian, gay and bisexual women

“It is devastating to have state-sanctioned dehumanization and exclusion. I am afraid for what these messages will do to the mental health of youth who are told they don’t matter or, for some, that they don’t even exist by parts of society.” —Dr. Sarah Goff, professor at the University of Massachusetts, Amherst, who was studying how to improve the delivery of mental health care to LGBTQ+ youth

“I honestly burst into tears. The evidence we would have gained from this work will not exist.” —Kirsty Clark, assistant professor at Vanderbilt University, who was finding best practices for preventing suicide in LGBTQ+ preteens

Losing a Generation

The grant terminations and subsequent instability have created a lost generation of scientists, dozens of researchers told ProPublica — cutting off an established pipeline at all stages of researchers’ careers.

Universities are trimming the number of openings in postdoctoral and graduate programs.

Young researchers are struggling to find funding to initiate studies or open new laboratories.

And some scientists are opting to pursue opportunities abroad.

Grants Terminated:

A grant to train researchers and public health professionals on HIV science.

A program to support the development of early-career scientists and researchers.

A grant to support Ph.D. students from historically underrepresented groups.

A program to train the next generation of pediatric research scientists.

Dr. Lauren Harasymiw, a scholar in the NIH’s Pediatric Scientist Development Program

Dr. Lauren Harasymiw was a medical resident in a neonatal intensive care unit when an infant took a turn for the worse. Born at only 23 weeks gestation — the edge of viability — the baby girl experienced a hemorrhage within the ventricles of her brain.

“What does this mean for her?” Harasymiw recalls asking her attending physician. The supervisor didn’t know. “The field of neonatology has made incredible strides over the last decades in helping our babies survive,” Harasymiw said. “But we’ve made less progress in protecting their neurodevelopmental outcomes.”

If doctors could better assess infants’ outcomes after a brain injury, they could target interventions sooner and provide families with better resources. To advance this area of medicine, Harasymiw pursued NIH-funded training to become a pediatric scientist.

But in March, the NIH terminated funding for the Pediatric Scientist Development Program, which funded Harasymiw’s salary and research, claiming that the program was connected to “DEI.”

“This is just ripping out the foundation of my career,” Harasymiw said.

In a statement about the grant terminations, Nixon, the HHS spokesperson, said that the NIH “continues to invest robustly in training and career development opportunities that produce measurable contributions to biomedical science and patient care.” However, he added that “while fostering the next generation of scientists is essential, effective leadership requires clear focus: prioritizing research that is impactful and results-driven over duplicative or low-yield programs.”

Dr. Sallie Permar, who runs the program and is chair of pediatrics at Weill Cornell Medicine, was perplexed by the cut; the program seemed to be in line with the administration’s focus on combating chronic disease in children.

“That’s exactly what we’re training these scholars to do,” she said.

More than 50 researchers told ProPublica that the funding cuts would harm the next generation of scholars, discouraging them from practicing in the United States.

“We have a generation of researchers that were planning to focus on these questions that are now either scared or don’t have funding to continue their training, or both.” —Mandi Pratt-Chapman, associate center director for community outreach, engagement and equity at the George Washington Cancer Center, who was identifying best practices for collecting data about LGBTQ+ people at small and rural cancer centers

“Admissions for graduate school have been downsized to a point where prospective students are giving up on pursuing a Ph.D.” —Tigist Tamir, assistant professor at the University of North Carolina at Chapel Hill, who received a career development grant and was studying how oxidative stress is regulated in breast cancer and obesity

“I already know several researchers on the job search who ended up taking faculty positions in Canada instead of the U.S.” —Dr. Benjamin Solomon, instructor of immunology and allergy in the department of pediatrics at Stanford Medical School, who received a career development grant and was examining rare genetic immune diseases in children

How We Reported the Story

Shortly after the public became aware of the termination of hundreds of grants at the National Institutes of Health, ProPublica published a call for tips in March, requesting that researchers with canceled grants share their experiences. ProPublica heard from more than 150 researchers and scientists and interviewed more than 70 about how the grant terminations were affecting their projects, their careers and the field of biomedical science at large. The story relies on the personal opinions of the researchers and does not reflect the views of their institutions. To understand the universe of NIH grant terminations, ProPublica relied on two main data sources: spreadsheets of terminated health grants released by the federal government to comply with Trump’s “Radical Transparency About Wasteful Spending” order, and data from Grant Watch, a private initiative tracking the terminations, led by researchers Noam Ross, Scott Delaney, Anthony Barente and Emma Mairson. They have used crowdsourcing and federal sources to create their dataset.

Were you involved in a clinical trial, participating in research or receiving services that have ended, been paused or been delayed because of canceled federal funding? Our reporters want to hear from you.

To share your experience, contact our reporting team at healthfunding@propublica.org.

Melody Kramer and Agnel Philip contributed research.

by Annie Waldman, Asia Fields and Ashley Clarke, design by Zisiga Mukulu, and photography by Bethany Mollenkof for ProPublica

US Senate GOP tries to ease the pain for states in sharing costs of SNAP benefits

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WASHINGTON — U.S. Senate Republicans will propose more moderate changes to the major federal food assistance program than their House counterparts, Senate Agriculture Chairman John Boozman said Wednesday, detailing a provision in a giant tax and spending cut bill that would penalize states less harshly than the House GOP version. The Agriculture section of the […]
Jacob Fischler, Jennifer Shutt

Thursday, June 12 - How this ghost story turned into an opera

4 weeks ago
This month the Opera Theatre of St. Louis is producing a new opera by one of the world’s most-celebrated living playwrights. Lynn Nottage — the only woman so far to win the Pulitzer Prize for Drama twice — wrote the libretto for “This House” with her daughter, Ruby Aiyo Gerber. The opera looks at African American history through the intersecting powers of memory and place.

Increasing humidity signals the return of weekend rain

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ST. LOUIS - St. Louis did not make it to 90 F Wednesday afternoon, but we made a good run. It was warm but overall pleasant, as the hot sun was filtered out behind some dense, high clouds. We say goodbye to the calm and quiet as we return to an unsettled Father's Day weekend. [...]
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“Delay, Interfere, Undermine:” How El Salvador’s Government Impeded a U.S. Probe of MS-13

4 weeks ago

Leer en español.

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

In mid-April, President Donald Trump sat down in the Oval Office with President Nayib Bukele of El Salvador to celebrate a new partnership. They had recently negotiated an extraordinary deal in which El Salvador agreed to incarcerate in a maximum security prison hundreds of Venezuelan immigrants that the Trump administration had labeled as violent criminals, though few had been convicted of such crimes. The U.S. also sent back accused members of the notorious Salvadoran gang MS-13 — which both the U.S. and El Salvador have designated as a terrorist organization.

Bukele’s presidency has been defined by his successful crackdown against MS-13. He has jailed tens of thousands of alleged gang members, transforming one of the hemisphere’s most dangerous nations into one of its safest. Although human rights groups have criticized his tactics, Bukele remains extremely popular in El Salvador.

During their meeting at the White House, Trump praised his guest as “one hell of a president.” He shook Bukele’s hand, saying, “We appreciate working with you because you want to stop crime and so do we.”

A long-running U.S. investigation of MS-13 has uncovered evidence at odds with Bukele’s reputation as a crime fighter. The inquiry, which began as an effort to dismantle the gang’s leadership, expanded to focus on whether the Bukele government cut a secret deal with MS-13 in the early years of his presidency.

New reporting on that investigation by ProPublica shows that senior officials in Bukele’s government repeatedly impeded the work of a U.S. task force as it pursued evidence of possible wrongdoing by the Salvadoran president and his inner circle.

Bukele’s allies secretly blocked extraditions of gang leaders whom U.S. agents viewed as potential witnesses to the negotiations and persecuted Salvadoran law enforcement officials who helped the task force, according to exclusive interviews with current and former U.S. and Salvadoran officials, newly obtained internal documents and court records from both countries.

In a previously unreported development, federal agents came to suspect that Bukele and members of his inner circle had diverted U.S. aid funds to the gang as part of the alleged deal to provide it with money and power in exchange for votes and reduced homicide rates. In 2021, agents drew up a request to review U.S. bank accounts held by Salvadoran political figures to look for evidence of money laundering related to the suspected diversion of U.S. funds. The list of names assembled by the agents included Bukele, senior officials and their relatives, according to documents viewed by ProPublica.

“Information obtained through investigation has revealed that the individuals contained within this submission are heavily engaged with MS-13 and are laundering funds from illicit business where MS-13 are involved,” the agents wrote. The people on the list “are also believed to have been funding MS-13 to support political campaigns and MS-13 have received political funds.”

The outcome of the request is not known, but its existence shows that the U.S. investigation had widened to examine suspected corruption at high levels of the Bukele government.

The investigation was led by Joint Task Force Vulcan, a multiagency law enforcement team created at Trump’s request in 2019. Agents found evidence that the Bukele government tried to cover up the pact by preventing the extraditions of gang leaders who faced U.S. charges that include ordering the murders of U.S. citizens and plotting to assassinate an FBI agent.

In addition, U.S. officials helped at least eight of their counterparts in Salvadoran law enforcement flee the country and resettle in the United States or elsewhere because they feared retaliation by their own government, current and former U.S. officials said.

It has been clear from the beginning what Trump wants from El Salvador: an ally who would accept, and even imprison, deportees. Less clear has been what Bukele might want from the United States. In striking the deal with the Salvadoran president, Trump has effectively undercut the Vulcan investigation and shielded Bukele from further scrutiny, current and former U.S. officials said.

Veterans of the Vulcan team are “concerned that all their work, the millions of dollars that were spent, going all over the United States, El Salvador, Guatemala, Mexico, that it will be weakened for political reasons,” said a U.S. official familiar with the investigation.

The task force worked closely with the Salvadoran attorney general’s office, whose prosecutors shared evidence from their own investigation of the gang negotiations and suspected graft in the Bukele government, according to current and former U.S. and Salvadoran officials.

“There was good information on corruption between the gang and the Bukele administration,” Christopher Musto, a former senior official at Homeland Security Investigations, or HSI, who worked on Vulcan, said about the Salvadoran investigation. “It was a great case.”

In May 2021, Bukele’s legislative majority in Congress ousted the attorney general and justices of the Supreme Court, which oversees extradition requests. Within seven months, newly installed justices reversed or halted six requests for senior gang leaders wanted in the U.S., according to interviews and documents.

“Bukele’s people were coming to the Supreme Court and saying under no circumstances are we extraditing the MS-13 leaders,” said the U.S. official familiar with the investigation. “‘Delay, interfere, undermine, do what you have to do.’”

Senior Bukele officials helped an MS-13 leader with a pending extradition order escape from prison, according to court records, U.S. officials and Salvadoran news reports. At least three other top gang leaders were released from Salvadoran custody after the U.S. filed extradition requests for them, according to Justice Department documents.

Published accounts in the United States and El Salvador have reported allegations that Bukele also pushed for the return of MS-13 leaders to prevent them from testifying in U.S. courts about the pact. Despite his government’s refusal to extradite gang bosses to the United States, the Trump administration in March deported one MS-13 leader accused of terrorism. The Justice Department is now seeking to dismiss charges against a second leader, which would allow him to be sent back to El Salvador, according to recent court filings.

The Justice Department declined to comment in response to questions sent by ProPublica. The State Department referred questions to the Justice Department.

A White House spokesperson did not respond to detailed questions.

“President Trump is committed to keeping his promises to the American people and removing dangerous criminals and terrorist illegals who pose a threat to the American public,” said Abigail Jackson, a White House spokesperson. “We are grateful for President Bukele’s partnership.”

Bukele, the Salvadoran Ministry of Foreign Affairs and the Salvadoran Supreme Court did not respond to lists of questions. Bukele has repeatedly denied making any agreement with MS-13. The Trump administration’s deportation of MS-13 members to El Salvador, he said in a post on X, will enable security forces to dismantle the gang.

“This will help us finalize intelligence gathering and go after the last remnants of MS-13, including its former and new members, money, weapons, drugs, hideouts, collaborators, and sponsors,” the post said.

President Donald Trump and Nayib Bukele, El Salvador’s president, during a meeting in the Oval Office in April 2025. Trump has praised Bukele as “one hell of a president.” (Al Drago/The Washington Post/Getty Images) “Just Fear”

Bukele was elected president of El Salvador in February 2019, promising to fight the country’s ingrained political corruption and pervasive gang violence, which he called “one of the greatest challenges” facing the nation.

During his first term, Trump also made MS-13 a high-profile foe, calling it “probably the meanest, worst gang in the world.” In August 2019, Attorney General William P. Barr created the Vulcan task force, teaming federal prosecutors with agents of the FBI, Homeland Security Investigations, Drug Enforcement Administration and other agencies. The goal: Eradicate MS-13.

For decades, MS-13 has bedeviled law enforcement in the Americas with its vast reach, extreme violence and complex culture. The initials stand for “Mara Salvatrucha.” “Mara” means a swarm, while “salvatrucha” has been said to refer to a clever Salvadoran, according to interviews and an academic study. The number represents the 13th letter of the alphabet, M, in homage to the Mexican Mafia, the powerful Southern California prison gang.

MS-13 emerged in the 1980s in Los Angeles among Salvadoran youths whose families had fled a bloody civil war. The gang expanded throughout the diaspora and, as the U.S. deported planeloads of ex-convicts starting in the 1990s, took root in El Salvador. Although most of the leaders were serving sentences in El Salvador, a jailhouse council of 14 bosses, known as the “Ranfla,” used cellphones to micromanage criminal activities in U.S. cities thousands of miles away.

The gang developed a reputation for torturing, brutalizing and dismembering its victims. Barr has called it “a death cult” in which violence is more important than riches.

“It was like a very violent mom-and-pop operation where the cousins and second cousins all want to be a part of it,” said Carlos Ortiz, who served as the HSI attaché in El Salvador from 2018 to 2024. “Minimal money, compared to others. Even though it’s an organization, a lot of it is just fear. Fear of the high-ranking bosses among the rest of the gang, that’s what drives it.”

Trained with military weapons, MS-13 warred with security forces in El Salvador, took over neighborhoods and generated one of the world’s worst homicide rates, driving an exodus of immigrants reminiscent of the 1980s. The Salvadoran Supreme Court designated the gang as a terrorist organization in 2015.

The Vulcan task force had about 30 members, including prosecutors, agents and analysts. Its director, John J. Durham, was a federal prosecutor in the Eastern District of New York who had spent a decade pursuing MS-13 cliques on Long Island. Members of the task force worked from bases around the country and traveled to Mexico and Central America.

One of the founding investigators, Newark FBI agent Daniel Brunner, spoke fluent Spanish and had worked gangs for seven years. He became a roving specialist providing expertise, communications intelligence and court transcripts, sometimes in person and sometimes from a distance.

“Our idea was that Vulcan was like a SEAL Team 6, going in to help the different districts build cases,” Brunner, who is now retired, said in an interview.

Vulcan built on the longtime U.S. presence and extensive influence in El Salvador, where the embassy has long funded and trained law enforcement agencies. FBI agents and others were embedded as advisers in police anti-gang and homicide units and worked with prosecution teams led by Attorney General Raúl Melara.

The U.S. task force modeled its strategy on the ones used against Mexican cartels and Colombian narcoguerrillas: Break the power of the MS-13 bosses by extraditing them to face trial and prison in the United States.

On Jan. 14, 2021, six days before the end of the Trump administration, Durham and FBI Director Christopher A. Wray joined acting Attorney General Jeffrey A. Rosen when he announced “the highest-reaching and most sweeping indictment targeting MS-13 and its command and control structure in U.S. history.”

Prosecutors charged the 14 members of the leadership council with major crimes including conspiracy to support and finance narcoterrorism. For more than two decades, the Ranfla ran a criminal network in the United States, Mexico and Central America that sanctioned the murders of Americans and trafficked drugs and arms, the indictment alleged.

The indictment contained a stunning charge: MS-13 bosses had taken the extraordinary step of giving an order, or “green light,” to assassinate an FBI agent working with local investigators in El Salvador. Embassy officials learned of the threat and evacuated the agent, according to interviews.

It is highly unusual for Latin American criminal groups to target a U.S. agent — they have learned that it invites an overwhelming law enforcement response. The assassination plot was a sign that the U.S. crackdown had rattled the gang chiefs, current and former officials said.

Family and friends attend the burial of Justin Llivicura in 2017 on Long Island, New York. Justin, a 16-year-old high school student, was one of four teenagers murdered in a park by members of MS-13. (Andrew Lichtenstein/Corbis via Getty Images) Vulcan on the Hunt

In conversations with American officials as president-elect, Bukele promised cooperation and welcomed their support against gangs and graft, even in his own Nuevas Ideas party, according to current and former U.S. officials.

At a press event about the Vulcan task force in 2020, Trump asserted that in the past El Salvador “did not cooperate with the United States at all,” but now it had become a strong law enforcement partner.

Already, though, there had been news accounts alleging that Bukele had cut deals with gangs when he was mayor of San Salvador. Vulcan investigators quickly found evidence that top aides to the new president were negotiating a new pact with gang chiefs, according to interviews.

For more than a decade, MS-13’s control of the streets had made it a political force. It could deliver votes, ignite mayhem or impose order. A series of politicians had held talks with gang leaders to seek electoral support and reductions in violence in return for improved prison conditions and perks such as prostitutes and big-screen televisions.

The Bukele government adopted a more sophisticated bargaining strategy, according to current and former U.S. and Salvadoran officials. During secret meetings in prisons and other sites, the president’s emissaries offered MS-13 leaders political power and financial incentives if they lowered the homicide rate and marshaled support for the Nuevas Ideas party, according to current and former U.S. and Salvadoran officials and court documents.

The chief negotiator was Carlos Marroquín, a former rap artist and confidant of the president. Bukele had appointed him the director of a new Justice Ministry program known as “Reconstruction of the Social Fabric” that operated in impoverished communities.

Marroquín promised the Ranfla a central role in developing the program, control of neighborhood youth centers, power over urban turf and other financial and political benefits, according to current and former U.S. officials, court documents and Treasury Department sanctions. Informants and communications intercepts indicated that some of the resources going to MS-13 came from U.S. government aid, a violation of U.S. law, according to interviews and documents.

“Money was going from us, from USAID, through to this social fabric group,” a former federal law enforcement official said. “They’re supposed to be building things and getting skills and learning. It was funding the gangs.”

Vulcan also gained information from two highly placed Salvadoran officials involved in the talks with MS-13. The officials provided inside information to U.S. agents about the negotiations, which they said Bukele directed, according to interviews.

The accumulating evidence about the gang pact and the suspected misuse of U.S. funds spurred the task force to broaden its initial focus and target alleged corruption in the Bukele government, current and former U.S. officials said.

In April 2021, federal agents prepared a list of powerful Salvadorans for a financial review by the U.S. Treasury Department. Bukele was one of the 15 names. So were Marroquín; Osiris Luna, the director of the national prison system and another alleged organizer of the gang talks; Martha Carolina Recinos, the president’s chief of staff; and other political figures and their relatives. The request asked the Treasury Department to search for possible illicit transactions in any bank accounts held in the United States by those on the list, according to documents seen by ProPublica.

The Vulcan task force was seeking evidence in U.S. banks of money laundering tied to the diversion of USAID funding through the gang pact, the documents showed. Agents explained that the task force had “uncovered information that MS-13 members are in close contact with politically exposed persons in El Salvador,” referring to prominent government figures.

“The USAID funding is believed to have been laundered by the individuals submitted in this request,” who were suspected of “facilitating, supporting and promoting MS-13 through their official positions,” said the request, which was viewed by ProPublica.

Made under section 314A of the USA Patriot Act, the request for a canvass of U.S. banks requires that investigators show reasonable suspicion rather than probable cause, which is a higher standard. The outcome of the request is unknown. The Treasury Department declined to comment. U.S. prosecutors have not publicly accused Bukele and the others of crimes related to USAID funds.

As U.S. investigators advanced in this political direction, they gained valuable information from the Salvadoran prosecutors who were pressing their own investigation of the gangs and the Bukele administration.

Known in English as Operation Cathedral, their probe was as ambitious and sensitive as the U.S. one. Investigators had documented the secret jailhouse deals with MS-13 and the official attempts to cover them up. They also pursued leads that revealed alleged widespread corruption involving the country’s COVID-19 relief programs, according to current and former U.S. and Salvadoran officials and documents. Political tensions increased as the Salvadoran prosecutors targeted the president’s inner circle and raided government offices, clashing with police who tried to stop them from searching the Health Ministry in one incident.

April 2021 was also when a delegation led by Attorney General Melara came to Washington to meet with leaders of Vulcan and other senior U.S. officials. The prosecutors laid out their case against prominent figures in the Bukele government. The “impressive” presentation, a former U.S. federal law enforcement official said, cited videos, phone intercepts and other evidence showing that Marroquín, prisons director Luna and others had clandestinely arranged for government negotiators and gang leaders to enter and leave prisons, smuggled in phones and destroyed logs of prison visits.

“Melara was very nervous because of the very high level of the people he was investigating,” a former U.S. federal law enforcement official said.

Melara declined to comment, saying he does not discuss his work as attorney general.

The Salvadoran director of prisons, Osiris Luna, right, speaks at a police facility in San Salvador, El Salvador, in November 2021. (Rodrigo Sura/EPA-EFE/Shutterstock) Interference

On May 1, 2021 — soon after Melara and his team met with U.S. investigators — the Salvadoran Legislature, controlled by Bukele, voted to expel the attorney general and five justices on the Supreme Court.

The purge was a decisive step by Bukele to centralize power. It drew international condemnation. In El Salvador, critics denounced the president’s actions as a “self-coup.” On his Twitter page, Bukele began calling himself “the world’s coolest dictator.”

For Vulcan, the expulsions marked a dramatic shift in its investigation. The Supreme Court justices had signaled their willingness to sign off on some extraditions. Melara had been a helpful ally who reportedly pledged to do “everything necessary” to extradite the Ranfla members, many of whom were in custody in El Salvador. But it soon became clear that the government was no longer interested in handing over senior gang leaders.

“The next prosecutors were not willing to work with us,” said Musto, the former HSI official. “We were not closed out, but all these things that we had in place that we were moving to getting people back here slowed down to a snail’s pace.”

The first clash came over Armando Melgar Diaz, an alleged MS-13 leader who acted as a middleman between gangs in the United States and senior leaders in El Salvador. Melgar, known as “Blue,” had ordered the kidnapping of a family in Oklahoma that owed the gangs $145,000, collected money from a drug ring operating out of restaurants in Maryland and Virginia and was involved with killings in the U.S., according to an indictment and interviews with U.S. officials. He was the first MS-13 member to be accused under terrorism laws.

The newly constituted Supreme Court voted to approve Melgar’s extradition but then reversed its decision, announcing that the matter needed further study. Later, Bukele’s new attorney general asked for a halt to the extradition. The reason: The United States had failed to guarantee that it would not seek the death penalty or life in prison, sentences not allowed under Salvadoran law.

The rationale made no sense to Vulcan prosecutors. The Justice Department had already promised that it would not pursue such punishments against Melgar, according to records and interviews. U.S. and Salvadoran officials attributed the sudden reversal to fear that Melgar could link Bukele and his government to the pact with MS-13.

“Melgar Diaz was going to be the test case,” Musto said. “It was going to be an easy win for Vulcan.”

Information obtained by U.S. agents included allegations that Bukele’s judicial adviser, Conan Castro-Ramírez, had called one of the new Supreme Court justices and told him to find ways to stop the extradition of Melgar, according to interviews. When the justice objected, saying that the extradition had already been approved, Castro allegedly ordered him to reverse it. “That’s why we put you there,” he said, according to the interviews.

The State Department sanctioned Castro for his role in assisting in the “inappropriate removal” of the Supreme Court justices and the attorney general. Castro did not respond to attempts to contact him.

A Salvadoran court sentenced Melgar to 39 years in prison for conspiracy to commit homicide, among other crimes. He was the first MS-13 leader whose extradition was blocked. Soon after, the U.S. extradition requests for other gang chiefs ran into opposition.

“Bukele and his government are using the entire state apparatus to prevent these people from being extradited,” a person with knowledge of the Salvadoran judicial system said in a recent interview.

Miguel Ángel Flores Durel, a newly appointed Supreme Court justice who reportedly had served as a lawyer for a top MS-13 leader, made sure that the requests were never granted, according to the person with knowledge of El Salvador’s judicial system. Flores instructed colleagues “do not work on extraditions at all,” the person said.

In July 2022, El Salvador agreed to extradite two lower-ranking MS-13 members charged with the murders of Salvadoran immigrants in Long Island in 2016 and 2017 in which victims were butchered with axes and machetes. The Supreme Court also approved the return of Salvadorans not affiliated with the gang who were accused in the U.S. of crimes such as murder.

This was a deliberate strategy, the person said. Flores said that El Salvador needed to continue some extraditions in order to “calm” U.S. officials, who were complaining about the lack of cooperation with Vulcan, the person said. (Flores died in 2023.)

It didn’t work. The extradition of other criminals by the Bukele-aligned Supreme Court only emphasized the lack of cooperation on requests for the senior MS-13 leaders.

“We were never told officially that it wouldn’t happen, but it became impossible,” said Brunner, the former FBI agent.

In October 2022, Bukele’s new attorney general announced that criminals would first have to serve their sentence in El Salvador before being sent to the U.S. — an interpretation of the country’s extradition treaty that differed from the previous Supreme Court.

“We aren’t going to be sending Salvadorans without them first paying for the crimes they have committed” in El Salvador, Rodolfo Delgado said.

Threats and Roadblocks

The Bukele government’s interference with the U.S. investigation went beyond blocking extraditions, U.S. officials said.

Senior Bukele allies also waged a campaign of harassment and intimidation against the Salvadoran officials who had investigated corruption and assisted the Vulcan task force, according to interviews with current and former U.S. and Salvadoran officials.

The government threatened officials with arrest and sent police patrols to their homes, according to current and former U.S. and Salvadoran officials. At least eight senior Salvadoran law enforcement and judicial officials fled El Salvador for the United States and elsewhere. Vulcan provided them with travel money, language classes, housing and help gaining legal immigration status and finding jobs. In one instance, a U.S. Embassy official escorted a Salvadoran prosecutor out of the country because American officials believed his life was in danger, according to an official familiar with the incident.

The Salvadoran government also weakened special “vetted units” of the police that had worked with the FBI and other U.S. agencies, according to current and former U.S. officials.

Bukele’s allies didn’t stop there. They allegedly helped the escape or release from prison of at least four members of the MS-13 leadership council sought by Vulcan for alleged crimes in the U.S., according to interviews, court documents and press reports.

Elmer Canales-Rivera, alias “Crook de Hollywood,” was one of the most wanted of the Ranfla members. He had been imprisoned for several murders in El Salvador, including a case in which he reportedly helped suffocate and drown in insecticide a gang member who violated orders. In the United States, prosecutors had accused him of orchestrating murders and kidnapping across the nation for more than 20 years.

In November 2021, Canales escaped from prison. El Faro, a prominent investigative news outlet, and other Salvadoran media published stories that detailed how Marroquín had escorted Canales from the prison. The articles featured taped calls between gang members and a person identified as Marroquín discussing his role in the escape, along with photos of officials apparently attempting to remove jail logs to conceal their presence at the prison.

Canales was caught in Mexico and turned over to U.S. authorities. Currently in prison awaiting trial, he has pleaded not guilty.

Leaders of the MS-13 street gang read the newspaper after a press conference at La Esperanza jail in San Salvador in 2013. Elmer Canales-Rivera, known as “Crook de Hollywood,” right, allegedly escaped from prison with the help of senior Salvadoran officials in 2021. (Jose Cabezas/AFP via Getty Images)

Over the next several months, three other MS-13 leaders disappeared from Salvadoran prisons, causing Durham, the head of the task force, to express his concern in a letter to the judge in New York overseeing the cases. At the time the Bukele administration had received extradition requests and Interpol notices, he wrote, the leaders had been in custody. Salvadoran media later reported that the country’s Supreme Court had formally denied the extradition requests for the three men.

The purge of the Supreme Court and prosecutors, the blocked extraditions and the disappearance of the MS-13 gang members marked a significant deterioration in relations between Bukele and the administration of President Joe Biden. Agencies across the government began looking for ways to push El Salvador to cooperate.

Acting U.S. Ambassador Jean Manes announced a “pause” in relations with El Salvador and left the country. A veteran diplomat who had previously served in El Salvador, Manes had pressured Bukele in public and private, criticizing the extradition delays and his increasingly authoritarian rule, according to State Department officials.

“What are we seeing now? It is a decline in democracy,” Manes said shortly before her departure.

In December 2021, the Treasury Department issued sanctions against Bukele aides Luna, Marroquín and Recinos, blocking them from conducting financial transactions in the United States because of alleged corruption. None of them responded to questions sent to a Bukele spokesperson.

Nonetheless, former members of the task force said they felt that the Biden administration treated Vulcan as a lower priority and cut its resources. They said Biden officials saw the task force as a Trump initiative and wanted to focus on other law enforcement targets, such as human trafficking.

“As soon as the Biden administration came in, we were slowed down,” Brunner said. “There was a lot more red tape we had to go through.” Former Biden officials denied this was the case.

Whatever truce had existed between the Salvadoran government and MS-13 collapsed in March 2022. The country descended into chaos. Over one three-day period, some 80 people were killed in gang-related violence.

Bukele reacted forcefully. He declared a nationwide “state of exception” that suspended constitutional protections. Police began rounding up thousands of accused gang members and others. He announced the construction of the megaprison known as CECOT.

The policies proved tremendously popular. Murder rates dropped dramatically, though human rights advocates criticized the loss of civil liberties. Bukele dismissed their complaints.

“Some say we have put thousands in prison, but the reality is that we have set millions free,” he has said, an assertion he repeated to Trump in the Oval Office.

The Turnaround

Despite the harsh treatment of gang members — an estimated 14,500 people are now held in CECOT — one thing did not change: The Bukele government continued to refuse to extradite senior MS-13 leaders to the United States.

The reasons for Bukele’s alleged protection of the gang leadership versus his relentless pursuit of the rank and file are the subject of speculation in both the United States and El Salvador. One possible explanation, according to current and former U.S. and Salvadoran officials: Bukele is aware that Vulcan was gathering evidence that could lead to criminal charges and political damage. The imprisoned leaders are potential witnesses to his alleged deal with MS-13, while El Salvador’s street-level gangsters are not.

Police escort accused Venezuelans and Salvadorans after their deportation from the United States to be held in the CECOT megaprison in El Salvador. (El Salvador Press Presidency Office/Anadolu via Getty Images)

In February 2023, the Justice Department unsealed an indictment for another group of leaders, most of whom operated a tier below the Ranfla, relaying its directives to gangsters on the streets. The 13 defendants were accused of terrorism and drug smuggling, among other charges.

The U.S. announced it would “explore options for their extradition with the government of El Salvador.” The Justice Department declined to say whether any such requests had been made.

In filing the charges, prosecutors made their strongest public accusations yet about deals between the Bukele government and the gangs. Without naming the president or his allies, prosecutors alleged that MS-13 leaders agreed to use their vast political influence to turn out votes for candidates belonging to Bukele’s Nuevas Ideas party in legislative elections in 2021.

The gang bosses also “agreed to reduce the number of public murders in El Salvador, which politically benefited the government of El Salvador, by creating the perception that the government was reducing the murder rate,” the indictment said.

As part of the arrangement, the senior MS-13 leaders demanded that the Bukele government refuse to extradite them, the indictment said. The alleged condition appears to be in effect. To date, none of the extradition requests for more than a dozen high-ranking gang members has been approved.

In the face of obstacles, Vulcan relied increasingly on the Mexican government for help. During the past four years, Mexican authorities have captured nine of the 27 MS-13 leaders named in the indictments and deported them to the United States, where they were arrested. This year, prosecutors obtained guilty pleas to terrorism charges from two lower-ranking bosses, including one who prosecutors said had helped implement the deal between the Bukele administration and the gang. Sentencing for the men is pending.

Since Trump took office this year, his administration has redirected Vulcan’s mission to also target Tren de Aragua, a Venezuelan gang that the president has put in the spotlight.

There has been a remarkable recent development related to MS-13, however. After more than five years leading the Vulcan task force, Durham wrote letters asking the judge overseeing the cases to dismiss charges against two gang leaders in U.S. custody, allowing them to be deported to El Salvador. The letters were dated March 11 and April 1, weeks after the Trump administration began negotiating the mass deportation deal with Bukele’s government.

César Humberto López Larios, a member of the Ranfla known as “Greñas,” had his charges dismissed and was returned to El Salvador with more than 250 Venezuelans and Salvadorans sent to CECOT as part of the Trump administration’s mass deportation of migrants on March 15. López, identified in media reports, is featured in a slickly produced video posted by Bukele on X, kneeling in the prison, his head shaved. He had pleaded not guilty to the charges against him.

Then, in April, Durham asked for the dismissal of terrorism charges against a lower-ranking MS-13 prisoner, Vladimir Antonio Arevalo-Chavez, alias “Vampiro,” according to recently unsealed court records. His defense lawyers are seeking to stall the request to give them time to fight his deportation to El Salvador. He has pleaded not guilty.

Durham acknowledged in his letters to the judge that the evidence against the two men is “strong.” After millions spent on an operation involving investigators and prosecutors from the U.S., El Salvador and other countries, Vulcan had amassed a trove of evidence aimed at incarcerating the MS-13 leaders who had overseen the killings, rapes and beatings of Americans. Prosecutors told defense attorneys they had more than 92,903 pages of discovery, including 600 pages of transcribed phone intercepts, 21 boxes of documents from prosecutors in El Salvador and 11 gigabytes of audio files.

Durham said prosecutors were dropping their pursuit of the cases “due to geopolitical and national security concerns.”

It was like a reverse extradition. Trump was giving Bukele the kind of high-level criminals that the United States had never received from El Salvador.

During the negotiations over the use of El Salvador’s prison, Trump officials agreed to pay some $6 million to house the deported men and acceded to an additional demand.

Bukele had one specific request, according to Milena Mayorga, his ambassador to the United States.

“I want you to send me the gang leaders who are in the United States,” she quoted Bukele as telling U.S. Secretary of State Marco Rubio.

For Bukele, she said in a broadcast interview, it was “a matter of honor.”

Mica Rosenberg contributed reporting, and Doris Burke contributed research.

by T. Christian Miller and Sebastian Rotella