The Trump administration has launched a comprehensive review of all research that involves fetal tissue, reopening an issue that has galvanized anti-abortion activists but worried scientists who fear their work could be under threat.

Fetal tissue has been used for a wide range of research in the U.S. since the 1930s, including the development of several vaccines and studies of genetic diseases. The tissue is obtained through elective abortions, and there are strict rules around how it can be procured and used.

In a statement released late Monday, however, the Department of Health and Human Services said it would review whether current oversight of fetal tissue is adequate “in light of the serious regulatory, moral, and ethical considerations involved.” The agency also said it would terminate a contract with Advanced Bioscience Resources, a California-based nonprofit that supplies fetal tissue for scientific research, because of concerns that the contract did not include “appropriate protections” or meet “procurement requirements.”

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STAT was unable to reach Advanced Bioscience by phone for comment.

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The announcement follows the release of a letter sent earlier this month by 45 anti-abortion leaders to HHS Secretary Alex Azar, expressing outrage about the Food and Drug Administration’s contract and urging him to end government funding for fetal tissue research. In 2017, the National Institutes of Health spent roughly $98 million on the research.

“The use of fetal tissue is important or even necessary for some kinds of work,” said Alta Charo, a bioethics professor from the University of Wisconsin who has defended fetal tissue research before Congress. Charo noted that research using fetal tissue led to the development of key vaccines and is now crucial to research on understanding how exposure to Zika virus during pregnancy causes birth defects.

“Fetal tissue continues to be an important resource for biomedical research, and the Association of American Medical Colleges fully supports its availability as one of the scientific methods that could save and improve lives,” said Dr. Ross McKinney, the organization’s chief scientific officer.

The controversy over fetal tissue was rekindled in 2015 after anti-abortion activists released a series of videos that purported to show Planned Parenthood officials discussing the sale of fetal body parts with fetal tissue firms, including Advanced Bioscience Resources. Planned Parenthood said the videos were edited in a way to be misleading. The following year, a Texas grand jury cleared Planned Parenthood of wrongdoing and instead indicted two members of the Center for Medical Progress, the anti-abortion group that made the videos.

GOP-led lawmakers in the House later established a special panel to examine the practice. The panel issued a 471-page report that recommended, among other ideas, that lawmakers ban federal funds from being spent on research that uses fetal tissue.

“I am not surprised this anti-research campaign has insinuated itself into HHS as well,” Charo said.

A House subcommittee went on to propose prohibiting federal funds from being spent on research that uses fetal tissue; the provision, however, never made it to the floor.

In the letter sent to Azar earlier this month, anti-abortion leaders renewed that request. They asked Azar to find “ethical alternatives” to fetal tissue in government-funded research as soon as possible.

HHS said it will explore whether there are such alternatives — and will push to fund and accelerate the development of any possible options.

That response did not satisfy anti-abortion activists.

The Susan B. Anthony List — the nonprofit that coordinated the letter to Azar — called the actions by HHS “completely inadequate.” “Secretary Azar should instead devote tax dollars to ethical alternatives that – unlike experimentation on fetal tissue – produce successful therapies for patients,” SBA List President Marjorie Dannenfelser said in a statement.

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