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Senators voted 100-0 to approve the former Obama administration official, who was the VA's top health official since 2015, in a rare show of bipartisanship amid partisan rancor over Trump's other nominees. Shulkin secured the backing of Senate Democrats after pledging at his confirmation hearing to always protect veterans' interests, even if it meant disagreeing at times with Trump. The 57-year old physician has ruled out fully privatizing the agency and says wide-scale firings of VA employees are unnecessary, describing the VA workforce as "the best in health care." Trump had made accountability and rooting out wrongdoing a cornerstone of VA reforms, having called the department "the most corrupt." Shulkin is the first nonveteran to head the government's second-largest agency, which has nearly 370,000 employees and an annual budget of nearly $167 billion. He'll have plenty to do once sworn in. Shulkin has acknowledged that Congress should hold him to a higher standard of faster results as a former VA official who has laid initial groundwork for changes. He says he should be fired from his job if, like some VA secretaries before him, he isn't able to significantly fix problems and regain veterans' trust. "You're not going to hear me asking for a learning curve," Shulkin said at his hearing. "I don't have a lot of patience and I am going to be serious about making these changes and regaining that trust." The immediate challenge includes revamping scheduling and access for VA medical appointments following a 2014 wait-time scandal. Shulkin is urging a more integrated VA network where veterans could seek outside private care only in coordination with the VA. He has not sketched out full details. "We've yet to hear from him how he'll pursue President Trump's vision for a public-private partnership at the VA," said Dan Caldwell, policy director for the conservative group Concerned Veterans for America.

A year after U.N. health officials declared Zika a global emergency, the city that produced some of the outbreaks most terrifying and indelible images of badly deformed infants feels like a place that has mostly moved on. Not the parents of the babies in those heartbreaking photographs. Initially, many feared that the infants would be merely the first wave of Zika victims, with many more to follow. Yet as the virus spread across the Americas and infected hundreds of thousands, it did not inflict the kind of damage seen here in northeast Brazil, where three-quarters of Zika-related birth defects have been reported. Today those families are like the survivors of a natural disaster. Though Zika scared a lot of people, its lasting harm fell on a relative few. Those families have developed new routines. Eliane Paz ferries her son, Davi Lucas, to five different hospitals a week for visual, motor and auditory therapy. The 1-year-old was diagnosed with severe microcephaly when he was born in October 2015, weeks before doctors connected the condition to Zika.

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