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The new Trump Administration has wasted no time in implementing its destructive agenda on matters that are of importance to human health – including climate policies, mining expansion, and tariffs on many health items including pharmaceuticals.
What has become obvious since Trump took office is the breadth and depth of damage to scientific research resources and support, effects that will be felt in the US and globally in health, particularly in low- and middle-income countries.
Following Trump’s actions in withdrawing from World Health Organization (WHO) and shutting down USAID, his Administration’s policies are now seemingly directed to both the process of how academic research and related health and science policy is done and how it is disseminated.
Dismantling sources of trusted information and capable opposition – including scientific and medical institutions – is a textbook strategy of authoritarians and one that must be fiercely resisted.
Some examples of damage included interfering with the weekly publication of the Centre for Disease Control and Prevention’s Morbidity and Mortality Weekly Report (MMWR), published continuously since 1961, and which provides an essential early reporting route for disease outbreaks.
To give a sense of its importance, in 1981, MMWR published the first report of five cases of healthy young men in Los Angeles with an unusual pneumonia – Pneumocystis carinii pneumonia (PCP) – which became the first reported cases of AIDS (CDC. Pneumocystis pneumonia — Los Angeles. MMWR 1981;30:250–2).
There has been extensive culling of vital health information elsewhere on the CDC website. On 31 January, The Washington Post reported that the CDC had ”removed or edited references to transgender people, gender identity and equity from its website”.
It also removed pages on the Youth Risk Behavior Surveillance System, which assesses the health behaviors of high school students and, bizarrely, removed information on the mpox vaccine from the site. Mpox is a disease that in the 2022/3 outbreaks was predominantly among gay, bisexual and other men who have sex with men; however, it has since moved into other populations.
The history of the vaccine page has fortunately been archived at the Wayback Machine of the Internet Archive – one example of the critical importance of organisations such as the Internet Archive in holding governments to account.
In further action, the CDC has directed that papers from their researchers that are under consideration at journals are withdrawn in order to remove language relating to gender – as the BMJ has noted, a clear indication that: “Gender is being dangerously weaponised”.
These attacks on so-called ‘gender-ideology’ and diversity, equity, and inclusion efforts undermine public health, the rights of affected populations, and the ability of researchers to pursue and report on new knowledge freely and in line with scientific best practice.
The Administration’s actions also extend to the grant making process. The National Science Foundation has been provided with a list of keywords that may not be included in grants and a flow chart on how to implement the list.
The list is so comprehensive, with words such as “biased” and “excluded”, it is hard to imagine that it will not preclude any grant being awarded. Perhaps that is the intent.
One of the earliest actions of the Administration was to halt grant review panels – now partially reinstated. Grant review panels are there to reduce unconscious bias and ensure there is a diversity of views and ideas, supporting top research. These actions seem determined to destroy the processes of scientific institutions.
Attempts are also being made to cut billions of dollars in medical research funding through the National Institutes of Health (NIH) grant system, which will affect the ability of universities, hospitals and other organisations to conduct vital research on conditions ranging from cancer to infectious diseases and threaten the sustainability of the entire US health research system.
Added to this direct attack on published and proposed research, the Trump Administration has also put a stop to educational opportunities, in that government employees cannot attend academic conferences and the CDC has been directed to stop communicating with WHO. Controlling a dominant narrative is a clearly authoritarian action.
These actions might just be the beginning. What is even more concerning is that other, non governmental organisations are now apparently pre-emptively acting in a way that aligns with Trump’s intentions.
The American Society for Microbiology altered an article on the history of women in microbiology without the author’s permission (it has now been returned to its previous state after an outcry by scientists)
On 5 February, the Howard Hughes Medical Institute sent a letter to all recipients of its program on Inclusive Excellence that the program had been “brought to a close”. Its web page is no longer accessible (also fortunately archived by the Wayback Machine).
What will happen next?
The world asked such when Pol Pot started his anti-academic tirade in then Kampuchea. It took that country many decades to reinstate support for academic endeavors and during that time, healthcare was close to non existent.
In addition to the CDC, the US Government controls other important academic institutions.
It owns PubMed, for example, which is the world’s biggest and most definitive database of medical publications, and also maintains a number of genomic data repositories.
These are incredibly important sources of information globally and in Australia, – including for researchers, health practitioners, and the general public. It’s not hard to imagine the effect of the Administration turning its attention to these.
Thus far the alarm on these actions is being sounded in some scientific and medical journals…
- BMJ (4 February): Medical journal editors must resist CDC order and anti-gender ideology
- Nature (6 February): ‘It is chaos’: US funding freezes are endangering global health
- Science (7 February): A world less safe and secure
- The Lancet (8 February): American chaos: standing up for health and medicine
…and on social media, but the effect of these actions extend well beyond that community.
We are witnessing a full-scale attempt to shape what is researched and what is in the public domain with regard to health and scientific evidence. These actions will have a direct effect on knowledge globally as well as patient care.
There is already clear targeting of specific vulnerable communities such as transgender people; reproductive rights are likely next in line.
It’s essential that countries globally understand that attacks on science and medicine are attacks on human rights and take them as seriously as those of Trump’s other devastating policies.
Medical journals, such as the MJA, have a very specific role to play here, and it is essential that they both uphold the international norms of publishing but also ensure that the actions taken by the Trump Administration are documented and countered.
The Trump Administration’s actions will have long term global effects. Global leadership is desperately needed now and ongoing from universities and governments who rely on quality research to inform appropriate policy making.
International bodies such as the WHO and other intergovernmental organisations have the authority and mandate to speak out on issues of international importance and they now need to take all the actions they can – political, moral and legal – to push back on Trump Administration’s actions.
The article originally appeared on Croakey.
Prof Virginia Barbour is the Editor-in-Chief of the Medical Journal of Australia. She is an Adjunct Professor at Queensland University of Technology. She was previously co-lead of the Office for Scholarly Communication at QUT and was Director of Open Access Australasia until 2024.
Dr Elizabeth Zuccala is the Senior Deputy Medical Editor at the Medical Journal of Australia.
Professor Jennifer Martin is a general physician and clinical pharmacologist; University of Newcastle.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.
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