Federal science agencies are at a crossroads in trying to comply with President Donald Trump's executive orders. As a result, the health of millions is potentially at risk.
Background
In a "head-snapping, blink-and-you'll-miss-it," two weeks, Trump issued executive orders recognizing only two genders and rolling back diversity, equity and inclusion initiatives within the federal government, said Science. Federal agencies, especially those focused on public health, have felt the heat and have had to "temporarily suspend new awards, review existing grants, block grantee access to funds already allocated and halt meetings of grant-review panels." They also retroactively "removed calls for proposals in specific areas, websites and access to public databases that deal with now off-limits topics."
The latest
One of the agencies most affected is the Centers for Disease Control and Prevention (CDC), which removed thousands of website pages containing the words, "gender, transgender, pregnant person, pregnant people, LGBT, transsexual, nonbinary, assigned male at birth, biologically male, biologically female, he/she/they/them," and anything related to gender ideology and identity as a whole, said Reuters. This especially threatens access to information regarding sexually transmitted infections and reproductive health. However, pages not directly related to the orders were purged as well. For example, the "purge had also swept up vaccine information statements, which must be given to patients before they can be immunized; guidelines for contraception; and several pages on how race and racism affect health outcomes," said The New York Times. The CDC also recently released data showing that bird flu (H5N1) was spread between cats and humans, but it was promptly deleted.
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Also affected is the National Science Foundation (NSF), which provides grants to research projects globally. Now, several funded projects are at a standstill. NSF staff have been "combing through thousands of active science research projects, alongside a list of keywords, to determine if they include activities that violate executive orders," said The Washington Post. According to an internal document, "NSF grants that are flagged for 'further action' because they don't comply with the executive orders could be subject to a range of additional steps, including modification to be in compliance or being terminated in part or whole."
Following public backlash to the purges, some CDC pages were restored, but several continue to be unavailable and many restored pages have changes to them. "Across the country, folks like me are trying to catalog what is missing and what has changed in terms of what's back up," said Dr. Megan Ranney, an emergency physician and the dean of Yale University's School of Public Health, to NPR. Doctors for America, an advocacy group representing physicians, has filed a lawsuit against federal health agencies in response to the removal of websites and databases.
The reaction
Doctors and scientists have expressed concern about the state of health care. "We can't just erase or ignore certain populations when it comes to preventing, treating or researching infectious diseases such as HIV. I certainly hope this is not the intent of these orders," said Carl Schmid, the executive director of the HIV+ Hepatitis Policy Institute, to Reuters. They have also called into question the legality of the purge. "It sounds incredible that this is compatible with the First Amendment. A constitutional right has been canceled," said Dr. Alfredo Morabia, the editor-in-chief of the American Journal of Public Health. "How can the government decide what words a journal can use to describe a scientific reality? That reality needs to be named."
"This is completely unprecedented," Dr. Nirav R. Shah, a senior scholar at Stanford University and former commissioner of the New York State Department of Health, said to NPR. "We're actually dimming the lights on our ability to protect and preserve the health of all Americans."
