It has been a brutal few weeks for anyone who cares about American medical science.
First, we watched as the safety of thousands of study subjects and years of carefully conducted research were endangered by decimation of the U.S. Agency for International Development. Then we got front-row seats to Trump and Elon Musk’s hatchet attack on federally funded medical science at home.
At the National Institutes of Health, the cuts were so severe that experts called it “an apocalypse for American science.” At the Centers for Disease Control — the agency that works to protect the country’s public health — mass firings were carried out in a way that Dr. Georges Benjamin, executive director of the American Public Health Association, called “destructive to the core infrastructure of public health.”
And lest we forget, vaccine skeptic and conspiracy theorist Robert F. Kennedy Jr. took a victory lap through the Senate and was sworn in to lead the Department of Health and Human Services, where he can now use his bully pulpit to undermine experts and promote wacky ideas — for example, that Lyme disease is actually a military bioweapon.
Put together, these events don’t look coincidental, but more and more like part of a coordinated attack on American medical science.
Yet despite the existential threat to American health, resistance from our leaders has been remarkably light. During the Kennedy nomination process, while grassroot physicians and medical scientists were writing letters and circulating petitions, our leaders — professional societies, heads of laboratories, deans of medical schools — stayed mostly mum. When they did muster some courage to speak, it was with anodyne statements designed not to offend.
Flummoxed doctors and scientists like myself are scanning the newswire looking for signs of an organized response from those who have some power to push back. Yet, with a few exceptions, we find ourselves mostly disappointed. What gives?
Some of this is no doubt naked self-interest. Who wants to risk putting their name — or their federally funded research lab — on an enemies list?
But some of the silence comes from a well-meaning but misplaced hesitancy to avoid being seen as “political.” After all, one reason doctors and scientists are respected by the public is because we speak the universal truth of science, and don’t let ourselves get sullied in day-to-day partisan mud fights.
But, from the first moments of the new Trump administration, it should have been obvious that the old playbook was not going to be enough. Standing quietly by, doing our work in the background and leaving it to others to explain to Americans what’s at stake is not going to cut it.
No one who is paying attention can believe Trump’s actions at the CDC, NIH and USAID are about saving tax-payer money. If that were the case, we would see a detailed review and a methodical accounting of budgets and programs, followed by a plan for reducing costs while protecting these institutions’ missions. Instead, we are getting the bull in the proverbial china shop smashing and toppling things over — just to show everyone that he can.
In fact, it seems the arbitrariness of the cuts is the point. What better way to show kingly power — and stick it to those pointy-headed scientists — than by governing with edicts that don’t make sense?
Fighting back against Trump’s war on medical science is going to require scientists and physicians to update their playbook. Individuals will need to continue to bravely speak to the public directly and explain what is happening, and why it matters. But the leaders of the medical establishment must get off the sidelines, leverage their authority and put their organizations’ reputations on the line.
Will an organized opposition from America’s doctors and scientists to Trump’s war on medical science make a difference? I don’t know, but we need to find out.
David Oxman practices intensive care medicine and is an associate professor of medicine at Sidney Kimmel Medical College in Philadelphia
