The war against research, equity, and data.

What in the Health?! 4/25/25

Apr 25, 2025

In the last few weeks I’ve been traveling a lot for work, spending long days in the field observing, listening, and learning from people working hard to improve and extend the lives of members of their community that most others have shunned or abandoned: people with opioid use disorders. This project focuses on learning about organizations that provide medications for addiction treatment like methadone or buprenorphine, designed to help people with addiction to opioids reduce the harm they experience and gain back stability in their lives. Yet despite convincing science that shows how safe and effective these medications can be, decades of stigma and restrictive policies based on fear and misinformation have prevented people from reliably accessing these life-changing medications. Stigma and misinformation have also meant that people who do access these medications are often treated badly by those around them, incorrectly being told they’re just trading one drug addiction for another, and that even as they take steps to seek treatment that will help them in life—which everyone tells them they should do—they’re “doing it wrong” and deserve derision, not praise for the steps they’re taking.

Listening over and over again to people using the words “stigma” and “trauma” and “struggle” to describe their experience seeking a scientifically proven treatment for drug addiction has made my head hurt, and it’s also caused me to reflect differently on what’s happening today with regard to US governmental interference in science. While I haven’t had the time or mental energy to put an update together in almost 10 days while on the road, I’ve managed to take time each day to read and compile information about what in the health is happening out there, so that when I had a few conscious hours to spare I could put together another update.

I try to avoid using violent language metaphorically in my writing when I can, but I’ve been spending my days thinking about systematic ways our society excludes and mistreats many people with drug addictions—then blames them for the challenging situations in which they find themselves, say, without stable housing or a stable job—and spending my nights gathering information about the latest executive orders or grant cancellations or press releases of this administration. The parallels have been unavoidable. We hear about the “War on Drugs,” which in practice has been much more effective as a war on people of color than it has on stopping the flow of drugs into our communities. But while this war continues to rage, the folks who have been working to clean up the collateral damage left behind are now fighting a new set of wars by the current government that distract and exhaust us every day.

The War on Research

If you’ve been following these updates for the last few months you’ve certainly heard about cuts to the NIH and the ways the Trump Administration is trying to shut down and control scientific research. This continues every day, regardless of what RFK Jr. says about wanting to make America’s children healthy again. When I posted about the NIH terminations on March 27—just under a month ago—there were 392 NIH grants known to be terminated by this government. As of today that number stands at 811 grants, and that doesn’t include the Harvard-related onslaught ($2.2 billion currently frozen, mostly affecting health-related research conducted by Harvard’s medical school and public health school faculty). The 811 is surely an undercount, and the count rises every day. I won’t repeat again why these grant terminations aren’t just harmful to our health but fly in the face the Congressional appropriations and contractual obligations already in place. I will, however, share an infographic published in Nature that might help illuminate why this war on research will have such devastating consequences in the US and abroad:
You might believe that it’s a bad idea to have one institution that “towers over the world’s next biggest funders of health research,” and you might think the US has a right to step back from our use of taxpayer dollars to fund and drive the majority of the world’s health-related research (and service provision). But even if that’s true, I implore you to pause to think about the impacts of just yanking these billions of dollars essentially overnight. The impact is death, now and in the future. Needless death, and suffering. Not to mention a lot of waste—the very thing this administration supposedly is trying to reduce. Oh, and on April 7 Trump announced he was considering spending $45 billion on domestic detention centers, a figure that is almost exactly the NIH's budget. He wants to take your taxpayer dollars away from preventing HIV and curing Alzheimer’s, and use it to imprison immigrants instead. Did you just file your taxes? Think about that.
It’s not just about the cuts to NIH, though; this war on research is also about what’s being funded. As I’ve explained before, the legislatively-mandated process by which NIH awards grant funds is that researchers around the country conduct a peer review of proposals and decide which have the best scientific merit and potential for widescale impact. These scientific review boards are currently being purged, and as reported last week in the Washington Post, only 6% of white males on these scientific boards were fired, compared with 25% of all women, and 50% of Black and Latina women. To put that another way: 38 of the 43 board members who were fired were female, Black, or Hispanic. This reverses decades of work to improve representation of women and people of color in positions of scientific leadership, which is necessary not just because women and people of color have brilliant contributions that have traditionally been ignored or dismissed due to racism and sexism in our institutions, but also because 70% of people living in the United States are women and/or people of color, and they benefit when science isn’t ruled by white men.
This week Dr. Kevin Hall stepped down from his position at NIH. Dr. Hall has been a leading nutrition scientist at NIH for decades, in 2019 publishing results from a randomized controlled trial that showed that ultra-processed foods (a huge portion of the average American diet) led to weight gain. It was an important finding, but it didn’t explain why that happens, which is what he’s been focusing on studying since. But RFK Jr. already thinks he knows the answer: ultra-processed foods are addictive. Unfortunately, one of Dr. Hall’s follow-up studies found that this might not actually be the reason. Another study is in progress, but currently suggests it might be more about high calorie density and taste. So what happened when RFK Jr. took over as HHS Secretary? First Dr. Hall was restricted from publicly sharing the results of his new studies that contradicted RFK Jr.’s thinking. Then they allowed him to comment, but only via the NIH press office, which heavily edited the text and framing. So after 21 years, Dr. Hall retired early from NIH, explicitly citing censorship as the reason he could no longer work for the government. He wants to be able to do good science and talk about what he found without government censorship. This is the USA in 2025.
You might have heard that last week, the editor-in-chief of CHEST, a journal that publishes research on diseases like asthma and chronic obstructive pulmonary disorder, or COPD, received a letter from a U.S. attorney asking them to respond to alleged bias in the articles it chooses to publish. This past week, the editor-in-chief of the New England Journal of Medicine—one of the premier medical journals in the world—received a similar letter. It’s unclear how many letters were sent out, as many major journals have declined to comment when asked about this. These letters ask six questions, apparently trying to inquire whether each journal might be unfairly suppressing scientifically sound content. While the letters don’t mention it, this is something RFK Jr. specifically said he would do on a podcast last year: “I’m going to litigate against you under the racketeering laws, under the general tort laws…I’m going to find a way to sue you unless you come up with a plan right now to show how you’re going to start publishing real science and stop retracting the real science and publishing the fake pharmaceutical science by these phony industry mercenaries, scientists.” Any claim that a journal like the New England Journal of Medicine (or CHEST) has a viewpoint ruled by the editorial board (like might be true of the editorial board of a newspaper, for example) demonstrates a misunderstanding of how these journals work. Peer-reviewed journals, by definition, are a collection of research findings that other qualified researchers around the world reviewed in detail, and assessed to be scientifically sound and appropriately reported. The editors don’t decide what gets published; peer scientists do. This isn’t to say that so-called publication bias doesn’t exist. It does. But accusing scientific journals of suppressing “real science” that RFK Jr. believes to be true and publishing “phony science” that serves the mainstream scientific narrative…well I hope you can see that this is similar to Fox News claiming that it’s “Fair and Balanced.” It won’t reduce publication bias, but if journals changed their practices the way the Trump Administration is trying to bully them into doing, it would reduce the scientific integrity of the scientific information shared worldwide, to the detriment of us all.

The War on Equity (not to mention Diversity and Inclusion)

The Trump Administration’s war on DEI has been explicit and very well-documented, and I won’t try to summarize it here. But just in case you missed it:

In 2022, a new program funded through HHS created a suicide lifeline for LGBTQ youth in the US. For the past 3 years a young person considering suicide could call 988, and reach someone who’s been trained specifically to support LGBTQ youth in this crisis. Since the program began, the Trevor Project has responded to more than 1.2 million calls from LGBTQ youth in crisis. This is such a critical service because LGBTQ young people are more than 4 times as likely to attempt suicide than their heterosexual peers. At least one LGBTQ young person attempts suicide every 45 seconds in the United States. But beginning October 2025, the Trump Administration wants to defund that program. This lifeline for these youth would end. The cruelty knows no bounds.
Unless you’re on a self-imposed media blackout I can’t imagine you missed RFK Jr’s latest absurd and outrageous comments about people with autism, saying “These are kids who will never pay taxes. They’ll never hold a job. They’ll never play baseball. They’ll never write a poem. They’ll never go out on a date. Many of them will never use a toilet unassisted.” Now, I’m guessing and hoping that every single person reading this knows someone personally who has autism and has a great job, pays their taxes, is happily married, and has no problem using the toilet. This statement just shows how out of touch with reality RFK Jr. really is (highlighting once again why his desire to control scientific communications coming from HHS or independent scientific journals is so dangerous). But to be clear: whether from autism or not, people who can’t use a toilet unassisted, or who never go out on a date, or will never play baseball or write a poem—these people are human beings too. They have value and deserve dignity and love, and don’t deserve to be used as a political pawn, ever. Doing so increases stigma and misinformation and harms autistic people.
Last week Trump signed a series of executive orders aimed at expanding coal mining in the US. “We’re going to put the miners back to work,” he said. One order was designed to, in Trump’s words, “end all discriminatory policies against the coal industry,” and another instructed the justice department to “expeditiously take all appropriate action to stop the enforcement of State laws” from places like Vermont, California, and New York, which “extort energy producers” or enact ‘climate change’ extortion law[s].” But despite the photo op in front of miners in hard hats, when you look at the bigger picture it’s very clear that this is about the coal industry making money and generating energy for others to use (like AI companies), not about miners. Why do I say that? At the same time Trump was working to “[slash] unnecessary regulations that targeted the beautiful, clean coal,” he was working with RFK Jr. to slash the CDC’s National Institute for Occupational Health and Safety (NIOSH) essentially into non-existence. An example of the 900 federal workers who have recently been sent packing? The agency’s respiratory health division in West Virginia, which oversaw an X-ray screening program for black lung. Plus 34 regional offices of the Mine Safety and Health Administration (MSHA) in 19 states have been slated for closure. Ask anyone with miners in their family—mining is a very dangerous job. Mines can cave in, and toxic gas and air laden with coal dust can cause explosions, COPD, and lung cancer. So if we’re going to re-energize coal mining in the US we should be doubling down on our efforts to keep miners as safe as possible; otherwise this is just another example of benefitting billionaires on the backs of some of the lowest-income people in the US. Don’t let yourself be misled that this is about improving the lives of people who live in coal-mining country.
Speaking of people who live in coal-mining country (and other rural areas of the US), according to senior officials at the Environmental Protection Agency, tens of millions of dollars are set to be cancelled that have previously been awarded to scientists studying environmental hazards faced by children in rural America, including the impacts of exposure to pesticides from agriculture, reducing the negative effects of wildfire smoke, and preventing “forever chemicals” from contaminating the food supply. The EPA has also closed down all offices responsible for addressing the disproportionately high levels of pollution that low-income communities in the US face. They’re not even trying to hide the fact that they want to make it easier for corporations to make money, even if it means the poorest and youngest among us are exposed to more chemicals and suffer from more health problems as a result.

The War on Data

Here’s a real doozy: if you try to go to covid.gov now, you get redirected here: https://www.whitehouse.gov/lab-leak-true-origins-of-covid-19/. If you want to see what used to be there, you can go to covid.govarchive.us. Webrecorder worked with Safeguarding Research and Culture (SRC) to preserve the original site. This new website not only makes a whole series of false claims (like that “by nearly all measures of science, if there was evidence of a natural origin [for SARS-CoV-2] it would have already surfaced,” and that there is no conclusive evidence that masks effectively protect against COVID-19) but also is designed to undermine the credibility of real scientists, especially Dr. Anthony Fauci. It looks and reads like a conspiracy theorist’s website, not a government one. It’s trying to rewrite history, and it’s embarrassing.
In an example of both a) making it easier for corporations to make money even if it hurts regular people and b) changing policies and procedures to promote RFK Jr’s favored narratives, the FDA announced a few days ago that due to funding cuts they will be suspending their quality testing of milk and other dairy products. This isn’t just about testing for bird flu in milk and cheese, but also other pathogens like the parasite Cyclospora. Cyclospora outbreaks often occur in warmer months, so this timing is particularly unfortunate. Dairy facilities are still subject to regular testing and inspections by state regulatory agencies, but there will no longer be routine safety checks for milk, cheese and yogurt for any “Grade A” dairy products. PBS and others reported a full 4 months ago that RFK Jr. had recently written he would “end the FDA’s war on public health,” including its “aggressive suppression” of raw milk. There’s a lot of evidence that drinking raw milk (which hasn’t been pasteurized to kill viruses and bacteria) increases people’s risk of foodborne illnesses—but if we’re not testing the milk, then what evidence will we have that these things are more likely to be in the raw milk people are consuming? We won’t.
Data related to COVID-19 and viruses and bacteria in our dairy products are just the tip of the iceberg. The budget cuts, firings, and policy changes at HHS mean that our access to quality health data is diminishing by the day. The entire team in charge of the National Survey on Drug Use and Health? Gone. The team that compiles the data about child welfare cases nationwide? Gone. The rates of maternal mortality—higher in the US than in any other high-income country in the world—will now be difficult to unpack due to the dismissal of the team that oversees the country’s Pregnancy Risk Assessment Monitoring System, or PRAMS. The EPA will no longer require industrial facilities like oil refineries and power plants to measure their greenhouse gas emissions, and the EJScreen mapping tool on the EPA website has disappeared, which used to allow anyone to look at the amount of industrial pollution in their community and how that has changed over time, or how it compares to other communities.

If we don’t collect data, or we don’t allow people to report or analyze data that were already collected, then we don’t have any way to know where our health is getting worse, or where some people’s health is a lot worse than others. This is by design. If we can’t see disparities that doesn’t make the disparities disappear, it just makes them invisible—and this makes them worse. The war on research is related to the war on data. The war on data is a direct result of the war on equity. It’s all related, and it’s all designed to benefit those in power with complete disregard for the rest of us. Don’t let them convince you otherwise.