Transitions in leadership within the White House often comes with significant changes, but this changeover from democratic power to a republican presidency was more so than others. The end of January and the beginning of Donald Trump’s term as president marked a flurry of Executive Orders and almost no scientific communication from federal health agencies like the National Institute of Health (NIH) and the Center for Disease Control (CDC). This silence was a direct result of the U.S. Department of Health and Human Services issuing a memo pausing almost all external messaging from these organizations on January 21. The memo advise[d] leaders of the CDC, the NIH and the Food and Drug Administration to “refrain from publicly issuing any document” or communication, including regulations and press releases, “until it has been reviewed and approved by a Presidential appointee.” Although a short pause in messaging is not unusual during transfers of power from one administration to the next, it usually doesn’t last for more than a week. In this case, the restrictions were originally supposed lifted February 1st but so far, sites remain down, or continue to be met with pop up messages such as the CDC’s which states: CDC’s website is being modified to comply with President Trump’s Executive Orders.
These freezes, thought not a huge deal for a short period of time, have began to have consequences, especially as more time ticks by and essential websites still aren’t fully functional. The weekly publication of the Morbidity and Mortality Weekly report, an highly respected report for public health was not release on January 22 or January 29 by the CDC for the first time in decades. Often called “the voice of CDC,” the MMWR series is the agency’s primary vehicle for scientific publication of timely, reliable, authoritative, accurate, objective, and useful public health information and recommendations, and with out it the public is extremely limited in its access to important health information. Especially now with increasing reports of the bird flu, H5N1, that are continuing to be addressed in upcoming by CDC reports.
Another unforeseen affect of these shutdowns was the insecurity of organizations receiving grant money. Although it’s currently unclear if this is a part of the Department of Health and Human Services communication pause, the NIH has stopped approving money or research grants. Without grants, scientists are unable to start any new research, from asthma and pediatric cancer to Covid and Ebola. The NIH awards more than 60,000 grants each year, supporting at least 300,000 researchers making them a vital contributor to the funding of ground breaking research. Although on a positive note, the agency director of the NIH claims ongoing clinical trials are continuing as scheduled, helping alleviate some worry from doctors and scientists. This is a substantial win for the healthcare community but the future of the agency still remains uncertain as any new projects remains on hold, and
Additionally these grant pauses appear to not only be a result of the HHS’s memo, but also in response with the recent executive orders signed into law by newly President Donald Trump pertaining to diversity, equity and inclusion (DEI) and “gender ideology” among other topics. These orders resulted in the Office of Personal Management directing departments and agencies to “take down all outward facing media (websites, social media accounts, etc.) that inculcate or promote gender ideology” and “withdraw any final or pending documents, directives, orders, regulations, materials, and forms.
These “withdrawals” are also sparking controversy with people finding that as some federal websites begin to start functioning again, some information has been changed or removed. Resultedly, Scientists and public health leaders are taking stock of the Trump administration’s abrupt decision to pull down these web pages, datasets and selected information from federal health websites. Dr. Megan Ranney, an emergency physician and dean of Yale University’s School of Public Health describes how some “of it is obvious — broken links and pages that are no longer there,” or pages that “have been scrubbed of certain words or categories of people. For example, pages on the CDC website that previously referred to ‘pregnant people’ now refer to “pregnant women.” Another affected datasets is CDC’s Behavioral Risk Factor Surveillance System (BRFSS), which is one of the most widely used national health surveys and has been ongoing for about 40 years. As of the writing of this article the data is back online, but the survey for the dataset isn’t. Similarly the Youth Risk Behavior Survey’s dataset is online, the but the questionnaire is not longer available. Not only are surveys unavailable, but some data sets, especially those related to HIV/AIDS in the US, environmental justice and global health efforts in low and middle income areas worldwide have been taken down, at least for the moment. These websites include, but are not limited to, CDC AtlasPlus, PEPFAR Data Dashboards, DHS databases and more. Loosing important data sets like these is detrimental to health organizations and continuing to understand and work to improve health problems, especially in rural areas with low population.
As the weeks since these shutdowns has progressed, so has internet-wide effort among scientists, journalists and concerned citizens to archive reams of data and web pages. Group like the American Congress of Obstetricians and Gynecologists are banding together to host clinical guidelines on topics such as reproductive health. Similarly, a group of 34 Democratic senators sent a letter to acting Secretary of Health and Human Services Dorothy Fink demanding an end to the communication freeze, in response to these communication suspensions and data wipes. They demanded “full accounting” by February 10th on scientific reports and data that many scientists are concerned are still missing or altered, but as of this moment many websites are still down or lacking data.
Not only are these disruptions testing the limits of presidential power and causing political turmoil, they have disrupted the relationships between organizations like the CDC and the NIH and its partners. These data sets help doctors keep society safe by aiding people to understand where infectious diseases and outbreaks are, and helping them stat up to date on crucial information. These data freezes although originally not uncommon during a change in presidential power, have continued longer and beyond the scope of ever before, and casts serious doubts into the future of our public health agencies and the communication of data vital to global health.
