Pulling resources and blocking access to key scientific data will cause untold long term harm

It’s been a disturbing couple of weeks in the United States for scientists, public health workers, and healthcare providers.

In January, shortly after Donald Trump’s inauguration as US President and the transition to the new administration, communications were halted across the Department of Health and Human Services (DHHS).1 This vast federal agency includes the Centers for Disease Control and Prevention (CDC), the Centers for Medicaid and Medicare Services (CMS), the Food and Drug Administration (FDA), and the National Institutes of Health (NIH). What followed was a haphazard shutdown of research processes, public health alerts, and communication with federal officials working in these agencies, as well as removal of publicly accessible health datasets, and clinical information used by those providing care.

The NIH halted its scientific review and advisory panels, and programme officials were not able to hold meetings or interact with scientists. Medicaid reimbursement portals were temporarily shut off for all 50 states.2 Numerous CDC databases were taken down, including the Youth Risk Behaviour Surveillance System (YRBSS) and the Behavioural Risk Factor Surveillance System (BRFSS), which has serially assessed the health behaviours of high school students and adults, respectively, for over 30 years. They are referenced for health programme planning and research. Online clinical resources, including guidance about the treatment of sexually transmitted infections—resources used frequently in my own work in the emergency department—and hormonal contraceptive selection, also disappeared. Publication of the CDC’s Morbidity and Mortality Weekly Report (MMWR), which has been in existence under this name for more than 70 years, was frozen on the week of 16 January 2025, and then restored again last week; however, one chart related to H5N1 in the middle of a report about wildfires appeared fleetingly then disappeared, raising concerns about the completeness of data now posted.3

For Americans, these resources usually have the same quality Benjamin Franklin famously attributed to death and taxes: they have been constants, reliable, and staid through many administrations. The extent to which they form the bedrock of health communications and public safety is difficult to overstate.4 In 1981, the MMWR reported five cases of a syndrome among previously healthy young men that subsequent investigation revealed to be AIDS.5 It alerted public health officials and clinicians and coordinated information when anthrax was being sent through the mail in 2001. It reports on both regional outbreaks and pandemics affecting the nation. “Every day the publication is delayed, doctors, nurses, hospitals, local health departments and first responders are behind the information curve and less prepared to protect the health of all Americans,” former CDC director Tom Frieden said.6 Some advocacy groups have sued the federal government for withholding critical clinical resources.7

The intent of this information freeze appears to be to purge efforts related to addressing health and workforce inequities, which the current US administration explicitly considers “dangerous ideology.” The government instructed CDC scientists to withdraw papers that had already been submitted to journals for review and those that had been accepted for publication but not yet published, so they could be reviewed for terms that this administration will not allow: “Gender, transgender, pregnant person, pregnant people, LGBT, transsexual, non-binary, nonbinary, assigned male at birth, assigned female at birth, biologically male, biologically female.”8 Over at the National Science Foundation (NSF), grants are under review for a similar, but longer list of forbidden terms, including “diversity,” “gender,” “biases,” and “inequities.”910 In light of these steps, the work of organisations like the Office of Research on Women’s Health and the National Institute on Minority Health and Health Disparities, seems to be at risk.

Programmes aimed at increasing diversity in the scientific workforce have been abruptly pulled. “And just like that,” one colleague said, “a grant I’ve been working on for two months [to fund undergraduate experiences in the sciences] can no longer be submitted.” The NIH website inviting applications to that opportunity now goes to a “Page not found” error.

Amidst what has been called a “web of censorship,” the US scientific community is blocked from accessing critical data sources, high quality clinical information, and scientific inquiry and reporting.11 And it is stymied from key activities that will develop a capable, enduring scientific workforce in the future.

It’s all terrible and unscientific beyond belief, while also not terribly surprising. Similar efforts were made during the last Trump administration, when officials across federal agencies were instructed to purge the use of the terms “diversity,” “transgender,” “fetus,” and “vulnerable” and “evidence-based” in documents in 2017.12 In 2020, the MMWR was challenged for scientific reports that were not in line with the administration’s views, and attempts were made to subject CDC documents to review before publication.1314 This time, the administration is going the more expedient, haphazard route, pulling whole resources without warning, then restoring some of them, but with broken links, leaving a skeleton of what was previously available.15

Whatever the new administration intends, stifling our ability to identify and understand specific groups does not make the groups go away. It simply makes our science less insightful and robust. Striking terms like those mentioned above hampers our ability to understand our whole population, in all its inherent heterogeneity, to identify and address when and where existing structures, systems, and therapies are not adequate to ensure health. That’s harmful to those already at risk for poor health outcomes; it’s harmful for us all as an interconnected body of people. And sustaining barriers to entering research fields keeps us from our own full potential as a nation of scientific discovery.

The challenge scientists in the US now faces is how to continue to pursue scientific excellence and mitigate the harms to progress in the upcoming years.