The CDC, an organization tasked with using science-based approaches to protect the lives and health of the vulnerable, is banned from using words like "science-based" and "vulnerable" from any documents detailing next year's budget. The other words from the ban list are “diversity,” “transgender,” “fetus,” “evidence-based,” and “entitlement”.
When it comes to science and the environment, the current US administration has taken some questionable decisions -- to put it mildly. From reversing a much-needed ban on African ivory to supporting the agenda of plastic-making companies, and from denying basic science to lifting protection for endangered sea creatures, the White House has done a lot to disappoint both scientists and the general population. We've learned to expect the worse when it comes to science and the environment.
But even so, when the new directives for the CDC were issued, they left everyone stunned, a policy analyst told the media. Other CDC officials confirmed this. It was an unprecedented request: the banning of specific words.
The reaction of people in the meeting was “incredulous,” the analyst said. “It was very much, ‘Are you serious? Are you kidding?’”
“In my experience, we’ve never had any pushback from an ideological standpoint,” the analyst said.
While it's not the first time this administration has tried to govern what people can and can't say, doing it when it comes to health policy is a whole different ball game.
With some words, like "transgender," for instance, it's clear what they are targeting. Donald Trump himself became the first president to speak at an anti-LGBT hate group summit -- so while saddening, it's not surprising that they want to target transgender policies. "Fetus" shares a similar story, as the administration is trying to ban abortion or make it as difficult as possible. The message is clear: it doesn't matter what the science says, it doesn't matter what health recommendations say, we just don't want you discussing this and that.
It gets even more bizarre with other terms, like "science-based" or "evidence-based". The current administration is basically forcing the leading national public health institute of the United States to forego, or at the very least rephrase, basic standards of science. The administration recommended replacing those words with "in consideration with community standards and wishes" -- a fit replacement, considering that the administration seems determined to replace science and evidence with their standards and wishes.
Here are just two paragraphs from the CDC budget overview, for 2017, which will now have to be rehashed (pdf):
Having evidence-based guidelines and recommendations is important to CDC and the agency’s guideline production is a key component of ensuring the safety of healthcare in the United States.
CDC supports science-based communication campaigns and other efforts to convey the benefits of vaccines to the public to aid individuals in making informed vaccine decisions to protect themselves and their loved ones.
What about "diversity" and "vulnerable"? The CDC has a number of programs in place, designed to protect vulnerable people:
The United States remains deeply committed to safeguarding the American public from terrorists, just as we are committed to providing refuge to some of the world’s most vulnerable people.
The Immunization Program purchases routinely recommended vaccines to protect at-risk and vulnerable populations not eligible for immunizations through the Vaccines for Children (VFC) Program and to meet urgent public health needs such as controlling VPD outbreaks.
The youngest, most vulnerable population in the United States are the approximately 24,000 infants born each year to HBV-infected mothers, because these infants are at highest risk for developing chronic HBV infection.
The CDC also has a Diversity and Inclusion Management program, but that also doesn't sit well with the new directive either.
The Office of Minority Health and Health Equity, includes the Office of Women’s Health and the Diversity Management Program, provides…guidance and oversight to the agency-wide implementation of the CDC Diversity Plan.
For decades, the CDC has had an impeccable reputation when it comes to responding to infectious disease outbreaks, like Ebola and Zika, as well as studying, tracking, and treating health situations of all sorts, both within the US and outside of it. Impeding with its due process is nothing short of reckless.
“Here’s a word that’s still allowed: ‘ridiculous,’” said Rush Holt, chief executive officer of the American Association for the Advancement of Science, in a statement reacting to the report.
Dr. Sandro Galea, dean of Boston University’s School of Public Health, emphasizes that this is a clear indication of what the current US administration wants: no more science, no more evidence, no more caring about diversity and the vulnerable.
“If you are saying you cannot use words like ‘transgender’ and ‘diversity’, it’s a clear statement that you cannot pay attention to these issues.”
This is also in tune with what President Trump has done with other agencies, most notably the Environmental Protection Agency, which effectively eliminated scientists from its ranks and issued a de facto ban on any climate science initiatives. The CDC is in an equally delicate position, as the White House and some Republican lawmakers have proposed dramatic reductions to the agency’s $7bn discretionary budget. Still, public support for the CDC remains high, and the agency's leaders remain somewhat optimistic.
In an email to agency employees on Saturday night, CDC director Dr. Brenda Fitzgerald noted the media report and wrote:
“I want to assure you that CDC remains committed to our public health mission as a science- and evidence-based institution. As part of our commitment to provide for the common defense of the country against health threats, science is and will remain the foundation of our work.”
But then again, what else could she have said?