The Corruption of Science

In this political season of the 2020 presidential election, it is important to take a sober look at the current status of science and public health in the U.S. Although the initial 3 years of the current administration witnessed a growth in budgets for the National Institutes of Health (NIH), thanks to the deep‐rooted support of Congress, other aspects of science, health care, public health, and public policy have been less fortunate. The expansion of coverage for the uninsured through the Affordable Care Act and Medicaid of the Obama administration has come under attack, resulting in a significant increase in the number of uninsured in underserved communities. Other sectors of science with an impact on public health, particularly those that deal with the environment, were subjected to policies that dramatically reversed prior efforts to control pollution and address climate change. U.S. cooperation on climate change on an international scale ended with our withdrawal from the Paris Accords, and the U.S. has withdrawn its participation from the World Health Organization.

The most visible undermining has occurred in public health. When the SARS‐CoV‐2 epidemic reached the U.S. in February and March of this year, the corruption of science and medicine within the federal government took on a new dimension. Now a pandemic accounting for more than 7 million cases and 210,000 deaths in the U.S., it has repeatedly been dismissed by the President and his close associates in their public pronouncements, calling it a “hoax,” a problem that would miraculously disappear within days. Their consistent disagreements with scientific experts have confused the public on critical and proven measures of pandemic control, such as the importance of masking, social distancing, avoiding large gatherings, the susceptibility of children to acquire and transmit the virus, and the need for testing and tracing of contacts.

Not only has the administration conducted a campaign of disinformation about COVID‐19, it has also placed unqualified spokespersons in positions to control and subvert the advice of its own agencies. The unwarranted intrusion of the President and his staff into the important scientific work of the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), and the NIH has resulted in the approval of unproven or ineffective therapies (e.g., hydroxychloroquine and convalescent plasma), the altering of CDC guidance on masking and contact testing, the discounting of expert advice from the NIH, and threatening to demand approval and distribution of a vaccine before its safety and efficacy is established. This appears to be a pre‐election effort to convince the public that we are in control of the virus and there is nothing to be feared.

Experts such as Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases and an acknowledged international authority on viral epidemics, have been directly attacked, sidelined, and muzzled. The Director of the CDC, Robert Redfield, under pressure from the White House, has repeatedly backtracked on key measures of disease control, such as masking, in‐person schooling, and aerosol transmission. In April, his office emasculated the report of his own agency on measures to control a COVID‐19 outbreak of more than 1,000 cases in meatpacking plants in South Dakota.

To counter the advice of acknowledged experts, the administration has placed unqualified physicians or even nonmedical persons in positions as decision makers for the Coronavirus Task Force (e.g., Vice President Michael Pence and Scott Atlas, a neuroradiologist who has made multiple statements leading to perceptions that he favors discredited “herd immunity” concepts). The administration inserted a nonscientist political operative, Michael Caputo, into the role of overseeing the sacrosanct Morbidity and Mortality Weekly Report and other public advisories of the CDC. Following a paranoid public outburst, Caputo retreated for a medical leave of absence. The White House also transiently inserted a former television personality as chief spokesperson for the FDA, and her inappropriate and incorrect statements led to her removal within 11 days, but not before significant damage was inflicted on the FDA's reputation.

An even more dangerous strategy to control the public health message came from Health and Human Services (HHS) Secretary Alex Azar, a former pharmaceutical executive, who announced that he is exerting his authority and will not delegate his rulemaking authority to the FDA Commissioner. Although the HHS Director has this statutory authority, and HHS has always reviewed rules and major guidances, this assertion of direct control raises concern that political appointees could make the final decisions about vaccine assessment and approval, effectively removing that authority from the full‐time nonconflicted FDA staff in the Center for Biologics Evaluation and Research. This Center's highly experienced team reports to Dr. Peter Marks, the center director, for virtually all decisions about individual products. It has been the established practice that the FDA Commissioner, as a political appointee, has further delegated the authority for vaccine assessment and approval to the center director so that politics would not influence what must be a public health and science‐driven decision. The effort to substitute political decision making in place of science is a key aspect of the administration's effort to convince the public that COVID‐19 is not a credible threat and that as a nation we are doing just fine, a vaccine is imminent, and we can get back to business as usual, when in fact the safety and efficacy of any vaccine has not been established, and in other ways, we have clearly failed to control this pandemic. Recognizing the danger of these actions to an informed and scientifically based stance on public health matters, seven former commissioners of the FDA issued a statement on September 29, 2020, accusing the administration of undermining the mission of their agency, FDA [1].

This is not the first time in modern history that science has been corrupted for political ends. Scientists and doctors, who depend on evidence‐based decision making rather than a profession of dogma, have challenged the message of 20th century authoritarian regimes in China, Russia, and Germany and as a result have become targets for repression. Concepts of democracy and good government depend on public acceptance of the rule of reason. The consequences of this corruption of science for political ends are fearful. As a nation, much of our economic and social progress has depended on the strength of our scientific enterprise and the close collaboration of academic scientists with their counterparts in government and industry. It should be noted that this collaboration has been responsible for the remarkable progress of the biomedical sciences, which has become the foundation for the economic growth of the U.S. If science is replaced by dogma and political tactics, lives will continue to be lost, the nation's health and economy will remain in jeopardy, our ability to respond to future pandemics will be compromised, and our existence as a democratic society propelled by reason will not survive.

To counteract this corruption of science, it is vital that the scientific community speak with one voice to protest. The directors of government agencies such as the CDC and FDA must not succumb to the inappropriate pressure and political motivations of the administration and, if necessary, should resign rather than collaborate in misguided policies and messaging. Furthermore, our academies and national organizations must speak out to defend the sanctity of science and protect the health of our nation.

Acknowledgments

I acknowledge Dr. Martin Murphy, Jr., and Dr. Robert Califf for their helpful advice in preparing this editorial.

Disclosures

Bruce Chabner: PharmaMar, EMD Serono, Cyteir, Eli Lilly & Co., Chugai Pharmaceuticals, Takeda (C/A), Cyteir (H), Biomarin, Seattle Genetics, GlaxoSmithKline, PharmaMar, Loxo, Blueprint, Immunomedics, Constellation, Bluebird, Alnylam, SpringWorks, Forty Seven (OI), Eli Lilly & Co., Genentech (ET).

(C/A) Consulting/advisory relationship; (RF) Research funding; (E) Employment; (ET) Expert testimony; (H) Honoraria received; (OI) Ownership interests; (IP) Intellectual property rights/inventor/patent holder; (SAB) Scientific advisory board

References