In the fall of 2020, even if scientists competed to develop COVID-19 vaccines, Americans’ trust in shots that saved these lives had plunged. Many have become more skeptical for the behavior of US leaders. In our recent research on the Journal of Health Politics, Policy and Law, the Trump administration applied public pressure to the FDA during the 2020 election season, tracking a crisis of vaccine trust. I am doing it.
For example, on August 23, 2020, FDA committee member Steven Han, a member of the FDA, announced an emergency permission of recovery from COVID-19 treatment, standing near President Trump, and the effectiveness of intervention is significant. I was exaggerated. This was first marked in the history of FDA, which was personally participated in the president’s presentation of treatment permission.
Trump continued to this event by accusing FDA on two different opportunities to delay vaccine approval until after the election and criticize institutional safety guidelines as “political movements.”
Trump’s multiple attacks on FDA and other triggers of the uncertainty of policy matched the vaccine spikes, including discussions on vaccines in the presidential debate. The impact of other events cannot be eliminated, but these events have created the most important reports and controversy during the election date from March 2020, and the impact of the uncertainty caused by these events is American. It seemed to affect the trust of. “Definitely,” the willingness to get a COVID-19 vaccine has plummeted from 42 % in May 2020 to 21 % in September 2020. For the Vice President, he raised concerns that the Trump administration was in a hurry for the vaccine for political reasons. There were hesitants of vaccines spiked over multiple groups, but they were particularly affected by Democrats, blacks, Asian Americans, and highly educated individuals. Asian Americans have seen the vaccine hesitation by about 30 %. Black Americans increased their vaccines 21 % and remained skeptical beyond the first crisis.
The impact has expanded beyond individual attitudes. By September 2020, some states have announced that they will establish their own independent vaccine review panels. Most of them were the Democratic governor, suggesting that they did not trust the federal government under Trump. The National Medical Association, which represents black doctors, has created another task force to judge the FDA decision. This is an unknown voting with no confidence in the independence of an institution from political impact.
Dangerous COVID-19 Correction of Trump
We realized that we are facing similar issues now. This time, we are concerned about political interference (or even perception of it), and has spread beyond COVID-19 to other areas of public and scientific governance. Within the past week, FDA has withdrawn draft guidance to improve the diversity of clinical trials, in accordance with the Diversity, Federation of Federal Agents, and the Demand Included Policy. Such actions indicate the regression of efforts to deal with the reliability of public health agencies, access to healthcare and to deal with well -described gaps in the results. Public communication from institutions such as NIH and FDA requires screening and approval by the president’s appointment, disseminating important health information and increases the risk of political interference. In addition, the administration stopped the ongoing research reviews and new subsidies, further confusing public health activities.
When a political leader tracks science agencies to the benefits of the election, they do not just lose their immediate public health efforts. They also cause permanent damage to institutional reliability, reducing the trust of the organization and the work they do. Experimental research shows that if the scientific approval guidelines are weakened, Americans lose their trust in vaccines and other products. It is essential to maintain the independence of a major science agency to prevent the further deterioration of the trust of the people, and that public health decisions are guided by evidence, not political considerations.
The first Trump administration’s tragic public health to Cobid Pandemic has made efforts to protect science agencies from political interference. In 2022, the government’s responsibility bureau (GAO) began to strengthen its institutions under the Ministry of Health and Welfare for political interference. The agency employees reported that the lack of means of reporting the problem, the fear of retaliation for reporting political interference, and that the high -ups had already recognized the problems at hand. 。 Thus, GAO has created seven recommendations for CDC, FDA, NIH, and HHS to focus on the definition of political interference, how to report and train employees and to create specific steps.
The Biden administration has also tried to strengthen the power of these institutions, including the establishment of the Scientific Consideration Council in the National Institute of Health and the establishment of scientific consistency officials. But these are not protected actions, and Trump can always eliminate them.
It is not easy to guarantee that scientific perfection is maintained, but there are still available roads. The confirmation of the Senate for the leaders of the health institution that begins this week needs to include a strict review of candidate’s commitment to scientific perfection, and leadership is a powerful and non -party -based policy planning based on evidence. It is necessary to guarantee that the dedication is reflected. The members of the parliament referring to the issues and results of Political interference in the past administration of Trump, and plans to alleviate the excessive impact of the administrative department so that the appointment is not eroded in these institutions. You need to ask.
New Watch Dog Report Show, where CDC, FDA, and NIH staff have not reported political interference
It is more important to create independent monitoring mechanisms to enhance the protection of whistleblower and protect the operation of institutions. The protection of whistleblower must be enhanced through policy reforms within the institution so that employees can report political interference without fear of retaliation. The means for reporting political interference throughout the institution should be very clear, the definition of political interference is fully enhanced, and it should be consistently included in the entire training of institutions.
Furthermore, as the FDA responded to the complaints of the whistleblower in recent history, the whistleblower needs to respond within the range of the right time. In accordance with the GAO report, HHS has established an updated scientific policy that referring to the report through the path of the scientific perfection of the institution. Others should follow this lead. However, the early signal is now, given the recent efforts of the Trump administration to dismiss officials such as HHS inspectors Christie Grimms and the wider threat to independence of the inspector’s general (OIG). The Trump administration is trying to eliminate such protection.
Therefore, a more dramatic and immediate solution is required to ensure the freedom of science from political interference and the authority of the internal monitoring agency. Congress must explicitly prevent the rejection of inspectors without the approval of the parliamentary parliament, and enact an emergency law that requires a formal investigation for proposed removal.
In addition, it is necessary to establish an independent committee with a summoning authority in order to supervise a wide range of actions taken by an institution with obvious political motivation, such as the current block of NIH grant activities. The parliament must immediately suspend such an attack on public trust and start a comprehensive investigation on its origin and impact. These steps not only protect the integrity of federal agencies, but also can have a permanent and harmful impact on public welfare and even temporary politics of science and health policies. Is also important for sending.
Regarding FDA, parliament must create a statutory independence panel from an institution leadership. This panel will overturn the staff’s decisions in order to ensure that the restrictive decisions, including potential political interference, are binding for dispute and to ensure that they are consistent with established scientific standards. We evaluate the justification of senior officials, and finally provide a transparent and public report on survey results and provide mechanisms. Sustainable accountability.
Public hygienese agencies not only impair immediate efforts to protect public health, but also cause permanent damage to public trust. There is an urgent need to implement protection measures to protect FDA, CDC, and other institutions from political interference. Recent rollbacks of clinical trials and policies, such as increasing institutional communication restrictions, emphasize the growing need for legislative protection. Without robust protection, these institutions threaten further politics and threaten the ability to effectively achieve their important public health missions.
Anushka Bhaskar is a research assistant on programs on the regulations, treatments and laws of Harvard University School of Medicine. Aaronkesselheim is a medical science professor at Harvard University School of Medicine and is a director of programs on the division of drug therapy and drug economics in Brigam and women’s hospitals. Daniel Carpenter is a professor of Ally S. Fried, the Chair of the Harvard University of the University of Harvard, and the author of the “reputation and power: FDA organization image and drug regulations.”
