Without science-based or evidence-based truths — the entitlement of the Centers for Disease Control (CDC) — we may never understand the genetic and physiological diversity associated with the developing human fetus or an individual who is transgender or what makes someone vulnerable to disease. Without these truths, we place our human species in jeopardy.
OK, I think I used all the words. Yeah, you know the words I’m writing about, the words the Trump administration has reportedly commanded the CDC not to use in next year’s budget documents: diversity, entitlement, evidence-based, fetus, science-based, transgender, vulnerable.
When I first read this mandate I whispered to myself, “what the — ?” and used a word that really shouldn’t appear in any government document, but I digress.
In banning these words, the Trump administration apparently suggested that the CDC could substitute other words for a couple of the forbidden ones. For instance, for “science or evidence-based,” the CDC could root a recommendation on “science in consideration with community standards and wishes.” What the — ?
Community standards are norms associated with acceptable conduct for a particular group, be it those in a geographic region, club or users of a particular social medium; they’re not necessarily formed with regard for the constitutional rights of others.
Community standards have been used to resolve legal disputes about what constitutes pornography. YouTube and Facebook use them in an effort to regulate content that could be deemed offensive to some.
Community standards also have been used in the past to punish homosexuals and people in interracial marriages.
So now, if the perceived community standard and wish is discrimination against a certain individual or group, the CDC should base its recommendation on this standard?
You can see the problem. If the Trump administration feels that abortion, sexual orientation and gender identity fall outside community standards, then recommendations by the CDC to study associated areas may be hampered by government regulation and/or funding.
I think about the infancy of the AIDS epidemic, before the sickness was characterized. It was during an era of prejudice, when the term “gay plague” was commonly used to describe the disease, which received little attention by politicians or the public because of its association with gay men.
The CDC’s response, however, was bold, swift and grounded on evidence-based scientific discovery.
In June 1981, the CDC published its first report of five cases of pneumocystiscarinii pneumonia (PCP) among previously healthy young men in Los Angeles. All of the men were described as “homosexuals”; two of these men died. In that same month, the CDC developed an investigative team to identify risk factors and develop outbreak criteria for the disease. Within 18 months of this report, the CDC identified all the major factors for AIDS and issued recommendations for prevention of sexual, drug-related and occupational transmission of the disease.
Dr. Jonathan Mann, the person perhaps most responsible for bringing world attention to AIDS said at an international conference in 1998: “Our responsibility is historic. For when the history of AIDS and the global response is written, our most precious contribution may well be that, at a time of plague, we did not flee, we did not hide, we did not separate ourselves."
This sentiment was echoed in 2011 when Drs. James Curran and Harold Jaffe, then director of the CDC, wrote in an article about the early years of AIDS and the CDC’s response that: “the future of prevention and care for HIV means standing up to two societal foes, scarcity and discrimination, as much as the biologic challenge of the virus itself.”
CDC scientists studying AIDS worked effectively and efficiently, uninhibited by a homophobic “community standard.” They didn’t hide behind a biased and prejudicial government standard, but instead set on a path of discovery that included many therapeutic breakthroughs, including the development of drug therapy that has dramatically increased the disease’s survival rate.
This is just one of many examples of unbiased, effective science-based research by the CDC over the years that has been essential in establishing disease etiology, therapy and prevention.
The CDC is the nation’s health protection agency, and its work requires government support. By limiting that support or by providing hurdles, the government puts our health and the health of all at risk.