The early months of Donald Trump’s presidency have brought sweeping changes to the country’s scientific and medical landscape. Deep cuts to research funding and widespread layoffs have threatened progress in medicine, energy, climate science and other key fields — areas where the United States has long been a global leader.
The future is uncertain, but decline isn’t inevitable. Times Opinion asked experts across disciplines to share concrete ways that individuals, organizations and local leaders can keep science and health efforts moving forward. Here are their ideas.
1. Protect vaccination.
Dr. Margaret Hamburg, former Food and Drug Administration commissioner: As the Trump administration moves to halt areas of vaccine research, drops funding for vaccine clinics and deletes vaccine information from government websites, it’s crucial to find ways to ensure that vaccine availability and use remains grounded in the best available science. The Vaccine Integrity Project is a new initiative that will be making recommendations about how to continue vaccination programs to avert death, disability and hospitalizations from preventable diseases. We see it as a precaution against potential threats, including the politicization of a Centers for Disease Control and Prevention vaccine advisory committee, an unchecked expansion of the measles and whooping cough outbreaks or the loss of state and local immunization program support.
2. Get creative with state policies.
Josh Green, governor of Hawaii: In May, Hawaii became the first state to pass a climate impact fee that will enable us to protect ourselves against future climate-related disasters like the devastating Maui fires. A small 0.75 percent increase in the hotel tax for all travelers to Hawaii will generate $100 million per year, which may also be used to bond $1 billion annually. These resources will fund new research, development and deployment of strategies to mitigate the impacts of climate change, such as reducing carbon emissions, protecting and restoring ecosystems and building climate-resilient infrastructure and communities. This is just one example of how state and local governments can take control of their own fates and survive harsh federal cuts.
3. Get mad in public.
Dr. Kate Marvel, climate scientist: Scientists are trained to support conclusions with evidence, not emotion. But rational arguments can’t stop irrational decisions. The people firing scientists and erasing data will tell you coal is clean, the climate isn’t changing and weather forecasting is unimportant. They are lying. In response, scientists can tell the truth. Not just in papers and talks but in the media, in our communities and on the streets. The fear of retaliation is real, and not everyone can speak up. But those of us who can should get angry, get loud, and show that mad scientists are a force to be reckoned with.
4. File a lawsuit.
Dr. Reshma Ramachandran, Doctors for America board member: Days after the Trump administration purged thousands of pages from federal public health agency websites, Doctors for America, an advocacy organization of over 27,000 physicians and medical students, filed a lawsuit to restore and protect these essential sources. The websites contain critical resources for treating patients, data to improve medical practices and public health and guidance to ensure that clinical trials for new treatments are designed to reflect demographics in the real world. We were successfully granted a temporary restraining order that has led to the restoration of several of these websites, and we continue to fight in court for access to them.
5. Lean on other scientists.
Brandon Jones, president of the American Geophysical Union: Scientific societies — professional organizations that represent researchers in specific fields — have a long history of stepping in when politics interferes with research. After the Trump administration suspended work in April on the U.S. government’s flagship report on the impacts of climate change, the American Geophysical Union and the American Meteorological Society partnered with plans to publish some of the research so the public can still access the findings. We’ve also surveyed our membership to document the erosion of scientific expertise in government, and we are legally challenging executive actions that threaten research. As the government terminates studies on environmental risks, we’re helping local communities do the work themselves.
6. Donate effectively.
Zachary Robinson, chief executive of the Center for Effective Altruism: Recent cuts of over $1 billion toward global health initiatives could result in hundreds of thousands to millions of excess deaths each year, according to some estimates. It’s easy to feel powerless in the face of these numbers — but we aren’t. Those of us earning $62,000 a year post-tax are in the top 1 percent of the world’s wealthiest. Not only do many of us have the means to help, we also have access to research from organizations like GiveWell to identify the most effective way to direct donations. GiveWell estimates it costs between $3,500 and $5,500 to save a life through organizations working on malaria prevention, nutrition and vaccinations. By donating 10 percent of their take-home pay, an American household can save a life every single year.
7. Create a mini N.I.H.
Andrew Marks, professor of physiology at Columbia University: We need a new funding model for science research. I propose the creation of the American Research Collaborative, a kind of mini-National Institutes of Health that could provide funding for universities. The A.R.C. would be led by a governing board elected by member organizations like the American Heart Association, the American Cancer Society and the Howard Hughes Medical Institute. Universities could opt in, and the collaborative’s tax-exempt status would attract private donors. Research groups could apply for grants with a short proposal and selection of their recent publications. Artificial intelligence could help rank the most promising applications and send off the top quarter for expert review. This system could provide stable, nonpolitical research support that complements the N.I.H. and help keep the system afloat during dry spells in funding.
8. Use opioid settlement funds for addiction care.
Maia Szalavitz, journalist covering addiction: The Trump administration canceled around $1 billion in grants from the Substance Abuse and Mental Health Services Administration, which funds essential addiction treatment and overdose prevention measures. (Mr. Trump’s proposed budget would eliminate funding to the agency.) Medicaid, which covers a large proportion of addiction treatment, is also facing huge cuts.
Now, with $50 billion from the opioid lawsuit settlements on its way to states, advocates must push to ensure that money fills funding gaps and supports approaches such as peer counseling, syringe exchanges and distribution of the overdose antidote naloxone. They can also keep pressuring the government to restore federal funding.
9. Support patient-led research.
Fiona Lowenstein, writer, editor and founder of Body Politic: When health agencies fracture, we shouldn’t forget the power of patients. Early in the Covid-19 pandemic, a strained health care system and confusing messages left those of us developing long Covid without guidance. So we built our own resources and infrastructure. The Body Politic Covid-19 support group grew to over 14,000 members in over 30 countries — a space for support and patient-led research, including surveys of our experiences and symptoms. The work helped secure recognition that our illness is real, leading to updated C.D.C. symptom lists, funding for N.I.H. research and the creation of long Covid clinics. Peer-to-peer support is always important, but it becomes vital during new disease outbreaks.
10. Join a humanitarian aid organization.
Dr. Craig Spencer, Doctors Without Borders physician during the 2014 Ebola outbreak and other crises: As a frontline medical worker, I’ve seen what happens when the world turns its back on global health: Clinics go without supplies, communities go without health care and lives hang in the balance. As the United States slashes support for global health, humanitarian organizations like Doctors Without Borders are often all that remain. They need more people willing to deliver emergency medical aid to people in crisis. Joining isn’t just about providing care. It’s about standing with those the world has left behind. It’s about recognizing our shared humanity and responding to malnutrition emergencies, displacement and disease outbreaks with action. Even if our government won’t show up, we still can.
11. Build new alliances.
Dr. Jane Lubchenco, co-founder of United by Nature: In January, over 100 scientists outside the federal government were struggling to come to grips with the administration’s cancellation of years of work on what would have been the first ever federal assessment of nature. We refused to quit. So we created a new path to deliver the report and show why the information matters. The initiative, called United by Nature, will have a governing body, advisers and partners, independent peer review and extensive public engagement. It’s a phoenix rising from the ashes: a new alliance of scientists, engineers, economists, health experts, policy experts, funders, businesses, conservation organizations and artists, all determined to deliver what the federal government should be doing but isn’t.
12. Replace research into vulnerable groups.
Dr. Jack Turban, pediatric psychiatrist and scientist: The G.O.P.’s approach to transgender youth is incoherent. On the one hand, they say there isn’t enough science in this area. On the other, they canceled grants for transgender health research and refuse to issue new ones — a recent Times report found that nearly half of recent N.I.H. grant cancellations were for L.G.B.T.Q.-health-related research. States should fund health research for vulnerable groups the Trump administration has abandoned. California Senate Bill 829, which would create the California Institute for Scientific Research, is model legislation that replaces funding cuts from the federal government, potentially including areas like transgender health research. It’s essential other states establish similar institutes.
13. Call your senator. Really.
Kathleen Sebelius, former secretary of the Department of Health and Human Services: While there are many ways states and organizations can and should take action, there is no replacement for the direct involvement of the federal government in research. The grants to universities for bench science in labs throughout the country, combined with the cutting-edge research at the N.I.H., have returned huge economic and health benefits to Americans. Federal budget cuts to this infrastructure cannot be replaced by the private sector, and will also encourage a brain drain of scientists and researchers. We will be relegated to importing blockbuster medications from other countries. This is preventable if Congress refuses to accept these devastating cuts. Americans must directly implore their representatives and senators to take action. These calls make a difference.
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