What would it take for you to speak out and take action? What form will that action take? For some, the tipping point has already passed. For others, it is fast approaching. The collapse of the world's most formidable scientific enterprise will not happen overnight; history has taught us that existential threats are preceded by subtle shifts that are accommodated.

 

Silence Won't Save Science

 

— What will it take for you to speak out and take action?

 

by Tracey A. Wilkinson, MD, MPH, and Gita Suneja, MD, MS April 6, 2025

Wilkinson is an associate professor of pediatrics and obstetrics & gynecology. Suneja is a professor of radiation oncology.

In the first few months of the new administration, we have witnessed an unprecedented dismantlingopens in a new tab or window of the national scientific and research enterprise. While certain shifts were anticipated in the wake of the 2024 presidential election, the speed and scope of these changes have been alarming. The consequences are rippling across every domain of science and medicine, leaving the academic community grappling with how to move forwardopens in a new tab or window in a rapidly shifting landscape. While debate is integral to the advancement of science, division across partisan lines harms the advancement of science and our collective health.

At a time when many individuals and organizations are unsure of how to respond, one thing is abundantly clear: silence will not protect science. As health equity researchers, our fields of science -- reproductive health, workforce diversity, and cancer disparities -- are once again at the center of conflict. One commonly observed response has been to obscure or rebrand "controversial" areas like diversityopens in a new tab or window or sexualityopens in a new tab or window in an attempt to avoid scrutiny. For example, researchers are considering and being asked to make changes to language in grants and manuscriptsopens in a new tab or window.

This strategy is both ethically and strategically flawed. Obfuscation erodes public trust and weakens the integrity of scientific inquiry. The recent threat of NIH indirect cost cutsopens in a new tab or window and canceling of grantsopens in a new tab or window and public health programsopens in a new tab or window serves as a stark warning: when we permit vulnerabilities in one area of research, the resulting fracture inevitably undermines the entire scientific infrastructure.

Another observed response is anticipatory obedienceopens in a new tab or window, where individuals and institutions preemptively shift their strategic priorities in an attempt to preserve stability. Websites are being scrubbed of words like "female" in an attempt to preemptively take action and lower the risks of future ire or attention. The notion that sacrificing one area of science to shield the rest, particularly as court proceedingsopens in a new tab or window and temporary injunctions challenge the recent executive orders, is shortsighted. As we have seen recently, no area of science is immune from attack. Vaccine science, once an area with bipartisan support, has been undermined by misinformation and politicization, leading to the resurgence of measles.

We recognize that many wish to speak out but feel isolated, fear retribution, or are not accustomed to marrying advocacy and science.

For health equity researchers, this is not the first time we have faced and surmounted obstacles. Work that examines the social, economic, environmental, and institutional factors driving differential health outcomes has received inconsistent attention over time. Historically, federal funding for health equity research has been precarious and in spite of some advances, health equity research accounts for less than 3%opens in a new tab or window of the federal research budget.

Nonetheless, the field of health equity research has grown substantially in its scope and impact; equity innovations have not only reduced disparities but have also improved health outcomes for all. In response to political and funding pressures, researchers have sought alternative funding sources, built cross-disciplinary collaborations, and strengthened community partnerships. Health equity researchers have navigated the complex political landscape directly, adapting while advocating to ensure the field continues to progress, even when funding and favor were lacking.

As we confront this new reality, we urge you as scientists, health professionals, and institutions to consider how you will operationalize your core values. What would it take for you to speak out and take action? What form will that action take? For some, the tipping point has already passed. For others, it is fast approaching. The collapse of the world's most formidable scientific enterprise will not happen overnight; history has taught us that existential threats are preceded by subtle shifts that are accommodated. If we fail to engage in meaningful dialogue and introspection now, we risk missing our opportunity to act until it is too late.

As members of the scientific community, we share a responsibility to advocate for evidence-based inquiry and to promote its integrity in policy making. Standing together in solidarity can be a blueprint for action and mitigate current and future damage. Science and medicine are not immune to criticism; they must evolve to address critical flaws.

Reform is urgently needed to reduce inefficiencies, accelerate the translation of research into practice, and to dismantle outdated systems that breed distrust. In clinical medicine, we need to address skyrocketing healthcare costs, reduce administrative bureaucracy, and shift from reactive care to disease prevention. Perhaps most importantly, we must center the communities we serve and rebuild public trust in science. But if we hope to reform and strengthen science tomorrow, we must resist its dismantling today. It is not too late to find our collective voice.

This moment is a profound reckoning. Our institutions are being tested and our individual and organizational responses will define the future of science in this country. Our values are demonstrated by actions and cannot be legislated. The impact of our choices will persist long after the political tides have shifted. The question is not whether science can survive this moment; it is whether we, as stewards of science and medicine, have the courage to ensure its integrity and resilience.

Tracey A. Wilkinson, MD, MPH,opens in a new tab or window is an associate professor of pediatrics and obstetrics & gynecology in the Department of Pediatrics/Children's Health Services Research at the Indiana University School of Medicine in Indianapolis. Gita Suneja, MD, MS,opens in a new tab or window is a professor of radiation oncology in the Department of Radiation Oncology at the University of Utah Spencer Fox Eccles School of Medicine in Salt Lake City.

https://www.blogger.com/blog/post/edit/21519732/5438143514686238617?hl=en