The United States of America is experiencing an unprecedented constitutional crisis, hurtling toward authoritarianism. While the first Trump administration had officials who acted as safeguards against his authoritarian impulses, such as National Health Advisor Anthony Fauci and FBI Director James Comey, this time around, those guardrails were torn out before the motorcade even arrived at the Capitol. The first weeks of the Trump administration have seen a sweeping overhaul of American bureaucracy, through dozens of executive orders that push the limits of presidential powers while bypassing congressional oversight. Amongst others, his orders have challenged birthright citizenship, allowed the detention of US migrants in Guantanamo Bay, where rights to legal counselling are withheld, given unelected billionaire Elon Musk – alongside recent high school graduates – access to the private health and income data of millions of Americans, and targeted federal employees in the DOJ, FBI and CIA who investigated Trump’s involvement in the January 6th attack on the Capitol.
Beyond targeting federal agencies and law enforcement, the Trump administration has also launched a direct assault on public health. Even those unbothered by Trump’s blatantly unconstitutional actions have reason to care about public health, as it does not discriminate based on political affiliation, gender, sexuality, ability, or any other demographic parameter. At the beginning of February, the U.S. Centers for Disease Control and Prevention (CDC)’s website displayed a banner that affirmed that its contents were “being modified to comply with President Trump’s executive orders” targeting “DEI” (Diversity, Equity, and Inclusion) and government spending. In a memo issued on January 21st, Trump’s first full day in office, the Department of Health and Human Services (HHS) halted all health-related external communications “until it has been reviewed and approved by a Presidential appointee.” Funding for the National Institutes of Health (NIH) has been frozen, a concerning development amid the rising risk of avian flu and a tuberculosis outbreak in the Midwest. Hundreds of pages on topics such as STIs, HIV, and gender-affirming care have been removed or altered on the Center for Disease Control and Prevention (CDC) website. Some have not returned. This disregard for public health goes back to 2017, when the Trump administration banned certain words from use in CDC research and reports, such as “vulnerable,” “entitlement,” “fetus” and “science-based.” Now, this banned word list has been expanded to include “gender,” “LGBT,” and “pregnant person”. By banning these terms, the Trump administration is promoting the erasure of vulnerable communities from healthcare data and research, effectively absolving itself from any future negative health consequences these communities may face as a result of other public health bans including those on gender-affirming care programs, restrictive abortion legislation, or halt of government subsidies for vital medications. By censoring the CDC, erasing vulnerable groups from health data, and gagging communications, the Trump administration avoids government accountability for public health failures. While the Trump administration claims it has a cost-cutting mandate for federal overhaul, the purge of public health data is not a mere bureaucratic maneuver; it is a deliberate attack on both public health and democracy, designed to erode informed citizenship.
Trump’s disdain for public health agencies did not begin with his effort to “end DEI.” Rather, it can be traced to his handling of the COVID-19 crisis, which hit the U.S. in 2020, the last year of his first term. In February 2020, as COVID-19 cases rose, Trump repeatedly asserted that the virus was not a problem, affirming that: “it’s like a miracle – it will disappear.” By the time he left office in January 2021, after a year of denying reality and openly contradicting the advice of his Chief Medical Advisor Anthony Fauci, the U.S. death toll was nearing 500,000. The failure of his administration to address COVID-19 cast a long shadow over his first term. Now in his second, Trump aims to cement his legacy as America’s strongman.
His legacy-building effort is evident in his repeated claims that the U.S. ‘needs’ Greenland for global security and his televised executive order signing at Washington’s Capital One Arena. His desire for geopolitical domination mirrors his attempt to obscure public health realities—rewriting narratives to benefit his strongman image.
As briefly alluded to earlier, Trump has endeavoured to replace all possible opposition with loyalists. One example is Trump’s National Health Secretary nominee, Robert F. Kennedy Jr., who is a prominent anti-vaccine advocate that stoked anti-vaccine sentiment on a 2019 visit to Samoa. At the time, the Carribean island was experiencing a measles outbreak and was beginning a vaccination campaign. Emboldened by Kennedy’s visit, local anti-vaccine campaigners became more prominent. In total, 83 people died during the outbreak – most of them children under 5.
Unfortunately for Trump, human health is unconcerned with political optics. His response to emerging public health crises –and national health in general– is misinformation. Trump has no qualms about denying verifiable public health data, as evidenced by his COVID-19 response, but denial does not change facts. When facts are unavailable, or are misconstrued and manipulated, denying a public health crisis becomes much easier.
Trump is trying to change America’s public health institutions, but he cannot change the commitment of American health sector professionals. In early February, before the purge, the entire CDC site pre-Trump administration was indexed through the Internet Archive by ACASignups.net – a site dedicated to healthcare policy developments and monitoring. On February 4th, the Association of Health Care Journalists (AHCJ) convened around a dozen representatives of news nonprofits and journalism scholars to begin work on creating a plan for protecting the integrity of health data. That same day, activist organization Doctors for America filed a lawsuit against the Office of Personnel Management, the CDC, the FDA, and HHS for removing and altering health related data. In their complaint, they state that removing data creates a “dangerous gap in the scientific data available to monitor and respond to disease outbreaks, deprives physicians of resources that guide clinical practice, and takes away key resources for communicating and engaging with patients.”
On the 11th of February, in response to the Doctor’s of America lawsuit, federal judge John Bates blocked the Trump administration’s purge of public health data. In the case’s memorandum, he wrote that “It bears emphasizing who ultimately bears the harm of defendants’ actions: everyday Americans, and most acutely, underprivileged Americans, seeking healthcare.” Democracy’s strongest defense lies in its institutions and people; public resistance and civil dissent, an independent judiciary, and civil society organizations like Doctors for America serve as critical safeguards against democratic erosion. America’s democracy –and the rights and freedoms of the American people– are under very real threat. As efforts across the country show, collective resistance to authoritarian overreach is the only way to safeguard its future.
Edited by Jamie Silverman
I’m a writer for Catalyst and the McGill Journal of Political Science. I am passionate about topics such as politics, sustainability and geography!