Editorial: Now we must mobilize for science, again...

In the US, a second Donald J. Trump term has begun, and his nominations for various government posts are being confirmed. The Senate recently confirmed Robert F. Kennedy Jr., who has repeatedly expressed an antivaccine attitude, as secretary of the US Department of Health and Human Services.

At the end of last year, an NPR article reported that the Louisiana Department of Health (LDH) was forbidding its employees from promoting or advertising the COVID-19, flu, or mpox vaccines. A statement from the LDH to NPR in response explains that the motivation behind this ban was to move away from “one-size-fits-all paternalistic guidance” to a policy in which the decision to get vaccinated is a personal choice. And on Feb. 13, a statement posted to the LDH website and an internal memo obtained by the Times-Picayune on the day of Kennedy’s confirmation signal an end to mass vaccination and vaccine promotion in Louisiana. Of course, we at C&EN do not want to deny people’s right to chose their medical treatment. But the LDH seems to think that people should make decisions about vaccination without the state providing access to scientifically based information in plain language.

This policy, while questionable in logic, isn’t particularly surprising. Positions on vaccines, like those taken by the LDH, can provide space for the antivaccine movement to grow even stronger. Vaccine skepticism has grown across the US, and those who are ignorant or in denial of the science supporting the effectiveness of vaccines have become more vocal in politics. These attitudes have only become more pronounced since the release of the COVID-19 vaccines. But history provides lessons for the scientific community about responding to political leadership that does not embrace global scientific consensus.

In the early 2000s, a growing number of people in South Africa denied the link between HIV and AIDS, thanks in part to then-president Thabo Mbeki. Mbeki claimed that HIV did not cause AIDS and that the medication recommended for HIV and AIDS at the time were poisons, including the commonly prescribed antiretroviral drug azidothymidine (AZT). Instead, Mbeki’s administration promoted herbal remedies, despite warnings from HIV and AIDS activist groups in South Africa and abroad that said AZT and other antiretrovirals are safe and effective when used in combination with other therapies.

Denying the benefits of vaccines has a quantifiable cost in human lives. Scientists estimated that Mbeki’s and the South African government’s HIV-AIDS denialism led to roughly 330,000 avoidable deaths. Scientists also estimated that, in the US, between January 2021 and April 2022, vaccination could have prevented over 318,000 deaths. And now, not far removed from the tragedy of a global pandemic, one of the most influential governments of the world is doubling down on antivaccine attitudes and restricting access to scientific information.

Thankfully, the hard lessons from the past also provide a playbook for the future. Intensive social mobilization in South Africa helped people to trust the connection between HIV and AIDS and to believe in the recommended medications. Advocacy groups, in South Africa and internationally, stepped up their public education campaigns and fought HIV-AIDS denialist legislation in the courts, ultimately leading to acceptance of the HIV-AIDS connection within the South African government. In the US, social mobilization campaigns also helped fight for scientifically informed policy during the COVID-19 pandemic. Now we need to mobilize again.

Convincing public health agencies to support science-based policy requires knowledgeable people to make their voices heard. This publication asks, what are you willing to do?

This editorial is the result of collective deliberation in C&EN. For this week’s editorial, the lead contributor is Max Barnhart.

Views expressed on this page are not necessarily those of ACS.