We Are About to Learn What a Post-Truth Approach to Public Health Feels Like
By Schuyler Mitchell , Truthout
Remember “alternative facts”? It’s been eight years since
Kellyanne Conway, a senior adviser to President Donald Trump, uttered those
words during a “Meet the Press” interview. The patently Orwellian phrase set
off a firestorm of coverage: According to Conway, White House Press Secretary
Sean Spicer wasn’t lying when he said Trump had drawn “the largest audience to
ever witness an inauguration,” despite clear evidence to the contrary. Spicer’s
facts weren’t false, Conway said, just “alternative.”
Trump seems to intend and an to US involvement in global health.
The US has quit the World Health Organization and frozen foreign aid.
Two months before that interview, in November 2016, Oxford
Dictionaries declared “post-truth” the word of the
year. Trump’s first presidential campaign and the global ascendancy of the far
right had sparked a pervading interest in fake news, disinformation and the
political utility of truth-telling in a world shaped by algorithmic forces.
Pundits grappled with the realization that social media’s prime role in
disseminating news now meant that quick reactions — the stronger the better —
would take precedence over thoughtful engagement.
If Trump had a first term marked by “alternative facts,” his
second has demonstrated an outright hostility to anything resembling truth at
all: Yes, there are the classic Trump lies (like his ludicrous claim that diversity, equity and
inclusion [DEI] programs are making planes fall out of the sky), but there’s
also his administration’s brazen purge of health and climate data — an assault on
foundational scientific knowledge that archivists have scrambled to preserve.
Trump has also ordered $4 billion in cuts to National
Institutes of Health (NIH) grants used to fund critical research at
universities, cancer centers and hospitals. A federal judge temporarily blocked Trump’s order on Tuesday, but
medical researchers have warned that, if implemented, the cuts could hamstring
efforts to cure cancer and chronic health conditions, rendering scientific
breakthroughs unobtainable.
And then Trump has made ridiculous statements like this: “We identified and stopped $50 million being sent to Gaza to buy condoms for Hamas,” he told reporters last month during a signing ceremony for the Laken Riley Act.
The baseless claim, first promoted by Elon Musk and his “Department of Government Efficiency”
(DOGE), seems in fact to be referencing an $83.5 million payment to support HIV
prevention and treatment efforts in the East African country of Mozambique,
whose Gaza province is unrelated to the Gaza Strip in the Middle East.
The nongovernmental organization that received the funds,
the Elizabeth Glaser Pediatric AIDS Foundation, said none of the money was used
to acquire condoms. This is a far cry from the eye-catching headlines about rash government
spending on “explosive condoms” for Hamas. But even the
use of government funds to purchase contraceptives is not particularly notable;
the U.S. Agency for International Development has worked on global HIV
prevention efforts for decades.
On Tuesday, Musk finally walked back the White House’s
claim, telling reporters, “Some of the things that I say
will be incorrect.” It’s a chilling acknowledgement — no more lip service will
be paid to the pursuit of truth, just expect and accept a steady stream of
falsities from those in power. While Musk tacked on a note that DOGE’s
incorrect statements “should be corrected,” he knows it doesn’t matter. The $50
million condom claim already went viral across social media and conservative
news networks; now that it’s lodged in the brains of countless Trump
supporters, it’s unlikely that a belated press briefing will change anyone’s
mind.
Plus, Musk then added, “I’m not sure we should be sending
$50 million worth of condoms to anywhere.” Again, we didn’t.
And yet this flippant ignorance is also part of the new anti-truth paradigm, a
weaponized, intentional “I’m just asking questions” attitude, crafted to
obfuscate simple facts. Musk could, of course, choose to learn the details of
global HIV prevention, why the U.S. does it, how public health efforts in
Mozambique have a ripple effect on all of us. But why would he?
The same ideological current runs through Trump’s gutting of
medical research. The slashed NIH funds for researchers’ overhead costs
boastfully disregards even considering why those costs might be necessary. And
the impact on public health could be devastating.
Take HIV prevention, for instance. U.S. health officials
first became aware of AIDS in 1981, but it took four more years for
then-President Ronald Reagan to speak about it publicly. By 1990, HIV was a
leading cause of death for young people in the U.S.; more than 40 million
people have died from HIV globally.
But today, for many in the U.S., the HIV/AIDS epidemic now
feels like it’s in the rearview mirror. That’s thanks in large part to
concerted efforts from activist groups like the AIDS Coalition to Unleash Power
(ACT UP), which fought to expand the approval and availability of life-saving
drugs. New HIV infections have declined since 1984 by an estimated 76 percent.
ACT UP’s efforts set the government’s public health agenda, pushing for vital
change from agencies like the Centers for Disease Control and Prevention (CDC)
and NIH. It is because of these efforts that we have federal funding for HIV
prevention and treatment in the first place — the same funding now being cut
or placed on pause.
But the epidemic is not over, certainly not globally, and
also not in the U.S. “Especially here in New York City where the HIV epidemic
really started, there’s been a lot of investment to get that last little bit to
end the epidemic in recent years,” Jason Zucker, an adult and pediatric
infectious disease physician at Columbia University Irving Medical Center, told
me. “If we want to end the epidemic, it’s going to be really hard. You have to
increase your efforts to increase testing and identify every person living with
HIV, so you can try to spend additional time and effort linking them to care
and getting them on treatment, because undetectable equals untransmittable.”
The second Trump presidency has made that battle all the
more difficult. I spoke with Zucker before Trump announced the cuts to NIH
funding, but after he had ordered a freeze on the disbursement of all federal
funds. While that freeze was also temporarily halted by a federal judge,
courts ruled Trump has been defying the judge’s order. And as part of Trump’s
ban on diversity, equity and inclusion programs and “gender ideology,” his
administration has continued to scour grants for any mention of words
that could be loosely construed as relating to DEI — which in practice has
spanned a range of topics, even flagging words like “diversity” and “women” for
review. Zucker noted that Trump’s multipronged attacks “will really impact our
ability to bring the epidemic to a close like had been planned.”
Public health, we know, is not a priority of the Trump
administration. Five years ago, the Trump administration failed to respond to the emergence of
COVID-19 in a timely or effective manner. The global pandemic sparked a new
wave of vaccine denialism and a crumbling of trust in our government’s health
agencies — trust that won’t be restored with Robert F. Kennedy Jr., a noted vaccine skeptic and conspiracy theorist,
at the helm of the Health and Human Services Department. The CDC botched its public health guidance,
first under Trump, and then continued to sow confusion under President Joe Biden’s
administration, shifting the onus of responsibility for public health from the
state to individuals.
Trump’s attacks on medical research, federal funding, and
access to health and climate data are the logical outgrowth of the post-truth
seeds first planted in 2016 and watered during the COVID-19 pandemic. And while
the media focus has been on the consequences for scientific research, Zucker
emphasized to me that the biggest impacts will be on treatment.
“The whole point of research is to give us better methods of
caring for people,” Zucker said. “I say that as someone who’s primarily a
researcher: My work doesn’t matter if I translate that into providing better
care.”
Schuyler Mitchell is a writer, editor
and fact-checker from North Carolina, currently based in Brooklyn. Her work has
appeared in The Intercept, The Baffler, Labor Notes, Los Angeles Magazine,
and elsewhere. Find her on X: @schuy_ler
