By now, there have been countless stories written about the termination of grants at the National Institutes of Health and Centers for Disease Control and Prevention, the firings of thousands of staff among these and other agencies of the Department of Health and Human Services, and the broader shutdown of programs and slashing of budgets across HHS. The scope and scale of these attacks are unprecedented. They have sent institutions reeling, from state and local health departments to colleges and universities, imperiling frontline work to protect the public health and aborting progress on new advances in the treatment and prevention of infectious and chronic diseases.

I’ve been trying to get my head around the singular question: Why? Why are they doing this? Some have tried to frame these cuts as responsive to a Make America Healthy Again agenda, or an attempt at downsizing a government gone wild—anything to try to shoehorn the rationale for these actions into some sort of standard, political logic. But I think something far more obvious may be at work, though it may be difficult to accept that it is happening here in the United States, or for most of the media to call it what it is.

What we are seeing is a purge—of the administrative state, of the universities, of expertise—that is consistent with events like the Cultural Revolution in China in the 1960s and ’70s, or the dismantling of the tsarist civil service after the Bolshevik Revolution in 1917. Just because this moment isn’t associated with the intense political bloodshed of those eras doesn’t make the comparison any less apt. In one way or another, the goal is to get rid of an entire set of people and institutions in the service of a radical ideology.

And what is rising in its place is also recognizable from history. From the Covid contrarians running the National Institutes of Health and the Food and Drug Administration to the anti-vaxxers down at HHS headquarters, we have our 21st-century Lysenkos propped up not by the strength of their ideas but by their political patrons in the White House.

While the short-term effects of the administration’s policies have been well-articulated, the long-term ones are just as chilling. In less than 100 days, President Trump has created a lasting legacy: We have lost a generation of expertise, of systems built up to care for our nation and provide for our collective future in terms of scientific advances. 

These resources won’t just spring back if Trump is gone. Senior figures outside the government are seeking other opportunities. Students and trainees are missing the chance right now to take up their chosen profession; they’re not all going to wait around indefinitely for the political winds to change. The rest of the human, administrative, and physical infrastructure for science, public health, and healthcare is starting to wither away as well. In government, in addition to the mass dismissals, we have people like Peter Marks—central to drug development and regulation for years—walking away from the FDA in disgust and protest. If you needed more evidence of the central punitive nature of these purges, some agency officials are getting told they can go work in remote rural locations in Alaska or Montana and remain in federal service. At least they are not getting a bullet to the head as they are marched out to the countryside. But they are indeed facing a kind of exile.

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Though the courts have pushed back against some of the executive actions and agency decisions being made, it’s not quite clear that anyone in the administration is listening to or cares about what judges have to say. Those that should fight back, including universities like Columbia, have simply taken the knife and plunged it into their own hearts, destroying the credibility of once-great institutions, and gaining little in terms of respite from the White House. 

Meanwhile, pseudoscience is on the rise, and like Lysenko’s, this will have deadly consequences. RFK Jr. is presiding over a flourishing measles epidemic in the US, while touting quack cures with real dangers to children. Despite the pathetic protestations of Senator Bill Cassidy, the HHS secretary is running full-steam ahead with his anti-vaxx agenda, including appointing an anti-vaxx doctor who has been banned from practicing medicine as the head of a study on the nonexistent links between vaccines and autism. According to The Wall Street Journal, Kennedy’s minions are also looking for data on brain swelling and deaths due to the measles vaccine—data that doesn’t exist because there are no such cases in the US.

In addition, Covid contrarians at NIH and FDA are desperate to relitigate the past five years of the pandemic by banning research on Covid (because, don’t you know, it is and never was such a big deal) and mRNA vaccine development for other diseases and conditions. They are even setting up their own journals, most notably the Journal of the Academy of Public Health, with their own colleagues to launder their scientific nonsense—because if standard peer review of your research doesn’t work, it’s time to get your own peers to work it out. 

These people whined for five years about their treatment at the hands of the biomedical research establishment, and called for greater openness to new ideas and risk-taking in science. But their mowing down several NIH institute chiefs and thousands of NIH employees in one week tells you this is about retribution, not new freedom of intellectual inquiry. And in one of the more bizarre and sad developments, these folks are being lauded by intellectuals like the Princeton political scientists and authors of In Covid’s Wake, which is a love letter to Covid contrarianism lapped up by a mainstream media eager to rewrite the history of this half decade. Hey, you can’t have a revolution without poputchiks, fellow travelers.

We’re in deep trouble. The midterms, the 2028 elections, should they change the balance of power in Congress or who is in the White House, all come too late. The patient is bleeding out in the waiting room. American science, public health, and healthcare will be damaged for a generation or more.

Why? Because this is what they want. Whatever their psychologies or philosophies are, these are irrelevant at this moment. We are living through times that are now focused on destruction as a central goal, meant to inflict pain and suffering on millions now and into the future, long after they’re gone.