Call to Boycott the American Diabetes Asociation (ADA)

So I had been chronicling the saga of the #NOLA5 (#NewOrleans5) and how the #AmericanDiabetesAssociation has been handling the situation.  I have not written about the latest events, but the main issue is that despite promising an independent "arms-length" review of the event, the #ADA chose to use an internal committee (the Audit and Governance Committee) to review the event, generate a report, only to selectively share some conclusions of the report without making the full report available, then say there is new information available that needs to be reviewed.  This is hardly an arms-length independent review.

Anyway, a call for a boycott of the ADA has started to make the rounds.  I am reproducing the complete e-mail along with the links and attachments.  Additional, you should note that the editorial board of Diabetes Care, the premier journal of the association, has decided to stop accepting new manuscripts.  Manuscripts submitted prior to the deadline will supposedly be processed in the normal fashion, but I don't know how that's going to work when the boycott is asking people so suspend supporting association activities, including manuscript reviews.  Initially, there was a notice of this when you visited the Diabetes Care website, but that notice is now gone.  I am guessing the Association removed it since they are claiming Diabetes Care is open for business as usual.  

I am providing the e-mail I received to give everyone a chance to read through things and make your own decision.  There is one declaration for those of us who are professional members of the ADA and a second one for those of you who are not professional members, but supporters of the ADA.  It is unfortunate this situation has gotten to this point, but the stakes are very high given our current environment and the fact that diabetes continues to be a significant global health issue.

The reproduced e-mail starts here:

Bottom Line Up Front: Sign here to Boycott the ADA 

Please use the above link if you serve on an ADA committee, editorial board, review grants, etc such that your boycotting will immediately stop ADA work from happening). Please only share the above link with ADA members or those who do substantive work on behalf of the ADA. You can see who else has signed on here Cosignatory List 

Please use this link (Petition to Boycott the ADA - PUBLIC) if you are a general supporter of this boycott but don't do anything directly for the ADA. Please DO share this with your network of likeminded supporters within and external to the ADA...patients, donors, providers, etc, etc. Feel free to sign both lists as we will collate all responses before sharing with the Board of the ADA

Yes, this will cause short term pain for many of us and those we serve, but it is in the best long-term interests of the organization to demand change given the woefully inadequate responses from ADA leadership to date.  

Mike

-------------------------

Michael Haller, MD

Professor and Chief

Pediatric Endocrinology

University of Florida

Details: Diabetes Care has suspended activities in support of this Boycott.  See letter below from Diabetes Care Editor in Chief, Dr. Steven Kahn, and attached articles for more information:

"A group of professional members of the American Diabetes Association (ADA) has posted a “Notice of Boycott of the American Diabetes Association.” The group that has been involved in organizing and supporting this boycott includes me and the three Diabetes Care deputy editors (Cheryl Anderson, John Buse, Liz Selvin). I would encourage you to read it and, if you agree, to join us in signing it. When you do so, please indicate that you are an editorial board member of Diabetes Care.

Some background for those of you who may not be up to date on everything since what happened on Friday, June 5th, at ADA Scientific Sessions.

1.   In his video message on 10 June 2026 to members of the ADA, the Chief Executive Officer, Charles “Chuck” Henderson, promised an independent investigation into what transpired. A review has occurred, but it has not been independent. Rather, it has been conducted by a subcommittee of the ADA’s Board of Directors, the Audit and Governance Committee. This committee includes two members of the current Board of Directors, who reviewed activities as they were occurring around the time of Scientific Sessions. Thus, it is hard to understand how they could be truly unbiased.

2.   On 1 September, the ADA put out a press release with comments about the committee’s report. This press release included quotes from Chuck Henderson and James Tai, Chair of the Board (attachment – “The American Diabetes Association Audit and Governance Committee Releases Independent Review 090126”). Simultaneously, in STAT, Chuck Henderson published an opinion piece (attachment – “Diabetes association CEO: What an independent review says happened at the ADA’s controversial June conference 090126”). The press release and opinion piece based on the report clearly did not take into account the interviews with the five who had their badges taken away. These interviews were held only a week before the report was discussed with the Board. 

3.   When the five people who were removed from the meeting asked for a copy of the report on which the press release of 1 September was based, we were told in an email from Chuck Henderson the following day that “I understand your interest in reviewing the full report being produced by the AGC. The report is confidential and will not be shared.”  (attachment – “Henderson RE EXTERNAL Re ADAs AGC Independent Review Update 090226”).

4.   On 6 September, ADA put out another press release that walked back the one from five days earlier (attachment – “ADA Board to Receive Additional Information from the Audit and Governance Committee on the Events Surrounding June Scientific Sessions | American Diabetes Association 090626”). This may well have been because there was further negative press coverage of the original press release.

5.   During the course of all of this, the editors of Diabetes Care decided to publish a compendium of six opinion pieces and an editorial about what transpired around Scientific Sessions. As is customary, they were forwarded to ADA on July 2nd. On July 8th, ADA informed us they were censoring them and would not allow them to be published in Diabetes Care. Given this infringement on editorial independence, they were therefore placed on Zenodo, a preprint server https://zenodo.org/records/21300053; attachment – Community Voices NOLA 5 et al).

Given the above, we, as editorial leadership of Diabetes Care, do not feel we can continue to serve on a daily basis as editors of the journal until such time as the ADA treats its professional members with respect and works for the good of people with diabetes.

Every member of the Diabetes Care editorial team that has spoken to me has expressed disgust at what transpired on June 5th and subsequently. They have all asked what I planned to do. Now you know what Cheryl, John, Liz, and I are doing. The decision is yours. I would strongly encourage you to join this boycott and would be pleased to hear from you if you decide to do so.

We will not be accepting any new submissions to Diabetes Care until such time as there is satisfactory resolution to this impasse. Importantly, as we do not feel it is fair to authors whose manuscripts are currently submitted, we plan to fully process these until they are either accepted or rejected. Thus, there will still be some work for you to do until these are all cleared.

In solidarity, as we look forward to an ADA that truly represents the interests of its membership and people with diabetes."

American Diabetes Association - Silence is not your friend

 So it has been over a month since the incident involving the so-called "#NewOrleansFive" or "#NOLA5".  If you're not familiar with what happened, see my previous post here.  I felt it would be useful to provide an update of what has or has not happened since.

Immediate Aftermath

As I noted in my previous post, the CEO of the #AmericanDiabetesAssociation (#ADA), Charles "Chuck" Henderson, posted a recorded apology on YouTube on June 10.  Although the words "I apologize" were said, the message can be more accurately described as a non-apology.  Furthermore, the delivery was such that it looked like a hostage reading a statement from his captors.  Aside from that video message, ADA posted an "Organizational Update" on their website on July 8 that basically said that the CEO posted an apology and essentially reiterated what was said in the video and listed things the ADA was working on.  Among that list was a statement that an arms-length review of the June 5 incident was underway (note that word) and that the findings would be made available at the conclusion of the review.  The other four items listed related to traditional association activities.  That "Organizational Update" was only posted on the association's website and was not widely distributed to ADA membership.  I did a comprehensive search of my e-mails (including my SPAM folders) and saw nothing and the same was true for multiple colleagues I asked.

The meeting ended June 8, the YouTube video appeared June 10, and the website post was done July 8.  So, aside from these two things, there has be total silence from the ADA regarding the NOLA5.  As I have posted a few times on #SocialMedia, ADA, silence is not your friend.

Meanwhile, Back at the Ranch

Despite the ADA's silence, much has been happening and most of it is not good.  The NOLA5 and deputy members of the Diabetes Care editorial board wrote an editorial and seven opinion pieces with the intent of having them published in the journal.  These were apparently sent to the ADA with the offer of including any response from the ADA.  The opinion pieces were to be published in the "Community Voices" section of the journal.  Not only did the ADA refuse the offer, but they refused to publish any of the submissions.  Therefore, the group has posted their submissions on the Zenodo repository where you can read all seven in their entirety.  Because these are publicly available for all to read, I won't spend too much time rehashing what is written.  However, there are some important points that should be highlight.

1. The ADA clearly didn't learn from their mistake in New Orleans.   While you might argue that because it's the association's journal, they can make any editorial decision they'd like, the optics of what they did only amplifies the mistakes they've already made.  This continues their mistake of suppression of free speech and exchange of ideas principles and suggests the problem emanates from and is owned by the NOLA5, not the other way around.
2. It's important to remember, in order to be fair and balanced, the description of the sequence of events and perceptions thereof are from only one side of the incident so far.  While you can say the ADA's actions tell you about their side, we are still not privy to the actual discussions that occurred on the ADA's side that led to their various actions.  That full accounting may never be known, given how ADA has thus far reacted to events.
3. Related to #2, Dr. Mark Atkinson's accounting of his role in this event and the reasons for his resignation as chair of the Scientific Sessions Meeting Planning Committee are important.  I should note the job of chair of the planning committee entails great responsibility, requires a plethora of skills that most individuals do not have, and requires a high level of integrity.  I personally found it appalling and disturbing that ADA leadership would put his name on an e-mail he did not agree with nor had an opportunity to review.  But, it also provides evidence of the level of ADA's desperation and lack of integrity.   
4. There were clearly a number of missed opportunities to steer things in a different direction, but they were either cast aside, ignored, or not recognized.  Such is always true of missed opportunities, but it shows the lack of leadership skills among the ADA leadership.
5. Apparently, there was a meeting scheduled between the NOLA5 and CEO Charles "Chuck" Henderson, but that meeting did not occur and has not be rescheduled.  The decision to not meet seems to be a response to the NOLA5 making requests that the meeting be recorded and that two representatives of the ADA's Emeritus Council (an advisory group made up of former ADA leaders) be present.  The ADA apparently were not receptive to those ideas.
6. There is still total silence regarding the "arms length review" supposedly being pursued by the ADA.  Although the ADA has not explicitly stated that a review has begun, anecdotal evidence suggests a committee exists and has begun its task.  The fact that the ADA has not explicitly informed member of this and has not identified who was tasked to lead this review is also very telling.  Again, silence from the ADA is not their friend.

I am not a public relations professional, but it doesn't take a PR person to see the ADA is failing in this arena.  The major issue is that their public declarations continue to cast, either directly or indirectly, the NOLA5 as the root of the problem when, in fact, the ADA has not looked in the mirror to see where the problem is.  When CEO Charles "Chuck" Henderson posted the "apology" YouTube video, I noted on social media that it was at least a step in the right direction, even if the content and delivery of the message was poor.  Sadly, ADA's efforts stopped there and it was the last real public step they took.  Since then, radio silence has been their primary tool.  Yes, they've posted materials on their website, but much of it has been buries among other regular ADA activities.  Some items have been sent to all members and some haven't.  This mixed messaging does not help the ADA's position.  

Generally, I agree with the steps proposed by the NOLA5 and the deputy editors of Diabetes Care.  More importantly, until the ADA leadership does a mea culpla and takes concrete steps to right the wrongs, this issue will not be going away anytime soon.  The organization is putting their primary mission, "...to prevent and cure diabetes and improve the lives of all people affected by diabetes" at jeopardy.  Continually deflecting the issue and telling membership to focus on the mission and the people we have pledged to help is not helping those people.  Leadership must take responsibility for what they did and do their utmost to repair the self-inflicted damage they have incurred.

Again, silence is not your friend.

 #DrWattAtUSC  #LetsMakeAmericaBuenoAgain  #diabetes

 

Shame on the American Diabetes Association

I have been involved in #diabetes and #obesity research coming up on 46 years.  Over that time, I’ve been a professional member of the #AmericanDiabetesAssociation (#ADA) for at least 35+ years.  I owe much to the ADA.  Attendance at the annual scientific sessions has allowed me to not just share my #science, but also build collaborations, share ideas, and commiserate with fellow scientists.  I have published my work in the Association’s primary journals, #DiabetesCare and #Diabetes.  Finally, the ADA funded my first independent research grant that kick-started my career as an independent investigator.  Throughout it all, I have been a supporter of the Association and its goals to find a cure for diabetes and obesity.  However, events at this year’s annual scientific sessions has made me ashamed to be an ADA member.

So why?  As many of you may have seen in the news and on social media, there was an “incident” at this year’s scientific sessions that not just detracted from scientists, health professionals, and diabetes/obesity patients from learning the latest and greatest in diabetes/obesity research and treatment, but highlighted the weakness of the leadership of the association.  What follows is a description of what I know about the “incident,” but also my broader thoughts about what happened.

The Scene

So, on Friday, June 5, the Director of the #NationalInstitutesOfHealth (#NIH), Dr. #JayBhattacharya was scheduled to be the keynote speaker to open the 2026 annual ADA Scientific Sessions (#ADA2026) in New Orleans.  It should be noted that the ADA Scientific Sessions is THE scientific meeting related to diabetes and obesity and is attended by scientists and health professionals from around the globe.  I made a conscious decision not to attend that session, because I had heard Dr. Bhattacharya speak earlier in the year and figured I wasn’t going to learn anything new and exciting.  In fact, Dr. Bhattacharya canceled at the last minute.  This was due to a sudden scheduling issue related to meeting with the President according to the ADA.  So, instead Dr. #RichardWoychik, a senior adviser to Dr. Bhattacharya and former director of the National Institute of Environmental Health Sciences, attended in his place.  While some have tried to tie this change to the incident, it doesn’t surprise me that an individual in Dr. Bhattacharya's position would be unexpectedly called away and I am willing to accept that he had to truly make a last-minute change and that this was independent of what was happening right outside the hall where the presentation was scheduled to happen.

Outside of the venue, five individuals were handing out copies of a recent editorial that appeared in the Association’s premier journal #DiabetesCare.  The five individuals were:

Dr. Steven (Steve) Kahn – Professor of Medicine at the #UniversityOfWashington and director of the UW Diabetes Research Center

Dr. Aaron Kelly – Professor of Pediatrics at the #UniversityOfMinnesota Medical School

Dr. Justin Ryder – Associate Professor of Pediatrics and Surgery at #NorthwesternUniversity School of Medicine

Dr. Irl Hirsch – Professor of Medicine at the #UniversityOfWashington

Dr. Desmond Schatz – Professor of Pediatrics at the #UniversityOfFlorida, director of the University of Florida Diabetes Institute, and past President of Science and Medicine for the ADA

Each have research programs that have contributed to the success of the annual scientific sessions, have been long-standing members of the ADA, and have supported the ADA in various roles.

The editorial they were distributing addressed the current proposals by the #TrumpAdministration via the #OfficeOfManagementAndBudge (#OMB) that in many of our opinions weaken and heavily politicizes science in the U.S.; something that is the antithesis of what science strives for.  Apparently their goal was to make meeting attendees aware of the current situation and served as a #CallToAction to scientists.  The editorial was co-authored by Dr. #StevenKahn, who is the current Editor-in-Chief of the journal.  If you’re interested in reading the editorial, you can find a copy here.  This link goes directly to a copy of the editorial and not to the Diabetes Care website.  It is important to note the editorial has at the top, in a highly visible location, a disclaimer by the Association that I reproduce here:

“The opinions expressed in this editorial are the personal views of the authors (S.E. Kahn, C.A.M. Anderson, J.B. Buse, and E. Selvin) and do not represent those of the American Diabetes Association or the authors’ employers. The American Diabetes Association had no role in the development or writing of this manuscript. The authors declare that they receive honoraria from the American Diabetes Association for serving as editors of Diabetes Care and are recipients of grant awards from the National Institutes of Health. There are no other relevant conflicts of interest.”

So while the Association claimed “neutral ground” with respect to the publication of this opinion piece, they had no objection to it appearing in their journal.

The Incident

I was not present at the actual incident, but it has been described in detail in multiple media pieces and there is video of the actual confrontation you can view here.  But, there are some facts that need to be clearly stated.  The five researchers were only handing out copies of the editorial to attendees passing by.  They were not disruptive, they were not actively protesting, and there was no signage.  Just five researches handing out this editorial and engaging individuals if they asked questions.  The ADA responded by having all removed from the convention center.  They were confronted again when they attempted to re-enter the convention center and threatened with arrest if they did not comply with requests to remain outside.  Their meeting credentials were confiscated and they were told they could no longer participate in the meeting.  I don’t know about the others, but Dr. Kahn was scheduled to give a presentation later in the meeting.  The Association purged his name and the session from the meeting agenda.

The Immediate Aftermath

News of the incident quickly spread among meeting attendees.  The video that first appeared on MedPage Today and others that appeared since on social media were widely shared and people were asking about what happened in terms of both the incident, but also the fate of the individuals.  The Association quickly sent an e-mail to its membership and meeting attendees that I am sharing in its entirety here.  This initial statement, which essentially says that distributed materials must get prior authorization and only distributed within the exhibit hall, cites these individuals violating this “rule” and sets the justification for expelling them from the meeting.   Note one of the signatories of this e-mail is Dr. Mark Atkinson, who was the chair of the meeting program committee.  This will be relevant below.

This initial “explanation” was followed by an “official” statement from the Association on June 7 that I reproduce here.  In this “official” statement, the ADA cites their 501(c)(3) status as a non-profit organization and that Association activities need to be non-partisan. This statement is in contradiction to the rationale presented in the e-mail sent on June 6.

June 7 also included a key session that included an address by the President of Medicine and Science, Dr. A. Enrique Caballero along with the #BantingMedal recipient, Dr. #TakashiKadowaki.  The Banting Medal is the highest honor for scientific achievement awarded by the ADA, so congratulations to Dr. Kadowaki who over the course of his career has done elegant work to help identify key components of #Type2Diabetes...but I digress.  Dr. Caballero attempted to address the "incident" by essentially not directly mentioning the "incident" and dancing around it with flowery language about how we can disagree about any topic, that we shouldn't be confrontational, and we need to focus on helping people living with diabetes and obesity.  This seemed to be the theme the Association was trying to push; ignore the "incident" and tell everyone to focus on the people we are trying to help.  However, by not specifically addressing the issue, he created more confusion among people who were unaware of what had happened.  Additionally, some attendees were clearly upset by how he handled things and walked out of the session, obviously in protest.  While I remained because I wished to hear Dr. Kadowaki's presentation, I was simultaneously baffled and disgusted at how Dr. Caballero handled things.  It was beyond pathetic and did nothing to clarify or mitigate, let alone resolve, the situation.  I do not know if Dr. Caballero did this statement on his own (highly unlikely) or whether he was given what to say (most likely).

The same day, there was supposed to be a session where Steve Kahn was scheduled to give a presentation.  However, because he was persona non grata he was unable to make his presentation.  Instead, Dr. John Buse (Professor of Medicine at University of North Carolina at Chapel Hill (#UNC) School of Medicine and past ADA President for Science and Medicine) gave a presentation in Dr. Kahn's place.  However, before his formal presentation, Dr. Buse addressed those in attendance.  His comments can be seen in a video posted by Dr. Alice Cheng here.  The open letter and #petition Dr. Buse mentions can be found here if you are interested.

The Continuing Aftermath

So this "incident" has generated much discussion and activity, particularly online.  Dr. Atkinson resigned as chair of the Scientific Planning Committee.  In talking with folks with knowledge of his decision, he did not agree with how the ADA handled the situation and was unhappy that his name had to be attached to the initial e-mail that went out to membership and meeting attendees.  The ADA President-elect for Science and Medicine, Dr. Jennifer Green of #DukeUniversity, resigned her position and the ADA has already stricken her from their website.  It's not clear how ADA intends to fill these important positions.

I have been hearing rumblings of additional potential resignations, so things are still in flux.  I have also heard from colleagues who have declared they will refrain from supporting ADA and halt participation in any ADA activities until the Association apologies to the individuals involved.  Thus far, the ADA has responded by saying they wish to resolve this situation to everyone's satisfaction and will schedule a meeting with the individuals as quickly as possible.  However, whether they will be successful or not is questionable.  I have already heard that at least Steve Kahn has said he will not meet with them until they issue an apology.  I wouldn't be surprised if the others take a similar stance.  So we will see what transpires.

My Thoughts

So at the top I said I was ashamed of the Association's actions with respect to this incident.  Let me explain why.  

First, and foremost, the Association's handling of this situation has been, and continues to be, disastrous at best.  The shifting explanations for their actions were stupid, but more importantly, nonsensical.  Unauthorized distribution outside of the exhibit hall?  I get tons of #propaganda from pharmaceutical, tech, and other companies that are included in my meeting packet, slipped under the door of my hotel room, and other forms of distribution directly related to the meeting.  The Association clearly condones these distributions "outside the exhibit hall" and has provided these parties necessary information to target me and other attendees.  Second, given the editorial being distributed was published in the Association's premier journal, is already in the public domain, and included a neutrality statement essentially means the Association had no problem with it.  In fact, I would have assumed they would be happy to see something they published being distributed to additional readership.

Second, the statement on protecting their #NonProfit status does not hold water.  The #IRS rules for 501(c)(3) organizations state that issue advocacy is permitted, so long as the advocacy does not clearly favor one side in an election.  Thus, groups can advocate for issues related to their missions.  Dr. Kahn and his colleagues were not being partisan, were not advocating any specific candidate or political party, there was no election at stake, and they were not even protesting.  They were simply advocating for science.  In fact, in the Association's distorted logic, if what these individuals were doing jeopardized the Association's non-profit status, then the Association's own activities advocating for the exact same issue put their non-profit status in jeopardy.  As evidence, I present the ADA's press release regarding their stance on the very same issue that was issued on June 3, just a few days before the start of the scientific sessions.  Of course, the Association's past history of lobbying and advocating for issues related to diabetes and obesity just adds to their hypocritical statement that they were only protecting their non-profit status.

Third, their efforts to misdirect members and meeting attendees by not directly addressing the incident and underlying issue and repeatedly telling folks to focus on the people living with diabetes and obesity just reveals their inability to truly stand up and advocate when they absolutely need to.  The scientific sessions and all the wonderful discoveries and promising treatments for people living with diabetes and obesity would not exist if it were not for the dedication of all of those who do the science.  That science is being threatened in a way that we have not seen at least in my lifetime.  If there was ever a time for the ADA to be taking a strong advocacy position on behalf of the people living with these chronic diseases, it's now.  Individual scientists and the Association must make a stand, lest there be no attendees and science to present at future scientific sessions.

Lastly, there is the issue of #FreeSpeech and #FreedomOfExpression.  The majority of us attending the ADA Scientific Sessions are academics where #integrity and #AcademicFreedom are core principles.  However, beyond academics, we, as the #democracy that we are supposed to be, hold free speech and expression as founding principles of our country.  Suppression of these activities takes us down a dark path.  Given what actually happened with this "incident," the ADA comes across as invoking #censorship simply out of fear and protecting themselves from reprisal from an administration that clearly does not have the health of America and the world at heart.  

The epilogue of this story is yet to be played out.  Much more is likely to happen in the days to come.  One hopes the ADA will make appropriate adjustments and realize their errors, but I am not holding my breath.  We live in a time where various groups are cow-towing to the Trump Administration and its various threats.  Standing against the administration threatens the very existence of various organizations and rather than risk their livelihood, many have chosen to comply.  This is exactly what the administration is hoping for and only helps them achieve their goals.  We are at a critical juncture where organizations like the ADA need to grow a spine.  If they truly want to focus on people living with diabetes and obesity, then they need to actively advocate on behalf of science and push back against the proposed changes.  If they don't and these proposals become policy, then the goalposts for finding a cure for diabetes and obesity will be significantly pushed back further into the future.

#DrWattAtUSC  #LetsMakeAmericaBuenoAgain 

Update:  No sooner had I published this blog, that I became aware that I might be mistaken about which editorial was being distributed at the meeting.  My original information suggested the one from the link above, but just yesterday, a new editorial penned by members of the Diabetes Care editorial board was published in the journal.  You can read it here,  This may have been what was being distributed at the scientific sessions.

 

The Attack on Biomedical Research - Part 6, Leadership (or Lack Thereof)

This will be the last segment in my series.  While there are additional important topics I can be discussing, I feel like I have hit the major ones.  Besides, it will be interesting to see what develops over the next several months as the current administration continues its remodeling of the executive branch of the government.

What is Leadership?

If you look up the term on the Mirriam Webster Dictionary website, you will see:

1. the office or position of a leader
2. capacity to lead
3. the act or an instance of leading 

Sometimes I hated the dictionary as a kid, because it would take a word and rather than explicitly define it for you, would essentially use the word you were looking up to define it...like "leader" and "leading" as it does above.  Parsing the answer I get using ChatGPT: 

Leadership is the process of influencing, guiding, and motivating a group of people toward achieving a common goal. It involves setting a vision or direction, inspiring commitment, and coordinating efforts to bring that vision to life.....Leadership can take many forms—such as transformational leadership (inspiring change and innovation), servant leadership (prioritizing the needs of others), transactional leadership (focused on rules and performance), and situational leadership (adapting style to context)

Traditionally, the Secretary of Health and Human Services (HHS) has the leadership role that spans policy formulation, inter-agency coordination, regulatory oversight, and emergency management.  HHS has 13 agencies that include the Centers for Disease Control and Prevention (#CDC), the Food and Drug Administration (#FDA), the National Institutes of Health (#NIH), Indian Health Service (#IHS), and others.  The primary overall leadership goal is to protect the health of the nation and support vulnerable populations.

 

When I first heard that Robert F. Kennedy Jr. was being considered for the position of HHS Secretary, I knew the nation was in for troubled times.  As most of you know, RFK Jr. had a reputation of being a vaccine denier and built a significant proportion of his career around challenging the efficacy and safety of #vaccines.  It was ludicrous to even put him on a list of individuals to consider for HHS Secretary given this background, but also the fact the he has ZERO, NONE, ZILCH experience in #health, #biomedicine, or #PublicHealth was a larger deficiency.  Despite the zero experience, he was asked to lead an agency with the responsibility of providing the best possible health information for Americans and others across the globe.  This included directing the world's leading and best research enterprise, the NIH.  

 

RFK Jr. was appointed HHS Secretary in February 2025 and has immediate led the nation down the path of chaos, misinformation, and degraded health.  The real danger of RFK Jr. is that many of the things he says have a kernel of truth in them.  Some examples...yes, we should review the #VaccineSchedule given the number and types of recommended vaccinations have increased over the years.  Yes, the quality of our #FoodSupply has gotten worse and we should work towards limiting the amount and types of additives in our foods.  Yes, we should probably review if it makes sense to continue fluoridating the water supply given improvements in oral health, but also the broader access to fluoride through other sources.  Yes, it makes sense to do "gold standard" science to address the multitude of health questions affecting humans.

 

However, RFK Jr. jumps from the kernel of truth to outright nonsense and conspiracy theory-based thinking.  Taking each of the examples I noted above:

• First and foremost, vaccines prevent disease....full stop.  RFK Jr. seems to have a problem saying this and jumps to the crazy notion of vaccines causing autism or causing unnecessary deaths.  Let me just be clear at this point.  The overwhelming evidence from studies in multiple populations across the globe support two important conclusions;  1) approved vaccines are safe and effective in preventing disease, 2)  there is no evidence vaccines cause #autism.   Instead of supporting the science that shows the efficacy of vaccines, he pushes alternative approaches that have little to no research supporting them.  The whole #Tylenol thing had me rolling my eyes.  Another example is our current #measles crisis.  RFK Jr. has not made a full-throated statement advising parents to vaccinate their children and instead has pushed alternatives that have exacerbated the crisis.  An example is his suggestion parents give their children vitamin A to treat their kids' measles.  Vitamin A has been shown to have some positive effects in children who are vitamin A deficient due to poor #nutrition.  However, there is no evidence vitamin A is helpful in children with sufficient vitamin A levels and, in fact, excessive vitamin A can have toxic effects.  Cases of what appear to be vitamin A toxicity have been reported in Texas, the epicenter of our current measles crisis.  Sorry...I went off on a tangent to the original statement I made.  In terms of the vaccine schedule, rather than cite science or recommend funding for studies to examine the vaccine schedule, RFK Jr. has made statements that may put children as risk for those diseases where vaccinations would provide protection.  He has essentially put children at risk whose parents listen to what he says.  We need research to assess what the "best" schedule might be to help maximize health, but protect and minimize any side effects.

• The quality of our food supply has gotten worse in many different ways over the years.  Industrialized food production, mass food distribution, and other modern aspects of feeding our huge nation has put profits over health.  As an example, I read an interesting description regarding the revival of #HostessFoods, the makers of the famed #Twinkie.  One reason for the demise of the original company was the fact that they operated their own shipping/delivery of product directly to stores.  Given the relatively short shelf life of their baked goods (25 days for the Twinkie) the timing of baking, shipping, and selling the product was limited by the short shelf life.  This essentially became a challenge that Hostess could not overcome as their business expanded and they went bankrupt.  The person who revived Hostess purchased the majority of the company sans the shipping group.  He then figured out the main issue related to shelf life of the product and reformulated products to have a longer shelf life and relied on a third party shipper to distribute the product.  The Twinkie went from a shelf life of 25 days to 45 days (sorry folks, they don't last forever).  This, of course, was accomplished by adding different preservatives.  We really do need to think of how we process and distribute our food in terms of not just profit, but also in term of relative health.  However, simply jumping to everything needs to be "organic" (I hate this word, since everything we eat is organic....it's not like we're eating rocks) or unprocessed is not a solution.  Also, jumping to the way we did things in the "old days" is also not a solution, since it's not just the food additives that are affecting health.  The interactions amongst diet, physical activity, genetics, and other factors all play into our health and simply saying that removing additives will solve our problems is a gross misunderstanding of how all this works.  Sadly, there is no #MagicBullet when it comes the many health challenges we face as humans.  

• The addition of #fluoride in our water supply has been credited with significant improvements in #OralHealth.  However, with the addition of fluoride to a multitude of oral products, one can question whether it makes sense to continue to fluoridate water.  We need research into whether this policy should be continued.  Unfortunately, RFK Jr. claims fluoride is #toxic and cites a single study that examined fluoride at concentrations 5-10 times higher than that used to fluoridate water.  Too much of anything can be bad and selectively choosing one study that supports your position is not putting the science into the right context.  As far as i am aware, the vast majority of research shows that fluoride at low concentrations can have benefits for oral health, while having no toxic side effects.  However, in this modern age where there are multiple sources of fluoride, it does make sense to do the science to see if maybe, just maybe, we don't need to fluoridate the water supply.

• As you can see from the above examples, RFK Jr. cherry picks bits of "evidence" to support his own misguided positions, without considering the spectrum of studies that have been performed on a given topic.  As I always teach my students, no single scientific study proves anything.  It's only after we repeat studies over and over and get the same result, then we can come to some conclusion.  RFK Jr. clearly does not understand how science works.  He also does not understand that the US has been the home to the most innovative and creative minds that have been doing high-quality research for decades.  His current statements of the need to do "gold standard" research or the idea that we seen do start implementing "gold standard" research clearly shows what little he knows about #BiomedicalResearch and its history.  The US has been doing "gold standard" research for decades and it's because of that research human health has significantly improved over the years.  In fact, you can even say we've been doing "gold standard" research despite the limitations place on science due to outdated funding policies (a different topic).  Just because the research doesn't generate the result that YOU want, doesn't mean it was not performed to the highest standard.  Furthermore, the research community replicating and validating findings has the secondary effect that bad science tends to be weeded out and good science tends to be perpetuated.   

So it's one thing to be biased and attempting to push #HealthPolicy in a direction that aligns with your misguided thinking, but RFK Jr. can't do it all by himself.  So, he's been very busy pushing out career professionals in the various agencies under his purview and installing like-minded individuals.  The alarming thing about this is that he's bringing in individuals with equally little to no experience in health or individuals who have their own agendas that loosely align with RFJ Jr.'s who sadly have titles that make them sound like experts.  He has also invited non-health professionals to meetings as if they were experts in health.  The most recent example was the "Make America Healthy Again" (#MAHA) Summit where leaders in the #SelfHelp, #AlternativeHealth, #NutritionalSupplement, and other unregulated industries were invited to sit and discuss along with other fringe scientists.  I had to laugh at some of the reporting from that summit, since these individuals all railed against the #PharmaceuticalIndustry while touting the benefits of what their individual industries provide.  The reason I laugh is that while it's easy to target the pharmaceutical industry as the root of all evil, it is regulated.  They have to follow rules, go through a regulatory process, and meet certain standards for their products to make it out to the market.  I'm not saying they're angels, but at least they're regulated.  In contrast, the industries invited by RFK Jr. are not regulated.  They can essentially create a product, fire up a website, tout its benefits, and start selling you a product.  They are, for the most part, the modern equivalent of hustlers of snake oil.  They are, to me, the worst of the worst as they claim to be helping those with health issues when, in fact, what they hustle does nothing to help people seeking solutions and only lines their pockets.

 

Finally, I continue to be appalled by the injection of individuals with #MD, #PhD, or other titles who are either not experts in the areas they are commenting on, have been identified as having past histories of #ScientificFraud, or have put their egos ahead of everything else and inflated their stated expertise.  This is probably the most dangerous group of individuals, as they give an air of authority to the bad decisions being made in the name of improving health.  The most recent example of this is the realignment of the CDC's Advisory Committee on Immunization Practices (ACIP). Membership of this committee has been realigned to include individuals with clear anti-vaccine positions.  At their most recent meeting where they made the recommendation to discontinue universal #HepatitisB vaccination of infants, they invited speakers to discuss the evidence for or against universal vaccination.  Among the individuals who provided "scientific evidence" to support the discontinuation included a scientist who has no expertise in vaccination research (well, let's say they do very poor vaccination research), a scientist who previously had publications retracted due to scientific misconduct and has zero expertise in this particular arena, and an individual who has overstated their expertise in the field of vaccines.  It drives me bonkers when people of science place their own egos and agendas ahead of doing good science and letting the data tell you what the answer might be.  This again is tantamount to cherry-picking the "science" to generate a specific outcome.  

 

Look, I'm not saying science is perfect.  It isn't.  In fact, science is inefficient and subject to change.  When I was a student I learned that adipose tissue was simply a form of energy storage and that excess energy was diverted to adipose tissue as long-term storage to provide energy as needed.  Aside from a few other minor contributions, adipose tissue seemed pretty boring and straightforward.  However, in the middle of my career it was discovered that adipose tissue was actual an endocrine organ that secreted a whole host of different hormones, primarily involved in feeding regulation, although some performed other critical functions.  This new discovery totally changed the way I had to think about adipose tissue.  I can cite all kinds of examples like this and if you think about what we "knew" as "facts" as humans hundreds or thousands of years ago, but now know differently, this shouldn't be a surprise.  That doesn't mean you shouldn't believe science and it doesn't mean that we as scientists don't keep open minds about what may or may not be.  However, we do maintain the standard that scientific evidence should support any new knowledge.  It can't be just because you want to believe something to be true, which is what RFK Jr. and his friends seem to want and seem to push for in their efforts to change health policies.

 

This particular post was difficult to write, because I had to fight the temptation to rave on about other aspects of RFK Jr.'s "leadership" and where it's taking us.  I'm already very disturbed by many of the changes implemented at the NIH, including the review of grants by an administrative official to determine its suitability....this reeks of a "#PoliticalOfficer" reviewing grants to ensure they align with "#PartyIdeology."  We are definitely moving down a dark path...  

 

#DrWattAtUSC  #LetsMakeAmericaBuenoAgain   

The Attack on Biomedical Research - Part 5, DEI

Disclaimer

The views I provide in this segment are founded in the following premises:

    ●    Everyone should be treated with dignity and respect

    ●    Everyone should have the opportunity to live a healthy life

    ●    Everyone should have ready access to healthcare

    ●    Everyone should have their health concerns addressed so as to achieve the above points 

When I say "everyone" I mean EVERYONE.  Your citizenship, race, ethnicity, religion, sexual orientation/preference, or any other label that might differentiate you from another person does not matter.  If you do not agree with these premises, then you may as well stop reading and go elsewhere in the digital domain, since you likely will not agree with anything I say below.  

Background

It is of interest to me how the Heritage Foundation and current administration have deftly hijacked the term "Diversity, Equity, and Inclusion" (DEI) to mean something totally different from its original meaning.  Their efforts have resulted in a large segment of the general public believing DEI meaning an unqualified person of color who was unjustly given an opportunity that should have gone to another person (primarily meaning a White individual).  It has also become a weird synonym for racism, with tons of things being labeled as being "DEI."

If you don't believe this is the case, I will digress here a bit and point out one example.  Immediately following the current administration's edict eliminating anything DEI related, groups across the country immediately began to scrub their websites of anything considered "DEI."  This was particularly true of government operated websites.  The various armed services began to scrub their websites by eliminating pages related to war heroes of color or the "wrong" sexual orientation, segregated units of color, anyone whose name included words that were on their verboten list (example, medal of honor recipient Thomas H. Gay), or any piece of equipment (yes, equipment) that had a name included words on their verboten list (example, the B-29 "Enola Gay" that dropped the first atomic bomb, which was named after the pilot's mother "Enola Gay Tibbets").  In the end, the only "White" heroes, units, etc. remained on these websites until public outcry forced many (not all) of them to be restored.  

The chair of the Board of Trustees for the Japanese American National Museum (JANM), Bill Fujioka, declared that JANM would scrub nothing from their websites.  When interviewed by The Los Angeles Times, Fujioka was quoted as saying "Our community is based on diversity, equity is guaranteed to us in the Constitution, and inclusion is what we believe in."  This stance highlights the fact that life is not just about a subgroup of the population nor is it about how a subgroup views the world.  It also highlights that we, as a country, have a long way to go in terms of achieving that idealistic society where everyone is treated equally with equal opportunity and "...with liberty and justice for all."  

In terms of science, I am going to confine my comments to two very broad areas that have been adversely affected by new DEI-based mandates; research that includes components that this administration considers "DEI" and training opportunities.  DEI in biomedical and basic research extends well beyond these two areas, but I focus on these two as they are the two I am most familiar with.  

DEI in Research

I start this section by sharing a shot of a key segment of a grant termination letter received by one of my colleagues earlier this year when the first of the National Institutes of Health (NIH) grants were being clawed back. 

Note some of the language, particularly the part that DEI-based studies are "...often used to support unlawful discrimination on the basis of race and other protected characteristics, which harms the health of Americans."  Huh?  This colleague was studying some of the challenges faced by certain racial groups and their ability to receive cancer treatment. 

One has to remember that disease, infectious or chronic, does not care about any of the political or social factors that divide us as a people.  It does not care about your political affiliation, religious preference, sexual orientation, religion, race, ethnicity....none of that matters.  However, the risks underlying these diseases are significantly affected by these factors, which is why we need to do research in an attempt to understand those inequities, how they affect health, and how we might rectify those inequities to improve health.  The idea that DEI-related work "...harms the health of Americans" is not only laughable, but cutting off such research is what will harm the health of Americans and people across the globe.  The fact that this administration is labeling research as "DEI-related" ignores the fact that health is very diverse, inequalities exist, and when trying to improve the health of Americans, everyone should be included.

An example of this is improving ones lifestyle to either prevent or deal with a chronic disease.  Typically, when you doctor notices you might be at elevated risk for a chronic disease like diabetes, hypertension, or cardiovascular disease, they will tell you to stop smoking, cut your alcohol consumption, increase your physical activity, and change your diet to eating healthier foods.  Sounds straightforward, doesn't it?  Unfortunately, because of historic racism, such as redlining, individuals in certain environments cannot easily make these changes.  Why is that?  What can we do to change that?  What are the components that create barriers for these individuals?  What changes are most effective?  These and other questions are research topics that are studied by a number of investigators.  There may also be genetic factors that play into how these inequities affect disease (an area of research interest for me).  However, researchers now find themselves unable to study these problems, because they are considered "DEI-related" and no longer an NIH "priority."  The politicization of science (a future topic in this series) has formalized a decision before ascertaining the research answer.  In other words, rather than research driving decisions, we are allowing politics to drive the decisions.  This has negative consequences for everyone's health.

We should be performing research to address everyone's health issues and identify those things we can change to improve the health.  Preventable morbidity and mortality is at the core of most biomedical research and the investment the United States has made has put us at the forefront and made us worldwide leaders in biomedical research.  However, these new restrictions and the subsequent downstream effects beyond the actual research, like unemployment for staff, is having catastrophic effects on U.S> research that even if reversed tomorrow, will have negative effects for decades.  The idea that somehow DEI-based research "supports unlawful discrimination" can only come from a political agenda that prioritizes certain groups or ideals over others.  In other words, using the veil of discrimination to claim unlawful discrimination.  Again, disease doesn't care about these things and removing this area of research limits our ability to reduce morbidity and mortality.

DEI in Training

A significant number of training programs have been terminated and research support for young investigators just starting their research careers have come to a screeching halt because the program or research has been declared "DEI-related" and, again, not an NIH priority.  However, the extremely biased interpretation of DEI taken by this administration has actually terminated opportunities for a wide spectrum of individuals; not just those of color.  I can use myself as an example.

Although I was fortunate that my father worked his ass off to provide us with a middle class lifestyle, the fact that both my parents never finished high school and English was not their primary language created certain barriers for my own educational path.  My parents did not have "connections" to help me find extracurricular activities like research experiences that my "connected" friends easily found.  I could not turn to them for advice on how to apply to college or what to write in my personal statement.  Although technically middle class, our financial situation raised concerns about how to pay for college.... my folks nor I were aware of financial aid.  In other words, I had to navigate all these things pretty much on my own, relying on friends and my high school's college counselor (who, in retrospect, was not all that good).  I did have the great fortune that my folks put a premium on education and I performed well in school.  So, when I got accepted into various universities, the financial aid was fairly generous.  When I told my folks I wanted to go to graduate school, my dad thought he was going to have to fork out more money.  However, I was supported by an NIH training grant that covered my tuition and paid me a stipend.  Similarly, when I transitioned to my post-doctoral training, I was initially supported by an NIH training grant, before I was able to apply for and received my own NIH fellowship.  These opportunities allowed me to apply for and receive my first independent grant, a young investigator award from the American Diabetes Association.  That initial award then led to my first NIH research grant.

The various programs that supported my training and that first young investigator award are what allowed me to build my scientific career and become the successful biomedical investigator I am today.  Without them, it is not clear to me how my career path would have evolved.  However, with NIH now eliminating many training programs arguing they are "DEI", many young investigators will not have the same opportunities that I had.  I was an example of why we need such programs, but I had one advantage that many did not....I lived in Los Angeles.  There were numerous universities, research labs, and other institutions that would allow me to seek training opportunities.  But what if I had lived in the middle of the country where the density of universities is much lower?  What if I came from a low socioeconomic family who could not afford to send me elsewhere to find such opportunities?  

These are just a some of reasons why these training programs exist.  It's not about advancing certain individuals because of their skin color or religion.  Many are just like I was...disadvantaged due to various other circumstances.  These programs help identify young individuals with great potential to help nurture them and train them to become our next generation of scientists.  These training programs recognize that society is not fair and equitable and that we need to uplift some who show great promise, but face certain barriers.  It's not about giving someone an unfair advantage.

This administration faults DEI as discriminatory and that merit should be a primary factor in deciding many aspects of society.  Merit is important and should be a significant component of any decision.  However, making decisions solely based on merit assumes all other things are equal.  Sadly, society does not work that way, which is why many of these training programs were created.  Bright and intelligent people of color, with physical disabilities, or with financial hurdles many times do not get to choose science as a career path because of those inequities.  Many of these training programs were designed to give them opportunities.  I have been involved in three such program, one of which I co-directed.  The goals across all three of these programs are the same; provide research opportunities to undergraduate students who might not otherwise might not have access to research opportunities.  Fortunately, one of these programs exists without Federal funding and another so far continues to receive Federal funding.  However, the one I co-direct has lost its Federal funding and likely trained its last cohort this past summer.  It is doubtful we will identify an alternative source of funding by next summer.  Our program, over the past 7 years, have helped over 40 undergraduate students from varied backgrounds gain research experience and transition into medical or graduate school.  These include a student with a hearing disability, a student from Guam, and a Native American student living on a reservation, just as examples.  I was extremely proud of the students we trained and how their various careers are moving forward.  I worry about those who might be affected by these recent changes that may derail their career paths.

DEI means different things to different people.  However, as Bill Fujioka noted, our communities are based in diversity (even if you cannot see it), equity is supposed to be guaranteed to us in the Constitution, and we should not be excluding anyone just because we do not like some perceived characteristic.  Merit-based decisions are only fair when the playing field is level and these programs were working to try to make that playing field a bit more level.  They were not designed to replace merit with some other characteristic.  In science, that's the last thing you want to do....have someone who is not qualified to be doing the job (the next topic in this series).