With Trump’s return to power, the right wing war on medical science has already reached new lows. Now patients participating in clinical trials—a key process for advancing scientific knowledge on pandemics like HIV—have reported that their treatment has been suspended by executive order.
On January 24, the Trump administration issued an executive order freezing all foreign aid for at least 90 days. Along with this came a stop-work order essentially dissolving the US Agency for International Development (USAID).
Before then, USAID was the world’s largest provider of foreign assistance, funding projects that fight poverty, provide disaster relief, support education and access to clean water, and develop treatments for communicable diseases.
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While USAID’s mission is humanitarian in nature, it is also a key element of US foreign policy, countering pandemics that could threaten the globe and staunching disasters that could lead to an upsurge in migrants. But it’s likely no surprise that the Trump administration views USAID as a simple handout. Secretary of State Marco Rubio described USAID as wasteful, despite representing less than 1% of the federal budget.
As with many of Trump’s executive orders, the result has been confusion and chaos. Even with a waiver issued by Rubio allowing some projects to continue (notably excluding those concerned with gender affirming care and abortions), many research studies have had their funding suddenly cut.
This is an especially dire situation for patients in the middle of clinical trials, some with experimental drugs or devices inside their bodies. Trump’s stop-work order directs scientists to discontinue treating such patients. This is in direct conflict with the Declaration of Helsinki, the guiding document for ethics in medical research.
“My first thought when I saw this order was, There are rings in people’s bodies and you cannot leave them,” Dr Leila Mansoor, a scientist for the Centre for the AIDS Programme of Research in South Africa, told The New York Times. “For me ethics and participants come first. There is a line.”
The Times catalogued at least 30 suspended studies, noting that the exact number cannot be known since the gutting of USAID has destroyed the public record. Dr Kenneth Ngure, president-elect of the International AIDS Society, explained how one HIV treatment, if left unmanaged in human bodies and exposed to the virus, could cause the virus to mutate and become resistant to common HIV drugs. “It’s wrong on so many levels — you can’t just stop,” Dr Ngure said.
“We have betrayed the trust of ministries of health and the regulatory agencies in the countries where we were working and of the women who agreed to be in our studies, who were told that they would be taken care of,” Dr Sharon Hillier, director of a five-year study on new HIV preventive treatments, said. “I’ve never seen anything like it in my 40 years of doing international research. It’s unethical, it’s dangerous and it’s reckless.”
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