This story was originally published by ProPublica.
Employees at the National Cancer Institute, which is part of the National Institutes of Health, received internal guidance last week to flag manuscripts, presentations or other communications for scrutiny if they addressed “controversial, high profile, or sensitive” topics. Among the 23 hot-button issues, according to internal records reviewed by ProPublica: vaccines, fluoride, peanut allergies, autism.
While it’s not uncommon for the cancer institute to outline a couple of administration priorities, the scope and scale of the list is unprecedented and highly unusual, said six employees who spoke on the condition of anonymity because they were not authorized to comment publicly. All materials must be reviewed by an institute “clearance team,” according to the records, and could be examined by officials at the NIH or its umbrella agency, the US Department of Health and Human Services.
Staffers and experts worried that the directive would delay or halt the publication of research. “This is micromanagement at the highest level,” said Dr. Georges C. Benjamin, executive director of the American Public Health Association.
The list touches on the personal priorities of HHS Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist who has repeatedly promoted medical conspiracy theories and false claims. He has advanced the idea that rising rates of autism are linked to vaccines, a claim that has been debunked by hundreds of scientific studies. He has also suggested that aluminum in vaccines is responsible for childhood allergies (his son reportedly is severely allergic to peanuts). And he has claimed that water fluoridation—which the Centers for Disease Control and Prevention has called “one of the 10 greatest public health achievements of the 20th century”—is an “industrial waste.”
In confirmation hearings in January, Kennedy said that he was not “anti-vaccine,” and that as secretary, he would not discourage people from getting immunized for measles or polio, but he dodged questions about the link between autism and vaccines.
Another term on the list, “cancer moonshot,” refers to a program launched by President Barack Obama in 2016. It was a priority of the Biden administration, which intended for the program to cut the nation’s cancer death rate by at least half and prevent more than 4 million deaths.
The list is “an unusual mix of words that are tied to activities that this administration has been at war with—like equity, but also words that they purport to be in favor of doing something about, like ultraprocessed food,” Tracey Woodruff, director of the Program on Reproductive Health and the Environment at the University of California, San Francisco, said in an email.
The guidance states that staffers “do not need to share content describing the routine conduct of science if it will not get major media attention, is not controversial or sensitive, and does not touch on an administration priority.”
A longtime senior employee at the institute said that the directive was circulated by the institute’s communications team, and the content was not discussed at the leadership level. It is not clear in which exact office the directive originated. The NCI, NIH and HHS did not respond to ProPublica’s emailed questions. (The existence of the list was first revealed in social media posts on Friday.)
Health and research experts told ProPublica they feared the chilling effect of the new guidance. Not only might it lead to a lengthier and more complex clearance process, it may also cause researchers to censor their work out of fear or deference to the administration’s priorities.
“This is real interference in the scientific process,” said Linda Birnbaum, a former director of the National Institute of Environmental Health Sciences who served as a federal scientist for four decades. The list, she said, “just seems like Big Brother intimidation.”
During the first two months of Donald Trump’s second presidency, his administration has slashed funding for research institutions and stalled the NIH’s grant application process.
Kennedy has suggested that hundreds of NIH staffers should be fired and said that the institute should deprioritize infectious diseases like COVID-19 and shift its focus to chronic diseases, such as diabetes and obesity.
Obesity is on the NCI’s new list, as are infectious diseases including COVID-19, bird flu and measles.
The “focus on bird flu and covid is concerning,” Woodruff wrote, because “not being transparent with the public about infectious diseases will not stop them or make them go away and could make them worse.”
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