The BMJ today warns that Trump's administration "is acting in ways that will suppress research and limit communication on scientific topics that it deems politically inconvenient."
Early policies "risk head-on collision with the scientific and health communities" say editors Jose Merino, Elizabeth Loder and Kamran Abbasi, and Harvard professor of health policy, Ashish Jha. "Trump's policies in other areas also have the potential to damage health," they add.
For example, they point to communications restrictions on several environmental protection and public health agencies, while scientific information on government websites "is being removed and becoming inaccessible."
And they warn that proposals to reform the Food and Drug Administration "will scale back the agency's ability to ensure the safety and efficacy of approved drugs, harming not only people in America but those in other countries that often follow the FDA's lead."
Instant repeal of the Affordable Care Act, without a viable alternative, will surely prove damaging, they write. While Trump's immigration policy "will disrupt the flow of scientific ideas and knowledge, hinder recruitment of scientists to American institutions, limit training opportunities for international physicians, and worsen national shortages of healthcare workers."
Of course, Trump isn't the first politician to flout scientific principles or favour "alternative facts," but this situation seems different and more worrisome, they say.
They point out that the United States is a powerful nation with a profound influence on the health of the world's population. "That power and influence, if misdirected, will damage efforts to create a healthier, stronger world, one that supports women's health, condemns torture and other human rights abuses, treats refugees and migrants with dignity and hospitality, and ensures that all people, especially the most vulnerable, have access to high quality healthcare."
The BMJ's solution is to "reaffirm our commitment to fostering and applying the best evidence for policy and practice, to be an open forum for rigorous debate that challenges the status quo and holds us all to account, to speak truth to power and support others who do the same, and to actively campaign for a better world, based on our values of transparency, independence, and scientific and journalistic integrity," they explain.
"Whichever way Trump turns, the scientific and healthcare communities must commit to serving the best interests of patients and the public," they say. "By arming ourselves with the fruits of science, being guided by facts and evidence, we can create a healthier planet, not just for Americans but for all the peoples of our world."