Uproar over purported ban at CDC of words like ‘fetus,’ ‘science-based,’ and more

Brenda Fitzgerald, director of the Centers for Disease Control and Prevention
Brenda Fitzgerald, director of the Centers for Disease Control and Prevention, at agency headquarters in Atlanta on Dec. 5, 2017. –photo for The Washington Post by Melissa Golden

WASHINGTON — The Department of Health and Human Services tried to play down Saturday a report that officials at the Centers for Disease Control and Prevention had been barred from using seven words or phrases, including “science-based,” “fetus,” “transgender” and “vulnerable,” in agency budget documents.

“The assertion that HHS has ‘banned words’ is a complete mischaracterization of discussions regarding the budget formulation process,” an agency spokesman, Matt Lloyd, said in an email. “HHS will continue to use the best scientific evidence available to improve the health of all Americans. HHS also strongly encourages the use of outcome and evidence data in program evaluations and budget decisions.”

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Lloyd did not respond to other questions about the news report, which was published late Friday by The Washington Post. The article said CDC policy analysts were told of the forbidden words and phrases at a meeting Thursday with senior officials who oversee the agency’s budget. Other words included “entitlement,” “diversity” and “evidence-based.”

In some cases, The Post reported, alternative phrases were suggested. Instead of “science-based,” or “evidence-based,” The Post reported, “the suggested phrase is ‘CDC bases its recommendations on science in consideration with community standards and wishes.’”

The news set off an uproar among advocacy groups and some Democratic officials, who denounced any efforts to muzzle federal agencies or censor their language.

The Times confirmed some details of the report with several officials, although a few suggested that the proposal was not so much a ban on words but recommendations to avoid some language to ease the path toward budget approval by Republicans.

A former federal official, who asked not to be named, called the move unprecedented.

“It’s absurd and Orwellian, it’s stupid and Orwellian, but they are not saying to not use the words in reports or articles or scientific publications or anything else the CDC does,” the former official said. “They’re saying not to use it in your request for money because it will hurt you. It’s not about censoring what CDC can say to the American public. It’s about a budget strategy to get funded.”

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A former CDC official, who asked not to be identified, said some staff members were upset because the purported ban suggested that their work was being politicized.

“I don’t know exactly who said what in the meeting, but I have to assume this came from HHS people, because they’re the ones who have to make the budget,” the former official said. “I’ve also heard that some of the words might have been a little misconstrued. “’Science-based’ and ‘evidence-based’ might not have been considered as unusable as the others.”

Some people also said that some effort to tone down language might make sense when appealing for funding from Republican conservatives in Congress.

The CDC budget documents are circulated to other agencies and Congress and submitted to the Office of Management and Budget in the Trump administration. The budget office did not respond to a request for comment.

There seemed to be confusion around the public health agencies about whether the ban originated at the agency’s parent department, Health and Human Services, or inside the CDC itself; and whether such a ban would apply beyond budget documents. The Food and Drug Administration was quick to note that it had gotten no such instruction. An agency spokeswoman, Jennifer Rodriguez, said, “We haven’t received, nor implemented, any directives with respect to the language used at FDA to describe our policy or budget issues.” The National Institutes of Health referred inquiries to Health and Human Services.

Since the Trump administration has taken office, officials at the country’s premier disease-fighting agency have privately complained that it has come under various pressures, most involving President Donald Trump’s “America First” stance and his dislike of foreign aid rather than basic science itself.

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Although Trump’s first “skinny budget” proposed deep cuts in medical work done overseas, it is not clear that he was going to get his way. Many legislators have recognized the value of detecting and fighting outbreaks abroad before they reach U.S. shores, and the President’s Emergency Plan for AIDS Relief, which was created by President George W. Bush, is a favorite with Christian conservatives in Congress. Many of the hospitals helped in Africa were founded by Christian missionaries. As a former Indiana representative, Vice President Mike Pence was among the agency’s strongest backers.

Even during the Obama administration, CDC officials were required to clear most statements through Health and Human Services.

Under Thomas Price, Trump’s first secretary of Health and Human Services, the department seemed preoccupied with killing the Affordable Care Act. Price resigned in September after he was criticized for his expensive air travel. During his early tenure, the CDC was run by an acting director, Dr. Anne Shuchat, who had been deputy to the former director, Dr. Thomas R. Frieden.

Since Dr. Brenda Fitzgerald was appointed director in July, the agency has kept a relatively low profile. In previous years, for example, Frieden would typically have held by now a news conference about the coming flu season and might have, for instance, publicly addressed other issues like the dangers of water contamination in post-hurricane Puerto Rico, human infections caused by drug-resistant bacteria on pet-store puppies and Mexican papayas, or even the risk of Madagascar’s plague outbreak spreading.

Critics were quick to denounce the CDC for its action. Dr. Vivek Murthy, a former surgeon general, expressed concern.

“Whether this is a directive from above is not clear,” he said. “But for CDC or any agency to be censored or passively made to feel they have to self-censor to avoid retribution — that’s dangerous and not acceptable. The purpose of science is to search for truth, and when science is censored the truth is censored.”

Michael Halpern, deputy director of the Center for Science and Democracy, based at the Union of Concerned Scientists, said he believed scientists at CDC will need assurance that they can continue their work without political interference.

“I don’t know if it will ever be clear who said what in this particular case,” Halpern said. “The fact that the agency began controlling what scientists can say to reporters a few months ago doesn’t suggest they want to be open and honest with the public.”

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