Intended for healthcare professionals

Editor's Choice

Why this US election matters so much

BMJ 2020; 371 doi: (Published 22 October 2020) Cite this as: BMJ 2020;371:m4077
  1. Fiona Godlee, editor in chief
  1. The BMJ
  1. fgodlee{at}
    Follow Fiona on Twitter @fgodlee

With only days to go before the US presidential election,1 the editors of medical and science journals have entered the political fray with unprecedented unity, voicing their shared concerns about Donald Trump’s record in office and his candidacy for re-election.2 Among them are two US based heavyweights that have traditionally been reticent on party political matters: Science and the New England Journal of Medicine.34 Together they have collated a devastating list of the ways in which Trump has undermined science and damaged health.

We at The BMJ welcome this criticism. Our own deep concerns about the damaging effects of Trump’s presidency on science and health have been stated early and often. An editorial published soon after he took office described how his policies were already damaging trust in health science and policy.5 In the three years since then, other editorials have decried Trump’s reneging on global treaties (including on climate change6), his decision to defund WHO,7 his attacks on reproductive rights in the US and worldwide,89 his reversals on gun control,10 and his attempts to reverse the Affordable Care Act, leaving millions of Americans without health insurance.1112

This year Trump’s incompetence has culminated in what Drew Altman calls the US’s “lamentable performance” on covid-19, caused by a failure of policy and leadership.13 As the US clocks up more than eight million cases and more than 225 000 deaths, Trump has become a “political determinant” of the pandemic, say Gavin Yamey and Gregg Gonsalvez.14 Trump downplayed the risks of the virus, delayed action, promoted unproved treatments, and undermined public health interventions. His actions and inaction have caused thousands of avoidable deaths. He has shown that he sees science as an opponent to be attacked, manipulated, and ridiculed.15 One of the worst things he has found to say about his rival in recent days was that Joe Biden would “listen to the scientists” if elected.16

His other great opponent, Anthony Fauci,17 on receiving one of US science’s greatest accolades this week,18 talked of the times we are going through as “disturbingly antiscience.” Trump’s term in office has been marked by the suppression, distortion, denigration, and denial of science. His is already a grim legacy. If he is returned to office, all of us committed to advancing science and rational debate must raise our voices loud and clear in the fight against distrust and division.19 The world will need all the cool heads, open minds, and wise counsel we can offer.


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