Public trust in scientific integrity is eroded by the politicization of institutions under Donald Trump’s US presidency. The implications extend far beyond US borders, striking at the core of how scientific knowledge is produced, disseminated, and trusted worldwide.

Recent directives seek to eliminate diversity, equity, and inclusion (DEI) initiatives, cut federal funding to critical health research agencies, and restrict references to gender, race, and climate science in official documentation. Scientific staff at federal agencies face mounting pressure to comply with politically motivated communication policies. Such institutional interference not only distorts scientific findings—it undermines the principles of transparency and editorial independence outlined in the International Committee of Medical Journal Editors (ICMJE) recommendations [1]. As members of ICMJE we feel compelled to speak out.

The ICMJE underscores that “editors should preserve the integrity of the scientific record by critically evaluating manuscripts free from undue influence and without compromising scholarly values.” [1] Yet, under the current administration, several US federal science agencies require pre-approval for external publications—a direct contravention of these editorial standards [2]. This climate of control stifles open inquiry and discourages evidence based discourse, particularly when scientific conclusions diverge from political narratives.

Health research in the US has historically flourished through bipartisan support and robust institutional independence. Federal investment after the second world war—guided by frameworks such as Vannevar Bush’s Science: The Endless Frontier2 and operationalized through agencies such as the National Institutes of Health (NIH) and National Science Foundation—ushered in decades of biomedical innovation leading to important health advances. Today, that legacy is imperiled by the very government meant to protect it. Budgetary threats to the NIH and the Centers for Disease Control and Prevention, coupled with staffing decisions that prioritize ideological loyalty over expertise, are undermining both the morale and the capacity of federal science agencies.

The administration’s executive orders to eliminate DEI related work in federal research not only violate the ICMJE’s call to promote diversity in authorship, peer review, and research design [1], they endanger public health. Inclusive research is not ideological; it is essential. Populations historically marginalized in science—including women, people of color, and LGBTQ+ individuals—will again be pushed to the periphery. This regression has tangible consequences for the scientific validity and societal relevance of health research. The rollback of DEI initiatives risks deepening existing health inequalities by ignoring the nuanced ways that race, ethnicity, gender, and socioeconomic status intersect with health outcomes.

Moreover, the administration has actively opposed environmental and climate related research. This opposition not only impedes the global scientific consensus on climate change but violates the ICMJE’s insistence that researchers and editors should advance science in the service of public good [1]. Climate science denial within federal institutions disrupts international collaboration, damages public preparedness for climate related disasters, and disproportionately harms vulnerable populations already at risk of climate related health effects.

Internationally, the consequences are no less stark. Authoritarian regimes elsewhere see the US as setting a precedent, finding in Trump’s agenda a justification to suppress dissent, censor scientific dialogue, and delegitimize independent inquiry. The undermining of scientific norms in the US reverberates beyond its borders, threatening global scientific cooperation and weakening international efforts to address pressing health challenges such as pandemics, climate change, and health equity.

This trend is not unique to the United States. It is also a concern in democratic nations beyond the US, where similar pressures on scientific discourse and editorial independence have been observed. We are deeply concerned that this dangerous erosion of scientific autonomy recalls some of the darkest episodes in modern history—namely, the rise of fascism during the 1930s and the McCarthy era assaults on academic freedom in the 1950s. The international academic community must treat the US case not as an isolated incident but as a cautionary tale—one that should prompt a thorough re-examination of editorial independence safeguards within their own systems. The suppression of science is a global threat that demands global vigilance. The US has traditionally provided scientific leadership through its role in supporting international bodies such as the World Health Organization, but its decision to no longer fund these institutions now threatens to delegitimize and weaken these multilateral efforts.

Independent scientific communication is equally under threat. Increasing pressure on government researchers to avoid controversial topics or reframe findings to suit political narratives creates an institutional chilling effect. Self-censorship born of fear may be more damaging than overt censorship. Researchers, particularly early career scientists and those from under-represented backgrounds, may choose to abandon public communication or controversial areas of inquiry altogether. This trend further narrows the scope of scientific innovation, limits the range of perspectives reflected in research agendas, and ultimately harms health.

The ICMJE has repeatedly cautioned against editorial practices influenced by political or commercial pressures, noting that “governments must not interfere in editorial decisions or constrain researchers’ freedom to communicate their findings.” [1] These principles are foundational not only to scientific publishing but to the broader democratic ideals that underpin open societies. The threats to medical journals, including three that are ICMJE members, are of particular relevance to us. Editors and publishers have a duty to resist governmental efforts to control scientific discourse and must actively protect the autonomy of researchers, and the independence of their decision-making processes.

To safeguard the future of medical science, we call for three actions. First, national and international scientific institutions should adopt clear policies to shield research from political interference. These protections should include codified rules on publication independence, protected speech for scientists, and data transparency standards. Second, medical journals must recommit to editorial independence and advocate for authors who face institutional censorship. Journals must publish work that challenges prevailing political narratives and amplify voices under threat. Third, scientists, scientific organizations, and editors must resist silence. As the ICMJE has stressed, the scientific community bears a collective responsibility to uphold integrity and protect vulnerable voices [1]. We appreciate that it is easier to raise your voice from outside a threatened system than from within, and therefore we are speaking up and urge others to do so.

This is a call for science grounded in ethical principles and dedicated to the service of humanity. Scientific research, especially in medicine and public health, is inherently intertwined with social justice. Silencing DEI initiatives, censoring climate science, and delegitimizing minority researchers is not neutrality—it is complicity in perpetuating harm.

Resistance is not without precedent. Past administrations that sought to control or defund scientific institutions were met with organized dissent. Whistleblowers, journal editors, and advocacy organizations have long served as guardians of scientific freedom. Today, that tradition must continue with renewed vigor. Editorial boards must uphold their independence. Universities and scientific bodies must defend faculty facing retribution. Policy makers must embed protections for scientific freedom into the legislative framework.

The Trump administration’s actions are not simply domestic political maneuvers; they are part of a global assault on evidence, inclusion, and truth. The stakes are higher than ever. History has shown where censorship and ideological orthodoxy lead. We cannot afford to relearn that lesson.