Four US health agencies lack or have inadequate procedures for defining political interference in scientific decision-making or detailing how such meddling should be reported and addressed, according to a new from the US Government Accountability Office (GAO).
Agency employees told GAO investigators that they had observed incidents they perceived as political meddling but did not report them because they feared retaliation or believed that agency leadership was already aware of the interference.
The GAO, described as a 鈥渃ongressional watchdog鈥� because of its role in providing auditing, evaluation, and investigative services for the US Congress, reviewed how the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the National Institutes of Health (NIH), and the Office of the Assistant Secretary for Preparedness and Response (ASPR) handle political meddling in their work.
Noting that the Coronavirus Aid, Relief, and Economic Security Act includes a provision for the GAO to report on its ongoing oversight efforts related to the COVID-19 pandemic, the report said that the GAO was also asked to review scientific integrity policies and procedures and how selected agencies of the Department of Health and Human Services (HHS) address political interference in scientific decision-making. The report defined scientific integrity as 鈥渦se of scientific evidence and data to make policy decisions that are based on established scientific methods and processes, are not inappropriately influenced by political considerations, and are shared openly and transparently with the public, when appropriate.鈥�
The report said that the 4 agencies it focused on have had essential roles in conducting and supporting scientific research, communicating information to the public, evaluating medical products for their safety and effectiveness, and directing other aspects of the public health response to the COVID-19 pandemic.
The GAO conducted a performance audit of the agencies from October 2020 to April 2022. Investigators interviewed a total of 16 employees, both managers and nonmanagers, at the CDC, FDA, and NIH and also created a confidential hotline (an email account and a voicemail inbox) where workers at the 4 agencies could report information on scientific integrity and possible political interference seeking to undermine the agencies鈥� impartiality, nonpartisanship, and professional judgment.
The GAO investigation found that the CDC, FDA, and NIH do not have procedures that define political interference in scientific decision-making or describe how it should be reported and addressed, despite a requiring each agency to have procedures for identifying and addressing episodes in which the scientific process or the integrity of scientific and technological information may be compromised.
鈥淭he absence of specific procedures may explain why the four selected agencies did not identify any formally reported internal allegations of potential political interference in scientific decision-making from 2010 through 2021,鈥� the GAO report noted.
However, employees of the CDC, FDA, and NIH told GAO investigators that they observed actions they perceived to be political interference but did not report them for various reasons, including fears of retaliation, believing agency leaders were already aware of the problems, or being unsure how to report problems.
鈥淎 few respondents from CDC and FDA stated they felt that the potential political interference they observed resulted in the alteration or suppression of scientific findings,鈥� the report notes. 鈥淪ome of these respondents believed that this potential political interference may have resulted in the politically motivated alteration of public health guidance or delayed publication of COVID-19鈥搑elated scientific findings.鈥�
The report also notes that despite the apparent absence of formally reported internal allegations of political meddling at the 4 health agencies, HHS agency employees may also file external complaints with the HHS or the US . It cited as an example a in May 2020 by a senior official from ASPR alleging that 鈥淗HS had retaliated against him for disclosing, among other things, concerns about inappropriate political interference to make chloroquine and hydroxychloroquine available to the public as treatments for COVID-19.鈥�
The report found that although all 4 agencies train staff on some topics related to scientific integrity, such as public health ethics, only the NIH includes information on political interference in scientific decision-making.
To address the problem, the GAO recommended that the heads of the CDC, FDA, NIH, and ASPR ensure that 鈥減rocedures for reporting and addressing potential political interference in scientific decision-making are developed and documented鈥� at their respective agencies. The 3 agencies that lack a definition of political interference (FDA, NIH, and ASPR) were also advised to document a definition.
The GAO also recommended that all 4 agencies offer training for employees and contractors who carry out scientific activities to ensure that they understand how to report allegations of political interference in scientific decision-making.
The report also noted that agencies 鈥渃ould include information on whistleblower protections鈥� to help reduce employees鈥� fears of retaliation and encourage appropriate reporting.
To examine the GAO report鈥檚 finding that career scientists observed incidents of political interference that resulted in the alteration or suppression of scientific findings related to the coronavirus, the House of Representatives鈥� Select Subcommittee on the Coronavirus Crisis has scheduled with the US Comptroller General and other experts on ensuring scientific integrity at federal public health agencies.
Published: April 26, 2022. doi:10.1001/jamahealthforum.2022.1534
Open Access: This is an open access article distributed under the terms of the CC-BY License. 漏 2022 Stephenson J. JAMA Health Forum.
Corresponding Author: Joan Stephenson, PhD, Contributing Editor, JAMA Health Forum (Joan.Stephenson@jamanetwork.org).
Conflict of Interest Disclosures: None reported.