"When you think that you've lost everything, you find out you can always lose a little more" -Bob Dylan

This moment is the "hill that IDSA should die on."

📣 If you are an IDSA member and you agree that they need to change course, make your voice heard. Your silence is perceived as tacit approval!

Write on the listserv (can be literally a couple sentences), email the BODs, or both. #IDSky

Unfortunately and unsurprisingly, the administration continues to charge ahead, running roughshod over norms, laws, and the dignity of and most basic protections for the people most vulnerable to infections. Many of the changes are summarized here, up to date as of Feb 4. Who will speak up, or better still, ACT UP for these individuals? The National Science Foundation has reportedly shared with program officers a list of forbidden "DEI"-related words that will result in grants being flagged. These include routinely used terms like "female", "biased", "systemic", "inclusion" and "exclusion" along with other words that specifically target vulnerable populations. While few clinical researchers rely on NSF grants, it can be reasonably expected that similar censorship with grants from NIH, CDC, etc is inevitable. USAID funding remains frozen, and in fact there are reports of efforts underway to eliminate the entire agency. The effects have already been devastating for programs dedicated to controlling TB, malaria, and HIV, among others. Despite claims that these would be exempt, distribution of antiretrovirals remains frozen. The Senate Finance committee advanced RFK Jr for confirmation as HHS Secretary. Kennedy's disdain for evidence-based medicine is no secret. He is a conspiracy theorist who engages in dangerous race-based pseudoscience. The IDSA has fallen short of other professional societies (e.g. the American Public Health Association, which represents 25,000 public health professionals) in calling for the outright rejection of RFK Jr's nomination. The CDC and NIH remain muzzled, unable to communicate with interstate or international agencies or the public. They have been instructed to recall submitted or accepted manuscripts to scrub objectionable language. They remain barred from traveling until at least the end of April. How will these actions affect our ability to detect and respond to infectious disease outbreaks?

Meanwhile, our members are experiencing significant moral injury, and some have expressed levels of morale that rival the nadirs felt during the worst of COVID19. Every day it is a new insult, the cumulative effect being the disassembly of public health protections and further marginalization of the most vulnerable in society. Reticence to call attention to ourselves, potentially putting our work in the administration's cross hairs, is entirely understandable. After all, we don't want to imperil existing and ongoing advocacy efforts, including those related to bolstering the ID workforce. A sober analysis would concede that the likelihood of any potential actions moving the needle on any of these issues is low. I would argue, however, that standing up for what is right is the most important thing we can do to reinforce our commitment to social justice and to our members and the patients in our care. What we can do and how we can do it is up for debate; some bold ideas have already been presented in the IDea exchange forum and I welcome further input from colleagues. What is certain is that as rank-and-file individuals, our voices can easily be dismissed, but as a trusted, bipartisan professional organization that represents >13,000 infectious diseases experts, we cannot be ignored, and we must not allow ourselves to cower in silence. The reality is that things are going to get worse, and standing up to the assault on public health will only get more difficult as the administration becomes further emboldened and the actions set in motion gather steam. In the words of John Lewis, "If not us, then who? If not now, then when?"

I am deeply disappointed by the subdued response of the Infectious Diseases Society of America (@idsainfo.bsky.social) to the dismantling of public health structures, both in the US & globally

Here's what I wrote in the closed listserv (response: 🦗) in hopes of stimulating discussion here #IDSky