Category Archives: Policy

A dark, dystopian government data center filled with towering servers and flickering computer screens. Dust-covered books and old research papers sit abandoned, while glowing terminals display files. A lone researcher, illuminated by the cold blue light of a monitor, desperately tries to recover lost data from a corrupted drive. The atmosphere is eerie, with dim overhead lights and an air of secrecy, symbolizing the slow decay of knowledge in a forgotten digital vault.

The Purge

The Trump administration has started one of the most significant assaults on human knowledge in centuries. Well-collected, curated and communicated data are facts—an evidence base. When facts contradict a political narrative, they are dangerous. The US government has realised the danger and begun The Purge. The government will now establish new “facts” to replace old facts. Purge-and-replace is part of the process of state capture. Evidence represents dissent, and the government must crush dissent. Reality is altered.

Until a week ago, successive US governments had invested in a data, evidence-based policy enterprise with generous global access. It was a resource for the world that supported research and evidence-based decision-making. And, unless the information was classified or subject to privacy laws (e.g., HIPAA for health data), anyone could look at everything from labor and criminal justice statistics to environmental and health data.

Going, going … !

Starting late last week, government websites began to disappear; among them, the USAID website vanished without a trace. All the development evidence USAID published has disappeared. If you try to reach the website today (2 Feb, 2025), you will get a message from your internet provider informing you the site does not exist. Perhaps you have the wrong address…or maybe it was never really there. (Queue spooky music.)

Individual pages on government websites are also disappearing. The Centers for Disease Control and Prevention (CDC) webpage, for example, providing evidence-based contraceptive guidelines has vanished. A week ago, the guidelines helped people exercise their reproductive choice using the best available evidence. But facts are dangerous. The idea of personal autonomy in reproduction runs counter to the authoritarian narrative of the current US administration. CDC is being scrubbed clean.

Data are also disappearing. The Youth Risk Behavior Surveillance System (YRBSS) is a longitudinal survey of adolescent health risks coordinated by the CDC. If I search the CDC website for “YRBSS”, I get links. If I follow the links: “The page you’re looking for was not found”. This loss of data is a tragedy. A quick look at PubMed reveals the kind of research that has used YRBSS data: everything from adolescent mental health to smoking. Without those data, no one today could do the same kind of research that was done before. Trends in adolescent health are lost and we will not know about any emerging health risk factors. It is hard to know precisely why the YRBSS has disappeared. However, in keeping with the religiously conservative nature of the current US government, maybe it is adolescent sex that is too dangerous for people to know about.

The US government is not content with just removing facts. They also want CDC scientists to rewrite their research to adopt a single, approved, authoritarian view of the world. Their research must conform to the Trump government’s ideology. An approach which is oddly reminiscent of Stalin’s insistence that Soviet researchers adopt the dead-end genetic science of Trofim Lysenko.

The CDC has instructed its scientists to retract or pause the publication of any research manuscript being considered by any medical or scientific journal, not merely its own internal periodicals…. The move aims to ensure that no “forbidden terms” appear in the work. The policy includes manuscripts that are in the revision stages at a journal (but not officially accepted) and those already accepted for publication but not yet live.

It hasn’t happened yet, but I have to wonder what will happen when the US Government targets PubMed and PubMed Central—exceptional scientific resources provided free of charge to the world by the National Library of Medicine (NLM)? NLM could be directed to purge from the database all abstracted data on every journal article that contains ideas that do not support the government’s worldview: gender, transgender, climate change, vaccines, air pollution (from fossil fuels)…. Commercial providers could still abstract those articles, but the damage would be enormous.

The vaccine denier, Robert F. Kennedy, junior, is currently being confirmed as Secretary of Health. He believes the widely debunked, fraudulent claim that vaccines cause autism. What happens when he decides that the National Library of Medicine should selectively purge evidence debunking the vaccine-autism link? Will that mean vaccines cause autism in the US (a “US-fact”) but not in the rest of the world (a “fact-fact”)? Researchers in universities and institutions that can afford subscription services can avoid such excesses, but that will not be the case for many Global South researchers who rely on PubMed for their research, nor will it be the case for the general public, who also have free access to PubMed.

I have focused on health because it is the domain I know the best. There is, however, almost no factual resource of the US government that will be safe from the purge. Facts that endanger a Trump administration political narrative must not be allowed to exist.

The US government is a climate-denying administration that has again pulled out of the Paris Climate Accord. It has already targeted climate change research. Justice, labour, and population statistics that do not conform to the US government’s socially conservative, racist and xenophobic views about the world will also be in danger. Trade data that don’t support Trump’s political narrative of a “golden age” will need to be adjusted.

One of the great tragedies is that, now that the US government has shown itself to be institutionally disinterested in (or actively opposed to) facts, it has endangered the value of its entire evidence-based policy enterprise. If you visit a US government website in a year, will you trust the content? You shouldn’t. Instead, you should ask yourself what political interest influenced the information. Researchers, policymakers, journalists—everyone— will need to parse US government websites like they parse information from any other authoritarian regime. Sadly, research coming out of US universities will also require extra scrutiny. Where we trusted the voices before, now we would need to ask, has US government policy biased it, what is the nature of the bias, and can we manage the bias?

Sometimes, it will be easier to ignore US research altogether because verification carries a cost.

There are small glimmers of hope. Archive.org (the Wayback Machine) has historical snapshots of US government websites, including some data snapshots, such as the YRBSS. These snapshot are BTP (befor the purge). Unfortunately, the archive is not as easy to navigate as the World Wide Web nor as easy to navigate as dedicated government websites. The value of the archived information also relies on the snapshot being taken at the right time to capture the latest BTP information. The CDC contraceptive-use guidelines purged a few days ago, are available on archive.org from a snapshot taken on 25 December, 2024. Assuming the CDC made no BTP updates since the last snapshot, the information is up to date…for now. Of course contraceptive guidelines evolve with new data and new technology and they will be out of date in the coming years.

If we are to survive the worst damage of The Purge, other government and non-government institutions worldwide will have to step into the breach. Historical data may need to be reconstructed and curated from sources such as archive.org. The Pubmed and Pubmed Central databases should be copied before the US government corrupts them. Where US data are still available, copy them. Outside the US, we will need to put in place prospective mechanisms to collect valuable global data that we can no longer trust from US sources.

…going…

We cannot assume that the facts from US government sources will remain uncorrupted tomorrow because they are uncorrupted today. The preservation of the truth will require resources and investment.

… GONE!

Welcome to The Purge

UKRI go its A.I. policy half right

UKRI AI policy: Authors on the left. Assessors on the right

UKRI AI policy: Authors on the left. Assessors on the right (image generated by DALL.E)

When UKRI released its policy on using generative artificial intelligence (A.I.) in funding applications this September, I found myself nodding until I wasn’t. Like many in the research community, I’ve been watching the integration of A.I. tools into academic work with excitement and trepidation. In contrast, UKRI’s approach is a puzzling mix of Byzantine architecture and modern chic.

The modern chic, the half they got right, is on using A.I. in research proposal development. By adopting what amounts to a “don’t ask, don’t tell” policy, they have side-stepped endless debates that swirl about university circles. Do you want to use an A.I. to help structure your proposal? Go ahead. Do you prefer to use it for brainstorming or polishing your prose? That’s fine, too. Maybe you like to write your proposal on blank sheets of paper using an HB pencil. You’re a responsible adult—we’ll trust you, and please don’t tell us about it.

The approach is sensible. It recognises A.I. as just one of the many tools in the researcher’s arsenal. It is no different in principle from grammar-checkers or reference managers. UKRI has avoided creating artificial distinctions between AI-assisted work and “human work” by not requiring disclosure. Such a distinction also becomes increasingly meaningless as A.I. tools integrate into our daily workflows, often completely unknown to us.

Now let’s turn to the Byzantine—the half UKRI got wrong—the part dealing with assessors of grant proposals. And here, UKRI seems to have lost its nerve. The complete prohibition on using A.I. by assessors feels like a policy from a different era—some time “Before ChatGPT” (B.C.) was released in November 2022. The B.C. policy fails to recognise the enormous potential of A.I. to support and improve human assessors’ judgment.

You’re a senior researcher who’s agreed to review for UKRI. You have just submitted a proposal using an A.I. to clean, polish and improve the work. As an assessor, you are now juggling multiple complex proposals, each crossing traditional disciplinary boundaries (which is increasingly regarded as a positive). You’re probably doing this alongside your day job because that’s how senior researchers work. Wouldn’t it be helpful to have an A.I. assistant to organise key points, flag potential concerns, help clarify technical concepts outside your immediate expertise, act as a sounding board, or provide an intelligent search of the text?

The current policy says no. Assessors must perform every aspect of the review manually, potentially reducing the time they can spend on a deep evaluation of the proposal. The restriction becomes particularly problematic when considering international reviewers, especially those from the Global South. Many brilliant researchers who could offer valuable perspectives might struggle with English as a second language and miss some nuance without support. A.I. could help bridge this gap, but the policy forbids it.

The dual-use policy leads to an ironic situation. Applicants can use A.I. to write their proposals, but assessors can’t use it to support the evaluation of those proposals. It is like allowing Formula 1 teams to use bleeding-edge technology to design their racing cars while insisting that race officials use an hourglass and the naked eye to monitor the race.

Strategically, the situation worries me. Research funding is a global enterprise; other funding bodies are unlikely to maintain such a conservative stance for long. As other funders integrate A.I. into their assessment processes, they will develop best-practice approaches and more efficient workflows. UKRI will fall behind. This could affect the quality of assessments and UKRI’s ability to attract busy reviewers. Why would a busy senior researcher review for UKRI when other funders value their reviewers’ time and encourage efficiency and quality?

There is a path forward. UKRI could maintain its thoughtful approach to applicants while developing more nuanced guidelines for assessors. One approach would be a policy that clearly outlines appropriate A.I. use cases at different stages of assessment, from initial review to technical clarification to quality control. By adding transparency requirements, proper training, and regular policy reviews, UKRI could lead the way with approaches that both protect research integrity and embrace innovation.

If UKRI is nervous, they could start with a pilot program. Evaluate the impact of AI-assisted assessment. Compare it to a traditional approach. This would provide evidence-based insights for policy development while demonstrating leadership in research governance and funding.

The current policy feels half-baked. UKRI has shown they can craft sophisticated policy around A.I. use. The approach to applicants proves this. They need to extend that same thoughtfulness to the assessment process. The goal is not to use A.I. to replace human judgment but to enhance it. It would allow assessors to focus their expertise where it matters most.

This is about more than efficiency and keeping up with technology. It’s about creating the best possible system for identifying and supporting excellent research. If A.I. is a tool to support this process, we should celebrate. When we help assessors do their job more effectively, we help the entire research community.

The research landscape is changing rapidly. UKRI has taken an important first step in allowing A.I. to support the writing of funding grant applications. Now it’s time for the next one—using A.I. to support funding grant evaluation.

Playing Fair: “Horizontality” and the Future of Aid

The arrival of US Aid, “from the American people”.

In his book, Playing Fair, the self-confessed Whig, Ken Binore argued for the redistribution of the “social cake”.

For progress to be made, it is necessary for the affluent to understand that their freedom to enjoy what their “property rights” supposedly secure is actually contingent on the willingness of the less affluent to recognize such “rights”. It is not ordained that things must be the way they are. The common understandings that govern current behavior are constructs and what has been constructed can be reconstructed. If the affluent are willing to surrender some of their relative advantages in return for a more secure environment in which to enjoy those which remain, or in order to generate a larger social cake for division, then everybody can gain. (p.7)

In other words, if we do not share the cake, “they” might burn down the bakery.

I am more idealistic. I have a sense that we should share the social-cake because it is the right thing to do, or maybe it is less the case that redistribution is right than it is wrong to leave people in states of significant disadvantage, particularly when one can do something about it. I am also sufficiently pragmatic not to care what motivates people to extend a hand to others.

Do it because it is right. Do it because it serves your own interests. Do it as a romantic, random act of kindness. I don’t care. The capacity of a dollar to make a difference is not altered. DO IT!

Let me extend this discussion to support offered by more affluent countries to less affluent countries. A couple of days ago I attended a virtual dialogue at Wilton Park as part of their “Future of Aid” series. “Aid” in this context is the (usually financial) assistance provided by one country to another.

Definition; Aid: Late Middle English from Old French aide (noun), aidier (verb), based on Latin adjuvare, from ad- ‘towards’ + juvare ‘to help’.

At least in conceptual origin, country-level aid is about one country doing something towards helping another country. And I would argue that what is really meant (or should be meant) by one country helping another country is that they are helping to improve the lives of the people who live in that country and, in particular, the less affluent and less powerful people.

An important idea emerged in the discussions about aid and that was “horizontality”. Horizontality is the idea that the donor and the recipient countries are equal partners. It is an attempt to move aid beyond neocolonial domination. I applaud this idea, at least I applaud the idea that we should not use aid as a vehicle for exchanging one kind of colonialism for another.

What I hope we are saying when we talk about horizontality is that aid is not about the exercise of power, it is about the redistribution of power. To achieve horizontality, aid can be neither handout, loan nor gift. Aid must be part of a just, redistributive process to improve lives and reduce suffering that recognises we all share one planet, and appreciates that donor and recipient governments are imperfect, though necessary, vehicles for realising these goals.

Horizontality does not mean that aid should be without conditions or accountability. In fact, it means the very opposite. Aid should have strong accountability mechanisms because the purpose of aid is to help people, and governments (and other involved commercial or civil society organisations) are simply vehicles for achieving that goal. The aid is from my people to yours.

If I give money to a homeless person, I am not asking for them to account for how they spend it. I am giving it to them because they need it. Maybe it goes on food or shelter, or maybe some momentary pleasure or relief from misery. If I give money, however, to a charity, I absolutely want them to account for how they spend it, because they are the means to the end and not the end in itself.

COVID-19 has brought the “future of aid” question into stark relief. We need better, more respectful mechanisms for delivering even more aid from more affluent countries to less affluent countries. The aid needs to come with strong accountability mechanisms to ensure that benefits are distributed according to an inverse power-law: the least powerful and the least affluent first. Aid, of all things, should not trickle down. When it does, governments on both sides of the aid-exchange should be held to account, by your people and mine.

What is the optimal number of broken jaws?

I was chatting with a friend recently about the COVID-19 response in different countries. Reflecting on her own country, she said, “It is so hard to know what is right!”; that is, it is so hard to know what the right response to COVID-19 should be.

The variation, for instance, in countries’ lockdown responses is substantial, but which country is doing the right thing? In some countries, there has been no lockdown. The government asked the people to be sensible. In other countries, the government legally confined people to their homes — only one person was allowed out at very specific (restricted) times to buy essentials. Given these two policy extremes (be sensible and house arrest), which one is the right one, and how do you know?

An economist, I have forgotten who once asked tongue-in-cheek, what is the optimal number of dead babies? The very purpose of such a crass question is to make you stop and think. What tradeoffs are you prepared to make to save the lives of babies? Sure, you could be lazy, condemn the questioner as immoral (for even asking you to think), and declare zero dead babies to be the right number. As a simple policy proposition, if zero dead babies is the right number, then all the resources of society should be aimed at preventing neonatal deaths. ALL RESOURCES! Until the policy goal has been achieved, there is more work to be done to reduce the number. One dead baby is too many!!! Farmers may farm, but only to produce the food that supports the workforce that is striving to reduce baby deaths to zero. Teachers may teach, but only to educate the people to fill the jobs to support the policy goal to reduce baby deaths to zero. There is very limited use for art, music, cinema, sport, fashion, restaurants, etc. They will all have to go! If five-year-old deaths increase, that is something to live with, just as long as we can save another baby.

At this point, you’re probably thinking, well that’s stupid. That’s not what I meant when I said the optimal number of dead babies is zero. What I meant was something more along the lines of, “In an ideal world there would be zero dead babies”. Equally, if you were asked about poverty or crime, or amazing works of art, you presumably would have stated the ideals in terms of zero poverty, zero crime, and lots more wonderful art. And this is quite a different proposition. An ideal world is not ideal in virtue of its achievement of a single goal. It is ideal in having achieved all sorts of different outcomes. And that is why the real and the ideal do not intersect. In the real world, we do not achieve the ideal anything. We seek to achieve many ideals, and realistically, we hope to make progress against them, knowing that there is always more to be done. In striving to improve the societal position against a basket of goals, we allocate limited resources and make trade-offs.

This is one part of the COVID-19 problem, and, as my friend observed, why it is so hard to know what is right. What is the right number of COVID-19 deaths? There are lots of important, rational debates to be had around this topic because it is about the tradeoffs we are prepared to make against a basket of societal goals against the myopic achievement of one. Muscular public health responses — effective house arrest — are very good at reducing the number of new COVID-19 cases. They are also very effective at increasing domestic violence, increasing depression, lowering child immunisation rates, degrading child education, increasing poverty and increasing unemployment. If the societal goal should be zero COVID-19 deaths, what is the optimal number of broken jaws, suicide attempts, measles encephalitis cases, illiterate and enumerate children, beggars, and soup kitchens?

All these issues, under normal circumstances, are things of concern to Public Health and maybe, one day, they will be again.

Another part of the COVID-19 problem is that, whether a government “did the right thing” will be determined in hindsight, and by making (inadequate) historical comparisons between the outcomes across countries’. In democracies, at least in the short-term, “did the government do the right thing?” will often be decided at the ballot box. This will surely get the answer wrong. In less-than-democracies, astute rulers will write the history books themselves ensuring that, without regard to the outcome, the government did the right thing.

One of the main reasons that “it is so hard to know what is right!” is that we rarely have a societal view about the long term goals we wish to achieve and the tradeoffs we are prepared to make. Furthermore, we are reluctant to accept the fact that one can do the right thing and still fail. We assume that the right course of action will, by definition, result in success. We are prospective Kantians and retrospective Utilitarians.