In June 1981, I was a young pulmonary fellow at one of the three Los Angeles hospitals where the first five cases of an unusual pneumonia in previously healthy young men were being identified. I read about them, as my colleagues did, in the Morbidity and Mortality Weekly Report (MMWR) – the small, dense bulletin the Centers for Disease Control had been publishing every week since 1952.

None of us yet knew what we were seeing. What MMWR gave us was a signal early enough to act on, and a system trustworthy enough that we did. What became Aids would, over the next decade, reshape every assumption I held about clinical medicine. I have spent the 40 years since then practicing critical care at UCLA, and the federal scientific architecture that produced that signal in 1981 has been the bedrock of my work.

That architecture is being dismantled. On Friday, the presidential personnel office sent termination notices to members of the National Science Board, the body Congress created in 1950 to insulate the country’s basic-science funding from political pressure.

The dismissals came in brief emails, with no explanation. They are the latest in a year of changes that share a single design: the federal institutions American physicians depend on still exist, but the layer of independence inside each of them has been removed. The agencies remain on the page. They are no longer the agencies that gave me, in June 1981, a signal I could act on.

The federal institutions American physicians depend on still exist, but the layer of independence inside each of them has been removed

The pattern is procedural, and it is built around statutes Congress wrote to make this kind of capture difficult. Federal law requires........

© The Guardian