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1. Shard Calculation

Query:

Response:

Calculated Shard: 76 (from laksa004)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa076.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://insidemedicine.substack.com/p/speaking-out-the-new-york-times-jeneen-aa4\')), getAhrefsUnparsedNoserviceFromURL(\'https://insidemedicine.substack.com/p/speaking-out-the-new-york-times-jeneen-aa4\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/insidemedicine.substack.com\/p\/speaking-out-the-new-york-times-jeneen-aa4","crawl_time":1772535342,"first_indexed_time":0,"http_code":200,"src_unparsed":"com,substack!insidemedicine,\/p\/speaking-out-the-new-york-times-jeneen-aa4 s443","src_root_hash":"14862242593741677076","history_drop_reason":null,"meta_title":"Speaking out: The New York Times’ Jeneen Interlandi on what losing HIV funding means.","meta_descriptions":["Featuring pediatric infectious diseases specialist, Dr. Jon Mannheim."],"attrs_boilerpipe_text":"This is the first of a series I’m calling “Speaking Out.”  The idea is to give even more prominence to people who are bravely using their voices to stand up for science, medicine, and the health of our nation.\nClosed captions (㏄) for the above video and a transcript option (📄) can be found beneath the video playback control bar above.\nToday, I was pleased to be joined by\nNew York Times\nstaff writer Jeneen Interlandi and pediatric infectious diseases specialist Dr. Jon Mannheim.\nWe discussed Jeneen’s major\nstory\n, “The Trump Administration’s War on Science Has a Human Cost,” which ran this weekend and for which Jon was a quoted on-the-record source.\nThe big thing: we need people to understand the human cost of the Trump administration’s attack on US science. That’s what made Jeneen’s piece so important. It’s also why we want to cheer Jon on for his willingness to speak out in this way.\nBelow you’ll find some background followed by a summary of our conversation.\nThank you for helping spread this important information\n!\nShare\nBackground:\nSince President Trump took office, we’ve covered his administration’s sustained attack on science and public health. For people in the\nInside Medicine\ncommunity, it’s easy to understand that deep cuts at the NIH, CDC, and elsewhere are dangerous. We understand what the numbers mean.\nBut what’s often missing from the coverage—here and in other outlets—is the perceptible human cost. That’s because some of the losses are not yet noticeable. In some instances, the destruction will\nnever\nbe obvious because we won’t see breakthroughs that failed to occur because funding was pulled. Moreover, the very people who might have delivered those breakthroughs have been intimidated into silence. Yes, we’ve been able to amplify important voices, but many remain afraid to speak out or don’t have the reach. For them, speaking out risks future funding because this administration has made no secret of its intentions.\nThat’s what makes this session so important.\nGuests:\nNew York Times\nstaff writer\nJeneen Interlandi\nhas written a superb piece that, in my view, begins to address this gap. The\npiece\n, “The Trump Administration’s War on Science Has a Human Cost,” ran in Sunday’s print edition of the\nNew York\nTimes\n.\n1\nFew mainstream media pieces have gone this deeply into explaining both the science and the scientists under attack. I’m looking forward to discussing it with the author\nand\na prominent source in the piece,\nDr. Jon Mannheim\n, a pediatrician specializing in HIV.\nAided by ChatGPT.\nWe opened by explaining that Inside Medicine has tracked the Trump administration’s assault on science and public health, but that numbers alone don’t translate for many people—and that we need first-person stories from the scientists and clinicians living the consequences.\nWe laid out the “double-edged sword”: public accountability requires people to talk, but researchers and public servants worry that speaking out will cost them grants, jobs, or future opportunities—so the harm stays abstract.\nWe asked Jeneen Interlandi how the piece came together, and she described an editorial push to capture the\nhuman\ncost of NIH cuts—then finding access through a Northwestern-based HIV prevention researcher, which naturally rooted the reporting in Chicago.\nWe dug into how grant reinstatements and court headlines can create false reassurance; even when money returns, the interrupted work, lost staff, and abandoned momentum create damage that doesn’t simply reverse.\nWe explored the idea that the earlier “end HIV by 2030” messaging reflected inattentiveness that allowed competent people to quietly build programs—whereas post-COVID politics made public health a target rather than an afterthought.\nWe argued that many skeptics will endorse “reduce HIV morbidity and mortality” in the abstract, but recoil when the work is described as studying marginalized communities—even though that work is often\nexactly\nwhat makes the first goal achievable.\nWe emphasized the distinction between diversifying scientific ranks and reducing health gaps—and noted how blunt “keyword” approaches (e.g., anything with “equity”) can gut legitimate public-health and implementation research.\nDr. Jon Mannheim described the atmosphere inside a county hospital: leadership-to-frontline anxiety about Medicaid cuts, looming service loss, and the bottom-line question of who will become harder—or impossible—to treat.\nWe used PrEP and long-acting options as the example: breakthroughs don’t end epidemics by themselves—patients still need access, follow-up, transportation, phones, time off work, and clinics that can keep doors open.\nWe talked through how communities can resist PrEP for social and cultural reasons, and why behavioral and implementation science isn’t fluff—it’s the difference between a miracle drug on paper and prevention in the real world.\nWe made the pragmatic case that humanizing people—down to basics like respectful interaction—can determine whether they engage with care, which ultimately affects everyone’s risk in a shared society.\nDr. Mannheim described fear-driven avoidance: patients skipping clinic because of ICE presence and targeting, with downstream consequences for TB and HIV—diseases that don’t stay contained within the communities being pressured.\nWe asked the practical timeline, and Dr. Mannheim explained it can range from months to years, with many patients getting into serious trouble around the one-year mark—highlighting why delayed harm is still real harm.\nWe walked through the plain-language economics: targeted prevention and delivery infrastructure can save money compared with ICU admissions for opportunistic infections—and research helps define who benefits most and how to reach them.\nWe discussed how concentrated HIV burden allows high-return investment—an approach aligned with classic infectious-disease strategy: focus resources where transmission is, not where it’s politically comfortable.\nDr. Mannheim made the point we kept returning to: clinicians aren’t the linchpin—support staff arranging rides, phones, outreach, food support, and continuity are what make prevention and treatment actually happen.\nWe highlighted perinatal HIV transmission and adolescent infections as fragile wins—dependent on systems that can be dismantled fast and rebuilt slowly, if at all.\nWe closed on the slow-motion catastrophe of expertise leaving government—and leaving the US—hollowing out the NIH\/CDC ecosystem that made the country a global research magnet after World War II.\nWe told viewers the recording would be available on Inside Medicine with no paywall, thanked Jeneen Interlandi and Dr. Jon Mannheim, and framed the series mission plainly: we need more people to speak out now—or we’ll regret how quiet we were later.","attrs_markdown":"[![Inside Medicine](https:\/\/substackcdn.com\/image\/fetch\/$s_!oQc8!,w_40,h_40,c_fill,f_auto,q_auto:good,fl_progressive:steep\/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F47f601dd-9987-4e09-81b2-c8b726dcefb6_1280x1280.png)](https:\/\/insidemedicine.substack.com\/)\n\n# [Inside Medicine](https:\/\/insidemedicine.substack.com\/)\nSubscribe\n\nSign in\n\nPlayback speed\n\n×\n\nShare post\n\nShare post at current time\n\nShare from 0:00\n\n0:00\n\n\/\n\n0:00\n\nTranscript\n\n68\n\n5\n\n## Speaking out: The New York Times’ Jeneen Interlandi on what losing HIV funding means.\nFeaturing pediatric infectious diseases specialist, Dr. Jon Mannheim.\n\n[![Jeremy Faust, MD's avatar](https:\/\/substackcdn.com\/image\/fetch\/$s_!BvEC!,w_36,h_36,c_fill,f_auto,q_auto:good,fl_progressive:steep\/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F70c01fb6-99e3-43dd-bfbf-79f0fe9c0d26_4500x4500.jpeg)](https:\/\/substack.com\/@insidemedicine)\n\n[Jeremy Faust, MD](https:\/\/substack.com\/@insidemedicine)\n\nMar 02, 2026\n\n68\n\n5\n\nShare\n\nTranscript\n\nThis is the first of a series I’m calling “Speaking Out.” The idea is to give even more prominence to people who are bravely using their voices to stand up for science, medicine, and the health of our nation.\n\n*Closed captions (㏄) for the above video and a transcript option (📄) can be found beneath the video playback control bar above.*\n\nToday, I was pleased to be joined by *New York Times* staff writer Jeneen Interlandi and pediatric infectious diseases specialist Dr. Jon Mannheim.\n\nWe discussed Jeneen’s major [story](https:\/\/www.nytimes.com\/2026\/02\/23\/opinion\/doge-hiv-funding.html), “The Trump Administration’s War on Science Has a Human Cost,” which ran this weekend and for which Jon was a quoted on-the-record source.\n\nThe big thing: we need people to understand the human cost of the Trump administration’s attack on US science. That’s what made Jeneen’s piece so important. It’s also why we want to cheer Jon on for his willingness to speak out in this way.\n\nBelow you’ll find some background followed by a summary of our conversation. *Thank you for helping spread this important information*\\!\n\n**Help amplify expert voices. Upgrade to Inside Medicine Premium.**\n\n[Share](https:\/\/insidemedicine.substack.com\/p\/pulmonary-embolisms-what-to-know?utm_source=substack&utm_medium=email&utm_content=share&action=share&token=eyJ1c2VyX2lkIjo5NTY4ODI3LCJwb3N0X2lkIjoxODc3OTk2MzIsImlhdCI6MTc3MjQ4NzI5MiwiZXhwIjoxNzc1MDc5MjkyLCJpc3MiOiJwdWItMTE4MzUyNiIsInN1YiI6InBvc3QtcmVhY3Rpb24ifQ.S0_V0GNx8wQvoib3gepm-LhMZAy1gdKYjIeVlJb7x2Q)\n***\n> **Background:** Since President Trump took office, we’ve covered his administration’s sustained attack on science and public health. For people in the *Inside Medicine* community, it’s easy to understand that deep cuts at the NIH, CDC, and elsewhere are dangerous. We understand what the numbers mean.\n> \n> But what’s often missing from the coverage—here and in other outlets—is the perceptible human cost. That’s because some of the losses are not yet noticeable. In some instances, the destruction will *never* be obvious because we won’t see breakthroughs that failed to occur because funding was pulled. Moreover, the very people who might have delivered those breakthroughs have been intimidated into silence. Yes, we’ve been able to amplify important voices, but many remain afraid to speak out or don’t have the reach. For them, speaking out risks future funding because this administration has made no secret of its intentions.\n> \n> *That’s what makes this session so important.*\n> \n> **Guests:** *New York Times* staff writer **Jeneen Interlandi** has written a superb piece that, in my view, begins to address this gap. The **[piece](https:\/\/www.nytimes.com\/2026\/02\/23\/opinion\/doge-hiv-funding.html)**, “The Trump Administration’s War on Science Has a Human Cost,” ran in Sunday’s print edition of the *New York* *Times*.[1](https:\/\/insidemedicine.substack.com\/p\/speaking-out-the-new-york-times-jeneen#footnote-1-189557062)\n> \n> Few mainstream media pieces have gone this deeply into explaining both the science and the scientists under attack. I’m looking forward to discussing it with the author *and* a prominent source in the piece, **Dr. Jon Mannheim**, a pediatrician specializing in HIV.\n# Summary & Highlights.\n*Aided by ChatGPT.*\n\n### Welcome + why we launched “Speaking Out” (0:32)\nWe opened by explaining that Inside Medicine has tracked the Trump administration’s assault on science and public health, but that numbers alone don’t translate for many people—and that we need first-person stories from the scientists and clinicians living the consequences.\n\n### The core problem: the people who need to speak are scared to (1:32)\nWe laid out the “double-edged sword”: public accountability requires people to talk, but researchers and public servants worry that speaking out will cost them grants, jobs, or future opportunities—so the harm stays abstract.\n\n### Bringing in Jeneen Interlandi: why she wrote this, and why Chicago (3:17)\nWe asked Jeneen Interlandi how the piece came together, and she described an editorial push to capture the *human* cost of NIH cuts—then finding access through a Northwestern-based HIV prevention researcher, which naturally rooted the reporting in Chicago.\n\n### The “temporary blip” illusion—and why that’s wrong (7:32)\nWe dug into how grant reinstatements and court headlines can create false reassurance; even when money returns, the interrupted work, lost staff, and abandoned momentum create damage that doesn’t simply reverse.\n\n### Why Trump 1.0 could sound pro-HIV while Trump 2.0 is different (9:02)\nWe explored the idea that the earlier “end HIV by 2030” messaging reflected inattentiveness that allowed competent people to quietly build programs—whereas post-COVID politics made public health a target rather than an afterthought.\n\n### Framing, DEI, and the category error people keep making (12:01)\nWe argued that many skeptics will endorse “reduce HIV morbidity and mortality” in the abstract, but recoil when the work is described as studying marginalized communities—even though that work is often *exactly* what makes the first goal achievable.\n\n### “DEI” vs “health equity”: two different things (14:03)\nWe emphasized the distinction between diversifying scientific ranks and reducing health gaps—and noted how blunt “keyword” approaches (e.g., anything with “equity”) can gut legitimate public-health and implementation research.\n\n### Dr. Jon Mannheim joins: safety-net reality and Medicaid dread (17:43)\nDr. Jon Mannheim described the atmosphere inside a county hospital: leadership-to-frontline anxiety about Medicaid cuts, looming service loss, and the bottom-line question of who will become harder—or impossible—to treat.\n\n### The meds exist; the *system* to deliver them is what’s being cut (19:16)\nWe used PrEP and long-acting options as the example: breakthroughs don’t end epidemics by themselves—patients still need access, follow-up, transportation, phones, time off work, and clinics that can keep doors open.\n\n### Stigma and behavior change: “best drug in the world” still fails without trust (22:12)\nWe talked through how communities can resist PrEP for social and cultural reasons, and why behavioral and implementation science isn’t fluff—it’s the difference between a miracle drug on paper and prevention in the real world.\n\n### Respect is self-interest: why dignity and language matter to disease control (25:42)\nWe made the pragmatic case that humanizing people—down to basics like respectful interaction—can determine whether they engage with care, which ultimately affects everyone’s risk in a shared society.\n\n### ICE as a public-health accelerant (27:31)\nDr. Mannheim described fear-driven avoidance: patients skipping clinic because of ICE presence and targeting, with downstream consequences for TB and HIV—diseases that don’t stay contained within the communities being pressured.\n\n### How fast “untreated” becomes “AIDS again” (29:30)\nWe asked the practical timeline, and Dr. Mannheim explained it can range from months to years, with many patients getting into serious trouble around the one-year mark—highlighting why delayed harm is still real harm.\n\n### Prevention isn’t just “cost-effective”—it’s often cost-saving (31:22)\nWe walked through the plain-language economics: targeted prevention and delivery infrastructure can save money compared with ICU admissions for opportunistic infections—and research helps define who benefits most and how to reach them.\n\n### Targeting hotspots works: “go where the virus is” principle (32:49)\nWe discussed how concentrated HIV burden allows high-return investment—an approach aligned with classic infectious-disease strategy: focus resources where transmission is, not where it’s politically comfortable.\n\n### The unglamorous MVPs: social workers, case managers, and the scaffolding of care (39:12)\nDr. Mannheim made the point we kept returning to: clinicians aren’t the linchpin—support staff arranging rides, phones, outreach, food support, and continuity are what make prevention and treatment actually happen.\n\n### “Solved problems” can become unsolved again (40:08)\nWe highlighted perinatal HIV transmission and adolescent infections as fragile wins—dependent on systems that can be dismantled fast and rebuilt slowly, if at all.\n\n### Brain drain: losing talent to industry and to other countries (44:17)\nWe closed on the slow-motion catastrophe of expertise leaving government—and leaving the US—hollowing out the NIH\/CDC ecosystem that made the country a global research magnet after World War II.\n\n### Call to action (48:14)\nWe told viewers the recording would be available on Inside Medicine with no paywall, thanked Jeneen Interlandi and Dr. Jon Mannheim, and framed the series mission plainly: we need more people to speak out now—or we’ll regret how quiet we were later.\n\n#### Discussion about this video\nComments\n\nRestacks\n\n[![Inside Medicine](https:\/\/substackcdn.com\/image\/fetch\/$s_!Nb96!,w_96,h_96,c_fill,f_auto,q_auto:good,fl_progressive:steep,g_auto\/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fb05b82ff-b933-4c26-94a0-fdd1c55b4e12_1744x1744.png)](https:\/\/insidemedicine.substack.com\/)\n\nInside Medicine Podcast\n\nMerging what I'm seeing in the ER with rigorous deep-dives on the very latest medical and public health data. I want you to know what really matters.\n\nMerging what I'm seeing in the ER with rigorous deep-dives on the very latest medical and public health data. I want you to know what really matters.\n\nListen on\n\nSubstack App\n\nRSS Feed\n\nAppears in episode\n\n[![Jeremy Faust, MD's avatar](https:\/\/substackcdn.com\/image\/fetch\/$s_!BvEC!,w_32,h_32,c_fill,f_auto,q_auto:good,fl_progressive:steep\/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F70c01fb6-99e3-43dd-bfbf-79f0fe9c0d26_4500x4500.jpeg)](https:\/\/substack.com\/@insidemedicine?utm_source=author-byline-face-podcast)\n\n[Jeremy Faust, MD](https:\/\/substack.com\/@insidemedicine)\n\nRecent Episodes\n\n![](https:\/\/substackcdn.com\/image\/fetch\/$s_!RWzS!,w_150,h_150,c_fill,f_auto,q_auto:good,fl_progressive:steep,g_auto\/https%3A%2F%2Fsubstack-video.s3.amazonaws.com%2Fvideo_upload%2Fpost%2F187799632%2F65e7b0cf-f61e-4c95-9bf9-8e8f88252852%2Ftranscoded-20515.png)\n\n[Pulmonary Embolisms: What to Know After the Death of Catherine O’Hara.](https:\/\/insidemedicine.substack.com\/p\/pulmonary-embolisms-what-to-know)\n\nFeb 13\n\n• [Jeremy Faust, MD](https:\/\/substack.com\/@insidemedicine)\n\n![](https:\/\/substackcdn.com\/image\/fetch\/$s_!6-KS!,w_150,h_150,c_fill,f_auto,q_auto:good,fl_progressive:steep,g_center\/https%3A%2F%2Fsubstack-video.s3.amazonaws.com%2Fvideo_upload%2Fpost%2F185565286%2F6e679239-3526-4405-9933-7cb4fa101331%2Ftranscoded-1769204233.png)\n\n[The new US Dietary Guidelines. What's the deal?](https:\/\/insidemedicine.substack.com\/p\/the-new-us-dietary-guidelines-whats)\n\nJan 23\n\n• [Jeremy Faust, MD](https:\/\/substack.com\/@insidemedicine), [Jessica Knurick, PhD, RDN](https:\/\/substack.com\/@drjessicaknurick), and [Kevin C. Klatt, PhD, RD](https:\/\/substack.com\/@kcklatt)\n\n![](https:\/\/substackcdn.com\/image\/fetch\/$s_!g0Au!,w_150,h_150,c_fill,f_auto,q_auto:good,fl_progressive:steep,g_auto\/https%3A%2F%2Fsubstack-video.s3.amazonaws.com%2Fvideo_upload%2Fpost%2F185235598%2F2a88c37b-372c-4ab0-97b0-6047bfb76777%2Ftranscoded-138001.png)\n\n[One Year In: How the Trump Administration Has Eroded Public Health.](https:\/\/insidemedicine.substack.com\/p\/one-year-in-how-the-trump-administration)\n\nJan 21\n\n• [Jeremy Faust, MD](https:\/\/substack.com\/@insidemedicine) and [Dr. Angela Rasmussen](https:\/\/substack.com\/@rasmussenretorts)\n\n![](https:\/\/substackcdn.com\/image\/fetch\/$s_!KQXG!,w_150,h_150,c_fill,f_auto,q_auto:good,fl_progressive:steep,g_auto\/https%3A%2F%2Fsubstack-video.s3.amazonaws.com%2Fvideo_upload%2Fpost%2F184482410%2F2f35c844-e679-4f5f-a570-c34dc25072d7%2Ftranscoded-00001.png)\n\n[\"The Pitt\" Watch-Along with an ER Doc (S1E1)](https:\/\/insidemedicine.substack.com\/p\/the-pitt-watch-along-with-an-er-doc)\n\nJan 14\n\n• [Jeremy Faust, MD](https:\/\/substack.com\/@insidemedicine)\n\n![](https:\/\/substackcdn.com\/image\/fetch\/$s_!NnRO!,w_150,h_150,c_fill,f_auto,q_auto:good,fl_progressive:steep,g_auto\/https%3A%2F%2Fsubstack-video.s3.amazonaws.com%2Fvideo_upload%2Fpost%2F183632475%2Ff5665fd2-08bd-4c0a-a90a-7435215cfc45%2Ftranscoded-41240.png)\n\n[RFK Jr. breaks major promise on childhood vaccines. Analysis with Demetre Daskalakis, Dorit Reiss, and Angie Rasmussen.](https:\/\/insidemedicine.substack.com\/p\/rfk-jr-breaks-major-promise-on-childhood)\n\nJan 7\n\n• [Jeremy Faust, MD](https:\/\/substack.com\/@insidemedicine) and [Dr. Angela Rasmussen](https:\/\/substack.com\/@rasmussenretorts)\n\n![](https:\/\/substackcdn.com\/image\/fetch\/$s_!VZrJ!,w_150,h_150,c_fill,f_auto,q_auto:good,fl_progressive:steep,g_auto\/https%3A%2F%2Fsubstack-video.s3.amazonaws.com%2Fvideo_upload%2Fpost%2F182102040%2Fffbbcd8d-f9eb-4a6d-9a87-17bba8c7a41b%2Ftranscoded-347704.png)\n\n[This Week in Public Hell. With Daskalakis, Rasmussen, and Faust](https:\/\/insidemedicine.substack.com\/p\/this-week-in-public-hell-with-daskalakis)\n\nDec 20, 2025\n\n• [Jeremy Faust, MD](https:\/\/substack.com\/@insidemedicine) and [Dr. Angela Rasmussen](https:\/\/substack.com\/@rasmussenretorts)\n\n![](https:\/\/substackcdn.com\/image\/fetch\/$s_!p1k_!,w_150,h_150,c_fill,f_auto,q_auto:good,fl_progressive:steep,g_auto\/https%3A%2F%2Fsubstack-video.s3.amazonaws.com%2Fvideo_upload%2Fpost%2F179846720%2F24b28b4c-4aa4-4fe2-b1c2-89015f343c67%2Ftranscoded-289965.png)\n\n[Rovina’s Choice, a New Yorker Documentary humanizing the destruction of USAID. With Dr. Atul Gawande and Dr. Jeremy Faust.](https:\/\/insidemedicine.substack.com\/p\/rovinas-choice-a-new-yorker-documentary)\n\nNov 26, 2025\n\n• [Jeremy Faust, MD](https:\/\/substack.com\/@insidemedicine) and [Atul Gawande](https:\/\/substack.com\/@agawande)\n### Ready for more?\n\n© 2026 Jeremy Faust · [Privacy](https:\/\/substack.com\/privacy) ∙ [Terms](https:\/\/substack.com\/tos) ∙ [Collection notice](https:\/\/substack.com\/ccpa#personal-data-collected)\n\n[Start your Substack](https:\/\/substack.com\/signup?utm_source=substack&utm_medium=web&utm_content=footer)\n\n[Get the app](https:\/\/substack.com\/app\/app-store-redirect?utm_campaign=app-marketing&utm_content=web-footer-button)\n\n[Substack](https:\/\/substack.com\/) is the home for great culture\n\nThis site requires JavaScript to run correctly. Please [turn on JavaScript](https:\/\/enable-javascript.com\/) or unblock scripts","attrs_readable_markdown":"This is the first of a series I’m calling “Speaking Out.” The idea is to give even more prominence to people who are bravely using their voices to stand up for science, medicine, and the health of our nation.\n\n*Closed captions (㏄) for the above video and a transcript option (📄) can be found beneath the video playback control bar above.*\n\nToday, I was pleased to be joined by *New York Times* staff writer Jeneen Interlandi and pediatric infectious diseases specialist Dr. Jon Mannheim.\n\nWe discussed Jeneen’s major [story](https:\/\/www.nytimes.com\/2026\/02\/23\/opinion\/doge-hiv-funding.html), “The Trump Administration’s War on Science Has a Human Cost,” which ran this weekend and for which Jon was a quoted on-the-record source.\n\nThe big thing: we need people to understand the human cost of the Trump administration’s attack on US science. That’s what made Jeneen’s piece so important. It’s also why we want to cheer Jon on for his willingness to speak out in this way.\n\nBelow you’ll find some background followed by a summary of our conversation. *Thank you for helping spread this important information*\\!\n\n[Share](https:\/\/insidemedicine.substack.com\/p\/pulmonary-embolisms-what-to-know?utm_source=substack&utm_medium=email&utm_content=share&action=share&token=eyJ1c2VyX2lkIjo5NTY4ODI3LCJwb3N0X2lkIjoxODc3OTk2MzIsImlhdCI6MTc3MjQ4NzI5MiwiZXhwIjoxNzc1MDc5MjkyLCJpc3MiOiJwdWItMTE4MzUyNiIsInN1YiI6InBvc3QtcmVhY3Rpb24ifQ.S0_V0GNx8wQvoib3gepm-LhMZAy1gdKYjIeVlJb7x2Q)\n\n> **Background:** Since President Trump took office, we’ve covered his administration’s sustained attack on science and public health. For people in the *Inside Medicine* community, it’s easy to understand that deep cuts at the NIH, CDC, and elsewhere are dangerous. We understand what the numbers mean.\n> \n> But what’s often missing from the coverage—here and in other outlets—is the perceptible human cost. That’s because some of the losses are not yet noticeable. In some instances, the destruction will *never* be obvious because we won’t see breakthroughs that failed to occur because funding was pulled. Moreover, the very people who might have delivered those breakthroughs have been intimidated into silence. Yes, we’ve been able to amplify important voices, but many remain afraid to speak out or don’t have the reach. For them, speaking out risks future funding because this administration has made no secret of its intentions.\n> \n> *That’s what makes this session so important.*\n> \n> **Guests:** *New York Times* staff writer **Jeneen Interlandi** has written a superb piece that, in my view, begins to address this gap. The **[piece](https:\/\/www.nytimes.com\/2026\/02\/23\/opinion\/doge-hiv-funding.html)**, “The Trump Administration’s War on Science Has a Human Cost,” ran in Sunday’s print edition of the *New York* *Times*.[1](https:\/\/insidemedicine.substack.com\/p\/speaking-out-the-new-york-times-jeneen#footnote-1-189557062)\n> \n> Few mainstream media pieces have gone this deeply into explaining both the science and the scientists under attack. I’m looking forward to discussing it with the author *and* a prominent source in the piece, **Dr. Jon Mannheim**, a pediatrician specializing in HIV.\n\n*Aided by ChatGPT.*\n\nWe opened by explaining that Inside Medicine has tracked the Trump administration’s assault on science and public health, but that numbers alone don’t translate for many people—and that we need first-person stories from the scientists and clinicians living the consequences.\n\nWe laid out the “double-edged sword”: public accountability requires people to talk, but researchers and public servants worry that speaking out will cost them grants, jobs, or future opportunities—so the harm stays abstract.\n\nWe asked Jeneen Interlandi how the piece came together, and she described an editorial push to capture the *human* cost of NIH cuts—then finding access through a Northwestern-based HIV prevention researcher, which naturally rooted the reporting in Chicago.\n\nWe dug into how grant reinstatements and court headlines can create false reassurance; even when money returns, the interrupted work, lost staff, and abandoned momentum create damage that doesn’t simply reverse.\n\nWe explored the idea that the earlier “end HIV by 2030” messaging reflected inattentiveness that allowed competent people to quietly build programs—whereas post-COVID politics made public health a target rather than an afterthought.\n\nWe argued that many skeptics will endorse “reduce HIV morbidity and mortality” in the abstract, but recoil when the work is described as studying marginalized communities—even though that work is often *exactly* what makes the first goal achievable.\n\nWe emphasized the distinction between diversifying scientific ranks and reducing health gaps—and noted how blunt “keyword” approaches (e.g., anything with “equity”) can gut legitimate public-health and implementation research.\n\nDr. Jon Mannheim described the atmosphere inside a county hospital: leadership-to-frontline anxiety about Medicaid cuts, looming service loss, and the bottom-line question of who will become harder—or impossible—to treat.\n\nWe used PrEP and long-acting options as the example: breakthroughs don’t end epidemics by themselves—patients still need access, follow-up, transportation, phones, time off work, and clinics that can keep doors open.\n\nWe talked through how communities can resist PrEP for social and cultural reasons, and why behavioral and implementation science isn’t fluff—it’s the difference between a miracle drug on paper and prevention in the real world.\n\nWe made the pragmatic case that humanizing people—down to basics like respectful interaction—can determine whether they engage with care, which ultimately affects everyone’s risk in a shared society.\n\nDr. Mannheim described fear-driven avoidance: patients skipping clinic because of ICE presence and targeting, with downstream consequences for TB and HIV—diseases that don’t stay contained within the communities being pressured.\n\nWe asked the practical timeline, and Dr. Mannheim explained it can range from months to years, with many patients getting into serious trouble around the one-year mark—highlighting why delayed harm is still real harm.\n\nWe walked through the plain-language economics: targeted prevention and delivery infrastructure can save money compared with ICU admissions for opportunistic infections—and research helps define who benefits most and how to reach them.\n\nWe discussed how concentrated HIV burden allows high-return investment—an approach aligned with classic infectious-disease strategy: focus resources where transmission is, not where it’s politically comfortable.\n\nDr. Mannheim made the point we kept returning to: clinicians aren’t the linchpin—support staff arranging rides, phones, outreach, food support, and continuity are what make prevention and treatment actually happen.\n\nWe highlighted perinatal HIV transmission and adolescent infections as fragile wins—dependent on systems that can be dismantled fast and rebuilt slowly, if at all.\n\nWe closed on the slow-motion catastrophe of expertise leaving government—and leaving the US—hollowing out the NIH\/CDC ecosystem that made the country a global research magnet after World War II.\n\nWe told viewers the recording would be available on Inside Medicine with no paywall, thanked Jeneen Interlandi and Dr. Jon Mannheim, and framed the series mission plainly: we need more people to speak out now—or we’ll regret how quiet we were later.","meta_canonical":null}

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Boilerpipe Text	This is the first of a series I’m calling “Speaking Out.” The idea is to give even more prominence to people who are bravely using their voices to stand up for science, medicine, and the health of our nation. Closed captions (㏄) for the above video and a transcript option (📄) can be found beneath the video playback control bar above. Today, I was pleased to be joined by New York Times staff writer Jeneen Interlandi and pediatric infectious diseases specialist Dr. Jon Mannheim. We discussed Jeneen’s major story , “The Trump Administration’s War on Science Has a Human Cost,” which ran this weekend and for which Jon was a quoted on-the-record source. The big thing: we need people to understand the human cost of the Trump administration’s attack on US science. That’s what made Jeneen’s piece so important. It’s also why we want to cheer Jon on for his willingness to speak out in this way. Below you’ll find some background followed by a summary of our conversation. Thank you for helping spread this important information ! Share Background: Since President Trump took office, we’ve covered his administration’s sustained attack on science and public health. For people in the Inside Medicine community, it’s easy to understand that deep cuts at the NIH, CDC, and elsewhere are dangerous. We understand what the numbers mean. But what’s often missing from the coverage—here and in other outlets—is the perceptible human cost. That’s because some of the losses are not yet noticeable. In some instances, the destruction will never be obvious because we won’t see breakthroughs that failed to occur because funding was pulled. Moreover, the very people who might have delivered those breakthroughs have been intimidated into silence. Yes, we’ve been able to amplify important voices, but many remain afraid to speak out or don’t have the reach. For them, speaking out risks future funding because this administration has made no secret of its intentions. That’s what makes this session so important. Guests: New York Times staff writer Jeneen Interlandi has written a superb piece that, in my view, begins to address this gap. The piece , “The Trump Administration’s War on Science Has a Human Cost,” ran in Sunday’s print edition of the New York Times . 1 Few mainstream media pieces have gone this deeply into explaining both the science and the scientists under attack. I’m looking forward to discussing it with the author and a prominent source in the piece, Dr. Jon Mannheim , a pediatrician specializing in HIV. Aided by ChatGPT. We opened by explaining that Inside Medicine has tracked the Trump administration’s assault on science and public health, but that numbers alone don’t translate for many people—and that we need first-person stories from the scientists and clinicians living the consequences. We laid out the “double-edged sword”: public accountability requires people to talk, but researchers and public servants worry that speaking out will cost them grants, jobs, or future opportunities—so the harm stays abstract. We asked Jeneen Interlandi how the piece came together, and she described an editorial push to capture the human cost of NIH cuts—then finding access through a Northwestern-based HIV prevention researcher, which naturally rooted the reporting in Chicago. We dug into how grant reinstatements and court headlines can create false reassurance; even when money returns, the interrupted work, lost staff, and abandoned momentum create damage that doesn’t simply reverse. We explored the idea that the earlier “end HIV by 2030” messaging reflected inattentiveness that allowed competent people to quietly build programs—whereas post-COVID politics made public health a target rather than an afterthought. We argued that many skeptics will endorse “reduce HIV morbidity and mortality” in the abstract, but recoil when the work is described as studying marginalized communities—even though that work is often exactly what makes the first goal achievable. We emphasized the distinction between diversifying scientific ranks and reducing health gaps—and noted how blunt “keyword” approaches (e.g., anything with “equity”) can gut legitimate public-health and implementation research. Dr. Jon Mannheim described the atmosphere inside a county hospital: leadership-to-frontline anxiety about Medicaid cuts, looming service loss, and the bottom-line question of who will become harder—or impossible—to treat. We used PrEP and long-acting options as the example: breakthroughs don’t end epidemics by themselves—patients still need access, follow-up, transportation, phones, time off work, and clinics that can keep doors open. We talked through how communities can resist PrEP for social and cultural reasons, and why behavioral and implementation science isn’t fluff—it’s the difference between a miracle drug on paper and prevention in the real world. We made the pragmatic case that humanizing people—down to basics like respectful interaction—can determine whether they engage with care, which ultimately affects everyone’s risk in a shared society. Dr. Mannheim described fear-driven avoidance: patients skipping clinic because of ICE presence and targeting, with downstream consequences for TB and HIV—diseases that don’t stay contained within the communities being pressured. We asked the practical timeline, and Dr. Mannheim explained it can range from months to years, with many patients getting into serious trouble around the one-year mark—highlighting why delayed harm is still real harm. We walked through the plain-language economics: targeted prevention and delivery infrastructure can save money compared with ICU admissions for opportunistic infections—and research helps define who benefits most and how to reach them. We discussed how concentrated HIV burden allows high-return investment—an approach aligned with classic infectious-disease strategy: focus resources where transmission is, not where it’s politically comfortable. Dr. Mannheim made the point we kept returning to: clinicians aren’t the linchpin—support staff arranging rides, phones, outreach, food support, and continuity are what make prevention and treatment actually happen. We highlighted perinatal HIV transmission and adolescent infections as fragile wins—dependent on systems that can be dismantled fast and rebuilt slowly, if at all. We closed on the slow-motion catastrophe of expertise leaving government—and leaving the US—hollowing out the NIH/CDC ecosystem that made the country a global research magnet after World War II. We told viewers the recording would be available on Inside Medicine with no paywall, thanked Jeneen Interlandi and Dr. Jon Mannheim, and framed the series mission plainly: we need more people to speak out now—or we’ll regret how quiet we were later.
Markdown	[![Inside Medicine](https://substackcdn.com/image/fetch/$s_!oQc8!,w_40,h_40,c_fill,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F47f601dd-9987-4e09-81b2-c8b726dcefb6_1280x1280.png)](https://insidemedicine.substack.com/) # [Inside Medicine](https://insidemedicine.substack.com/) Subscribe Sign in Playback speed × Share post Share post at current time Share from 0:00 0:00 / 0:00 Transcript 68 5 ## Speaking out: The New York Times’ Jeneen Interlandi on what losing HIV funding means. Featuring pediatric infectious diseases specialist, Dr. Jon Mannheim. [![Jeremy Faust, MD's avatar](https://substackcdn.com/image/fetch/$s_!BvEC!,w_36,h_36,c_fill,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F70c01fb6-99e3-43dd-bfbf-79f0fe9c0d26_4500x4500.jpeg)](https://substack.com/@insidemedicine) [Jeremy Faust, MD](https://substack.com/@insidemedicine) Mar 02, 2026 68 5 Share Transcript This is the first of a series I’m calling “Speaking Out.” The idea is to give even more prominence to people who are bravely using their voices to stand up for science, medicine, and the health of our nation. Closed captions (㏄) for the above video and a transcript option (📄) can be found beneath the video playback control bar above. Today, I was pleased to be joined by New York Times staff writer Jeneen Interlandi and pediatric infectious diseases specialist Dr. Jon Mannheim. We discussed Jeneen’s major [story](https://www.nytimes.com/2026/02/23/opinion/doge-hiv-funding.html), “The Trump Administration’s War on Science Has a Human Cost,” which ran this weekend and for which Jon was a quoted on-the-record source. The big thing: we need people to understand the human cost of the Trump administration’s attack on US science. That’s what made Jeneen’s piece so important. It’s also why we want to cheer Jon on for his willingness to speak out in this way. Below you’ll find some background followed by a summary of our conversation. Thank you for helping spread this important information\! Help amplify expert voices. Upgrade to Inside Medicine Premium. [Share](https://insidemedicine.substack.com/p/pulmonary-embolisms-what-to-know?utm_source=substack&utm_medium=email&utm_content=share&action=share&token=eyJ1c2VyX2lkIjo5NTY4ODI3LCJwb3N0X2lkIjoxODc3OTk2MzIsImlhdCI6MTc3MjQ4NzI5MiwiZXhwIjoxNzc1MDc5MjkyLCJpc3MiOiJwdWItMTE4MzUyNiIsInN1YiI6InBvc3QtcmVhY3Rpb24ifQ.S0_V0GNx8wQvoib3gepm-LhMZAy1gdKYjIeVlJb7x2Q) * > Background:** Since President Trump took office, we’ve covered his administration’s sustained attack on science and public health. For people in the Inside Medicine community, it’s easy to understand that deep cuts at the NIH, CDC, and elsewhere are dangerous. We understand what the numbers mean. > > But what’s often missing from the coverage—here and in other outlets—is the perceptible human cost. That’s because some of the losses are not yet noticeable. In some instances, the destruction will never be obvious because we won’t see breakthroughs that failed to occur because funding was pulled. Moreover, the very people who might have delivered those breakthroughs have been intimidated into silence. Yes, we’ve been able to amplify important voices, but many remain afraid to speak out or don’t have the reach. For them, speaking out risks future funding because this administration has made no secret of its intentions. > > That’s what makes this session so important. > > Guests: New York Times staff writer Jeneen Interlandi has written a superb piece that, in my view, begins to address this gap. The [piece](https://www.nytimes.com/2026/02/23/opinion/doge-hiv-funding.html), “The Trump Administration’s War on Science Has a Human Cost,” ran in Sunday’s print edition of the New York Times.[1](https://insidemedicine.substack.com/p/speaking-out-the-new-york-times-jeneen#footnote-1-189557062) > > Few mainstream media pieces have gone this deeply into explaining both the science and the scientists under attack. I’m looking forward to discussing it with the author and a prominent source in the piece, Dr. Jon Mannheim, a pediatrician specializing in HIV. # Summary & Highlights. Aided by ChatGPT. ### Welcome + why we launched “Speaking Out” (0:32) We opened by explaining that Inside Medicine has tracked the Trump administration’s assault on science and public health, but that numbers alone don’t translate for many people—and that we need first-person stories from the scientists and clinicians living the consequences. ### The core problem: the people who need to speak are scared to (1:32) We laid out the “double-edged sword”: public accountability requires people to talk, but researchers and public servants worry that speaking out will cost them grants, jobs, or future opportunities—so the harm stays abstract. ### Bringing in Jeneen Interlandi: why she wrote this, and why Chicago (3:17) We asked Jeneen Interlandi how the piece came together, and she described an editorial push to capture the human cost of NIH cuts—then finding access through a Northwestern-based HIV prevention researcher, which naturally rooted the reporting in Chicago. ### The “temporary blip” illusion—and why that’s wrong (7:32) We dug into how grant reinstatements and court headlines can create false reassurance; even when money returns, the interrupted work, lost staff, and abandoned momentum create damage that doesn’t simply reverse. ### Why Trump 1.0 could sound pro-HIV while Trump 2.0 is different (9:02) We explored the idea that the earlier “end HIV by 2030” messaging reflected inattentiveness that allowed competent people to quietly build programs—whereas post-COVID politics made public health a target rather than an afterthought. ### Framing, DEI, and the category error people keep making (12:01) We argued that many skeptics will endorse “reduce HIV morbidity and mortality” in the abstract, but recoil when the work is described as studying marginalized communities—even though that work is often exactly what makes the first goal achievable. ### “DEI” vs “health equity”: two different things (14:03) We emphasized the distinction between diversifying scientific ranks and reducing health gaps—and noted how blunt “keyword” approaches (e.g., anything with “equity”) can gut legitimate public-health and implementation research. ### Dr. Jon Mannheim joins: safety-net reality and Medicaid dread (17:43) Dr. Jon Mannheim described the atmosphere inside a county hospital: leadership-to-frontline anxiety about Medicaid cuts, looming service loss, and the bottom-line question of who will become harder—or impossible—to treat. ### The meds exist; the system to deliver them is what’s being cut (19:16) We used PrEP and long-acting options as the example: breakthroughs don’t end epidemics by themselves—patients still need access, follow-up, transportation, phones, time off work, and clinics that can keep doors open. ### Stigma and behavior change: “best drug in the world” still fails without trust (22:12) We talked through how communities can resist PrEP for social and cultural reasons, and why behavioral and implementation science isn’t fluff—it’s the difference between a miracle drug on paper and prevention in the real world. ### Respect is self-interest: why dignity and language matter to disease control (25:42) We made the pragmatic case that humanizing people—down to basics like respectful interaction—can determine whether they engage with care, which ultimately affects everyone’s risk in a shared society. ### ICE as a public-health accelerant (27:31) Dr. Mannheim described fear-driven avoidance: patients skipping clinic because of ICE presence and targeting, with downstream consequences for TB and HIV—diseases that don’t stay contained within the communities being pressured. ### How fast “untreated” becomes “AIDS again” (29:30) We asked the practical timeline, and Dr. Mannheim explained it can range from months to years, with many patients getting into serious trouble around the one-year mark—highlighting why delayed harm is still real harm. ### Prevention isn’t just “cost-effective”—it’s often cost-saving (31:22) We walked through the plain-language economics: targeted prevention and delivery infrastructure can save money compared with ICU admissions for opportunistic infections—and research helps define who benefits most and how to reach them. ### Targeting hotspots works: “go where the virus is” principle (32:49) We discussed how concentrated HIV burden allows high-return investment—an approach aligned with classic infectious-disease strategy: focus resources where transmission is, not where it’s politically comfortable. ### The unglamorous MVPs: social workers, case managers, and the scaffolding of care (39:12) Dr. Mannheim made the point we kept returning to: clinicians aren’t the linchpin—support staff arranging rides, phones, outreach, food support, and continuity are what make prevention and treatment actually happen. ### “Solved problems” can become unsolved again (40:08) We highlighted perinatal HIV transmission and adolescent infections as fragile wins—dependent on systems that can be dismantled fast and rebuilt slowly, if at all. ### Brain drain: losing talent to industry and to other countries (44:17) We closed on the slow-motion catastrophe of expertise leaving government—and leaving the US—hollowing out the NIH/CDC ecosystem that made the country a global research magnet after World War II. ### Call to action (48:14) We told viewers the recording would be available on Inside Medicine with no paywall, thanked Jeneen Interlandi and Dr. Jon Mannheim, and framed the series mission plainly: we need more people to speak out now—or we’ll regret how quiet we were later. #### Discussion about this video Comments Restacks [![Inside Medicine](https://substackcdn.com/image/fetch/$s_!Nb96!,w_96,h_96,c_fill,f_auto,q_auto:good,fl_progressive:steep,g_auto/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fb05b82ff-b933-4c26-94a0-fdd1c55b4e12_1744x1744.png)](https://insidemedicine.substack.com/) Inside Medicine Podcast Merging what I'm seeing in the ER with rigorous deep-dives on the very latest medical and public health data. I want you to know what really matters. Merging what I'm seeing in the ER with rigorous deep-dives on the very latest medical and public health data. I want you to know what really matters. Listen on Substack App RSS Feed Appears in episode [![Jeremy Faust, MD's avatar](https://substackcdn.com/image/fetch/$s_!BvEC!,w_32,h_32,c_fill,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F70c01fb6-99e3-43dd-bfbf-79f0fe9c0d26_4500x4500.jpeg)](https://substack.com/@insidemedicine?utm_source=author-byline-face-podcast) [Jeremy Faust, MD](https://substack.com/@insidemedicine) Recent Episodes ![](https://substackcdn.com/image/fetch/$s_!RWzS!,w_150,h_150,c_fill,f_auto,q_auto:good,fl_progressive:steep,g_auto/https%3A%2F%2Fsubstack-video.s3.amazonaws.com%2Fvideo_upload%2Fpost%2F187799632%2F65e7b0cf-f61e-4c95-9bf9-8e8f88252852%2Ftranscoded-20515.png) [Pulmonary Embolisms: What to Know After the Death of Catherine O’Hara.](https://insidemedicine.substack.com/p/pulmonary-embolisms-what-to-know) Feb 13 • [Jeremy Faust, MD](https://substack.com/@insidemedicine) ![](https://substackcdn.com/image/fetch/$s_!6-KS!,w_150,h_150,c_fill,f_auto,q_auto:good,fl_progressive:steep,g_center/https%3A%2F%2Fsubstack-video.s3.amazonaws.com%2Fvideo_upload%2Fpost%2F185565286%2F6e679239-3526-4405-9933-7cb4fa101331%2Ftranscoded-1769204233.png) [The new US Dietary Guidelines. 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With Daskalakis, Rasmussen, and Faust](https://insidemedicine.substack.com/p/this-week-in-public-hell-with-daskalakis) Dec 20, 2025 • [Jeremy Faust, MD](https://substack.com/@insidemedicine) and [Dr. Angela Rasmussen](https://substack.com/@rasmussenretorts) ![](https://substackcdn.com/image/fetch/$s_!p1k_!,w_150,h_150,c_fill,f_auto,q_auto:good,fl_progressive:steep,g_auto/https%3A%2F%2Fsubstack-video.s3.amazonaws.com%2Fvideo_upload%2Fpost%2F179846720%2F24b28b4c-4aa4-4fe2-b1c2-89015f343c67%2Ftranscoded-289965.png) [Rovina’s Choice, a New Yorker Documentary humanizing the destruction of USAID. 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Readable Markdown	This is the first of a series I’m calling “Speaking Out.” The idea is to give even more prominence to people who are bravely using their voices to stand up for science, medicine, and the health of our nation. Closed captions (㏄) for the above video and a transcript option (📄) can be found beneath the video playback control bar above. Today, I was pleased to be joined by New York Times staff writer Jeneen Interlandi and pediatric infectious diseases specialist Dr. Jon Mannheim. We discussed Jeneen’s major [story](https://www.nytimes.com/2026/02/23/opinion/doge-hiv-funding.html), “The Trump Administration’s War on Science Has a Human Cost,” which ran this weekend and for which Jon was a quoted on-the-record source. The big thing: we need people to understand the human cost of the Trump administration’s attack on US science. That’s what made Jeneen’s piece so important. It’s also why we want to cheer Jon on for his willingness to speak out in this way. Below you’ll find some background followed by a summary of our conversation. Thank you for helping spread this important information\! [Share](https://insidemedicine.substack.com/p/pulmonary-embolisms-what-to-know?utm_source=substack&utm_medium=email&utm_content=share&action=share&token=eyJ1c2VyX2lkIjo5NTY4ODI3LCJwb3N0X2lkIjoxODc3OTk2MzIsImlhdCI6MTc3MjQ4NzI5MiwiZXhwIjoxNzc1MDc5MjkyLCJpc3MiOiJwdWItMTE4MzUyNiIsInN1YiI6InBvc3QtcmVhY3Rpb24ifQ.S0_V0GNx8wQvoib3gepm-LhMZAy1gdKYjIeVlJb7x2Q) > Background: Since President Trump took office, we’ve covered his administration’s sustained attack on science and public health. For people in the Inside Medicine community, it’s easy to understand that deep cuts at the NIH, CDC, and elsewhere are dangerous. We understand what the numbers mean. > > But what’s often missing from the coverage—here and in other outlets—is the perceptible human cost. That’s because some of the losses are not yet noticeable. In some instances, the destruction will never be obvious because we won’t see breakthroughs that failed to occur because funding was pulled. Moreover, the very people who might have delivered those breakthroughs have been intimidated into silence. Yes, we’ve been able to amplify important voices, but many remain afraid to speak out or don’t have the reach. For them, speaking out risks future funding because this administration has made no secret of its intentions. > > That’s what makes this session so important. > > Guests: New York Times staff writer Jeneen Interlandi has written a superb piece that, in my view, begins to address this gap. The [piece](https://www.nytimes.com/2026/02/23/opinion/doge-hiv-funding.html), “The Trump Administration’s War on Science Has a Human Cost,” ran in Sunday’s print edition of the New York Times.[1](https://insidemedicine.substack.com/p/speaking-out-the-new-york-times-jeneen#footnote-1-189557062) > > Few mainstream media pieces have gone this deeply into explaining both the science and the scientists under attack. I’m looking forward to discussing it with the author and a prominent source in the piece, Dr. Jon Mannheim, a pediatrician specializing in HIV. Aided by ChatGPT. We opened by explaining that Inside Medicine has tracked the Trump administration’s assault on science and public health, but that numbers alone don’t translate for many people—and that we need first-person stories from the scientists and clinicians living the consequences. We laid out the “double-edged sword”: public accountability requires people to talk, but researchers and public servants worry that speaking out will cost them grants, jobs, or future opportunities—so the harm stays abstract. We asked Jeneen Interlandi how the piece came together, and she described an editorial push to capture the human cost of NIH cuts—then finding access through a Northwestern-based HIV prevention researcher, which naturally rooted the reporting in Chicago. We dug into how grant reinstatements and court headlines can create false reassurance; even when money returns, the interrupted work, lost staff, and abandoned momentum create damage that doesn’t simply reverse. We explored the idea that the earlier “end HIV by 2030” messaging reflected inattentiveness that allowed competent people to quietly build programs—whereas post-COVID politics made public health a target rather than an afterthought. We argued that many skeptics will endorse “reduce HIV morbidity and mortality” in the abstract, but recoil when the work is described as studying marginalized communities—even though that work is often exactly what makes the first goal achievable. We emphasized the distinction between diversifying scientific ranks and reducing health gaps—and noted how blunt “keyword” approaches (e.g., anything with “equity”) can gut legitimate public-health and implementation research. Dr. Jon Mannheim described the atmosphere inside a county hospital: leadership-to-frontline anxiety about Medicaid cuts, looming service loss, and the bottom-line question of who will become harder—or impossible—to treat. We used PrEP and long-acting options as the example: breakthroughs don’t end epidemics by themselves—patients still need access, follow-up, transportation, phones, time off work, and clinics that can keep doors open. We talked through how communities can resist PrEP for social and cultural reasons, and why behavioral and implementation science isn’t fluff—it’s the difference between a miracle drug on paper and prevention in the real world. We made the pragmatic case that humanizing people—down to basics like respectful interaction—can determine whether they engage with care, which ultimately affects everyone’s risk in a shared society. Dr. Mannheim described fear-driven avoidance: patients skipping clinic because of ICE presence and targeting, with downstream consequences for TB and HIV—diseases that don’t stay contained within the communities being pressured. We asked the practical timeline, and Dr. Mannheim explained it can range from months to years, with many patients getting into serious trouble around the one-year mark—highlighting why delayed harm is still real harm. We walked through the plain-language economics: targeted prevention and delivery infrastructure can save money compared with ICU admissions for opportunistic infections—and research helps define who benefits most and how to reach them. We discussed how concentrated HIV burden allows high-return investment—an approach aligned with classic infectious-disease strategy: focus resources where transmission is, not where it’s politically comfortable. Dr. Mannheim made the point we kept returning to: clinicians aren’t the linchpin—support staff arranging rides, phones, outreach, food support, and continuity are what make prevention and treatment actually happen. We highlighted perinatal HIV transmission and adolescent infections as fragile wins—dependent on systems that can be dismantled fast and rebuilt slowly, if at all. We closed on the slow-motion catastrophe of expertise leaving government—and leaving the US—hollowing out the NIH/CDC ecosystem that made the country a global research magnet after World War II. We told viewers the recording would be available on Inside Medicine with no paywall, thanked Jeneen Interlandi and Dr. Jon Mannheim, and framed the series mission plainly: we need more people to speak out now—or we’ll regret how quiet we were later.
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