Days into his presidency, Donald Trump's Administration has already said and done enough to warrant concern for the state of free speech, as when his Press Secretary, Sean Spicer, went out to make demonstrably false claims about the crowd size at his inauguration. Between Trump's election and the inauguration, there were calls for scientists working with the US Government to begin backing up their data so it could not be manipulated, misused, or deleted. What might have seemed like undue paranoia is proving to be prescient advice.

Unlike politics, science depends on facts not just for its legitimacy, but for it to function. Without a rigorous investigation into facts that everyone can access and dispute, we are left with what White House Counselor Kellyanne Conway called “alternative facts”: truth not as a bedrock, but as one of many alternative perspectives to be held and abandoned as needs warrant, a mere debater's tool. In a Perspective in this issue, Michael Marmot explores science's role in accountability in a post-truth world. Noting that scientists are among the most trusted people in public life, Marmot writes, “We are trusted and are potentially a powerful antidote to the purveyors of falsehood and bullshit.” Trump speaks with a loud voice, and seems willing to say anything necessary in the moment, but according to polls, he remains the least popular man to ascend to the presidency in the modern era.

Those who hold science and truth to be foundational aspects of civilisation need to stand firm in our efforts to hold Trump accountable to the truth he seems to so publically disdain with his actions. One such troubling act is the reinstatement of the so-called global gag rule, touted as an “anti-abortion” and “pro-life” policy that instead will likely increase the number of abortions done globally and leave more women dead. Seemingly impervious to facts, Trump's policy is clearly antithetical to the concept of free speech, with potentially devastating global implications. History has now wrapped Trump in the mantle of authority, but we must witness and hold him to account for the consequences of his actions.

United States of Health hub see For The Lancet'ssee http://www.thelancet.com/us-health

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Article Info Publication History Identification DOI: https://doi.org/10.1016/S0140-6736(17)30265-9 Copyright © 2017 Elsevier Ltd. All rights reserved. ScienceDirect Access this article on ScienceDirect

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