The Lost Art Of Medicine: What Maimonides Knew That We Forgot – OpEd
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Posthumous engraving in Thesaurus Antiquitatum Sacrarum, from which all modern portraits of Maimonides are derived, c. 1744. Credit: Wikipedia Commons
April 7, 2026
By Joseph Varon
Contemporary medicine is not failing for lack of knowledge. It is failing under the weight of its own complexity. The present era is defined by unprecedented access to data, advanced technologies, an ever-expanding network of subspecialties, and a dense architecture of protocols and performance metrics. Nearly every aspect of patient care can now be measured, quantified, and standardized. Interventions that were unimaginable only decades ago are now routine. Yet despite these advances, a fundamental element has been eroded. This erosion is philosophical.
Medicine has accumulated extraordinary capability, but it has lost clarity of purpose. Increasingly, it functions as a system optimized for processes rather than a profession oriented toward patients. The distinction is subtle but consequential. Without a clear understanding of its purpose, medicine risks becoming an efficient mechanism that delivers care without understanding the individual it serves.
In the 12th century, Maimonides (Rabbi Moses ben Maimon [1135–1204], known as the Rambam), one of history’s most influential physician-philosophers and a court physician in Egypt, practiced medicine in an era devoid of modern diagnostics, randomized trials, or institutional oversight. Trained within the intellectual traditions of Andalusian and Islamic medicine, and deeply influenced by Greek philosophy, he integrated empirical observation with rigorous reasoning and ethical responsibility. Although he lacked contemporary tools, he possessed something far more important: clarity. In Regimen of Health, he asserted that the physician’s foremost responsibility is to preserve health rather than simply treat disease¹. This principle stands in sharp contrast to the modern system, which frequently prioritizes intervention over prevention.
The Physician As Intellectual Practitioner Rather Than Technician
Maimonides regarded medicine as an intellectual discipline rooted in observation, reasoning, and adaptation. His clinical writings consistently emphasize individualized care guided by physician judgment, rather than strict adherence to generalized rules². In his model, the physician was not merely a technician following predefined steps, but a thinker adept at navigating uncertainty.
Modern medicine increasingly emphasizes compliance. Clinical guidelines and protocols, though valuable, have expanded to the extent that they often define practice rather than merely inform it. Evidence-based medicine, initially conceived as the integration of clinical expertise with the best available evidence, is now frequently implemented as strict guideline adherence³.
When adherence is used as the primary metric of quality, deviation is perceived as risk. However, no patient precisely matches the populations studied in clinical trials. Maimonides recognized this implicitly, treating individuals rather than statistical abstractions. This distinction is not merely philosophical; it has practical consequences at the bedside. A physician trained to follow protocols may deliver technically correct care, yet fail to recognize when a patient falls outside expected patterns.
In contrast, a physician trained to think can identify nuance, adapt in real time, and challenge assumptions when necessary. Maimonides’ model required intellectual engagement with every patient encounter. Modern systems, in their effort to standardize care, risk reducing that engagement. The result is not necessarily incorrect medicine, but it is often incomplete medicine.
Prevention As the Core Principle of Medical Care
Maimonides positioned prevention as the central tenet of medicine. His recommendations regarding diet, exercise, sleep, and emotional balance reflect a systematic understanding of health maintenance as the physician’s principal responsibility¹. In his framework, disease frequently resulted from an imbalance.
Modern medicine recognizes the significance of prevention but, structurally, incentivizes intervention. Chronic disease management is predominantly pharmacological, while upstream determinants receive comparatively less systematic attention. This dynamic reflects systemic incentives rather than a lack of scientific understanding. Frieden has argued that effective clinical decision-making must extend beyond randomized trials to incorporate broader determinants of health⁶. Maimonides’ framework anticipated this perspective centuries earlier.
This imbalance becomes particularly evident in the management of chronic disease, where treatment pathways are well defined, but prevention strategies remain inconsistently applied. The modern patient often enters the healthcare system after the disease has already progressed, at which point interventions are more complex, more costly, and less effective. Maimonides’ emphasis on daily habits (i.e, nutrition, movement, and moderation), reflects an understanding that health is constructed over time rather than restored episodically. This temporal dimension of medicine is frequently underappreciated in contemporary care models.
The Integration of Psychological and Physical Health
Maimonides recognized that emotional and physical health are inseparable. He described the influence of psychological states on bodily function and emphasized that effective treatment must address both².
Unfortunately, modern healthcare often fragments this unity. Psychiatry, internal medicine, and behavioral health typically function in parallel rather than in an integrated fashion. Consequently, the patient is divided across multiple systems. Epstein and Street have shown that patient-centered care requires understanding the full context of the patient’s experience¹². Maimonides’ approach inherently embodied this principle.
The fragmentation of care also alters the physician’s perception of responsibility. When different aspects of the patient are managed by separate systems, accountability becomes diffuse. No single clinician is responsible for integrating the whole. Maimonides’ approach avoided this fragmentation by necessity. His model implicitly required the physician to synthesize physical, emotional, and environmental factors into a unified understanding of the patient. This integrative responsibility is increasingly difficult to sustain in modern practice.
Ethical Practice Amidst Systemic Pressures
For Maimonides, medicine was inherently ethical. The physician’s duty was unequivocal: to act in the patient’s best interest. Modern physicians operate within a framework shaped by administrative, financial, and legal pressures. Relman described the emergence of the “medical-industrial complex,” in which economic forces influence care delivery¹⁰.
The consequences of these systemic pressures are evident in the prevalence of physician burnout. Shanafelt and Noseworthy have associated this phenomenon with systemic pressures that undermine professional fulfillment⁹. This is more accurately described as moral injury: the inability to consistently act in accordance with ethical obligations.
This shift has implications beyond physician well-being. It affects trust. Patients may not fully perceive the structural constraints under which physicians operate, but they often sense when care is mediated by systems rather than guided by judgment. The erosion of trust in medical institutions may, in part, reflect this disconnect. Maimonides’ framework, centered on a direct ethical obligation between physician and patient, preserved that trust by design.
The Interplay of Knowledge, Authority, and Uncertainty
Maimonides engaged rigorously with intellectual authority but did not defer to it. He critically evaluated prevailing knowledge and underscored the provisional nature of understanding.
Despite its scientific foundation, modern medicine can gravitate toward authority-driven practice. Guidelines and consensus statements may become rigid beyond their evidentiary basis. Djulbegovic and Guyatt highlight the persistent tension between standardized evidence and individualized care³. Excessive certainty can constrain inquiry.
Individualized Care Versus Population-Based Approaches
Population-based data are essential, yet inherently limited. The concept of the “average patient” remains an abstraction. Maimonides treated individuals. His clinical reasoning was adapted to the specific patient rather than conforming the patient to a model.
Montori and colleagues have emphasized that optimal care requires integrating evidence with individual context and values¹⁵. This principle aligns directly with Maimonides’ approach. Yet, few modern healthcare providers apply it.
Technological Advancement in the Absence of Guiding Principles
Modern medicine’s technological capacity is without precedent. However, technology is not inherently beneficial; its value reflects the priorities of the system in which it is employed.
Topol has argued that technological innovation may restore the human dimension of medicine⁸. Nevertheless, electronic medical records frequently divert attention from the patient to documentation. Verghese describes a system in which the patient becomes secondary to their digital representation¹⁴. As a result, the clinical encounter risks subordination to its documentation. Maimonides practiced medicine without technological aids, yet maintained a profound presence.
Technology, when aligned with clinical reasoning, enhances care. When it replaces reasoning, it constrains it. The distinction lies not in the tool itself but in its role within the clinical encounter. Maimonides’ practice demonstrates that the absence of technology does not preclude effective medicine, while modern experience suggests that the presence of technology does not guarantee it. The challenge is not to limit technological advancement, but to ensure that it remains subordinate to clinical judgment.
Essential Elements Lost and the Need for Recovery
Cassell emphasized that medicine must address suffering, not merely disease¹¹. This aligns closely with Maimonides’ framework. Starfield distinguishes between patient-centered and person-focused care, noting that true care must address the individual beyond disease labels¹³. Maimonides practiced this inherently.
What has been lost is not knowledge itself. Rather, it is coherence.
Conclusions
Maimonides represents not a historical curiosity but a standard we have yet to reclaim. His medicine was grounded in principle: prevention over intervention, judgment over compliance, the individual over the average, ethics over expediency.
Modern medicine possesses extraordinary tools. But without a guiding philosophy, those tools risk being applied without direction.
The future of medicine will not be determined by how much more we can do.
It will be determined by whether we remember why we do it. Because a system that measures everything, standardizes everything, and controls everything, yet fails to understand the patient in front of it, is not advanced. It is incomplete. And if left uncorrected, it risks becoming something far more dangerous than outdated medicine:
It becomes medicine that no longer knows what it is.
References
Maimonides M. Treatise on Asthma. In: Rosner F, editor. The Medical Writings of Moses Maimonides. New York: Ktav Publishing; 1971.
Djulbegovic B, Guyatt GH. Progress in evidence-based medicine: a quarter century on. Lancet. 2017;390:415–423.
Rosner F. The Medical Legacy of Moses Maimonides. Hoboken: KTAV Publishing; 1998.
Rosner F. Maimonides as a physician. JAMA. 1965;194(9):1011–1014.
Frieden TR. Evidence for health decision making—beyond randomized, controlled trials. N Engl J Med. 2017;377:465–475.
Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence-based medicine: what it is and what it isn’t. BMJ. 1996;312:71–72.
Topol EJ. Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again. New York: Basic Books; 2019.
Shanafelt TD, Noseworthy JH. Executive leadership and physician well-being. Mayo Clin Proc. 2017;92(1):129–146.
Relman AS. The new medical-industrial complex. N Engl J Med. 1980;303:963–970.
Cassell EJ. The nature of suffering and the goals of medicine. N Engl J Med. 1982;306:639–645.
Epstein RM, Street RL. The values and value of patient-centered care. Ann Fam Med. 2011;9(2):100–103.
Starfield B. Is patient-centered care the same as person-focused care? Perm J. 2011;15(2):63–69.
Verghese A. Culture shock—patient as icon, icon as patient. N Engl J Med. 2008;359:2748–2751.
Montori VM, Brito JP, Murad MH. The optimal practice of evidence-based medicine. JAMA. 2013;310(23):2503–2504.
Joseph Varon
Joseph Varon, MD, is a critical care physician, professor, and President of the Independent Medical Alliance. He has authored over 980 peer-reviewed publications and serves as Editor-in-Chief of the Journal of Independent Medicine.
.jpg)
Posthumous engraving in Thesaurus Antiquitatum Sacrarum, from which all modern portraits of Maimonides are derived, c. 1744. Credit: Wikipedia Commons
April 7, 2026
By Joseph Varon
Contemporary medicine is not failing for lack of knowledge. It is failing under the weight of its own complexity. The present era is defined by unprecedented access to data, advanced technologies, an ever-expanding network of subspecialties, and a dense architecture of protocols and performance metrics. Nearly every aspect of patient care can now be measured, quantified, and standardized. Interventions that were unimaginable only decades ago are now routine. Yet despite these advances, a fundamental element has been eroded. This erosion is philosophical.
Medicine has accumulated extraordinary capability, but it has lost clarity of purpose. Increasingly, it functions as a system optimized for processes rather than a profession oriented toward patients. The distinction is subtle but consequential. Without a clear understanding of its purpose, medicine risks becoming an efficient mechanism that delivers care without understanding the individual it serves.
In the 12th century, Maimonides (Rabbi Moses ben Maimon [1135–1204], known as the Rambam), one of history’s most influential physician-philosophers and a court physician in Egypt, practiced medicine in an era devoid of modern diagnostics, randomized trials, or institutional oversight. Trained within the intellectual traditions of Andalusian and Islamic medicine, and deeply influenced by Greek philosophy, he integrated empirical observation with rigorous reasoning and ethical responsibility. Although he lacked contemporary tools, he possessed something far more important: clarity. In Regimen of Health, he asserted that the physician’s foremost responsibility is to preserve health rather than simply treat disease¹. This principle stands in sharp contrast to the modern system, which frequently prioritizes intervention over prevention.
The Physician As Intellectual Practitioner Rather Than Technician
Maimonides regarded medicine as an intellectual discipline rooted in observation, reasoning, and adaptation. His clinical writings consistently emphasize individualized care guided by physician judgment, rather than strict adherence to generalized rules². In his model, the physician was not merely a technician following predefined steps, but a thinker adept at navigating uncertainty.
Modern medicine increasingly emphasizes compliance. Clinical guidelines and protocols, though valuable, have expanded to the extent that they often define practice rather than merely inform it. Evidence-based medicine, initially conceived as the integration of clinical expertise with the best available evidence, is now frequently implemented as strict guideline adherence³.
When adherence is used as the primary metric of quality, deviation is perceived as risk. However, no patient precisely matches the populations studied in clinical trials. Maimonides recognized this implicitly, treating individuals rather than statistical abstractions. This distinction is not merely philosophical; it has practical consequences at the bedside. A physician trained to follow protocols may deliver technically correct care, yet fail to recognize when a patient falls outside expected patterns.
In contrast, a physician trained to think can identify nuance, adapt in real time, and challenge assumptions when necessary. Maimonides’ model required intellectual engagement with every patient encounter. Modern systems, in their effort to standardize care, risk reducing that engagement. The result is not necessarily incorrect medicine, but it is often incomplete medicine.
Prevention As the Core Principle of Medical Care
Maimonides positioned prevention as the central tenet of medicine. His recommendations regarding diet, exercise, sleep, and emotional balance reflect a systematic understanding of health maintenance as the physician’s principal responsibility¹. In his framework, disease frequently resulted from an imbalance.
Modern medicine recognizes the significance of prevention but, structurally, incentivizes intervention. Chronic disease management is predominantly pharmacological, while upstream determinants receive comparatively less systematic attention. This dynamic reflects systemic incentives rather than a lack of scientific understanding. Frieden has argued that effective clinical decision-making must extend beyond randomized trials to incorporate broader determinants of health⁶. Maimonides’ framework anticipated this perspective centuries earlier.
This imbalance becomes particularly evident in the management of chronic disease, where treatment pathways are well defined, but prevention strategies remain inconsistently applied. The modern patient often enters the healthcare system after the disease has already progressed, at which point interventions are more complex, more costly, and less effective. Maimonides’ emphasis on daily habits (i.e, nutrition, movement, and moderation), reflects an understanding that health is constructed over time rather than restored episodically. This temporal dimension of medicine is frequently underappreciated in contemporary care models.
The Integration of Psychological and Physical Health
Maimonides recognized that emotional and physical health are inseparable. He described the influence of psychological states on bodily function and emphasized that effective treatment must address both².
Unfortunately, modern healthcare often fragments this unity. Psychiatry, internal medicine, and behavioral health typically function in parallel rather than in an integrated fashion. Consequently, the patient is divided across multiple systems. Epstein and Street have shown that patient-centered care requires understanding the full context of the patient’s experience¹². Maimonides’ approach inherently embodied this principle.
The fragmentation of care also alters the physician’s perception of responsibility. When different aspects of the patient are managed by separate systems, accountability becomes diffuse. No single clinician is responsible for integrating the whole. Maimonides’ approach avoided this fragmentation by necessity. His model implicitly required the physician to synthesize physical, emotional, and environmental factors into a unified understanding of the patient. This integrative responsibility is increasingly difficult to sustain in modern practice.
Ethical Practice Amidst Systemic Pressures
For Maimonides, medicine was inherently ethical. The physician’s duty was unequivocal: to act in the patient’s best interest. Modern physicians operate within a framework shaped by administrative, financial, and legal pressures. Relman described the emergence of the “medical-industrial complex,” in which economic forces influence care delivery¹⁰.
The consequences of these systemic pressures are evident in the prevalence of physician burnout. Shanafelt and Noseworthy have associated this phenomenon with systemic pressures that undermine professional fulfillment⁹. This is more accurately described as moral injury: the inability to consistently act in accordance with ethical obligations.
This shift has implications beyond physician well-being. It affects trust. Patients may not fully perceive the structural constraints under which physicians operate, but they often sense when care is mediated by systems rather than guided by judgment. The erosion of trust in medical institutions may, in part, reflect this disconnect. Maimonides’ framework, centered on a direct ethical obligation between physician and patient, preserved that trust by design.
The Interplay of Knowledge, Authority, and Uncertainty
Maimonides engaged rigorously with intellectual authority but did not defer to it. He critically evaluated prevailing knowledge and underscored the provisional nature of understanding.
Despite its scientific foundation, modern medicine can gravitate toward authority-driven practice. Guidelines and consensus statements may become rigid beyond their evidentiary basis. Djulbegovic and Guyatt highlight the persistent tension between standardized evidence and individualized care³. Excessive certainty can constrain inquiry.
Individualized Care Versus Population-Based Approaches
Population-based data are essential, yet inherently limited. The concept of the “average patient” remains an abstraction. Maimonides treated individuals. His clinical reasoning was adapted to the specific patient rather than conforming the patient to a model.
Montori and colleagues have emphasized that optimal care requires integrating evidence with individual context and values¹⁵. This principle aligns directly with Maimonides’ approach. Yet, few modern healthcare providers apply it.
Technological Advancement in the Absence of Guiding Principles
Modern medicine’s technological capacity is without precedent. However, technology is not inherently beneficial; its value reflects the priorities of the system in which it is employed.
Topol has argued that technological innovation may restore the human dimension of medicine⁸. Nevertheless, electronic medical records frequently divert attention from the patient to documentation. Verghese describes a system in which the patient becomes secondary to their digital representation¹⁴. As a result, the clinical encounter risks subordination to its documentation. Maimonides practiced medicine without technological aids, yet maintained a profound presence.
Technology, when aligned with clinical reasoning, enhances care. When it replaces reasoning, it constrains it. The distinction lies not in the tool itself but in its role within the clinical encounter. Maimonides’ practice demonstrates that the absence of technology does not preclude effective medicine, while modern experience suggests that the presence of technology does not guarantee it. The challenge is not to limit technological advancement, but to ensure that it remains subordinate to clinical judgment.
Essential Elements Lost and the Need for Recovery
Cassell emphasized that medicine must address suffering, not merely disease¹¹. This aligns closely with Maimonides’ framework. Starfield distinguishes between patient-centered and person-focused care, noting that true care must address the individual beyond disease labels¹³. Maimonides practiced this inherently.
What has been lost is not knowledge itself. Rather, it is coherence.
Conclusions
Maimonides represents not a historical curiosity but a standard we have yet to reclaim. His medicine was grounded in principle: prevention over intervention, judgment over compliance, the individual over the average, ethics over expediency.
Modern medicine possesses extraordinary tools. But without a guiding philosophy, those tools risk being applied without direction.
The future of medicine will not be determined by how much more we can do.
It will be determined by whether we remember why we do it. Because a system that measures everything, standardizes everything, and controls everything, yet fails to understand the patient in front of it, is not advanced. It is incomplete. And if left uncorrected, it risks becoming something far more dangerous than outdated medicine:
It becomes medicine that no longer knows what it is.
References
Maimonides M. Regimen of Health. Translated by Bar-Sela A, Hoff HE, Faris E. Philadelphia: American Philosophical Society; 1964.
Maimonides M. Treatise on Asthma. In: Rosner F, editor. The Medical Writings of Moses Maimonides. New York: Ktav Publishing; 1971.
Djulbegovic B, Guyatt GH. Progress in evidence-based medicine: a quarter century on. Lancet. 2017;390:415–423.
Rosner F. The Medical Legacy of Moses Maimonides. Hoboken: KTAV Publishing; 1998.
Rosner F. Maimonides as a physician. JAMA. 1965;194(9):1011–1014.
Frieden TR. Evidence for health decision making—beyond randomized, controlled trials. N Engl J Med. 2017;377:465–475.
Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence-based medicine: what it is and what it isn’t. BMJ. 1996;312:71–72.
Topol EJ. Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again. New York: Basic Books; 2019.
Shanafelt TD, Noseworthy JH. Executive leadership and physician well-being. Mayo Clin Proc. 2017;92(1):129–146.
Relman AS. The new medical-industrial complex. N Engl J Med. 1980;303:963–970.
Cassell EJ. The nature of suffering and the goals of medicine. N Engl J Med. 1982;306:639–645.
Epstein RM, Street RL. The values and value of patient-centered care. Ann Fam Med. 2011;9(2):100–103.
Starfield B. Is patient-centered care the same as person-focused care? Perm J. 2011;15(2):63–69.
Verghese A. Culture shock—patient as icon, icon as patient. N Engl J Med. 2008;359:2748–2751.
Montori VM, Brito JP, Murad MH. The optimal practice of evidence-based medicine. JAMA. 2013;310(23):2503–2504.
Joseph Varon
Joseph Varon, MD, is a critical care physician, professor, and President of the Independent Medical Alliance. He has authored over 980 peer-reviewed publications and serves as Editor-in-Chief of the Journal of Independent Medicine.
Photo Credit: Ajay Kumar Singh from Pixabay.
April 7, 2026
Observer Research Foundation
By Lakshmy Ramakrishnan
Since 2018, India has faced periodic outbreaks of the deadly Nipah virus (NiV), most recently in West Bengal in February this year. Marked as a priority pathogen by the World Health Organization (WHO), NiV serves as a critical example of the One Health approach, which emphasises interconnectedness of human, animal, and environmental health in addressing global health and disease. With no licensed vaccines or therapeutics available, advances in mRNA vaccine research offer an encouraging pathway for response, including efforts led by the Coalition for Epidemic Preparedness and Innovations (CEPI) and India’s Gennova Biopharmaceuticals Limited to develop an mRNA vaccine candidate. However, scientific progress alone is insufficient. As the WHO marks this year’s World Health Day under the theme, “Together for Health. Stand with Science”, it serves as an opportunity to recognise that the challenge involves not only developing medical countermeasures, but also ensuring that societies are willing to trust science and accept its applications.
Misinformation Economy
Vaccine hesitancy, a major threat to global health, has been exacerbated by a rapidly evolving information economy. Misinformation casts doubt on the safety and efficacy of vaccines and thrives in an ecosystem where social media amplifies both factual and false information. During the COVID-19 pandemic, the WHO labelled the information overload as an infodemic. Research from the Massachusetts Institute of Technology (MIT) found that false information travels faster than factual content on social media, particularly when it evokes strong emotional responses such as fear. Repeated exposure to misinformation from a credible authority can reinforce belief in it and facilitate its spread.
Post-truth Dynamics
Anti-vaccine narratives utilise this ecosystem by applying conspiracy theories, misrepresenting studies through cherry-picking, and amplifying voices that discredit evidence-based science. False information influences public opinion, creating fear over vaccine safety. For instance, claims that Covid-19 mRNA vaccines cause ‘turbo cancers’—aggressive forms of cancer—gained significant traction online, despite having no scientific basis. In a post-truth world, where objective facts are increasingly found to be less influential in shaping public opinion than methods that appeal to emotion and personal belief, doubt and confusion are created. This leads to erosion of collective decision-making abilities, a decline in trust in science, and the widespread social acceptance of misinformation.
Its impact is evident in the resurgence of vaccine-preventable diseases across the world. Ongoing measles outbreaks in the United States (US), the United Kingdom (UK), and European countries demonstrate how declining vaccine uptake can rapidly cause outbreaks and contribute to shrinking herd immunity. This is concerning as it raises the possibility of a surge in severe measles infections, which has alarmed the medical community. A complication from measles—subacute sclerosing panencephalitis (SSPE)—which typically appears a year after infection, can lead to disability, paralysis and often fatality. This trend highlights how misinformation can directly transform into debilitating public health threats.
Politics of Health
Vaccine hesitancy is further complicated by the politicisation of science. It involves overemphasis on the inherent uncertainty of science to undermine existing scientific consensus. In the US, during the COVID-19 pandemic, vaccines were associated with political identity. Attitudes towards vaccine acceptance ranged from outright refusal to hesitation, to immediate vaccine uptake, with partisanship acting as a critical determinant. Studies suggest that political affiliation influenced susceptibility to misinformation and responsiveness to pro-vaccination campaigns. In this manner, politicisation can reinforce the acceptance and spread of misinformation.
This dynamic is now evident in the US childhood immunisation schedule. Recent attempts to alter the schedule—including shifting vaccines for rotavirus, meningitis, and hepatitis A and B from ‘routine administration’ to ‘shared clinical decision-making’, in which a patient or parent and clinician discuss the risks and benefits of vaccination—represent a significant policy change. Without a robust scientific rationale or review, it risks increasing childhood infections and hospitalisations. Although these attempts have been blocked by a federal judge, these shifts indicate how such policies can destabilise trust in science. Further, this discourse may potentially impact the course of scientific innovation.
Future of Innovation
The course of mRNA vaccine technology provides a notable illustration of the tension between scientific progress and public trust. In August 2025, the United States Department of Health and Human Services (HHS) abruptly terminated funds dedicated to mRNA vaccine research, including the cancellation of 22 contracts granted by the Biomedical Advanced Research and Development Authority (BARDA) valued at US$ 500 million. These cuts are likely to result in severe health and economic consequences, given that mRNA vaccines are estimated to prevent US$ 75 billion in economic costs each year. In addition to pandemic preparedness, mRNA platforms hold transformative potential for treating diseases such as cancer, making investment crucial.
This decision has been justified by concerns about vaccine effectiveness and safety, although the studiesused to support these claims focus heavily on in vitro studies, which do not adequately reflect clinical outcomes. Concomitantly, claims linking the sudden death of young healthy adults and mRNA-based COVID-19 vaccines have circulated widely, prompting further scientific scrutiny. Existing studies do not establish COVID vaccines as a causative factor. Studies have identified rare occurrences of myocarditis (inflammation of the heart) following vaccination; however, evidence suggests that these risks are higher following COVID-19 infection. Further, vaccine-induced inflammation is not unique to mRNA vaccine platforms but may occur with less public attention and scrutiny.
These concerns now extend to regulatory agencies. Moderna’s mRNA-based flu vaccine (m1010) recently came under the limelight when the US Food and Drug Administration (FDA) initially declined to review its application. Though the FDA has since agreed to proceed, with a decision expected in August this year, Moderna indicated that it will wait for this outcome before proceeding with its combined flu-COVID-19 vaccine (m1083), which has already been approved by the European Medicines Agency (EMA). These developments, along with speculation around future funding for mRNA vaccine research, have created uncertainty around the vaccine innovation ecosystem and its impact on health.
Rebuilding Trust in Science
The WHO’s Strategic Advisory Group of Experts (SAGE) is tasked with ensuring that vaccination policies are grounded in evidence-based decision-making. However, translating these measures into effective public health outcomes requires a pragmatic approach that enables meaningful public engagement with science. Addressing vaccine misinformation requires a shift towards scientific empowerment rooted in sustained trust-building. This includes clear science communication that counters false claims with accurate, evidence-based information. Pre-bunking—warnings issued before exposure to misinformation—can help reduce its impact. Misinformation can be debunked through multiple strategies, including myth–fact corrections, fact-only messaging, or ‘sandwiching’ myths between facts. While some studies suggest that corrective messaging may occasionally backfire, the notion that truth cannot catch up with ‘flying falsehoods’ reflects a resigned stance that is ultimately counterproductive to public health communication.
Strengthening science literacy through formal and informal education can help individuals better understand the benefits of science and enhance their decision-making. Integrating scientific expertise into policymaking must be reinforced through evidence-based measures. Engagement should include both scientific experts and non-scientific voices to bridge gaps in understanding and to reduce feelings of alienation. Community outreach activities should include trustworthy communicators to ensure credibility and relevance. Collectively, these approaches tackle the misinformation ecosystem head-on to cultivate a more informed public and strengthen trust in science.
Conclusion
Addressing vaccine hesitancy is not only a scientific endeavour but also a political and social one. Emerging global threats such as the Nipah virus (NiV) underscore that medical countermeasures alone are insufficient; success depends equally on public trust. In a post-truth world, where social media amplifies both factual and false information, building confidence in science requires sustained commitments to communication, education, and inclusive engagement. The year’s World Health Day theme, “Together for Health. Stand with Science”, emphasises the need to build collective trust and acceptance of medical technologies to ensure societies are not vulnerable to both existing and emerging health threats.
About the author: Lakshmy Ramakrishnan is an Associate Fellow with the Centre for New Economic Diplomacy at the Observer Research Foundation.
Source: This article was published by the Observer Research Foundation.
ORF was established on 5 September 1990 as a private, not for profit, ’think tank’ to influence public policy formulation. The Foundation brought together, for the first time, leading Indian economists and policymakers to present An Agenda for Economic Reforms in India. The idea was to help develop a consensus in favour of economic reforms.
ORF was established on 5 September 1990 as a private, not for profit, ’think tank’ to influence public policy formulation. The Foundation brought together, for the first time, leading Indian economists and policymakers to present An Agenda for Economic Reforms in India. The idea was to help develop a consensus in favour of economic reforms.
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