Malcolm X, Noam Chomsky, Sexual Predator Associations and Legacy Twists

Bruce E. Levine

 April 10, 2026

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Elijah Muhammad standing behind microphones at podium / World Telegram & Sun photo by Stanley Wolfson.

“An extraordinary and twisted man, turning many true gifts to evil purpose. . . . Malcolm X had the ingredients for leadership, but his ruthless and fanatical belief in violence . . . set him apart from the responsible leaders of the civil rights movement and the overwhelming majority of Negroes.”

—New York Times, February 22, 1965 (one day after Malcolm X’s assassination)

“Malcolm X had been a pimp, a cocaine addict and a thief. He was an unashamed demagogue. His gospel was hatred.

—Time, March 5, 1965

“I can assure you he [Noam Chomsky] is not as passive or gullible as his wife claims. He knew about Epstein’s abuse of children. They all knew. And like others in the Epstein orbit, he did not care. . . . His association with Epstein is a terrible and, to many, unforgivable stain. It irreparably tarnishes his legacy.”

— Chris Hedges, “Noam Chomsky, Jeffrey Epstein and the Politics of Betrayal,” February 8, 2026

Malcolm X was far more deeply involved with a sexual predator—his superior, Elijah Muhammad, leader of the Nation of Islam (NOI)—than Noam Chomsky was involved with Jeffrey Epstein. However, Malcolm X’s association with Muhammad has had virtually no effect on Malcolm’s legacy, which has skyrocketed among the general public since his death.

In “This American Life: The Making and Remaking of Malcolm X” (New Yorker, 2011), David Remnick writes, “In 1992, Spike Lee set off a bout of ‘Malcolmania,’ with his three-hour-plus film. In its wake, people as unlikely as Dan Quayle talked sympathetically about Malcolm. . . . Bill Clinton wore an ‘X’ cap.” In 1999, 34 years after Malcolm X’s 1965 assassination (which at the time was applauded by most of U.S. society), the U.S. post office issued a Malcolm X stamp. This elevation, for labor and socialist activist Ike Naheem (“To the Memory of Malcolm X: Fifty Years After His Assassination,” 2015), has unfortunately come at the expense of Malcolm X being: “transformed by ‘mainstream’ forces into a harmless icon, with his sharp revolutionary anti-imperialist and anti-capitalist political program diluted and softened,” which for Naheem, “is a travesty of the actual Malcolm X and his actual political and moral trajectory.”

What about Malcolm X’s deep association with Elijah Muhammad? Malcolm X’s biographer, Manning Marable, concludes Malcolm should have known that Muhammad was a sexual predator well before Malcolm publicly acknowledged it, however, he stayed in denial because of powerful psychological forces. Marable was a great admirer of Malcolm, but his love for him does not prevent Marable from being highly critical of Malcolm’s flaws and blind spots:

“Yet the central irony of Malcolm’s career was that his critical powers of observation, so important in fashioning his dynamic public addresses, virtually disappeared in his mundane evaluations of those in his day-to-day personal circle.” —Manning Marable, Malcolm X: A Life of Reinvention (2011)

The initial psychological attractiveness for Malcolm X to Elijah Muhammad’s NOI is understandable, as it validated Malcolm’s feelings about the illegitimacy of white authority, offered him a strong community, and provided the previously criminal and selfish Malcolm with a spiritual path to care about something larger than himself. Malcolm put all his trust and faith in Elijah Muhammad; however, no different than Epstein, Muhammad was not only a sexual predator but a consummate exploiter of people, and he used Malcolm X’s charisma, speaking talents, and organizing skills to greatly expand his power.

Ultimately, Malcolm X publicly acknowledged that Elijah Muhammad was sexually involved with several young NOI secretaries and had fathered children with them. The African American Historical Society reports that Elijah Muhammad “impregnated seven women, including several of his teenage secretaries, and fathered thirteen children outside of his marriage.”

When should Malcolm X have known that Elijah Muhammad was a sexual predator? When did Malcolm acknowledge it to himself, and when did he acknowledge it to the world? What psychological forces kept Malcolm in denial, and then what political forces did Malcolm have to transcend for him to publicly acknowledge it?

To answer these questions, I am not alone in trusting Manning Marable. Cornell West says of Marable and his biography of Malcolm X: “Manning Marable is the exemplary black scholar of radical democracy and black freedom in our time. His long-awaited magisterial book on Malcolm X is the definitive treatment of the greatest black radical voice and figure of the mid-twentieth century.”

Marable tells us, “The revelations [about Elijah Muhammad] should not have been a complete surprise to Malcolm, who first heard hints about Muhammad’s sexual misconduct in the mid-1950s. Yet for years, it had been impossible for Malcolm to imagine that . . . [Muhammad] was using his exalted position to sexually molest his secretarial staff.” By late 1962, Marable notes that tales of Muhammad’s “sexual adventures had reached New York City and the West Coast. . . . [but] Malcolm pretended that he knew nothing about the rumors, desperately hoping that somehow they would go away.”

However, when Malcolm was told in 1963 by one of Elijah Muhammad’s sons, Wallace, that the rumors were true, Malcolm sought proof. Malcolm met with three of Elijah Muhammad’s former secretaries, and all had similar stories, which were even uglier than sexual misconduct alone. Malcolm learned, as Marable reports, “Once their pregnancies had been discovered, they had been summoned before secret NOI courts and received sentences of isolation. Muhammed provided little or no financial support for his out-of-wedlock children.” Malcolm was both shaken and appalled, and in 1964, Malcolm X would expose this to the general public.

Today, Malcolm is deeply admired as a truth teller—not only of racial and political truths but of truths about his own failings. A major reason that Malcolm X is forgiven by his admirers for his denial of the horrors of Muhammad is that in that brief period between Malcolm’s acknowledgement and his assassination, Malcolm was able to be bluntly honest about his own failings with profound humility. In an interview, he described his psychology of denial:

When you understand the makeup of the Muslim movement and the psychology of the Muslim movement, as long as . . . if I tie myself in by having confidence in the leader of the Muslim movement, if someone came to me and I had no knowledge whatsoever of what had taken place, and they told me what I’m saying [about Muhammad’s predatory behavior], I would kill them myself. The only thing that would prevent me from killing someone who made a statement like this [is that] they would have to be able to let me know that it’s true. Now if anyone had come to me other than Mr. Muhammad’s son, I never would have believed it even enough to look into it. But I had been around [Elijah Muhammad] so closely I had seen indications of it . . . the reality of it, but my religious sincerity made me block it out of my mind.

Even after Malcolm X was no longer in denial of the reality of the monstrous behavior of Elijah Muhammad, Malcolm describes the existential quandary he experienced as to whether or not to reveal it: “The only reason that I didn’t make this public knowledge was I knew the implications, and I felt that if the Muslims who were in the Nation of Islam knew it, that which enables them to be so strongly religious and exercise moral discipline, [they] would be shattered, and it would cause all of them to go right back and start doing the things that they had been doing previously.”

Malcolm felt strongly about the value of NOI in building self-respect, dignity, and empowerment for African Americans, and he knew that a major part of followers’ belief in the teachings of NOI had to do with their faith in Elijah Muhammad, and so he felt a need to, as he put it, “protect Mr. Muhammad himself primarily because the image that he had created was the image that enabled his followers to remain strong in faith . . . and I didn’t want to see any adverse effect or negative result developed in the faith of all of his followers.”

Ultimately, Malcolm’s passion for truth prevailed. When he exposed the ugly truths about Elijah Muhammad, he knew full well that doing so would likely cost him his life. During that brief period after Malcolm X parted from NOI and before his assassination, Marable reports that Malcolm intellectually liberated himself from NOI policies. Elijah Muhammad had opposed involvement in politics, but Malcolm transformed himself into a political thinker who before his life was cut short, Marable notes, “publicly made the connection between racial oppression and capitalism.”

Malcolm X admirers can thank an incompetent FBI in part for Malcolm’s positive legacy. The FBI, along with other law enforcement agencies, would have loved to see Malcolm discredited or even killed (there is evidence that the FBI and other law enforcement agencies knew about Malcolm’s impending NOI assassination but did nothing to stop it). The FBI likely knew about Elijah Muhammad’s predatory behaviors, and the FBI could have exposed it before Malcolm did and then accused Malcolm of covering it up. If the FBI had done so prior to Malcolm himself having confirmed Muhammad’s predatory behaviors, Malcolm’s distrust for the FBI and law enforcement agencies would have certainly resulted in him attacking the FBI and defending Muhammad. And in such a hypothetical scenario, given that the entire mainstream media despised Malcolm X, when he finally did acknowledge that Muhammad was a sexual predator, there likely would have been a chorus of: “I can assure you Malcolm X is not gullible. He knew about Elijah Muhammad’s sexual predatory behaviors. Everyone in the Nation of Islam knew. They all knew. And like all of them, Malcolm X did not care.”

Ultimately, Malcolm X’s capacity for brutal self-honesty, humility, self-correction and redemption enabled him to evolve into one of the most extraordinary anti-authoritarians in U.S. history.

The trajectory of Malcolm X’s life is Shakespearean in the sense of high-stakes drama, life-and-death power struggles, tragically misplaced trust, heroic redemption, and assassination. And the psychological sources of his denial and the political reasons for his delay in exposing the monstrous reality of Elijah Muhammad are also epic.

In contrast to the Shakespearean arc of Malcolm X’s life, the trajectory of Noam Chomsky’s life is quite pedestrian. And so the possible psychological sources for Noam Chomsky’s denial of the monstrous reality of Jeffrey Epstein would also be quite pedestrian.

Just as Manning Marable tells us that Malcolm X should have known that Elijah Muhammad was a sexual predator and a monster, Noam Chomsky should have known that Jeffrey Epstein was a sexual predator and a monster. However, in contrast to what Marable and many of us conclude about Malcolm, Chris Hedges concludes that Noam not only should have known the truth of Epstein but did know and did not care.

Noam certainly should have known. By 2015, the time Valéria Chomsky reports when the Chomskys were first introduced to Epstein, it was widely known that Epstein was not simply a convicted sex offender who made a mistake, but that he had long been—and continued to be—an unrepentant scumbag who traveled in circles with other arrogant sleazebags.

In June 2008, Epstein plead guilty to one count of soliciting prostitution and one count of soliciting prostitution from someone under 18, but in a “sweetheart deal,” he was sentenced to serve most of his sentence in a work-release program that allowed him to leave jail during the day; and under a secret arrangement, the U.S. attorney Alexander Acosta agreed not to prosecute him for federal crimes. In November 2018, the Miami Herald did a series of stories focusing partly on Acosta, who had become the labor secretary in Trump’s first administration; and this Miami Heraldcoverage intensified public interest in Epstein. On July 6, 2019, Epstein was arrested on new sex trafficking charges brought by federal prosecutors in New York, and on August 10, 2019, Epstein was found dead in his jail cell in New York (officially ruled suicide but believed by some, including Epstein’s brother, to have been murder).

The slew of email exchanges between Jeffrey Epstein and Noam Chomsky released on January 30, 2026 provided shocking revelations that have now been widely reported: With the walls closing in on Epstein prior to his 2019 arrest for child sex trafficking, Epstein asked Chomsky for advice, and in response, Chomsky emailed him what amounts to crisis management ideas and sympathized with the “horrible way you are being treated in the press and public”; Chomsky flew on Epstein’s infamous private jet nicknamed the Lolita Express; Chomsky accepted invitations to stay at Epstein mansions; Chomsky met not only with Epstein but with Steve Bannon and Woody Allen; and Noam Chomsky and his wife Valéria were clearly appreciative of Epstein as a friend and advisor.

Noam Chomsky, now 97, suffered a debilitating stroke in 2023 leaving him unable to speak, but Valéria Chomskyreleased an official statement on February 9, 2026 that attempted to explain his relationship with Epstein. She statedthat “Epstein’s 2008 conviction in the state of Florida was known by very few people, while most of the public—including Noam and I—was unaware of it. That only changed after the November 2018 report by the Miami Herald.”

The truth is that long before the Miami Herald story, it was widely known that Epstein was a sleazebag. Even in 2006, prior to Epstein’s initial 2008 conviction, Epstein was seen as notorious enough for Eliot Spitzer, then running for governor of New York, to return a $50,000 Epstein contribution to his campaign. Spitzer, as did many others, would have known that in July 2005, Epstein had retained a high-profile legal team, including Alan Dershowitz and Ken Starr, to defend him against charges of soliciting prostitution; and all of this was reported by the New York Times in 2008 following Epstein’s conviction. And in 2015, the Guardian reported that three charities, including New York City’s Mount Sinai hospital, would not accept any more gifts from Epstein.

Valéria Chomsky stated, “Only after Epstein’s second arrest in [July] 2019 did we learn the full extent and gravity of what were then accusations—and are now confirmed—heinous crimes against women and children. We were careless in not thoroughly researching his background.”

In response to Valéria Chomsky’s statement, Chris Hedges essentially calls her a liar. As noted, Hedges stated, “I can assure you he [Noam Chomsky] is not as passive or gullible as his wife claims. He knew about Epstein’s abuse of children. They all knew. And like others in the Epstein orbit, he did not care.”

If Hedges is correct that Noam “knew about Epstein’s abuse of children” and “he did not care,” then Noam is simply a despicable human being. For Hedges, it does not seem possible that Noam Chomsky could be so stupidly in denial when it came to Epstein. In other words, it does not seem possible to Hedges that the brilliant Noam Chomsky could be as humanly psychologically flawed as the brilliant Malcolm X.

What creates the conditions for denial? It is obvious in the case of Malcolm X that supreme intelligence is no antidote to denial, and in fact such intelligence can be used to justify and rationalize denial. The conditions for denial include arrogant ego attachments, including to one’s beliefs, as well as overwhelming emotions, especially to emotions one may be unaccustomed to experiencing.

While I have my own speculations for the sources of Noam’s possible denial—speculations based on my dive into the released emails, my clinical experience, and previous research on him—these are only speculations, and my hunch is that the best answers will come one day from Noam’s children Aviva, Diane, and Harry, but they have made no public statement. They are probably wise to be silent in the current climate, as their explanation for their father’s awful behavior would likely be condemned as a defense of it.

So what were Noam Chomsky’s ego attachments and overwhelming emotions he was likely unaccustomed to experiencing? We can only speculate.

Noam has long taken unpopular stands, and he has perhaps been even ego attached to being fearless in this regard. He has a history of being highly critical of any type of interference to free thought and free speech, and he was increasingly critical of what has come to be called “cancel culture”; this could was likely have been exploited by Epstein. Chomsky justified having a relationship with Epstein with this rationalization: “What was known about Jeffrey Epstein was that he had been convicted of a crime and had served his sentence. According to U.S. laws and norms, that yields a clean slate.” Chomsky was too arrogant to put in the small effort required to discover that Epstein had not just been convicted of a crime and served his sentence, but that he was an unrepentant sleazebag.

There may well have been an even more important fuel for Noam Chomsky’s denial. Emails between Noam and his children reveal an emotional state that Noam had perhaps never navigated before. Noam was extremely upset about being confronted by his children regarding Valéria and Noam’s increase in spending since Noam’s remarriage (his children emailed him: “Your spending has increased dramatically and unexplainably since you got married and this unprecedented outflow is placing your financial future at risk”); as well as Noam having been upset by conflicts with his children over a trust fund (for which Noam and Valéria sought Epstein’s advice and help). In one email to his son, Noam states, “I’m more than sorry, not just about the conversation. Worst thing that’s ever happened to me. Could never have imagined that this would happen in my late years.”

Such an emotional state will subvert critical thinking, including one’s capacity to recognize that such a state renders one vulnerable to exploitation. Valéria forwarded the correspondence between Noam and his children to Epstein, who appeared to inflame the conflict and then used it to deepen his bond with the Chomskys.

To be clear, I am only speculating. Maybe Chris Hedges turns out to be right that Noam Chomsky “knew about Epstein’s abuse of children” and “he did not care.” However, I consider it to be arrogance on Hedges’s part to be so certain of the truth of his speculations about Noam Chomsky’s state of mind; and while money is certainly a root of evil, so too is arrogance. Arrogance was a major root of the evil of both Jeffrey Epstein and Elijah Muhammad, as it was for other infamous sexual predators, including Bill Cosby, Bill Clinton, Donald Trump, and Harvey Weinstein.

One does not have to be a clinical psychologist to observe tragic denials in many intelligent and otherwise highly ethical people, just as one does not have to be a historian to recognize that denial has long occurred in brilliant and otherwise admirable famous people. And most of us—at least those with any degree of humility—will acknowledge having experienced some type of “stupid” denial in our lives.

Bruce E. Levine, a practicing clinical psychologist, writes and speaks about how society, culture, politics, and psychology intersect. His most recent book is A Profession Without Reason: The Crisis of Contemporary Psychiatry—Untangled and Solved by Spinoza, Freethinking, and Radical Enlightenment (2022). His Web site is brucelevine.net

The Lost Art Of Medicine: What Maimonides Knew That We Forgot – OpEd




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.

Standing With Science In A Post-Truth World – Analysis

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.