Putting Our Health at Risk

The recent decision by the Department of Health and Human Services (HHS) to implement significant staffing and funding cuts across its agencies, including the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and the National Institutes of Health (NIH), raises serious concerns about the future of public health in the United States. These cuts, which will eliminate nearly 20,000 positions, mark one of the largest reorganizations in the department’s history. As a physician, it is hard to see this as anything but a step backward – one that will likely cost lives, stall medical progress, weaken the resilience of both our national and global health systems, and make Americans less safe.

To be fair, few dispute that there is waste in government. Every large bureaucracy has inefficiencies that deserve scrutiny. And HHS, like any federal agency, is not above reform. But there is a wide gulf between sensible streamlining and reckless disassembly. As Dr. Drew Altman of the Kaiser Family Foundation rightly observed in his March 29 essay, previous HHS reorganizations sought to strengthen the government’s ability to deliver health programs. This one seems designed to do the opposite. It appears focused on shrinking government not for efficiency’s sake, but out of ideological distrust of its role in public health.

Since World War II, the United States has been the undisputed global leader in biomedical research and public health innovation. Our tax dollars have funded the discovery of vaccines, treatments for cancer and heart disease, and advanced methods for preventing and controlling infectious disease. The NIH alone has supported the foundational research behind nearly every major medical breakthrough of the past 70 years, often in partnership with academic institutions across the country. That research has not only improved health outcomes and led to economic growth domestically, but also fueled a global engine of medical progress. The CDC, meanwhile, has served as the world’s early warning system for disease outbreaks. Whether it is detecting Zika, tracking Ebola, or coordinating the U.S. response to COVID-19, the CDC has historically been trusted worldwide for its scientific rigor and public health leadership.

This reorganization, however, threatens to dismantle much of that capacity. The FDA is slated to lose about 3,500 employees, roughly 20 percent of its workforce, including many in administrative and support roles essential to inspections and safety reviews. Although the cuts reportedly spare front-line drug and food inspectors, the loss of infrastructure will inevitably slow responses to foodborne outbreaks, delay drug approvals, and weaken oversight. The CDC faces similar reductions, with approximately 2,400 positions eliminated and entire programs, such as the Global Health Center, defunded. That center served as a critical line of defense in identifying health threats abroad before they reached our borders. Gutting it is a dangerous gamble in an era of increasing pandemic risk.

The NIH is expected to cancel over 230 research grants, including a significant number tied to HIV prevention and treatment, while cutting more than 1,200 staff. This threatens to stall research on cancer, Alzheimer’s disease, antibiotic resistance, and chronic illnesses affecting millions of Americans. Reducing our national commitment to research also weakens our global scientific standing. Other nations, including China, South Korea, and Germany, are already stepping up their research investments and are ready to take the lead in a field the U.S. once dominated, including offers of employment to some of our top scientific and medical minds. Innovation does not wait. If we pull back, we risk losing not just medical discoveries but also economic growth, skilled jobs, and strategic influence.

Here in Indiana, the impact is already being felt. The Indiana Department of Health is bracing for a 40 million dollar loss in federal public health support, including cuts to COVID-related testing and vaccination programs. The Marion County Public Health Department has lost a $454,000 CDC immunization grant, threatening local outreach programs and preventive care access. Meanwhile, researchers at Indiana and Purdue Universities, whose labs depend on NIH funding, stand to lose millions in active grants, according to recent reporting from the Indiana Capital Chronicle. These funds not only support science, they employ people, train students, and produce treatments that eventually save lives in towns like ours.

Globally, the damage may be even more significant. Countries with fewer resources often rely on U.S.-led research and CDC advisories to guide their own health systems. From setting vaccine schedules to establishing treatment protocols, America’s science has often been the foundation. Weakening that support structure during an era of climate-driven health crises and rising antimicrobial resistance leaves the world more vulnerable and less prepared for the next pandemic. We are pulling away from a leadership role we earned through decades of investment and collaboration.

At a time when new threats are emerging faster than ever, we should be reinforcing our public health defenses, not dismantling them. The capacity of the NIH, CDC, and FDA to protect Americans has been built over generations. It is a mistake to undo that work now in the name of short-term savings. What we risk losing is not just jobs or programs. It is our edge in science, our resilience in crisis, and our credibility on the world stage. And those are losses none of us can afford.