How Deeply Trump Has Cut Federal Health Agencies
by Brandon Roberts, Annie Waldman and Pratheek Rebala, illustrations by Sam Green for ProPublica When the Trump administration announced massive cuts to federal health agencies earlier this year, Health and Human Services Secretary Robert F. Kennedy Jr. said he was getting rid of excess administrators who were larding the government with bureaucratic bloat. But a groundbreaking data analysis by ProPublica shows the administration has cut deeper than it has acknowledged. Though Kennedy said he would add scientists to the workforce, agencies have lost thousands of them, along with colleagues who those scientists depended on to dispatch checks, fix computers and order lab supplies, enabling them to do their jobs.Done in the name of government efficiency, these reductions have left departments stretching to perform their basic functions, ProPublica found, according to interviews with more than three dozen former and current federal employees. Over 20,500 Workers Lost as of Aug. 16 Food and drug facility inspectors are having to go to the store and buy supplies on their own dime so they can take swab samples to test for pathogens. Some labs have been unable to purchase the sterile eggs needed to replicate viruses or the mice needed to test vaccines. And less than five years after a pandemic killed more than a million Americans, scientists who study infectious diseases are struggling to pay for saline solution, gloves and blood to feed lab mosquitos. The Trump administration has refused to say how many workers have been lost so far. But ProPublicas analysis reveals the cuts in unprecedented detail. Who HHS Has Lost Since January More than 3,000 scientists and public health specialists are gone.Over 1,000 regulators and safety inspectors have also left.In total, more than 20,500 workers, orabout 18% of the Department of Health and Human Services workforce, have left or been pushed out, according to ProPublicas analysis of federal worker departures using public information from the HHS employee directory. The analysis is an undercount it doesnt include the hundreds or even thousands of workers who have received layoff notices but remain on administrative leave.No health agency has been spared, with some important divisions losing more than 1 in 5 workers. The Centers for Disease Control and Prevention, in charge of public health, lost 15% of its staff; the National Institutes of Health, the largest funder of biomedical research in the world, 16%; and the Food and Drug Administration, which ensures the safety of most of what goes into peoples bodies from baby formula to cancer drugs to hip implants 21%.Thousands of these employees were laid off or had their contracts cut, while some took buyouts or retired earlier than anticipated. Divisions have experienced a brain drain of epic proportions, ProPublica found, losing senior leaders behind some of the biggest health initiatives of the modern era, like the rapid rollout of the COVID-19 vaccine. Many of the cuts contradict what the administration has said about its priorities. The secretary who has questioned the safety of vaccines has pushed out scores of regulators who work to make vaccines safe. And while he has declared a new era in the fight against chronic disease, he has decimated a center dedicated to that very goal. Division leaders and staffers told ProPublica the cuts will lead their agencies to neglect their duties: Federal researchers will conduct fewer clinical trials and studies, regulators will conduct fewer or less-thorough inspections of egg farms and foreign drug factories, and public health specialists will be less prepared to combat outbreaks of deadly viruses. With exit and severance packages pending, many former and current workers would only speak anonymously, out of fear of retribution.HHS did not dispute the findings of ProPublicas analysis and didnt directly respond to questions about the consequences of the cuts of thousands of scientists, public health specialists and safety inspectors. HHS also did not respond to our questions about why it wouldnt share data on workforce reductions. A spokesperson for the department said the idea that Kennedy is weakening public health is dishonest. Yes, weve made cuts to bloated bureaucracies that were long overdue for accountability, the spokesperson said in an email. At the same time, we are working to redirect resources to science that delivers measurable impact, rebuilds public trust, and helps Make America Healthy Again.Former health secretary Xavier Becerra, who served under President Joseph Biden until earlier this year, called the cuts reckless. Public health isnt a luxury its a core function of government, he said. This hollowing out of expertise could leave us dangerously exposed. It takes years to build a professional workforce with the technical knowledge and public trust these roles require. Once you lose that, its not easy to get back. REGULATORS LOST Spotlight: The Food and Drug AdministrationWhen HHS announced the federal worker cuts, the department said that the FDA's safety inspectors and reviewers overseeing food, drugs and medical devices would be spared. However, ProPublica has found that the FDA has lost more than 400 workers who support inspections of everything from dairy farms to seafood processors to blood banks, and who ensure that companies follow federal regulations. More than a third of them worked at its Office of Inspections and Investigations, which serves as the eyes and ears of the agency. More than 240 consumer safety specialists have left across the agency, including nearly 40 workers responsible for safeguarding food, plus about 220 chemists, biologists and toxicologists. 21% of FDA Workers Have Left The Food and Drug Administration, the primary agency responsible for regulating food, drugs and vaccines, has lost over 900 scientists and health experts since January, along with over 500 regulators, investigators and compliance workers. Many of the investigators who left had honed their skills over years of field visits and inspections, developing a sixth sense for possible violations. I could walk into a plant and within five minutes could tell you if there was a rodent problem, said a former division director at the investigations office who left the FDA after inspecting countless facilities over more than two decades. Once youve been in a hot warehouse and you smell rodent urine, its like fresh-cut grass, you know exactly what it is the minute you smell it.With diminished capacity to spot potential problems, the system of oversight, which has historically been short-staffed, could break down, several former investigators told ProPublica. They might miss something a contaminant in a drug, a contaminant in a piece of food, a microbug in something because we had to freeze it for six months until they had enough person power to actually look at the sample, the former director said. In April, CBS News reported that the investigations office was already planning on reducing routine surveillance inspections in response to worker cuts.Key support staff who make sure investigators have everything they need, from essential supplies to travel visas, have also been cut. About 65% of the staff in the division responsible for budget, facilities and travel for the investigations office have left. Dr. Peter Lurie, who was an associate commissioner at the FDA during the Obama administration, said that such drastic cuts will hamper the agencys ability to recruit future inspectors and scientists. The big attraction of federal employment has always been its stability and its benefits, and were at the point that the stability is undermined, said Lurie, who is currently the president of the Center for Science in the Public Interest. This is a set of cuts that is going to hamstring the FDA for a decade or more.Vaccine Regulators Pushed OutOne of the divisions of the FDA most impacted by workforce cuts has been the Center for Biologics Evaluation and Research. It ensures the safety and quality of biological products for human use, like red blood cells for people with sickle cell disease, immunotherapy for those battling cancer and vaccines for everyone. Since January, the center has lost about 500 people, or 26% of its workforce.During the COVID-19 pandemic, the center played a crucial role in ensuring the quick rollout of safe and effective vaccines. It reviews and approves new vaccines and oversees their manufacturing and use. The center also conducts its own research to support the development of vaccines.But in February, when the administration began slashing the federal workforce, the research stalled. At some point, we decided which experiments were the priority for us, a former CBER scientist told ProPublica.The center was already somewhat understaffed for the workload, said Dr. Peter Marks, who led the center from 2016 to 2025. Now with these cuts, particularly cuts of the most experienced individuals who have left for various reasons, the agency, and in particular the Center for Biologics Evaluation and Research, is just a shadow of its former self.Marks, who helped launch the program to rapidly develop COVID-19 vaccines, resigned under pressure in March, citing an unprecedented assault on scientific truth in his departure letter. Kennedy, who has long been a fierce critic of vaccines, has used his office to further sow doubt about immunizations, despite decades of evidence of their safety and efficacy. Two of the centers top cell and gene therapy officials were placed on leave this summer. HHS did not respond to questions about the high-profile exits, but it has previously suggested the gene therapy leaders werent aligned with the administrations goals and said that Marks had no place at the agency if he did not support restoring science to its golden standard.As civil servants have departed the center, political appointees have gained a foothold. Under the leadership of Dr. Vinay Prasad, who the administration brought in to lead CBER in May, the center was run as a political organization, said Marks. Decisions were not being made on science, nor were they even being made on articulated policy. They were being made essentially on an arbitrary basis. The New York Times reported that Prasad overruled his centers experts on the use of COVID vaccines, recommending restricting the shots. Prasad did not respond to ProPublicas emailed questions.A spokesperson for HHS said in an email that Kennedy was not antivaccine and that the agency would continue to regulate immunizations. The FDA remains steadfast in enforcing rigorous vaccine oversight, ensuring the highest standards of safety and protection for all Americans, said the spokesperson, adding that Kennedy was pro-safety, pro-transparency, and pro-accountability. SCIENTISTS CUT Spotlight: The Centers for Disease Control and PreventionIn May, Kennedy claimed in a Senate committee hearing that HHS had not fired any working scientists, only targeting those in IT or administration. In terms of working scientists, our policy was to make sure none of them were lost and that that research continues, he said. But ProPublica has found that more than 1,050 scientists, physicians and public health specialists many of whom were conducting research and disease surveillance have left or been pushed out of the Centers for Disease Control and Prevention alone since January. Over a Thousand Scientists Lost The Centers for Disease Control and Prevention has lost over 3,000 workers. A third of them worked as scientists or in health care roles. One of the key responsibilities of scientists at the CDC is surveillance gathering and studying data on deaths or disease outcomes;many of the experts leading this work are gone. The team tracking maternal and infant health outcomes, which helps the public understand how people die in childbirth, has been placed on administrative leave. The program cataloguing the frequency of common injuries, such as car accidents, overdoses, dog bites and drownings, was cut. The staff that monitors lead poisoning in children was eliminated. Dr. Thomas Frieden, who led the CDC during the Obama administration, said the cuts were endangering the public. What public health does is it helps us see the invisible: See whether its the microbes that are killing us, or the toxins that are poisoning us, or the trends in diseases that we need to respond to protect ourselves and our families, he said. To the extent that these actions weaken our ability to see health trends and health risks, they make Americans less safe.Chronic Disease Experts Forced OutDuring one of his January Senate confirmation hearings, Kennedy declared war on chronic disease. President Trump has asked me to end the chronic disease epidemic and make America healthy again, he testified. Despite this proclamation, Kennedy-approved cuts slashed the staff of the CDCs chronic disease center by about 20%; nearly half of those lost were scientists and public health workers. Several divisions of the National Center for Chronic Disease Prevention and Health Promotion have also been radically diminished: 45% of its oral health division, which protects the teeth of kids whose parents cant afford dentists, has been lost, along with more than 35% of the division that focuses on preventing heart disease and strokes.The cuts are worse than they appear on paper because they dont reflect the people on administrative leave. At the centers smoking and health office, for example, our analysis shows more than a quarter of the workforce is gone, but according to multiple former staffers, only one federal employee is actually still working there.As the office emptied out following a wave of mass layoffs and forced retirements, a handful of stragglers frantically boxed up historical research, guidance documents and reports so that they wouldnt be destroyed. Its 60 years of work that could be thrown in trash dumps, said a former staffer.The work of the office, which tracks tobacco use and supports state smoking prevention programs, has essentially been eliminated, said multiple workers. Federal grants have been delayed, leading some states to cut their programs. While cigarette smoking has decreased in recent decades, vaping and e-cigarette use has surged, particularly among young people, even as evidence mounts of their dangers. But after this year, the offices tracking of youth smoking and tobacco use is expected to be discontinued.If eliminated, the expertise that existed at the Office on Smoking and Health, it doesnt just pause, it disappears, and that would take years to rebuild, said Ranjana Caple, the national senior manager of advocacy at the American Lung Association. The nation loses its ability to prevent the next wave of nicotine addiction, protect kids and help people quit. RESEARCH STAFF TARGETEDSpotlight: The National Institutes of HealthOne of the central roles of the NIH is its funding of research at academic and biomedical institutions. It awards roughly $30 billion annually. Since January, the administration has terminated more than 1,450 research grants and withheld more than $750 million in funding. Even the grants that survived are not being paid out, partly because the administration has fired the workers who administer the funding, said former and current staffers.There were all of these cuts to the people who deliver the grant funds, the people who are in charge of the funds and reviewing the funds, said Anna Culbertson, a former NIH scientific program specialist who was a probationary federal employee and was laid off in February. The consequence of grant funding delays is that some experiments and trials that take years may have to be restarted.At three NIH institutes focused on mental health, aging and infectious disease, 30% or more of the workers in divisions responsible for approving and dispatching money have been cut, leading to substantial delays in payouts. A recent analysis by STAT found that NIH grant funding levels have dropped nearly 30% compared with previous years. The Nations Primary Medical Research Agency Has Lost 16% of Its Workforce The National Institutes of Health has lost more than 7,000 workers since January. Because HHS does not provide job titles for the majority of workers at the NIH, we are unable to show worker departures by job category. With the resignations, retirements, firings and contractors being lost, the capacity to get grants out the door is diminished, said a scientific review staffer still with the agency. We just cant get everything done.The delays have forced universities to pause research, fire staff and even turn away students. At the University of Washington, the renewal of 73 federal grants totaling over $61 million was delayed as of April, leading to furloughs and layoffs, court documents reveal. And at the University of California, the delays have contributed to a systemwide hiring freeze on new faculty and staff. The financial instability created by the funding delays led the University of Massachusetts, Amherst to reduce admissions to its doctoral programs by 250 students.Infectious Disease Researchers Scaled BackThe National Institute of Allergy and Infectious Diseases, which supports research that develops and tests vaccines, lost more than 850 workers, or roughly 17% of its workforce, since January. The institute has long played a critical role in combating infectious disease: It funded decades of research on coronaviruses, laying the foundation for vaccines; it extensively supported HIV/AIDS research, which has transformed the disease from a death sentence to a chronic condition; and it has trained scores of scientists and researchers, fostering their careers and discoveries. But in recent years, it has become a target of the right. Its former director, Dr. Anthony Fauci, who led the center for nearly four decades until 2022 and was a member of Trumps Coronavirus Task Force, was accused by Republican lawmakers of wielding unchecked power over public health policy by encouraging temporary stay-at-home orders. Citing his leadership, Senate Republicans in 2023 proposed abolishing the institute and divvying up its functions.Since January, scores of senior officials at the institute have been forced out or placed on administrative leave, which several former high-level employees told ProPublica they believed was political retribution in response to pandemic policies. HHS did not respond to questions about whether the moves were retaliatory.The most recent director of the institute, Dr. Jeanne Marrazzo, was forced to choose between dismissal or a reassignment in an outpost of the Indian Health Service. Theyre taking out the head, said a NIAID scientist who recently left, because then theres no one to protect us. Sophie Chou contributed data reporting.Art Direction by Andrea Wise.
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