Since Trump’s return as president, the Elon Musk-helmed Department of Government Efficiency (DOGE) has been making cuts to US Government departments, beginning with the culling of employees at the US Agency for International Development (USAID) in February. Now, the US Department of Health & Human Services (HHS) is on the chopping block.
Under plans outlined by HHS Secretary Robert F Kennedy, Jr (RFK Jr), thousands of employees at the health agencies under the HHS received notices on 1 April that their jobs were being eliminated.
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Last week, under a transformation plan touted to ‘Make America Healthy Again’, the White House revealed plans to cut around 10,000 employees from HHS departments, including the US Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and the National Institutes of Health (NIH).
The Trump administration estimated that the cuts, including retirements and voluntary resignations, would result in a culling of the combined agencies’ workforce from 82,000 full-time employees to 62,000.
Notable names that have departed the agencies include Peter Marks, the FDA’s top vaccine official who chose to tender his resignation rather than face being fired. Effective 5 April, his resignation letter to Sara Brenner, acting commissioner of the FDA, emphasised the value of scientific truth and the hazards of misinformation.
Addressing the Texas measles outbreak in his letter, Marks said it “reminds us of what happens when confidence in well-established science underlying public health and well-being is undermined”. This is likely a reference to RFK Jr’s initial views on the matter, not to mention his various anti-vaccination remarks over the years, which include the unfounded claim that vaccines cause autism.
While RFK Jr has since called the ongoing multistate measles outbreak in Texas “serious”, the HHS secretary initially said the Texas measles outbreak was “not unusual” after an unvaccinated child died from the virus in West Texas. RFK Jr has also suggested that Vitamin A may prove a suitable alternative treatment to measles than a vaccine.
According to reports, Peter Stein, director of the Office of New Drugs in the Center for Drug Evaluation and Research division and an individual considered by many to be the world’s top drug regulator, also chose to resign.
Severe fallout
The fallout of such deep cuts, ranging from the most well-known agencies under the HHS to smaller departments that still provide immense value in their respective fields, is hard to predict.
Commenting on the situation, former FDA commissioner Robert Califf wrote in a post to Linkedin that with most of the leaders with institutional knowledge and a deep understanding of product development and safety no longer employed, the “FDA as we’ve known it is finished”.
“I believe that history will see this a huge mistake,” wrote Califf. “I will be glad if I’m proven wrong, but even then, there is no good reason to treat people this way.”
According to Dr Andrew S Thompson, director of therapy research and analysis in medical devices for GlobalData, “chaos” and the rise of contractors as “a means of staffing functions” could be the result of the HHS job cuts, which in effect will likely mean “no money actually saved”.
“It’s how the [US] Department of Defence (DoD) has been run for years, in effect,” Thompson said.
“But it means government might become more responsive to changes in demand. That’s the theory. If I look at defence, that means a handful of companies become providers of a workforce.”
“I’m expecting lots of failed experiments to see how many functions could be replaced with AI.”
The American Federation of Government Employees (AFGE) national president Everett Kelley lambasted the HHS agency cuts, branding them “dangerous, irresponsible, and unacceptable”.
Kelley commented: “Cutting 10,000 critical public health jobs puts every American at risk – weakening our defences against disease outbreaks, unsafe medications, and contaminated food.
“Congress and citizens must join us in pushing back. Our health, safety, and security depend on a strong, fully staffed public health system.”
In a similar vein, the Infectious Diseases Society of America (IDSA) maligned the job cuts, stating that “we cannot do the complex and serious work of protecting Americans from infectious diseases amid this chaos and confusion” and concluding that the actions were “counter” to the goal of keeping America healthy.
Although Bill Cassidy, chairman of the Senate Committee on Health, Education, Labor, and Pensions and ranking member senator Bernie Sanders, have issued a letter calling on RFK Jr to testify on 10 April about the ‘proposed reorganisation’ of the HHS, the job cuts – for now – look set to be permanent.
