On 27 March the US health secretary Robert F Kennedy Jr, abruptly announced the termination of 10 000 jobs at the Department of Health and Human Services (HHS), with 10 000 more cut through early retirement and buyouts.1 The repercussions became clearer this week as employees received their notice on 1 April—or turned up to work to find their security passes had been deactivated.
Kennedy said that HHS was being “recalibrated to emphasize prevention, not just sick care.” On X he wrote, “The reality is clear: what we’ve been doing isn’t working.2
Two senators, Bill Cassidy and Bernie Sanders, invited Kennedy to a 10 April hearing to explain the restructuring. A HHS spokesperson told Politico that Kennedy had yet to accept the invitation.
Senior figures reassigned and relocated
As employees were served notice by email early on 1 April, many staff in high ranking posts found themselves reassigned and facing relocation or put on administrative leave.
Science reported that at least five directors of 27 institutes and centres of the National Institutes of Health had been told they were being reassigned. Several centre directors at the Food and Drug Administration (FDA) were also removed. The deputy director and scientific director of the National Institute on Ageing and extramural division directors at the National Institute of Allergy and Infectious Diseases were also told they’d been put on leave.
Jeanne Marrazzo, director of the allergy and infectious diseases institute, is among several staff reassigned to the Indian Health Service, the HHS division that provides medical care for US recognised tribes and Alaska Native people. Insiders told the online health news website Stat that, although this service did need more staff, vacancies were largely for physicians and nurses, not research scientists, analysts, and managers.3
Marezzo’s predecessor was Anthony Fauci, the former adviser to President Joe Biden who clashed with Trump during the covid-19 pandemic. Fauci’s wife, Christine Grady, who heads the NIH Office of Bioethics, was among those reassigned, according to the New York Times, along with another of Fauci’s allies, Clifford Lane, who oversaw clinical research. The Times reported that Renate Myles, the NIH communications director, had also received a notice of reassignment.
CNN reported that several senior leaders at the Centres for Disease Control and Prevention (CDC) were reassigned to other roles, and some were told that they would have to relocate.
Sweeping cuts to CDC staff and contracts
The Trump administration is demanding that the CDC cut $2.9bn of contract spending, reported the New York Times.4 Elon Musk’s Department of Government Efficiency (DOGE) asked the public health agency to sever around 35% of its spending on contracts by 18 April.
Revelation of the demand came as the CDC faces having to shed a fifth of its staff.
The CDC’s National Center for Chronic Disease and Health Promotion was among those whose staff was slashed, despite Kennedy’s intended refocus on chronic disease.5 Scientists studying environmental health and asthma, injuries, lead poisoning, smoking and climate change, blood disorders, violence prevention, and access to vaccines were also let go.
The agency’s centre on HIV and sexually transmitted diseases lost about 27% of its staff, reported the New York Times,6 adding that the National Institute for Occupational Safety and Health was all but dissolved and that most of the Division of Reproductive Health has been shut.
Gun safety was also put on the back burner as cuts to the National Center for Injury Prevention and Control meant that staff studying how to prevent gun violence, as well as those looking at child abuse and elder abuse, were fired.
Pharma industry shock at FDA cuts
Drugmakers expressed dismay at the state of the FDA after the raft of staff sackings, totalling around 3500. Politico reported that Pharmaceutical Research and Manufacturers of America (PhRMA) had questioned whether the regulator had enough capacity to do its job.
PhRMA spokesperson Alex Schriver told Politico, “We recognize the need to find efficiencies, but it’s critical the FDA has the expertise and capacity it needs to maintain its gold standard regulatory review. The rapid and substantial changes at FDA this week raise questions about the agency’s ability to fulfil its mission to bring new innovative medicines to patients.”
Former FDA commissioner Robert Calif mourned the expertise being forced out in the cuts. He said his former agency was “finished,” with most of the leaders with institutional knowledge and a deep understanding of product development and safety no longer employed.7
“Unless there’s some super plan, there’s going to be an effect on safety, because it takes whole teams of people to monitor safety of products, and the timetables for product review will probably be delayed,” he wrote on LinkedIn.
Centre that drove down smoking rates purged
Stat reported that the majority of staff, including the entire management and regulation divisions, were cut from the FDA’s Center for Tobacco Products.8 Brian King, its director, was among the senior figures let go this week. In his outgoing email to staff King praised them for driving adult smoking rates down to a 75 year low and youth tobacco product use to a 25 year low, including a 70% decline in youth e-cigarette use over the past five years.
Freedom of information staff fired
Despite promises to improve transparency, HHS has purged the teams handling Freedom of Information Act requests at the CDC, FDA, and NIH as part of its staff reductions. According to CBS News,9 all of the workers in the CDC’s FOIA office were cut, alongside two thirds of those at the FDA’s office and “many” at the NIH, though the exact number has not been disclosed. “For most types of FOIA requests there is no staff,” an FDA official told CBS. HHS said the goal was to create a central place to handle FOIA requests for the whole of HHS, making it easier for the public to submit their requests.
Communications and education departments across the board were hit hard by the cuts. The New York Times spoke to one employee at the National Institute of Dental and Craniofacial Research, an NIH branch that educates people on childhood dental health, including birth defects such as cleft lips and palate, and on water fluoridation and oral health. Jessica C Henry said she had been fired along with her entire team of communications and health education specialists.
At the CDC, specialists in tuberculosis communications and education were laid off.
The FDA’s entire press office was also shut down and staff put on administrative leave, CNN said.
Labs in chaos as key scientists and staff fired
Wired magazine reported that several key NIH scientists had been dismissed in the HHS cuts.10 They include Richard Youle, a leading researcher in the field of neurodegenerative disorders who was previously awarded the Breakthrough Prize in Life Sciences for identifying mechanisms behind Parkinson’s disease.
Senior investigators at the National Institute of Neurological Disorders and Stroke, the National Institute on Ageing, and researchers noted for their work in HIV, emerging infectious diseases, and child brain and neural disorders were also let go. Laboratories affected by the layoffs include those involved in clinical trials and in preclinical studies. Staff told Wired it was unclear what would happen to the data they had accumulated or to patients involved in ongoing trials.
Science reported the loss of entire NIH acquisitions offices that handled purchase orders for laboratory needs ranging from reagents to biological samples and software.11 Acquisitions are now supposed to be centralised, but NIH has yet to set up a new system. At one institute warehouse staff were also gone, and incoming shipments of reagents and biological samples had to be turned away. Support staff for information technology and many building staff who deal with chemical and other emergencies were also dismissed, an employee told Science.
At least one FDA laboratory also had to close after support staff were fired. “In my office, one of our labs has shut down today, because we’ve run out of supplies due to the halt on procurement. The people that could help the supply issue have been let go,” an employee told the Federal News Network.12
Health research agency halved
Politico reported that the Agency for Health Research and Quality lost 111 employees and has “likely been cut in half,” its former director said. Stat confirmed that more than half of the employees at the Office of the Assistant Secretary for Planning and Evaluation and the Agency for Healthcare Research and Quality had been laid off. The two agencies made up 0.04% of the federal government’s healthcare spending.13
Among those let go were communications staff and employees who manage contracts and grants and administer health services research programmes. Cuts also affected the agency’s Office of Extramural Research, Education and Priority Populations, which deals with health disparities.
Health safety researchers decried the cuts. Carol McLay, president of the nonprofit Association for Professionals in Infection Control and Epidemiology told Politico, “The budget is very small . . . but they have such a big impact on hospitals and infection prevention and patient safety. They translate research into practical guidance and tools that people on the ground, on the front line, and the hospitals can actually use.”
Office of Minority Health gutted
Nearly all staff at the Office of Minority Health at the CMS have been let go, a former HHS employee told CNN. The office is charged with improving the health of racial and ethnic minority groups and has a focus on rural health, diet, and diabetes. Its website was offline as of 1 April.
Health resources and medical device safety staff cut
Staff at the Health Resources and Services Administration (HRSA) were shocked to find themselves among those cut. Kennedy’s 27 March announcements did not mention the department as among those facing the axe. HRSA funds community health centres, the Ryan White HIV/AIDS programme, the nation’s organ donation and transplant system, the National Health Service Corps, which helps get healthcare into rural and urban areas, and maternal and child health.
The Center for Devices and Radiological Health, which oversees the safety of some medical devices, was also reported to have had staff cut.
