In what is being described as a “bloodbath,” the Department of Health and Human Services has dramatically reduced personnel at the Centers for Disease Control and Prevention, National Institutes of Health, Food and Drug Administration, and other federal health agencies. The cuts are expected to include 10,000 people.
Word of the cuts came early Tuesday morning, April 1, shortly before Health Secretary Robert F. Kennedy Jr. swore in new NIH Director Dr. Jay Bhattacharya and new FDA Commissioner Dr. Marty Makary. Some staffers first learned of the news when their badges no longer allowed them to access their offices, followed by emails saying they were placed on administrative leave.
The changes affect many of the agencies’ operations, including the CDC’s National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention, the Division of Reproductive Health, and the National Institute of Occupational Safety and Health, as well as NIH’s Office of Science Policy and the National Institute for Allergy and Infectious Diseases, according to a spreadsheet of cuts reported by staffers and shared with reporters. Administrative functions, such as public communication, appear to be hit especially hard.
High-level staff cuts include NCHHSTP director Dr. Jonathan Mermin and Dr. Jeanne Marrazzo, who succeeded Dr. Anthony Fauci as head of NIAID. Both reportedly declined reassignment to positions with the Indian Health Service in Alaska.
“In a matter of just a couple days, we are losing our nation’s ability to prevent HIV,” stated Carl Schmid, a gay man who’s executive director of the HIV+Hepatitis Policy Institute. “The expertise of the staff, along with their decades of leadership, has now been destroyed and cannot be replaced. We will feel the impacts of these decisions for years to come and it will certainly, sadly, translate into an increase in new HIV infections and higher medical costs.”
On March 27, Kennedy announced a “dramatic restructuring” of DHHS that will involve 10,000 layoffs in addition to another 10,000 people who accepted buyouts or early retirement. According to the Wall Street Journal, which first reported the news, the FDA is expected to lose 3,500 full-time employees (about 19% of its workforce), the CDC will lose 2,400 people (about 18%), and the NIH will lose 1,200 people (about 6%).
DHHS’ 28 divisions will be reduced to 15. A new Administration for a Healthy America (AHA) which will combine multiple agencies including the National Institute for Occupational Safety and Health, the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration, which oversees the Ryan White HIV/AIDS Program. Citing unnamed federal health officials, CBS reported last week that the entire staff of the Office of Infectious Disease and HIV/AIDS Policy, which administers the Ending the HIV Epidemic initiative launched during President Donald Trump’s first term, could be laid off.
“We are streamlining HHS to make our agency more efficient and more effective,” Kennedy wrote in a post on X . “We will eliminate an entire alphabet soup of departments, while preserving their core functions by merging them into a new organization called the Administration for a Healthy America, or AHA. This overhaul will improve the health of the entire nation.”
But clinicians, researchers, and advocates fear that the cuts will decimate public health, patient care, and crucial medical research.
“There is no other way to say this: Today is the day the CDC was essentially dissolved,” Dr. Boghuma Titanji of Emory School of Medicine wrote on BlueSky. “What’s left is a husk. People will die as a direct result.”
The HIV Medicine Association was also alarmed.
“In addition to the losses across the Department of Health and Human Services, the elimination of entire branches within the Centers for Disease Control and Prevention’s HIV Prevention Division devoted to evaluating interventions, developing treatment guidelines and targeting resources where they are needed most will result in chaos, inefficiencies and interruptions in essential care,” stated HIV Medicine Association Chair Dr. Colleen Kelley. “The randomness of today’s actions is reckless and will harm Americans rather than make them healthy.”
Cuts at the federal level will have an effect on state and local health efforts. The DHHS regional office in San Francisco is slated to close by late April or early May, Politico first reported. The office, which manages Medicaid, Medicare, HIV, and other programs for several states and Native American tribes, is expected to move to Denver.
“This shortsighted office closure would lead to critical service slowdowns for San Franciscans to get the resources they need and detrimental impacts to our public health response capabilities – all in the name of so-called ‘government efficiency,” Congressmember Nancy Pelosi (D-San Francisco) said in a statement. “Make no mistake: the reported plans to restructure HHS and close the San Francisco regional office would directly harm our most vulnerable communities and make America sicker.”
Updated, 4/2/25: This article has been updated with additional information.