The Dismantling of America's Public Health Shield

The Dismantling of America’s Public Health Shield

Eleven Months of Documented Damage to Domestic Health Infrastructure

The Numbers

Since January 20, 2025, the current administration has eliminated approximately 20,000-24,000 positions from the Department of Health and Human Services¹—roughly one-quarter of the workforce at agencies tasked with protecting Americans from disease and illness.

To put this in perspective: That’s equivalent to emptying every public health department in the states of California, Texas, Florida, and New York combined.

What We Lost

The Centers for Disease Control and Prevention lost 2,400-2,600 employees (10% of its workforce)², including 50 Epidemic Intelligence Service officers—the disease detectives who investigate outbreaks. The entire Freedom of Information Act office was eliminated³, meaning Americans can no longer request transparency about what CDC knows about emerging health threats.

The National Institutes of Health, America’s premier biomedical research agency, lost 1,200-1,500 employees⁴ and saw $2.4 billion in canceled and frozen research grants as of early April 2025⁵. The Food and Drug Administration cut 3,500 positions⁶, including medical device reviewers and international inspection coordinators.

The National Institute for Occupational Safety and Health—which studies workplace hazards and how to prevent worker deaths and injuries—lost two-thirds of its staff⁷.

The Price Tag

The administration claims these cuts will save $1.8 billion annually⁸. Let’s examine what that money represents:

• 90 elementary schools could be built nationwide with that amount⁹
• 800,000 Americans could receive a full year of SNAP food assistance¹⁰
• This represents 0.1% of the $1.8 trillion federal budget¹¹

For context, under the previous administration, CDC’s budget ranged from $9.7 to $11.6 billion¹². The current administration proposes cutting it to $4.3 billion¹³—the lowest level in 20 years. NIH faced similar cuts: previous funding stood around $48 billion; current proposals seek $27.5 billion, an $18 billion reduction¹⁴.

That $18 billion could build 900 elementary schools or feed 8 million Americans for a year.

The Human Cost: Measles Returns

The consequences are already visible. In 2024, the United States recorded 285 measles cases¹⁵. By December 16, 2025: 1,958 confirmed cases across 49 outbreaks¹⁶. Three children are dead¹⁷.

This isn’t abstract. Eight-year-old Daisy Hildebrand died in Texas in April 2025¹⁸. The Health Secretary attended her funeral while simultaneously presiding over the gutting of the very agencies designed to prevent such deaths.

The U.S. now faces losing its measles elimination status—a designation held since 2000—by January 2026¹⁹. Vaccination rates have dropped: kindergarten exemptions rose from 3.3% to 3.6% nationwide²⁰, with Idaho at 15.4% and Utah at 10.3%.

Seventeen states now have kindergarten exemption rates exceeding 5%²¹—above the 95% vaccination coverage needed for herd immunity²².

What Changed: A Comparison

2009-2017 (Previous Republican Administration):

• CDC budget grew from $6.5 billion to $7.2 billion²³
• Zero measles deaths during final term
• Maintained robust Epidemic Intelligence Service
• Strengthened international disease surveillance
• Created PEPFAR with bipartisan support, saving millions of lives

2021-2025 (Previous Democratic Administration):

• Proposed increasing CDC budget to $11.6 billion²⁴
• Rebuilt pandemic response capacity after COVID-19
• Maintained WHO partnership
• Zero measles deaths in 2021-2024 combined²⁵
• Sustained public health infrastructure investments

2025-Present (Current Administration):

• Proposed 53% CDC budget cut²⁶
• 3 measles deaths in 11 months²⁷
• Withdrew from WHO²⁸
• Eliminated 10% of CDC workforce²⁹
• Ended emergency response for H5N1 bird flu despite continued outbreaks³⁰

The Infrastructure Damage

Beyond workforce, critical systems have been dismantled:

Data and Transparency

• Thousands of public health websites removed³¹
• Federal health databases eliminated³²
• Morbidity and Mortality Weekly Report publication paused³³
• H5N1 tracking reduced to monthly reporting (from daily)³⁴
• Entire CDC FOIA office eliminated³⁵

Research Capacity

• $500 million in mRNA vaccine research canceled³⁶
• HIV prevention research grants terminated³⁷
• Safe to Sleep infant death prevention program ended after 30+ years³⁸
• Monkey research programs at CDC ordered shut down by December 2025³⁹

Prevention Programs

• 879 family planning clinics (24% of all Title X clinics) had funding frozen⁴⁰
• State public health departments lost $11.4 billion in COVID-19 supplemental funding (partially restored by courts in 23 states)⁴¹
• Vaccine confidence programs eliminated⁴²
• CDC’s Immunization Services Division team dismissed⁴³

The Advisory Committee Purge

In June 2025, the Health Secretary dismissed all 17 members of the Advisory Committee on Immunization Practices (ACIP)⁴⁴—the independent scientific panel that has guided vaccine policy for decades. He replaced them with members critical of COVID-19 vaccines, including several who have expressed broader concerns about vaccine safety despite overwhelming scientific evidence to the contrary⁴⁵.

By November 2025, CDC’s website was changed to say studies “have not ruled out the possibility that infant vaccines cause autism”⁴⁶—contradicting decades of scientific consensus showing no link between vaccines and autism. The American Medical Association⁴⁷, American Academy of Pediatrics⁴⁸, and autism advocacy organizations⁴⁹ condemned the change.

What $20 Million Buys

The administration cut 20,000+ public health jobs to save $1.8 billion annually.

For comparison:

• One elementary school costs approximately $20 million⁵⁰
• The average American classroom costs $1.4 million to build⁵¹
• One year of food assistance costs $2,244 per person⁵²

The $1.8 billion in “savings”:

• Equals 90 elementary schools
• Equals 1,286 classrooms
• Equals food for 800,000 Americans for one year

The proposed $18 billion NIH cut:

• Equals 900 elementary schools
• Equals 12,857 classrooms
• Equals food for 8 million Americans for one year

By The Numbers: What We’re Trading

Every public health worker who lost their job represents specific expertise:

• Contact tracers who track disease spread
• Epidemiologists who identify outbreak patterns
• Laboratory scientists who identify pathogens
• Grant administrators who fund university research
• Food safety inspectors who prevent contamination
• Medical device reviewers who keep dangerous products off the market

We traded these for the cost of 90 elementary schools—in a nation with over 130,000 K-12 schools⁵³.

The Broader Pattern

These cuts came as part of a broader restructuring announced in March 2025. HHS stated it would reduce its workforce by eliminating 10,000 full-time positions, with total cuts across the department reaching 20,000 workers⁵⁴. The administration framed this as eliminating “waste and inefficiency”⁵⁵, though the $1.8 billion in savings represents 0.1% of total federal spending.

The restructuring also included:

• Proposed elimination of the Office of Minority Health⁵⁶
• Closure of the Office of Infectious Diseases & HIV Policy⁵⁷
• Major cuts to the Bureau of Primary Health Care⁵⁸
• Dissolution of the Office of Health Equity at CDC⁵⁹

Federal courts temporarily blocked some workforce reductions in May 2025⁶⁰, but the Supreme Court overturned those blocks in July⁶¹, allowing the administration to proceed with mass layoffs. By August 2025, it was estimated that over 20,000 jobs at HHS had been eliminated⁶².

The October Shutdown

During the October 2025 government shutdown, an additional 600+ CDC employees were fired⁶³, including staff working on injury prevention, health statistics, and Congressional relations. Some termination notices were later described as “sent in error”⁶⁴, but hundreds of positions remained eliminated.

Groups representing federal workers filed lawsuits challenging whether such firings during a government shutdown are legal⁶⁵.

Moving Forward

This is not a political argument. These are documented facts:

• 20,000+ jobs eliminated
• $1.8 billion in workforce cuts
• $18 billion in proposed NIH cuts
• 1,958 measles cases vs. 285 last year
• 3 deaths vs. 0 last year
• Elimination status at risk for first time in 25 years

The question isn’t whether this happened. The question is whether Americans believe 90 elementary schools’ worth of savings is worth dismantling the public health infrastructure that took 75 years to build.

References