April 4, 2025
This week’s issue covers drastic cuts across the US Department of Health and Human Services (HHS), where a dramatic 20% downsizing effort is underway. On Tuesday, HHS began issuing reduction-in-force (RIF) notices across its agencies, triggering mass layoffs at the US Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), and the US Food and Drug Administration (FDA). The ripple effects are vast—gutting HIV prevention, infectious disease research, and vaccine development, while threatening the stability and viability of the workforce that sustains US public health and biomedical research. Read AVAC’s statement on HHS here.
This issue also covers growing legal, institutional, and global responses to these actions.
Reduction-in-Force Notification at HHS
Tuesday, HHS began issuing reduction-in-force (RIF) notices across its agencies, with deep cuts at the CDC, NIH, and FDA. This effort is part of a sweeping reorganization announced by HHS Secretary Robert F. Kennedy Jr. last week, which aims to downsize HHS by 20%. Framed as a “painful period”, HHS leadership claim to be refocusing the agencies on rising chronic disease. Read more below for details.
IMPLICATIONS: The dismissal of 20,000 public servants and leaders across every domain of global health research, policies and programs is absent of any clear plan to sustain life-saving work across these agencies. These ill-informed decisions dismantle the US capacity to advance and regulate science, medicine and health. They risk a resurgence of diseases like HIV and TB, reversing years of scientific advancement and bipartisan federal investment. They also mean the loss of an essential American brain trust in research and development, including the potential of a “chilling effect” in bringing in the next generation of young investigators.
CDC Developments
At the CDC, widespread layoffs have decimated critical divisions, including Reproductive Health, Population Health, and HIV and STD Prevention. Half of the employees at the Division of HIV Prevention received RIF notices. Jonathan Mermin, director of the National Center for HIV, Hepatitis, STD, and Tuberculosis Prevention (NCHSSTP), has been placed on administrative leave, and the Center has been cut, along with the tuberculosis elimination and research branches. The CDC is said to be among the agencies seeing the largest workforce cuts with 2,400 employees to be laid off.
READ:
- The CDC Has Been Gutted—Wired
- These CDC Teams Were Hardest Hit by Trump’s Mass Layoffs—Medpage Today
FDA Developments
Peter Marks, who led the FDA’s vaccine and biologics center and played a key role in COVID-19 vaccine approvals dubbed “Operation Warp Speed”, stepped down under duress. His resignation letter, which was made public, warned of dire consequences of the US government’s positioning on vaccines and the proliferation of misinformation, evidenced by the growing measles outbreak in Texas. Following his departure, HHS announced plans to cut about 3,500 full-time FDA positions. The agency stated that the layoffs will not impact drug, device, or food reviewers. The FDA has worked in conjunction with the CDC and the USDA to combat bird flu’s rapid spread.
READ:
- New FDA Commissioner Agreed to Oust Top Vaccine Regulator after Private Swearing-in—The New York Times
NIH Developments
Since Monday, directors of five NIH institutes, including NIAID’s Jeanne Marrazzo, and other senior leaders have received RIF notices, been placed on leave or offered reassignment. As the world’s largest funder of biomedical research, decades of NIH investments have driven the discovery and development of therapies and preventive interventions for HIV, tuberculosis, STIs, viral Hepatitis, other infectious and noncommunicable diseases. NIH-funded research contributed to the development of 354 of 356 drugs (99.4%) approved in the US between 2010 and 2019.
The Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN)—created in 2001—revolutionized research by generating data to develop and deliver life-saving HIV and STI interventions for adolescents, an often-excluded group in research. However, the ATN grant was terminated, undermining decades of investment by NIH and American taxpayers to advance healthcare for adolescents.
An analysis by amfAR shows the cascading economic harm, which will affect all 50 states. “Each year the NIH awards over 60,000 grants that support over 300,000 researchers at more than 2,500 institutions across the US. For every $1 of NIH funding received, a state generates $2.46 on average in increased economic activity.”
READ:
- Five NIH institute directors and numerous lab heads ousted in unprecedented shake-up—STAT
- The Best Investment You Didn’t Know You Made: How NIH Funding Fuels Innovation and Economic Growth—amfAR
Top Researchers Sound Alarm Over Federal Attacks on Science
Nearly 2,000 top US scientists have signed an open letter condemning the administration’s attacks on science, including funding cuts, censorship, and pressure to alter research. The scientists—all elected members of the National Academies of Sciences (NASEM)—warn that the latest actions threaten both public health and America’s global scientific leadership. They describe a “climate of fear” in research, where scientists self-censor to avoid political backlash.
READ:
Crisis and Cuts at WHO
At a global Town Hall meeting of World Health Organization (WHO) staff, Director General Tedros Adhanom Ghebreyesus announced major cost-cutting measures, including staff reductions starting with senior leadership, and a restructuring based on a “prioritization exercise.” WHO is facing a deepening financial crisis, with a $1.9 billion shortfall in its planned $4.2 billion budget for 2026–2027, and an additional $600 million deficit through 2025. The crisis is largely due to the US withdrawal from WHO, it also includes $130 million of obligations owed from 2024 dues.
READ:
- Faced with $600M Income Gap, WHO to Scale Back on Work, Staff, Budget—Devex
- WHO Budget Crisis Bigger Than Previously Thought – $2.5 Billion Gap for 2025-2027—Health Policy Watch
New Lawsuit Challenges NIH Grant Terminations
Scientists and organizations including the ACLU, Center for Science in the Public Interest, Ibis Reproductive Health and Protect Democracy filed a lawsuit against the US administration arguing that the NIH’s rationale of “not supporting agency priorities” is vague, arbitrary, and illegal under the Administrative Procedure Act and the Fifth Amendment’s due process clause. Many canceled grants involved research on topics politically opposed by the administration, such as transgender health, LGBTQ+ issues, and workforce diversity. The lawsuit contends that the terminations violate congressional mandates, undermine scientific progress, and could ultimately endanger public health.
READ:
What We’re Reading
- RFK Jr. Mimics AIDS Denier Thabo Mbeki—The Washington Post (opinion)
- The Quiet Way the NIH Is Stalling Some Research Before It Starts—Chronicle of Higher Education
- HIV Cases More Than Double in Middle East and North Africa—The Telegraph
- As US Cuts HIV Help, South Africa Turns to Miners, Insurer—Bloomberg Law
- Millions of Women Will Lose Access to Contraception as a Result of Trump Aid Cuts—The New York Times
- Dropping U.S. Biodefenses: Why Cuts to Federal Health Agencies Make Americans Less Safe—Just Security
- Rollout of ‘Miracle’ HIV Prevention Drug is Threatened by Trump Cuts to Global AIDS Relief Program—STAT
- International Scientists Rethink U.S. Conference Attendance—Science
Resources
- Domestic Funding Contributions to Health: Comparing Changes in Domestic Financing in PEPFAR and Non-PEPFAR Supported Countries—amfAR
- Impact of US Funding Cuts on the Global AIDS Response—UNAIDS
- The USAID List of Terminated Global Health Awards – What Does it Tell Us—KFF
- Impact of PEPFAR Stop Work Orders on PrEP—AVAC