The Trump Administration's Ongoing Assault on Public Health

Budget cuts, scientific suppression, and political extremism are putting American lives at risk

Image from Greater Green Bay YMCA

Public health is, at its core, a promise — a commitment a society makes to protect its members from the diseases, toxins, and disasters that no individual can fend off alone. In the United States, that promise has been built over more than a century through research, regulation, and the slow accumulation of institutions designed to keep people alive.

The Trump administration is dismantling that promise. The word “assault” comes to mind. Merriam-Webster’s dictionary defines assault as “a concerted effort (as to reach a goal or defeat an adversary). And that’s the perfect word for the Trump Administration’s attack on public health – systematic, deliberate, and at a scale that experts across the political spectrum — including veterans of Republican administrations — have called unprecedented. [We’ve written on SciLight before about the Administration’s assault on science, for example here, here, and here.]

From gutting the agencies that track disease and fund medical research, to appointing an avowed vaccine skeptic to run the nation’s health department, to stripping millions of Americans of health insurance while withdrawing the United States from the institutions that govern global health, the administration has launched a sweeping assault on our nation’s public health infrastructure.

Agencies: Cutting the Heart Out of Public Health

The Trump administration moved against America’s public health agencies with startling speed and breadth. Within weeks of taking office, it targeted the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), the Food and Drug Administration (FDA), and the Centers for Medicare and Medicaid Services (CMS) — the four pillars of the federal public health system.

By April 1, 2025, mass layoffs had eliminated 10,000 employees across these health agencies in a single day, with approximately 2,400 cut from the CDC, 3,500 from the FDA, and 1,200 from the NIH. Thousands more had already left through the administration’s “Fork in the Road“ forced resignation initiative, organized by Elon Musk’s Department of Government Efficiency. In total, more than 20,000 HHS workers — roughly a quarter of the entire federal public health workforce — lost their jobs in the first weeks of the new administration.

The budget proposals that followed made the intent clear: a 44 percent cut to the CDC’s budget, reducing it from $9.2 billion to $5.2 billion; a 40 percent cut to the NIH, reducing it from $47 billion to $27 billion; and an overall 26 percent reduction in HHS discretionary spending. Johns Hopkins health policy scholar Liz Fowler said it plainly: “It is the biggest cut to our social safety net in history.”

Meanwhile, in February 2026, the administration announced more than $600 million in additional cuts to public health grants in California, Illinois, Colorado, and Minnesota — including grants that had already been authorized and signed into law by Trump just weeks earlier. Four state attorneys general immediately sued. A federal judge blocked the cuts with a temporary restraining order.

And then there’s the assault on the Environmental Protection Agency (EPA) and on the Occupational Safety and Health Administration (OSHA). Rollbacks at the EPA will profoundly affect public health, just as Trump’s deregulatory agenda for the Occupational Safety and Health Administration (OSHA) will affect our nation’s workers.

Science Blackout: Silencing Communication, Deleting Webpages, and an Unqualified Appointment

Alongside the layoffs and budget cuts, the administration moved to suppress the scientific information the public depends on.

In the first days of the new term, the administration paused all communications from the CDC, FDA, and NIH with the public. Thousands of government webpages were taken down, including CDC databases containing information on sexual orientation and gender identity, disease trends, maternal health, and environmental exposures. The FDA removed diversity requirements from its clinical trial guidance on its own website.

The gag orders extended to advisory committees. The communications freeze forced the cancellation of NIH study sections — the bodies that review grant applications — along with advisory committee meetings, halting the flow of science at its source. While these assaults were relatively short-lived, with this Administration, the threat remains.

The administration also elevated anti-science figures to positions of power. No single appointment crystallized the administration’s relationship with public health science more starkly than the confirmation of Robert F. Kennedy Jr. as Secretary of Health and Human Services. The appointment of a person with no health expertise to oversee our nation’s critical health agencies -- the CDC, NIH, FDA, and CMS. A coalition of national medical, scientific, public health and patient organizations called for Kennedy’s ouster. Need I say more? Well, I guess I could point out that a district court judge just struck down Kennedy’s vaccine policies, noting that the federal government had not based its decisions on science in limiting Covid shots and revising the childhood immunization schedule.

Global Impacts

The administration’s assault on public health did not stop at America’s borders. Its actions on global health will be measured in millions of lives.

Leaving the World Health Organization. On his first day in office, Trump signed an executive order initiating the United States’ withdrawal from the World Health Organization — the institution at the center of global pandemic preparedness, disease surveillance, and international health coordination. The United States had been the WHO’s largest financial contributor, providing $1.284 billion in 2022-23 — funding crucial initiatives for pandemic preparedness, disease control, and health equity globally.

In July 2025, the U.S. also rejected the amended International Health Regulations and opted out of the new Pandemic Agreement — abandoning the legal frameworks designed to prevent the next pandemic from devastating the world.

Dismantling USAID and Threatening to Withhold HIV Treatment. In January 2025, taking a sledgehammer to humanitarian aid, the Trump administration issued stop-work orders for virtually all U.S. foreign assistance programs — halting the flow of American health aid around the world. By the end of March 2025, 86 percent of all U.S. global programs had been terminated. The US Agency for International Development (USAID), the agency that had distributed 42 percent of global humanitarian aid — was effectively dissolved.

And just today (3/17/26), in favoring access to minerals over human health, the NYT reports that the Administration may withhold HIV treatment in Zambia unless it expands our access to minerals. This assistance has been provided through the decades-old U.S. President’s Emergency Plan for AIDS Relief (known as PEPFAR) and on tuberculosis and malaria medications that save tens of thousands of Zambian lives each year.

Eliminating Health Equity Infrastructure. The administration has also specifically targeted offices and programs designed to address the disproportionate health burden on communities of color.

The director of NIH’s National Institute on Minority Health and Health Disparities was placed on administrative leave and then fired. The CMS Office of Minority Health was closed. Research grants were canceled if they so much as touched on racial health disparities, LGBTQ+ health, or environmental justice — all of which the administration classified as “DEI.”

These offices and programs existed because the data demanded them. It was research funded by institutions like these that documented the disparate impact of COVID-19 on Black and brown communities, linking higher death rates to a combination of occupational exposure, housing density, and lack of insurance

An Ideological Agenda Dressed as Efficiency

Administration officials, including RFK Jr. and DOGE-master Elon Musk, have framed the cuts to public health infrastructure as efforts to reduce waste and increase efficiency. I don’t buy it, and the data do not support it. As the Economic Policy Institute noted: the administration is proposing catastrophic damage to American public health in exchange for savings that represent “one-tenth of one percent of total federal spending.”

The Congressional Budget Office has estimated that the Medicaid and ACA cuts will generate $1 trillion in savings — but at a cost of 17 million people losing insurance, rural hospitals closing, and the sickest and poorest Americans being left with nowhere to turn.

Stripped of its efficiency rhetoric, what remains is a coherent ideological agenda: shrink the federal government’s role in protecting health, gut institutions that hold corporations accountable for environmental and product-related harms, and replace evidence-based medicine with a combination of market forces and personal responsibility — leaving individuals and communities to bear the full weight of risks they cannot control and did not choose.

Bottom Line

Public health is generally slow-acting. The damage being done today may not appear as a mortality statistic for months or years to come, although a child whose mother can’t afford an inhaler could die from an asthma attack in a matter of minutes. Similarly, the children who lose their Medicaid coverage may not immediately show up as deaths; they will appear as delayed diagnoses, untreated asthma, or cancer found too late because a rural clinic closed. The NIH researchers who have been fired or who have left will not produce the cancer, vaccines, and other therapies that might save thousands of lives.

Our voice and participation can make a real difference. For example, we can contact our representatives at all levels of government to urge their support for public health programs and initiatives. We can testify at hearings on public health issues. We can sign on to public letters or coalitions supporting public health legislation. We can support organizations that include public health in their missions. We can join public health coalitions or task forces to gain visibility among key stakeholders. We can share stories and ideas on social media platforms.

And of course, WE CAN VOTE.

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