‘Decimated’: Health department layoffs wipe out divisions and key programs, critics say

When Health & Human Services Secretary Robert F. Kennedy Jr. announced his plans to lay off 10,000 workers last week, he said that the department was getting rid of bureaucrats and would keep the personnel who had direct work in health and safety.

Health & Human Services Secretary Robert F. Kennedy Jr. says the department's layoffs are necessary to refocus the agency. Critics say the staff reductions undermine key programs to protect the public health. (Image: HHS)

Public health leaders say that’s not how the health department’s staff cuts are playing out.

Days after Kennedy announced the layoffs, thousands of health workers found out they lost their jobs Tuesday.

Public health leaders condemned the cuts to the health department and said the layoffs are damaging programs that protect Americans. Several leaders of public health organizations said the cuts are “decimating” successful health and prevention programs, including vaccinations, HIV prevention and anti-smoking efforts.

Sharon Gilmartin, executive director of the Safe States Alliance, said that the “cuts to CDC in particular and the HHS workforce have been unprecedented. They are completely out of step with history and best practices.”

“Projects tackling the very issues that our administration claims to prioritize are now left without anyone to actually work on them,” Gilmartin said. “These cuts are not the bureaucratic streamlining that was promised.”

Between the layoffs taking place and earlier buyout and early retirement programs, the health department is shedding 20,000 workers this year, or a quarter of its workforce.

With the layoffs, the Food and Drug Administration and the Centers for Disease Control & Prevention are losing nearly one-fifth of their staff, the health department said last week. The FDA is slated to lose 3,500 workers, while the CDC is eliminating 2,400 jobs. The National Institutes of Health is losing 1,200 workers, with layoffs taking place just as Jay Bhattacharya, MD, the NIH’s new director, took office Tuesday.

“They clearly are eliminating whole divisions and branches, which doesn't speak to bureaucratic streamlining,” Gilmartin said. “It speaks to moving forward an agenda which has not been elucidated for the public health community. It's not been elucidated for the public.”

Kennedy wrote a post on X acknowledging the disruptions but defended the layoffs and reorganization of the department as a necessary shift in course. He has said the layoffs would save taxpayers $1.8 billion.

“This is a difficult moment for all of us at HHS,” Kennedy said. “Our hearts go out to those who have lost their jobs. But the reality is clear: what we've been doing isn't working.”

‘All gone or dramatically reduced’

Health leaders warned of the potential of lasting damage to health programs before the terminations began this week, and their outrage mounted as they learned about the places where staff were being cut.

Lori Freeman, chief executive officer of the National Association of County and City Health Officials, said the layoffs weakened federal programs that also support state and local health departments.

“While we're still learning about the full impact of these actions, it's clear that entire sectors of work have been eliminated or decimated,” Freeman said. “These layoffs are going to disrupt actions that keep people healthy and safe and able to live their lives without fear, possibly for years to come.”

During a joint news conference Tuesday, public health leaders outlined what they had heard about the cuts and the impacts on federal programs.

Those programs include the CDC’s HIV prevention program, the Office of Smoking and Health, the CDC’s Climate & Health Program, gun violence prevention, environmental disaster teams, the CDC’s divisions of reproductive health, and others.

Susan Polan, associate executive director of the American Public Health Association, said the programs are “all gone or dramatically reduced.”

“CDC keeps us healthy. It keeps Americans out of the healthcare system,” Polan said.

The CDC Injury Center lost 200 staff members, Gilmartin said. “It's one of the smallest centers at CDC,” she said. “It is certainly not able to absorb that type of cut without significant impacts on its programs.”

Health leaders also condemned the way the layoffs were carried out, saying that the process should have been more deliberate and done in concert with Congress. Health leaders also said HHS staff came to work only to find out that they were laid off without any advance warning and denied access to their offices.

Gilmartin said the layoffs undermine Kennedy’s campaign to “Make America Healthy Again.” She said, “How can we do that when the people who have spent decades of their lives combating the most pervasive health issues in the nation are being kicked out with no notice?”

‘Setting us back decades’

Health leaders said the layoffs are compounding the Trump administration’s move to claw back $11 billion in Covid-related funding given to state and local health departments. Public health officials say the money was designed to build up programs to track outbreaks and strengthen emergency response. On Tuesday, Democratic attorneys general in 23 states filed a suit Tuesday to stop the Trump administration from pulling back the money.

Dr. Phil Huang, director of Dallas County Health and Human Services in Texas, said the damage of the HHS layoffs could endure for many years. Local and county health agencies like his rely on the federal government for support and technical expertise.

“This truly is setting us back decades,” Huang said. “You cannot just build this back again, and it's taken a long time to develop this expertise.”

Huang and others pointed to the disappointment over cuts aimed at the CDC’s HIV prevention programs. Preventing just one individual case of HIV can avert more than $400,000 in healthcare costs, he said.

“HIV prevention is one of the most cost-effective things that we were doing,” he said.

The CDC partners with local health departments on a daily basis, sharing expertise from experienced staff and communicating about potential threats. CDC experts also help ensure local and state health officials know “what might be coming and how to prepare for those threats," Freeman said.

“Today's cuts eliminate or severely curtail these abilities, and the impacts almost certainly will be with us for a long time to come,” she said.

‘Assault on public health’

Chrissie Juliano, executive director of the Big Cities Health Coalition, said the support and experience being eliminated at the federal level is irreplaceable.

“I think it's really critical to understand that you can't just replace this amount of federal money and this amount of federal expertise and people,” Juliano said.

“Absolutely there is a role for the private sector philanthropy, our organizations and partners," she said. "But, you know, the federal government plays a critical role in the governmental public health system and in how the system as a whole, operates … It's just not practical that all of this could be replaced by partners, the private sector, philanthropy, others.”

Given Kennedy’s stated desire to focus on chronic diseases, health leaders said they were baffled by reductions in programs to prevent smoking. Freeman said efforts to curb tobacco use are undermined by the “gutting” of the FDA’s Center on Tobacco Products and the elimination of the CDC’s Office of Smoking and Health.

“Smoking is a leading factor for chronic diseases and a leading cause of preventable death in the United States,” Freeman said.

Dr. Tom Frieden, former CDC director under President Barack Obama, said the elimination of the CDC's tobacco control program puts lives at risks. He said the CDC tracks tobacco use and helps local and state agencies develop programs to prevent the use of tobacco.

"Eliminating CDC’s tobacco prevention program would mean less data to inform physicians and parents, weaker state programs, fewer evidence-based strategies, and more people—especially kids—addicted to tobacco," Frieden wrote on X.

Gilmartin called the layoffs an “ongoing assault on public health.”

“We are crippling the very system that's in place to protect us,” Gilmartin said.

“There's a lot of widespread uncertainty and chaos, which is perhaps the goal of HHS leadership,” she added. “But meanwhile, the very issues that these agencies are preventing do not go away when the staffing is reduced.”