The NIH Restructured: The Fork in the Road, Reduced Labor and Measuring the Public Health Ignorability
“While public health is declining, a few isolated divisions are neglecting public health entirely and seem only accountable to the industries that they’re supposed to be regulating.” he said, without naming the divisions or industries he was referring to.
Sen. Bill Cassidy wants to see the HHS do more to improve Medicare services. I’m looking forward to hearing how the reorganization improves these goals.
Calley Means is one of Kennedy’s allies in the Make America healthy again movement, and she wrote an X post about the restructure, which she called the cause of our bad health outcomes.
The cuts are rattling staff at the health agencies, according to three current NIH employees who did not want to be identified because of fears of retribution.
“It is impossible for me to imagine that cuts of this size will not substantially affect functions negatively,” said Jeremy Berg of the University of Pittsburgh, who served as the director of the National Institute of General Medical Sciences, part of the National Institutes of Health, from 2003 to 2011. It is another assault on the ability of the National Institute for Health to achieve its important missions.
Another NIH employee said the agency has lost about 4,400 employees so far out of a staff of about 18,000. There are 1,200 RIFs announced on Thursday as well as 1,200 new hires who were fired previously and 2,000 who accepted the Fork in the Road offer.
The HHS Restructuring: Why the American Public Health Association is Frustrated and Why the Federal Government Will Not Respond to COVID
The Administration for Strategic Preparedness and Response is being housed in the CDC instead of being directly notified of natural disasters and public health emergencies. Dawn O’Connell told NPR that the move could limit its scope. “It’s curious to me that they would put us into CDC at a time when they want CDC to focus on infectious disease work.”
Under the Biden administration, ASPR was elevated into an operating division so it could respond more nimbly to emergencies, in response to lessons learned during COVID, O’Connell says.
“I don’t begrudge a new administration coming in to figure out whether we got it right. She says that the idea of losing progress is going to put them back.
The head of the American Public Health Association said that the HHS restructuring is contrary to the goal of improving health in the United States.
Benjamin said that this is a nonsensical reorganization of agencies and an excuse to ruin the workforce for financial reasons. It will cause more deaths, increase health costs and undermine our economy.
The union representing many federal workers, the National Treasury Employees Union, issued a statement Thursday condemning the cuts and saying it will “fight back.”
“If this disastrous plan is carried out and the agency loses an additional 10,000 employees, as proposed, the impact to public health services across the country will be devastating,” said NTEU president Doreen Greenwald.
Have information you want to share about the ongoing changes across federal health agencies? Reach out to these authors via encrypted communications: Selena Simmons-Duffin @selena.02, Pien Huang @pienhuang.88 and Rob Stein @robstein.22.
He described “little fiefdoms” within HHS of being “so insulated and territorial that they actually hoard our patient medical data and sell it for profit to each other,” though he didn’t offer further details.
Behind the scenes, HHS employees do a lot of work to prevent fraud and ensure health care programs provide the services promised. Reductions in the federal workforce could result in more wasteful spending down the road.”
“When I arrived, I found that over half of our employees don’t even come to work,” he said. HHS didn’t respond to questions about whether employees were put on administrative leave or approved teleworking arrangements.
The cuts include employees who have taken the Trump administration’s Fork in the Road offer and early retirement, plus an additional reduction in force of 10,000 jobs. The agency says it will take up to 62,000 workers to work in the HHS.
HHS is the umbrella agency that includes the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Food and Drug Administration, the National Institutes of Health (NIH) and other smaller divisions.
The new Administration for a healthy America will be intended to coordinate chronic care and disease prevention programs. Maternal and child health, mental health, and HIV/AIDS are some of the things it will focus on.
There were 3,500 full-time employees at the FDA, as well as 2,400 at the CDC, 1,200 at the NIH and 300 at the Centers for Medicare & Medicaid Services, according to an HHS fact sheet. Drug, medical device or food reviewers will not be affected by the new job cuts at the FDA. The reorganization will not impact Medicare or Medicaid.
The cuts are in keeping with President Donald Trump’s vision of dramatically reducing the size of the federal government and have been led by the Musk Department of Government Efficiency (DOGE).
Addiction experts told NPR they are now bracing for what many believe will be deep cuts to Medicaid funding, which provides the largest single source of insurance coverage for drug and alcohol treatment nationwide.
State and county public health departments are reeling after the Trump administration canceled and withdrew grant funding for addiction, mental health and other programs.
“This is cutting things off in the middle while people are actually doing the work, and that’s what addiction policy researchers like to do,” said Humphreys. He warned the move could lead to layoffs and treatment disruptions.
The grant funding was going to last until September 2025. In a statement sent to NPR, a spokesperson with the U.S. Department of Health and Human Services said it made sense to freeze the program immediately.
“The COVID-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago,” the statement said, adding that the Trump administration will refocus funding on America’s “chronic disease epidemic.”
Drug overdoses linked to fentanyl and other substances have declined sharply in recent years, thanks in part to a surge in funding for addiction treatment during the Biden administration. But street drugs still kill more than 84,000 people in the U.S. every year, according to the latest data from the Centers for Disease Control and Prevention.
President Donald Trump has made fentanyl smuggling a top concern during the opening weeks of his administration, extending an emergency declaration linked to the powerful street opioid.
But his team has also also rapidly slashed the number of federal researchers focused on addiction and Trump pardoned a tech mogul convicted of building a “dark web” platform used to traffic illicit drugs.
The move to rescind funds that include addiction-care grants drew criticism from experts who warned progress reducing overdose deaths could be reversed.
“DOGE is now actively cutting funding aimed at reducing overdose deaths by clawing back money from states,” wrote Regina LaBelle, an expert on drug policy at Georgetown University who served in the Biden administration in a post on social media. Are DOGE declaring victory, with overdose deaths still exceeding 80,000 annually?
A spokesman for Ohio’s Republican Governor Mike DeWine said they were waiting to hear more about the cuts.
“Senselessly ripping away this funding Congress provided will undermine our state’s ability to protect families from infectious diseases like measles and bird flu and to help people get the mental health care and substance use treatment they need,” said U.S. Sen. Patty Murray, a Democrat from Washington state, in a statement.
The loss of federal funds in her state could cost more than 200 jobs in public and non-profit health organizations.
“At a time when New York is facing an ongoing opioid epidemic, multiple confirmed cases of measles and an ongoing mental health crisis, these cuts will be devastating,” Hochul said. There isn’t any state in the country with the financial resources to backfill the federal funding cuts.
A person with the Colorado’s Behavioral Health Administration said that federal budget cuts could affect as many as 60 programs and put patients at risk.
According to a spokeswoman for Colorado Public Radio, “in so many cases, these are life saving programs and services and we worry for the wellbeing of those who have come to count on this support.”
Tom Wolf: Addiction, Recovery, and Treatment in the U.S. After the First Adolescence Overdoses Reaction Conference
Tom Wolf, an addiction activist in San Francisco who has been critical of Democratic approaches to address the overdose crisis, said he remains broadly supportive of Trump’s policy ideas.
He expressed concern about the pace of change and the risk that effective addiction treatment could be defunded at a time when thousands of people in the U.S. are still dying from fatal overdoses.