Trump Administration Changes

Authors: Ifrah Ahmad, Katelyn Miyasaki, Yaneer Bar-Yam

On June 11, WHN published a statement expressing ‘grave concern over the ongoing dismantling of core public health institutions in the United States [1]. In this newsletter, we review actions taken in recent months that impact public health in the U.S. and globally.

Executive orders issued after the January 20 inauguration prompted broad changes to public health communications, grant disbursements, and agency organization. These actions posed risks to health data accessibility, clinical research, and disease surveillance capacity. 

In response, federal courts issued injunctions blocking several of these measures, citing the threat of immediate harm to clinical care, outbreak response, and research continuity (see Table I). The blocks are in force as of this writing, though proceedings remain ongoing and final outcomes may change.

Here we summarize the impacts of several of the executive orders and associated actions:

• Disruption in Public Health Communications
  • Beginning January 20, multiple U.S. federal health agencies paused external communications, including public announcements, social media activity, and publication of the CDC’s Morbidity and Mortality Weekly Report (MMWR). These platforms play a central role in disseminating time-sensitive health data, outbreak surveillance reports, and clinical guidance used by health professionals and researchers across the country [2,3].
  • While some communications resumed after February 5, others remained restricted [4]. The suspension occurred during ongoing transmission events, including regional tuberculosis outbreaks, substantial measles clusters, and H5N1 in mammals and humans—each of which benefits from timely and coordinated public health messaging [5,6,7].
• Removal of Public Health Web Content
  • As of early February, numerous federal health agency web pages were removed or modified in ways that excluded previously available health information, including CDC content related to HIV [8]. A court subsequently ordered the restoration of this material, citing its importance for physicians in managing health conditions and communicating with patients [9].
  • At the time of writing, not all information appears to have been reinstated. Previously available versions of affected pages can be accessed via public web archives, including an archived version of the CDC’s HIV site from January 23, 2025 [10].
• Unexplained Removal of Scientific Information Related to H5N1
  • A figure suggesting possible household transmission of H5N1 avian influenza between cats and humans was briefly published in a CDC air-quality–related report in early February 2025 and then removed without public explanation [11]. No correction, erratum, or retraction was issued, and the figure has not reappeared in official CDC publications. In standard scientific and public health practice, errors are typically addressed through formal retraction or clarification. The absence of such notice raises concerns about whether the removal reflected editorial or political interference rather than a technical revision. Access to timely and transparent information is critical during 
• Withdrawal of the United States from the World Health Organization (WHO)
  • An executive order issued in January 2025 began the process of withdrawing the United States from the World Health Organization. Under current legislative requirements, withdrawal cannot take effect for one year and may require Congressional action to be finalized. During this period, funding and programmatic arrangements are subject to uncertainty pending legislative or administrative clarification.
  • The United States is the largest contributor to the WHO, providing an estimated $988 million for the 2024–2025 budget cycle—approximately 14% of the organization’s $6.9 billion total budget [12]. These funds support global disease surveillance, laboratory coordination, vaccination programs, and emergency response infrastructure. The potential loss of this funding threatens the continuity of programs that detect and contain outbreaks, deliver essential care, and coordinate international response—affecting people both in the United States and worldwide [13,14].
  • The CDC has also been directed to suspend collaboration with the WHO, affecting joint efforts in pandemic monitoring, laboratory data sharing, and technical assistance [15].
  • In addition to operational disruptions, the withdrawal may weaken U.S. influence in global health governance. Public health coordination has historically served as a neutral platform for international cooperation, and the loss of this engagement could reduce early access to critical information and diminish global leverage during health emergencies [16].
• Disruptions to Biomedical Research Funding (NIH and NSF)
  • Multiple disruptions of research funding have occurred. Health research advances the development of new treatments, informs response to emerging conditions, and improves care through iterative discovery. These advances depend on a cumulative, layered process—where each stage builds on the work that came before. Disrupting that process does not simply pause progress; it undermines the impact of prior research and the basis for future discoveries.
  • On January 20, 2025, the National Institutes of Health (NIH) suspended research grant review activities as part of a broader administrative pause. Review sessions resumed on February 2. During this period, the NIH—responsible for administering the world’s largest public biomedical research portfolio—was unable to issue new grants, affecting approximately 80% of its $47 billion annual budget [17,18].
  • The interruption delayed funding decisions for thousands of researchers across disciplines, leading institutions to report potential layoffs or project shutdowns due to uncertainty in funding flow, with early-career researchers particularly vulnerable to loss of momentum, hiring delays, or tenure risk [19]. More broadly, the disruption inhibited ongoing scientific research, paused the launch of new investigations, and limited the system’s ability to respond to emerging public health questions.
  • In parallel, 22 states filed suit against the NIH to prevent additional proposed cuts to research funding, citing anticipated impacts on scientific advancement, healthcare innovation, and institutional stability [19].
  • At the National Science Foundation (NSF), changes to grant review procedures now subject proposals containing terms such as “female,” “trauma,” or “diversity” to increased scrutiny or disqualification under revised federal guidance. These terms are foundational in a wide range of scientific fields, including research on physical and psychological trauma, women’s health, and population differences in health outcomes. Restricting such proposals may inhibit the study of injuries, reproductive health, mental health, and variation in diagnosis and treatment effectiveness—areas central to effective health research and public policy [20].
  • As a result of ongoing instability, several research universities—including MIT, Columbia, and Northwestern—have announced hiring freezes and administrative restructuring in response to budget shortfalls linked to delayed or canceled federal grants [21].
• Agency Layoffs and Health System Capacity Amid Active Outbreaks
  • On January 20, 2025, the federal government enacted a hiring freeze [22,23,24], followed by cuts to public health staffing including CDC’s Laboratory Leadership Service and Epidemic Intelligence Service. These units are essential for detecting and investigating infectious threats such as SARS-CoV‑2 and H5N1 avian influenza. Reduced staff capacity may impair timely outbreak detection and response in regions where surveillance networks are already stretched thin.
    • Tuberculosis (TB) in Kansas is among the largest in decades. Though general population risk remains low, rising TB incidence over the past two years underscores the need for robust public health infrastructure and rapid detection systems [25].
    • Measles has surged across the U.S.: in early 2025, CDC reported 800 confirmed cases in 25 jurisdictions—an approximately 180 % increase over 2024—and hundreds of additional cases emerged later. The total now exceeds 1,288 cases across 38 states, with three deaths and more than 160 hospitalizations, making it the worst outbreak since 1992  . The resurgence—largely among unvaccinated individuals—is concentrated in West Texas, New Mexico, and Kansas. A decline in MMR coverage below the 95 % herd-immunity threshold is a key driver [26,27].
    • H5N1 avian influenza continues to spread in U.S. animal populations. As of early 2025, CDC has reported 70 confirmed human infections, primarily linked to exposure to infected poultry or dairy cattle; the virus is considered to have pandemic potential if genetic changes enable person-to-person spread [28].
  • The National Institute for Occupational Safety and Health (NIOSH), which plays a central role in workplace safety research and respiratory protection standards, was subject to severe staffing reductions in early 2025. By April, more than 850 of its approximately 1,000 staff had been laid off, affecting core programs including respirator certification, mining safety, firefighter exposure research, and occupational health surveillance. These functions are critical not only for occupational protections but also for emergency response readiness and pandemic preparedness. Although NIOSH was later reinstated, the disruption raised serious concerns about the vulnerability of essential health infrastructure to administrative decisions. Even temporary dismantling of such programs can disrupt certification pipelines, delay safety standard development, and undermine confidence in the protective systems relied on during public health emergencies..
• Reduced Protections for Healthcare Access and Workplace Safety
  • Executive orders previously issued to improve access to healthcare and strengthen workplace safety have been rescinded under a January 2025 directive [29]. These reversals may affect programs related to healthcare affordability, worker protections in high-risk settings, and enforcement of public health standards across sectors. The impact on healthcare access and safety measures may be compounded by concurrent reductions in public health agency capacity and surveillance infrastructure.

For ongoing updates on developments affecting public health policy and systems, visit: https://whn.global/public-health-alerts

Table I: Legal Injunctions Justified by Public Health Impact

In multiple cases, courts held that restoring access to information, sustaining grant flows, or preserving agency staffing was legally necessary to prevent measurable public health harms. These rulings are temporary (TROs or preliminary injunctions) and are subject to further adjudication—but in each instance, judges’ statements pointed to the direct risks to patient care, outbreak readiness, and clinical research as the primary rationale. These decisions did not assess the scientific validity of agency content or programs; rather, they affirmed that a collapse in agency capacity or data access constituted legal—and health-related—injury.

References:

[1] https://whn.global/scientific/whn-statement-on-the-dismantling-of-u-s-public-health-institutions/

[2] https://www.nature.com/articles/d41586-025-00231-y

[3] https://apnews.com/article/trump-health-communications-cdc-hhs-fda-1eeca64c1ccc324b31b779a86d3999a4

[4] https://www.nbcnews.com/health/health-news/cdc-health-agencies-communication-allowed-still-blocked-rcna190527

[5] https://publichealth.jhu.edu/2025/tuberculosis-in-kansas-the-larger-picture

[6] https://www.usatoday.com/story/news/health/2025/02/21/texas-measles-outbreak-2025-90-cases/79456182007/

[7] https://whn.global/newsletter/h5n1-update-for-june-2025/

[8] https://www.npr.org/sections/shots-health-news/2025/02/06/nx-s1-5288113/cdc-website-health-data-trump

[9] https://apnews.com/article/trump-cdc-fda-doctors-for-america-5263fc6b6cbc723ca0c86c4460d02f33

[10] https://web.archive.org/web/20250123181347/https://www.cdc.gov/hiv/ 

[11] https://www.nytimes.com/2025/02/06/health/cdc-bird-flu-cats-people.html

[12] https://open.who.int/2024-25/contributors/contributor

[13] https://apnews.com/article/who-trump-tedros-global-health-a2eafc341cd2200e8800a2421d30bdfc 

[14] TIME. (2025). U.S. Withdrawal from WHO Threatens Global Health Security. https://time.com/7208937/us-world-health-organization-trump-withdrawal/

[15] AP News. (2025). CDC ordered to end collaboration with WHO. https://apnews.com/article/cdc-who-trump-548cf18b1c409c7d22e17311ccdfe1f6

[16] Johns Hopkins University. (2025). The Consequences of the U.S. Withdrawal from the WHO. https://publichealth.jhu.edu/2025/the-consequences-of-the-us-withdrawal-from-the-who

[17] Scientific American. (2025). Trump Cancels Science Reviews at NIH, World’s Largest Public Biomedical Funder. https://www.scientificamerican.com/article/trump-cancels-science-reviews-at-nih-worlds-largest-public-biomedical/

[18] Nature. (2025). US Researchers Face Unprecedented Disruption in NIH Funding.https://www.nature.com/articles/d41586-025-00231-y

[19] Commonwealth of Massachusetts. (2025). Complaint in Commonwealth v. NIH et al. https://www.mass.gov/doc/ecf-complaint-mass-v-nih/download

[20] Business Standard. (2025). NSF Research Grant Review Tightens Following DEI Directive. https://www.business-standard.com/world-news/nsf-research-grant-review-trump-orders-dei-keywords-scrutiny-women-trauma-125021000459_1.html

[21] Inside Higher Ed. (2025). Federal Funding Uncertainty Prompts Hiring Freezes at Major Universities.https://www.insidehighered.com/news/government/politics-elections/2025/02/19/federal-funding-uncertainty-prompts-hiring-freezes

[22] The White House. (2025, January 20). Presidential Memorandum on Hiring Freeze. https://www.whitehouse.gov/presidential-actions/2025/01/hiring-freeze/

[23] Associated Press. (2025, April 4). Layoffs threaten U.S. firefighter cancer registry, mine research and mask lab. Reports approximately 850 of 1,000 NIOSH staff terminated—impacting critical occupational health programs. https://www.msn.com/en-ca/health/other/layoffs-threaten-us-firefighter-cancer-registry-mine-research-and-mask-lab/ar-AA1ClIJk

[24] ISHN.com / CBS News sources (via ISHN). (2025, May 5). NIOSH lays off most remaining staff. Approximately 90% of NIOSH workforce received layoff letters; mining safety research, respirator lab, and personal protective equipment testing are compromised. https://www.ishn.com/articles/114722-niosh-lays-off-most-remaining-staff

[25] Johns Hopkins University Bloomberg School of Public Health. (2025). Tuberculosis in Kansas: The Larger Picture. https://publichealth.jhu.edu/2025/tuberculosis-in-kansas-the-larger-picture

[26] CDC. (2025, April 12). Measles — United States, January 1–March 31, 2025. MMWR Weekly 74(14), 305–311. https://www.cdc.gov/mmwr/volumes/74/wr/mm7414a1.htm

[27] Reuters. (2025, July 31). U.S. vaccination rates for measles and other diseases drop further, government data says.https://www.reuters.com/business/healthcare-pharmaceuticals/us-vaccination-rates-measles-other-diseases-drop-further-government-data-says-2025-07-31/

[28] CDC. (2025, March 19). CDC Response to Highly Pathogenic Avian Influenza A(H5N1), 2024–2025.https://www.cdc.gov/bird-flu/spotlights/h5n1-response-03192025.html

[29] The White House. (2025). Initial Rescissions of Executive Orders on Health and Safety. https://www.whitehouse.gov/presidential-actions/2025/01/initial-rescissions-of-harmful-executive-orders-and-actions/

[30] https://storage.courtlistener.com/recap/gov.uscourts.dcd.277069/gov.uscourts.dcd.277069.12.0_1.pdf, see also https://apnews.com/article/5263fc6b6cbc723ca0c86c4460d02f33 

[31] https://fingfx.thomsonreuters.com/gfx/legaldocs/zgpojbqxnvd/03052025nih_ruling.pdf, see also https://www.reuters.com/business/healthcare-pharmaceuticals/us-judge-bars-trump-administration-cutting-nih-research-funding-2025-03-05/  

[32] https://www.courthousenews.com/wp-content/uploads/2025/05/preliminary-injunction-hhs-rfk-covid-funding-cuts.pdf, see also https://www.reuters.com/business/healthcare-pharmaceuticals/us-judge-blocks-11-billion-trump-administration-health-funding-cut-now-2025-04-03/  

[33] https://fingfx.thomsonreuters.com/gfx/legaldocs/zdvxkomnrpx/07012025hhs.pdf, see also https://www.reuters.com/legal/litigation/us-judge-blocks-trump-administration-move-overhaul-health-agencies-2025-07-01/