The War on Public Health Continues

Friday’s layoffs announcements at CDC targeted infectious disease control

During the COVID outbreak, President Trump said, “If we stopped testing right now, we’d have very few cases, if any.”  That philosophy seems to have taken hold during his second term in office. On Friday, the Administration sent out notices that it was firing more than a thousand CDC workers, including the scientists and doctors who provide key information and expertise about infectious disease outbreaks.

Among those receiving the notices were the members of the Epidemic Intelligence Service, who are deployed to investigate outbreaks. The Administration also decided to dispense with the entire team that publishes the CDC’s weekly public health report, the Moribidity and Mortality Weekly Report.  In the Center for Forecasting and Outbreak Analytics, the Administration axed the division of technology and innovation. CDC’s Global Health Center was also eliminated, including the distinguished expert who was leading the measles response.  She had been well-regarded by the Administration, but that was no protection during the purge of agency expertise.

Apparently realizing that it had made a PR blunder, the Administration is now citing “procedural error” for some of the most blatantly stupid terminations. It is frantically trying to reverse some of those. But hundreds will still lose their jobs, and CDC will be permanently damaged.  Even putting the best conceivable light on the Administration’s actions, it’s clear that they didn’t care enough to bother getting things right in the first place.

The Administration’s attitude toward science was represented by Health Secretary Robert F. Kennedy, Jr. during a meeting with Trump and the Cabinet the same day. Kennedy admitted that there was no medical proof of Kennedy’s cherished belief that Tylenol is connected with autism. Not to worry, Kennedy said: “It is not proof. We’re doing the studies to make the proof.”

One of the most puzzling aspects of this Administration is its war on medical science.  The  proposed budget for the National Institutes of Health cuts spending on medical research from $40 billion to $24 billion. The CDC’s budget would be cut roughly in half. As a Brookings expert observed, “In sum, the president’s 2026 health budget is at best contradictory and at worst self-defeating, threatening lower economic growth, protection from new infectious diseases and food-borne illness, and the potential for diseases such as AIDS or drug-resistant tuberculosis jumping international borders and threatening health in the U.S.”

Why would anyone think this was a good idea, regardless of their political ideology? I’ve toyed with a few theories:

1. Maybe it’s a backdoor way of controlling medical costs: if we don’t invent new lifesaving drugs or technologies, we won’t have to pay for their use.

2. Maybe they think the private sector will fund all necessary research.  Economists don’t think that’s likely, especially as to basic research. It also contradicts the first argument, since if the private sector is paying for the research, it will need to recoup through higher healthcare costs.

3. Or maybe they think that AI will make the need for human researchers obsolete. But  the AI would also need to have a lot of healthcare data and a lot of experimental results.

It’s possible that one of these views is held by some members of the Administration. It’s harder to believe that policy is being silently driven by something like these theories.  More likely, this is just an example of rational considerations being swamped by the culture wars. Once, like Secretary Kennedy, you decide that the purpose of science and evidence is to confirm your preexisting beliefs, there’s really not much point in bothering with them anymore.

CDC, public health, scientific integrity, Trump Administration