State of CDC Report

Introduction 

Imagine a school system discovers unsafe levels of lead in some of their buildings. It puts in a request with the Centers for Disease Control and Prevention (CDC) to help it investigate the problem. Then, that request is denied because CDC’s entire Lead Program was fired due to a Reduction in Force (RIF) the week before.

This exact scenario took place in April of last year when Milwaukee Public Schools filed an EpiAid request after discovering lead in multiple schools. Luckily, that program was reinstated a few weeks later. However, it never should have been cut in the first place. 

EpiAid requests are one of the many resources CDC provides to improve the health and safety of Americans. Every day, CDC programs like those that track smoking rates, prevent drownings, and prepare states for natural disasters operate in the background to keep us healthy. The public usually does not notice them until something goes wrong. But, over the course of the past year, the CDC has been dismantled. Over the past year, about 25% of CDC’s full-time federal employees have left the agency through RIFs, retirements, and resignation; entire programs were eliminated. Last June, all members of the Advisory Committee on Immunization Practices (ACIP)—the independent committee within CDC that helps set vaccine recommendations in the United States—were fired and replaced by new members handpicked by Secretary Kennedy. 

This report outlines the past year of destruction at CDC. It covers what has been dismantled, how it affects the public, who is fighting back, and what comes next. We also acknowledge that as of January 20, 2025, the system needed improvement. But rather than addressing those gaps, recent actions have widened them, removing capacity and expertise that directly impacts public safety. The path forward is not to rebuild the past, but to create a stronger, more reliable system that works for everyone.

What Has Been Dismantled 

Almost 80% of CDC’s budget goes back out into communities, funding things like state and local health departments, laboratories, universities, and nonprofits. On average, about 50% of every state’s public health budget comes from CDC. Cuts to the agency will be felt in every state and in other nations around the world. Programs that everyday Americans rely on to protect their health will disappear. 

Over the course of 2025, billions of dollars in public health funding were clawed back. The future of other funding is uncertain. Many CDC programs were fully funded when the 2026 budget passed in February, but their staff have been cut from the agency. The full implications of the 2025 cuts may not reveal themselves for years. Experts who help train the next generation of public health professionals have retired. Communications and policy staff who help translate science into action were hit especially hard by RIFs. For an in-depth look at what programs and grants were lost, visit the CDC Data Project. 

Four Ways You Are Now Less Safe

 1.   Science Has Been Politicized

Secretary Kennedy has used his position to endanger lives by reshaping US health policies to fit political goals. This politicization of science begins by silencing scientists, allowing misinformation to fill the void. In early 2025, CDC’s public communication was banned for weeks, and then Kennedy and his staff fired or sidelined communication staff. Today, public communications remain under heightened scrutiny by Health and Human Services (HHS). The Morbidity and Mortality Weekly Report, a cornerstone of public health messaging, saw a 50% drop in publications from 2024 to 2025. This has left communication with the public unduly muted during high-profile events like measles outbreaks and the discovery of botulism contamination in infant formula. What information the CDC has been able to release has lacked the agency’s typical clear and urgent calls to action.

While this is happening, the U.S. is becoming more isolated. The decision to withdraw from the World Health Organization was shaped by political dynamics but leaves the American public more vulnerable to disease threats while reducing US influence over the global health decisions that will affect them regardless. Domestically, long-term partnerships have been damaged. Trusted medical organizations like the American Academy of Pediatrics are publicly challenging Secretary Kennedy decisions. Even former leaders, including six surgeon generals and Kennedy’s own HHS employees, have publicly disavowed his actions. This level of unified concern across traditionally cautious institutions is rare, signaling something deeper than routine disagreement.

Politics is changing health guidance rooted in scientific consensus into propaganda for fringed and discredited beliefs. Recent examples include the changes to the US childhood vaccine schedule, which are driven not by new scientific evidence but by misinterpretation of evidence by unqualified political appointees, and the proposal to study newborn hepatitis B vaccination in Guinea-Bissau which, in its proposed form, would involve withholding necessary vaccine from at-risk children to give the study a no-treatment arm for which there is no scientific justification.. These decisions were ultimately reversed but only after successful legal and ethical intervention.

Perhaps most concerning, the guardrails are being removed. The dismantling of independent advisory committees like the Advisory Committee of Immunization Practices (ACIP) weakens the buffer between scientific data and political pressure. Under Secretary Kennedy, ACIP has been filled with members without the expertise needed to interpret vaccine data in an unbiased and scientifically rigorous manner. This changes ACIP from the backbone of US vaccine policy to a source of confusion and mistrust.

2.   The Experts Are Gone 

Public health programs cannot function without trained, dedicated staff. Yet, under the current Trump administration, CDC has lost over 3,000 full-time employees through mass firings, resignations, and early retirements, people with a range of critical skills that protect the lives of everyday Americans. They include epidemiologists who run disease surveillance systems, grant specialists who ensure funding reaches state and local health departments, communication experts covering smoking and tuberculosis, physicians working to control infectious diseases, and trainees who represent the future of the field. These losses represent decades of institutional knowledge that cannot be easily replaced.

The staff who remain face a tumultuous existence filled with unpredictability, open hostility from their own leadership, and threats to their safety. Many are forced to weigh ethical boundaries against financial necessity. They are being asked to fill critical gaps left by staffing shortages, often stepping into roles outside their expertise. The result is a workforce stretched thin at a moment when capacity matters most.

At the top, a leadership vacuum is leaving the agency rudderless. The rapid firing of Dr Susan Monarez over scientific integrity exemplifies the leadership crisis that exists. The Immediate Office of the Director is now staffed by political appointees with little public health or scientific experience, selected only for their loyalty to the administration. Donald Trump has since broken the law by failing to nominate a new director, leaving Jay Bhattacharya, a COVID vaccine contrarian, in charge of both the National Institutes of Health and CDC. 

The CDC workforce is in crisis. This is a public health emergency with consequences for both the United States and worldwide that will persist long beyond this administration.

3.   States and Communities Are Losing Funding That Protects Them

CDC grants are the backbone of state and local public health infrastructure. On average, about half of every state’s public health budget comes from HHS, and, in many rural and Southern states, that share is even higher. These funds allow health departments to pay for day-to-day functions such as staffing, laboratory testing, vaccination clinics, emergency response, disease surveillance, chronic disease prevention programs, mental health, and substance use programs. 

However, since January 2025, that foundation has been destabilized. Funds have been frozen, clawed back, or cut mid-program. State and local partners who attempt to carry out work already approved and funded have instead been met with a barrage of unnecessary administrative obstacles. The result is not just inefficiency and undermining of the work itself. It is cruel.

One avenue that CDC has used to fund future studies is also facing roadblocks. Notices of Funding Opportunity (NOFOs), in which the CDC allows the states to bid on grants so they may plan, apply, and sustain programs, have dropped by 56% from 2024 to 2025. Some projections suggest that multiple CDC centers may post zero new funding opportunities in 2026. 

The consequences are immediate and far-reaching. Programs that communities rely on, vaccination clinics, public health labs, HIV prevention programs, maternal and child health services, and opioid response initiatives, are being scaled back or at risk of being cut. Health departments already chronically understaffed have had to lay off employees rather than recruit. This instability has also forced health departments to take time away from public health work to mitigate and react to these threats.

The hardest hit communities are those already carrying the greatest burden. Rural areas, low-income populations, and people living with chronic illness stand to lose the most. In many of these communities, HHS-funded programs are not supplemental. They are the only infrastructure supporting longer, healthier lives. Undermining these systems not only weakens public health systems but also widens the very disparities those systems were built to address.

4.   Slow Damage, Lasting Impact 

Herd immunity, the ability of a mostly-vaccinated population to protect its unvaccinated and immunocompromised individuals, does not collapse all at once. It first erodes gradually, then collapses. Measles elimination status is a way to measure how close we are to the breaking point. Scientists can use it to track vaccination rates, outbreak response, and our ability to detect disease before it spreads. The United States is on the verge of losing its measles elimination status, if it has not already.

The infrastructure that supports and protects the health and safety of American families are no longer operating within CDC. The work to prevent common injuries and deaths is gone. For example, CDC was the only federal agency funding drowning prevention, but this program has been cut. Drowning is the number one cause of death for children ages 1-4 and results in over $50 billion dollars per year in medical spending. The older adult fall prevention program has also been cut. Older adult falls are the leading cause of injury and death for adults 65+ and result in around $80 billion per year in Medicare costs. Many other programs, like childhood lead poisoning prevention, traumatic brain injury programs, tobacco prevention programs, and maternal mortality tracking have also been cut or are at risk of being cut.

Today’s children carry the longest exposure to these risks and will have to live with the preventable consequences. 

These cuts also break the public health workforce pipeline. Epidemiologists, disease trackers, maternal health specialists, communication specialists, and prevention program coordinators represent years of specialized training,  institutional knowledge, and trust. Experienced professionals move on to more stable careers, and fewer new graduates enter the field when they see instability. That leaves both a gap today and a weaker pipeline for the future. 

Who Is Still Fighting 

There is still hope, and it lives in the people fighting for our public health systems. Many are dedicated civil servants who once worked quietly and who now refuse to stay silent. Across the CDC, those who were fired, who resigned, and who retired are coming together, united by a shared mission to protect the nation’s health. They are defending scientific integrity and supporting those who remain. 

We are seeing similar resolve across respected organizations such as the American Academy of Pediatrics (AAP), the American Medical Association, the American Public Health Association, and the Infectious Diseases Society of America. Dedicated professionals are speaking out and taking action, including filing legal challenges to check Secretary Kennedy’s authority. AAP recently secured preliminary relief blocking the January 2026 changes in the childhood vaccine schedule, preventing Kennedy’s 13 ACIP appointees from serving and voiding their votes.

Even this deeply divided Congress has upheld the importance of CDC’s mission. Despite President Trump’s desire for deep budget cuts, Congress maintained near level funding in CDC’s FY26 budget and added guardrails on agency actions. For example, it directed HHS to maintain sufficient staffing levels and, in some cases, specific program staffing and required the agency to consult Congress before terminating grants.

Communities and individuals are also stepping up. This includes groups like Voices for Vaccines, a family-led organization that fosters positive decisions about vaccination, and Grandparents for Vaccines, which shares stories of how vaccines changed our world. There are also brave parents, students, and teachers attending school board meetings to oppose attacks on science and vaccines.

Hope for public health is not abstract. It is organized, vocal, and growing.

What Comes Next

These actions do not only reduce harm in this moment. They simultaneously secure a better future for all Americans, a future that takes note of what worked and did not work in our public health system in the past, that includes input from people across the country, and that, at its foundation, supports everyday people’s health needs and sets our country up for long-term fair success. Shaping the future of public health is no small task. It will require input and dedication from civil servants, professionals, voters, policy makers, and more. To build a collective and effective public health system, we must start to build collective efforts that focus on the following tenets: 

• Share true and accurate information, not information that fits our own biases.

• Teach friends, neighbors, families, and communities how to read and evaluate health information. In the age of TikTok, Instagram, and AI, critical review of health information is essential. 

• Support and care for local public health heroes and the people keeping the lights on. Our state and local health departments are on the front lines in this attack on public health and yet they continue to do the same work with fewer resources, often at the expense of their own mental and physical health. 

• Hold our elected officials accountable. All public health space workers should reach out to officials at all levels and tell them what they do and why it matters to their voters. All voters should contact their representatives to make sure they know public health is a priority. Policy makers deserve to be held accountable at the ballot box. 

It is always harder to build something than it is to tear something down. We and future Americans deserve a public health system that works and fosters our constitutional right to life, liberty, and the pursuit of happiness.