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“They’re dismantling and destroying everything” – Public Health Under Siege

Welcome to Public Health Watch, a weekly roundup from Protect Our Care tracking catastrophic activity as part of Donald Trump’s sweeping war on health care. From installing anti-vaccine zealot RFK Jr. as Secretary of HHS to empowering Elon Musk to make indiscriminate cuts to our public health infrastructure, including the National Institutes of Health and the Centers for Disease Control, Donald Trump is endangering the lives of millions of Americans. Protect Our Care’s Public Health Watch will shine a spotlight on the worst of the Trump/RFK/Musk war on vaccines, science and public health and serve as a resource for the press, public and advocacy groups to hold them accountable. 

What’s Happening In Public Health?

Catastrophic Cuts Are Creating Chaos And Endangering Americans’ Health And Scientific Innovation

Stat: Trump proposes billions in cuts to federal health agencies from NIH to CDC President Trump on Friday proposed massive cuts to the federal government’s health agencies in his 2026 budget request, arguing that Congress should reduce spending by tens of billions from current levels. The request would be a 26% cut to the Department of Health and Human Services’ discretionary budget, which doesn’t include spending on health coverage programs like Medicare and Medicaid. The administration justified proposed cuts across HHS by saying programs are duplicative, overly ideological, or better left to the states — despite many of them being supported in the first Trump administration and many previous Republican administrations.

  • New York Times: Trump’s Budget Cuts Funding for Chronic Disease Prevention Robert F. Kennedy Jr., the nation’s health secretary, has said that tackling a chronic disease “epidemic” would be a cornerstone of his Make America Healthy Again agenda, often invoking alarming statistics as an urgent reason for reforming public health in this country. On Friday, President Trump released a proposed budget that called for cutting the funding of the Centers for Disease Control and Prevention by almost half. Its chronic disease center was slated for elimination entirely, a proposal that came as a shock to many state and city health officials. “Most Americans have some sort of ailment that could be considered chronic,” said Dr. Matifadza Hlatshwayo Davis, health director for the city of St. Louis. Of the proposed cuts, she said, “How do you reconcile that with trying to make America healthy again?”

CBS: HHS redirects $500 million to Trump appointee’s vaccine project, bypassing reviews  The Department of Health and Human Services has transferred $500 million from research into next-generation COVID-19 vaccines, redirecting the money to a single vaccine project linked to the Trump administration’s former acting head of the National Institutes of Health. Multiple federal health officials said they were surprised by the announcement, which bypassed the usual procedures overseen by career scientists at the NIH and the Biomedical Advanced Research and Development Authority, known as BARDA. Those reviews are intended to ensure that federal research money goes to the projects with the greatest scientific merit.  The HHS says the initiative, dubbed “Generation Gold Standard,” aims to start clinical trials next year for universal influenza vaccines that could protect against any strain of the virus. It hopes to get a vaccine approved by the Food and Drug Administration by 2029. All of the money is being transferred to an influenza vaccine project called beta-propiolactone or BPL, according to emails seen by CBS News. Two officials said the decision to pour $500 million into a single vaccine platform is unusual, given the limited data on it.  The transfer makes it effectively one of the largest awards to date from a BARDA effort to speed funding to new experimental vaccines and treatments, topping a previous award of $452 million to a company developing an experimental oral COVID-19 vaccine.

  • Stat: Scientists question NIH project’s use of 20th century technology to make a universal flu vaccine When word broke this week that the Department of Health and Human Services was investing half-a-billion dollars on a National Institutes of Health project to develop a vaccine platform for pathogens that could trigger pandemics, a number of scientists who work in the field of vaccinology had decidedly mixed feelings. That HHS and NIH are going to continue to invest in efforts to make vaccines that could reduce the impact of future pandemics was good news, many thought. But why spend so much money on using whole killed viruses — an approach pioneered in the last century — as the basis of the vaccines? “I was confused by the messaging, because it is a 70-year-old technology,” said one scientist who works in vaccine development, noting this was the method used by Jonas Salk to create the world’s first polio vaccine in the early 1950s. Another scientist familiar with the scope of research that is being done to try to develop a so-called universal flu vaccine to protect against a range of dangerous strains — like H5N1 bird flu — was blunt. “There is incredible work going on. This is not it.”

Science: NIH under siege In NIH entryways, recently installed portraits of Trump, Vice President JD Vance, Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr., and new NIH Director Jayanta “Jay” Bhattacharya have become a forum for silent protests. A photo of tanks rolling through Tiananmen Square during China’s 1989 student uprising was briefly plastered below one set of visages. On a different wall on another day, flyers appeared for a nationwide protest of Trump’s science cuts along with a Post-it note with the word “Shame.” A staff memo sent out the day a Science reporter visited warned of penalties for “damage or destruction of federal property” including “defacement of portraits.” A researcher who has spent more than 2 decades with NIH’s intramural research program believes the world’s largest biomedical agency will never be the same. ‘However bad everyone on the outside thinks it is, it is a million times worse. They’re dismantling and destroying everything.’  Along with firing about 2500 of the agency’s 20,000-strong federal workforce and pushing others to retire, Trump officials have used what some call “bureaucratic sabotage” in ways that likely explain why NIH has disbursed at least $1.8 billion less in funding to outside researchers in this administration’s first 3 months than it did in the same time period in 2024. They have canceled more than 800 grants on topics such as HIV research, transgender health, and vaccine hesitancy. NIH, at HHS’s behest, also tried to impose a crippling cut in the overhead payments made to universities that carry out grant-funded research. More disruption looms, including HHS-demanded cuts to billions of dollars in contracts that fund key support staff and research centers and a White House proposal due any day now that will likely aim to slash up to 44% from NIH’s $47.4 billion budget and overhaul its structure. An agency that once had strong bipartisan support and was seen as the crown jewel of U.S. science, and the envy of the world, now faces a diminished, uncertain future.

Wired: RFK Jr.’s HHS Orders Lab Studying Deadly Infectious Diseases to Stop Research A research facility within the US National Institutes of Health that is tasked with studying Ebola and other deadly infectious diseases has been instructed by the Trump administration’s Department of Health and Human Services (HHS) to stop research activities. According to an email viewed by WIRED, the Integrated Research Facility in Frederick, Maryland, was told to stop all experimental work by April 29 at 5 pm. The facility is part of the National Institute of Allergy and Infectious Diseases (NIAID) and is located at the US Army base Fort Detrick. It conducts research on the treatment and prevention of infectious diseases that are deemed “high consequence”—those that pose significant risks to public health. It has 168 employees, including federal workers and contractors.

Health Impacts:

Local Impacts: 

Chaotic Firings and Re-Hirings:

Cruel and Destructive Policy Changes:

The FDA Is Being Dismantled – Stalling Drug Development And Leaving Us Vulnerable To Food-Borne Illness 

Stat: How RFK Jr.’s vaccine criticism is taking hold at the FDA When Marty Makary was tapped to lead the Food and Drug Administration, public health experts hoped the Johns Hopkins physician would shield the agency from the vaccine criticism of his boss, health secretary Robert F. Kennedy Jr.  So far, that hasn’t been the case. Instead, Makary seems just as willing to use his power and position to more harshly scrutinize vaccines and to shift vaccination policy.  Over the weekend, he signaled that the FDA may depart from longstanding precedent by requiring Covid vaccine makers to submit new effectiveness data before adjusting their products for new strains — a regulatory hurdle that could leave people unprotected from new versions of the disease.  It’s the latest in a series of events illustrating that the FDA is not immune to broader vaccine skepticism in the Trump administration. Kennedy’s history as a prominent vaccine critic nearly derailed his confirmation to lead the Health and Human Services Department. Makary’s confirmation process, by contrast, was relatively seamless, and he faced few questions from lawmakers on vaccines.

NOTUS: FDA Leaves the Door Open to Reimposing Restrictions on Abortion Pills The Food and Drug Administration is leaving the door open to reimposing restrictions on access to the abortion pill mifepristone, following calls from anti-abortion advocates and conservative leaders for the agency to reconsider its decades-old approval of the medication. Sen. Josh Hawley, a staunch anti-abortion ally, wrote Monday to the FDA’s commissioner, Marty Makary, demanding that the agency “take all appropriate action to restore critical safeguards on the use of mifepristone” following the release of a study on the drug from the conservative Ethics and Public Policy Center. Asked if the FDA would consider Hawley’s request, an agency spokesperson said: “The FDA is committed to safeguarding public health by ensuring the safety, efficacy, and quality of the products it regulates. The agency rigorously evaluates the latest scientific data, leveraging gold standard science to make informed decisions.” The spokesperson then referred NOTUS to a comment Makary made at a Semafor event last week where he said, “There is an ongoing set of data,” on mifepristone. “If the data suggests something or tells us that there’s a real signal, we can’t promise we’re not going to act on that data,” Makary said.

Additional FDA News: 

RFK Jr. Is An Extreme MAGA Anti-Vaxxer Who’s Breaking His “Assurances” To Key Republicans To Get Confirmed And Mis-Managing HHS 

New York Times: Kennedy Issues Demands for Vaccine Approvals That Could Affect Fall Covid Boosters Health Secretary Robert F. Kennedy Jr. on Thursday announced plans to require all new vaccines to be tested against placebos and to develop new vaccines without using mRNA technology, moves that extend his reach deep into vaccine development and raise questions about whether Covid boosters will be available in the fall. A spokesman for the Department of Health and Human Services called the requirement for placebo testing “a radical departure” from existing standards. But that will depend on how the department defines “new,” because most new vaccines are already tested either against placebos — inert substances — or, in some cases, against vaccines for other diseases. Mr. Kennedy is one of the nation’s leading vaccine skeptics, and he has been vocal about his disdain for mRNA technology, which was used to develop coronavirus vaccines during the first Trump administration. He once wrote on social media that “mRNA jabs don’t stop infection, don’t block transmission, don’t block mutants, don’t last, don’t work at all.”

New York Times: Kennedy Orders Search for New Measles Treatments Instead of Urging Vaccination With the United States facing its largest single measles outbreak in 25 years, Health and Human Services Secretary Robert F. Kennedy Jr. will direct federal health agencies to explore potential new treatments for the disease, including vitamins, according to an H.H.S. spokesman. The decision is the latest in a series of actions by the nation’s top health official that experts fear will undermine public confidence in vaccines as an essential public health tool. The announcement comes as Mr. Kennedy faces intense backlash for his handling of the outbreak. It has swept through large areas of the Southwest where vaccination rates are low, infecting hundreds and killing two young girls. On Friday, the Centers for Disease Control and Prevention reported more than 930 cases nationwide, most of which are associated with the Southwest outbreak. Critics have said Mr. Kennedy has focused too much on untested treatments — such as cod liver oil supplements — and offered only muted support for the measles vaccine, which studies show is 97 percent effective in preventing infection. The decision to put more resources into potential treatments, rather than urging vaccination, could have grave consequences at the center of the outbreak. “We don’t want to send the signal that you don’t have to get vaccinated because there’s just a way to get rid of it,” said Jennifer Nuzzo, an epidemiologist at the Brown University School of Public Health.

NBC: Kennedy planning $20 million HHS ‘Take Back Your Health’ ad campaign Health and Human Services Secretary Robert F. Kennedy Jr. plans to launch a sweeping, four-year public relations campaign called “Take Back Your Health” that could cost tens of millions of dollars, according to a document obtained by NBC News.  Kennedy is conducting sweeping budget cuts that could eliminate 10,000 jobs and several HHS divisions, including global health and domestic HIV prevention. The document, a request for proposals, calls for public relations firms to bid to run the campaign. The winning firm would employ up to 30 people to manage the campaign and oversee the purchase of up to three ads a day on five major television networks.  The total dollar amount for the campaign is not listed in the document. A person familiar with the campaign said labor costs are expected to be at least $20 million and estimated that television and digital ad purchases could cost tens of millions over the next four years. An HHS official praised the initiative. “Empowering Americans with the knowledge to make healthy decisions is central to HHS’s mission. Our upcoming ad campaign is both an investment in our nation’s wellbeing and a commitment to Make America Healthy Again,” the official said in a statement.

New York Times: Kennedy Advises New Parents to ‘Do Your Own Research’ on Vaccines Health Secretary Robert F. Kennedy Jr. advised parents of newborns to “do your own research” before vaccinating their infants during a televised interview in which he also suggested the measles shot was unsafe and repeatedly made false statements that cast doubt on the benefits of vaccination and the independence of the Food and Drug Administration. Mr. Kennedy made the remarks to the talk show host Dr. Phil in an interview that aired Monday on MeritTV to mark the 100th day of the Trump administration. He said, as he has in the past, that “if you want to avoid spreading measles, the best thing you can do is take that vaccine.” But Mr. Kennedy also made clear, as he has in the past, that he believes it is up to individuals to decide. In suggesting vaccines are unsafe, he contradicted decades of advice from public health experts, including leaders of the Centers for Disease Control and Prevention. “I would say that we live in a democracy, and part of the responsibility of being a parent is to do your own research,” the health secretary said, in response to a question from a woman in the audience who asked how he would advise a new parent about vaccine safety. “You research the baby stroller, you research the foods that they’re getting, and you need to research the medicines that they’re taking as well.”

The Guardian: RFK Jr and health agency falsely claim MMR vaccine includes ‘aborted fetus debris’ Health secretary Robert F Kennedy Jr and his department have made a series of misleading statements that alarmed vaccine experts and advocates in recent days – including that the measles, mumps and rubella (MMR) vaccine includes “aborted fetus debris”. Health department officials released statements saying they could alter vaccine testing and build new “surveillance systems” on Wednesday, both of which have unnerved experts who view new placebo testing as potentially unethical. “It’s his goal to even further lessen trust in vaccines and make it onerous enough for manufacturers that they will abandon it,” said Dr Paul Offit, an expert on infectious disease and immunology and the director of the Vaccine Education Center at Children’s Hospital of Philadelphia, about the statements and Kennedy. “It’s a fragile market.”

USA Today: RFK Jr., pushing curbs on fluoride, says ‘the more you get, the stupider you are’ Health and Human Services Secretary Robert F. Kennedy Jr. took a fresh swipe at fluoride, saying the chemical used to protect teeth is making Americans ‘stupider’ as he touted his plan to scale it back in the country’s drinking water. ”The more you get, the stupider you are, and we need smart kids in this country, and we need healthy kids,” he said during a cabinet meeting on April 30 with President Donald Trump.

Other MAHA Activities:

RFK’s Autism Plans Draw Widespread Condemnation And Calls For His Resignation 

NBC: Many in Autism Community Say Health Secretary Kennedy Doesn’t Understand Their Needs In just two months on the job, Health Secretary Robert F. Kennedy Jr. has raised the profile of autism more than any recent public official. Autism advocacy groups typically welcome more attention to their cause. But many autistic people say Kennedy is exploiting their community — and perpetuating harmful stereotypes — as part of his decadeslong campaign against vaccines, even as the Trump administration threatens to eliminate services that help people with autism reach their full potential. At an April press conference on autism rates among school-age kids, Kennedy described autism as an epidemic and a “tragedy” that “destroys families.” “These are kids who will never pay taxes, they’ll never hold a job, they’ll never play baseball, they’ll never write a poem, they’ll never go out on a date. Many of them will never use the toilet unassisted,” Kennedy said.  In response, 15 advocacy groups issued a joint statement calling for autistic people to be treated with respect and support. The groups said they are “deeply concerned by growing public rhetoric and policy decisions” that fail to “reflect the inherent value, rights and diverse needs of autistic people.”

Axios: RFK Jr. Autism Data Project Stokes Alarm Over Motives Health Secretary Robert F. Kennedy Jr.’s push to collect troves of personal medical data to find the cause of autism has researchers and patient advocates questioning whether his plan to cast a wide net makes it easier to pick and choose information that supports certain theories — including the debunked idea that vaccines cause autism. The big picture: The National Institutes of Health has long pushed to include more data collected during health care delivery in its research. Kennedy would put a new twist on that, by combining federal health data, medical records, insurance claims and readouts from wearables into what Health and Human Services calls a “real-world data platform.” The accelerated effort could cut red tape and lead to more effective treatments. Or it could turn scientific research into elaborate cherry-picking, akin to “Just give us everything, and we’ll find what we need.” Gathering huge amounts of data will make it easier to generate “phony evidence for RFK’s predetermined conclusion” that vaccines cause autism, the Autism Self Advocacy Network said in a statement about the research initiative.

Stat: Autism Evaluations Are Being Canceled Over Fears About a National Registry Michael VanPelt spent several weeks recently glued to his telephone, dialing doctors who might be able to get his 3-year-old son in for an autism evaluation. The music teacher ran out of providers who took his health insurance, but luckily the New Jersey public school system provided him with an independent neurologist, who diagnosed his son with autism on April 3.  VanPelt was thrilled. His son — prone to sensory overload and outbursts when deviating from his routine — would finally get the individualized attention he needed. But the father’s excitement quickly curdled to fear in the following weeks, as federal health leaders announced initiatives aimed at finding autism’s origins. “Did we just screw up our child’s life? In seeking to help him, did I just paint a giant target on his back?” he wondered.  For now, VanPelt plans to hold off filing any health insurance claims for his son’s diagnosis. He is not alone. People with autism and parents of autistic kids are asking clinicians to erase their diagnoses and cancelling appointments with medical professionals, according to interviews conducted in recent days at an international autism conference.  Amy Esler, a pediatric psychologist at the University of Minnesota, said she has heard of similar cancellations from peers across the country through the International Collaboration for Diagnostic Evaluation of Autism network, which includes more than 20 major autism care and research centers such as Vanderbilt University Medical Center. Families seeking a pre-diagnosis evaluation from the University of North Carolina TEACCH Autism Program have removed themselves from the waitlist, according to Hannah Morton, a UNC psychiatry professor. Multiple organizations declined to comment about the issue. The cancellations are driven by panic and distrust among the autism community in response to the recent remarks made by health secretary Robert F. Kennedy, Jr. and National Institutes of Health Director Jay Bhattacharya, researchers and advocates told STAT.

More fallout from RFK Jr.’s autism plans:

GOP State Policymakers Are Following RFK Jr.’s Lead Attacking Vaccines And Proven Public Health Measures

CNN: Texas Attorney General Targets Toothpaste Companies Amid Increased Scrutiny of Fluoride 

The public health practice of adding fluoride to drinking water is facing heavy scrutiny from the Trump administration, and toothpaste companies are being pulled into the fray now, too. The Texas attorney general announced Thursday that he has launched an investigation into two major toothpaste manufacturers – the Colgate-Palmolive Co. and Procter & Gamble Manufacturing Co., which makes Crest – for “illegally marketing” their products “to parents and children in ways that are misleading, deceptive, and dangerous.” 

Washington Post: Florida Lawmakers Pass Ban on Fluoride in Drinking Water Florida is poised to outlaw fluoride in drinking water under a bill approved Tuesday by the state legislature, adding the state to a growing backlash against a long-standing public health measure. The legislation heads to Gov. Ron DeSantis (R), who has criticized fluoridation as “forced medication.” His office did not immediately respond to a request for comment. The effective ban on fluoride is included in a broader farm bill, as a provision to prevent local governments from using additives in drinking water that are necessary to meet safety standards or improve quality. The move would make Florida the second state to ban fluoride after Utah. A prohibition there is scheduled to take effect May 7. The Trump administration is mobilizing to crack down on fluoride nationally, citing evidence of eroding benefits as fluoridated toothpaste and mouthwash become widely available, and possible health problems at high concentrations.

Heartland Signal: Minnesota GOP Introduces Second Bill Designating mRNA Vaccines as Weapons of Mass Destruction Republicans in the Minnesota state Senate have introduced Senate File 3456, another bill that attempts to designate mRNA vaccines as weapons of mass destruction in the state. This is the second attempt from Minnesota Republicans after members of the state House introduced a similar bill earlier this month. If either bill were signed into law, anyone who administers an mRNA vaccine would be guilty of a misdemeanor and subject to a $500 fine. Although the House version was introduced by far-right members of the state Republican Party, House File 3219 was largely written by Joseph Sansone, a practicing hypnotist in Florida.

Public Health Threats

Associated Press: CDC Reports 216 Child Deaths This Flu Season, the Most in 15 Years More U.S. children have died this flu season than at any time since the swine flu pandemic 15 years ago, according to a federal report released Friday. The 216 pediatric deaths reported by the Centers for Disease Control and Prevention eclipse the 207 reported last year. It’s the most since the 2009-2010 H1N1 global flu pandemic. It’s a startlingly high number, given that the flu season is still going on. The final pediatric death tally for the 2023-2024 flu season wasn’t counted until autumn. “This number that we have now is almost certainly an undercount, and one that — when the season is declared over, and they compile all the data — it’s almost certain to go up,” said Dr. Sean O’Leary, of the American Academy of Pediatrics. There are likely several contributors to this season’s severity, but a big one is that fewer children are getting flu shots, added O’Leary, a University of Colorado pediatric infectious diseases specialist.

CBS: Weekly Measles Cases Hit New Record Amid Worst Outbreak Since 1990s Weekly measles cases have set a new record, according to figures published Friday by the U.S. Centers for Disease Control and Prevention, topping the peak of an outbreak in 2019 that ranked as the worst since the 1990s. The number of cases that had their symptoms start during the week of March 30 has grown to 111, according to the agency’s latest update. Authorities backdate newly reported measles cases based on when their rash began, to account for delays in reporting and diagnosis.  That tops the 102 cases reported for the week of March 23, 2019, at the height of that year’s wave. By the end of 2019, measles cases that year added up to the largest annual tally since endemic spread of the virus was declared eliminated in 2000.

  • Houston Chronicle: Texas Measles Outbreak Rises to 683 Cases, Spreads to Three New Counties The measles outbreak centered in northwest Texas grew to 683 cases and spread to three new counties on Friday, according to health officials. The latest update from the Texas Department of State Health Services adds 20 new cases since the agency’s last update on Tuesday. Upshur, Eastland and Hardeman counties all reported their first cases associated with the outbreak. So far 89 people have been hospitalized for treatment and two children, an 8-year-old girl and a 6-year-old girl, died after contracting the virus. Neither child had received the measles, mumps and rubella vaccine, and they did not have any underlying medical conditions, according to the DSHS.

Bloomberg: US Vaccine Watchdog Effort Begins as Measles Surge Draws Alarm The Center for Infectious Disease Research and Policy at the University of Minnesota has quietly begun to steer a national initiative to safeguard the scientific foundations of US vaccine policy — a bold move at a time of mounting political interference and an escalating measles outbreak. Funded by a $240,000 gift from Alumbra, a foundation established by Walmart Inc. heiress Christy Walton, the so-called Vaccine Integrity Project will explore how independent groups, including scientists, doctors and public health organizations, can help uphold science-based vaccine guidance if government groups are weakened by political pressure or resource cuts.

Financial Times: Scientists Urge Trump Administration to Fight Threat of Bird Flu Pandemic The US should step up efforts to combat its year-long bird H5N1 flu outbreak and control the pandemic risk to people, an international group of virologists has warned. The high historical human mortality rate from H5N1 suggests “the terrible consequences of underreacting to current threats”, say human and animal virologists from the Global Virus Network spanning more than 40 countries. Their intervention on Tuesday highlights alarm at the proliferation of the H5N1 avian pathogen now detected in poultry in all 50 US states, infecting scores of people and causing at least one confirmed death. They also raise concerns about the impact of turmoil in US scientific institutions on H5N1 surveillance efforts, as the Trump administration pushes through spending cuts and curbs communications. In an article in the journal The Lancet Regional Health — Americas, the scientists call on governments around the world to enhance surveillance, implement biosecurity measures and prepare for potential people-to-people spread.