Public health experts and Democrats are worried the incoming Trump administration will leave public health agencies understaffed and underfunded, which they worry, in turn, will leave them ill-equipped to handle another pandemic.
President-elect Donald Trump announced Thursday he picked vaccine skeptic Robert F. Kennedy Jr. to lead the Department of Health and Human Services, which would give him responsibility for 13 agencies, including the Centers for Disease Control and Prevention and the Food and Drug Administration. These agencies would be key players in a future pandemic — a prospect experts say is just a matter of time.
“The elephant in the room is Robert F. Kennedy Jr.,” said Allison Winnike, director of the western region of the Network for Public Health Law. “I worry that we will not have the sort of levels of subject matter expertise leading these agencies that we have in past administrations, or even in the previous Trump administration.”
Kennedy has said he would fire “corrupt” FDA employees who contribute to what he sees as the agency’s “aggressive suppression” of alternative and holistic treatments. After Trump’s win, he told MSNBC he supports clearing out “entire departments” of federal service workers “in some categories” of the CDC and FDA, pointing to the FDA’s nutrition department specifically.
Trump and Kennedy did not respond to requests for comment.
HHS employs more than 80,000 people tasked with everything from investigating outbreaks to developing vaccines. About 19,500 of those employees work at the FDA, and 11,800 work at the CDC. Kennedy would also oversee the National Institutes of Health, which employs about 19,500 people. Last weekend, he said he would replace hundreds of NIH workers on Day One of Trump’s administration.
“There’s been a lot of threatening language about cleaning house and throwing people out on the street that I think can be very destructive to morale,” said Georges Benjamin, director of the American Public Health Association. “So you lose people in a scattered and uncontrolled way, some of the very people you need to respond to these kinds of emergencies.”
Some CDC employees have reportedly already made plans to leave the agency prior to Kennedy’s appointment.
CDC, FDA and HHS did not respond to requests for comment.
But Kennedy firing the experts isn’t the only thing that concerns lawmakers about his potential appointment.
Democratic Rep. Raul Ruiz, ranking member of the Select Subcommittee on the Coronavirus Pandemic, a committee that is winding down, told NOTUS he is concerned about the federal government maintaining public health data under Trump’s administration. (Kennedy has said he would like increased access to federal health data so that he can show that vaccines are unsafe.)
“The best predictor of future behavior is past behavior, and you saw the disastrous, chaotic, ineffective behavior of President-elect Trump during COVID-19. In addition to that kind of behavior, they want to gut HHS, both in resources and personnel that would help us better respond,” Ruiz said.
The prospect of Kennedy leading the incoming Trump administration’s public health decision-making represents a stark departure from the first Trump administration’s approach to public health.
During the COVID-19 pandemic, the Trump administration headed Operation Warp Speed, a multi-departmental, public-private partnership that quickly produced and distributed vaccines that saved up to 140,000 lives, according to NIH research.
But the first Trump administration also drew criticism from health experts who said that it missed opportunities to stymie the COVID-19 pandemic and ignored guidance from the country’s top infectious disease experts.
Some Republicans are not worried about Kennedy’s proposals for the incoming administration. Rep. Rich McCormick, who also serves on the COVID-19 subcommittee, told NOTUS Thursday he wasn’t concerned about the Trump administration firing officials with pandemic-response experience.
“You can’t lose knowledge. It’s on computers. You can look it up on Google, right? So what you’ll lose is bureaucratic knowledge, which means how to work the system to empower a government over a people, which, I’m never worried about losing those people,” McCormick said.
If Kennedy reduces funding to disease-prevention and surveillance programs, it could exacerbate existing funding gaps that have widened as COVID-era initiatives run out of money. Researchers are already grappling with the impending loss of programs that permitted them to surveil the virus’s spread and better monitor new threats, like H5N1, also known as bird flu.
While there have been no known cases of human-to-human transmission, Canada recently detected its first human case of bird flu — and the source of the infection is still unknown. Recent bird flu outbreaks have been seen mostly in farm animals, although some agricultural workers have also been sick. The CDC still considers the overall risk of infection to be low, but experts worry that it could proliferate if it mutates and becomes more contagious to humans. The CDC said on Nov. 15 that there have been 46 confirmed human infections of bird flu in the U.S.
“The funding structure is not conducive to preventing future pandemics,” said Rep. Deborah Ross, a Democrat, during the House coronavirus subcommittee’s final hearing before it wraps up a two-year investigation into what the federal government could have done better during the pandemic. Ross pointed to a federal wastewater testing program as an example of a resource that was expanded in response to the COVID-19 pandemic but that has now become critical for surveillance of multiple health threats, including bird flu. It is at risk of losing funding.
“We must ensure that tools like this are fixtures of our public health strategy rather than waiting for emergent situations to implement them,” Ross said.
But experts fear that a Trump administration would not expand these testing strategies to respond to another pandemic proactively. Kennedy said on X in June 2024 that he was concerned that bird flu was bioengineered and deliberately released. There is no evidence that this is the case.
“I think we could be doing a better job of testing farmworkers, the poultry and the livestock to really get a better sense of the disease numbers,” Winnike said. “I just don’t expect to see that improve under the next administration, when we’re hearing things about reducing funding and priority on public health issues.”
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Emily Kennard and Margaret Manto are NOTUS reporters and Allbritton Journalism Institute fellows.