The United States Department of Health and Human Services (HHS) is undergoing one of the most significant restructurings in decades, a move that has left many public health experts deeply concerned. Dr. Peter Marks, former director of the US Food and Drug Administration’s (FDA) Center for Biologics Evaluation and Research, has been particularly vocal about the potential consequences of these changes. Marks, who played a crucial role in the federal government’s COVID-19 vaccine program, “Operation Warp Speed,” recently stated that these job cuts and reorganizations leave the United States “weaker as a nation”.

The Context of the Restructuring

Health Secretary Robert F. Kennedy Jr. announced a plan to cut 10,000 jobs across HHS, reducing the workforce from 82,000 to 62,000 employees. This restructuring aims to streamline the agency’s 28 divisions into 15 new divisions, creating a new umbrella group called the Administration for a Healthy America (AHA). The stated goal is to save $1.8 billion annually while focusing on new priorities such as ending chronic illness epidemics and eliminating environmental toxins.

The Fallout for Public Health

Marks’ resignation was prompted by what he perceived as a lack of commitment to truth and transparency within the HHS. In his resignation letter, he wrote, “It has become clear that truth and transparency are not desired by the Secretary, but rather he wishes subservient confirmation of his misinformation and lies.” Marks emphasized that the FDA’s vaccine approval process ensures that vaccines are safe, effective, and of high quality, and he urged parents to vaccinate their children against diseases like measles, which has seen a recent outbreak in Texas, Oklahoma, and New Mexico.

The Broader Implications

The job cuts extend beyond the FDA. The Centers for Disease Control and Prevention (CDC) is set to lose 2,400 employees, while the National Institutes of Health (NIH) will cut 1,200 positions. The National Institute for Occupational Safety and Health (NIOSH), a critical agency for worker safety, is also facing significant layoffs, with approximately two-thirds of its staff—about 875 people—expected to lose their jobs. This reduction will severely impact NIOSH’s ability to conduct essential research and evaluations to protect workers from occupational hazards.

The Loss of Expertise and Capacity

Marks highlighted the potential dangers of these cuts, noting that the United States is now less prepared to respond to both natural and man-made threats. He pointed out that many viruses, such as Ebola, could pose significant risks to the country, and the current restructuring has left the nation weaker in its ability to respond. Critics argue that these cuts could jeopardize disease response capacity, scientific research, and regulatory oversight.

The Future of Public Health

The restructuring plan has faced significant backlash, with critics arguing that the scale of the cuts could have severe consequences for public health. Senator Patty Murray warned that the plan “is putting lives in serious jeopardy”. Despite these concerns, HHS maintains that the restructuring will improve health outcomes for lower-income Americans and enhance areas such as maternal health, mental health, and environmental health.

The sweeping job cuts and reorganizations at HHS represent a significant shift in the federal government’s approach to public health. While the stated goals of the restructuring include cost-saving measures and a focus on new priorities, the potential loss of expertise and capacity has left many experts, like Dr. Peter Marks, deeply concerned. As the United States navigates these changes, the future of public health initiatives and the nation’s ability to respond to emerging threats remain uncertain.