Thousands of health workers at CDC, FDA, NIH and other federal health agencies began receiving their walking papers Tuesday, sending shock waves through the public health community.

Many agency leaders within the U.S. Department of Health and Human Services were either fired, put on leave or given an option for reassignment to a distant destination. Among them were Jeanne Marrazzo, MD, MPH, director of the National Institute of Allergy and Infectious Disease, the position Anthony Fauci held before retiring; Brian King, PhD, MD, director of the Food and Drug Administration’s Center for Tobacco Products; and Jennifer Hoenig, PhD, MPH, director of the National Survey on Drug Use and Health at the Substance Abuse Mental Health Services Administration.

Hoenig said in a LinkedIn post Tuesday that the entire SAMHSA team of the Office of Population Survey had been fired.

The firings appear to be motivated not simply to reduce "bureaucratic sprawl,” as HHS Secretary Robert F. Kennedy Jr. calls it, but rather are part of a broad agenda to remake HHS, experts said at a briefing Tuesday.

“The goal seems to be to undermine the leadership of these agencies,” Susan Polan, PhD, associate executive director of the American Public Health Association, said at the briefing.

Combined with previous layoffs, early retirements and buyouts, the new cuts reduce the HHS workforce by a quarter, to 62,000 employees.

Among the firings at HHS, the Food and Drug Administration is losing 3,500 full-time employees; the Centers for Disease Control and Prevention is losing 2,400; the National Institutes of Health, 1,200; and the Centers for Medicare and Medicaid Services, 300, according to HHS.

At CDC, workers in the National Institute of Occupational Safety and Health and the National Center for Injury Prevention and Control were given notice Tuesday, according to news reports. Other affected divisions focused on topics such as environmental health, population health, reproductive health and HIV prevention. Staff were locked out without ensuring there were plans for transition, reports said.

Former CDC Director Tom Frieden, MD, MPH, who is now president and CEO of Resolve to Save Lives, was among the many leaders who denounced the massive layoffs.

“Massive cuts to programs that prevent disease would make Americans sicker,” Frieden said on X. “Cutting things isn’t likely to improve them. Actually improving takes expertise and investment.”

The layoff notices arrived about a week after HHS, under the leadership of Kennedy, proposed eliminating $11.4 billion in grants earmarked for distribution to local and state public health departments.

“This unprecedented work has stopped public health in its tracks,” Lori Freeman, MBA, CEO of the National Association of County and City Health Officials, said at the briefing. “All this is done without any consultation with public health partners or Congress."

In Texas, the Dallas County Health and Human Services department was notified a week ago that three federal grants would stop as part of a clawback of public health funding from HHS. Vaccination, epidemiology, technology modification and staffing are impacted, even as the state wrestles with a major measles outbreak.

On Friday, 11 full-time workers and 10 part-time workers involved in infectious disease surveillance and delivering routine child vaccinations were laid off, Phil Huang, MD, MPH, director and health authority of the Dallas health agency, said during the briefing. The agency has canceled over 50 immunization clinics at schools and in communities in Dallas County.

Smaller health agencies are experiencing even greater loss because of the funding rescission, even if it is only one or two workers being let go, Huang said.

“One staff person is critical, doing multiple jobs,” Huang said. “These cuts can have a huge impact in rural areas and at small health departments.”

APHA is urging public health supporters to send a message to their members of Congress in opposition to the staff and funding cuts using an Association action alert.

Photo by by Aimintang, courtesy iStockphoto