Trump appointees to lead NIH, FDA start jobs as HHS begins cutting 10,000 health staff

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The new leaders of the National Institutes of Health (NIH) and Food and Drug Administration took their posts as their governmental parent, the U.S. Department of Health and Human Services (HHS), began cutting workers on April 1.

“The revolution begins today!” HHS Secretary Robert F. Kennedy Jr. said in a social media post, as reported by the Associated Press. Physician groups already warned about potential bad effects on patient care, public health and other challenges in the nation’s health infrastructure.

Jay Bhattacharya, MD, PhD
_{© National Institutes of Health}

Jayanta “Jay” Bhattacharya, MD, PhD, began his tenure as the 18^th director of NIH, where he will oversee the nation’s medical research agency. He “will play an instrumental role in shaping the agency’s activities and outlook and ensuring they align with” President Donald J. Trump’s Make America Healthy Again Commission, according to NIH’s official announcement.

Martin Makary, MD, MPH
_{© U.S. Food and Drug Administration}

Martin Makary, MD, MPH, took his oath of office to become the 27th commissioner FDA. “I look forward to working with this administration and the FDA workforce to advance our shared goals in meeting the agency’s public health mission,” he said in the FDA announcement. “As commissioner, I hope to ensure that the FDA holds to the gold standard of trusted science, transparency, and common sense so that we can Make America Healthy Again.”

Just hours after HHS employees were receiving emailed layoff notices, Kennedy Jr. posted online videos of the swearing-in ceremonies for Bhattacharya and Makary, according to a report by The Associated Press.

Other national news outlets were reporting numerous layoffs at the health agencies HHS oversees. It was part of the announced plan to reduce the HHS workforce from 82,000 to 62,000. The plan is projected to save $1.8 billion for taxpayers through reducing the workforce by 10,000 full-time staff, with reductions through other efforts including early retirement and restructuring.

For the employees involved, “it’s a terrible dark day,” one staffer of the U.S. Centers for Disease Control and Prevention (CDC) told NBC News. That outlet report various communications staff at the U.S. Food and Drug Administration and its Center for Drug Evaluation and Research were let go, along with workers at divisions dedicated to tackling HIV, improving minority health, and preventing injuries including gun violence.

Reuters published photos of HHS workers lined up outside the agency, where at least some were turned away at the door with instruction to return their employee identification badges. NPR reported Jeanne Marrazzo, MD, MPH, leader of the National Institute of Allergy and Infectious Diseases, was offered reassignment to the Indian Health Service elsewhere in the country.

At the Food and Drug Administration, senior leaders were pushed out and offices focused on food, drug and medical device policy were hit with deep staff reductions amounting to about 3,500 agency staff members, according to The New York Times. Some workers said that they discovered they were fired when they attempted to scan their badge to get into the building early Tuesday.

Former leaders speak out

The developments have been widely condemned across health care. This week, a group of approximately 1,900 scientists warned the administration's approach is jeopardizing American medical research and the nation's status as global leader of health care. One health expert characterized it as an "ongoing assault on public health," with patients at direct risk of complications when infections increase as prevention decreases.

News reports included statement from at least two high-ranking former leaders within HHS — and their outlooks were pessimistic.

“These cuts to agency experts and programs leave our country less safe, less prepared and without the necessary talent and resources to respond to health threats,” Mandy Cohen, MD, MPH, told NBC News. Cohen was CDC director in the administration of President Joe Biden.

Former FDA Commissioner Robert Califf, MD, FACC, said “The FDA as we’ve known it is finished, with most of the leaders with institutional knowledge and a deep understanding of product development and safety no longer employed.” USA Today cited Califf’s post on job networking site LinkedIn.

History will see this as a huge mistake, Califf said, adding he would be glad if he is proven wrong.

Lawmakers opine

On April 1, the House Energy & Commerce Committee’s Health Subcommittee held a hearing, “Examining the FDA’s Regulation of Over-the-Counter Monograph Drugs.” Chairman Rep. Buddy Carter (R-Georgia) cited examples of successful businesses making those type drugs and why Congress should renew the Over-the-Counter Monograph Drug User Fee Program, known as OMUFA.

Ranking Member Rep. Frank Pallone (D-New Jersey) acknowledged the importance of the topic, and of "Aging Technology, Emerging Threats: Examining Cybersecurity Vulnerabilities in Legacy Medical Devices," subject of a separate April 1 hearing by the subcommittee on Oversight and Investigations.

As important as those are, they could wait due to “the Trump administration dismantling our public health infrastructure before our eyes,” Pallone said.

“Let’s be clear what is happening here — the Trump Administration’s goal is to hollow out the agencies to find savings for their giant tax breaks for their billionaire friends, including Elon Musk himself,” Pallone said. “But it is also crystal clear that the administration is looking to get rid of those who refuse to bend to their anti-science agenda and medical quackery.”

CMS leader affirms medical stances

This week, Mehmet Oz, MD, MBA, clarified his stances on health care-related issues in written answers to questions from Sen. Josh Hawley (R-Missouri). Oz affirmed his commitment to following the president’s executive orders, if confirmed by the Senate. That is likely because Oz already has the Senate Finance Committee’s endorsement and Bhattacharya and Makary received the full Senate’s nod.

Hawley posted Oz’ letter on social media website X, formerly Twitter. He noted Oz, as a television host, previously had guests including transgender advocates and a surgeon who performed transgender surgery. Oz said since he hosted that show, medical research has shown previous clinical approaches were not sufficiently evidence-based and contained inconsistencies. Oz said he would enforce the president’s orders “to end the chemical and surgical mutilation of children.” Likewise on the president’s directives on abortion: “I am unequivocally pro-life, and if confirmed, I look forward to advancing a pro-life agenda at CMS.”