In the first 100 days of President Donald Trump’s second term, the United States has witnessed a sweeping transformation of its public health apparatus—marked by the elimination of over 20,000 health-related jobs, the gutting of long-standing federal programs, and a sharp ideological pivot under the stewardship of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. These changes, detailed in a Washington Post exposé (April 30, 2025), are being implemented under the banner of the “Make America Healthy Again” initiative. While the administration promises a renewed focus on chronic disease, transparency, and cost efficiency, public health professionals and researchers are sounding alarms over the lasting implications.
Compounding the concern, a new nationally representative poll from the Harvard T.H. Chan School of Public Health, in partnership with the de Beaumont Foundation and supported by the Robert Wood Johnson Foundation, reveals a growing crisis of trust in federal health agencies. The poll, published April 29, 2025, found that 44% of Americans expect to lose trust in public health recommendations due to the leadership changes—suggesting that the reorganization of agencies like the CDC and NIH could be as much a communications emergency as a policy one.
Restructuring Health Agencies: Cuts, Consolidation, and Controversy
According to the Washington Post, the administration’s reorganization plan includes a major overhaul of the Department of Health and Human Services, the elimination of entire programs within the Centers for Disease Control and Prevention (CDC), and the redirection of billions in scientific research funding. One of the most striking changes is the creation of a new entity, the Administration for a Healthy America (AHA), designed to consolidate functions from now-defunded or downsized agencies such as the National Institute for Occupational Safety and Health (NIOSH).
Among the programs reportedly dissolved or suspended:
- CDC’s injury and lead poisoning prevention programs
- Chronic disease initiatives including cancer screenings and smoking cessation
- Food safety functions within the FDA, including labs overseeing milk and pet food safety
- Infectious disease surveillance labs monitoring sexually transmitted infections and hepatitis
- Research on vaccine hesitancy, transgender health, and reproductive health
The administration argues these shifts are necessary to tackle chronic illness more directly and efficiently. Yet many in the scientific and public health community see the changes as ideologically driven, anti-science, and potentially dangerous for population health outcomes.
Trust in Turmoil: Public Skepticism on the Rise
The Harvard Chan School and de Beaumont Foundation poll offers critical insights into how these changes are being perceived by the American public. Conducted between March 10 and 31, 2025, with over 3,300 adults nationwide, the survey found:
- 44% say they will trust public health recommendations less under the new leadership.
- Only 28% say their trust will increase.
- Trust divisions are starkly partisan: 76% of Democrats expect to lose trust, while 57% of Republicans expect to gain it.
More troubling, among those anticipating a decline in CDC performance, majorities expressed deep concern that the agency would:
- Make politicized health recommendations (76%)
- Cut programs too aggressively (75%)
- Downplay public health threats (72%)
- Reduce access to vaccine information (70%)
- Be influenced by corporate interests and fringe science (68% and 63%, respectively)
Gillian SteelFisher, director of the Harvard Opinion Research Program, cautioned that “new fault lines are emerging in trust for public health agencies,” and that “the American people will need to see more effort to sustain public health capacity than what they’ve seen so far.”
Biomedical Research: A Strategic Retreat?
Perhaps no sector has been more disrupted than federally funded biomedical research. The National Institutes of Health (NIH), the largest public funder of such research in the world, has seen hundreds of grants terminated. Affected areas include:
- Vaccine development and hesitancy
- Space-related health research
- Transgender and reproductive health studies
- Tuberculosis and infectious diseases
These decisions not only halt current scientific inquiry but threaten the pipeline of future researchers, as postdoctoral programs shrink and early-career scientists face limited opportunities. Critics warn that this could fracture the long-standing collaboration between government and academia that has historically powered U.S. medical and technological breakthroughs.
Vaccine Policy and Autism: A Return to Debunked Narratives
The administration has also removed top vaccine regulators and begun research initiatives that revive discredited theories. Notably, HHS hired David Geier, a widely discredited figure in the vaccine-autism debate, to study possible links between childhood vaccines and autism—despite overwhelming scientific consensus that no such link exists.
This has sparked widespread concern that legitimate vaccine policy could be undermined by pseudoscience. Already, public health officials warn that efforts to combat measles outbreaks, like the one currently affecting Texas, are being hampered by the weakening of infectious disease surveillance and a drop in public confidence.
Implications for Vulnerable Populations
In addition to programmatic disruptions, budget drafts include $900 million in proposed cuts to the Indian Health Service, threatening care in already underserved tribal communities. Reproductive health programs have also been curtailed, with layoffs affecting data collection systems like PRAMS (Pregnancy Risk Assessment Monitoring System), which are vital for improving maternal and infant health outcomes.
Common Ground: Bipartisan Priorities Remain
Despite growing distrust and political polarization, the Harvard-de Beaumont poll revealed broad agreement on the top public health priorities Americans want addressed:
- Chronic disease prevention (91% of Democrats, 86% of Republicans)
- Pandemic preparedness
- Maternal and infant mortality reduction
- Safe drinking water
- Mental health and substance abuse treatment
- Improved food and nutrition policy
As Brian Castrucci, president and CEO of the de Beaumont Foundation, put it, “These findings are a call to action to fund what works, fix what doesn’t, and find ways to work together to address these shared concerns.”
A Fragile Future for U.S. Public Health
The Trump administration’s early public health agenda reflects a radical departure from traditional approaches to disease prevention, scientific research, and agency governance. While marketed as a corrective to institutional failure, the evidence suggests a significant erosion of capacity, trust, and expertise—raising critical questions about the ability of the U.S. to respond effectively to health threats in the years ahead.
For public health professionals and global health security stakeholders, these developments demand vigilance, advocacy, and renewed public engagement to preserve the integrity and effectiveness of America’s public health institutions.
SOURCES:
- Washington Post. How public health has been upended in Trump’s first 100 days. April 30, 2025.
- Harvard T.H. Chan School of Public Health. Poll: Many Americans say they will lose trust in public health recommendations under federal leadership changes. April 29, 2025.