In a deeply troubling move for public health and biomedical science, the Trump administration has quietly dismantled the Healthcare Infection Control Practices Advisory Committee (HICPAC), a linchpin in the United States’ defense against infectious disease threats. HICPAC, a federal advisory body to the Centers for Disease Control and Prevention (CDC) under the Department of Health and Human Services (HHS), had for over 30 years played a vital role in shaping national infection prevention guidelines—those very practices that keep hospitals safe, contain outbreaks, and ensure uniform health protections across all care settings.
The committee’s abrupt dissolution came under the guise of a broader federal workforce reduction mandated by President Trump’s February executive order. But this is no mere bureaucratic reshuffle. The elimination of HICPAC and similar scientific bodies reflects a growing pattern of anti-science governance and public health neglect—one that risks reversing decades of progress in infection prevention and disease control.
What Was Lost: The Role and Achievements of HICPAC
Since its establishment in 1991, HICPAC has issued over 540 infection control recommendations—90% of which the CDC fully implemented. These guidelines have defined the national standards for hand hygiene, environmental decontamination, surgical field sterility, and the use of personal protective equipment (PPE).
The committee has been instrumental in:
- Defining Standard Precautions (1996): HICPAC’s guidance that all bodily fluids be treated as potentially infectious transformed hospital protocols and protected healthcare workers across the country.
- Updating Hand Hygiene (2002): The promotion of alcohol-based hand rubs helped establish hand sanitization as a cornerstone of modern infection control.
- Environmental Infection Control (2003): These guidelines addressed hospital air and water quality, critical in preventing the spread of pathogens like Legionella and C. difficile.
- Guidelines for the Prevention of Intravascular Catheter-Related Infections (2011): These comprehensive recommendations helped drive a national push to reduce central line-associated bloodstream infections (CLABSIs), resulting in significant declines in infection rates in intensive care units nationwide.
- Core Infection Prevention and Control Practices for Safe Healthcare Delivery in All Settings (2016): This guidance laid out a standardized framework for infection prevention practices across diverse healthcare environments, from hospitals to outpatient clinics, helping unify safety practices nationwide.
- Enhanced Barrier Precautions for Nursing Homes (2019): In response to rising threats from multidrug-resistant organisms (MDROs), HICPAC advised the implementation of enhanced precautions—such as gown and glove use for certain high-risk residents—to curb transmission in long-term care settings.
- Updated Guidance on Antimicrobial Stewardship in Hospitals (2021): HICPAC helped shape policy that strengthens antibiotic stewardship programs, aiming to combat antibiotic resistance and reduce unnecessary antimicrobial use in inpatient settings.
- Draft Guidelines on Airborne Pathogen Transmission (pending): Before its termination, the committee was finalizing critical updates to respiratory precautions—last revised in 2007—drawing from hard-won lessons during the COVID-19 pandemic to modernize protections for healthcare workers and patients alike. These updates have now been halted.
HICPAC’s influence stretched beyond recommendations. Its work informed Medicare and Medicaid participation requirements, Joint Commission accreditation standards, and state-level public health regulations. Its standards shaped the very infrastructure of infection control across the American healthcare system.
A Dangerous Vacuum
Without HICPAC, healthcare institutions may find themselves without a unified, scientifically grounded playbook. State and local health departments could diverge in infection protocols, causing confusion and undermining patient and worker safety. As Dr. Anurag Malani of the Infectious Diseases Society of America warned, “You’d want to avoid seeing state and local health departments try to figure this out on their own.”
Having no centralized, science-based advisory body opens the door for local and state government to fill the vacuum with their own infection control guidelines — many of which may be shaped more by politics than by evidence. In states where public health policy has increasingly been subject to partisan influence, there’s a growing risk that infection prevention measures could be weakened or ignored altogether in favor of ideology or economic priorities.
We’ve already seen examples of this dynamic during the COVID-19 pandemic, when some states downplayed mask use, undermined vaccine efforts, or promoted unproven treatments. In the absence of strong federal guidance, fringe science and misinformation can gain traction, leading to uneven protections across the country. This not only puts Americans at risk but also threatens to erode national progress on infection prevention — allowing preventable illnesses to spread unchecked in communities that adopt looser, politically driven standards.
The CDC’s archived HICPAC webpages now stand as a time capsule—useful for historical reference but frozen in time, no longer evolving with scientific discovery. This is a particularly dangerous scenario amid rising antimicrobial resistance and the looming threat of new pandemics.
The Bigger Picture: Systematic Dismantling of Public Health Infrastructure
The elimination of HICPAC is far from an isolated incident. It is part of a sweeping effort by the Trump administration to slash scientific and public health programs across federal agencies:
- HHS Restructuring: In March, HHS announced a reorganization plan to eliminate up to 20,000 full-time positions and consolidate from 28 divisions to 15. These cuts have already stalled infection prevention programs and pandemic preparedness efforts.
- NIOSH Layoffs: The National Institute for Occupational Safety and Health lost much of its workforce, including those managing PPE safety and workplace protections in healthcare. The lab responsible for validating N95 masks and detecting counterfeit PPE has been effectively shuttered.
- HIV Prevention Defunded: The CDC abruptly defunded the Together TakeMeHome HIV self-testing program at Emory University, which had prevented an estimated 500 HIV infections and saved hundreds of millions in healthcare costs.
- Other Advisory Panels at Risk: Several additional scientific advisory committees are reportedly being wound down, further weakening the evidence base that informs federal health policy.
These actions are not just about cost-cutting. They represent a calculated rejection of expert advice, biomedical science, and public accountability in favor of political expediency and bureaucratic “streamlining.” The long-term costs—in lives, trust, and national preparedness—are incalculable.
How This Affects You: The Human Cost of Dismantling HICPAC
While HICPAC may seem like a distant, technical advisory body, its absence has direct consequences for everyday Americans — especially the most vulnerable.
Loved Ones in Nursing Homes or Long-Term Care
HICPAC’s guidelines have played a vital role in keeping infections like MRSA, C. difficile, and drug-resistant bacteria from spreading in senior and long-term care facilities. With the committee gone, updates to these infection control standards may stall, leaving nursing homes to rely on outdated or inconsistent practices. For families with elderly parents or immunocompromised loved ones in care homes, this increases the risk of preventable infections — many of which can be fatal.
Rising Burden on Hospitals
Without national, evidence-based guidance from HICPAC, hospitals may be left to navigate complex infection control strategies independently. This not only creates inconsistencies between facilities but also heightens the risk of outbreaks, particularly during respiratory virus season or in the event of emerging threats like COVID-19 variants or novel pathogens. More infections mean longer hospital stays, more antibiotic use, and higher healthcare costs — all of which strain already overburdened systems.
Delays in Responding to New Threats
From Ebola to COVID-19, HICPAC has contributed to readiness plans that protect healthcare workers and patients alike. Without their expert input, the CDC loses a key mechanism for rapidly updating guidelines in response to new threats. This lag could result in confusion among frontline clinicians and slower implementation of life-saving precautions.
Erosion of Public Trust and Transparency
HICPAC’s public meetings and open deliberations have provided a rare window into how national infection control guidelines are developed. Their elimination removes a layer of accountability, allowing key decisions about public health to be made behind closed doors. For citizens who expect transparency in how federal health policy is shaped — particularly after the lessons of the COVID-19 pandemic — this is a significant step backward.
In short, this isn’t just about bureaucratic restructuring. It’s about whether your local hospital will have the latest tools to stop an outbreak. It’s about whether your child undergoing surgery, your spouse on dialysis, or your elderly parent in a care facility can receive safe, evidence-based care. The impact is personal, and it is profound.
Why It Matters Now
As global health threats—from antimicrobial resistance to future pandemics—become more complex, the U.S. needs more scientific guidance and coordination, not less. Gutting the very institutions that translate research into practice will not make us leaner or more efficient. It will make us slower to respond, less prepared, and more vulnerable.
The public health, clinical, and scientific communities must push back. Now more than ever, defending science-based policy is a matter of national security.
SOURCES AND FURTHER READING:
- NBC News: Trump administration has shut down CDC’s infection control committee
- MedPage Today: What’s at Stake if CDC’s Infection Control Practices Committee Is Cut
- The Hill: Trump nixes CDC infectious disease advisory committee
- Becker’s Hospital Review: CDC cuts stall infection prevention work
- CDC HICPAC Archived Pages