The Centers for Disease Control and Prevention (CDC) continues to publish critical research papers even as it grapples with the fallout of recent layoffs that have affected several key experts. Among those affected are the scientists who helped write the WHO guidelines on prophylactic treatments after sexual and injection exposure to HIV infection. Their dismissals have sparked further questions about the agency’s ability to conduct essential public health activities.
In the month leading up to the publication of new guidelines aimed at preventing HIV transmission, six CDC experts received “reduction in force” notices. This decision, part of a broader cut initiated by the Trump administration, came as the agency sought to streamline operations amid ongoing budgetary constraints. The repercussions of these cuts are becoming increasingly evident as the CDC published papers that omitted critical contributions from these now-former employees.
One of the most notable publications was a paper detailing nationwide investigations into lead poisoning cases, which, while informative, left out significant details concerning the role of those laid off. About a month or two after the paper’s public release, the CDC fired at least six of these former authors. That alone raises serious concerns about the agency’s transparency and accountability.
Erik Svendsen, former director of the CDC’s Division of Environmental Health Science and Practice, was among those affected by the layoffs. He expressed concern over the implications of losing such expertise, stating, “Our team’s gone. People usually pull us in, and then we work with them to figure it out, but they can’t pull us in anymore. They’re on their own.”
The CDC has been involved in various public health programs, including a childhood lead poisoning prevention initiative that provided funding for three epidemiologists stationed in North Carolina. This program is critical to identifying sources of lead exposure. It targets, specifically, communities that suffer disproportionate rates of contamination and seeks to alleviate those hazards.
Additionally, a study authored by nine CDC scientists highlighted the need for integrating smoking cessation programs into mental health treatment facilities. Since this paper was released on April 24, 2023. Not even a month later, the agency announced its guidelines for HIV prophylaxis, just in time on May 8. These publications reflect ongoing efforts to address pressing health issues despite internal challenges.
As part of this effort, the CDC identified a single factory in Ecuador as the source. This factory created the environmental contamination that led to numerous cases of lead poisoning in Hickory, North Carolina. They partnered with state inspectors and local health officials to quickly get tainted products off store shelves. Collectively and individually, they did a great job of mitigating further risks.
Despite these successes, uncertainty hangs over how the CDC will implement this work going forward. An official from the Department of Health and Human Services (HHS) indicated that as reorganization plans take shape, all strategic programs and priorities will be reassessed. The impact of this program will be felt for years to come,” they wrote. The continued havoc caused by these disruptions is deeply concerning to public health defenders.
As a public health professional, Ed Norman expressed his concerns about what is happening at the CDC today. “What’s happening at CDC right now is jeopardizing our ability to do any of this work,” he remarked. Furthermore, he emphasized the potential consequences of these layoffs, noting that without proper monitoring, “we would never know which kids have exposures.”
Public health experts are urging a federal case definition to provide consistency and accuracy in data collection from state to state. David Nicholas, an advocate for standardized reporting practices, explained, “To make sure we’re all using the same case definition, we’re all classifying cases the same way… this gives you a centralized way to collect the data and to report out on the data.”
It’s clear that the CDC is sailing through some stormy seas. It needs to rebuild lost public health profession confidence and it needs to make sure that internal discord doesn’t stop it from pursuing its core research mission. The ability to respond effectively to public health crises relies on maintaining a robust workforce equipped with the necessary expertise.
