Centers for Disease Control and Prevention workers whose jobs have been reinstated after dizzying Trump administration disruptions say they remain stuck in a budgetary, political, and professional limbo.<\/p>\n
Their work includes major agency priorities such as HIV testing and monitoring, as well as work at the nation\u2019s leading sexually transmitted infections lab. And while employees are back, many projects have been canceled or stalled, as funding disappears or is delayed.<\/p>\n
\u201cFor a while, work was staring at a blank screen,\u201d an HIV scientist said. \u201cI had a couple of projects before this. I\u2019m trying to get them restarted.\u201d<\/p>\n
\u201cWe don\u2019t know what\u2019s happening or what to do,\u201d said an HIV prevention researcher who was fired then rehired.<\/p>\n
These employees voiced deep concern over the future of the agency and its work on HIV and other threats. The unprecedented downsizing could lead to loss of life and higher spending on medical care, they say. Their uncertain employment status has sunk morale. Many worry about the future of public health.<\/p>\n
On Aug. 8, a gunman identified by Georgia authorities as Patrick Joseph White fired shots at CDC buildings in Atlanta. A first responder on the scene, DeKalb County police officer David Rose, was killed. White, who was found dead, was possibly motivated by his views on vaccines, according to news reports.<\/p>\n
The attack added another level of anxiety for agency workers.<\/p>\n
\u201cWe feel threatened from inside, and, obviously, now from outside,\u201d a lab scientist said Aug. 10. \u201cThe trauma runs so differently in all of us. And is this the last straw for some of us? The overall morale \u2014 would you go back in the building and you could be shot at?\u201d<\/p>\n
Healthbeat interviewed 11 CDC workers, who offered a rare glimpse into conditions at the agency. All but one had been fired then offered their jobs back. Most have worked on HIV-related projects for at least several years. All spoke on the condition of anonymity, citing a fear of retaliation.<\/p>\n
They fear their employment, in the HIV scientist\u2019s terms, \u201cis on shaky ground.\u201d<\/p>\n
\u201cI\u2019m concerned there is chaos and that we lost ground on HIV prevention\u201d from reductions in data collection and layoffs of local public health workers, an HIV epidemiologist said. \u201cI feel like a pawn on a chessboard.\u201d<\/p>\n
HHS spokesperson Emily Hilliard responded to a query with this statement:<\/p>\n
\u201cUnder Secretary Kennedy\u2019s leadership, the nation\u2019s critical public health functions remain intact and effective. The Trump administration is committed to protecting essential services \u2014 whether it\u2019s supporting coal miners and firefighters through NIOSH, safeguarding public health through lead prevention, or researching and tracking the most prevalent communicable diseases. HHS is streamlining operations without compromising mission-critical work. Enhancing the health and well-being of all Americans remains our top priority.\u201d<\/p>\n
The workers received some positive news July 31, when a Senate committee voted to keep CDC funding at more than $9 billion, near its current level. \u201cIt is very encouraging, but that\u2019s only one step in the appropriations process,\u201d the HIV researcher said.<\/p>\n
Still, under the Trump administration\u2019s budget request, the CDC\u2019s programs on HIV face uncertainty. John Brooks, who retired as chief medical officer of the CDC\u2019s Division of HIV Prevention last year, expressed concern over the Ending the HIV Epidemic initiative. Launched in President Donald Trump\u2019s first term, it \u201cbreathed new life into HIV prevention,\u201d Brooks said.<\/p>\n
The successes of the Ending the HIV Epidemic initiative are jeopardized by the administration plan to scale back HIV prevention efforts, Brooks said. That would include the potential elimination of the CDC Division of HIV Prevention, which provides funds to state health departments and other groups for testing and prevention, conducts HIV monitoring and surveillance, researches HIV prevention and care, and assists medical professionals with training and education.<\/p>\n
\u201cThere is no way to achieve the goals of EHE without maintaining the national prevention infrastructure it depends on,\u201d Brooks said. \u201cThere is every reason to worry that in fact new HIV infections will rise again.\u201d<\/p>\n
Under Secretary Robert F. Kennedy Jr., the Department of Health and Human Services carried out widespread layoffs at the CDC and other health agencies beginning in early April. Lawsuits over those mass firings are playing out in federal courts.<\/p>\n
The administration\u2019s budget blueprint would move CDC HIV work \u2014 with many fewer employees, according to people Healthbeat interviewed \u2014 to the Administration for a Healthy America, a new HHS division Kennedy has championed.<\/p>\n
The Medical Monitoring Project, which tracks outcomes, quality, and gaps in HIV treatment, is set to be a casualty<\/a> under the Trump restructuring plan, an HIV prevention physician said.<\/p>\n HHS officials have not communicated with the rank and file about the restructuring, several CDC workers said.<\/p>\n \u201cIt\u2019s been crickets,\u201d the HIV scientist said.<\/p>\n The White House\u2019s proposed CDC budget for the next fiscal year contains a cut of more than 50%, plummeting from $9.2 billion in fiscal year 2025 to about $4.2 billion, according to administration documents and public health advocacy groups, with some agency functions transferred to the proposed AHA. The Senate committee, by an overwhelming vote, injected billions back into the agency budget and declined to fund the AHA.<\/p>\n U.S. Sen. Jon Ossoff, a Georgia Democrat, thanked the committee for \u201crejecting the unacceptable effort to defund most of the CDC.\u201d<\/p>\n \u201cThe budget request from the White House included a 56% cut to the world\u2019s preeminent epidemiological agency,\u201d Ossoff said. He also criticized a \u201csystematic destruction of morale at the CDC, the disbandment of entire agencies focused on maternal health and neonatal health and disease prevention at the CDC.\u201d<\/p>\n If the White House prevails and the prevention program is eliminated, \u201cwe would see most states have no funding for HIV prevention,\u201d said Emily Schreiber, senior director of policy and legislative affairs for the National Alliance of State and Territorial AIDS Directors. \u201cThat means most states would not be able to conduct any HIV testing, any referral to care, and\/or referral to preventive services like PrEP,\u201d or pre-exposure prophylaxis, a drug that can prevent HIV infections<\/a>.<\/p>\n \u201cIt means that states would not be able to help people get access to medications,\u201d she said, \u201cand that means that we would see new cases and an increased spread of HIV across the United States.\u201d<\/p>\n \u201cWe would definitely see layoffs at the CDC, and I think we\u2019d probably see them at state health departments and community-based organizations as well,\u201d she added.<\/p>\n The Los Angeles County Department of Public Health has recently laid off or reassigned dozens of HIV workers due to funding problems, according to a statement emailed to Healthbeat.<\/p>\n \u201cI fear all HIV prevention work will go away permanently,\u201d the HIV prevention researcher said. \u201cI don\u2019t think this administration wants HIV prevention work to be done by the federal government.\u201d<\/p>\n Georgia leads U.S. states in the rate of new HIV infections, according to the latest data from AIDSVu<\/a>. CDC workers also said they\u2019re concerned that vulnerable communities of color and LGBTQ+ communities would be deeply harmed by funding cuts.<\/p>\n In Georgia and other states, information provided by the Medical Monitoring Project about access to care will disappear, the HIV physician said. Information on prevention and treatment will dwindle for people who are disadvantaged, he said, including those with substance abuse problems or mental illness, transgender people, and those living in poverty.<\/p>\n \u201cThere is a lot of anger and sadness among people over the termination of the project,\u201d the physician said. \u201cA lot of the enthusiasm is gone.\u201d<\/p>\n An effective home testing program for HIV plans to shutter this fall, said Patrick Sullivan, the Together TakeMeHome<\/a> project\u2019s lead scientist and a professor at Emory University\u2019s Rollins School of Public Health. In its notice canceling funding for the project, the CDC said it no longer had the staff to oversee it. Based at Emory, the project delivered more than 900,000 free home testing kits to people across the country through an easy-to-use website and integration with dating apps.<\/p>\n More than 100 HIV workers were among the more than 450 CDC staffers brought back, said employees interviewed by Healthbeat. Some cited media coverage<\/a>, support in Congress, and advocacy by patient groups and pharmaceutical companies for their reinstatement. \u201cMembers of Congress are going to bat for HIV,\u201d the epidemiologist said.<\/p>\n Several are closely watching a lawsuit brought by 20 Democratic attorneys general, seeking to halt an agency restructuring plan Kennedy announced in March<\/a>. They are also paying attention to a lawsuit filed in California that challenges the firings.<\/p>\n A few people whose jobs were restored have retired or moved on to other work. \u201cSome people aren\u2019t trusting we will remain, so they\u2019re leaving,\u201d the HIV prevention researcher said.<\/p>\n At the CDC\u2019s sexually transmitted infections lab in Atlanta, work has also slowed due to a shrinking staff and new spending constraints on supplies, the lab scientist said.<\/p>\n Restored lab workers are focusing on high-priority areas such as syphilis and gonorrhea while other diseases have been back-burnered, the scientist said, adding \u201ca lot of what we were doing was staying ahead of the next pathogen, and we feel like our time and effort to do that now is limited.\u201d<\/p>\n \u201cWe\u2019re all public health because we know what the mission is,\u201d the scientist said. \u201cWe just want to get our job done and protect the American public.\u201d<\/p>\n Healthbeat is a nonprofit newsroom covering public health published by <\/em>Civic News Company<\/em><\/a> and <\/em>KFF Health News<\/em><\/a>. Sign up for its national newsletter <\/em>here<\/em><\/a>.<\/em><\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\nUSE OUR CONTENT<\/h3>\n