The Trump administration began sending notices of termination to thousands of staffers at federal health agencies Tuesday, according to interviews with employees and officials at multiple agencies and e-mails reviewed by NPR.
The Department of Health and Human Services last week announced it planned to dismiss 10,000 people. These cuts come on top of around 10,000 people already leaving the agencies under the Trump administration's Fork in the Road offer and early retirement.
Termination emails went out Tuesday morning to employees and leadership of agencies within HHS, the Food and Drug Administration, the National Institutes of Health, the Centers for Disease Control and Prevention as well as several smaller agencies.
Many of those workers only found out they had been fired when they tried to badge into the building after waiting in line and couldn't get in, NPR learned from multiple sources at HHS who didn't want to share their names for fear of repercussions.
On Thursday, HHS Secretary Robert F. Kennedy Jr. said in a statement that the layoffs were intended to reduce "bureaucratic sprawl." "We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic," he said.
But agency staff and leaders in the field say the cuts are a blow to public health, medicine and biomedical research in the U.S.
"We've never seen anything like this before," Dr. Ashish Jha, the dean of the Brown University School of Public Health, who served as President Biden's COVID-19 Response Coordinator, told NPR in an interview.
"We rely on our CDC for things like tracking down disease outbreaks. We rely on NIH for research into new treatments and tests and vaccines. At this moment, whether those will continue to be effective has really been put into question. We don't know what the implications of all of this will be. I'm worried that what we're going to see is more people getting sick, more disease outbreaks and infrastructure that is going to be less and less capable of responding to those threats."
HHS, FDA and NIH did not immediately respond to NPR's request for comment.
FDA sees major changes
At the FDA, the entire team that handles communications for the agency lost their jobs, according to staffers who were among those fired. They spoke on condition of anonymity for fear of retaliation for publicly criticizing the administration. According to an HHS fact sheet, 3,500 FDA jobs are being eliminated. The FDA's top vaccine regulator, Dr. Peter Marks, revealed on Friday that he's been forced out. And FDA Center for Tobacco Products chief Brian King was fired, the AP reports.
Before Trump took office, there were around 18,000 employees at the agency — there have been departures and firings since then, in addition to today's cuts.
At the FDA's Center for Drug Evaluation and Research, more than 800 people lost their jobs, according to an official who was laid off and fears retribution for sharing information. This part of the agency, which had around 6,000 employees before the cuts, is responsible for new drug approvals as well as monitoring unexpected side effects after approval and making label changes.
Former FDA leaders who served under presidents from both parties took to social media to voice their concerns about the cuts.
"The FDA as we've known it is finished," Dr. Robert Califf, who served as FDA commissioner twice, and stepped down in January, wrote on LinkedIn. He explained that he was "overwhelmed" with messages about the staff cuts and that the agency's leaders who know the most about product development and safety had been let go.
"I believe that history will see this [as] a huge mistake," he wrote. "I will be glad if I'm proven wrong, but even then there is no good reason to treat people this way. It will be interesting to hear from the new leadership how they plan to put 'Humpty Dumpty' back together again."
Dr. Scott Gottlieb, who served as FDA commissioner during Trump's first term from May 2017 through April 2019, wrote on X Tuesday that he fears the United States will regress to a time when Americans suffered a "drug lag" in getting access to new drugs and treatments.
"Through a generation of congressional actions, investments in expertise and hiring, and careful policymaking, we built the FDA into the most efficient, forward-leaning drug regulatory agency in the world. ... Today, the cumulative barrage on that drug-discovery enterprise, threatens to swiftly bring back those frustrating delays for American consumers."
Many FDA staffers and their work are funded by user fees paid by drug and device companies as well as the makers of certain tobacco products. Congress passed the first user fee law in 1992 to fund staffing to speed drug approvals.
Some of the staffers funded by these fees tell NPR they lost their jobs, too. This includes staff in the Center for Tobacco Products. Because they weren't paid by taxpayers, those layoffs won't save taxpayer dollars.
NIH leaders get reassigned
Hundreds of staffers at the National Institutes of Health have received notices. About 1,200 jobs were expected to be cut at the agency. Many of the NIH cuts appear to involve communications, IT and other support staff. But at least several high-ranking NIH officials also appear to be on their way out.
Dr. Jeanne Marrazzo, who took over as the director of the National Institute of Allergy and Infectious Diseases after Dr. Anthony Fauci departed, was offered reassignment to the Indian Health Service elsewhere in the country, according to an e-mail shared with NPR.
Several other leaders received the same offer including Renate Myles, director of communication for NIH, Dr. Eliseo J. Pérez-Stable, director of the National Institute on Minority Health and Health Disparities, Dr. Shannon Zenk, director of the National Institute of Nursing Research, and Dr. Diana Bianchi, the director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, according to several NIH employees who were not authorized to speak publicly.
"Despair, I think, is the only fitting word," said one NIH employee describing the mood at the agency Tuesday. The person, who was not fired, asked not to be identified because of fear of losing her job.
The cuts prompted widespread condemnation outside the agency.
"The level of cuts at NIH I am hearing about today is truly mind-boggling," wrote Jeremy Berg of the University of Pittsburgh, who served as the director of the National Institute of General Medical Sciences, part of the National Institutes of Health, from 2003 to 2011, wrote NPR. " I try not to be hyperbolic but this seems to be a massacre. … I honestly don't know where this leads."
The NIH office in charge of responding to freedom of information requests has also been cut, according to one official.
The cuts came as Dr. Jay Bhattacharya, a Stanford University health economist, took over as the new NIH director.
"I recognize that I am joining the NIH at a time of tremendous change," Bhattacharya wrote in a message to the agency. Every inch of the federal government is under scrutiny – and NIH is not exempt."
But he added, "NIH's mission to enhance health remains vital as millions of children and adults in this country face poor outcomes due to chronic diseases like obesity, health disease and cancer."
The NIH, the world's biggest public funder of biomedical research, was already reeling from the departures of other high-profile leaders, including Fauci and former NIH Director Francis Collins, along with earlier staff cuts and the cancellation of hundreds of grants to outside scientists.
Cuts at agencies serving the disabled, elderly and low-income households
The Administration for Community Living, which coordinates federal policy on aging and disability, was gutted – 40% of staff there lost their jobs, according to Alison Barkoff, the former head of the agency who says she learned this by talking to multiple members of her former staff. The ACL funds programs that run senior centers and distributes 216 million meals a year to older and disabled people.
"The programs that ACL implements control the lives of literally tens of millions of older adults, people with disabilities and their families and caregivers," says Barkoff, who currently serves as a law professor with George Washington University's Milken Institute School of Public Health. "There's no way to have these RIFs and not impact the programs and the people who rely on them."
Every single staffer was laid off from another HHS office, the Division of Energy Assistance, which runs a program helping 5.9 million low-income households pay their heat and cooling bills and with other issues around utilities, according to two employees who lost their jobs, Andrew Germain and Vikki Pretlow, and another staffer who spoke to NPR but didn't want to share their name for fear of repercussions.
The office runs the Low-Income Home Energy Assistance Program. The staffers said layoffs came as a surprise and expressed concern about whether the program would continue once funding runs out at the end of September.
Some members of Congress have raised alarm about the scope of cuts at HHS.
"The Trump Administration has launched an unprecedented attack on the federal health workforce," said House Energy and Commerce Committee Ranking Member Frank Pallone, Jr., D-NJ, during remarks he made Tuesday at an oversight and investigations hearing on technology and cybersecurity related to medical devices.
"[Sec.] Kennedy claims that health care services will not be harmed by the dramatic downsizing, but he is wrong, and everyone who is paying any attention knows it," he said.
Have information you want to share about the layoffs and restructuring across federal health agencies? Reach out to these authors via encrypted communications: Selena Simmons-Duffin @selena.02, Sydney Lupkin @sydneylupkin.36, and Rob Stein @robstein.22.
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