Travel, grant and funding cuts ‘stifling’ US health agencies in new Trump era

US health agency employees are now banned from nearly all travel and certain agencies and programs have been ordered to stop issuing new contracts and grants until further notice.

The limits on travel and spending, announced internally on Wednesday, add to previous indefinite halts on external communications, including publishing new reports or even posting to social media, and on reviewing and approving new medical research, a nearly $50bn industry in the US.

Employees of the 13 agencies overseen by US Health and Human Services (HHS) may only travel to return from assignments or to escape life-threatening situations. That means regular meetings with state and local health officials, training sessions and grant reviews are now on hold.

All federal agencies have been ordered to stop funding for foreign projects, including global health, and to stop work immediately on any programs involving the World Health Organization. Some agencies have also been ordered to stop cutting checks for projects and programs.

The mood at health agencies has been “nothing short of morose and somber”, said one CDC employee who requested anonymity because of the ban on communications.

Most staff members have experienced administration transitions under Democratic and Republican presidents before, but this transition has signaled “a dramatic shift” in the second Trump administration’s approach to federal agencies, especially those working on health and science, the employee said.

Agencies are still grappling with the outpouring of executive orders and how to interpret them, the employee said. The uncertainty amid these changes has left federal employees with “an overwhelming sense of dread and hopelessness”.

Halting vital response efforts and research, even temporarily, could take years to undo, the employee added.

Outbreak response will suffer from the bans on travel and communications, which is particularly dangerous given the evolving outbreak of highly pathogenic bird flu among animals and people, experts said.

“The US is in a critical period in responding to H5N1,” said Jennifer Nuzzo, director of the Pandemic Center and professor of epidemiology at the Brown University School of Public Health. “Any actions that slow or prevent the ability of US scientists to collect, analyze and disseminate data will weaken our abilities to track and protect ourselves from this virus.”

If, for example, a state detects a new pattern of transmission or a new cluster of cases in people, officials from the US Centers for Disease Control and Prevention (CDC) or the US Food and Drug Administration (FDA) might not receive clearance for a “mission critical” exception for travel to that state to aid in outbreak response or even to communicate with the state or the public.

“Stifling the ability of these agencies to participate in public health conversations and to mount unbridled responses to outbreaks is a terrible idea with predictable outcomes that will include unnecessary infections, disability and deaths,” said Ilan Schwartz, an infectious disease doctor in North Carolina.

The US Department of Agriculture (USDA), which is tracking the bird flu outbreak among animals, is not an HHS agency and thus may continue its work.

But HHS agencies like the CDC and FDA, as well as others including Centers for Medicare & Medicaid Services, the Indian Health Service, the National Institutes of Health (NIH), and the Substance Abuse and Mental Health Services administration, are now forced to curtail their activities.

The unprecedented halt to US medical research through the NIH also announced on Wednesday meant meetings were canceled, some right before they were scheduled to happen and others that were stopped halfway through.

Researchers on social media spoke about cancer research grinding to a halt as participants wait for experimental treatments and the effects the shutdown would have on universities and scientific advancement around the world.

Funding from the NIH is “the lifeblood of the entire US biomedical research enterprise, which is a cornerstone of the US economy”, Schwartz said. The agency directly funds more than 400,000 jobs, and every $1 spent by the NIH generates $2.46 of economic activity.

The transition to the new administration has created uncertainty in other ways. There is currently no one formally in charge at the CDC, with no acting head named.

Trump’s nominee for CDC director, Dave Weldon, who has previously proposed breaking off the vaccines division of the agency, has not yet been scheduled for a nomination hearing before the Senate.

Robert F Kennedy Jr, the nominee to oversee HHS, is slated to appear before the Senate finance committee on Wednesday.