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On Thursday, US Health Secretary Robert F. Kennedy Jr., announced drastic job cuts and the destruction of large sections of public health infrastructure, as part of Trump’s unprecedented assault on federal employees and government services.

A Department of Health and Human Services (HHS) press statement outlined plans to implement a “dramatic restructuring in accordance with President Trump’s Executive Order, ‘Implementing the President’s “Department of Government Efficiency” Workforce Optimization Initiative.’”

The cuts include the following:

• reduction of the HHS staff by 25 percent, from 82,000 to 62,000 employees;
• consolidation of 28 department divisions to 15 under a new Administration for a Healthy America, referred to as AHA; and
• closure of five of the HHS 10 regional offices.

Claiming the staff reductions “will save taxpayers $1.8 billion per year,” the statement said 10,000 full-time jobs will be eliminated. The other 10,000 jobs are coming from workers who have taken early retirement and voluntary separation offers made by President Trump and billionaire DOGE head Elon Musk at the beginning of March.

In an accompanying “fact sheet,” HHS said the staff reductions would come from the Food and Drug Administration (FDA), with 3,500 full-time jobs cut; the Centers for Disease Control and Prevention (CDC), with 2,400 full-time jobs cut; the National Institutes of Health (NIH), with 1,200 full-time jobs cut; and the Centers for Medicare and Medicaid Services (CMS), with 300 full-time jobs cut.

The magnitude and sweeping character of the cuts make clear that what is now being pursued by Trump, DOGE and Kennedy is no less than the dismantling of HHS in an effort to destroy what remains of the public health system in the US. In particular, the targeting of the CDC and NIH shows that the fascists in the White House are seeking to remove all remaining impediments to the spread of infectious diseases and the transmission of deadly viruses among the public.

In a video statement posted on X, Kennedy justified the attack on public health and the primary federal health agencies by posing it as a “paradox.” He said the population is suffering from increasing rates of chronic disease and cancer, and the US ranks last among 40 developed nations in terms of health, “but we spend two to three times more per capita than those nations.” 

Kennedy pointed to the steady drop in US life expectancy, saying Americans are living six years shorter than Europeans. However, he did so without mentioning the COVID-19 pandemic or the criminal response of both the Trump and Biden administrations, which led to the excess deaths of nearly 1.5 millions Americans and accelerated the precipitous fall in life expectancy from 78.9 years in 2014 to 76.1 years today, a 3.5 percent decline that wiped out increases going back to 1996.

Kennedy blamed the alarming state of public health on a “sprawling bureaucracy” and said, “When I arrived, I found that over half of our employees don’t even come to work,” essentially blaming federal health agency workers for the crisis. Kennedy capped off his comments with the absurdity that the cuts were aimed at “making America healthy again,” the Trump administration’s Orwellian phrase for sickening and killing ever-broader numbers of Americans.

Any honest and critical review of the American healthcare system will show that declining life expectancy and rising rates of chronic disease and cancer are no paradox but the result of the subordination of the rights of the population to free and high quality healthcare to the profit system and the massive healthcare, pharmaceutical and insurance corporations.

Kennedy went on to say:

As part of President Trump’s DOGE workforce reduction initiative, we’re going to streamline HHS and make our agency more efficient and more effective. We’re going to imbue the agency with a clear sense of mission to radically improve the health of Americans and to improve agency morale.

Despite his public relations spin, Kennedy gave a glimpse of the reality of what this “downsizing” will entail, noting that this “will be a painful period for HHS.” Stating “we’re keenly focused on paring away excess administrators,” he added, “We’re going to eliminate an entire alphabet soup of departments and agencies.”

Without providing any details, Kennedy claimed the “core values” of HHS would somehow be preserved while the department is gutted. As with everything that has been announced by Trump and DOGE, underlying their fraudulent claims to eliminate “waste, fraud and abuse” in the federal government is an effort to privatize government services, while “saving the taxpayers money” is a euphemism for cutting taxes for the financial oligarchy as the conditions of life for the working class continue to deteriorate.

The response by public health experts to Kennedy’s HHS announcements was swift and scathing. For example, anti-COVID advocate Dr. Lucky Tran wrote on X:

No matter how you try to spin it, firing 20,000 federal health workers is not going to Make America Healthy Again, it’s going to make America sicker.

Former administrator at the Centers for Medicare and Medicaid Services (CMS) Chiquita Brooks-LaSure said in a statement:

When you take a wrecking ball to an agency like CMS, you’re taking a wrecking ball to the people who are out across the country ensuring our parents and grandparents can get safe, affordable care as they age. You’re taking a wrecking ball to cancer patients who need a new, innovative treatment to be covered. You’re taking a wrecking ball to mothers and newborns who are both at the most critical points of their lives.

That the moves against HHS by Kennedy and DOGE have nothing to do with improving public health or the quality of healthcare in the US was demonstrated on Wednesday when the department abruptly cancelled more than $12 billion in federal grants to states used for tracking diseases, mental health services, addiction treatment and other urgent health problems.

According to a report in the New York Times on Wednesday, the cuts will hamstring state health departments that are already underfunded and struggling with the challenges of chronic diseases, rising infections like measles and the threat of bird flu.

The Times report says:

State health departments began receiving notices on Monday evening that the funds, which were allocated during the Covid-19 pandemic, were being terminated, effective immediately. “No additional activities can be conducted, and no additional costs may be incurred, as it relates to these funds,” the notices said.

Meanwhile, a study by The Commonwealth Fund and the Milken Institute School of Public Health at George Washington University is predicting that the DOGE cuts to Medicaid will lead to the loss of 477,000 healthcare jobs in 2026 alone. The US House of Representatives passed a budget bill in February that calls for $880 billion in cuts over 10 years, the majority of which would come from Medicaid.

As they have with all previous attacks on the federal workforce, the Democrats are appealing to their fascist Republican “colleagues” to act against Trump and DOGE leader Musk. For example, Colorado’s Democratic Representative Diana DeGette, ranking member of the House Energy and Commerce Health Subcommittee, and New Jersey’s Democratic Representative Frank Pallone Jr. called on Republicans to prevent the cuts, writing in a statement:

It’s beyond time for Republicans in Congress to hold this Administration accountable for the consequences of these short-sighted actions. Republicans have a responsibility to help us stop these catastrophic cuts from going into effect.

Meanwhile, in a statement of absolute prostration before the elimination of 20,000 HHS employee jobs, American Federation of Government Employees (AFGE) President Everett Kelley said:

AFGE is preparing immediate legal action and will fight relentlessly to protect our rights, our members and all working Americans from these unprecedented attacks.

In other words, the AFGE union bureaucracy is blocking the mobilization of the enormous power of its 820,000 members to fight the unprecedented attack on the federal workforce.

To oppose the deepening war on public health and science, workers at all HHS agencies must build new organizations of struggle, rank-and-file committees independent of the AFGE union bureaucracy. These committees must forge links with other federal workers, as well as the broader working class, in the US and internationally, to carry out a unified struggle against the descent into fascist dictatorship and barbarism. The International Workers Alliance of Rank-and-File Committees (IWA-RFC) is spearheading this movement, and we urge all federal workers under attack to join its ranks.