Michael V said:

SCIENCE said:

nice

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00799-3/fulltext

On Aug 11, 2025, a gunman who falsely believed that mRNA COVID-19 vaccines were dangerous went on a shooting rampage at the US Centers for Disease Control and Prevention’s (CDC) main campus, shattering 150 windows and tragically killing a 33-year-old CDC security officer. Staff, still reeling from firings and programmatic shifts that began with the new Trump administration, were deeply traumatised. 8 months later, the windows have not been repaired. The CDC was once the gold standard for public health leadership. Today, it is struggling to maintain scientific excellence, trustworthiness, and relevance, a result of the actions of the Trump administration and the US Department of Health and Human Services that have undermined the agency.

80% of the CDC’s highest positions are vacant, with directors of 20 out of 25 centres having left. An estimated 2000 staff, almost one in five, have been fired, and about 300 are on administrative leave. There is still no CDC director since Susan Monarez was fired less than 1 month into her appointment in August, 2025 because she refused to pre-approve vaccine recommendations and to fire career scientists. The agency’s ability to protect health in the US has been badly eroded. Disease surveillance, for example, provides data to inform targeted public health planning and serves as the early warning system for outbreaks. The CDC has had to cut back on services it routinely provided for disease detection. One study found that 38 CDC datasets, mostly vaccination-related, have been halted. Without regularly updated data, the agency is flying without radar.

Internationally too, the CDC has a long-standing legacy of country and multilateral partnerships centred on building sustainable public health capacity, accelerating disease eradication, and bolstering global health security that the Trump administration’s stance now threatens. The President’s Fiscal Year 2027 budget request for the CDC says that it aims to ensure that the CDC “serves as the nation’s first line of defence against emerging infectious diseases”. But CDC cannot gather epidemic intelligence and mount an outbreak response without international partners in other countries. It is hamstrung by Presidential Executive Order 14155, which barred CDC staff from communicating and coordinating with WHO, the global normative body for pandemic preparedness. CDC staff secondments to national governments and UN agencies, critical in disease elimination initiatives such as measles, polio, and hepatitis B elimination, have been an important way of furthering the agency’s mission and cultivating strong relationships. They too have been cancelled. International candidates are no longer eligible to be admitted to the CDCs Epidemic Intelligence Service, the competitive postgraduate fellowship that has trained more than 4100 elite public health responders at home and abroad. Whatever its shortcomings, WHO serves a normative function in international health arising from its composition of 194 member states that cannot be replaced by the agency of one country, mandated to uphold an America First approach to global health.

What then, does the future of the agency look like? A new candidate for CDC director Erica Schwartz will go before the Senate. A retired rear admiral of the US Public Health Service Commissioned Corps, Schwartz is respected. But if appointed, she will inherit a CDC that is weak on multiple fronts, including its core mission to protect the public and respond to public health threats. How much she will be able to change the agency’s fortunes under Robert F Kennedy Jr remains to be seen. In global health, the trend is towards building greater regional capacity, thereby empowering autonomous regional institutions. And domestically, as a recent report in The Lancet noted, there are multistate initiatives attempting to fill the gaps left in public health by the Trump administration. The West Coast Health Alliance, for example, brings together Washington, Oregon, California, and Hawaii, aiming to coordinate multistate responses to emerging public health gaps, including joint vaccine procurement and distribution, cross-state disease surveillance, and the development of shared guidance and policy. Do such initiatives represent the future of public health in the USA?

But while it’s hard to argue against stronger state-level public health, and better state-level coordination, the alliances so far are concentrated in Democratic states, the risk being that–for all their good intentions–such initiatives risk further fracturing public health along political lines. Despite these developments, the USA still needs a strong federal-level agency that has the capacity, mandate, trust, expertise, and broad political support to protect health across the country.

Thanks.

Biden dropped the ball on Bird Flu and gosh I want to know why. He had a Pandemic Book with a whole process outlined.