Trump dismantles, cuts and shakes up world of health in first 100 days

President Trump's first 100 days has roiled health and science as part of the administration's plan to reshape the federal government. 

Agencies have been disbanded; thousands of jobs have been eliminated; and billions of dollars for biomedical research have either been clawed back or stopped completely.  

Here are some of the most prominent ways Trump has made his mark on health. 

HHS is getting 10,000 job cuts

The U.S. Department of Government Efficiency has been gutting federal agencies in the name of cost savings. HHS hasn’t been immune, in perhaps the most striking example of the administration’s changes. 

Early in the morning of April 1, layoff notices began arriving for employees across all parts of the sprawling agency.  

In total, as many as 10,000 jobs were expected to be eliminated—though agency officials couldn’t give congressional staff a clear number during a briefing earlier this month, illustrating the speed at which the layoffs were conducted. 

The Food and Drug Administration (FDA) was among the hardest hit of all agencies targeted by DOGE, losing nearly 20 percent of its workforce.  

The top officials overseeing new drug reviews and tobacco safety were ousted, as well as researchers studying ways to reduce prescription drug costs. Scientists looking for contaminants in drugs were laid off, as were several dozen food safety scientists, though these officials have been subsequently rehired. 

The Centers for Disease Control and Prevention (CDC) cut senior infectious disease officials, as well as researchers working in the Division of HIV Prevention, the Substance Abuse and Mental Health Services Administration, and the National Center for Immunization and Respiratory Diseases.  

HHS has set a June 2 deadline to complete the cuts, including rehiring anyone who may have been laid off by mistake — though any rehiring is happening on a case-by-case basis.  

Massive funding changes 

The Trump administration has made a concentrated effort to purge any program or funding opportunity that promotes, or seems to promote, diversity, equity, and inclusion.  

Officials have eliminated grants to public and private universities that were being used to study health equity, LGBTQ+ people, and COVID-19, among other topics. 

Under new National Institutes of Health (NIH) grant rules announced last week, any institution that has a DEI program or boycotts an Israeli company might not be awarded new grants and could have existing grants terminated. 

The White House has particularly targeted elite universities like Harvard and Columbia, cancelling billions of dollars in research funding. 

Some of the most significant changes began in February, when the NIH abruptly set a 15 percent cap on payments for “indirect costs” in a purported effort to save money. Critics said the indirect costs — which can cover universities’ overhead and administrative costs, like electricity and utilities, janitorial services and rent — are a slush fund. 

Attorneys general of 22 states challenged the move in federal court, and a judge earlier this month permanently blocked the cuts from taking effect; the administration is appealing.   

In yet another move the administration said was aimed at saving money, HHS at the end of March moved to rescind nearly $12 billion in grants for state and local health agencies. The money was used to track infectious diseases, health disparities, vaccinations, mental health services and other health issues.  

The administration said the grants were tied to the COVID-19 pandemic and were no longer needed.  

Agency-wide cuts have been happening at such a rapid pace even Health and Human Services Secretary Robert F. Kennedy Jr. hasn’t been able to keep up. 

“I’m not familiar with those cuts,” Kennedy said when pressed in a CBS interview about the public health funding grants. “We’d have to go … the cuts were mainly DEI cuts, which the president ordered.”

Kennedy Jr.'s pledge to find the true cause of autism 

During his confirmation hearing, Kennedy downplayed his past criticisms of vaccines, though he notably refused to rule out a link between vaccines and autism. No reliable study has shown a link between autism spectrum disorder and any vaccine. 

In the months since that hearing, he’s doubled down on what autism advocates call increasingly harmful rhetoric, and made a controversial pledge to find the underlying cause by September.  

The government-sponsored study into the causes of autism is being conducted by the NIH, not the CDC. Kennedy has reportedly hired to lead the study a prominent figure in the anti-vaccine movement who spent years promoting the false link between vaccines and autism. 

Trump has also repeatedly connected the two, most recently during a Cabinet meeting in April when he said without any basis said autism could be caused by “something artificial” and “maybe it’s a shot.”  

“There will be no bigger news conference than that,” Trump said, when Kennedy announced the September timeline. “If you can come up with that answer where you stop taking something, you stop eating something, or maybe it’s a shot. But something’s causing it.” 

Kennedy has not specifically mentioned vaccines as a cause, but in a recent news conference stressed that HHS would investigate the “environmental toxins” he believes is causing rising rates of autism spectrum disorder, contradicting researchers within his own CDC.  

Kennedy said autism is preventable, and called research into the genetic factors that researchers say play a significant role in whether a child will develop autism “a dead end.” 

“Genes don’t cause epidemics,” Kennedy said.

The federal government spent more than $300 million on autism research in 2023, according to the most recent figure available. Former President Biden in January signed a five-year extension of the Autism CARES Act to authorize nearly $2 billion for autism research. 

Make America Healthy Again (MAHA)  

Kennedy's MAHA movement has blitzed the federal government and states, as he and his followers seek to promote a range of policies tied to food, the environment, and an overarching focus on chronic disease.  

States are banning soda from SNAP, fluoride may no longer be added to drinking water, and certain food dyes are being targeted for removal.  

The MAHA efforts cut across federal agencies, and Kennedy is out in front leading the charge. 

Earlier this month, Kennedy went to Utah to promote its first-in-the-nation law banning fluoride from public water supplies. Kennedy said he would direct the CDC to stop recommending fluoride in drinking water, and that he will be assembling a task force to focus on potential health risks. 

The Environmental Protection Agency Administrator is launching a review of scientific information on the “potential health risks of fluoride in drinking water,” taking what could be an initial step toward new national limits or a ban on the substance. 

Another MAHA priority is allowing states to ban soda and candy from their food stamp programs. The Trump administration said it will fast track any state that requests a federal waiver to do so, and at least three GOP-led states have since announced their intention to do so. The Department of Agriculture under previous administrations had refused to grant state waivers to modify SNAP.  

In another MAHA priority, the Food and Drug Administration announced its intention to phase out artificial food dyes over concerns about children’s health. 

Kennedy said major food manufacturers had reached an “understanding” with him on the dyes, though it’s not clear how the agency is going to move ahead with its plan. 

Ending USAID 

One of the first moves the Trump administration made was to take a sledgehammer to its foreign aid budget; officials froze nearly all funding for foreign aid and dismantled the United States Agency for International Development (USAID). 

All remaining USAID functions will be absorbed into the State Department effective July 1, and according to a reduction in force notice to remaining staff, will “obviate” the need for an independent USAID. 

That decision has led to massive disruptions in global health, especially programs focused on preventing HIV/AIDS. According to an analysis by KFF, 71 percent of USAID contracts related to HIV treatment and prevention were terminated. 

The State Department issued waivers to allow certain “lifesaving” programs, including the President’s Emergency Plan for AIDS Relief (PEPFAR), to continue. But the waivers were unevenly applied, and organizations granted waivers said they still weren’t being paid.  

The Trump administration also plans to end U.S. funding for Gavi, a global program that purchases shots to help vaccinate children in developing countries against some of the world’s deadliest diseases.  

Gavi supports vaccines against 20 infectious diseases, including COVID-19, HPV, Ebola, malaria and rabies.