Analysis: How a 2nd Trump presidency might cut back the CDC

What Trump winning the election could mean for the CDC Conservatives in Congress and Washington think tanks have proposed eliminating CDC programs they say are not central to fighting infectious diseases. Lena H. Sun The Washington Post

State and local health departments would no longer be able to track opioid overdoses, provide cancer screenings and help people quit smoking, according to health officials, if Republicans carry out their plans to dramatically shrink the Centers for Disease Control and Prevention under a second Donald Trump presidency.

Conservatives in Congress and Washington think tanks have proposed eliminating programs they say are not central to fighting infectious disease. Republican House appropriators want to slash the public health agency’s budget by about 20 percent and eliminate two dozen programs they consider “duplicative and controversial,” including initiatives to study the public health impact of climate change.

Key advisers in the Trump administration had discussed narrowing the CDC’s mission in the early months of the coronavirus pandemic in 2020. Since then, Republican scrutiny has sharpened, with lawmakers and other policy experts voicing growing support to downsize the agency’s scope.

“Many of the things within CDC really don’t belong there,” said Joel Zinberg, a former health policy adviser in the Trump administration who co-authored a policy paper last year with Drew Keyes, senior policy adviser to House Speaker Mike Johnson (R-Louisiana), for the Paragon Health Institute and the Competitive Enterprise Institute, conservative think tanks.

The CDC was founded in 1946 to fight malaria, but over the decades, “diverse and fashionable concerns” such as environmental justice and health equity have crept into the agency’s portfolio, Zinberg said. Those programs should be moved to other agencies, he said, so the CDC can focus solely on preparing for the next pandemic.

Scott Gottlieb, former commissioner of the Food and Drug Administration under Trump, has sounded this theme repeatedly. In his most recent essay published this month in JAMA Health Forum, he wrote that transferring some CDC responsibilities, such as its annual survey of middle and high school students about tobacco use, to the FDA, which regulates tobacco products, could help the CDC gain more money and authority.

“The only way to properly resource the core functions of CDC is to get a broader political compromise around the scope of the agency’s mission,” Gottlieb said in an interview.

But the proposals to refocus the agency have prompted an unusual outcry from eight former CDC directors who served in Democratic and Republican administrations. They warned in a recent letter that restricting CDC’s efforts to only infectious diseases would cost lives and damage the economy. The agency’s tobacco control program, for example, protects millions of people from addiction and cuts the need for expensive smoking-related medical care for lung disease, cancer, strokes and heart attacks, they said.

“Limiting our health defense to just some threats would be like allowing our military to protect us from only some types of attack, telling the National Weather Service to warn people about tornadoes but not hurricanes, or allowing doctors to treat only some diseases,” the former directors wrote in the Sept. 5 letter to the editor published in STAT.

Signatories include Rochelle Walensky, who served under President Joe Biden; Robert Redfield, who served under Trump; and Tom Frieden, who served under Barack Obama.

Congressional Republicans have succeeded in limiting the CDC’s focus in the past. In 1996, lawmakers forbade CDC funding from being used to advocate for gun control, effectively halting research on gun violence for two decades.

It’s unclear which GOP proposals to restructure CDC will be implemented. Some Republican lawmakers have voiced support for the agency’s work, especially on overdoses, maternal health and mental health. GOP House appropriators have proposed more money to combat emerging and zoonotic infectious diseases. Final budget decisions won’t be made until after the Nov. 5 election.

...

Country / Region Tags:

General Topic Tags: