For the first time in six decades, the Centers for Disease Control and Prevention (CDC) did not publish its Morbidity and Mortality Weekly Report (MMWR) on Thursday, just one effect of a flurry of executive orders and administrative moves after President Donald Trump’s January 20 inauguration.
Trump’s Gag Order Halts CDC Publication www.medpagetoday.com/infectiousdi... For the first time in its more than 60-year history, the CDC’s Morbidity and Mortality Weekly Report (MMWR) did not go out as scheduled.
— Carlos del Río, MD, FACP, FIDSA (@docdelrio.bsky.social) January 23, 2025 at 11:48 AM
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Clinicians, local health officials and science journalists rely on MMWR to learn about disease outbreaks and other important public health developments, such as the first report of AIDS in June 1981. Three reports about the emerging H5N1 bird flu epidemic were scheduled for this week’s edition, The Washington Post reported. While MMWR generally steers clear of politics, it was subject to pressure regarding COVID-19 reports during Trump’s first administration.
CDC
The MMWR hiatus stems from a pause on external communications from federal health agencies under the Department of Health and Human Services (DHHS), including the CDC, the Food and Drug Administration (FDA) and the National Institutes of Health (NIH). The freeze will last at least through February 1, according to a memo from acting Health and Human Services Secretary Dorothy Fink, MD.
Trump nominated Robert F. Kennedy, Jr. for the top DHHS position, but he has not yet had a Senate confirmation hearing. Trump chose former Florida congressman Dave Weldon, MD, to lead the CDC, and Biden’s appointee, Mandy Cohen, MD, MPH, stepped down earlier this month. The CDC head did not require Senate confirmation in the past, but that changed this year. Weldon has not yet had a hearing, and it is unclear who—if anyone—is leading the agency in the meantime.
CDC
This week’s order also covers agency press releases, health advisories, guidance documents, regulations, announcements in the Federal Register, social media posts and websites—although some web content is being taken down. Numerous journalists have reported that agency spokespeople have been unreachable or declined to comment to the media. However, the FDA did publish a drug safety alert on Wednesday.
The freeze is also affecting public meetings and speaking engagements. Federal employees were told that government travel is suspended indefinitely, which could affect their attendance at upcoming conferences, such as the Conference on Retroviruses and Opportunistic Infections (CROI) in March.
“HHS has issued a pause on mass communications and public appearances that are not directly related to emergencies or critical to preserving health,” NIH said in a statement. “This is a short pause to allow the new team to set up a process for review and prioritization.”
Many are disconcerted by the abrupt and chaotic process. On Wednesday, an NIH training workshop for junior scientists was “halted midstream,” Science reported. The following day, a joint Infectious Diseases Society of America/CDC clinician call about the bird flu outbreak went ahead without the scheduled CDC representative. Looking to the future, a February 20–21 meeting of the National Vaccine Advisory Committee, which advises DHHS on vaccine policy, was canceled and not rescheduled, according to STAT.
Research Funding Suspended
Communication glitches are not unexpected during a presidential transition, though such a lengthy blackout is unusual. Perhaps more concerning is the apparent suspension of the NIH funding process. What’s more, the health agencies are subject to a government-wide hiring freeze.
A dangerous move to freeze NIH hiring, grant review meetings and travel — an action which will only reduce America’s competitiveness and hamper research innovation even with a short delay period. www.science.org/content/arti...
— Benjy Renton (@bhrenton.bsky.social) January 22, 2025 at 4:29 PM
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Several scheduled meetings of grant review committees, known as study sections, have been suddenly canceled, according to social media posts. One cancer researcher, for example, said a study section meeting he planned to attend this week in conjunction with the ASCO Gastrointestinal Cancers Symposium in San Francisco had been scrapped.
Researchers lamented that even brief delays in funding can disrupt studies, leave laboratory staff unpaid and affect career trajectories, especially for junior scientists. Jane Liebschutz, an opioid addiction researcher at the University of Pittsburgh, told Science that she and her colleagues are feeling “a lot of uncertainty, fear and panic.”
Those funded by the National Institute of Allergy and Infectious Diseases (NIAID) may be particularly anxious, as Kennedy has said he wants to “give infectious disease a break” and shift the focus to chronic conditions.
Study sections are the review panels that allocate NIH research grants. They bring in experts from around the country and have to be scheduled many months in advance; they provide the funds that keep the nation’s biomedical research going. It’s hard to overstate the disruption this causes.
— Carl T. Bergstrom (@carlbergstrom.com) January 22, 2025 at 3:20 PM
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On the other hand, some Trump supporters say the panic is unwarranted. An unnamed individual in the NIH director’s office told the DisInformation Chronicle that the DHHS communications memo said nothing about halting private meetings (as opposed to public speaking engagements), suggesting that acting NIH officials shut down study sections in an effort to “scare everyone” and “tar the new administration.”
With a budget approaching $50 billion, NIH awards tens of thousands of grants for biomedical and behavioral research each year, supporting some 300,000 scientists. NIAID is a major funder of HIV research, both in the United States and worldwide, while the National Cancer Institute (NCI) provides around $7 billion annually for cancer research. NIH funds much of the basic science that lays the foundation for drug development by pharmaceutical companies.
Biden’s NIH director, Monica Bertagnolli, MD, stepped down last week. Trump named Jay Bhattacharya, MD, PhD, a professor of health policy at Stanford University, as her replacement, but he is also awaiting a Senate hearing. Trump has not yet named an NCI director to replace W. Kimryn Rathmell, MD, PhD. In the interim, Douglas Lowy, MD, has been named acting director, a role he has filled before. Other NIH institute directors don’t require Senate confirmation. NIAID head Jeanne Marrazzo, MD, MPH—an HIV researcher who replaced longtime director Anthony Fauci, MD—remains in the position for now.
WHO Withdrawal
In an executive order issued on Monday, Trump declared his intent to withdraw the United States from the World Health Organization. Among other reasons, he cited the country’s disproportionate share of WHO funding. The United States is WHO’s top donor, contributing nearly $1.3 billion in 2022–2023—about 20% of the organization’s total budget. Conservatives are also concerned about the United States becoming a party to a global pandemic treaty that they say would threaten American sovereignty.
The WHO issued a statement in response, saying the organization regrets the announcement.
“WHO plays a crucial role in protecting the health and security of the world’s people, including Americans, by addressing the root causes of disease, building stronger health systems and detecting, preventing and responding to health emergencies, including disease outbreaks, often in dangerous places where others cannot go,” it reads. “We hope the United States will reconsider, and we look forward to engaging in constructive dialogue to maintain the partnership between the USA and WHO, for the benefit of the health and well-being of millions of people around the globe.”
In July 2020, during his first term, Trump announced his intent to withdraw from WHO—a process that requires a one-year notice—in part due to its “mishandling” of the COVID-19 pandemic and “inability to demonstrate independence from the inappropriate political influence of WHO member states.” President Joe Biden retracted the notification of withdrawal upon taking office in January 2021, but Trump has now revoked that retraction.
The new executive order directs the secretary of state and the director of the Office of Management and Budget to pause future WHO funding, recall and reassign U.S. government personnel or contractors “working in any capacity” with the organization and “identify credible and transparent United States and international partners to assume necessary activities previously undertaken by the WHO.”
Critics of the move argue that the United States needs access to WHO’s global surveillance data to monitor disease outbreaks, and American pharmaceutical companies benefit from access to global pathogen samples and genomic sequencing data. What’s more, the U.S. can have more impact on global health as a member country.
“If America withdraws from WHO, U.S. diplomats will be on the outside looking in,” Lawrence Gostin, a professor at Georgetown University and director of the WHO Center on National and Global Health Law, wrote in an open letter to Trump. “The irony is that if the U.S. does exit WHO, that would cede influence to our adversaries, especially China. And decisions taken by WHO won’t reflect American interests and values.”
“In today’s globally interconnected society, where people and goods move rapidly worldwide, a global public health agency is legitimate and necessary,” Jeffrey Singer, MD, of the libertarian Cato Institute concurred. “Cooperating with such an agency to reduce the spread of deadly communicable and infectious diseases that can come to our shores is putting America first.”
IAS President Beatriz Grinsztejn and the International AIDS Society stand united with the global health community in expressing deep concern over the US withdrawal from @who.int.
— IAS - the International AIDS Society (@iasociety.bsky.social) January 21, 2025 at 7:53 AM
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The International AIDS Society (IAS) expressed “deep concern” about the withdrawal. “Inevitably, reduced U.S. funding and collaboration with WHO will weaken global health responses,” IAS president Beatriz Grinsztejn, MD, PhD, said in statement. “This includes HIV testing, treatment and prevention programs, particularly in low- and middle-income countries most affected by HIV.”
Health officials and advocates are also concerned about another Trump executive order that pauses foreign development aid for 90 days while the administration assesses “programmatic efficiencies and consistency with United States foreign policy.”
Although specific programs aren’t named, this could impact PEPFAR, the President’s Emergency Plan for AIDS Relief, which provides global funding for HIV pre-exposure prophylaxis (PrEP) and antiretroviral treatment, primarily in low-income countries in Africa. PEPFAR is credited with saving millions of lives since it was launched by President George W. Bush with bipartisan support in 2003.
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