Trump Officials Block HHS Communications — How This Affects You

In a flurry of executive actions—some of which are of questionable legality—the Trump administration has dramatically changed the scope and capabilities of the government. The scope of forced pauses in communication is far greater than temporary pauses in previous administrations. In conjunction with other executive actions, it will have an impact lasting years. Concern has been expressed in the public health community that the immediate effects are likely to be particularly crippling to the health and welfare of the public as well as to science and research.

Communications “Pauses”

As of January 22, the administration decreed that there would be a “pause” on all communications between government agencies and with outside individuals. It’s been unclear how long the “pause” will continue. Communications are to be paused until “approved by a political appointee.” Optimistically, some say “only” until February 1, while others say it is indefinite.

How will that affect different agencies?

FDA and CDC

The FDA was initially told that it could not discuss projects with NIH, for example, even on shared projects. Fortunately, this appears to no longer be the case, although no clear announcement has been issued.

The FDA still can’t proceed with collaborations with outside partners. For example, meetings with different groups often take months to schedule, so if canceled, can’t immediately be rescheduled. One such joint meeting and webinar had 1200 people registered, but it was canceled only the day before.

A similar thing happened with the CDC. A One Health call between them and states affected by bird flu was canceled the day before it was to be held.

Antimicrobial resistance is a growing and urgent problem. We are seeing more antibiotic-resistant bacteria in patients, particularly since the COVID-19 pandemic began, and the pipeline for new antibiotics is very limited. The Presidential Advisory Council on Combatting Antibiotic-Resistant Bacteria) planned for Jan 28-29, 2025, was also canceled “as the new Administration considers its plan for managing federal policy and public communications.” John Rex, MD, an expert in antibiotic development suggests that cutting such an important meeting is extraordinarily short-sighted, given the threat of AMR and the thin pipeline of drugs we have to combat that.

Gagging the FDA by limiting its communications also means that the public will not be informed in as timely a manner of any foodborne outbreaks or drug recalls. Several people on social media are directing readers to Canadian food recall alerts (although not all of our products might be listed).

A specific problem for the FDA is that it can’t issue any guidances, which are documents that tell pharmaceutical sponsors how to do clinical trials and what is expected of them. Drugs often work differently in men or women and in different ages. There are also differences in how people of various ethnicities metabolize drugs, so guidances and including diverse populations in trials is critical.

One additional problem is that the administration has created an enormous amount of confusion with different guidances being issued to various agencies and then, within an agency, being interpreted differently by other people. It also creates great stress among the staff at these agencies, particularly as the administration has threatened to fire many career civil servants by reclassifying them as Schedule F political employees who can be terminated at will.

Besides the abrupt freeze in spending, the communications freeze also means that grant reviews stopped, as these all rely on reviewers from outside the NIH. Without the grants and renewal of funding, staff will be laid off and are unlikely to return later. The bureaucrats making these decisions aren’t just pausing a program, but is effectively killing it, as you’ve destroyed your infrastructure. Clinical trials will be halted if funding is abruptly withdrawn, leaving researchers and patients in the lurch.

The communications freeze has also devastated young researchers who were supposed to speak at conferences, an essential step in their career development.

Ultimately, all of these abrupt changes result in broken promises, destroy trust, and imperil future relationships, all of which depend on collaboration. No one will want to work with the government.

WHO

The U.S. abruptly withdrew from the World Health Organization despite the fact that this requires congressional consent and paying for the rest of the year’s obligations.

Long-term projects with the World Health Organization were abruptly canceled. This is a problem because long-term investments in relationships and specific data gathering and sharing have gone up in smoke. Also, many of these projects involved diseases that might kill people in the U.S. (like Marburg, Ebola, or Lassa fever), but where we don’t have access to the patients or environments in which to study them on our own and better assess our risk.

There is currently an outbreak of Ebola in the Democratic Republic of the Congo and, recently, Marburg cases in Tanzania. Yet, the CDC is not allowed to work with WHO to try to control these deadly outbreaks. They don’t have enough information, even on whether to issue travel warnings.

CDC

The communications freeze has similarly muzzled the CDC. After 60 years uninterrupted, they can no longer publish the weekly MMWR report, which has been their primary way of communicating with clinicians about evolving outbreaks, along with the CDC’s Health Alert Network. Just this week, new alerts about the avian influenza H5N1 were blocked from publication.

We have no new information about the numbers of cases of bird flu, Covid, or any other reportable diseases because the CDC cannot share this information with the public.

How is anyone supposed to make informed decisions?

These executive actions have taken place just in this first week, dismantling much of the U.S. research infrastructure and public health warning systems. What will come next?