During the presidential campaign, President Trump and Robert F. Kennedy Jr. warned the public of impending mass firings at the Department of Health and Human Services should President Trump be re-elected. Now that he is president again, his administration has begun fulfilling the pledge to purge thousands at HHS agencies, including the Centers for Disease Control and Prevention, National Institutes of Health, Food and Drug Administration, Centers for Medicare and Medicaid Services and the Indian Health Service.
Approximately 5,200 probationary workers from the agencies started getting letters from their employer saying “you are not fit for continued employment because your ability, knowledge and skills do not fit the Agency’s current needs.”
The cuts are among the thousands being let go this month across the federal government, all as part of attempts to reduce the size of the federal workforce. The firings are being overseen by President Trump and the task force headed by Elon Musk, the Department of Government Efficiency.
All of the most recent class of hires, roughly 1,300 individuals, who serve in CDC’s Epidemic Intelligence Service were told Friday they were being dismissed, according to CBS News. The CDC’s EIS officers are sometimes referred to as “disease detectives” who investigate new threats, from anthrax to Ebola to bird flu. The group being fired consists of nearly half of the CDC’s EIS officers.
It appears that cuts in staffing at CMS include people hired to conduct oversight of Affordable Care Act exchanges. It’s unknown at this time which other CMS workers were among those laid off.
Cuts in probationary staff have also occurred at the NIH. What isn’t clear yet is which specific parts of the agency are being targeted. It’s possible that this initial salvo is a prelude to what Kennedy declared prior to the election about “pausing infectious disease programs” and firing 600 employees at the NIH. Or, as a corollary, it’s plausible that the moves at NIH signal a desire to cut roughly in half the number of NIH institutes and centers from 27 down to 15, something Republican legislators have argued should happen.
The Trump administration also laid off FDA staff. Thus far, it appears that the bulk of the employees being terminated are in the food, medical device, artificial intelligence and tobacco divisions of the agency. It’s no surprise that the FDA, and in particular the food and nutrition division, would be a target of the purge. In an interview, Kennedy had said that “there are entire departments, like the nutrition department at the FDA that have to go, that are not doing their job, they’re not protecting our kids.” Additionally, Kennedy wrote on X just before the November election. “If you work for the FDA and are part of this corrupt system, I have two messages for you: 1. Preserve your records, and 2. Pack your bags.”
Employees working on drug approval applications at FDA seem to be “mostly spared for now,” according to a tweet posted by Adam Feuerstein of STAT News. But Zach Brennan of Endpoints News tweeted that “sources saying probationary FDA employees under user fees still hit by cuts—unclear how big of a hit it’ll be on PDUFA dates.”
Prescription Drug User Fee Act dates are essentially deadlines set by the FDA for completing its review of a new drug or a biologics license application. Congress passed and President George H.W. Bush signed PDUFA, a law that provides FDA with resources to make the drug review and approval process more efficient. In 2024, $3.3 billion, or almost 46% of the agency’s $7.2 billion budget, came from user fees, payments made by pharmaceutical and medical device manufacturers to fund the staff resources required to review products expeditiously regarding their safety and efficacy.
Neither Kennedy nor the likely to be confirmed FDA Commissioner Makary can unilaterally rescind PDUFA. But it’s possible for agencies to shed staff, including probationary workers involved in the drug approval process. Their jobs are to some degree made possible by user fees. But given HHS Secretary Kennedy’s dislike of user fees, it wouldn’t be surprising if more dismissals in this area of FDA’s work are forthcoming.
Notably, the firings of personnel at the NIH, CDC, FDA and CMS are happening before their respective heads, Jay Bhattacharya, Dave Weldon, Marty Makary and Mehmet Oz are confirmed by the Senate. This implies that the firings occurred without their formal input.
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