RFK Jr's cuts to US health
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This week we saw massive cuts to U.S. health agencies, including at the FDA, CDC, and National Institutes of Health. That includes the removal of top scientists overseeing public health, cancer research, and vaccine and drug approvals. Health and Human Services Secretary Robert F. Kennedy Jr. says these cuts are essential to streamlining a bloated bureaucracy.

And they fit into the mission from President Donald Trump and Elon Musk to shrink the federal government and slash spending. So that's the goal. But what effect will these cuts have? On this weekend episode of Reuters World News, a check-in on America's health under the supervision of RFK Jr. I'm your host, Jonah Green.

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I'm joined now by U.S. health and pharma editor Caroline Humer and global health editor Michelle Gershberg. Thanks for coming on, you two. Sure. Thank you, Jonah. First, can you characterize these cuts? I think a lot of exhausted newsreaders are becoming a bit numb to such headlines. So-and-so agency cuts X thousand staffers, right? But so what have we seen happen here? And who is getting the chop?

You know, when you look at the cuts by sheer numbers, it's 10,000 people. It's across, you know, some of the biggest agencies. It's out of what started as an 80,000

person sort of health ecosphere, but they already had lost about 10,000 people through some firings, but also through a lot of people leaving. So in the end, you're left with potentially, you know, about 60,000 people. So instead of like a, you may be thinking like a 12% cut and my math's not great, but this is more like more than 20, sort of 25% cut. So that's just the numbers. The

One thing that's different to me about these cuts is that people interact on a health basis with a lot of these agencies. So it's kind of different than like the IRS, which you hope to never interact with, right? Like you, if you're in a Medicaid plan, you're interacting with Medicaid. If you're in Medicare, you're interacting with Medicare. Like you're, if you are...

waiting for a new drug to be approved, you have your eye on the FDA. So it just feels kind of what's going on with these cuts is that they're a little bit personal. You know, if you are using a medication right now, just as a small example, the FDA is the agency that ensures that that drug supply is safe and continues to be safe. It collects the information on whether or not there are any side effects that warrant investigation.

So when you think about it in those terms, as Caroline is saying about how personal it is,

That's a lot of people in the country, right, who would be affected in that way if the work that an agency like FDA does is disrupted. Or think about CDC. We're in the midst of a growing measles outbreak in parts of the United States. And the CDC is playing a role. That's what our reporting has found. But as it begins to experience these layoffs, people who are involved in helping track the disease outbreak

whether it's measles or anything else that might come up, flu. We've had mpox outbreaks here. That infrastructure starts to erode. And what the outcome of that is, we don't know. For the last 24 or 36 hours, we have been inundated with information and trying to understand, in even small pieces of it,

reflect a very major disruption. And it's hard to completely connect the dots. That's what we are trying to do, certainly others. But there are just these like little pieces that in and of themselves by being cut, that's a big deal. For example, the FDA's communications team, the people who provide information of what's happening with the FDA received these layoff notices. And so, you know, we don't have somebody to turn to to ask questions.

At FDA, we are turning to other health agencies to get that information. The former FDA Commissioner Robert Califf wrote this in a LinkedIn post, quote, The FDA as we've known it is finished, with most of the leaders with institutional knowledge and a deep understanding of product development and safety no longer employed.

Is that the kind of alarm that you're hearing from the people that you're speaking to? If we look at the heads that have all left from the FDA, the head of drug review, the head, Peter Marks, right, of more complicated drug review and vaccines,

the head of tobacco, the head of food. That's really the institutional knowledge walking out the door, mostly pushed out the door given an ultimatum is what the reporting has shown, right? And so when you think about investiture

investors and analysts and how they're feeling about the changes going on there. You know, Cantor Fitzgerald, their biotech analyst team, you know, sent out this note really basically saying that, you know, this essentially that the new HHS secretary, Robert F. Kennedy Jr., anti-vaccine, sort of sitting at the top of all this saying that we must remake health to be

to be focused on chronic disease, that the U.S. health infrastructure, all of these agencies, that that is their remit. They viewed that as him as a danger to society, essentially. So, I mean, the reaction where we've seen it has been strong. And before it felt like there was a lot of tiptoeing around. And now, you know, we've seen some in the past few days not tiptoeing around.

We are definitely hearing these stronger statements of anybody who thought that Kennedy would be different in the role of health secretary and in some way be more protective of the infrastructure that has been built has been proven wrong. You know, Kennedy is...

pursuing policies that are in line with what his track record has been before he took office. One interesting thing that happened yesterday after all of this, that in the Senate, which has been so quiet on so many of these categories,

that the HELP committee head, Senator Cassidy, called a hearing next week for Kennedy to come forward and talk about that. And it felt like, you know, we're not sure, was it on the books? I mean, he was supposed to go talk to them or was this a reaction? But it will put Kennedy in front of, you know, a pretty powerful committee and he'll be, have to answer some questions. Right.

What has been the response from healthcare experts and scientists about these cuts? There is a well-known group of academics and public health experts and people we were talking to throughout COVID who have been warning about these moves. They warned about Kennedy's appointment.

They warned about reports and plans for cuts, and now those voices have grown louder. And they simply say, we are less prepared now for a pandemic if it showed up at our door tomorrow. There is less oversight of food and drugs and of research.

And the fact that all of the federal employees who work in these health agencies, their lives have been disrupted. So even if they have not been laid off, they are wondering if, you know, they, you know, if the shoe is going to drop for them next week. Some of them are looking for jobs elsewhere, some percentage of them, and they are, you know, their ability to work is disrupted. So.

So that group will talk about how vulnerable the United States is right now to a health crisis. There is also a cohort, and these are people who have supported Kennedy's rise, who say he's bringing in needed change and additional viewpoints and people who may question the way things are done. And there certainly were grounds, you know, there were a lot of questions over how things were done.

before the second Trump administration. Issues of how closely the health agencies might be tied to their industries, the industries they regulate, right? What kind of scrutiny is there of bad medicine and bad food? Is it robust enough? But to Carolyn's point, we aren't getting yet very succinct answers to how do the steps being taken today get us to something different?

And I guess I would just add maybe we might not be looking for something different if the

healthcare spending wasn't as high as it is. It is extremely significant at 18% of GDP right now in the U.S. And that's a number that's really hard to contemplate. And when you look at the forecast, the number just keeps going up and up. And that's the point that they keep coming back to in the current administration is that healthcare spending is too high. Right.

And I don't think there's anybody out there who would say, oh, yeah, this is a just right number. We've also seen mistakes. The health agencies are caught in the cross currents between President Trump, the Department of Government Efficiency led by Elon Musk, and then Robert F. Kennedy Jr. Each have their own specific missions to accomplish. And

And so we saw, for example, that in the first wave of FDA firings, a number of people who are involved in reviewing the safety of medical devices were fired. And then they were quite quickly rehired when it became clear that doing so would jeopardize the oversight of medical devices. And in other areas of the federal government, there were issues like that with nuclear scientists and

And so that is a question right now as well, is, you know, for each person who's received a termination notice, who made that decision on what basis? And could some percentage of those notices have been in error? So, Caroline, you mentioned that the FDA's top vaccine official, Peter Marks, was essentially being pushed out. And Peter Stein, he headed the Office of New Drugs at the FDA. He's now gone. This week, we saw...

Pharma stocks take a big hit. Moderna dropped 12% the day that it was announced that Peter Marks was leaving. Can you explain what the relationship is between big pharma

and these agencies and why their stocks would suffer as a result of these cuts, which, you know, if you hear Kennedy describe them, they're about, you know, streamlining and perhaps deregulation. The street is always looking for some sort of, you know, consistency, right? So there's not a lot of consistency here. So that's like one piece of that. But it is an issue of the

this relationship, right? The drug companies, the medical device companies, the vaccine makers, the food companies, everything.

Everybody who's regulated, I miss tobacco, right? All of these companies that are regulated by the FDA do have relationships with the FDA. When a drug is going through a review, there is a lot of back and forth. There's back and forth before they file for the review. There's back and forth after they file for the review, right? Throughout that process, the FDA for any given drug as part of an agreement that has been, you know, worked through Congress, they

the drug makers actually pay for their own drug approvals. I mean, not like specifically, but overall with by paying fees to the agency. And so with that, they're supposed to have a time period of 180 days. It could be longer. It could be shorter. It depends exactly on what kind of

product you have and what kind of approval format you're using. But in the end, that is an accountability right that was created so that the FDA, considered the gold standard regulatory agency of the world because of this, delivers approvals on time. And so a lot of concern, how can you fire or have so many people leave or lose this institutional knowledge?

without impacting those timelines. And investors hate that, right? Companies hate that. Everybody hates that. And so it felt very much like a hit to that and a sign of that something that investors have been nervous about, that companies have been quietly talking about as a fear had perhaps happened.

was more certain to come through. And then we did actually see our first big miss on a drug authorization or a vaccine authorization. A company called Novavax that makes a COVID-19 vaccine was waiting for its

They indicated that it was coming on time, they thought, and then it wasn't some reporting shows. So I think that there's a mistrust that's starting to build. And I want to add, so Peter Marks, right, has become a very important figure within FDA, longtime member.

FDA official. He was instrumental in the effort to identify a COVID vaccine starting in the beginning of the pandemic. It was this program, public-private program the Trump administration set up. They had nicknamed it Operation Warp Speed. He was at the center of it. And as we had reported at the time, it was our scoop. Peter Marks had said, if anyone tries to rush the vaccine without data,

I will resign. So he put himself on the line and is a person viewed with great credibility by scientists, by industry. So his forced exit, if you will, was a big shock to the system here. And also just raising the concerns about the future of vaccine reviews, approvals under

a health department that is led by somebody who has sown doubts about whether or not vaccines are safe or effective. You were asking about the pharmaceutical industry, and as Caroline is saying, the pharmaceutical industry, they dislike disruption, right? Like any industry. But given that the U.S. healthcare industry is the most regulated of them all, and there are so many processes that they have to follow, as soon as uncertainty starts to get

inserted into various points in that process, it creates problems for the pharmaceutical companies. Now, on sort of the 30,000-foot view, the Trump administration would say, we want to ensure that we can get drugs to market more quickly, even more quickly than they are right now for the United States. But if you undercut the staff that helps provide that, even the support staff, then that's contradictory, right, to that goal. We also have a bit of a measles problem.

outbreak happening in the U.S. Is that putting any more pressure on Kennedy? Do we have a sense that health agencies are taking this seriously? I mean, what we're seeing in the response to the measles outbreaks are that state health departments are taking a very active role. And that's not, you know, that's as it should be, right? They, you know, they are responsible for the health within their borders.

And they do that, you know, have done that throughout outbreaks. You know, that's the point. And CDC plays a supporting role. We do wonder whether or not the cuts that are happening at CDC right now are going to change that balance. But where Kennedy has really come under criticism is for not being kind of the standard bearer nationwide in saying to families, if your child is not vaccinated for measles,

go get a shot. That is usually, you know, been a key platform of any health secretary in the United States or head of the centers, you know, for disease control and prevention is

is that they would be the standard bearers and they would also be at the forefront of the communication nationwide. So if there was an outbreak in one state, you would expect that state to be in the lead in communicating what's happening. Right now, what started in Texas has spread to New Mexico. There are cases in Kansas. There are cases in Oklahoma. At this point where you have a constellation of states that are trying to curb this outbreak,

You would have in the past, in the recent past, seen CDC officials giving regular briefings to the public about the state of affairs and what efforts were being taken to curb the outbreak. And we don't have that right now.

that right now the federal government is not performing that function. And Kennedy's response has been to say that vaccination is a personal choice. He has not urged families to vaccinate their children. And what we've seen in the recent years is an increasing trend of families who are worried about vaccine risks

We don't have evidence to substantiate those risks, but the rate of vaccination among school-age children for measles is declining nationwide and in certain places, especially where this outbreak is focused in Texas, it has declined substantially.

And doctors in those locations are pleading with families to vaccinate their children. And local health officials are also urging families to do so. But there's mixed messaging when at the federal level, you're not hearing that.

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We reached out to Kennedy's spokesperson at HHS, and they did not respond to a request for comment. Reuters is still reporting on the impact of these cuts, especially as the country sees this measles outbreak spread. You can follow along with the latest developments on Reuters.com or the Reuters app.

Thanks again to Caroline and Michelle for their time and expertise. Reuters World News is produced by Gail Issa, David Spencer, Christopher Waljasper, Sharon Reich-Garson, and me, Jonah Green. Our senior producers are Tara Oaks and Carmel Crimmins. Our executive producer is Lila DeKrentzer. Sound design and musical composition by Josh Sommer. Make sure to follow us on your favorite podcast player, and we'll be back on Monday with our daily headline show.