On April 1, the Trump administration began making sweeping changes to the U.S. Department of Health and Human Services (HHS) by firing thousands of staff, some of whom learned of this decision when they arrived at work on Tuesday morning and were not allowed to enter the building. According to HHS, the administration plans to reduce the HHS workforce from 82,000 full-time employees to 62,000. It is also consolidating the current 28 divisions into 15 divisions, and eliminating five of the 10 regional offices in the United States, among other changes.

HHS Secretary Robert F. Kennedy Jr. framed these changes as part of his “Make America Healthy Again” agenda, citing recent declines in life expectancy, while neglecting to mention that those declines were largely due to the COVID-19 pandemic. The Trump administration’s stated goals are to streamline HHS, save taxpayer money, focus more on chronic illness, and make HHS more responsive and efficient. It claims it can make these reforms without impacting critical services. In practice, however, the administration has cut essential funding that was helping states and cities prepare for outbreaks; reassigned leaders who were stopping biological threats in other countries from spreading; undermined the United States’ ability to quickly review and approve treatments and vaccines during an emergency; and disrupted essential work to create vaccines, tests, and treatments for dangerous diseases. These approaches do not make America healthy. They make America less safe.

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Egg prices are dropping in the United States, pushing highly pathogenic avian influenza out of the political and economic spotlight. However, the disease won’t likely be cowed by the temporary reprieve, health experts have warned.

“I keep hearing a sort of a hope, a wish, and perhaps a belief ... that this is going to blow over,” Jennifer Nuzzo, the director of the Pandemic Center at Brown University School of Public Health, said at a panel focused on the U.S. experience with H5N1 bird flu. “I’m here to say that it’s not going to blow over somehow, that this is really a long-term situation that we have to deal with.”

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Dallas, Texas – Therissa Grefsrud still remembers the email. The COVID-19 pandemic had been raging for nearly a year, and a woman had reached out to ask about vaccines: Would they cause infertility in her or her future children?

Grefsrud, a nurse specialised in infection prevention, had heard such concerns before. But studies show no link between infertility and vaccination of any kind.

Still, Grefsrud exchanged messages with the woman as she shared her fears. Then she pointed her towards the facts.

“She came to me about a month later and let me know how grateful she was for me making this space without judgement,” Grefsrud said. The woman also shared that she was now vaccinated.

Fast forward four years, and Grefsrud is among the healthcare professionals in Texas confronting a new outbreak: measles.

When Stephanie Psaki, a senior fellow in public health, joined the U.S. Department of Health and Human Services in 2021, she was tasked with helping coordinate the government’s response to the global COVID-19 pandemic.

She then joined the National Security Council at the White House in the Biden-Harris administration where she worked for two and a half years. A scientist and an academic by training, she told The Herald she didn’t expect to move to this policy-focused role.

“I didn’t think that I was going to do this job when I was in undergrad or in grad school,” she said. “It never occurred to me.”

But now, Psaki has returned to academia, bringing her policy experience to Brown.

Leaders at the Centers for Disease Control and Prevention ordered staff this week not to release their experts’ assessment that found the risk of catching measles is high in areas near outbreaks where vaccination rates are lagging, according to internal records reviewed by ProPublica.

In an aborted plan to roll out the news, the agency would have emphasized the importance of vaccinating people against the highly contagious and potentially deadly disease that has spread to 19 states, the records show.

A CDC spokesperson told ProPublica in a written statement that the agency decided against releasing the assessment “because it does not say anything that the public doesn’t already know.” She added that the CDC continues to recommend vaccines as “the best way to protect against measles.”

But what the nation’s top public health agency said next shows a shift in its long-standing messaging about vaccines, a sign that it may be falling in line under Health and Human Services Secretary Robert F. Kennedy Jr., a longtime critic of vaccines:

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The US National Institutes of Health (NIH) and Centers for Disease Control and Prevention (CDC) have begun cancelling billions of dollars in funding for research related to COVID-19.

COVID-19 research funds “were issued for a limited purpose: to ameliorate the effects of the pandemic,” according to an internal NIH document that Nature has obtained and that provides the agency’s staff members with updated guidance on how to terminate these grants. “Now that the pandemic is over, the grant funds are no longer necessary,” the document states. It is not clear how many of these grants will be ended.

What are the biggest threats to the health security of the American people? There are some strong candidates. Avian influenza is spreading in birds, cattle, and 50 mammalian species. Measles cases are surging at home and abroad. COVID-19 is still spreading and could mutate into a more deadly strain. Farther afield, Uganda continues to respond to an Ebola outbreak and Mpox has been seen in 127 countries. But perhaps the biggest threat to America’s health could be self-inflicted. According to a report published yesterday in the New York Times, our leaders intend to end funding for international immunization programs—including the Gavi Alliance I led from 2011 to 2023—that for decades have protected Americans from health threats abroad. These cuts would represent a grave threat to the health, well-being, and livelihoods of every American.

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The United States cutting funding to Gavi, an organisation that provides vaccines to the world's poorest countries, could result in more than a million deaths and will endanger lives everywhere, the group's CEO warned on Thursday.

The news that Washington is planning to end funding for Gavi, first reported in the New York Times, comes as the two-month-old administration of President Donald Trump aggressively slashes foreign aid.

The decision was included in a 281-page spreadsheet that the severely downsized United States Agency for International Development sent to Congress on Monday night.

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The US National Institutes of Health (NIH) and Centers for Disease Control and Prevention (CDC) have begun cancelling billions of dollars in funding on research related to the COVID-19 pandemic.

COVID-19 research funds “were issued for a limited purpose: to ameliorate the effects of the pandemic”, according to an internal NIH document that Nature has obtained and that provides the agency’s staff members with updated guidance on how to terminate these grants. “Now that the pandemic is over, the grant funds are no longer necessary,” the document states. It is not clear how many COVID-19 grants will be terminated.

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A project to track and contain menacing animal viruses across seven countries, from avian influenza in poultry to Lassa virus in rodents, ended with a single email. In late January, Jonathon Gass, an epidemiologist and virologist at Tufts University, was about to leave for Bangladesh to close out an effort to monitor and combat avian influenza, when the emailed letter arrived from the U.S. Agency for International Development (USAID), ordering an immediate halt to work on the $100 million STOP Spillover project. Gass, a co-deputy director of the project, stayed in Massachusetts and started to call staff around the world to tell them to drop everything. One colleague monitoring Lassa virus in Liberia was driving to a field site. “I had to tell him that he needed to turn the car around, come back, and book a plane ticket home,” Gass says.

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The White House is nominating Dr. Susan Monarez, the current acting director of the US Centers for Disease Control and Prevention, to lead the agency, President Donald Trump said Monday.

The move comes weeks after the White House abruptly withdrew its nomination of Dr. Dave Weldon to lead the public health agency.

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After returning home from a trip abroad last week, an infant in Houston was hospitalized with measles.

In Lamoille County, Vermont, this month, a child became sick with measles after returning from foreign travel.

The same thing happened to an adult in Oakland County, Michigan, whose vaccination status was unknown.

Although measles was declared eliminated in the United States in 2000, it still rages on in many parts of the world. With decreasing vaccination rates across the US, experts say, imported cases can have large consequences.

“Each one of those imported cases now is like a match being thrown into a bit of forest,” said Dr. Brian Ward, associate director of the JD MacLean Tropical Disease Center at McGill University. “The susceptible people in our communities now are like that accumulating fuel in a forest.”

Often, these illnesses happen “because a US resident goes outside of the US and is exposed and brings measles back. And I think that’s something that’s been happening for a while, and we’re certainly seeing … an upward trend in the last couple of years,” said Dr. Matthew Ferrari, director of the Center for Infectious Disease Dynamics at Penn State University.

The outbreak spanning Texas, New Mexico and Oklahoma is behind the majority of the more than 400 US measles cases this year, according to a CNN tally, but there have been many reports of travel-related cases throughout the country.

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