I. Historical Context

Upon entering office in January 2025, the Trump administration was quick to take action against the public health sector, aiming to reduce the importance of healthcare and defund research into disease prevention and vaccination care. Previously, over 80% of all federal support for health programs, such as the National Institute of Health (NIH) and the US Agency for International Development (USAID), went to programs that provided or subsidized healthcare insurance coverage. Additionally, the U.S. government spent 17.8% of its GDP on healthcare, a significantly larger percentage than other high-income nations, as concluded by Wager et al. However, the first four months of the new administration have caused medical professionals to hypothesize that these rates will sharply decrease in the years to come. 

During the Biden administration, healthcare faced unforeseen global challenges, the most notable of which being the rise of the coronavirus pandemic in 2020. Despite these tribulations, though, there were never any large scale healthcare cuts. In fact, according to the Associate Editor for the Johns Hopkins Bloomberg School of Public Health, “Enrollment in the Affordable Care Act increased every year of the Biden administration and reached a record 24 million enrollees for 2025.” This highlights the prosperous period of awareness and growth in the public health sector from 2020-2024.

In contrast, the Trump administration has proposed legislation to defund Medicaid and Medicare. Joan Alker, a research professor at Georgetown University, warns that  “the just-released draft House budget resolution includes punishing cuts of at least $880 billion over ten years to Medicaid.” This decision would create a chain effect, forcing States to expand on the eligibility requirements to balance their budget. Moreover, in April 2025, Chief Healthcare Executive suggests that the healthcare department may have a third of its funding removed with the new Trump Budget Plan, underscoring the radical lengths of the new administration in their mission of slicing healthcare. The CHE furthers this point, asserting that the Centers for Disease Control and Prevention (CDC) budget may drop from $9.2 billion to $5.2 billion, a drop of about 44%, per the Post report.

 The budget reduction on medical research regarding deadly diseases and harmful chemicals is another notable mission of the new administration. In 2022, the National Institutes of Health (NIH) had a holding budget of nearly $48 billion, funding over 60,000 grants and supporting more than 300,000 researchers at over 2,500 institutions as discovered by J. Mohammad, Associate Professor at Harvard Medical School, and H. Zeynep, Senior Lecturer, MIT Sloan. 

The actions of the new administration have caused medical professionals, such as those under CHE, to suggest further regression in the near future. These developments have led many to question the future of healthcare, the stability of potential job opportunities, and the consequences of eliminating research into pressing healthcare matters due to budgetary constraints. 

II. Current Policy

The Trump administration has cut funding for several public health programs, such as the National Institute of Health (NIH), the World Health Organization (WHO), and the US Agency for International Development (USAID). These actions have garnered responses from medical professionals, nonprofit organizations, and government officials all around the world. As of now, the Trump Administration is considering a plan that would cut the federal health budget by a third. 

On January 20th, 2025, Donald Trump ordered a 90 day program-by-program review to determine which projects were essential and which were redundant. Both Elon Musk and Donald Trump have voiced desires  to eliminate almost 90% of USAID’s foreign contracts, claiming that they are largely ineffective. Doing so would eradicate over $60 billion in US assistance around the globe, cutting 5,800 of the 6,200 multiyear USAID contracts and 4,100 of the 9,100 state department grants.

The Trump administration has taken a similar stance with the NIH, deeming that many projects were problematic and had to be terminated. Over 29% of the eliminated studies were on HIV/AIDS and 24.3% were on transgender health. More than 1,000 researchers have been fired, with Trump announcing that more layoffs are to come. Many of these researchers were doing important work on Alzehimers, cancer, or autism.

Through the slew of executive orders that President Trump signed on January 20th, he was also able to withdraw from the World Health Organization. The driving force behind this decision was concerns with China and the belief that the organization mishandled the COVID-19 pandemic. All future transactions and fundings to WHO have now been stopped as America continues the withdrawal process.

While leaders like President Trump, Robert F. Kennedy Jr, and Elon Musk continue to support funding cuts, many public officials disagree. A coalition of 22 attorney generals, led by Letita James of New York, filed a lawsuit against the funding cuts made by the Trump administration. Organizations like the American Public Health Association have also stated that these cuts could cause significant problems for Americans.

The nonprofit Doctors Without Borders has also raised concerns about the people who rely on aid from the United States. Once responsible for 40% of the world’s public health aid, America has now cut their aid to almost 0%. Doctors Without Borders now reports that there is confusion and chaos with potentially life-threatening consequences.

III. Reasoning for Support

The U.S. Department of Health and Human Services (HHS) has announced a plan of extreme restructuring meant to complement President Trump’s Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.” The heart of this restructuring effort is the creation of the Administration for a Healthy America (AHA), which will combine multiple agencies: the Office of the Assistant Secretary for Health (OASH), Health Resources and Services Administration (HRSA), Substance Abuse and Mental Health Services Administration (SAMHSA), Agency for Toxic Substances and Disease Registry (ATSDR), and National Institute for Occupational Safety and Health (NIOSH).

According to the HHS Press Office, the reasoning for this centralized format is to “improve coordination of health resources” and “create operational efficiency for low-income Americans.” The AHA department will focus on areas such as primary care, maternal and child health, mental health, environmental health, HIV/AIDS, and workforce development. Administrative and technical operations will also become more “centralized,” uniting human resources, information technology, procurement, external affairs, and policy functions.

The HHS Press Office’s releases underscore the financial benefits of their plan, framing their restructuring as an effort that “will… serve multiple goals without impacting critical services.” The U.S. Department of HHS claims this restructuring will save taxpayers $1.8 billion dollars per year by reducing the number of full-time employees from 82,000 to 62,000.

Ultimately, the HHS department states that such “consolidation and cuts are designed not only to save money, but to make the organization more efficient and more responsive to Americans’ needs.” The department also plans to implement a goal they title Make America Healthy Again, which aims to end the chronic disease epidemic. In Secretary of Health Kennedy’s words,“This overhaul will be a win-win for taxpayers and for those that HHS serves. That’s the entire American public, because our goal is to Make America Healthy Again.”

International responses to President Trump’s funding cuts on NIH and restructuring of HHS initiatives are focused, rather, on recruiting U.S. researchers whose jobs are in jeopardy. The Australian Academy of Science recently implemented a global talent attraction program, with the academy’s president, Professor Jagadish AC, explaining that Australia had “an ‘urgent and unparalleled opportunity to attract the smartest minds leaving the United States… there is no time to waste as other countries have already recognised the opportunity and are mobilising to attract talent to their shores.” Norway has also launched a program to “lure top international researchers amid growing pressure on academic freedom in the US under the Trump administration.” Alongside multiple institutions across Europe, the Research Council of Norway started a fund worth 100m kroner (£7.2m) to recruit international researchers.

IV. Drawbacks

The cuts imposed by the National Institutes of Health, the World Health Organization, and the US Agency for International Development have caused concern with public health experts, physicians, and some politicians. Many critics believe that these decisions will put the backbone of America’s public health system at risk.

One of the major concerns is that these cuts would shrink the United States’ capability for biomedical research by slashing the NIH budget up to 40%. The NIH funds thousands of research projects at institutions across the country, employing more than 300,000 scientists and staff. As Nature reports, nearly 800 research projects have already been cancelled with over $2.3 billion in funding cuts. These monetary gaps have forced many labs to conduct layoffs, implement low-cost strategies, and sometimes close altogether. In the words of former NIH head Francis Collins, “shredding the fabric of the government’s commitment to advanced medical research designed to improve health and longevity for Americans" is not acceptable.

The economic implications are also troubling. NIH funding is not only a driver of scientific discovery but also a major source of jobs and economic activity locally. Roughly 40% of institutions losing NIH grants are in states that voted for Trump, and public universities are among those most affected. The loss of funding threatens to erode the biomedical workforce, reducing opportunities for young scientists and weakening the pipeline of talent needed to tackle future health crises.

Beyond the laboratory, the impact on patient care and public health is a major concern. Cuts have targeted research on vaccines, opioid addiction, adolescent health, and the needs of marginalized groups, including minorities and LGBTQ+ individuals. Medical professionals warn that eliminating these programs could exacerbate health disparities and increase long-term healthcare costs, leaving vulnerable populations without answers to critical health questions. As Shirley Tilghman, the former president of Princeton University, stresses, “You cannot eliminate a segment of the population by executive order, but you can harm them greatly.”

The international consequences are equally alarming. The US has long played a leadership role in global health, funding disease surveillance, pandemic preparedness, and life-saving treatments through agencies like the WHO and USAID. However, the WHO Director-General has expressed fear of severe disruptions to malaria, HIV, and tuberculosis programs due to US funding cuts, with millions of lives at risk. USAID, facing an 83% budget reduction, has already begun scaling back support for major UN health initiatives. If US global health funding were eliminated and not replaced, up to 25 million additional deaths could occur worldwide over the next 15 years, especially from AIDS, tuberculosis, and maternal and child health issues.