HHS Secretary Kennedy unveiled a sweeping plan this week that will substantially dismantle the nation’s public health infrastructure. His announcement signals a drastic shift in HHS’ decades long approach to evidence-based public health, with major consequences for CDC, FDA, HRSA, CMS, IHS and the NIH. Kennedy’s decisions this week included a wholesale firing at those HHS agencies.

Kennedy used a two-pronged approach to disassembling public health infrastructure: massive budget cuts for state and county health departments, as well as laying off thousands of employees across various HHS agencies.

These actions are just the first step in what is expected to be a broader effort to reduce the federal government’s role in public health and health regulation.

One element of Kennedy’s plan to fire staff includes closing several HHS regional offices, including the one in San Francisco, which serves Arizona. These closures, including the relocation of services to other cities like Denver are less about operational efficiency and more about encouraging current staff to quit rather than uproot their lives and families.

In essence, these closures could force employees to make difficult decisions about their careers, further reducing the government’s investment in public health infrastructure.

The implications for Arizona are significant. The HHS regional office in San Francisco plays a crucial role in overseeing public health efforts in the state, especially in terms of grant funding and accountability.

Trump plan for overhauling health agencies will cut 10,000 positions | Science | AAAS

As a primary function of many positions within these agencies, project officers are tasked with overseeing the use of federal funds at the state and local levels. These positions ensure that state and local health departments are held accountable for how they use the grants they receive, reinforcing transparency and responsible allocation of resources.

Kennedy’s decision to cut these positions is not just a cost-saving measure; it is a direct attack on accountability.

Without project officers overseeing the spending of federal funds, Arizona’s state and local health departments lose important guidance and oversight. This erosion of accountability isn’t about streamlining operations; it’s part of a broader effort to disassemble the health sector’s regulatory framework.

By reducing the staff that holds local agencies accountable, Kennedy’s plan undermines the very mechanisms that ensure public health policies are effectively implemented, and funds are used appropriately.

Kennedy to cut 10,000 jobs at Health and Human Services

This announcement is likely only the beginning. We can expect further reductions in public health infrastructure and services. These cuts will affect Arizona’s health agencies to respond to emerging health threats, both chronic and infectious. As federal oversight and resources dwindle, the state will be left to fend for itself, with fewer tools and less guidance from the federal government.

Secretary Kennedy’s announcement marks a turning point in the federal government’s approach to public health. While his focus on chronic diseases may have some merit, the dismantling of critical public health infrastructure poses a serious threat to public health systems across the United States, including in Arizona.

By cutting staff, reducing oversight, and closing regional offices, Kennedy’s plan undermines the very framework that ensures public health efforts are effective and accountable.

These changes are likely just the first step in a larger, more destructive overhaul of the nation’s health system, and the consequences will be felt for years to come.