CDC officials plan for the agency’s splintering, but questions remain

NEW YORK (AP) — A top Centers for Disease Control and Prevention official told staff this week to start planning for the agency’s splintering.

Several parts of CDC — mostly those devoted to health threats that aren’t infectious — are being spun off into the soon-to-be-created Administration for a Healthy America, the agency official told senior leaders in calls and meetings.

The directive came from Dr. Debra Houry, the agency’s chief medical officer, according to three CDC officials who were in attendance. They declined to be identified because they weren’t authorized to talk about the plans and fear being fired if they were identified.

Asked to comment, Houry referred The Associated Press to CDC media relations representatives. CDC spokesperson Jason McDonald acknowledged the agency is planning for possible changes but that “none of the items discussed at the meeting have been finalized, and are subject to change.”

Dr. Scott Harris, president of the Association of State and Territorial Health Officials, said there are “a lot more questions than there are answers right now.”

Those questions include whether the split will interrupt funding and assistance to state health departments that ultimately implement federal health policy, said Harris, who also is Alabama’s state health officer.

“We’d love to be able to give input,” he said.

Officials deciding what to do with programs that lost many staffers

The Atlanta-based CDC is charged with protecting Americans from preventable health threats. It had roughly 13,000 employees at the beginning of the year, the bulk of them in Georgia.

Since taking office in January, the Trump administration has embarked on a dramatic downsizing of many federal agencies. The CDC’s headcount was slashed by rounds of early retirements and layoffs that reduced staffing by 3,500 to 4,000 employees.

The layoffs targeted not just job classifications but offices and programs. For example, everyone at the CDC’s division on dental health was axed, as were most workers at an office that investigates occupational diseases and promotes job safety.

Now, federal health officials are deciding how to reassemble what’s left. They have a Monday deadline to submit a reorganization plan to the White House.

Health Secretary Robert F. Kennedy Jr. has already outlined plans for the new Administration for a Healthy America, which would largely focus on health problems not caused by infections.

“We aren’t just reducing bureaucratic sprawl. We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic,” Kennedy said in a statement last month.

Experts wonder whether CDC workers would have to move

Kennedy has said the AHA will contain — among other things — the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration and the U.S. Surgeon General.

In the meetings this week, Houry said the new AHA agency also will likely absorb what’s left of the CDC centers devoted to birth defects, chronic conditions, environmental health, injuries, and workplace safety.

It’s not clear if those staffers would stay in Atlanta — and that “deeply matters,” said Jason Schwartz, a Yale University health policy researcher who studies government health agencies.

If those jobs are moved to the Washington, D.C., area, “you certainly are going to lose lots of the kinds of experts who have built lives and careers and families in and around Atlanta, many of whom I’m sure would be unable or unwilling to relocate their lives,” he said.

That would likely mean “you are building something anew, rather than just changing reporting lines,” he said.

CDC’s remaining HIV staff would be moved to new agency

The parts of CDC not being moved into the AHA would be be mainly focused on infectious diseases, with one notable exception: HIV.

The CDC’s HIV prevention staff was decimated in the layoffs, with 160 people eliminated. What’s left — the agency’s HIV surveillance and lab operations, for example — would shift to the AHA under the realignment plan.

Such a change would place that CDC work under the same organizational umbrella as HRSA’s Ryan White HIV/AIDS Program. That program provides outpatient care, treatment and support services to people with HIV but no health insurance.

A cleaving of the CDC was proposed in Project 2025, the sweeping Heritage Foundation government-shrinking proposal that surfaced last year. That document called the CDC “the most incompetent and arrogant agency in the federal government” and proposed splitting it into two smaller agencies — one focused on disease data collection and the other more generally on public health.

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