As of April 1, the Centers for Disease Control and Prevention has shut down its Maternal and Child Health Branch, which works with other countries to ensure that mothers and children at risk of or infected by HIV receive treatment. All 22 staff were terminated.
That's one of the ways that global health will be affected by the 25% reduction in staff and 35% reduction in contracts for the agency — ordered on April 1 by Secretary of Health and Human Services Robert F. Kennedy Jr. as part of an effort to "reduce bureaucratic sprawl."
Although CDC has a sweeping domestic agenda, it also focuses on worldwide issues through its Global Health Center, which has about 550 employees.
As part of the restructuring, the director of the center Kayla Laserson was one of several CDC directors transferred to the Indian Health Service, leaving the Global Health Center in the hands of deputies.
What was cut?
Neither HHS nor CDC released further information on the cuts, but six current CDC/Global Health Center employees gave details to NPR. They asked for anonymity because they are not authorized to speak to the press.
The Global Health Center has three divisions. Two of the divisions were unscathed: global immunization, which supports vaccine distributions for polio and other diseases, and global health protection, which is responsible for disease surveillance, gathering information and drawing on their network of labs.
The third division, Global HIV and TB, however, had seven of its 15 branches eliminated, terminating all of their staff and leadership.
Three CDC employees who spoke to NPR said they were especially shocked by the elimination of the Maternal and Child Health Branch. The team was made up of epidemiologists and physicians who focused on preventing babies from getting HIV from their mother and keeping children with HIV around the world alive and on treatment to suppress the virus.
Two scientists who worked at Maternal and Child Health said CDC was "providing HIV treatment for over 300,000 children, and we provided treatment for over 380,000 HIV positive pregnant and breastfeeding women in 2024."
Those employees have been one of several federal teams — including from the State Department and the now dismantled USAID — that were critical in carrying out the programs of PEPFAR — a widely hailed government initiative to control HIV, started by President George W. Bush in 2003, that the State Department credits with saving 25 million lives since its inception.
"This team is especially critical right now, because with the recent cuts to USAID, our branch was the only team left in PEPFAR that had maternal and child health HIV expertise," one CDC scientist told NPR. "So our cuts impact not just CDC but PEPFAR as a whole." The scientist, who was part of the Maternal and Child Health Branch, was this week placed on admin leave until June 2, when their job will be terminated.
Another CDC scientist from the team complained about mixed messages from the government: "HIV treatment for pregnant women and children was identified as critical and lifesaving by the State Department earlier this year because without it, many lives would be lost," the scientist said. "It seems like maybe this is an indication of the lack of coordination and chaos in the government, where the State Department is saying our work is critical, yet we're cut by HHS."
NPR reached out to HHS for comment on the CDC global health cuts and their impact but did not receive a response.
Assessing the impact
All CDC sources who spoke to NPR agreed with one individual's characterization that the cuts to the Global Health Center and its HIV branches would have "catastrophic consequences."
One of the scientists with the Maternal and Child Health team said the cuts were a major blow personally and professionally.
"My colleagues at the branch and I have really dedicated our careers to ensuring that mothers and babies receive the HIV services they need, and we serve as advocates for children to get the services they need so that they can be healthy and stay alive," the scientist said. "I personally am just worried that no one will be advocating for these populations that are often overlooked anymore, and that that puts them more at risk for dying."
One epidemiologist who was not affected by these cuts said even though this was a global health program, its elimination could have a direct impact on the lives of Americans.
"HIV knows no boundaries. If we see a resurgence of HIV globally. It's going to have long term consequences everywhere, with what we know about mutations of HIV, resistance to drugs, transmission rates. It's just going to be detrimental. It's going to harm economies around the world," the epidemiologist said.
The U.S. has played a major role in global health and helped save millions of lives around the world with its support for global immunization efforts and HIV/AIDs treatments, says Janeen Madan Keller, the deputy director of the global health policy program at the Center for Global Development, a Washington, D.C., think tank.
"I think one of the challenges that we're really confronting is that these sweeping and unprecedented actions that are being taken by the current administration are coming at a time when many other governments are also cutting their foreign aid budgets for many different reasons."
That raises a big question, Keller says: "is there anyone who can step into the role the U.S. played?
"I don't think we have an answer."
There's another as yet unanswered question: Will there be future cuts to the Global Health Center?.
"The message [from the leadership] in HHS and CDC is that this is it for the reduction-in-force. But for global health, we have been told that may not be the case," a current CDC official told NPR.
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