How Federal Funding Cuts are Undermining Public Health Infrastructure

Last week, the Trump Administration terminated more than $12 billion in public health funding authorized and appropriated by Congress through the Centers for Disease Control (CDC) and Substance Abuse and Mental Health Services Administration (SAMHSA), a move that threatens to erode essential public health infrastructure and undercut critical efforts to address health inequities. 

This funding was allocated in response to COVID-19, supporting COVID-specific efforts like testing, vaccination, and education. But these grants also helped strengthen essential infrastructure for tackling infectious diseases, substance abuse, mental health, and health inequities, and marked a long-overdue investment in chronically underfunded public health systems. COVID-19 was an acute-on-chronic crisis that exposed the fragility of our core public health infrastructure. By investing in core public health functions, these grants aimed to build more resilient public health systems that are prepared to respond to future health threats. 

Now, that progress is at risk. Cutting these funds will devastate critical work being done to address the gaps prevalent in public health systems across the country. Community health workers (CHWs),who are frontline public health workers with trusting relationships in the community, are particularly impacted. Investments in CHW programs under the CDC’s Community Health Workers for COVID Response and Resilient Communities, dispersed more than $340 million across 67 organizations to support the hiring, training, and deployment of CHWs nationwide. The abrupt termination of these funds is resulting in mass layoffs and leaving many communities without access to essential services. 

While the full impact of these cuts may take months or even years to fully understand, many communities, including those where PIH-US works, are feeling the disruption and harm right now. In Arizona, the Pima County Health Department lost $1.9 million, impacting health disparity and vaccine equity programs and cutting at least 25 jobs. North Carolina faces $100 million in cuts and over 80 job losses, impacting immunization efforts, disease monitoring, behavioral health, and more statewide. And in New Jersey, $350 million in cuts will threaten disease tracking, addiction treatment, mental health services, and public health infrastructure. 

Although many of these funds were originally set to expire in the coming months, last week's clawback accelerates this funding cliff, leaving many projects unfinished. This premature termination highlights a deeper, ongoing failure to establish sustainable, long-term funding for community health worker initiatives and public health more broadly. These funding cuts undermine health departments’ efforts to implement sustainability measures, leaving them without the necessary staff to plan for transitions away from federal dollars and setting back critical, ongoing programs that cannot simply be paused and resumed. Without consistent investment, our public health infrastructure remains fragile and unprepared to effectively respond to both current challenges and future health crises. 

While we’re encouraged to see states and advocacy groups fighting back through litigation, lawsuits alone won’t be enough. To protect our public health infrastructure, we must continue to apply relentless public pressure and ensure these cuts remain a national outrage—not a forgotten headline. We cannot afford more cuts to public health.