A second term for Donald Trump could mean significant shifts in the Centers for Disease Control and Prevention’s (CDC) mission, focusing the agency primarily on infectious diseases and curbing its involvement in chronic health initiatives, the Washington Post reports.
The prospect has drawn attention, with conservative lawmakers and think tanks supporting a streamlined approach that some argue could sharpen the CDC’s focus on pandemic preparedness and public health emergencies.
Trump’s administration and Republican allies have expressed interest in scaling back the CDC’s scope to focus on “core” functions related to infectious diseases. Proponents of this approach argue that shifting responsibility for chronic disease management to other health agencies could help the CDC better prepare for outbreaks and future pandemics. Joel Zinberg, a former Trump administration health policy adviser, suggests that issues like environmental justice and tobacco control, while significant, could be better managed outside the CDC, allowing it to concentrate on pandemic readiness.
One proposal includes transferring CDC’s chronic disease responsibilities, such as programs targeting obesity, diabetes, and cancer prevention, to the National Institutes of Health (NIH) or Food and Drug Administration (FDA). This shift, some argue, would allow the CDC to dedicate more resources to its original infectious-disease mission.
Republican lawmakers have proposed cutting CDC funding by approximately 20%, potentially eliminating programs they consider “duplicative” or outside CDC’s infectious disease mandate, including climate health initiatives and cancer screenings. Advocates for these cuts suggest that other agencies could manage these health priorities without diverting the CDC’s resources from its primary mission.
Scott Gottlieb, former FDA Commissioner under Trump, has echoed this view, advocating for the CDC to narrow its scope. He argues that consolidating CDC efforts could lead to more targeted funding and greater efficacy in the agency’s response to health crises.
If the CDC narrows its mission, state and local health departments that rely on federal support for various public health initiatives could face budget constraints. For instance, CDC-backed programs that track opioid overdoses or fund cancer screenings may see reductions, leading health officials to explore alternative sources of funding for local health services.
Opponents of the proposed changes, including eight former CDC directors, warn that scaling back the agency’s mandate could reduce its capacity to address comprehensive health threats, potentially impacting overall public health. Local health departments have highlighted that CDC funding supports programs targeting violence prevention, youth health education, and chronic illness management, which some argue are essential for community well-being.
Trump’s recent collaboration with Robert F. Kennedy Jr. to tackle chronic diseases, through a “Make America Healthy Again” initiative, has added complexity to the debate. While some conservative policy advisers envision an infectious-disease-centered CDC, Trump’s campaign has shown interest in addressing chronic illnesses, potentially signaling a nuanced approach. According to one Trump campaign advisor, the CDC could still play an active role in addressing issues like childhood obesity and diabetes.
Yet, Trump’s policy approach may ultimately rely on the flexibility granted to the Secretary of Health and Human Services (HHS), who could unilaterally reorganize the CDC’s priorities even without legislative action. This administrative avenue could permit a gradual, executive-driven realignment of the CDC’s focus.
