By Bruce Y. Lee, Forbes 2025年3月29日報導
美國在COVID-19疫情之後，仍面臨許多公共衛生挑戰：長新冠案例持續增加、禽流感威脅升高、麻疹疫情重現，以及抗藥性病原體在醫療院所擴散。然而，美國衛生部部長小羅伯特・甘迺迪（RFK Jr.）的下一步，竟是裁撤整個「傳染病與愛滋病政策辦公室（OIDP）」的全體人員。
據CBS報導和前OIDP員工在LinkedIn上的貼文指出，這項決策是RFK Jr.進行衛生部（HHS）重整與縮編計畫的一部分，整體將從約82,000名員工裁減至62,000人。其中包括FDA裁減約3,500人、CDC裁2,400人、NIH裁1,200人。
OIDP主要負責協調與推動全國性的傳染病防治計畫，包括：
- 國家愛滋病策略（National HIV/AIDS Strategy）
- 疫苗國家戰略計畫（Vaccines National Strategic Plan）
- 病毒性肝炎與性傳染疾病的策略計畫
- 終結愛滋疫情、預防醫療相關感染、控制蜱傳疾病等多項行動方案
此外，OIDP還維護數個重要的科學諮詢委員會，如：
- 總統愛滋諮詢委員會（PACHA）
- 對抗抗藥菌委員會（PACCARB）
- 血液與組織安全委員會
- 疫苗諮詢委員會（NVAC）
有消息指出，PACCARB已於本週五正式解散。
目前RFK Jr.與川普政府尚未清楚說明未來這些公共衛生任務將由誰接手、分配在哪個單位，也未公布具體替代方案。多位專家私下坦言，內部狀況「混亂」，擔心若再爆發新傳染病，美國將難以有效應對。
回顧歷史，川普政府在2018年曾解散全球衛生安全與生物防禦單位，當時負責疫情應變的白宮官員也相繼離職，導致2020年COVID-19疫情爆發時，美國處於缺乏準備的狀態。
如今，在長新冠未解、禽流感升溫、抗藥性細菌持續擴散、疫苗接種率下滑（導致麻疹再度流行）等背景下，大幅削弱聯邦政府傳染病防治能力，恐將為公共衛生帶來重大風險。
RFK Jr. Expected To Lay Off Entire Office Of Infectious Disease And HIV/AIDS Policy
Senior Contributor. Bruce Y. Lee, M.D., MBA, covers health, medicine, wellness and scienceFollow Author
Mar 29, 2025, 09:25pm EDTShareSaveComment2
The U.S. is still reeling from the COVID-19 pandemic with more and more long COVID cases emerging. Bird flu is a growing threat. Measles outbreaks have been occurring. Antibiotic-resistant organisms continue to spread in healthcare settings. So what do you do next if you are in charge of the U.S. Department of Health and Human Services, which is supposed to protect the health of humans in the U.S.? How about lay off the entire staff of the U.S. government’s Office of Infectious Disease and HIV/AIDS Policy?
Office Of Infectious Disease ‘Gutting’ Is Part Of RFK Jr.’s Downsizing And Restructuring Of HHS
Yep, that’s the word from various federal health officials and external experts who work with the OIDP. Alexander Tin reporting for CBS News described it as gutting the OIDP. And here’s a LinkedIn post from Chloe Loving, MPH, CHES, CPH, who worked as a Public Health Analyst and Committee Management Officer for the Office of the Assistant Secretary for Health and the Presidential Advisory Council on HIV/AIDS:
PROMOTED
It’s apparently part of the whole HHS downsizing and restructuring plan from Robert F. Kennedy, Jr., as the Secretary of HHS that’s been posted as a fact sheet. That fact sheet indicates that the number of HHS employees will be slashed from around 82,000 to 62,000. This will include cutting around 3,500 jobs at the Food and Drug Administration, 2,400 at the Centers for Disease Control and Prevention and 1,200 at the National Institutes of Health.
The problem is that the general public may not be fully aware of all that OIDP does and the expertise that will be lost. Chances are that more people are more familiar with the acronym GOT, which stands for Game of Thrones, than the acronym OIDP. But the cuts at HHS are beginning to resemble the plots of GOT in different ways. Each week, it’s not clear who will be gone next.
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OIDP Serves Important Roles In Infectious Disease Prevention And Control
The stated mission of the OIDP is “to provide strategic leadership and management, while encouraging collaboration, coordination, and innovation among federal agencies and stakeholders to reduce the burden of infectious diseases.” This includes implementing various national plans to prevent and control infectious diseases. For example, there’s the National HIV/AIDS Strategy, Vaccines National Strategic Plan, Viral Hepatitis National Strategic Plan and the Sexually Transmitted Infections National Strategic Plan. The OIDP also directs different initiatives, such as initiatives to end the HIV epidemic in the U.S., prevent healthcare-associated infections and control tick-borne diseases. Maintaining such plans and initiatives may be kind of difficult with no staff around.
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Also potentially going poof are the various advisory committees of external scientific experts that the OIPD has been maintaining. This includes the Advisory Committee on Blood and Tissue Safety and Availability, Presidential Advisory Council on HIV/AIDS, Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria and National Vaccine Advisory Committee. In fact, sources have told me that the PACCARB has already been disbanded as of Friday.
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RFK Jr. Has Not Yet Provided A Clear Plan On Who Now Will Handle Different Aspects Of Infectious Disease Control
Tearing stuff down is a typically whole lot easier than building up things. For example, asking, “Who can trash a house” will probably get more takers such as many of your classmates when you were in high school than asking, “Who can build a house?” By jettisoning the staff and advisors for the OIDP, the federal government will lose years and years of experience and expertise that will be super hard to replace.
Of course, there is the possibility that some of these initiatives, plans and advisory committees will somehow resurface in some other forms in the near future. However, neither RFK Jr. nor the rest of the Trump Administration has provided a clear and adequately detailed plan to date of how HSS specifically will be reconfigured and what scientific, health and public health efforts will be covered by what part of this new version of HHS and in what way.
For example, no one whom I have talked to at HHS and in the infectious disease community knows where in HHS the prevention and control of healthcare associated infections will eventually reside and how many people will be involved in such efforts. In fact, the word “chaos” has come up frequently in conversations. And chaos would not be a good way to combat infectious pathogens.
The first term of Donald Trump’s presidency should have been a lesson on what can happen when you get rid of or lose experts on preventing and controlling infectious diseases. Recall that in 2018, the Trump Administration disbanded of the Global Health Security and Biodefense unit that was responsible for pandemic preparedness. That same year Timothy Ziemer, the top White House official in the National Security Council for leading U.S. response against a pandemic, departed. And guess what happened less than two years later. Hint, it rhymes with the words “a pandemic.” Imagine how the response to COVID-19, which was often described as chaotic, may have been different had the government kept its pandemic preparedness experts.
How Will This Affect The Ability Of The U.S. To Deal With Multiple Ongoing Infectious Disease Threats
It’s never a good time to play around with infectious disease prevention and control capabilities without first having a clear plan. This is particularly not a good time with a range of different ongoing infectious disease threats. Fore example, the U.S. still has no clear long-term strategies on how to deal with COVID-19 and the growing burden of long COVID. Since the COVID pandemic emerged in 2020, there have been repeated attempts by politicians from both major political parties to sweep COVID under the rug rather than deal with it head on as needed. But you can’t sweep under the rug the fact that people are still getting COVID-19, getting COVID-19 brings the risk of long COVID, and there still aren’t enough adequate treatments for this chronic ongoing condition.
Meanwhile, there is apparently still no clear plan on how to deal with H5N1 avian influenza, which has been spreading among other animals and could at some point become a real threat to humans. Even if this bird flu doesn’t eventually become the p-word, other pandemic possibilities will likely emerge in the coming years. How ready will the U.S. government be to deal with them? Hopefully not 2020-ready in hindsight.
At the same time, the problem of antimicrobial-resistant organisms and healthcare-associated infections has continued to grow and grow and grow. Last year, I wrote about publications in The Lancet that called for more urgent action against antimicrobial resistance and predicted millions and millions of deaths around the world, including in the U.S., if more isn’t done about this problem.
Then there’s the infectious disease problem that wasn’t a problem in 2000 but has become a problem in 2025 because of a big problem. The big problem is misinformation and disinformation. That has resulted in drops in measles vaccine coverage. As a result, measles, which was declared eliminated from the U.S. in 2000, is no longer that. I have already written on Forbes.com about the measles outbreaks that have been occurring in Texas, New Mexico and other states and how measles can cause various long-term problem, including death, which is a really long-term problem.
