An Open Letter to the Federal Employees Who Sustain the U.S. Health System
To the dedicated federal employees across the Centers for Disease Control and Prevention (CDC), Health Resources and Services Administration (HRSA), National Institutes of Health (NIH), Substance Abuse and Mental Health Services Administration (SAMHSA), Food and Drug Administration (FDA), and other critical public health agencies, including those who have been unjustly terminated or silenced:
On behalf of the International Association of Providers of AIDS Care (IAPAC) and the Fast-Track Cities Institute, I write to convey our deepest gratitude for your service and sacrifice. You are the lifeblood of the U.S. health system – epidemiologists, clinicians, researchers, program officers, policy advisors, and countless others who labor each day to prevent disease, protect communities, and advance health equity. The country owes you more than it has given in return. You are the unseen yet indispensable force that keeps our health system functioning and evolving, often in the face of adversity.
Your efforts have never been more vital or more visible. From monitoring the spread of SARS-CoV-2 to expediting the development and delivery of vaccines, including mRNA, your work saved lives. Through HRSA’s Ryan White HIV/AIDS Program and CDC’s HIV prevention efforts, you have helped drive progress toward ending the U.S. HIV epidemic. At the NIH, your research has deepened our understanding of HIV pathogenesis and accelerated the development of next-generation treatments and vaccines. SAMHSA’s integration of behavioral health into HIV services has transformed care for communities affected by both substance use and HIV. And the FDA’s rigorous oversight has ensured the safety and efficacy of antiretroviral drugs and PrEP innovations that are now standard of care.
We at IAPAC and the Fast-Track Cities Institute are proud to have partnered with many of you over the years, across agencies and disciplines, on initiatives that blend science with service. From amplifying Undetectable equals Untransmittable (U=U) as a life-affirming message to focusing on optimizing the HIV care continuum by strengthening syndemic responses that leverage clinical and behavioral science, our collective work has changed lives. These innovations are not abstract; they are made possible by your expertise, dedication, and the principled functioning of federal health institutions. You have helped ensure that our shared mission to accelerate health equity and improve outcomes for communities most affected by HIV is not just a vision, but a reality we are building together.
Yet today, many of you are being subjected to a campaign of disrespect, chaos, and politicization. Wrongful terminations, ideological censorship, and chronic underfunding threaten not only your livelihoods but also the health and safety of the nation. The politicization of science, erosion of trust, and devaluation of your labor are not isolated incidents – they are symptoms of a systemic crisis that undermines the integrity of our public health infrastructure. Many of you are also valued members of IAPAC, and your contributions to our association – as thought leaders, educators, clinicians, and advocates – have been instrumental in shaping our U.S. domestic and global HIV activities grounded in science, compassion, and equity.
To those of you who have been forced out or silenced, please know that your work was not in vain. The policies you shaped, the programs you implemented, the data you curated, and the innovations you helped bring to scale endure and will continue to serve as building blocks for future progress. You are not forgotten. We honor your service and affirm our solidarity with you during this profoundly difficult period. Your knowledge, principles, and experience remain vital to the future of public health, and we will continue to advocate for your reinstatement, recognition, and rightful place in this essential U.S. federal government workforce.
To those who continue to serve under immense strain: We see you. You are holding the line against disease, inequity, and misinformation. The strength and resolve you bring to your work, often without thanks or recognition, is nothing short of heroic. You embody the ideals of public service and the promise of evidence-based policymaking. We will continue to stand beside you, amplify your voices, and advocate for the resources and protections you deserve. Your perseverance reminds us that the heart of public health beats strongest in those who refuse to be silenced or sidelined, even when the path forward is steep.
The United States has long been a beacon of scientific excellence and innovation, particularly in HIV and public health. But these gains are fragile. They require an infrastructure grounded in science, protected by law, and supported by sustained investment. We call on elected leaders to reject the dismantling of our public health institutions, reinstate those who have been wrongfully removed, and recommit to the principles of integrity, equity, and accountability. We also call on our peers in health, academia, and civil society to raise their voices in defense of public health workers and institutions. If we allow this erosion to continue unchecked, we will all bear the consequences – not just in loss of talent, but in lives needlessly lost.
To every federal health employee, past and present, who has helped to advance the HIV response, safeguarded public health, and uphold the highest standards of service: Thank You. We value you, we support you, and we will fight alongside you to protect and preserve the institutions that make health, dignity, and justice possible.
With deep respect, unwavering solidarity, and unequivocal resolve,
Dr. José M. Zuniga, President/CEO, @IAPAC and @FTC2030
