Cruel, Misguided, Remediable:

Reckoning with the Attack on America’s Public Health Institutions

Statement by Dr. José M. Zuniga

President/CEO, IAPAC

April 2, 2025 ▪ Washington, DC

There are moments when words fail us – when no adjective seems sufficient to capture the depth of destruction, the scale of harm, or the recklessness of decisions made under the banner of governance. While devastating might be apt, it feels hollow in the face of what has occurred. Three other adjectives rise to the surface: cruel, misguided, and remediable, and it is through these words that we begin to confront the scale of what has happened and envision a path forward.

What we are witnessing in the decimation of the CDC, FDA, and NIH is cruel. There is no other way to describe the targeted degradation of agencies whose sole mission is to protect and improve the health and well-being of the American people. What has transpired is not a passive neglect, but an active, calculated undermining of public trust, professional autonomy, and institutional capacity.

The CDC, once regarded as the gold standard for epidemiological surveillance and infectious disease response, has been hollowed out. Experts have been silenced, data manipulated, and the authority of science subordinated to political expediency. This cruelty is not abstract. It will translate into delayed responses to outbreaks, poor coordination during national health emergencies, and vulnerable communities left without credible guidance or resources.

The FDA, the guardian of drug and food safety, has not been spared. Political interference in the agency’s regulatory process will shake public confidence in the safety of life-saving medications and vaccines. This erosion of credibility is not without consequence. It breeds skepticism, fuels misinformation, and endangers lives. Americans depend on the FDA to ensure that what they ingest or inject is safe and effective. Undermining that faith is a cruel betrayal.

The NIH, the engine of biomedical innovation, has seen its scientific agenda distorted by ideological constraints. Research initiatives have been shuttered, funding weaponized, and entire areas of inquiry, particularly those addressing sexual health, gender identity, and racial health disparities, have been delegitimized. This is not just a loss for scientists. It is a loss for patients, for families waiting on the promise of medical breakthroughs, for communities striving to close health gaps that have persisted for generations.

The cruelty lies in the consequences: children who go unvaccinated, HIV services disrupted, communities left without accurate health data, researchers who flee public service, and a nation increasingly ill-equipped to face future health crises. This cruelty is neither accidental nor collateral. It is structural and, in many cases, deliberate.

The idea that weakening America’s public health institutions somehow makes the country stronger is not only wrong – it is both misguided and dangerously delusional. These attacks are rooted in a false narrative that frames public health as a threat to individual liberty rather than a cornerstone of national security. This ideological shift leaves the country exposed, fractured, and fundamentally unprepared for any public health crisis or emergency.

Public health is not partisan. It is pragmatic. It is preventative. And it is cost-effective. Every dollar invested in disease surveillance, preventive care, and health education saves lives and reduces long-term health expenditures. The misguided efforts to shrink, politicize, or privatize our public health infrastructure do not liberate Americans. These efforts endanger them.

The undermining of HHS agencies reflects a deep misunderstanding of their purpose. These institutions are not meant to serve any political ideology. They are meant to serve the people – all people. When public health becomes politicized, truth becomes optional, and science becomes suspect. This has real-world consequences, from declining vaccination rates to increased maternal mortality, from delayed cancer screenings to avoidable mental health crises.

Moreover, these misguided actions ignore the interconnectedness of modern health threats. Pandemics, environmental health risks, antimicrobial resistance, and chronic disease burdens do not respect state lines or ideological divisions. They require a coordinated federal response grounded in science and equity. Weakening that response capacity does not make America freer. It makes it more vulnerable – economically, socially, and existentially.

For all that has been lost, not all is lost. Damage can be repaired. Institutions can be rebuilt. Public trust can be restored, but only if we act swiftly and with moral clarity. Congress has both the authority and the responsibility to demand accountability and chart a course of redress. This begins with oversight – robust, non-performative oversight that examines how and why decisions were made to weaken our public health infrastructure. Who benefited? Who was harmed? What systems were corrupted or dismantled, and to what end? Transparency must be the first step toward justice.

But accountability is not enough. Restoration must follow. This means reinvesting in the people and systems that make public health possible. Rebuilding scientific integrity within HHS agencies requires legal protection for whistleblowers and career scientists. It demands a recommitment to data transparency and non-interference in regulatory processes. It also means funding. Not just emergency appropriations, but sustained, predictable funding that allows for long-term planning, talent retention, and innovation.

Congress must also engage the public. Health equity and public trust go hand in hand. Communities need to see themselves reflected in the priorities and personnel of our health agencies. They need culturally competent care, linguistically accessible communication, and policies that account for structural barriers to health.

This work is difficult, but it is not impossible. America has rebuilt before – after Watergate, after Katrina, after the 2008 financial crisis, after COVID-19. We have learned, painfully and repeatedly, that ignoring dysfunction only deepens it. The same lessons apply here. What has been broken can be repaired, but only if we resist the temptation to normalize the current situation. We must reject cruelty as governance. We must name misguided policies for what they are. And we must embrace the responsibility to remediate… to do the hard work of rebuilding in service of a healthier, safer, and more equitable nation.

The choice before us is stark. We can accept the dismantling of science, the erosion of trust, and the politicization of health. Or we can fight for institutions that live up to their mandate: to protect the health and dignity of every person in this country. The latter will take courage, leadership, and vision. But it is not just possible. It is necessary.

#  #  #

About IAPAC: IAPAC represents more than 30,000 clinicians globally committed to ending AIDS as a public health threat.