Public Health Infrastructure in Crisis: Report Highlights Severe Federal Cuts

Trust for America's Health (TFAH), a valued partner of ASPPH's, has released its 2025 annual report on federal public health funding. The report focuses on the scale, scope, and potential impacts of federal actions on the public health system. It tallies and analyzes the changes (current and proposed) to CDC and other select HHS agencies due to their central role in supporting public health programs and crisis response nationally and at the state and local levels.

Among the report's findings are:

• The President's proposed FY 2026 budget for the Centers for Disease Control and Prevention (CDC) amounts to a 53 percent reduction in funding as compared to FY 2024. This figure reflects proposed cuts to CDC and its sister agency, the Agency for Toxic Substances and Disease Registry (ATSDR). These reductions are pending Congressional action.
• Within the total proposed cut, CDC's Public Health Emergency Preparedness program - the primary source of federal funding for state and local emergency preparedness - faces a 52 percent funding reduction.
• Overall, the proposed budget cuts CDC and ATSDR funding by slightly more than half and then restores about one-quarter of the lost funding to two newly proposed U.S. Department of Health and Human Services (HHS) divisions: the Administration for a Healthy America and the Office of Strategy.
• Over 100 public health programs and funding lines would be eliminated under the President's proposed FY 2026 budget, including 61 programs at CDC and 40 programs at the Substance Abuse and Mental Health Services Administration.
• The proposed reorganization of HHS agencies would reduce the number of staff positions working on public health programs by 16 percent, even when accounting for the creation of the proposed Administration for a Healthy America.
• This year's termination of already-approved funds clawed back over $12 billion in COVID-19 era grants - funding that in addition to supporting the pandemic response was intended to strengthen public health infrastructure beyond the pandemic, including infectious disease monitoring and laboratory capacity.

Included in the report are interviews with two public health officials, Dr. Scott Harris, State Health Officer of Alabama and President of the Association of State and Territorial Health Officials, and Dr. Katherine Wells, Director of Public Health of Lubbock, Texas, describing the on-the-ground impacts and challenges created by the recent and proposed federal actions.

The report also acknowledges that the public health system has room for improvement. It needs to be modernized and strengthened to meet ongoing and emerging population health challenges. The report calls for collaboration between the administration, Congress, and public health leaders to strengthen the system through data-driven actions.

Some of the report's policy recommendations include:

• Congress and the administration should restore federal health agencies, funding, and workforces that were cut in 2025.
• The administration and Congress should maintain and strengthen the structure and capabilities of federal health agencies, which have specific, complementary, and distinct roles and expertise in protecting the nation's health.
• Congress, in collaboration with federal agencies and outside experts and partners, should lead a bipartisan, deliberative process of reviewing proposals for federal health agency restructuring or development of new agencies.
• Congress and the administration should strengthen CDC as a national, comprehensive public health agency with responsibilities across the detection, prevention, and mitigation of the leading causes of preventable death, illness, and injury.
• Congress should ensure continuous improvement of the nation's public health capabilities and essential services, including workforces, laboratories, and data systems at all levels.

ASPPH shares TFAH's call for renewed investment in the nation's public health infrastructure and remains steadfast in advocating for policies that protect and promote the health of all communities. Through collaboration with members, partners, and policymakers, ASPPH continues to champion a modern, well-resourced public health system capable of responding to today's challenges and building resilience for the future.