SACRAMENTO, the United States, April 18 (Xinhua) -- The abrupt downsizing of the U.S. Centers for Disease Control and Prevention (CDC) could be more than an internal shake-up, but a direct threat to the nation's health, according to a report of the Journal of the American Medical Association (JAMA) published online Friday.

On April 1, about 2,400 CDC employees received surprise emails telling them they had been terminated as part of the Department of Government Efficiency (DOGE) Workforce Optimization Initiative, according to the JAMA Medical News report.

"It is hard to understand the reasoning here," said David Fleming in the report. He chairs the advisory committee to the CDC director and previously served as acting CDC director in 2002.

Fleming compared the situation to a game of Jenga, where players remove blocks until a tower collapses. "It's not about efficiency, it's not about eliminating waste," he said. "Instead, it is resulting in a federal agency that is not going to be able to function effectively."

The cuts have eliminated or severely reduced programs addressing HIV prevention, occupational safety, cancer clusters, asthma, tobacco use, violence prevention, lead poisoning, reproductive health, global health threats, birth defects, and disability prevention.

John Brooks, a former epidemiologist who retired from the CDC last year, expressed concern about cuts to HIV prevention efforts. Only half of the CDC's Division of HIV Prevention branches remain fully staffed, threatening progress on U.S. President Donald Trump's initiative to end the HIV epidemic by 2030.

"I think that Secretary Kennedy is sabotaging the president's initiative to end America's HIV epidemic," Brooks said, referring to the U.S. Health and Human Services Secretary Robert F. Kennedy, Jr.

The cuts also devastated state and local health departments that rely on CDC funding. In Minnesota, the health department had to lay off 170 employees after promised CDC grants were canceled.

In Minnesota, for example, the cuts would affect the state's ability to respond to measles and bird flu outbreaks, conduct wastewater surveillance, and operate the public health laboratory and vaccine clinics, said the state's health commissioner Brooke Cunningham.

Communication between the CDC and state health departments has virtually ceased, leaving local officials in the dark about potential outbreaks.

"It is not hyperbole to say I don't know if they're still there. I don't know if they're going to be allowed to talk to me if they are there," Cunningham said. "That has a real impact on public health preparedness in our country."

Public health expert Brian Castrucci predicted the nation will eventually restore CDC funding, but at a cost.

"We will fund public health again. The question is how many Americans have to die before we do it," he said in the report. "We will have a CDC again. There's just going to be a price." Enditem

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