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Former Director of USAID: Millions Will Die Because of Musk’s Chainsaw

By dianeravitch
April 9, 2025 //
2

This important article appeared on the blog called “Inside Medicine,” which appears on Substack. It describes the terrible consequences of Elon Musk’s decision to eliminate USAID. Many of us are still wondering how he got the authority to dismantle an agency authorized and funded by Congress. Many of us wonder why the Republicans in Congress ceded their Constitutional powers to this one man.

Musk said merrily that he was “feeding it to the woodchipper.” He strutted onstage at a Trump rally, waving a bejeweled chainsaw to flaunt his power. What a cruel and callous man he is. How little he cares about human life. He tells us we must procreate (I think he means whites), yet he is completely uncaring about the people who will die because he cut off medical services, medicine, and food to those in need.

Inside Medicine is written by Dr. Jeremy Faust, MD, MS, a practicing emergency physician, a public health researcher, writer, spouse, and girl Dad. He blends his frontline clinical experience with original and incisive analyses of emerging data to help readers make sense of complicated and important issues. Thanks for supporting it!

This past week, Dr. Atul Gawande briefed US Senators on the effects that the destruction of USAID is already having. Here are the facts we need to know. 

Over the last couple of months, the Inside Medicine community has been fortunate to hear and learn about USAID directly from Dr. Atul Gawande. 

Today, I’m sharing the first public release of Dr. Gawande’s latest update provided to members of the United States Senate, remarks that were delivered in person in Washington, D.C. last week. 

This is essential and up-to-date information that we all need to know. When people ask what the human costs of this administration’s brazen actions have been, we must respond with facts. Well, here they are…

First, a quick reminder: Inside Medicine is 100% supported by reader upgrades.

Thank you!👇

(And, as always, if you can’t upgrade due to financial considerations, just email me and it’s all good). 

Do you have any idea where things stand with USAID? With everything else going on, I realized that even I needed an update. So, I again reached out to our friend Dr. Atul Gawande, who, until noon on January 20, 2025, ran global health for USAID.

Here’s where things stand: While the Supreme Court ruled last month that the Trump administration still has to pay its bills for work already completed by USAID contractors, that was not exactly a high bar to clear—and even that decision was a narrow 5-4 ruling. Meanwhile, all of the contract terminations and personnel purges have been permitted to go through while the overall issues are litigated. Therefore, the reality is that even if the courts eventually determine that the complete gutting of USAID was not lawful, it will already be a fait accompli—that is, practically impossible to reverse. 

So, what of USAID’s crucial work remains, and what has—in Elon Musk’s own words—already been ‘fed to the wood chipper’? In testimony to members of the US Senate this past week, Dr. Gawande summarized what has already been destroyed by callous and brutal DOGE-directed terminations since January. We are only just beginning to be able to estimate the number of deaths these cuts will cause in the coming months and years, but unless something changes, it will surely amount to millions of human lives lost. A particularly depressing aspect is that these are senseless deaths (not to mention other suffering from disease and poverty), without reasonable or accurate justifications, as Dr. Gawande explicitly delineated in his presentation. 

I’m grateful that Atul has provided his remarks for publication here in Inside Medicine. Please read his words and share them. 

Senate Roundtable on The Dangerous Consequences of Funding Cuts to U.S. Global Health Programs.

Tuesday, April 1 from 2:30-3:30PM. U.S. Senate Visitors’ Center, Room 200/201.

Testimony of Atul Gawande, MD, MPH:

I was the Assistant Administrator for Global Health at USAID during the last administration. It was the best job in medicine most people haven’t heard of. I led 800 health staff in headquarters working alongside more than 1600 staff in 65-plus countries. With less than half the budget of my Boston hospital system – about $9 per U.S. household – they saved lives by the millions and contained disease threats everywhere.

Before my departure on January 20, I briefed this committee about several major opportunities ahead for the next few years. Among them were three breakthroughs. The journal Science had just declared one of them the scientific breakthrough of 2024. American scientists had developed a drug called Lenacapavir that could prevent or treat HIV with a single injection that lasted six months and perhaps even a year. Deploying this game-changer in high-risk communities through PEPFAR could finally bring an end to HIV as a devastating public health threat.

Similarly, USAID launched a trial of a four-dose pill that could prevent tuberculosis in exposed individuals and dramatically reduce cases – while three TB vaccines complete testing.

And USAID was just about to scale up a novel, inexpensive package of existing drugs and treatments that was found to reduce severe hemorrhage after childbirth – the leading cause of maternal death – by 60%.

American companies, nonprofits, and scientists played key roles in these breakthroughs, and they were poised to transform global health over the next five to ten years. The next administration had no reason not to pursue these objectives. Congress had already funded them. There was nothing partisan about them at all.

But instead of saving millions of lives, we got surgery with a chainsaw. The new administration not only shuttered this work, they fired the staff of the entire agency, terminated 86% of its programs, and kneecapped the rest – all against Congressional directives. They dismantled the US’s largest civilian force advancing global stability, peace, economic growth, and survival. And they have done it in a way maximized loss of life and mismanagement of taxpayer dollars.

Here are few specific examples of the global health damage:

● Our 50-country network for stronger surveillance to deadly diseases from bird flu to swine fever – gone.

● Our emergency response system that cut response times to global outbreaks from >2 weeks to <48 hours – gone.

● AIDS programs to prevent new cases of HIV in high-risk populations – gone.

● Programs for preventing child and maternal deaths that reached 93 million women and children under 5 in 2023 and added 6 years of life on average – cut 92%.

● Lifesaving tuberculosis programs – cut 56%.

● Lifesaving water and sanitation programs – cut 86%.

● Funding for Gavi, the global vaccine alliance, which was set to vaccinate half a billion children — terminated and, if not restored, will cost 500,000 lives a year and drive higher exposure to measles in the US.

The damage is already devastating. And it is all part of a larger dismantling of America’s world-leading capacity for scientific discovery, health care delivery, and public health that goes well beyond USAID. They are using the same playbook to purge staff and destroy programs in across our entire domestic infrastructure in government, universities, and medical center. And they are inserting political controls on NIH science research, FDA approvals, and CDC guidance.

For the sake of power, they are destroying an enterprise that added more than 30 years to US life expectancy and made America the world leader in medical technology and innovation. We need you in Congress to stop this process. USAID cannot be restored to what it was. But we must salvage what we can of our health, science, and development infrastructure and stop the destruction.

Thank you, Dr. Gawande!

Categories Cruelty, Disruption, Ethics, Evil, Extremism, Funding, Health, International, Musk, Elon, Science, Trump

Washington Post: Trump and RFK Jr. Are Destroying Public Health Agencies

By dianeravitch
April 6, 2025 //
4

The Washington Post editorial board warned that Robert Kennedy’s deep cuts at the Department of Health and Human Services will damage the economy. They will also damage the nation’s health. Kennedy is not laying off paper-pushing bureaucrats. He is firing scientists and closing divisions working on drugs and cures for dangerous diseases and conditions.

The editorial board wrote:

The market took no time to weigh in on Robert F. Kennedy Jr.’s mass layoffs at the nation’s health agencies. As Health and Human Services employees arrived to work on Tuesday to discover their badges no longer worked, stock prices for health-care and biotech companies plunged. By the end of the day, the S&P’s index for the pharmaceutical industry had dropped 4 percent.

This should be a warning to the new HHS secretary and President Donald Trump: The employees of these institutions are as essential to the U.S. economy as they are to public health.

HHS officials have defended their planned 25 percent reduction in force (affecting about 20,000 employees) as a means to achieve efficiency. They claim it will save taxpayers about $1.8 billion annually. But this amount — minuscule relative to the multitrillion-dollar federal budget — could be wiped out by the economic damage that comes from discarding broad institutional knowledge.

The Food and Drug Administration, for instance, is slated to shed 3,500 staffers, or about 19 percent of its workforce. Among those who received layoff notices on Tuesday were many experts who assist with reviews at the Office of New Drugs. The director of this office, Peter Stein, resigned after being reassigned to patient affairs. Other top leaders have also been pushed out, including Hilary Marston, the FDA’s chief medical officer, and Peter Marks, its highest-ranking vaccine scientist.

HHS insists these layoffs will not weaken the agency’s core functions, especially drug approvals — but given how many high-level positions now sit vacant, this is hard to believe. Scott Gottlieb, who was FDA commissioner during Trump’s first term, said on X that the “barrage” threatens to bring “frustrating delays for American consumers, particularly affecting rare diseases and areas of significant unmet medical need.”

The National Institutes of Health, a sturdy engine of biomedical innovation, also saw many of its leaders defenestrated. Directors of at least four of the 27 institutes that make up the agency were removed from their posts, including Jeanne Marrazzo, the country’s most senior infectious-diseases official.

Meanwhile, hundreds of other layoffs at the agency’s research centers threaten to diminish its scientific prowess. The National Human Genome Research Institute, for one, which has made countless discoveries about the roles genes play in diseases, lost dozens of staffers as well as its acting chief, Vence L. Bonham Jr., who was installed just last month.

This turmoil comes amid the administration’s attempt to slash funding that NIH provides to outside research institutions. The administration seems not to care about U.S. investments in science that have been essential to building and maintaining a strong economy.

Equally concerning is what these layoffs could mean for public health. At the Centers for Disease Control and Prevention, which is set to lose 2,400 workers (an 18 percent reduction in staff), HHS cost-cutters have erased entire offices, including those dedicated to curbing HIV, tuberculosis, tobacco use, lead poisoning, substance abuse, birth defects and many other health threats. Kennedy — who also laid off many of the department’s communications staffers — has provided little rationale for any of these cuts. But if his goal is to save money, this is the wrong strategy. By keeping health-care costs down, public health programs often bring substantial returns on investment.

What makes these risky cuts especially baffling is that they’re being made only a few years after the covid-19 pandemic taught Americans about the need for a strong public health system, and amid the worst domestic measles outbreak in years. Bird flu also has begun spreading to humans — yet among those laid off were nearly all of the leading staffers at the FDA’s Center for Veterinary Medicine, which is assisting the government with its bird flu response.

It’s true that HHS’s vast bureaucracy has long needed serious — even radical — reforms to eliminate waste and make its agencies more effective. The CDC often acted clumsily during the pandemic and struggled to communicate effectively with the public. And although the FDA was streamlined during the Biden administration, it could use innovative ideas to energize its food division — perhaps by making it a stand-alone agency.

But the job cuts this week do not amount to efficient reform. The Trump administration has shown great skill at “moving fast and breaking things,” to borrow the motto used by chief bureaucracy-smasher Elon Musk. But Trump and Kennedy should remember, too, that when “you break it, you buy it.” The damage they do to the country’s public health and biomedical research infrastructure is their responsibility, and they will bear the political consequences.

Categories Accountability, Budget Cuts, Disruption, Extremism, Funding, Health, Science, Stupid, Trump

Immigrant Women in ICE Detention Endure “Hell on Earth”

By dianeravitch
April 4, 2025 //
3

Lauren Villagran of USA Today wrote about the inhumane conditions for women in an ICE detention center called Krome. Krome is one of about 130 such centers around the country. It is managed by a for-profit company called Akima Infrastructure Protection, which has a contract for $685 million. Given the horrible living conditions, DOGE and Musk might want to check out waste, fraud, and abuse. We taxpayers are paying a lot for such a tawdry facility.

Villagran writes.

Immigrant women say they were held “like animals” in ICE detention and subjected to conditions so extreme they feared for their lives.

Chained for hours on a prison bus without access to food, water or a toilet. Told by guards to urinate on the floor. Held “like sardines in a jar,” as many as 27 women in a small holding cell. Sleeping on a concrete floor. Getting one three-minute shower over three or four days in custody.

“We smelled worse than animals,” one detainee said. “More girls were coming every day. We were screaming, begging them, ‘You can’t let them come.’ They didn’t have space.”

Four women were held in February at the Krome North Processing Center in Miami – a detention center reserved for men. U.S. Immigration and Customs Enforcement took the women into custody on alleged immigration violations, but none has a criminal background, according to a review of law enforcement records. They shared their experiences with USA TODAY on condition of anonymity, fearing retaliation by the government because they are still detained.

The allegations come after two men at Krome died in custody on Jan. 23 and Feb. 20.

USA TODAY provided ICE and its parent agency, the Department of Homeland Security, with a detailed list of the allegations on March 11. A day after publication, on March 24, an ICE spokesperson responded with an emailed statement saying the agency can’t substantiate specific allegations without the names of the individuals.

“ICE takes its commitment to promoting safe, secure, humane environments for those in our custody very seriously,” the statement said. “These allegations are not in keeping with ICE policies, practices and standards of care.”

The government’s own investigators have repeatedly found serious problems in immigration detention centers around the country. The problems have persisted through Democrat and Republican administrations and range from fatal medical neglect to improper use of force.

Last year, a report on unannounced inspections at 17 detention centers from 2020 to 2023 – bridging the Trump and Biden administrations – found that “regardless of time, location, detainee population and facility type, ICE and facility staff have struggled to comply with aspects of detention standards.”

But the women’s allegations at Krome, which was one of the 17 centers reviewed in the report, suggest detention conditions have deteriorated rapidly as the new Trump administration works to deliver on the president’s promises for tougher immigration enforcement.

ICE reported holding 46,269 people in custody in mid-March, well above the agency’s detention capacity of 41,500 beds. Immigration detention is “non-punitive,” according to ICE policy, in recognition that most immigration violations are civil, not criminal.

Mich González, an immigration attorney representing the family of the Ukrainian man who died Feb. 20 in Krome custody, visits the facility regularly to meet with clients. The guards there “are overwhelmed,” he said.

“Guards themselves have made those comments to us: ‘It shouldn’t be like this,'” said González, founding partner of Sanctuary of the South.

The shift from a “flexible” immigration policy to a “very aggressive” one means “the system simply can’t process all of these people,” said Miami-based immigration attorney Nenad Milosevic.

Krome is overwhelmed and understaffed, he said. “I know the conditions are extremely bad, and they’re not supposed to be that way.”

‘He didn’t want to scare me more’

One of the four women wanted to explain what she went through to her fiance. She wrote what she remembered on paper and titled it “Hell on Earth.”

She dialed out on a scratchy phone line and asked him to record her as she read from her notes.

“The officer only say that I am going to spend the night in Miami,” she said, using the English she learned during nearly two decades in the United States. “Now remembering his face, like I knew he knew that I am going to go through hell and he didn’t want to scare me more.”

This account is based on that 15-minute audio recording detailing the alleged mistreatment, as well as numerous telephone and video interviews with the woman and her fiance and with three other detained women, their family members and attorneys, as well as the two attorneys who independently witnessed the deteriorating conditions.

All four women described being chained at the wrist, waist and chest and loaded onto a prison bus, where they were held, in one case, for six hours; in another, for 11 or 12 hours.

“They took us to a bigger bus,” the woman said in the audio recording. “They checked us, and then they put like chains on us, hands to waist, connected. It was very scary because they chained my chest super-tight and I couldn’t breathe properly. I was really scared because I thought, ‘I’m not going to be able to breathe.'”

There was no access to a toilet, so guards told the women – whose accounts in some cases occurred on different days or different buses – to urinate or defecate on the floor. They watched, helpless, as some did.

“A man in the back of the bus – we were separated with a door – he was screaming, ‘Somebody wants a bathroom,'” the woman said in the audio. “And somebody peed there. It stank so badly.”

She described her first impression of Krome as “a really chaotic-looking place.” Guards rushed the women through a corridor, past the male dormitories where men pressed their faces to the glass, “wildly staring … like they had never seen women before.”

“We were pushed in a room, filled with women, like sardines in a jar,” she said. “I will never forget those first seconds when I heard the door behind me locked.”

Open the link to continue reading.

Categories Accountability, Cruelty, Ethics, Extremism, Health, Immigration

Chicago: Teachers Union Wins Landmark Agreement with School Board

By dianeravitch
April 2, 2025 //
4

After nearly a year of bargaining, the Chicago Teachers Union reached a landmark agreement with the City of Chicago and the school board. Karen Lewis, the late President of the Chicago Teachers, was a champion for the city’s children, their teachers, and the public schools. She must be smiling in heaven to see what the CTU has accomplished.

The CTU announced:

Chicago Teachers Union

NEWS ADVISORY: 
For Immediate Release

April 2, 2025

CONTACT:312-329-9100
Communications@ctulocal1.org

CTU to Hold Press Conference to Announce Results of Special House of Delegates Meeting

Union to announce results of next step to transform Chicago Public Schools after the 60+ rank and file members of the Big Bargaining Team sent tentative agreement to the House of Delegate members for approval.

What: Press conference announcing results of House of Delegates vote

Where: Chicago Teachers Union, 1901 W Carroll Ave; enter through the East entrance off Wolcott; parking will be available for camera trucks in the South lot (on Fulton)

When: Immediately following House of Delegates meeting (Meeting starts at 4:45pm and we will alert press once the media is adjourned)

Who: CTU officers, big bargaining team members, and elected delegates

In the next step toward ratifying a contract that represents a major leap forward in the process of transforming Chicago Public Schools started by CTU in 2012, the union will hold a special House of Delegates meeting on Wednesday, April 2nd. At the meeting, the elected delegates of the union will vote on whether or not the tentative agreement landed by the 60 rank and file members of the Big Bargaining Team shall be sent to the full membership for a vote as early as next week.

The union will hold a press conference immediately following the meeting to announce whether the tentative agreement that creates smaller class sizes, a historic investment in sports, grants recess students were being denied, and enshrines protections for Black history and academic freedom – among more than 150 other items – is going to a full membership vote or back to the bargaining table for improvements.

BACKGROUND

After more than eleven months of bargaining, working without a contract throughout the entire school year, and for the first time in more than 15 years of doing so without a strike or strike vote, the Chicago Teachers Union announced their big bargaining team made up of rank and file members approved a tentative agreement with Chicago Public Schools.

The tentative agreement will go to CTU’s House of Delegates Wednesday which will decide whether or not to advance it to CTU’s 30,000 members for a ratification vote. If accepted, it will represent a major leap forward in the transformation of a district that is still recovering from the gutting and financial irresponsibility carried out by Trump’s Project 2025 style efforts under Rahm Emanuel, Arne Duncan, Paul Vallas, and other privatization forces that closed over 200 public schools between 2002 and 2018.

Despite the efforts of right wing actors like Paul Vallas, The Liberty Justice Center, and Illinois Policy Institute, and the MAGA forces that seek to deny the investments Chicago’s students deserve, this proposed contract builds upon the past several contracts won by CTU in 2012, 2016, and 2019. It charts a new direction of investment, expansion of sustainable community and dual language schools, increased staffing, and a focus on reparatory equity to provide the educational experience Chicago students deserve no matter what neighborhood they live in.

The 2012 strike won the air conditioning that kept CPS open during the back-to-school heatwave at the beginning of the school year. 2016 established the model of 20 sustainable community schools, a program that helped to stabilize and resource schools like Dyett High School whose boy’s basketball team won the state championship this year. 2019 won social workers and nurses in every school and established the sanctuary status that protected CPS students from Trump’s federal agents earlier this year.

In 2025, some highlights of the Chicago Teachers Union contract include:

  • Doubles the number of libraries and librarians for our schools
  • Enforceable and smaller class sizes for all grade levels
  • Ensuring social workers and nurses serve students in every school, every instructional day
  • Doubles the bilingual education staffing supports for students 
  • Additional staffing, curricular and enrollment supports for Early Childhood education students and programs. 
  • Creates 215 more case manager positions district-wide to support students with disabilities. 
  • A cost of living adjustment of 17-20% compounded (tied to inflation) over the four years of the contract
  • Provide new steps that compensate veteran educators for their experience
  • Increases in prep time for clinicians, elementary and special education teachers so students arrive to classrooms ready for them
  • Expanded benefits for dental, vision, infertility and abortion care, gender-affirming care, hearing aids, speech therapy, physical therapy, occupational therapy, chiropractic services
  • A more than tripling of the number of Sustainable Community Schools, from 20 to 70, over the course of the agreement. 
  • Provides CTU, CPS, City and sister agency coordination for the first time to provide housing support, section 8 vouchers, rental assistance and affordable units to CPS families in need. 
  • Enshrines 12 weeks paid parental leave, equal parental, personal illness, and supplemental leave rights for PSRPs to teachers
  • A Green Schools initiation of additional resources and collaboration to remediate lead, asbestos and mold in aging school buildings while upgrading to green energy with environmentally sustainable technology, materials and practices. 
  • Protections for academic freedom, Black history, and culturally relevant curriculum for the first time in the contract. 
  • An additional $10 million annual investment in sports programming
  • Protections for academic freedom that enshrine educators’ ability to teach Black, indigenous, and other history
  • Continuation of Sanctuary School procedures
  • A new article that creates LGBTQIA+ safe schools

See the full list of tentative agreements at https://www.ctulocal1.org/movement/contract-2024.

“Our union is bargaining for what every parent wants for their child in our school communities. It shouldn’t be a fight for children to get access to arts, sports, wrap around supports, and libraries. It’s what should already exist,” explains CTU Local 1 President Stacy Davis Gates. “We’re proud to have landed a transformative contract that turns away from decades of disinvesting in Black children and turns toward creating the world-class education system for every single student in CPS no matter their zip code. If the contract is ratified by our members, we will be one major leap forward toward the educational experience Chicago’s children and the mainly women workers who serve them in our schools deserve.”

Additional Information:

###

The Chicago Teachers Union represents nearly 30,000 teachers and educational support personnel working in schools funded by City of Chicago School District 299, and by extension, more than 300,000 students and families they serve. The CTU is an affiliate of the American Federation of Teachers and the Illinois Federation of Teachers and is the third-largest teachers local in the United States. For more information, please visit the CTU website at www.ctulocal1.org.

Categories Chicago, Class size, Closing schools, Community Schools, Courage, Democracy, Early Childhood Education, Equity, Freedom to Learn, Freedom to Read, Funding, Health, Justice, Students, Supporting public schools, Teacher Tenure, Teachers, Turnaround Schools, U.S. Department of Education, Union

DOGE Creates Chaos and Fear at HHS

By dianeravitch
April 1, 2025 //
3

Government Executive reports that the Secretary Of Health and Human Services Robert F. Kennedy Jr. plans to lay off 10,000 of the Department’s 80,000 employeees. Entire divisions will be eliminated or merged. But no one knows who will be laid off. Decisions about layoffs are being made by Elon Musk’s DOGE. Since no one knows who will be fired or why, everyone is fearful.

Government Executive writes:

The Health and Human Services Department has told its employees that 10,000 of them will soon receive layoff notices, though it has not offered any details on who will be impacted or when they will learn of their fates. 

The uncertainty has dangled over the more than 80,000 HHS employees since Thursday, when the department first announced it was planning to shed around 25% of its workforce and half of those eliminations would come through reductions in force. Leadership at individual components and offices are regularly seeking to update their employees on what is happening, according to seven individuals within HHS, though they have all said they have been fully kept out of the loop and only a small group of political leaders within HHS know the plans.

The Food and Drug Administration is expected to lay off 3,500 employees, the Centers for Disease Control and Prevention 2,400, the National Institutes of Health 1,200 and the Centers for Medicare and Medicaid Services 300, according to an HHS fact sheet. HHS did not respond to an inquiry into why the notices were delayed or when they would go out.

Several employees were told to expect RIF notices to hit inboxes on Friday. When that did not happen, they were told to expect them Friday evening or over the weekend. As of Monday afternoon, the notices have still not gone out. 

“FDA leadership doesn’t know who will be cut,” said an employee briefed on the matter. “They didn’t have any input into these cuts whatsoever.” 

Employees at CDC and NIH expressed similar messages were going out from leadership to the workforce. 

“It’s unnecessarily cruel,” said one CDC employee of the uncertainty and delays. 

A second CDC employee said they spent the entire weekend refreshing their email waiting to see if a RIF notice arrived. The employee was resigned to their fate, but wanted an answer: “Just put me out of my misery,” the staffer said. 

Prior to an “all hands” meeting at one NIH office, employees were encouraged to download their complete personnel files, current position description, pay stubs, tax documents, awards information and contact information for human resources and their supervisor in case they lost access upon being laid off. 

The department will not allow those who are subject to RIFs to be allowed back onto HHS campuses, according to two employees briefed on the matter. Some staff were told to bring their laptops homes each day in case they were laid off and not allowed back into their offices. Unlike other agencies that have gone through RIFs, which have immediately placed impacted staff on administrative leave, at least some HHS employees will be expected to work until their date of separation. 

At FDA, conversations with office directors were taking place to identify U.S. Public Health Service Commission Corps members who could escort laid off employees to their desks to collect their laptops and personal belongings. The uniformed personnel would be available for the RIF-affected staff who need to retrieve items on campus.

The RIFs are expected to take effect May 27, according to the National Treasury Employees Union, which represents much of the HHS workforce. That date could get pushed back given the delay in sending out official RIF letters, however, as agencies typically provide 60 days notice before separations take effect. 

Directors at the highest level of the component agencies have communicated “have no knowledge over what is happening,” one employee said in a sentiment echoed by those throughout the department. 

A senior HHS official said even HR at component agencies have received no information on who is being laid off or when the notices were going out, though the latest expectation was the letters would be delivered Monday. 

“Radio silence,” the official said. “It is madness!” 

Government Executive previously reported that top officials were being left out of the workforce reduction process. At NIH, for example, liaisons from the Department of Government Efficiency dictated staffing targets without input from the agency or anyone else at HHS. 

Some informal notices were beginning to trickle out Monday afternoon. CDC is planning to eliminate its entire Freedom of Information Act office, according to an impacted employee, which could create legal questions as agencies are required to maintain those functions. The official notices had not yet gone out as of Monday afternoon but all of the office’s 40 employees are expected to receive them. 

The reductions will be part of a comprehensive reorganization of HHS. The cuts will save $2 billion annually, department Secretary Robert Kennedy said last week, and HHS will go from 28 divisions throughout the department down to 15. Department-wide functions such as human resources, IT, procurement, external affairs and policy will be centralized into the Administration for Healthy America and regional offices will be slashed in half to just five.

The new AHA will fold into its structure the Substance Abuse and Mental Health Services Administration, Agency for Toxic Substances and Disease Registry and National Institute for Occupational Safety and Health. HHS will divide up the functions of the Administration for Community Living, which provides oversight of those serving older and disabled Americans, into CMS, the Administration for Children and Families and the Assistant Secretary for Planning and Evaluation. ASPE itself will be combined with the Agency for Health Research and Quality into the Office of Strategy.

This hurried reorganization is being imposed by the young engineers and computer geeks who work for Musk, apparently without consulting anyone who has done the work. The changes are rushed, haphazard, and carried out without the participation of those with knowledge and experience.

Please open the link to continue reading the article.

Categories Accountability, Budget Cuts, Cruelty, Disruption, Evil, Extremism, Health, Musk, Elon, Science, Trump

How a Democrat Won as Governor in North Carolina

By dianeravitch
April 1, 2025 //
0

Thomas Mills writes a blog called PoliticsNC. In this post, he explains how a Democrat won the Governor’s race in North Carolina, which is now a red state. North Carolina used to be considered the most progressive state in the south, electing Democrats to state level offices and the General Assembly with regularity.

But in 2010, the Tea Party Republicans swept the state legislature. They gerrymandered the state so adeptly that Democrats had no chance to win control of the legislature again.

While the legislature has a Republican supermajority, the governorship has been captured by a Democrat in the last three elections: by Dr. Roy Cooper in 2016 and 2020, and by Josh Stein in 2024.

Governor Josh Stein

Political observers have long wondered about North Carolina’s split ticket voting. The state routinely elects Democrats to top statewide jobs like governor and attorney general while voting for Republicans for president and US Senate in the same election cycle. Josh Stein has won three elections, two for attorney general and one for governor, while Trump carried the state. His State of the State address offers insight into how Democrats win here. National Democrats should take notice. 

Stein delivered his address to the legislature on Wednesday night. At its core, the speech was people-oriented. He put the struggles of the state in human terms instead of political ones. He downplayed political divisions and his swipes at Republicans were muted. 

He led off with the recovery from Hurricane Helene, recognizing several families and business owners who are recovering from the disaster. He praised their resilience and the commitment of both individuals and community organizations like Baptists on Mission. He declared, “[T]he people who have been aiding folks out west don’t care a whit about the politics of the people they are helping.”

Stein never mentioned FEMA. His only reference to the federal response to the disaster was his declaration that he’s working with the Trump administration and Congress to get more money into the state. He kept the focus on the people who were most affected by the storm. His only political shot was urging the GOP led legislature to pass a bill giving $500 million more to disaster recovery. 

He moved from disaster recovery to job development. He leaned heavily into apprentice programs and community colleges. The focus was inherently working class. Stein said, “Folks should not have to get a bachelor’s degree to get a good-paying job and provide for their family.” He never mentioned the university system. 

Stein next shifted to child care and education. He highlighted the shortage and expense of child care in the state, calling for a task force to find “innovative solutions.” He called for family friendly tax cuts instead of reducing the corporate income tax. He called for raising teacher pay and pointed out that North Carolina is 48th in the nation in per pupil spending. He proposed a $4 billion bond to build more schools and fix existing ones.

He challenged the Republicans on their voucher program. While he didn’t focus on the vouchers themselves, he called out the tax breaks offered to wealthy families who receive voucher money and the unregulated schools that tax dollars support. He framed the debate in terms favorable to Democrats, looking for wins on accountability and shifting resources to working families instead of wealthy ones. 

Stein also built on one of his priorities as attorney general, combatting fentanyl. He highlighted the death of a young man and asked the legislature to fund a Fentanyl Control Unit. He’s getting on the right side of an issue that concerns much of rural North Carolina and setting up a challenge for Republicans if they rebuke his request. 

Stein stayed away from divisive cultural issues. He was inclusive in the broadest sense of the word. He focused on shared priorities that cross ethnic, racial, and gender lines. 

Stein’s overall tone was bipartisan or nonpartisan. He laid out priorities that are widely shared—Helene recovery efforts, creating jobs and developing our workforce, increasing access to child care, improving public education, combatting fentanyl deaths—while acknowledging we might differ in how to achieve these goals. He offered hope instead of pointing fingers. 

When Stein did pick fights, they were subtle and put Democrats on the side of working people —child care tax breaks for working families instead of the corporate tax cuts, raising teacher pay instead of subsidizing tuition of wealthy families. He brought a populist tone to his education and tax arguments. He made direct appeals to the working class voters that Democrats need to attract. 

Democrats across the country should take notice. Stein turned down the heat instead of inviting divisions. He gave very little red meat to the base, but stayed true to core Democratic values, like supporting public education and helping working families. While he set up subtle contrasts with Republicans in the legislature, he also celebrated bipartisan victories like Medicaid expansion. 

Stein gave a unifying speech, one that was hard for Republicans to attack. He laid down the foundation for working across party lines. He focused on solutions instead of problems. He set priorities that were largely noncontroversial. He made clear that he would be governor of the whole state, not just the leader of a party. He offered a sharp contrast to the divisive politics of Washington. That’s how Democrats win in a state like North Carolina.

Categories Education Reform, Health, North Carolina, Supporting public schools

CDC Downplays Importance of Vaccines, Reflecting Malign Influence of RFK Jr.

By dianeravitch
March 30, 2025 //
10

ProPublica reported that the Centers for Disease Control (CDC) recently watered down its advice about how to respond to the danger of measles. Pre-Trump and RFK Jr., the CDC was quick to warn the public about the importance of getting vaccinated, especially when there was an uptick in contagious diseases. Now, with vaccine critic RFK Jr. in charge of the Department of Health and Human Services of which the CDC is a part, the message has been muted. Now, getting vaccinated is a matter of personal choice, not a matter of public health.

Leaders at the Centers for Disease Control and Prevention ordered staff this week not to release their experts’ assessment that found the risk of catching measles is high in areas near outbreaks where vaccination rates are lagging, according to internal records reviewed by ProPublica.

In an aborted plan to roll out the news, the agency would have emphasized the importance of vaccinating people against the highly contagious and potentially deadly disease that has spread to 19 states, the records show.

A CDC spokesperson told ProPublica in a written statement that the agency decided against releasing the assessment “because it does not say anything that the public doesn’t already know.” She added that the CDC continues to recommend vaccines as “the best way to protect against measles.”

But what the nation’s top public health agency said next shows a shift in its long-standing messaging about vaccines, a sign that it may be falling in line under Health and Human Services Secretary Robert F. Kennedy Jr., a longtime critic of vaccines:

“The decision to vaccinate is a personal one,” the statement said, echoing a line from a column Kennedy wrote for the Fox News website. “People should consult with their healthcare provider to understand their options to get a vaccine and should be informed about the potential risks and benefits associated with vaccines.”

ProPublica shared the new CDC statement about personal choice and risk with Jennifer Nuzzo, director of the Pandemic Center at Brown University School of Public Health. To her, the shift in messaging, and the squelching of this routine announcement, is alarming.

“I’m a bit stunned by that language,” Nuzzo said. “No vaccine is without risk, but that makes it sound like it’s a very active coin toss of a decision. We’ve already had more cases of measles in 2025 than we had in 2024, and it’s spread to multiple states. It is not a coin toss at this point.”

For many years, the CDC hasn’t minced words on vaccines. It promoted them with confidence. One campaign was called “Get My Flu Shot.” The agency’s website told medical providers they play a critical role in helping parents choose vaccines for their children: “Instead of saying ‘What do you want to do about shots?,’ say ‘Your child needs three shots today.’”

Nuzzo wishes the CDC’s forecasters would put out more details of their data and evidence on the spread of measles, not less. “The growing scale and severity of this measles outbreak and the urgent need for more data to guide the response underscores why we need a fully staffed and functional CDC and more resources for state and local health departments,” she said.

Kennedy’s agency oversees the CDC and on Thursday announced it was poised to eliminate 2,400 jobs there.

Open the link to continue reading.

Measles is very serious. The World Health Organization estimated that 107,500 people--mostly unvaccinated children under the age of 5–died in 2023 from measles.

Categories Health, Science

Top Vaccine Official Resigns to Protest RFK Jr.’s “Lies and Misinformation”

By dianeravitch
March 29, 2025 //
8

Dr. Peter Marks, the leading vaccine expert at the Department of Health and Human Services resigned to protest Secretary Robert F. Kennedy Jr.’s persistent lies about the efficacy of vaccines. At his Senate hearings, Kennedy assured the committee that his days as a vaccine opponent were over. He lied.

The New York Times reported:

The Food and Drug Administration’s top vaccine official, Dr. Peter Marks, resigned under pressure Friday and said that Health Secretary Robert F. Kennedy Jr.’s aggressive stance on vaccines was irresponsible and posed a danger to the public.

“It has become clear that truth and transparency are not desired by the secretary, but rather he wishes subservient confirmation of his misinformation and lies,” Dr. Marks wrote to Sara Brenner, the agency’s acting commissioner. He reiterated the sentiments in an interview, saying: “This man doesn’t care about the truth. He cares about what is making him followers.”

Dr. Marks resigned after he was summoned to the Department of Health and Human Services Friday afternoon and told that he could either quit or be fired, according to a person familiar with the matter.

Dr. Marks led the agency’s Center for Biologics Evaluation and Research, which authorized and monitored the safety of vaccines and a wide array of other treatments, including cell and gene therapies. He was viewed as a steady hand by many during the Covid pandemic but had come under criticism for being overly generous to companies that sought approvals for therapies with mixed evidence of a benefit.

His continued oversight of the F.D.A.’s vaccine program clearly put him at odds with the new health secretary. Since Mr. Kennedy was sworn in on Feb. 13, he has issued a series of directives on vaccine policy that have signaled his willingness to unravel decades of vaccine safety policies. He has rattled people who fear he will use his powerful government authority to further his decades-long campaign of claiming that vaccines are singularly harmful, despite vast evidence of their role in saving millions of lives worldwide.

“Undermining confidence in well-established vaccines that have met the high standards for quality, safety and effectiveness that have been in place for decades at F.D.A. is irresponsible, detrimental to public health, and a clear danger to our nation’s health, safety and security,” Dr. Marks wrote.

Mr. Kennedy has, for example, promoted the value of vitamin A as a treatment during the major measles outbreak in Texas while downplaying the value of vaccines. He has installed an analyst with deep ties to the anti-vaccine movement to work on a study examining the long-debunked theory that vaccines are linked to autism.

And on Thursday, Mr. Kennedy said on NewsNation that he planned to create a vaccine injury agency within the Centers for Disease Control and Prevention. He said the effort was a priority for him and would help bring “gold-standard science” to the federal government.

An H.H.S. spokesman said in a statement Friday night that Dr. Marks had no place at the F.D.A. if he was not committed to transparency.

In his letter, Dr. Marks mentioned the deadly toll of measles in light of Mr. Kennedy’s tepid advice on the need for immunization during the outbreak among many unvaccinated people in Texas and other states.

Dr. Marks wrote that measles, “which killed more than 100,000 unvaccinated children last year in Africa and Asia,” because of complications, “had been eliminated from our shores” through the widespread availability of vaccines.

Dr. Marks added that he had been willing to address Mr. Kennedy’s concerns about vaccine safety and transparency with public meetings and by working with the National Academies of Sciences, Engineering and Medicine, but was rebuffed.

With the outbreak of measles in several states, Kennedy’s refusal to advocate immunization is a danger to public health. Only someone as dumb or malevolent as Trump could put a conspiracy theorist and vaccine opponent in charge of public health.

Categories Accountability, Ethics, Extremism, Health, Science

Trump Administration Cuts Funding for Vaccines for World’s Poorest Nations

By dianeravitch
March 27, 2025 //
3

The cruelty and sheer meanness of the Trump administration can never be overestimated. As the administration closes down USAID, without Congressional authorization, it announced a series of cuts that will kill millions of people. Having an ardent opponent of vaccines in charge of Heakth and Human Services removes any advocacy to distribute proven methods to save lives and prevent epidemics.

Stephanie Nolen of The New York Times reported:

The Trump administration intends to terminate the United States’ financial support for Gavi, the organization that has helped purchase critical vaccines for children in developing countries, saving millions of lives over the past quarter century, and to significantly scale back support for efforts to combat malaria, one of the biggest killers globally.

The administration has decided to continue some key grants for medications to treat H.I.V. and tuberculosis, and food aid to countries facing civil wars and natural disasters.

Those decisions are included in a 281-page spreadsheet that the United States Agency for International Development sent to Congress Monday night, listing the foreign aid projects it plans to continue and to terminate. The New York Times obtained a copy of the spreadsheet and other documents describing the plans.

The documents provide a sweeping overview of the extraordinary scale of the administration’s retreat from a half-century-long effort to present the United States to the developing world as a compassionate ally and to lead the fight against infectious diseases that kill millions of people annually.

The cover letter details the skeletal remains of U.S.A.I.D. after the cuts, with most of its funding eliminated, and only 869 of more than 6,000 employees still on active duty.

In all, the administration has decided to continue 898 U.S.A.I.D. awards and to end 5,341, the letter says. It says the remaining programs are worth up to $78 billion. But only $8.3 billion of that is unobligated funds — money still available to disburse. Because that amount covers awards that run several years into the future, the figure suggests a massive reduction in the $40 billion that U.S.A.I.D. used to spend annually.

A spokesperson for the State Department, which now runs what is left of U.S.A.I.D., confirmed the terminations on the list were accurate and said that “each award terminated was reviewed individually for alignment with agency and administration priorities, and terminations were executed where Secretary Rubio determined the award was inconsistent with the national interest or agency policy priorities.”

The memo to Congress presents the plan for foreign assistance as a unilateral decision. However because spending on individual health programs such as H.I.V. or vaccination is congressionally allocated, it is not clear that the administration has legal power to end those programs. This issue is currently being litigated in multiple court challenges.

Among the programs terminated is funding for the United Nations Food and Agriculture Organization, which conducts surveillance for diseases that can be transmitted from animals to humans, including bird flu, in 49 countries. Some major programs to track and fight malaria, one of the world’s top killers of children, have also been ended.

Dr. Austin Demby, the health minister of Sierra Leone, which relies on Gavi’s support to help purchase vaccines, said he was “shocked and perturbed” by the decision to terminate U.S. funding and warned that the ramifications would be felt worldwide.

“This is not just a bureaucratic decision, there are children’s lives at stake, global health security will be at stake,” he said. “Supporting Gavi in Sierra Leone is not just a Sierra Leone issue, it’s something the region, the world, benefits from.”

“The guiding principle of my work is ‘go there.’ I want to hear directly from the people who are affected by disease, or lack of access to a new drug. I’ve been writing about global health for 30 years and have reported from more than 80 countries.”

In addition to trying to reach all children with routine immunizations, Sierra Leone is currently battling an mpox outbreak, for which Gavi has provided both vaccines and critical support to deliver them, he said.

“We hope the U.S. government will continue to be the global leader it always been — putting money in Gavi is not an expenditure, it’s an investment,” Dr. Demby said

Gavi is estimated to have saved the lives of 19 million children since it was set up 25 years ago. The United States contributes 13 percent of its budget.

The terminated grant to Gavi was worth $2.6 billion through 2030. Gavi was counting on a pledge made last year by President Joseph R. Biden Jr. for its next funding cycle.

New vaccines with the promise to save millions of lives in low-income countries, such as one to protect children from severe malaria and another to protect teenage girls against the virus that causes cervical cancer, have recently become available, and Gavi was expanding the portfolio of support it could give those countries.

The loss of U.S. funds will set back the organization’s ability to continue to provide its basic range of services — such as immunization for measles and polio — to a growing population of children in the poorest countries, let alone expand to include new vaccines.

By Gavi’s own estimate, the loss of U.S. support may mean 75 million children do not receive routine vaccinations in the next five years, with more than 1.2 million children dying as a result.

Categories Cruelty, Ethics, Evil, Extremism, Funding, Health, International, Science, Trump

Refugees in Bangladesh Will Die of Starvation Due to U.S. Budget Cuts in Foreign Aid

By dianeravitch
March 25, 2025 //
7

Mujib Mashal wrote in The New York Times about the desperate starvation facing the Rohingya refugees as a result of the shutdown of U.S. foreign aid. They escaped Myanmar’s “ethnic cleansing” and now live in a United Nations camp, where their survival depends on donations of food from benevolent nations. The U.S., thanks to billionaires Trump and Musk. They should take a tour of the camps and see for themselves why foreign aid is impirtant.

Mashal writes:

More than a million people in the world’s largest refugee camp could soon be left with too little food for survival. 

In the camp in Bangladesh, United Nations officials said, food rations are set to fall in April to about 18 pounds of rice, two pounds of lentils, a liter of cooking oil and a fistful of salt, per person — for the entire month.

The Trump administration’s freeze on aid has overwhelmed humanitarian response at a time when multiple conflicts rage, with aid agencies working feverishly to fill the void left by the U.S. government, their most generous and reliable donor. Many European nations are also cutting humanitarian aid, as they focus on increasing military spending in the face of an emboldened Russia.

The world is left teetering on “the verge of a deep humanitarian crisis,” U.N. Secretary General António Guterres warned on a visit to the Rohingya refugee camp in southeastern Bangladesh on Friday.

“With the announced cuts in financial assistance, we are facing the dramatic risk of having only 40 percent in 2025 of the resources available for humanitarian aid in 2024,” he said, addressing a crowd of tens of thousands of Rohingya refugees. “That would be an unmitigated disaster. People will suffer, and people will die.”

At the refugee camp at Cox’s Bazar, overcrowded warrens of bamboo and tarp huts on mounds of dirt house more than a million Rohingya people driven from their homeland, Myanmar, by a campaign of ethnic cleansing that intensified in 2017.

Fenced off from the rest of Bangladesh, and almost entirely cut off from opportunities to find work or integrate into the country, the Rohingya refugees remain entirely at the mercy of humanitarian aid. The United Nations, with the help of the Bangladeshi government and dozens of aid organizations, looks after the needs of the traumatized people — education, water, sanitation, nutrition, medical care and much more.

The sudden drop in humanitarian aid threatens a wide range of programs and communities around the world, but the plight of the Rohingya is unusual in its scale and severity.

“Cox’s Bazar is ground zero for the impact of budget cuts on people in desperate need,” Mr. Guterres said. “Here it is clear budget reductions are not about numbers on a balance sheet. Funding cuts have dramatic human costs.”

Even at the current food allowance of $12.50 per person, per month, more than 15 percent of the children at the camp are acutely malnourished, according to the United Nations — the highest level recorded since 2017, when hundreds of thousands of refugees arrived after a sharp escalation of violence in Myanmar.

When a funding shortfall slashed the monthly food allowance to $8 in 2023, malnutrition and crime soared. People tried to flee the camp by embarking on dangerous and often fatal boat journeys.

During Mr. Guterres’s visit to the camp, U.N. officials had set up on a table sample food baskets showing what refugees currently get at $12.50 per person, and what that will be slashed to next month if, as they now project, the allotment falls to $6, barring a last-minute rescue.

Pointing to the sparse basket marked “$6,” Dom Scallpelli, the Bangladesh country director for the World Food Program, said, “If you give only this, that is not a survival ration.”

Even the $6 diet expected for the month of April would be made possible only because the United States unfroze its in-kind contribution, agreeing to send shipments of rice, beans, and oil, Mr. Scallpelli said. The cash contributions — the United States provided about $300 million to the Rohingya response last year, a little over half the entire response fund — remain halted.

“If we didn’t even have that, it would have been a total nightmare situation,” Mr. Scallpelli said about the in-kind donations. “At least we are thankful to the U.S. for this.”

Abul Osman, a 23-year-old refugee who arrived at Cox’s Bazar in 2017, said the refugees were already struggling with the bare minimum and the slashing of rations would be devastating for a population with no livelihood options. The Rohingya in Bangladesh are only allowed schooling inside the camp, and are not allowed access to higher education or jobs outside.

Pregnant women and children will suffer the most from dire food shortages, but the resulting mental health crisis will affect everyone, he said.

“It’s a threat to our survival,” he said.

People will die. Many thousands will die. Should we care? Our government claims to be Christian. What is the Christian response to a humanitarian catastrophe?

Categories Accountability, Billionaires, Corruption, Cruelty, Disruption, Ethics, Evil, Extremism, Failure, Funding, Health, International, Musk, Elon, Trump
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