The Next Pandemic Won’t Wait for Us to Rebuild Them
Estimated reading time: 16 minutes
Welcome to Citizen Jack’s Mud Creek Chronicles. If you are new to my blog, thank you for joining us. This essay highlights significant changes in the U.S. federal public-health landscape following Anthony Fauci’s retirement in December 2022.
Under President Trump, with Robert F. Kennedy Jr. as Health Secretary, the administration initiated extensive workforce cuts, reshaped vaccine strategy, terminated some mRNA vaccine projects, and withdrew from the World Health Organization (WHO).
I believe these decisions raise serious concerns about pandemic capacity. The essay emphasizes the loss of institutional memory, weakened vaccine capacity, and eroding public trust. As the next pandemic looms, these decisions may compromise critical defenses.
Key Takeaways
- Beginning with Trump’s second term, the Trump administration made significant changes to U.S. public health that risk weakening America’s pandemic capacity.
- The workforce reductions and restructuring at HHS, CDC, and FDA threaten the loss of crucial institutional memory and expertise.
- Kennedy’s vaccine policy changes, including disbanding an expert advisory committee and halting some mRNA vaccine projects, may further undermine public trust in vaccines.
- America’s withdrawal from the WHO raises questions about its ability to respond swiftly to emerging global health threats during future pandemics. The American CDC was not the first to respond to the Ebola outbreak in the Democratic Republic of the Congo and Uganda. It was the WHO and the CDC of Africa that responded immediately.
- Together, these decisions suggest a precarious future for America’s pandemic capacity as the next pandemic approaches.
Introduction
Anthony Fauci left the federal government in December 2022 after thirty-eight years directing the National Institute of Allergy and Infectious Diseases (NIAID). His departure was ordinary; scientists eventually retire. In December 2002, I left Georgia State University after 33 years as Professor of Science Education, and head of the Science Education section. My departure was ordinary; science educators eventually retire.
What happened next was not ordinary.
Beginning in 2025, the federal scientific and public-health establishment underwent one of the most rapid transformations in its history.
Donald Trump returned to the White House determined to shrink and remake the federal government. Elon Musk and the Department of Government Efficiency (DOGE) helped drive dramatic reductions in the federal workforce. Robert F. Kennedy Jr. became Secretary of Health and Human Services and began reshaping federal vaccine policy. Federal investments in some mRNA vaccine projects were terminated. And in January 2026, the United States completed its withdrawal from WHO.
Each decision has its own rationale. But the Trump oligarchy underpinned these decisions with Project 25, an initiative that serves as a blueprint for reshaping the federal government.
Together they raise a larger question:
Are we making America better prepared for the next pandemic—or dismantling some of the defenses we spent decades building?
The answer depends on capacity: the people, memory, technologies, networks, and trust that must already be in place before a crisis begins.
Workforce Capacity: When Scientists Walk Out the Door
The Trump administration and DOGE initially pursued enormous reductions across the federal government.
HHS announced a restructuring that, combined with voluntary departures, the department expected would reduce its workforce from approximately 82,000 to 62,000. The reductions reached CDC, FDA, NIH, and other health agencies (U.S. Department of Health and Human Services, 2025a).
The administration argued that HHS had become bloated and inefficient and that restructuring would reduce duplication, lower costs, and return agencies to their core missions.
That argument deserves consideration. Government agencies can become bureaucratic, and scientific agencies are not immune from poor management.
But there is a problem with treating a scientific institution like an ordinary bureaucracy.
“Its most valuable assets often walk out the door”.
A career epidemiologist who has investigated outbreaks for twenty-five years possesses knowledge that cannot be recreated simply by hiring someone into the same position.
A laboratory scientist may have decades of experience with particular pathogens, diagnostic systems, and networks of researchers.
An administrator who worked through H1N1, Ebola, Zika, and COVID knows which agencies must communicate when an emergency begins—and may know exactly whom to call when formal procedures fail.
That is institutional memory. It doesn’t appear neatly on an organizational chart, and it is remarkably easy to lose.
The story has since become more complicated. In April 2026, Kennedy said HHS employment had climbed back to approximately 72,000 and that the department intended to hire another 12,000 employees (Reuters, 2026).
That matters, but replacing positions is not necessarily the same as replacing capacity.
Headcount can be restored. Experience cannot be rehired on demand.
A scientist with twenty years of outbreak experience does not leave those twenty years sitting behind on a desk for the next employee.
If workforce reductions threaten the people who recognize danger, vaccine policy determines whether the country preserves enough tools to respond once danger appears.
Vaccine Capacity: Kennedy and the Vaccine Question
The second experiment concerns vaccines.
Robert F. Kennedy Jr. entered HHS after years as one of America’s most prominent vaccine skeptics. Since becoming secretary, he has substantially changed the institutions responsible for federal vaccine policy.
In June 2025, Kennedy removed all 17 sitting members of CDC’s Advisory Committee on Immunization Practices—the expert panel responsible for evaluating vaccine evidence and making recommendations about their use (U.S. Department of Health and Human Services, 2025b).
Kennedy said replacing the committee was necessary to address conflicts of interest and restore public trust in vaccine recommendations.
The stated objective—public trust—is important.
But an expert committee possesses institutional memory too.
Replacing every member simultaneously eliminates continuity and the very problems the restructuring is meant to correct.
Kennedy’s reduction of routine childhood vaccine recommendations from 17 to 11 increases the risk of preventable disease outbreaks and creates confusion for families. The Trump administration is weighing changes to the government’s recommended vaccine schedules that experts say would, if adopted, have far-reaching consequences for public health.1 According to Mogensen, there are more changes to come for childhood vaccinations.
Then came another decision with direct implications for pandemic preparedness.
In August 2025, HHS announced that BARDA would wind down 22 mRNA vaccine projects (U.S. Department of Health and Human Services, 2025c).
Kennedy argued that mRNA vaccines had important limitations against respiratory infections such as COVID and influenza and that federal resources should instead support other vaccine technologies.
There is nothing inherently wrong with investing in alternative technologies. We should do that. No country should depend upon a single vaccine platform.
But that logic cuts both ways.
Preparedness means preserving multiple options before we know which one the next pathogen will require.
And mRNA has one strategic advantage that matters enormously during a rapidly spreading pandemic:
speed.
Once scientists possess a pathogen’s genetic sequence, they can begin designing an mRNA vaccine candidate rapidly.
The issue isn’t whether every future vaccine should use mRNA.
It is whether we should narrow our options before we know what we’re fighting.
Technology alone, however, does not create preparedness; the public must trust the institutions asking them to use it.
Public Trust Capacity: A Vaccine Nobody Trusts
COVID also demonstrated that inventing a vaccine is only half the problem. People have to take it.
The COVID vaccines arrived with remarkable speed. They also arrived in an atmosphere of extraordinary political mistrust.
Vaccination itself became an ideological marker.
Those divisions haven’t disappeared.
Kennedy says his reforms will restore scientific integrity and public confidence in vaccine policy. Critics contend that his long history of vaccine skepticism and changes to federal advisory structures risk further weakening confidence. We might consider Kennedy a danger to childhood health, given his recent changes in vaccine policy.
However, as measles cases rise across the U.S., children’s routine vaccination rates continue to decline while exemptions from school vaccination requirements, particularly non-medical exemptions, have increased. In a new analysis, KFF (the independent source for health policy research, polling, and journalism) finds that about 280,000 kindergarteners were unvaccinated against measles in the 2025–2026 school year, and for the sixth year in a row, MMR vaccinations fell below the 95% level needed to prevent community transmission1.
We may not know the full consequences until another emergency.
Imagine that a new virus begins killing thousands of Americans.
Scientists develop a vaccine in eight months.
Then what?
If millions of Americans believe the vaccine is more dangerous than the pathogen, scientific achievement will not be enough.
A vaccine sitting in a vial is a scientific accomplishment. A population willing to receive it is a public-health accomplishment.
The difference is trust.
And trust cannot be manufactured in the middle of an emergency.
Even a trusted domestic response depends on receiving early warnings from beyond America’s borders.
Global Surveillance Capacity: Now Move the Outbreak 10,000 Miles Away
There is another vulnerability: the next dangerous virus may not first appear in Seattle, Atlanta, or New York.
It might appear in Indonesia or the Democratic Republic of Congo.
A physician notices several strange cases.
A laboratory identifies an unfamiliar virus.
How quickly does that information reach CDC scientists in Atlanta?
That question matters because the United States is no longer a member of WHO.
Trump first attempted to withdraw from WHO during his first presidency. The withdrawal never took effect because President Biden reversed the decision upon taking office.
Trump tried again in January 2025.
This time it happened.
On January 22, 2026, the United States formally completed its withdrawal from WHO. Federal funding ended. The administration recalled American personnel assigned to the organization. The United States ceased official participation in WHO committees, governing structures, and technical working groups (U.S. Department of Health and Human Services and U.S. Department of State, 2026). This is important. When WHO sent a team of scientists to China in March 2020 to conduct research to find the source of COVID-19. No American scientists were invited to be part of the research team. WHO conducted a second research trip to CHINA, American were not present.
The Trump administration argues that WHO failed badly during COVID, was too susceptible to political influence, placed an unfair financial burden on the United States, and resisted necessary reform.
Those criticisms should not simply be dismissed.
But withdrawal creates another risk.
Viruses don’t recognize national sovereignty.
The first warning of the next pandemic may come from a physician or laboratory thousands of miles from America. What matters then is how rapidly genomic sequences, biological samples, epidemiological observations, and warnings move across borders.
The administration believes direct relationships with countries and other organizations can move that information more effectively. Perhaps they can; perhaps they can’t.
The next pandemic is an uncomfortable time to discover the answer.
Ebola: A Real-Time Test of Pandemic Preparedness
We do not have to wait for the next unknown pathogen to test whether the world’s disease-control system still works.
The test is already underway.
In May 2026, health authorities in the Democratic Republic of the Congo and Uganda identified an outbreak of Ebola disease2 caused by Bundibugyo virus. It has since become the largest Ebola outbreak ever recorded in the DRC and the second-largest Ebola outbreak in history, exceeded only by the West African epidemic of 2013–2016. By August 12, WHO reported 4,665 confirmed cases and 2,184 deaths in the DRC alone. The disease had spread into 54 health zones across six provinces.
This outbreak provides an unusually revealing test of the argument I have been making
What happens when a dangerous infectious disease emerges after the United States has dismantled USAID, withdrawn from the World Health Organization, reduced and reorganized parts of its public-health workforce, and begun replacing multilateral health cooperation with bilateral relationships?
The answer so far is complicated.
WHO sounded the international alarm
The World Health Organization moved quickly. On May 17, Director-General Tedros Adhanom Ghebreyesus declared the Ebola outbreak a Public Health Emergency of International Concern, or PHEIC. He took the unusual step of making the declaration before convening WHO’s Emergency Committee because he believed urgent international action was necessary. The committee subsequently agreed with the decision.
That answers one important question: yes, Ebola is currently a global public-health emergency—but it has not been classified as a “pandemic emergency.” Under the amended International Health Regulations, a pandemic emergency is a still higher category. WHO explicitly determined that the present Ebola outbreak has not reached that level.
WHO, working with Africa CDC and national governments, has helped coordinate surveillance, contact tracing, clinical care, border monitoring, infection control, community engagement, and international assistance. Its work in Uganda provides an encouraging example. Uganda recorded 20 confirmed cases—15 imported from DRC and five resulting from local transmission—but aggressive surveillance, isolation, contact tracing, and border controls stopped the chains of transmission. More than 800 contacts were identified and monitored. On August 27, WHO and Africa CDC announced that Uganda had completed 42 consecutive days without a new confirmed case, the international benchmark for ending an Ebola outbreak.
The contrast with DRC is striking.
There, the epidemic continues expanding. WHO warned in August that in some areas the virus was outpacing the response. Conflict, population movement, weak health infrastructure, difficulties reaching remote communities, and insufficient resources have complicated containment.
What about the CDC?
The CDC did not disappear from the international response when the United States left WHO.
When the outbreak was confirmed, CDC reported that it was notified immediately through existing relationships with the health ministries of DRC and Uganda and began supporting the response. It issued an alert to American physicians and public-health departments, assessed the risk to the United States, and provided guidance on recognizing, testing, isolating, and safely managing a possible imported Ebola case. CDC has continued to classify the risk to the American public as low.
That is important evidence for the Trump administration’s argument that direct government-to-government relationships can continue to function outside WHO membership.
But there is an equally important qualification.
CDC has been permitted to coordinate with WHO and other international organizations involved in the response even though the United States has formally withdrawn from WHO. In other words, when confronted by an actual international infectious-disease emergency, the practical response has still required American scientists to work alongside the multilateral system from which the United States withdrew. However, Federal directives instructed CDC staff to immediately halt all official communication, cooperative agreements, and joint working groups with the WHO.3
The Ebola outbreak is therefore testing the proposition that bilateral relationships can replace participation in WHO. The evidence so far does not provide a simple verdict.
CDC is still functioning internationally.
But it is doing so inside a disease-control ecosystem in which WHO and Africa CDC remain central coordinators.
And then there is USAID
This may be the most troubling part of the story.
For decades, American pandemic preparedness did not begin at the American border. USAID financed disease surveillance, laboratories, community health programs, trained health workers, and strengthened health systems in countries where emerging infectious diseases were most likely to appear.
That infrastructure helped detect threats before they became threats to Americans.
The Trump administration dismantled USAID in 2025 as part of its restructuring of foreign assistance. Subsequent bilateral agreements restored some U.S. global-health funding to DRC and Uganda, including money for disease surveillance and outbreak response. But an analysis by KFF (An independent source for health policy, research, polling & news) found that the funding promised under the new five-year agreements represented about a 27 percent reduction compared with U.S. assistance during the previous five years.
Public-health officials who had worked in the region told STAT (Stat News) that the earlier cuts disrupted programs that had been helping DRC prepare for precisely this kind of emergency. They argued that the loss of American assistance probably hindered both early detection and the subsequent response.
We should be careful about causation.
USAID’s elimination did not cause the Ebola outbreak. DRC has struggled with Ebola repeatedly, and this epidemic is occurring amid armed conflict, population displacement, weak infrastructure, difficult geography, and highly mobile populations.
But that isn’t the relevant question.
The relevant question is whether dismantling disease-surveillance and public-health programs made a difficult outbreak harder to detect and contain.
There is growing evidence that it did.
And that brings us back to the meaning of pandemic preparedness.
For decades, American global-health policy rested on a simple insight: the cheapest and safest place to stop an epidemic threatening the United States is often thousands of miles from the United States.
A laboratory in Congo can therefore be part of America’s pandemic defense.
- So can a Ugandan contact tracer.
- So can an epidemiologist employed by CDC.
- And so can a USAID-funded surveillance program.
Whether the United States belongs to it or not, the World Health Organization does too. Yes, we are no longer partners with the WHO because of an American president’s ignorance, callowness, and empty-headedness. Trump has also done the same with world climate policy: the Paris Accords.
Ebola is showing us that these institutions are not independent pieces on an organizational chart. They form a network.
When one part disappears, the others have to compensate.
That is precisely what makes the current Ebola epidemic a test case for America’s pandemic capacity.
We do not yet know the final result.
Uganda offers an encouraging example of what experienced institutions, rapid surveillance, international coordination, and decisive local leadership can accomplish.
The continuing epidemic in DRC shows the opposite side of the equation: what happens when a lethal pathogen encounters insecurity, weak health infrastructure, insufficient resources, and gaps in surveillance and response.
The next pandemic may involve a completely different pathogen.
But the infrastructure that will have to find it, track it, and stop it will look remarkably similar.
Ebola is testing that infrastructure right now.
How Pandemic Capacity Is Lost
Seen through the capacity framework introduced earlier, these developments are not separate controversies.
- DOGE and federal employment.
- Kennedy and vaccines.
- mRNA vaccine projects.
- WHO withdrawal.
But they belong to the same story. They belong to a pandemic capacity that is an interconnected system, as shown in Figure 1. They are decisions about capacity.
The figure shows pandemic preparedness as a repeating capacity cycle: assess threats, plan responses, implement tools, and optimize before the next emergency. The chart also identifies recent political decisions that weaken the system, e.g. large scale layoffs via DOGE, overhaul of vaccine advisory committee, cuts to mRNA vaccine investments, withdrawal from WHO, and erosion of trust.
Remove or weaken one component and the others become less effective. A surveillance system is useless if no one is experienced enough to recognize and interpret the signal. A brilliant vaccine technology is useless if investment disappears before scientists need it. A vaccine is useless if citizens won’t take it. And an extraordinary CDC laboratory cannot identify an emerging virus quickly if crucial information never reaches it.
That is why we should never treat scientific capability as permanent national property.
It has to be maintained.
Agencies must train and retain scientists. Laboratories must remain capable. Research programs must survive changes in political leadership. Multiple vaccine technologies should remain available. International surveillance networks must move information quickly. Public-health institutions must earn public confidence before the emergency begins.
An Extraordinary Experiment
None of the decisions made since 2025 guarantees that America will fail during the next pandemic. Some may ultimately produce the more efficient public-health system their architects promise.
But taken together, they constitute an extraordinary experiment.
We have reduced the federal health workforce and are now rebuilding it. Kennedy replaced an entire vaccine advisory committee. We have curtailed federal investment in some mRNA vaccine projects. We have withdrawn from WHO. And we are doing all of this during the relatively quiet interval between pandemics.
That is precisely when preparedness is either built or lost.
Eventually, somewhere, a physician will encounter a patient whose illness doesn’t make sense. A laboratory will produce an unfamiliar sequence. An epidemiologist will recognize a pattern. Someone will send a warning up the chain. The pathogen won’t care which administration created a program or which party eliminated it. It won’t care whether Robert F. Kennedy Jr. trusted a particular vaccine technology. It won’t care whether the United States belongs to WHO.
It will simply encounter whatever defenses we have left in place.
And then we will discover whether we remembered—or forgot—the great lesson of COVID.
The next pandemic won’t wait for us to rebuild them.
Summary
The essay from Citizen Jack’s Mud Creek Chronicles I discuss the significant changes to the U.S. public health system since the start of Trump’s second term. Under Donald Trump’s administration, particularly with Robert F. Kennedy Jr. as Health Secretary, there are substantial workforce reductions and major alterations to vaccine policies, raising concerns about preparedness for future pandemics. The withdrawal from the World Health Organization further jeopardizes America’s ability to respond to global health threats. These decisions risk eroding institutional memory, weakening vaccine capacity, and diminishing public trust, potentially compromising defense against the next pandemic.
Related Links
Bibliography
Coalition for Epidemic Preparedness Innovations. (2025, February 5). “Pushing mRNA Vaccine Development Timelines to New Speeds.”
U.S. Department of Health and Human Services. (2025a, March 27). “HHS Announces Transformation to Make America Healthy Again.”
Reuters. (2026, April 16). “Kennedy says US health agency has 72,000 staff, up from 62,000 after DOGE cuts.”
U.S. Department of Health and Human Services. (2025b, June 9). “HHS Takes Bold Step to Restore Public Trust in Vaccines by Reconstituting ACIP.”
U.S. Department of Health and Human Services. (2025c, August 5). “HHS Winds Down mRNA Vaccine Development Under BARDA.”
U.S. Department of Health and Human Services and U.S. Department of State. (2026, January 22). “United States Completes WHO Withdrawal.”
Centers for Disease Control and Prevention. (2025, August 8). “ACIP Recommendations.”
World Health Organization. “International Health Regulations.”
World Health Organization. “Surveillance in Emergencies.”
World Health Organization. “Global Genomic Surveillance Strategy for Pathogens with Pandemic and Epidemic Potential, 2022–2032.”
Centers for Disease Control and Prevention. (2024, November 14). “Preparing for the Next Pandemic: Lessons Learned and the Path Forward.”
Footnotes
- Jackie Flynn Mogensen, HHS quietly signals possible changes coming to childhood vaccination schedule. Scientific American. August 25, 2026 ↩︎
- Ebola is a severe, often fatal illness in humans caused by infection with a group of viruses known as orthoebolaviruses. ↩︎
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