A Difficult Week for Public Health: The Cost of Incomplete Efforts

March 31, 2025 | Susan Kansagra

Last week state, territory, and local public health departments received abrupt notices terminating several CDC funding streams that covered a range of public health activities. While the rationale given was that these funds supported COVID-19 (no longer a declared public health emergency), the reality is that the funds supported public health response infrastructure as a whole — both for COVID-19 and for other health threats. While some jurisdictions may be able to absorb or reprioritize activities, most are reporting detrimental impacts on their ability to deliver public health services. Here are just a few of the impacts we’re hearing from states/territories, locals, and partners.

A House Without a Roof

First, the funding cuts will halt technology improvements and data systems modernization that would have made sharing information with health care facilities and the public timelier and more efficient. In addition to impacting future work, cutting funding early for these public health technology improvements results in waste of past work. Why? It’s like building four walls of a house and then abruptly stopping construction before the roof is in place. The usefulness of the whole house goes to waste. This is the quandary that many health departments are facing as funding terminates for updates already underway to immunization, surveillance, and case reporting systems as well as laboratories themselves.

The First Line of Defense Against Health Threats

When you walk into an emergency room you expect a health care provider to treat you. Likewise, when an outbreak occurs, public health expects it will step in to contain disease spread and protect the community. For some states, these funding cuts disrupt the very core duties of what health departments do to detect and respond to health threats like measles, H5N1, and mpox. And that’s to say nothing of diseases we don’t know about yet.

For example, these funds were allocated by Congress to support lab capacity including specialized lab personnel and equipment. So, if there is a suspected or known measles or foodborne outbreak, many health departments will have less capacity to quickly test and use that knowledge to prevent people from getting sick. They will also have limited capacity to deliver treatments and vaccinations directly to people. For some communities, that will mean fewer clinic hours, longer waits, and delays in accessing care.

Timing and Communication Matter

In addition to the impact of the cuts themselves, public health departments report struggling with how abruptly they learned about them. Many public health workers found out about funding termination the same day the funding ended. The suddenness felt akin to shutting off the lights to the operating room while the surgeon is still in the middle of a procedure. In short, while the cuts themselves had a health impact, so did the lack of notice. For some funding streams, health departments were already preparing to close out the funds, but for many it created unnecessary disruption for people still depending on the services from these funds today.

Overall, most jurisdictions report that the loss of these activities leaves an immediate hole in public health infrastructure that will impact their ability to respond to health threats both now and into the future.