The planned changes would affect workers across the Department of Health and Human Services, including staff involved in shaping public health policy, regulation and research oversight, the sources said. The move follows Trump’s campaign pledge to reclassify certain federal employees viewed by his advisers as exercising significant influence over government policy.

The proposal is tied to a revived version of “Schedule F,” a federal employment category first introduced during Trump’s first term that would allow agencies to remove some career civil servants from traditional job protections. Critics said the measure could expose career officials to politically motivated dismissals, while supporters argued it would increase accountability within the federal bureaucracy.

Employees at agencies overseen by HHS, including the Centers for Disease Control and Prevention, the Food and Drug Administration and the National Institutes of Health, could be affected depending on how individual positions are classified, the sources said.

The administration has not publicly disclosed how many employees may lose protections or which roles would be targeted first. HHS did not immediately respond to requests for comment.

Trump and allies have argued that career officials across federal agencies have obstructed presidential priorities and insulated policy decisions from elected leadership. During the 2024 election campaign, Trump repeatedly pledged to reshape the federal workforce and remove what he described as entrenched bureaucratic resistance within government institutions.

Federal employee unions and governance watchdog groups have opposed the effort, warning it could weaken the independence of scientific and regulatory agencies responsible for public health oversight, drug approvals and medical research funding.

The issue is expected to draw legal and political scrutiny as the administration moves to implement broader changes across the federal workforce.

A limited hantavirus outbreak linked to an international cruise ship has intensified scrutiny of the United States’ public health preparedness, as scientists and global health officials warn that staffing reductions, laboratory disruptions and political disputes over infectious disease research may undermine responses to future outbreaks.Health experts say the current outbreak remains controllable, with transmission still largely confined to close contacts of infected individuals.

However, the incident has exposed broader concerns about whether public health agencies retain sufficient testing capacity and operational flexibility to respond rapidly if a more dangerous pathogen emerges.According to officials at the World Health Organization, investigators are increasingly focused on evidence suggesting limited human-to-human transmission among individuals who had prolonged close contact with infected patients.

The outbreak has drawn comparisons to a similar hantavirus cluster in Argentina between late 2018 and early 2019, when 34 people tested positive and 11 died. WHO officials said current transmission patterns appear consistent with those earlier cases, including infections involving close family members and healthcare workers.

Maria Van Kerkhove said investigators believe transmission likely occurred between the first infected patients and several close contacts, including a physician who treated patients aboard the cruise ship where the outbreak was first identified.WHO infection prevention specialist Abdirahman Mahamud said aggressive contact tracing, quarantine measures and rapid isolation protocols remain central to containing the outbreak.

He said lessons learned during the Argentina outbreak demonstrated that transmission chains can be interrupted through coordinated public health action.Authorities are now attempting to track passengers from 12 countries, including the United States, who disembarked before the outbreak was identified and later returned home. Epidemiologists said tracing those individuals and anyone they may have contacted while symptomatic remains a critical component of containment efforts.

William Hanage said international coordination may prove more complicated than in previous outbreaks because the passengers dispersed across multiple jurisdictions governed by different public health authorities.Hanage said aggressive contact tracing and quarantine measures would likely be necessary to prevent wider transmission, though he noted that political resistance to such interventions following the Covid-19 pandemic could complicate implementation.

The outbreak is unfolding as US public health infrastructure faces mounting operational and political pressures. Scientists and health officials say laboratory staffing reductions and administrative pauses have already disrupted testing capacity for multiple infectious diseases.According to infectious disease specialist Rochelle Titanji, laboratories responsible for hantavirus testing have experienced staffing cuts, while some federal testing programs have been temporarily suspended.

States currently cannot send samples to the US Centers for Disease Control and Prevention for orthopoxvirus testing, including tests related to mpox, because that division has been paused temporarily, Titanji said. She also noted that federal laboratories can no longer conduct certain diagnostic testing used to determine the specific parasite responsible for leishmaniasis infections.

In April, rabies testing at the CDC was also halted temporarily, according to health officials familiar with the disruptions.At the same time, virology research in the United States has become increasingly politicised. The White House recently issued an executive order restricting certain forms of virus research, while the National Institutes of Health implemented broad funding reductions affecting related scientific work.

US lawmakers have also introduced legislation targeting what they describe as “gain of function” research, a term used in debates surrounding experiments that modify pathogens to study transmissibility or virulence.The debate has intensified amid continuing political disputes over the origins of Covid-19. Although many scientists maintain that available evidence strongly supports zoonotic spillover from animals to humans as the most likely origin of Sars-CoV-2, investigations into possible laboratory-related scenarios continue.

Researchers involved in virology and pandemic studies have increasingly faced subpoenas, investigations and public political scrutiny linked to those debates.Hanage said the current political environment risks weakening scientific preparedness for future outbreaks by discouraging research into zoonotic spillover events.“We should be investing in doing more to understand how these spillover events take place,” he said, adding that current policy trends were moving in the opposite direction.

Public health specialists also expressed concern over legal restrictions adopted in many US states following the Covid-19 pandemic. More than half of US states have enacted laws limiting the authority of public health officials to impose quarantines, recommend masks or enforce certain emergency health measures.Some states have also restricted vaccine requirements for schools and limited the authority of schools to suspend in-person operations during future outbreaks.

Titanji said the relatively limited hantavirus outbreak was already exposing potential weaknesses in outbreak coordination and public compliance. She warned that a more severe pathogen with higher transmission rates or mortality could create substantially greater risks.Despite the United States formally beginning withdrawal procedures from the WHO, the country remains connected to the International Health Regulations framework and continues receiving technical updates and outbreak information from the organisation.

Mahamud said collaboration between WHO officials and US institutions remained active and transparent during the current outbreak response.WHO director-general Tedros Adhanom Ghebreyesus said the outbreak illustrated the continuing importance of international coordination mechanisms during infectious disease emergencies.

He urged both the United States and Argentina to reconsider decisions to leave the WHO, warning that gaps in international cooperation create opportunities for viruses to spread more easily across borders.

In February 2025, Robert F. Kennedy Jr. assumed office as secretary of the Department of Health and Human Services with a message that diverged from conventional public health framing.

Addressing employees, he described the United States’ primary challenge as not only chronic disease but a broader “spiritual malaise,” linking public health outcomes to moral and personal factors. He stated that solutions must begin with “a spiritual question” centered on individual responsibility.Within weeks of that address, the White House initiated plans to reduce staffing levels at the department by 20,500 positions, according to the provided data.

The move came as the agency continued to manage a range of public health responsibilities, including disease prevention and response.In March 2025, during what was described as the country’s most significant measles resurgence in 34 years, Kennedy reiterated his emphasis on non-medical dimensions of health.

Speaking to an audience of medical trainees, he referred to “malevolent forces” and framed responses in terms of “spiritual warfare,” describing family routines such as shared meals as part of the response.

Over the course of his tenure, Kennedy has also promoted a range of alternative or non-mainstream health approaches cited in the material, including the use of vitamin A for measles, peptides for longevity, and the consumption of raw milk. At the same time, he has questioned aspects of vaccine safety and efficacy, positions that have drawn attention within public health discussions.

Analysts and observers cited in the material link Kennedy’s rhetoric to broader political currents. Savannah Tate, who has written about her experience within religious movements, described the use of terms such as “spiritual warfare” as consistent with language associated with Christian nationalist ideology.

She characterized such language as part of a broader narrative framework that emphasizes conflict between opposing moral forces.The material describes Christian nationalism as a movement advocating alignment between governance and a specific interpretation of Christianity, including the potential erosion of the separation between church and state.

Some political figures referenced in this context include Russell Vought, identified as associated with the Heritage Foundation’s “Project 2025,” and Donald Trump, who has described his administration’s agenda as addressing internal challenges, including “anti-Christian bias.”Other officials cited include JD Vance, who has referred to Christianity as foundational to American identity, Pete Hegseth, who has described the United States as a Christian nation, and Mike Johnson, who has supported policies aligned with conservative religious positions.

Public health experts referenced in the material have raised concerns about the implications of such rhetoric. Gary Gunderson, a professor at Wake Forest University School of Medicine, stated that the use of religious language in governance could affect the relationship between scientific institutions and public trust. He described the development as an attempt to reshape the basis of that relationship.

Academic research cited in the material, including work by sociologists Joseph Baker, Stephen Perry, and Andrew Whitehead, suggests that tensions between religious and scientific frameworks may arise where science is perceived as an alternative source of authority.

Within the Department of Health and Human Services, internal tensions have also been reported. Calley Means, a senior adviser to Kennedy, has publicly described efforts to reform institutions such as the Centers for Disease Control and Prevention.

His statements included references to combating “demonic forces,” directed in part at former officials such as Demetre Daskalakis, who later resigned following policy changes including the dismissal of members of a federal immunization advisory committee.Budgetary decisions have accompanied these policy and rhetorical shifts.

According to figures cited in the material, reductions include $518 million from National Institutes of Health research grants, $698 million from the National Science Foundation, $6.9 billion from Centers for Disease Control and Prevention programs, and $28 billion from the Environmental Protection Agency. A proposed 2027 budget includes a $16 billion reduction in HHS funding compared to 2026 levels.

Additional reductions include $389 million from the Substance Abuse and Mental Health Services Administration, with a portion of funding redirected toward faith-based initiatives addressing addiction. These measures have been linked to Kennedy’s stated emphasis on addressing underlying “spiritual” causes of health conditions.

The material also outlines financial and institutional intersections involving individuals in advisory roles. Calley Means, identified as co-founder of Truemed, held substantial equity in the company while advising the administration, according to disclosed financial records cited in the text.

The company facilitates purchases of wellness-related products using health savings accounts.Other figures referenced include Mark Hyman, associated with wellness businesses, and Nicole Saphier, who replaced a previous nominee for surgeon general. These developments are presented as part of a broader shift in health policy priorities and messaging.

The material further describes how rhetoric emphasizing personal responsibility and skepticism toward institutions may influence public perceptions of healthcare. A cited example involves a South Carolina family declining vaccination despite severe health consequences, referencing statements attributed to political leaders about vaccine schedules.

Researchers such as Fatima-Zahra Aklalouch have analyzed the communication strategies used in this context, noting a framing that contrasts “natural” and “unnatural” approaches to health. According to her analysis, such framing can align with broader ideological narratives that question institutional authority.

Viet Nam has strengthened its pandemic preparedness systems over more than a decade through sustained technical and financial support from the World Health Organization, positioning itself as an increasingly active contributor to regional and global health security efforts, according to a feature report published on April 17.

Central to this progress has been the implementation of the Pandemic Influenza Preparedness Framework Partnership Contribution, which since 2013 has supported the development of coordinated national planning mechanisms.

Vietnamese health authorities have established and continuously updated the Pandemic Influenza Preparedness and Response Plan, alongside a national vaccine deployment strategy, creating a structured framework for emergency response.

Although initially designed to address influenza outbreaks, the preparedness plan provided the operational backbone for Viet Nam’s response to the COVID-19 pandemic. Authorities revised the framework in 2023 to incorporate lessons learned from that crisis, further aligning it with evolving public health risks.

Laboratory capacity has also expanded significantly under the programme. Four regional laboratory institutes, including two National Influenza Centres, have enhanced capabilities in viral isolation, molecular diagnostics and genomic sequencing.

These investments enabled rapid adaptation during the COVID-19 pandemic, when laboratory networks were repurposed to support SARS-CoV-2 testing and variant tracking.Officials from the National Influenza Centres said the strengthened systems improved both domestic response capacity and Viet Nam’s contribution to global surveillance efforts.

Laboratory data generated through these facilities has supported international monitoring of respiratory viruses and informed public health decision-making.Surveillance systems have been reinforced through improvements in monitoring influenza-like illness and severe acute respiratory infections.

Enhanced data quality, reporting mechanisms and coordination across institutions have allowed earlier detection of unusual respiratory disease clusters.The system integrates multiple levels of the health sector, including the National Institute of Hygiene and Epidemiology, Pasteur Institutes, provincial Centers for Disease Control, hospitals and laboratories.

This network feeds into global platforms such as the Global Influenza Surveillance and Response System and WHO’s RespiMart data-sharing platform.Authorities have moved to institutionalize integrated surveillance covering influenza, SARS-CoV-2 and other respiratory pathogens under the 2026–2035 National Target Programme on Healthcare, Population and Development.

The initiative aims to strengthen early warning capabilities by linking community-level data, clinical reporting and laboratory analysis into a unified system.Viet Nam has also expanded its capacity to assess zoonotic disease risks.

The country adopted the Joint Risk Assessment tool in 2019, enabling coordinated evaluation of health threats across animal and human sectors. In 2024, this mechanism supported responses to two avian influenza incidents, demonstrating cross-ministerial coordination and rapid decision-making.Health officials say these measures reflect a broader effort to integrate public health preparedness into national development planning.

Investments in health security have accompanied Viet Nam’s wider socio-economic growth, with authorities emphasizing the importance of sustained international cooperation.Dr Vo Hai Son, Deputy Director General of the Viet Nam Administration of Disease Prevention, said the country’s progress has been supported in part by long-term collaboration with WHO under the preparedness framework.

He noted that continued engagement with global partners remains essential to maintaining and expanding system capacity.The WHO report highlights Viet Nam’s role in contributing to regional preparedness by sharing surveillance data, strengthening laboratory networks and participating in global health initiatives.

These efforts are expected to support collective responses to future pandemics and emerging infectious diseases.The report indicates that Viet Nam’s preparedness system is now more interconnected and responsive, with improved capacity to detect, assess and respond to public health threats.

Ongoing collaboration with international partners is expected to further enhance these capabilities as the country continues to invest in health system resilience.

The decision marks a significant move toward reducing tobacco consumption among an estimated 100 million smokers while strengthening India’s commitment to global health standards.

The government has long recognised the economic and social burden caused by tobacco-related diseases.

With healthcare systems under pressure due to preventable illnesses, the new taxation framework aims to discourage smoking without disrupting broader market stability.

Finance Minister Nirmala Sitharaman emphasised that affordability must not encourage unhealthy consumption habits.

She noted that cigarette taxes currently make up around 53% of retail prices—well below the World Health Organization’s recommended threshold of 75%.

The newly approved Central Excise (Amendment) Bill 2025 replaces earlier temporary levies on cigarettes and certain luxury products.

Under the revised framework, cigarettes will now incur a value-based excise tax ranging from ₹2,700 to ₹11,000 per 1,000 sticks depending on size, in addition to the existing 40% goods and services tax.

Experts suggest that these changes will push overall tax rates upward by 25% to 40% compared with the current structure.

Such increases are internationally recognised as effective methods to reduce tobacco consumption and encourage healthier behaviour patterns.

India’s cigarette industry, which includes major companies such as ITC and Godfrey Phillips India, has yet to issue public comments on the updated tax policy.
Industry analysts, however, anticipate that companies may revise retail prices in response to the new excise rates.

Public health advocates view the reform as a meaningful step toward decreasing the number of smoking-related deaths in the country.

According to global health assessments, tobacco usage contributes to nearly 1.35 million deaths annually in India, making strengthened regulation a public priority.

The government has already implemented several measures over the years, including graphic warning labels, awareness campaigns and regulatory restrictions on selling tobacco near educational institutions.

The new law strengthens these ongoing efforts by aligning taxation with international best practices.

While the immediate impact on retail cigarette prices will depend on manufacturer decisions, the long-term vision is clear.

India aims to balance fiscal responsibility with social well-being and ensure that future generations have fewer tobacco-related health risks.

Experts believe that the new tax structure will drive positive behavioural changes, supporting a nationwide shift toward better health outcomes.

With smoking rates still high, the legislative move signals a proactive approach to safeguarding public health while reinforcing India’s commitment to global health objectives.

As India continues to modernise its fiscal and regulatory landscape, measures like this reflect a stronger emphasis on long-term sustainability.

By discouraging harmful habits and promoting healthier lifestyles, the country is taking a forward-looking step that benefits both its citizens and its healthcare infrastructure.