Qualified experts increasingly absent from public health decisions

Robert Malone, MD, listens during an ACIP meeting in December. Appointed by the Trump administration, Malone later resigned from the committee. Science-based health advisory committees have been in turmoil under the administration, with hundreds eliminated altogether.

Photo by Elijah Nouvelage, courtesy Getty Images

“That is a quandary we're facing in public health: the erosion of trust in experts, done not by honest mistakes or missteps during an outbreak or a pandemic, but by people who are doing it on purpose.”

— René Najera

Federal scientific advisory committees are behind much of the nation's public health policies and research. They regularly meet to review science that shapes the health of the nation, from injury prevention and dietary guidelines to environmental health.

But advocates say their influence is increasingly getting sidelined. The Trump administration terminated 75 of 273 scientific advisory committees at the U.S. Department of Health and Human Services alone last year, a recent report from Public Citizen found. With fewer outside expert voices, agency leaders are operating without the best scientific guidance.

“Silencing and biasing external experts makes HHS vulnerable to stagnation and corruption that erodes the health of all Americans,” Michael Abrams, PhD, MPH, a senior researcher in Public Citizen's Health Research Group and author of the report, said in a news release.

Forty-nine scientific advisory committees were cut from the National Institutes of Health last year. That included the Advisory Committee to the Director, a high-level steering panel that advised the NIH director on issues ranging from genetic engineering to sexual harassment. Most of the remaining cuts were to committees that reviewed grant applications and set funding priorities.

In the same year, NIH cut billions of dollars in research funding, halting studies on cancer, Alzheimer's disease, HIV prevention and maternal health. A March study in Proceedings of the National Academy of Sciences found that the cuts disproportionately affected early-career researchers, particularly women.

Public health experts say the changes could accelerate a “brain drain” of highly skilled researchers as some leave their fields or the nation. In fact, a 2025 poll in Nature found that three-quarters of U.S.-based scientists have considered moving abroad.

Elsewhere, committee members are meeting less frequently. Scientific advisory committees at the Food and Drug Administration had 63% fewer meeting days in 2025 than in 2024, according to the Public Citizen report. But expert panels, which are not bound by the same legal rules and procedures, met more often.

Expert groups axed by the Trump administration last year included the Healthcare Infection Control Practices Advisory Committee, which advised on policies such as hand hygiene and surgical safety at healthcare facilities.

Photo by SDI Productions, courtesy iStockphoto

Transparent, public meetings are essential to allowing experts such as Abrams into the agency's approval process. Without rigorous oversight and independent scientific review, newly approved drugs and medical devices could be less safe and effective.

“There's a lot of pressure to get things to market,” Abrams, an APHA member, told The Nation's Health. “It's the FDA's responsibility to be a careful gatekeeper, and that gets compromised in the absence of advisory committees.”

At the Centers for Disease Control and Prevention, nine scientific advisory committees were axed last year. Among them were the Healthcare Infection Control Practices Advisory Committee, which issued guidance on infection prevention practices such as hand hygiene and surgical safety, and the Safety and Occupational Health Study Section, which reviewed research proposals on workplace health and safety.

“It's really concerning when they go away because that means these issues are potentially being deprioritized by these agencies,” APHA member Darya Minovi, MPH, a fair access research manager at the Union of Concerned Scientists, told The Nation's Health. “We might be less likely to see policymaking or programs that are focused on these issues.”

Without federal scientific advisory committees, agencies may rely on limited or flawed information to make policies and recommendations, Minovi said, potentially leading to harmful health consequences.

The Trump administration also restructured CDC's Advisory Committee on Immunization Practices, replacing every member with under-qualified handpicked appointees, some of whom have expressed anti-vaccine views.

Observers say health agency leaders under Trump are operating on political agendas instead of science.

“This administration and their scientific leaders seem to be afraid of criticism that they should be welcoming,” Abrams said.

As the Trump administration fires experts and eliminates science-based committees, public trust is falling.

Photo by Igor Suka, courtesy iStockphoto

Federal advisory committees have traditionally drawn on a range of expertise to ensure diverse perspectives. But at committees such as ACIP, the range of perspectives now includes those that conflict with established scientific evidence, according to APHA member René Najera, DrPH, MPH.

That does not lead to effective practice “because now you're not relying on the advice of experts, you're relying on the nodding heads of people who approve with you,” said Najera, director of the Center for Public Health and editor of the History of Vaccines project at the College of Physicians of Philadelphia.

Increasingly, Americans are losing trust in federal health agencies to act in the best interests of the public. Just 40% of adults say they trust CDC to act independent of politics, while 36% say the same of the Food and Drug Administration and the Environmental Protection Agency, according to an April KFF poll.

“That is a quandary we're facing in public health: the erosion of trust in experts, done not by honest mistakes or missteps during an outbreak or a pandemic, but by people who are doing it on purpose,” Najera told The Nation's Health.

In the absence of commitment to scientific integrity at the federal level, public health advocates have stepped up to fill the void.

At the University of Minnesota, the Vaccine Integrity Project was developed last year to provide vaccine guidance that is anchored in the best available science. Other independent scientific committees have formed to promote environmental justice and to preserve reliable climate information.

Still, independent efforts cannot fully replace the role of the federal government, said Robert Hopkins Jr., MD, medical director of the National Foundation for Infectious Diseases.

“That depth of knowledge is really hard to replicate without the resources the federal government (has) to do it,” Hopkins, a former chair of the National Vaccine Advisory Committee, told The Nation's Health.

President Trump signed an executive order during his first term directing federal agencies to cut their advisory committees by a third. Although the Biden administration restored some of the advisory panels that were eliminated, the long-term damage may be harder to repair this time around.

“We've lost a lot of the connections that help keep public health in action,” Hopkins said. “I think recovery is feasible, but it's not going to be easy.”

For more on the Public Citizen report, visit www.citizen.org.

• Copyright The Nation’s Health, American Public Health Association