Actions Speak...
Actions
Over the past 11 years I’ve written 45 articles here on Health and Communications, each exploring various forms and means of health communication. Those forms have included writing, graphic and industrial design, music, typography, color theory, and more. The means, 18 of which were detailed in the article The Landscape of Health Communications, spanned everything from public service advertising campaigns to continuing medical education, from marketing to prescribing information inserts.
One topic that I’ve barely touched on, but which deserves much more attention now, is what actions communicate. With that in mind, let’s look at five recent health-related actions taken by the current US administration and a brief exploration what each of them communicates.
Action One: Shuttering the US Agency for International Development (USAID)
What it Communicates:
You are willing to forgo 64 years of accumulated good will throughout the developing world.
You are willing to let people starve in Somalia, Nigeria, and elsewhere.
You naively think that others will immediately and fully backfill every form of health and development aid withdrawn by the US.
You either do not know or do not care that without USAID’s critical nutrition and medical support, people will die.
Action Two: Nominating Robert F. Kennedy, Jr. to the Secretary of Health and Human Services
What it Communicates:
You do not value expertise.
You do not believe in science.
You implicitly support conspiracy theories, exacerbating anxieties and encouraging dangerous and harmful behaviors.
You are willing to bet, unwisely, that there will be no pandemics or widespread disease outbreaks requiring exceptional leadership and thousands of dedicated public servants willing to follow that leader’s direction.
Action Three: Withdrawing US participation in the World Health Organization (WHO)
What it Communicates:
You do not believe diseases cross national borders.
You have not learned any of the lessons of COVID.
You do not understand that suspending anti-viral and other treatments midway trough a regimen will result in more virulent diseases, which may become more or wholly drug-resistant.
You do not know or do not care that without the US’s substantial support of critical care programs, people will die.
Action Four: Curtailing National Institutes of Health (NIH) research grants
(see Dr. Silver’s letter and the infographic below in Note 1)
What It Communicates:
You are willing to cede US leadership in all aspects of biomedical research from prevention to treatment.
You do not care that many of the brightest minds in research will leave the US to work elsewhere.
You are unaware that medical schools will lose students and teaching hospitals will lose staff, only exacerbating the critical shortage of medical professionals.
You do not understand that when research and treatment fail to evolve and improve, diseases are indifferent and will only become more burdensome and deadly.
You do not know or do not care that curtailing research means treatments, vaccines, and cures will be delayed –if found at all– meaning people will die.
Action Five: Suspending all outgoing communication at HHS, particularly, at CDC.
What it Communicates:
You think preventing the communication of bad news actually means there is no bad news, just as you tried by failing to test and report adequately for COVID.
You fail to understand that an essential element of the scientific method is publishing results and then engaging in debate to either prove or disprove what has been proposed.
You are preventing the CDC from coordinating with WHO to identify the correct variants to formulate and produce this coming fall’s flu vaccine, at a time when 24 million people have already contracted the flu this season, resulting in more hospitalizations than for COVID.
Others Actions and Others Who Could Be Targeted
There are, of course, many other actions that have been taken that threaten our collective and individual health. Among them are the seemingly capricious and likely illegal firing of countless federal employees working in health and the biosciences. Exact numbers are hard to come by, and are also likely to increase, but here’s what we know so far:
Across HHS
5,200 [2] [4]
Because DOGE and the White House are not being transparent about this, it’s not clear if the 5,200 figure includes the CDC, FDA, and NIH cuts listed below or if the 5,200 is for HHS employees only. Either way, these are troubling numbers.
CDC
750, with another 750 slated for termination. [3] [4]FDA
89. [5]NIH
Between 1,000 and 1,200. [3]CMS (Medicare / Medicaid)
CMS is said to be a coming target of both DOGE and Congress. [6] [7]
Outside HHS
Work on health care, health research, and health protection is spread all across the US government. All of those programs could face substantial reductions as well. Here, for example, are some of the health-related programs outside of HHS:
Department of Veterans Affairs
“VA employs nearly 371,000 health care professionals and support staff at VA medical facilities across the country.” [8]Department of Defense
”The Defense Health Agency is now 11 years old. With over 700 medical, dental and veterinary hospitals & clinics, and a global workforce of almost 130,000 civilians and military personnel, DHA serves over 9.5 million service members, retirees and their families.” [9]Department of the Interior - Indian Health Service
”Total IHS employees: 15,265.” [10]
…and so many more, like
the Directorate for Biological Sciences at the National Science Foundation
the Office of Health Industries at the Department of Commerce
the Office of Emergency Medical Services at the Department of Transportation
as well as interagency programs like the Federal Partners in School Health, involving
the Department of Education,
the Environmental Protection Agency
the Centers for Disease Control and Prevention
the Health Resources & Services Administration of the Department of Health and Human Services.
Actions –like eliminating programs or dismissing personnel– are possible for all of these as well.
Conclusion
Actions are undoubtedly a potent way to communicate, as demonstrated by the Trump Administration’s defunding of WHO, dismantling of USAID, and decimation of HHS, NIH, CDC, FDA, and more. The result, in all of these cases, is that people will die, and the communication is that those taking these actions simply do not care. And when those actions directly contradict what has been said before, they of course become the new reality. So when we hear “Medicare, Medicaid – none of that stuff is going to be touched,” it might be prudent to give that a pause and wait to see what actions are actually taken, or as Nixon’s Attorney General, John Mitchell, famously admonished the press, “Watch what we do, not what we say.” [11]
Notes
[1]
[2]
https://apnews.com/article/fda-job-cuts-trump-hhs-kennedy-cdc-nih-76dee97eee8209b2605fadac34427aab
[4]
https://apnews.com/article/fda-job-cuts-trump-hhs-kennedy-cdc-nih-76dee97eee8209b2605fadac34427aab
[5]
https://www.washingtonpost.com/health/2025/02/18/trump-health-firings-fda-cdc/
[6]
https://www.hipaajournal.com/doge-access-cms-systems/
[11]
https://health.mil/About-MHS/OASDHA/Defense-Health-Agency/#:~:text=DHA%20Sizzle%202024,Anytime%2C%20anywhere%2C%20always.