The recent ouster of Centers for Disease Control and Prevention Director Susan Monarez and the resignations of top officials mark not just an institutional crisis but the latest chapter in a political war on evidence-based public health. This purge is not reform. It is the culmination of a right-wing assault that began in President Donald Trump’s first term, when science was mocked, expertise sidelined and conspiracy theories elevated above epidemiology.

From Trump’s withdrawal of the United States from the World Health Organization to his nomination of Robert F. Kennedy Jr., a longtime vaccine skeptic and conspiracy theorist, as secretary of health and human services, to his current dismantling of the CDC, the pattern is clear: Public health is being redefined not as a shared good but as an ideological battleground.

The CDC, long regarded as the world’s gold standard of epidemiology, is under siege. Programs targeting infant mortality, youth violence, smoking, maternal and child health, mental health, obesity, lead poisoning and infectious disease tracking have been slashed. Surveillance reports and early warning systems have been curtailed, while health promotion and advocacy for communities disproportionately affected by inequity are being censored. Scientists are leaving in droves and being replaced by political loyalists.

This is not just an attack on a federal agency. It is an assault on the fragile compact that links science, population health, democracy and the common good. During the pandemic, the world saw the catastrophic consequences of politicizing medicine and public health. That same destructive logic now drives the hollowing out of the CDC.

The pandemic exposed what anthropologist and physician Paul Farmer called the pathologies of power: the way structural violence normalizes the suffering of the poor and decides who lives and who dies. COVID-19 did not invent inequality; it revealed the neoliberal hollowing out of public institutions, as scholar Henry Giroux argues. In America, death and disease fell hardest along familiar lines: inadequate health coverage, insecure work without sick leave and neighborhoods poisoned by neglect. As medical ethicist Harriet Washington shows in “Medical Apartheid,” Black and brown bodies have long borne the brunt of exploitation. That legacy persists today in America’s racial mortality gaps.

The numbers confirm it. In 2022, life expectancy at birth for Black Americans was 72.8 years, compared with 77.5 years for white Americans, according to the National Center for Health Statistics. There was a modest rebound in 2023 — when Black life expectancy rose to 74.0 years and white life expectancy to 78.4 years — but what looks like progress on the surface only conceals entrenched inequities and suboptimal health that continue to cost Black lives.

What dismantling public health does is protect economic and racial privilege. It advances politicians who thrive on anti-government rhetoric and preserves racial hierarchies that allow some Americans to look away while others die.

Farmer’s warning remains urgent: When governments dismantle public health, they inscribe suffering into the very structure of society. Many infectious diseases are lethal only for the poor; they are layered atop comorbidities and chronic conditions produced by social and commercial determinants of health.

The global consequences are just as devastating. For decades, the CDC has been the backbone of global health partnerships, supporting Africa in the fight against HIV/AIDS, malaria, Ebola and now COVID-19. Its collapse dismantles those lifelines. America’s retreat from WHO deepens the damage by weakening global systems for monitoring outbreaks, reviewing evidence and maintaining databases such as the Global Burden of Disease. Without U.S. financial support, WHO faces program cuts, slower outbreak response and job losses. For Africa and the Global South, where WHO often provides the first and only line of defense, this translates directly into more deaths, more suffering and wider inequity.

The Rev. Martin Luther King Jr. was right: “Of all the forms of inequity, injustice in health is the most shocking and the most inhuman.” America may weather another partisan cycle, but a broken CDC means preventable deaths will mount, avoidable suffering will multiply and the most vulnerable will once again be sacrificed on the altar of ideology.

Every cut to the CDC, every withdrawal from WHO, every concession to anti-science populism shortens lives — not only in Chicago, Harlem and Houston but also in Lagos, Caracas, Mumbai, Gaza and Nairobi.

WHO’s landmark “World Health Report 2000: Health Systems — Improving Performance” warned that the true measure of any health system is not only how much health it produces, but also how fairly it distributes financial burdens and how effectively it addresses the wider determinants of health. By those standards, the United States ranks poorly: Despite spending more than any nation, it placed 37th in overall health system performance. Our contractual, contribution-based system favors those with steady jobs and wealth while leaving millions to navigate premiums, co-pays and gaps in coverage that fall hardest on the poor. WHO underscored that health systems must pool risks broadly, protect against catastrophic costs, and extend beyond hospitals to encompass housing, education, nutrition, clean air and safe workplaces. Yet America’s system is transactional, rewarding affluence while neglecting the very conditions that produce disease.

Stewardship, the “very essence of good government,” as WHO called it, requires vision, risk pooling and protection of the vulnerable. But as the CDC is gutted by political interference, the country is stripping away even its most basic public health stewardship. The predictable result is a system in which the poor pay more, suffer more and die younger — not because the United States lacks resources, but because it has abandoned fairness and optimal health for all as a common good.

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Stan Chu Ilo is a Catholic priest and a senior research professor on religion, global health and social ethics at the Center for World Catholicism and Intercultural Theology at DePaul University in Chicago. He serves on the WHO Faith Network and has advised global health, faith and development networks across Africa, Europe and North America.

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