The First 100 Days of the Trump Presidency

In a radio address on July 24, 1933, Franklin Delano Roosevelt (FDR) coined the first “hundred days” as a measure of presidential effectiveness. Within 100 days, FDR had signed 99 Executive Orders and worked with Congress to pass 15 major laws to get America through the Great Depression, ranging from tackling unemployment and poverty to stabilizing the banking system, kickstarting the New Deal. By contrast, President Trump entirely bypassed Congress, signing an unprecedented 142 Executive Orders tearing down the social safety net, decimating global health, and castigating science and public health.

Cuts to Federal Agencies and Research Funding

The Trump administration has implemented sweeping staffing and funding cuts, as well as restructuring federal health agencies. The changes are almost too numerous to list, and the onslaught is likely to continue.

Thousands of career scientists and experts have been laid off, including personnel at the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the National Science Foundation (NSF), bringing the country’s research capacity to a virtual standstill. Staff that remain say that basic research and public health protection have become impossible. The massive layoffs hollowed out core centers of scientific expertise.

On March 27, Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr announced an additional 10,000 staff cuts on top of an earlier 10,000 person reduction in the workforce. Nearly 2,000 members of the National Academies (Disclosure: LG is a member of the National Academy of Medicine and signed the letter) warned that the nation’s scientific enterprise was being decimated. At NIH, 2,500 staff were terminated, leading a principal investigator to describe the agency as “non-functional.” In response to the mass layoffs and the consolidation of 28 HHS divisions into just 15, 19 states and the District of Columbia sued the administration, alleging the reorganization incapacitates HHS’s core functions and deprives states of needed federal funds and expertise.

Multiple agencies have been undermining or eliminating scientific advisory committees following an executive order reducing the size the federal government, including HHS’s Advisory Committee on Long COVID, and the Healthcare Infection Control Practices Advisory Committee.

NIH funding for basic research has created federal/university partnerships that have driven scientific innovation, catapulting the United States as the world’s leader of biomedical research. All of this may abruptly end, given the Trump administration’s plan to retroactively slash NIH indirect cost support to 15%. On March 5, a federal judge issued a nationwide preliminary injunction, but the Justice Department is appealing to the First Circuit Court of Appeals. Moreover, extensive cuts to federal research funding have decimated US scientific capacity, and evidence has already emerged of a brain drain. NIH typically awards over 60,000 research grants per year, and supplied funding that contributed to 99.4% of drug approvals from 2010 to 2019. But in a little over a month, NIH terminated 694 research grants across nearly all NIH institutes and centers, affecting $1.81 billion in funding, of which 30% had not been expended. These included grants deemed to violate Trump’s executive orders on “radical and wasteful” diversity, equity, and inclusion (DEI) programs and “gender ideology.” The cancellations impact research on HIV, vaccine hesitancy, COVID-19, climate change, and transgender health (which independently lost at least $157 million).

Similarly, NSF, a key funder of basic scientific research, terminated research grants that were flagged if they contained words that could conflict with the President’s orders, such as “diversity”, “inclusion,” and even “health inequities.” It had already frozen and then unfrozen some grants following an earlier court order. NSF now says it has stopped awarding new grants altogether. In April, the agency halved its graduate research fellowship program. The White House has now proposed $4.7 billion (more than half) in cuts to the agency’s $9 billion budget, including projects for climate research, ”woke social, behavioral and economic sciences” and ”all DEI-related programs.”

Scientific censorship is rife. A whole host of words has been systematically removed from federal websites, databases, and communications. The administration ordered compliance with the executive orders by CDC in all of its external communications, censoring the agency in its communications with the public amid active outbreaks of measles and H5N1 bird flu. Despite the fact that most evidence supports a natural zoonotic spillover at the Huanan Seafood Wholesale Market in Wuhan, China, the White House changed its website on COVID-19 origins to an alarming slogan: “Lab Leak: The True Origins of COVID-19.”

Major research universities across the country have also faced escalating interference, with the administration threatening, suspending or cancelling billions in health and science research grants in response to perceived non-compliance with the President’s orders or in feigned service of fighting antisemitism on campus. Harvard alone faces freezes in $2.2 billion in grants and $60 million in contracts and is now suing the administration.

The Trump administration’s proposed 2026 budget contains massive cuts to health and scientific agencies, including slashing $18 billion from NIH and nearly halving CDC’s budget. This will only wreak further havoc.

Rejection of Science

Secretary Kennedy’s longstanding rejection of well-established science has elevated science skepticism and disinformation to the highest levels of government. In the face of a major measles outbreak, the Secretary has touted non-vaccine treatments like high-dose Vitamin A and the inhaled steroid budesonide, while directing CDC to research treatment alternatives. He advised parents that vaccines are a “personal choice,” even though a decision not to vaccinate places the child and the public at risk. Worse still, he’s actively promoting the widely debunked theory that MMR vaccines cause autism, coupled with disparaging remarks about autistic people. He directed HHS to report on the causes of “the autism epidemic” by September. Remarkably, Kennedy appointed vaccine conspiracy theorist to head the study. Meanwhile, the administration pushed out the FDA’s chief vaccine regulator. Complicating matters further, scientists studying vaccine hesitancy and disease communication teams were casualties of HHS’s restructuring and mass layoffs.

The Secretary has used his position to advocate the removal of fluoride from drinking water, and will instruct CDC to alter its guidance, despite the fact that fluoride is regarded as an effective public health strategy for combatting dental disease. Already, two red states have followed his lead, Florida and Utah.

Retreating from Global Health

Trump launched a sweeping rollback of US global health leadership, beginning with withdrawing the US from the World Health Organization (WHO) and dismantling the United States Agency for International Development (USAID). The United States historically has been the largest funder of global health and humanitarian assistance, providing 42% of all international health assistance in 2024. Yet, that amounts to less than 1% of the annual federal budget.

Trump, together with Elon Musk’s Department of Government Efficiency, took a sledgehammer to USAID, cutting 83% of its programs and effectively absorbing the agency into the State Department. While the State Department said it would grant limited waivers, in many cases that lifesaving work was disrupted or never resumed. Models project that up to 25 million former recipients of US assistance through programs dedicated to HIV/AIDS, tuberculosis, and maternal and child health could die in the next 15 years without assistance.

A similar crisis looms for global hunger. The US was the biggest donor to the United Nations’ World Food Programme (WFP), providing nearly half of its $9.8 billion budget in 2024. Now, the WFP is expected to cut its staff by up to 30%. The abrupt termination of funding and stop work orders for emergency food assistance have already led to the downsizing or total closure of food programs in over a dozen mostly conflict-affected countries. The WFP described those cuts as a death sentence.

Perhaps most importantly, President Trump signed an Executive Order giving a year’s notice of the United States’ intent to withdraw from the World Health Organization, which will make America and the world less safe. But for all intents and purposes, the president has already withdrawn from WHO. He immediately cut all funding, directed CDC staff seconded to WHO to return to Atlanta, and ordered HHS not to even communicate with the Organization. Now, WHO faces a budget shortfall of $600 million through 2025 and a projected $1.9 billion gap for the 2026-2027 biennium. The funding cuts have already spurred drastic cost-cutting measures and a vast restructuring at WHO, including shrinking its program divisions from 10 to 4 and cutting up to 40% of its Geneva-based staff. Trump seems hostile to international norms. The Biden administration drove major reforms of the International Health Regulations, but on day one, Trump disavowed the reforms. At the same time, he withdrew from negotiations of a Pandemic Treaty. Those negotiations recently successfully concluded. Abandoning WHO, the US forfeits its long-held leadership role in global health.

The next 100 days will almost certainly bring further cuts, closures, and chaos—setting progress in science and health back decades. Lives lost will be lost forever, programs eliminated may never return, and lost trust will be exceedingly hard to regain.

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