The CDC closed its offices in Angola and South Sudan on Oct. 1 as the State Department ties foreign health aid to country-by-country deals, Politico reported Oct. 6.
The CDC office in Zimbabwe is set to close at the end of the year. Current and former CDC officials told Politico they expect more than a dozen other foreign offices to close in the next few years.
Under the administration’s “America First” approach, the CDC’s work abroad now depends on agreements in which recipient countries promise to pay a growing share of their own health costs and show progress on health metrics. Deals with 35 countries took effect Oct. 1. Each country chooses the CDC services it wants, and the State Department pays the agency for them.
Angola and South Sudan both signed deals. Angola is set to receive $71 million by 2030, and South Sudan is set to receive $146 million over three years. However, a current CDC official told Politico that declining funding, operating restrictions from the State Department and security challenges made it hard to keep those offices open.
Earlier this year, Zimbabwe rejected a deal, citing concerns about sharing sensitive health data in exchange for U.S. funding. A study published Oct. 1 in the Journal of Acquired Immune Deficiency Syndromes projects 75,000 new HIV infections in Zimbabwe as a result of the end of U.S. aid.
The State Department said countries “have now selected CDC services that will result in CDC overseas funding levels that are at or higher than prior years.” It said only the deals with Kenya and Rwanda would lower CDC funding “slightly.” The department has not released what the services cost or how much the CDC will receive.
HHS said the CDC will maintain its global health security capabilities “through regional offices, headquarters staff, other U.S. government personnel and implementing partners.”
Some former CDC staff doubt that.
“I don’t see the numbers adding up to a place where you can actually have a robust CDC presence in the same way,” said John Blandford, PhD, who led the CDC’s South Africa office until he retired last year.
The CDC already has 30% fewer employees than when President Donald Trump took office. The Department of Government Efficiency cut its staff, and the U.S. Agency for International Development, its partner in foreign assistance, was shut down. The agency’s overseas staff have served as an early warning system for outbreaks that could reach the U.S., including the ongoing Ebola outbreak in the Democratic Republic of Congo.
“Who’s going to pick up the phone if there’s a Marburg outbreak and the Zimbabwe office has closed?” Asia Russell, executive director of HIV advocacy nonprofit Health GAP, told Politico.
In June, 24 Democratic senators and Senate Health Committee Chair Bill Cassidy, R-La., asked appropriators to keep $2 billion flowing from the State Department to the CDC for global health work in the fiscal 2027 spending bill, which has not been released.
