Robert F. Kennedy Jr. announced plans Thursday to slash the Department of Health and Human Services, cutting nearly a quarter of its workforce in a major restructuring that will consolidate several departments.

According to the Department of Health, the cuts will save $1.8 billion annually and — combined with previous downsizing — reduce the employee headcount from 82,000 to 62,000 full-time employees.

Under a restructuring plan, the number of health department divisions will drop from 28 divisions to 15 — including a new Administration for a Healthy America, or AHA. The number of regional offices will drop from 10 to five.

“We aren’t just reducing bureaucratic sprawl,” the Health secretary said in a statement. “We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic. This Department will do more — a lot more — at a lower cost to the taxpayer.”

Many in the national and global health community have been steeling themselves for dramatic change since Kennedy, an opponent of some vaccines and an advocate of stronger food safety, took office vowing radical reform.

The primary target of Kennedy’s cuts is the Food and Drug Administration, which works to ensure the safety and efficacy of foods, drugs, medical devices, tobacco and other regulated products. It will cut its workforce by 3,500 full-time employees — a reduction that a health department fact sheet said “will not affect drug, medical device, or food reviewers, nor will it impact inspectors.”

The Centers for Disease Control and Prevention, a vast $9-billion agency that works to prevent chronic diseases, fight infectious disease outbreaks and make vaccine recommendations, will also cut 2,400 employees.

Dr. Tom Frieden, the former CDC director who now works as president and CEO of the nonprofit health organization Resolve to Save Lives, said Kennedy’s plans were unlikely to result in greater efficiency.

“Breaking up the agency by sending the experts in non-communicable diseases to another new agency isn’t efficient, it just creates new bureaucracy,” Frieden said in a statement to The Times. “Infectious diseases do not occur in a vacuum, and factors including pre-existing chronic diseases play critical roles in understanding and controlling infectious diseases.”

The CDC, Frieden said, has been the “flagship of public health for generations” as it pursued its “core mission of saving lives and protecting people from health threats of all kinds.”

“No other part of the federal government has the depth and breadth tracking, understanding and supporting communities and providers to stop our leading killers,” Frieden said. “CDC has contributed to saving millions of lives — not just from infectious diseases but also from cancer, heart attack, stroke and other leading causes of death of Americans; better road safety; and prevention of injury and drug overdose.”

The National Institutes of Health, the primary federal government agency for conducting and supporting medical research, will cut 1,200 employees.

A former NIH official and Trump administration critic said the reductions would have far-reaching consequences.

“You can’t cut that many people without drastically having to scale back the work that NIH and HHS are doing,” said Nate Brought, who resigned last month from his position as director of NIH’s Executive Secretariat. “It’s just not possible.”

Brought said he worried that research on the LGBT community and AIDS would be completely cut and studies on cancer and childhood disease would falter.

“We’ve already seen them cut back on HIV and AIDS assistance and, to some extent, research, and now I would not be surprised to see most of that go away as well,” he said. “Cancer research I think is a huge one… Anything that touches on any childhood disease being cut is going to obviously be a huge problem. I don’t think Americans are about children dying to meet their political goals.”

In an address posted to the social media platform X on Thursday, Kennedy painted a dark, apocalyptic picture of the U.S health department, noting that as its budget and staff increased, all that money has failed to improve the health of Americans.

“In fact, the rate of chronic disease and cancer increased dramatically as our department has grown,” he said. “Our lifespan has dropped. So Americans now live six years shorter than Europeans. We have the sickest nation in the world, and we have the highest rate of chronic disease. The US ranks last among 40 developed nations in terms of health, but we spend two to three times more per capita than those nations.”

Kennedy called his department an “inefficient” and “sprawling bureaucracy” that had seen rates of cancer and chronic disease increase as its budget had increased.

“When I arrived, I found that over half of our employees don’t even come to work,” Kennedy said. “HHS has more than 100 communications offices and more than 40 IT departments and dozens of procurement offices and nine HR departments. In many cases, they don’t even talk to each other. They’re mainly operating in their silos.”

During the Biden administration, Kennedy said the health department budget had increased by 38% as staffing increased by 17%.

“But all that money has failed to improve the health of Americans,” he said.

Dorit Reiss, a professor of law at UC San Francisco who specializes in public health, questioned the premise that the nation’s health agencies were overstaffed.

“If anything, the FDA and CDC are understaffed, they don’t have as many people as they need to combat the many challenges we’re facing,” she said, and noted that the nation was in the middle of a measles outbreak. “This isn’t a good time to cut the organization that’s at the front line of fighting it.”

The new Administration for a Healthy America — which according to a fact sheet will “more efficiently coordinate chronic care and disease prevention programs and harmonize health resources to low-income Americans” — will have multiple divisions including, Primary Care, Maternal and Child Health, Mental Health, Environmental Health, HIV/AIDS, and Workforce.

Kennedy admitted that his overhaul of the department would be a “painful period” for the agency. But he said he wanted all employees to rally together “behind a simple, bold mission.”

“I want every HHS employee to wake up every morning asking themselves, ‘What can I do to restore American health today?’ I want to empower everyone in the HHS family to have a sense of purpose and pride and a sense of personal agency and responsibility to this larger goal. We’re going to save taxpayers nearly $2 billion a year, and we’re going to return HHS to its original commitment to public health.”

Brought however, said that the government had never been less efficient than it was now under the Trump administration.

“At this point, morale is at an all-time low, productivity is at an all-time low, and then you’re going to throw something like this on top of it,” he said.

“People who are constantly being told that they’re about to be fired, that their jobs are in danger,” he added, “are not doing their best work, as efficiently and as well as they are capable of and as they were before.”