Hot Topics in IPC: Avian Flu and Results From Trump's Executive Orders

Global Health Policies and Infection Prevention

Since last week, there has been an increase in Executive Orders (EOs) from President Trump, which have serious implications for not only global health but also infection prevention and control. Last week, President Trump shared EOs that withdrew the US from the World Health Organization (WHO), the Paris Climate Agreement, and significant cut to foreign aid and development.

Since then, we’ve seen more hits to global and domestic health initiatives. In line with efforts to freeze foreign aid, a new directive was put into place to stop the disbursement of HIV medications purchased and dispersed under PEPFAR (the President’s Emergency Plan for AIDS Relief, which has been a widely successful effort started under President George W. Bush, saving more than 25 million lives, yielding bipartisan support). This move will have serious implications for HIV prevention and treatment abroad.

In addition to this, the CDC was ordered to halt communication and collaboration with the WHO, which will only worsen the data and information disparity that is now occurring as the Trump administration has “instructed federal health agencies to pause all external communications, such as health advisories, weekly scientific reports, updates to websites and social media posts, according to nearly a dozen current and former officials and other people familiar with the matter.” This means no H5N1 updates from CDC, or influenza/COVID-19/ respiratory syncytial virus weekly reports…in fact, no Morbidity and Mortality Weekly Report at all.

Moreover, this means no communications from Health and Human Services, the Federal Drug Administration (FDA), CDC, and the National Institute of Health (NIH) at all – from drug and device recalls to outbreak reports. Simply put, we are officially flying blind during an unprecedented outbreak of H5N1, an outbreak of Marburg in Tanzania, increasing influenza activity, and all the other diseases we’re facing (outbreaks of norovirus, tuberculosis, vaccine-preventable diseases, mpox, etc.). Between the drop in communications and withdrawal from the WHO, we will continue to see significant and negative impacts on not only global health but also domestic response and prevention efforts. Those egg prices? Not likely to go down any time soon.

The latest news, though, on Monday evening, was that the White House has temporarily paused grant, loan, and financial assistance programs at a federal level. The pause on funds for programs will severely impact the country as many health, research, and response programs are funded by federal support. This comes a few days after NIH was hit with a freeze that would impact everything from grant review panels (canceled) to communications, hiring, travel, training, and even rescinding offers.

[Editor's note: With only a few minutes to spare, a federal judge, Lored L. AliKhan has temporarily blocked part of the plan to freeze federal aid through at least 5 PM ET on Monday, February 3, 2025.]

In short, research, like clinical trials, is being severely impacted—and in some cases, halted. Information sharing, data reporting, global partnerships, research, and safety alerts will be in short order, so we may be relying on a wider variety of information networks, which means double-checking for misinformation is critical. The APIC EID task force is working to share more real-time information, which is helpful to infection preventionists.

In terms of vaccine-preventable diseases – this is a great article by Katie Wu, PhD, on ACIP and the vital role they have that is potentially dangling in the balance.

A Few Bits on Bird Flu

The UK has reported its first human H5N1 case since 2022—an individual with significant exposure to sick birds is being treated in the West Midlands region in a high-consequence disease unit (biocontainment unit). A duck farm in California has also detected avian influenza (HPAI H5N9 and H5N1). “State officials quarantined the affected farm, and a culling operation of the facility's nearly 119,000 birds was completed on December 2,” according to the Center for Infectious Disease Research and Policy. “Scientists with the USDA's Animal and Plant Health Inspection Service (APHIS), state partners, and wildlife officials are conducting a comprehensive epidemiologic investigation.”