Last month, the administration unveiled its new global health strategy, prioritizing outbreak prevention and response to protect American citizens and the economy. The report highlighted the immense cost of past outbreaks, such as the $5.4 billion spent globally and over $70 million domestically to contain the Ebola epidemic a decade ago. It starkly warned that “an outbreak anywhere in the world can quickly become a threat to Americans.”
Despite this stated priority, a January freeze on foreign aid significantly hampered numerous programs crucial for extinguishing outbreaks. Citing “waste, fraud, and abuse” within federal agencies, the administration proceeded to lay off thousands of scientists, including many dedicated to preventing and containing infectious diseases.
While some programs have since been reinstated and a number of scientists rehired — including a mass rescission of erroneous layoffs just days prior — many other specialists remain in limbo, unsure of their next career steps.
A spokesperson for the Department of Health and Human Services affirmed that the department “has preserved the expertise necessary for pandemic preparedness” and remains “committed to infectious disease research, surveillance, and response.” They added that support for this critical public health mission continues through “ongoing monitoring, vaccine development, and partnerships at home and abroad.”
However, many experts express deep concern that the loss of this specialized knowledge leaves the nation vulnerable to emerging pandemic threats. Dr. Lorin Warnick, dean of Cornell’s College of Veterinary Medicine, cautioned, “The diseases aren’t going away. The risks are even higher now.”
We spoke with four highly respected infectious disease scientists to learn about their vital work, their current lives, and their insights into the nation’s current state of pandemic preparedness.
‘Abrupt Demonization’
Just three years ago, Sarah Paige led a team at the U.S. Agency for International Development (U.S.A.I.D.) that was instrumental in containing an Ebola outbreak in Uganda. Now 51 and jobless since the agency’s dissolution, Dr. Paige is freelancing, reviewing research proposals for a private company, all while Ebola continues its spread in the Democratic Republic of Congo.
“I just wanted to do something and have meetings, because in the afternoons I get so lonely,” she shared recently.
Dr. Paige’s research focuses on the intricate connections between human populations, the environment, and disease transmission.
Early in her global health career, while working at Kibale National Park in Uganda, she observed baboons raiding kitchens and red colobus monkeys intimidating children and dogs. These interactions led to a profound realization: diseases can transmit from humans to animals, not just the other way around.
Years after earning her doctoral degree in these vital relationships, she applied to U.S.A.I.D. During a late-night virtual interview, agency officials unexpectedly asked her to turn on her camera. At 9 p.m., Dr. Paige appeared on screen, her headlamp illuminated by swirling mosquitoes and other insects. She got the job.
In September 2022, she spearheaded U.S.A.I.D.’s Ebola response in Uganda, collaborating closely with other American agencies. Dr. Wilberforce Owembabazi Ndyanabo, then a colleague, praised her remarkable ability to “navigate the gymnastics” of swiftly mobilizing resources and personnel.
However, this success came at a personal cost. Dr. Paige developed early-stage liver disease, high blood pressure, and shingles, prompting her return home.
Last January, she rejoined U.S.A.I.D., expecting to dedicate the remainder of her career there. Yet, just weeks later, the administration began dismantling the agency. Dr. Paige’s position, along with U.S.A.I.D. itself, ceased to exist on July 1. She expressed deep distress over what she perceives as “the abrupt demonization of everybody” who served the agency.
She now fears the nation is even less equipped to handle a pandemic than it was before Covid-19. The next major outbreak, whatever form it takes, is “getting closer,” she warned. But with public health infrastructure eroding and vaccine hesitancy on the rise, she believes, “we’re just not prepared.”
Though her husband, a chef, supports the family, the sudden cessation of her meaningful work, especially as Ebola continues its spread, has plunged her into severe depression.
To cope, she volunteers at an animal shelter and takes long walks with her dog. Still, she describes her days as feeling like she is “walking through mud.”
An H.I.V. Bulwark
In May, Dr. Jonathan Mermin spent a glorious day in Atlanta tending to his backyard: feeding his five chickens, collecting and washing their eggs, baking bread, and drying grapes for his wife’s snack. These domestic tasks were a stark contrast to his responsibilities six weeks prior, when he directed the Centers for Disease Control and Prevention’s (C.D.C.) efforts against H.I.V. and other sexually transmitted diseases.
In April, Dr. Mermin, 60, known as Jono to friends and colleagues, was placed on administrative leave and reassigned to the Indian Health Service. He still awaits clarification on his new role. The H.I.V. prevention division, which he once led, was initially dissolved, then reinstated, and is now again facing potential closure by the administration.
He warned that if Congress fails to save the division, “we won’t be able to detect outbreaks, and we won’t be able to respond to them effectively, putting more people at risk for getting H.I.V.”
Despite his plans to seek another position, Dr. Mermin remains in close contact with his former colleagues and is dismayed by his departure from the C.D.C.
He dedicated nearly his entire career to the agency, continuing as a civilian after retiring last year from the Commissioned Corps of the U.S. Public Health Service as a two-star rear admiral.
During the first Trump administration, Dr. Mermin was pivotal in developing the “Ending the H.I.V. Epidemic” strategy, which garnered widespread praise as a significant success.
Adm. Brett Giroir, an assistant health secretary in that administration, described Dr. Mermin as “not political in any sense.”
Under Dr. Mermin’s guidance, new H.I.V. infections nationwide fell by 36 percent, and the resurgence of other sexually transmitted infections began to show the first signs of a national plateau.
He also directed health departments to prioritize prevention efforts in their spending. Greg Millett, a former deputy for the Office of National AIDS Policy in the Obama White House, lauded this as “a very precise and scientific and logical approach” to achieve maximum impact with minimal resources.
Now, however, Dr. Mermin spends his days at home with his chickens and his mischievous cat. The future of the H.I.V. division hangs precariously, and he fears that lawmakers may not grasp its crucial importance. “What if no one cares?” he pondered.
Animal Threats
The administration’s latest strategy acknowledges that three-quarters of emerging infectious diseases, such as bird flu, originate from animals. Effectively combating these threats requires scientists with more than just a medical degree; they need hands-on experience with animals, a deep understanding of diseases, and expertise in public health.
Dr. Stéphie-Anne Dulièpre fit this profile perfectly when she joined U.S.A.I.D. in October 2024. A licensed veterinarian with experience at the Agriculture Department and a public health background from Johns Hopkins University, she brought a comprehensive skillset.
However, she lost her position just months later with the closure of U.S.A.I.D. “It’s devastating because I have barely scratched the surface of what I can do with all of my skills,” she lamented.
Dr. Dulièpre, who lived in Haiti until age 11, recalls a childhood spent among dogs, goats, and chickens, bringing home “insects upon insects” to study, and having a natural ability to tame even the most feral cats. This profound connection to animals eventually led her to pursue veterinary medicine at Cornell, a field where only about 2 percent of veterinarians identify as Black.
“The typical veterinarian is not a Black woman, let me just say that,” she stated. “I had no one that I knew that took the path ahead of me.”
Stephanie Martz, her former supervisor, noted that Dr. Dulièpre’s unique skills made her an invaluable asset for various projects on emerging zoonotic diseases at U.S.A.I.D.
On one project in Dong Nai Province, Vietnam, which involved assisting farmers with captive wildlife, staff members were housed in a hostel with a tarantula living behind the toilet. The team fully expected Dr. Dulièpre to withdraw from the project upon hearing about the spider.
“But she was like, ‘No, sign me up, I’m going to go,’” Ms. Martz recounted. “We knew she was going to be a good fit.”
Since U.S.A.I.D.’s collapse, Dr. Dulièpre has returned to working as a veterinarian to cover her bills and the remaining $125,000 in student loan debt.
“I’m still searching,” she expressed, “looking around to see where else I can use these skills.”
The Vaccine Specialist
Dr. Emily Erbelding’s professional challenges may have begun during the coronavirus pandemic.
As an infectious disease expert at the National Institutes of Health (N.I.H.), she played a leading role in Operation Warp Speed, President Trump’s initiative for rapid Covid vaccine development during his first term. However, her N.I.H. division also supervised a grant to EcoHealth Alliance, which became a focal point in the controversy surrounding the coronavirus’s origins.
Though the grant underwent peer review and was canceled when issues arose, she, along with Dr. Anthony Fauci, has faced significant criticism. She believes her involvement in this controversy may have contributed to her ousting from the agency in April.
Immediately following Mr. Trump’s January inauguration, a deluge of spreadsheets arrived at the N.I.H. An executive order mandated that studies collecting gender identity information either remove that component or cease entirely.
Subsequent directives ordered the termination of grants aimed at promoting diversity, equity, and inclusion; awards to Columbia University and South African scientists; and funding for international research collaborations.
“It made me heartsick to look at the spreadsheets,” Dr. Erbelding recalled.
She recounted that employees were often seen crying in her office or in the bathroom, adding, “There’s just a lot of idealism that’s being crushed.”
Dr. Erbelding developed her focus on infectious diseases during medical school at Indiana University. Her fellowship at Johns Hopkins coincided with dual epidemics of H.I.V. and syphilis in Baltimore, solidifying her career path.
In 2010, she became deputy director of the N.I.H.’s AIDS division, just as H.I.V. drug distribution was significantly expanding.
She later led a division addressing other infectious diseases, including those with pandemic potential, and played a role in developing vaccines against them.
Then came an actual pandemic. Dr. Erbelding was present from the very first planning meeting for a vaccine in January 2020. She ensured that clinical trials included crucial populations, such as children, minority groups, and individuals with H.I.V.
She warns that if another pandemic were to strike, the depleted federal agencies might be unable to replicate an effort like Operation Warp Speed.
“You’re destroying something with these draconian cuts that took years to build,” she stated. “It can’t be rebuilt as fast as it was taken down.”
At 64, she has no intention of retiring. She rows in Baltimore three or four times a week when the weather permits, frequently competing in regattas and returning with hands covered in blisters.
She finds that focusing on her rowing stroke “cleanses the mind really nicely.” “You can forget about all the ills of the world,” she concluded.
