Trump administration orders health programs to shift focus from overdose prevention
16 reported4 unconfirmed
The Trump administration has ordered health programs receiving federal funding to agree to new priorities within days, including a focus on “parental authority” in education and a move away from proven overdose-prevention methods like harm reduction, according to a memo obtained by the Guardian. The US Centers for Disease Control and Prevention (CDC) informed health programs at the state, territorial, tribal and local level on Wednesday that they must agree to the list of priorities within five business days, or by 1 July. The notice did not come from program staff at the CDC, who were unaware of the new requirement, according to a source familiar with the memo. It is not clear whether all programs received the notice, though programs focused on immunizations, HIV, hepatitis and tobacco did. While the requirement was not explicitly tied to funding, the grant note references a previous CDC statement that funding may be canceled if programs do not comply. After this story was published, Emily Hilliard, a spokesperson for the US Department of Health and Human Services (HHS), said grantees were directed to review their work plans to ensure activities align with department priorities. The new priorities include “parental authority” and policies giving parents greater control over their children’s education, which could be a reference to vaccination requirements for school attendance. Housing first, harm reduction and safe consumption programs for substance use are also deprioritized, the memo said.
What’s reported
The CDC informed health programs on Wednesday they must agree to new priorities within five business days, or by 1 July.
The notice did not come from CDC program staff, who were unaware of the requirement, according to a source familiar with the memo.
It is not clear whether all state, territorial, tribal and local programs received the notice; programs focused on immunizations, HIV, hepatitis and tobacco did.
The grant note references a previous CDC statement that funding may be canceled if programs do not comply.
Emily Hilliard, an HHS spokesperson, said grantees were directed to review work plans to ensure activities align with department priorities.
New priorities include “parental authority” and policies giving parents greater control over their children’s education.
Housing first, harm reduction and safe consumption programs for substance use are deprioritized.
Nabarun Dasgupta, a street drug researcher at UNC Chapel Hill, said the move “absolutely” appears to signal greater political interference into public health.
Dorit Reiss, a vaccines expert at UC Law San Francisco, said some policies “are in tension with public health” and would undermine that work.
The Trump administration has signaled a focus on ending school vaccine mandates, including letters from HHS Secretary Robert F Kennedy Jr.
Vaccine mandates are set at the state and sometimes local level.
Withholding federal funding because a state or locality mandates vaccines would be “essentially begging for a lawsuit,” Reiss said.
On the east coast, fentanyl is being replaced with the drug adulterant medetomidine, which causes heart attacks among people who try to quit cold turkey, Dasgupta said.
Medetomidine represents a sea change in street drugs with even greater consequences than the introduction of fentanyl, which was partly responsible for driving the overdose crisis to a record 107,941 known drug overdose deaths in 2022, Dasgupta said.
The CDC is also prioritizing evidence-based programs to reduce homelessness, drug use and “public disorder,” which is not defined in the memo.
A July 2025 executive order from the White House took aim at unstably housed and mentally ill people, creating a pathway to criminalize greater numbers of people, experts have said.
Open questions
Whether all state, territorial, tribal and local programs received the notice.
Whether the requirement is explicitly tied to funding, though the grant note references possible cancellation of funding.
How the new priorities will be enforced or challenged legally.
The specific definition of “public disorder” in the memo.
Key figures
Nabarun Dasgupta, street drug researcher and senior scientist at the University of North Carolina at Chapel Hill’s Injury Prevention Research Center
Dorit Reiss, vaccines expert and professor at UC Law San Francisco
Emily Hilliard, spokesperson for the US Department of Health and Human Services (HHS)
Robert F Kennedy Jr, HHS secretary
Sources: The Guardian
