Trump watch: 23 states and 2000 scientists sue president over cuts, WHO budget crisis deepens, and more

DC and 23 states sue Trump government

The District of Columbia and 23 US states have launched legal action against President Donald Trump’s administration after the cancellation of $11bn (£8.54bn; €10bn) in public health funding left over from the covid pandemic.1 The funding was being used in programmes tracking the spread of disease and vaccine rollouts, as well as addiction and mental health services and others.

The lawsuit, which asks the court to immediately block the funding cut, says that the federal government did not provide a “rational basis” or facts to support the cuts. The attorney generals representing these states said that the move would lead to “serious harm to public health” and would put states “at greater risk for future pandemics and the spread of otherwise preventable disease and cutting off vital public health services.”

California’s attorney general, Rob Bonta, said that Trump and the health secretary, Robert F Kennedy Jr, were “completely out of bounds,” adding that the funding cut “far exceeds” any statutory or regulatory authority given to Kennedy’s Department of Health and Human Services. Bonta added, “Congress explicitly authorised funding for the grants at issue to help keep our country healthy and protect us from future pandemics.”

Scientists launch lawsuit over NIH grant

A group of around 2000 scientists filed a lawsuit against the Trump administration’s cuts to grant funding from the National Institutes of Health (NIH).2 The lawsuit—filed by the American Public Health Association, unions representing scientists, and researchers who were stripped of grants—argues that the cuts were not guided by federal funding rules, which include a science based review process designed to insulate the grant process from politicisation. Ending projects midstream could put patients who are undergoing NIH funded treatment at risk and would waste taxpayer money, the lawsuit claims.

WHO budget gap widens by $1.9bn

The World Health Organization (WHO) has revealed that its funding crisis is far bigger than previously thought, after the US withdrew funding from the agency. In a staff meeting, senior officials said that the organisation was short by nearly $1.9bn, along with a $600m deficit through to the end of 2025.

The gap leaves it short of nearly 45% of the money it needs to run, even on the reduced budget of $4.2bn it had planned for 2026-27. Officials revealed that the outgoing US administration of President Joe Biden had never paid 2024 dues of $130m owed before leaving office. Health Policy Watch reported that, altogether, the US owed $260m in dues for 2024-25, which WHO is unlikely to receive from Trump despite a legal obligation to pay.34

Trump restores funding to anti-abortion states

Oklahoma and Tennessee have had millions of dollars in family planning funds restored after Trump’s government reversed the Biden administration’s decision to withhold the money because of their stance on abortion. These states had refused to comply with programme rules requiring participating clinics to counsel patients about all their pregnancy options. The Oklahoma State Department of Health confirmed to Politico on 1 April that it had so far received less than $2m for the year, having previously received $4.5m.5

Elsewhere, the US Supreme Court is considering a bid by the state of South Carolina—backed by the Trump administration—to exclude the non-profit group Planned Parenthood from its Medicaid programme, which provides health funds for low income patients. Planned Parenthood is the US’s largest single provider of abortions. South Carolina argues that because Planned Parenthood provides abortion using other funds it should not be able to receive Medicaid for contraception, screening for sexually transmitted infections, or prenatal care. Politico reported that the case would hinge on whether Medicaid patients have the right to sue over being denied their free choice of healthcare provider, but the Supreme Court’s decision will essentially determine whether states can choose who gets to participate in the programme, and it could encourage other conservative states to similarly cut reproductive and sexual healthcare from Medicaid.

The New York Times has reported that nearly 50 million women in low and middle income countries will lose access to contraception after the dismantling of the US Agency for International Development (USAID).6 The US provided about 40% (around $60m) of government contributions to family planning programmes in 31 lower income countries. The Guttmacher Institute, a sexual health research organisation, calculated that US funding had averted 17.1 million unintended pregnancies and 5.2 million unsafe abortions and that 34 000 women could die from preventable maternal deaths each year without it.

Trump had also terminated US funding for the UN sexual and reproductive health agency UNFPA—the US having been the largest donor. The New York Times reported “chaos” caused by the abrupt loss of funds, which had already caused clinics to run out of contraceptive and family planning products. An estimated $27m worth of such products already procured by USAID before its dismantling are stuck in boats, ports, or warehouses, with no programmes or employees left to unload them or hand them over. A former employee told the New York Times that the new, Trump appointed USAID leadership had proposed to destroy the products.

Novavax covid vaccine approval is paused

The Food and Drug Administration (FDA) has paused approval of Novavax’s covid-19 vaccine, Politico reported. Sara Brenner, the preventive medicine doctor appointed by Trump as principal deputy commissioner of the FDA, took the unusual step of intervening in an agency review of the vaccine. The move came as the leading vaccine official Peter Marks quit and his deputy, Julie Tierney, was put on administrative leave, as part of sweeping cuts to US health departments.7 Novavax said that it had responded to all the FDA’s information requests and believed that the vaccine shot was ready for approval.

Utah is first to ban fluoride in drinking water

The state of Utah banned fluoride in public drinking water despite opposition from dentists and national health organisations, who warned that the move would lead to medical problems disproportionately affecting low income communities.8 Kennedy has previously called for the removal of fluoride from water systems,9 and Utah is the first state to do so.

Confirmations and appointments

• Mehmet Oz was confirmed by the US Senate as head of the Centers for Medicare and Medicaid Services.10

• Trump nominated Sara Carter, a Fox News journalist, as director of the Office of National Drug Control Policy. Stat News noted that Carter had no previous background in drug policy, public health, law enforcement, or government, but she is a staunch supporter of Trump and has criticised Biden for failing to crack down on the illicit drug trade.11