under the microscope
under the microscope
By Rodney Rohde, PhD, MS, SM( ASCP) CM, SVCM, MBCM, FACSc
What is the Impact of the Ongoing Cuts to CDC, ACIP, CLIAC, and NIH on Healthcare-Associated Infections and Infection Prevention?
In recent years, the U. S. has seen a troubling trend of proposed and actual funding cuts to several critical public health agencies, including the Centers for Disease Control and Prevention( CDC), the Advisory Committee on Immunization Practices( ACIP), the Clinical Laboratory Improvement Advisory Committee( CLIAC), and the National Institutes of Health( NIH). These institutions form the backbone of the country’ s infectious disease prevention and control efforts. As budgets tighten, experts are warning that these reductions may severely compromise the nation’ s ability to manage and prevent healthcare-associated infections( HAIs), threatening both patient safety and broader public health.
The Role of Key Agencies in Infection Prevention
To understand the impact of funding cuts, it’ s essential to recognize the role these agencies play:
● CDC: The CDC is the central authority for public health surveillance, outbreak response, and guideline development. It supports hospital infection control programs, tracks HAI trends, and allocates resources to states and hospitals for antimicrobial stewardship and prevention initiatives.
● ACIP: This expert panel advises the CDC on vaccine use and immunization schedules. Their recommendations are integral to preventing vaccine-preventable diseases that can lead to secondary HAIs, especially in vulnerable hospitalized populations.
● CLIAC: While more behind the scenes, CLIAC ensures the quality and accuracy of clinical laboratory testing through oversight of the Clinical Laboratory Improvement Amendments( CLIA). Accurate lab diagnostics are foundational to identifying and responding to infections, including HAIs.
● NIH: The NIH funds crucial biomedical research, including the development of new antimicrobial agents, diagnostic tools, infection control strategies, and vaccines. Its support has propelled innovations in managing multidrug-resistant organisms( MDROs), a major cause of HAIs.
Direct Impacts on HAIs and Infection Prevention
HAIs affect approximately 1 in 31 hospitalized patients daily in the U. S., according to CDC data. These include bloodstream infections, catheter-associated urinary tract infections, surgical site infections, and ventilator-associated pneumonia. Funding cuts to the agencies that combat these infections can have several direct and cascading effects:
➊ Reduced Surveillance and Data Sharing
Budget cuts to the CDC may weaken the National Healthcare Safety Network( NHSN), the country’ s most comprehensive system for tracking HAIs. Without robust data, hospitals may miss trends in MDRO outbreaks, and national policymakers will lack the evidence needed to prioritize infection control strategies.
➋ Erosion of Laboratory Quality Standards
CLIAC provides essential guidance on laboratory testing standards. Diminished support may lead to inconsistencies in diagnostic accuracy, delayed detection of pathogens, and increased risk of inappropriate treatment— all of which contribute to HAIs.
➌ Weakening of Vaccine-Driven Prevention
If ACIP’ s influence is diminished due to reduced CDC support, the development and communication of evidence-based immunization policies could falter. This threatens not only vaccine uptake but also herd immunity in hospitals and long-term care settings. Preventing diseases like influenza and pneumococcal pneumonia is key to reducing secondary bacterial infections in healthcare environments.
➍ Disruption of Research on Drug Resistance
NIH cuts are likely to slow or halt progress in understanding the mechanisms of antimicrobial resistance and in developing novel therapies. As resistance grows, infections become harder to treat and more likely to be spread within healthcare facilities.
Indirect Impacts on Infection Prevention
Beyond the direct effects, funding reductions create systemic vulnerabilities in the U. S. healthcare system:
● Decreased Training and Support for Healthcare Workers: CDC-supported infection prevention training programs may be scaled back, limiting access to up-to-date practices in hospitals and rural or under-resourced settings.
● Slowed Innovation in Diagnostic Technology: NIH grants have supported rapid molecular diagnostics and point-of-care testing. Less funding means slower adoption of such tools, which are vital for early infection identification and isolation procedures.
● Strain on State and Local Health Departments: Many local infection prevention programs rely on federal grants. Cuts would disproportionately affect areas with limited local budgets, further exacerbating healthcare inequalities.
● Pandemic Preparedness and Response Degradation: The same infrastructure that prevents HAIs is essential in responding to future pandemics. For example, the COVID-19 pandemic underscored how infection prevention practices, personal protective equipment, and surveillance systems must be integrated and well-funded.
● Erosion of Interest in Healthcare Majors and Careers: College students and early professionals will be impacted by reduction in funding and awareness for these future career pathways. The front end( recruitment) and back end( retention) pipeline of these workforce areas will be negatively impacted.
8 • www. healthcarehygienemagazine. com • jul-aug 2025