Rebuilding health and human services: a call to strategic planning and action.

Abstract

The capacity of the U.S. Department of Health and Human Services (HHS) has been substantially reduced since early 2025. This has included staffing cuts on a scale not seen in decades, delays in implementing billions of dollars in grants, and other disruptions to normal operations, all of which have received considerable public coverage and attention. To date, far less public attention has been given to rebuilding efforts. This commentary presents recommendations for rebuilding HHS' lost capacity, following a series of roundtable discussions convened by a network of former senior HHS appointees. The roundtables included former HHS political appointees, career program staff and division leaders, and health policy researchers from universities, think tanks, and policy organizations. Based on common themes in these discussions, we propose 5 recommendations to rebuild HHS capacity: (1) treating and funding the rebuilding of federal health and health research capacity as an urgent national security priority; (2) shifting from reactive crisis management to coordinated forward planning; (3) continued documentation of what capacity has been lost and why; (4) establishing an independent, nonpartisan science advisory body across HHS; and (5) drafting legislation now so that policy windows are not missed when they open.