Senator Bernie Sanders published an op-ed in The New York Times on August 30, 2025, urging Health and Human Services Secretary Robert F. Kennedy Jr. to step down, citing what he calls a “crisis of confidence” in America’s public health institutions.

Sanders’ critique comes in the wake of a string of controversial actions by Kennedy, including the abrupt dismissal of CDC Director Susan Monarez, the disbanding of the Advisory Committee on Immunization Practices (ACIP) and the halting of nearly $500 million in federal funding for mRNA vaccine development.

According to Sanders, these actions “undermine scientific integrity, disrupt vaccine development, and threaten Americans’ access to life-saving healthcare.” He highlights the resignation of top CDC officials in protest as a stark signal that Kennedy’s leadership is incompatible with the responsibilities of HHS.

The op-ed frames the resignation as both a moral and practical imperative, stressing that political ideology must not override science in safeguarding public health and ensuring pandemic preparedness. Sanders warns that dismantling vaccine advisory structures and defunding research could leave the U.S. vulnerable to future outbreaks.

He also calls on Congress to hold HHS accountable for the upheaval, noting that the Trump-era appointee’s actions “threaten the public’s trust in health institutions that Americans rely on for safety and scientific guidance.” Sanders’ intervention signals rare but urgent congressional scrutiny of executive health policy, highlighting deep divisions over vaccine strategy, public trust, and governance.

Susan Monarez isn’t “aligned with” President Donald Trump’s agenda and refused to resign, so the White House terminated her, spokesman Kush Desai said Wednesday night.

Her lawyers said she was targeted for standing up for science.

The U.S. Department of Health and Human Services had announced her departure in a brief social media post late Wednesday afternoon. Her lawyers responded with a statement saying Monarez had neither resigned nor been told she was fired.

“When CDC Director Susan Monarez refused to rubber-stamp unscientific, reckless directives and fire dedicated health experts, she chose protecting the public over serving a political agenda. For that, she has been targeted,” attorneys Mark Zaid and Abbe David Lowell wrote in a statement.

“This is not about one official. It is about the systematic dismantling of public health institutions, the silencing of experts, and the dangerous politicization of science. The attack on Dr. Monarez is a warning to every American: our evidence-based systems are being undermined from within,” they said.

Her departure coincided with the resignations this week of at least four top CDC officials. The list includes Dr. Debra Houry, the agency’s deputy director; Dr. Daniel Jernigan, head of the agency’s National Center for Emerging and Zoonotic Infectious Diseases; Dr. Demetre Daskalakis, head of its National Center for Immunization and Respiratory Diseases; and Dr. Jennifer Layden, director of the Office of Public Health Data, Surveillance, and Technology.

In an email seen by The Associated Press, Houry lamented the crippling effects on the agency from planned budget cuts, reorganization and firings.

“I am committed to protecting the public’s health, but the ongoing changes prevent me from continuing in my job as a leader of the agency,” she wrote.

She also noted the rise of misinformation about vaccines during the current Trump administration, and alluded to new limits on CDC communications.

“For the good of the nation and the world, the science at CDC should never be censored or subject to political pauses or interpretations,” she wrote.

Daskalakis worked closely with the Advisory Committee on Immunization Practices. Kennedy remade the committee by firing everyone and replacing them with a group that included several vaccine skeptics — one of whom was put in charge of a COVID-19 vaccines workgroup.

In his resignation letter, Daskalakis lamented that the changes put “people of dubious intent and more dubious scientific rigor in charge of recommending vaccine policy.” He described Monarez as “hamstrung and sidelined by an authoritarian leader.” He added: “Their desire to please a political base will result in death and disability of vulnerable children and adults.”

He also wrote: “I am unable to serve in an environment that treats CDC as a tool to generate policies and materials that do not reflect scientific reality.”

HHS officials did not immediately respond to questions about the resignations.

Some public health experts decried the loss of so many of CDC’s scientific leaders.

“The CDC is being decapitated. This is an absolute disaster for public health,” said Public Citizen’s Dr. Robert Steinbrook.

Michael Osterholm, a University of Minnesota infectious disease researcher, said the departures were “a serious loss for America.”

“The loss of experienced, world-class infectious disease experts at CDC is directly related to the failed leadership of extremists currently in charge of the Department of Health and Human Services,” he said. “They make our country less safe and less prepared for public health emergencies.”

Monarez, 50, was the agency’s 21st director and the first to pass through Senate confirmation following a 2023 law. She was named acting director in January and then tapped as the nominee in March after Trump abruptly withdrew his first choice, David Weldon.

She was sworn in on July 31 — less than a month ago, making her the shortest-serving CDC director in the history of the 79-year-old agency.

Her short time at CDC was tumultuous. On Aug. 8, at the end of her first full week on the job, a Georgia man opened fire from a spot at a pharmacy across the street from CDC’s main entrance. The 30-year-old man blamed the COVID-19 vaccine for making him depressed and suicidal. He killed a police officer and fired more than 180 shots into CDC buildings before killing himself.

No one at CDC was injured, but it shell-shocked a staff that already had low morale from other recent changes.

Monarez had scheduled an “all hands meeting” meeting for the CDC staff — seen as an important step in addressing concerns among staff since the shooting — for Monday this week. But HHS officials meddled with that, too, canceling it and calling Monarez to Washington, D.C., said a CDC official who was not authorized to talk about it and spoke to the AP on condition of anonymity.

The Atlanta-based federal agency was initially founded to prevent the spread of malaria in the U.S. Its mission was later expanded, and it gradually became a global leader on infectious and chronic diseases and a go-to source of health information.

This year it’s been hit by widespread staff cuts, resignations of key officials and heated controversy over long-standing CDC vaccine policies upended by Health Secretary Robert F. Kennedy Jr.

During her Senate confirmation process, Monarez told senators that she values vaccines, public health interventions and rigorous scientific evidence. But she largely dodged questions about whether those positions put her at odds with Kennedy, a longtime vaccine skeptic who has criticized and sought to dismantle some of the agency’s previous protocols and decisions.

Sen. Patty Murray, a Washington Democrat, praised Monarez for standing up to Kennedy and called for him to be fired.

“We cannot let RFK Jr. burn what’s left of the CDC and our other critical health agencies to the ground,” she said in a statement Wednesday night.

The Washington Post first reported Monarez was ousted.

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AP reporter Amanda Seitz in Washington contributed to this report.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

So, how concerned should we be about human cases of screwworm infestations?

What are some good precautions to take when traveling to an area with a screwworm outbreak?

What if the 10,000-steps-per-day mark was just a publicity campaign from the 1960s that caught the public’s attention, and recent science indicates that 7,000 is the true mark that carries a health benefit with it? That is exactly the scenario that’s playing out.

The latest large-scale analysis, published in The Lancet Public Health and drawing from over 160,000 adults across 57 studies worldwide, challenges the fabled 10,000-step mark. Researchers not only concluded that walking 7,000 steps per day was in fact linked to dramatic improvements in longevity and protection against a wide array of diseases, but that going the extra 3,000 steps didn’t make that much of a difference after all.

Why 10,000 steps became ‘the goal’

For years, “10,000 steps” has been consecrated as the gold standard of daily fitness. But the origin of that benchmark wasn’t medical—it was marketing. Ahead of the 1964 Tokyo Olympics, a Japanese pedometer called the “manpo-kei,” which translates to “10,000-step meter,” launched a global fitness trend. That catchy round number stuck, becoming the default goal for millions using wearable trackers.

The 10,000 steps benchmark just seems to be one of those things that lodges in your head. Popular YouTubers and fitness influencers run “10,000 step challenges” encouraging followers to meet or exceed the daily target, often featuring “walk with me” workout sessions. It’s been granted official status by digital apps, with the number “10,000” now a default setting on devices such as Fitbit. Corporate wellness programs, social media challenges, and public health campaigns also routinely use the 10,000-step mark as a motivational goal and badge of accomplishment.

The bombshell findings

The new research poured cold water on the idea of 10,000 as a scientific minimum. Compared to the least active group (2,000 steps), those who managed 7,000 steps per day saw:

• 47% decreased risk of premature death
• 25% lower chance of cardiovascular disease
• 38% reduced risk of dementia
• 6% lower cancer risk
• 22% lower incidence of depressive symptoms
• 28% reduction in falls
• 14% lower risk of developing Type 2 diabetes

What’s more, these massive benefits approached a plateau with 7,000 steps; walking all the way to 10,000 steps per day generated only small additional reductions in risk for most conditions. For some diseases—like heart disease—benefits increased slightly beyond 7,000, but for many others, the curve flattened.

“Although 10,000 steps per day can still be a viable target for those who are more active,” according to the abstract, “7,000 steps per day is associated with clinically meaningful improvements in health outcomes and might be a more realistic and achievable target for some.” The authors add that the findings should be interpreted in light of limitations, such as the small number of studies available for most outcomes, a lack of age-specific analysis and potential biases at the individual study level.

‘More is better’—but only up to a point

Walking more remains beneficial, particularly for those who are mostly sedentary. The study found the greatest jump in health benefits when moving from very low step counts (~2,000) up to 7,000 daily. For the general adult population, 7,000 steps—about three miles—delivers the bulk of the effect. For adults over 60, benefits plateau a bit earlier, around 6,000–8,000 steps, while younger adults may see the curve level off closer to 8,000–10,000.

The researchers also revealed that the pace of walking was far less important: just getting in the steps, regardless of speed, provided the protective benefits.

Rethinking the fitness message

This research could prompt a shake-up in public health messaging, which has long promoted aspirational but somewhat arbitrary targets. Fitness professionals and wearable device makers now have fresh evidence to advise clients and consumers that a daily goal of 7,000 is both realistic and powerfully protective. Then again, 10,000 steps is catchy.

For this story, Fortune used generative AI to help with an initial draft. An editor verified the accuracy of the information before publishing. 

A government’s budget is about much more than numbers: It’s a moral document that reflects a nation’s values. Chief among those should be providing for the most vulnerable. This includes guaranteeing health care for Americans; shoring up Medicare, Medicaid and the Affordable Care Act; providing food assistance to needy people, including the elderly and children; funding science and medical research; and requiring the very richest to pay their share of taxes.

Within this framework, it’s clear that Donald Trump and the GOP’s One Big Beautiful Bill Act is a moral failure in the making, where values of greed, cruelty and sociopathy masquerade as responsible public policy. In a recent interview with “Democracy Now!,” Rev. William Barber correctly described it as the “Big, Ugly, Destructive, Deadly Bill.”

If enacted, the legislation will further tear apart an already weak social safety net and strip health care from millions of Americans. Medicare, Medicaid and the Affordable Care Act (ACA) will be cut by more than 1 trillion dollars. The massive tax cuts from Trump’s first term will be extended. Hundreds of billions will be spent on defense and the administration’s mass deportation campaign against undocumented immigrants. The legislation will create one of the biggest transfers of wealth in American history: hundreds of billions of dollars — and likely trillions — of dollars will be taken from the poor, working class, and the middle class and given to the wealthiest Americans and corporations. According to the nonpartisan Congressional Budget Office, the bill will cause the federal deficit to explode by at least $3.3 trillion over 10 years.

The very richest Americans already have more wealth than they could reasonably spend in several lifetimes. For example, the top 10 percent of Americans control approximately 70 percent of the nation’s wealth. By comparison, the lower half of the American population controls a pitiful 2 to 6 percent of the nation’s wealth. The amount of wealth owned by the American middle class is less than that owned by the top 1 percent.

Wealth and income are directly correlated with how long a person lives and their quality of life. At its core, the “Big Beautiful Bill” will help the rich to live longer and be happier while everyday Americans will live even shorter and more miserable lives.

In early June, Dr. Alison Galvani, director of the Center for Infectious Disease Modeling and Analysis at the Yale School of Public Health, joined with other public health and policy experts at Yale and the University of Pennsylvania in signing an open letter to Democratic Sens. Ron Wyden of Oregon and Bernie Sanders of Vermont, both of whom serve on the Senate Finance Committee. The group, in warning about the bill’s potential impacts, predicted the unnecessary deaths of at least 51,000 people each year in the United States.

In a recent conversation, Dr. Galvani explained how public health is directly connected to the health of American democracy and why authoritarian governments cause sickness, death and shorter lives for the people who suffer under them.

America’s democracy crisis is not just one discrete thing. It overlaps with most, if not all, areas of society and life. What do we know empirically about the impact of authoritarianism on public health and well-being?

Authoritarian regimes often suppress scientific inquiry, censor data and discredit experts, which is devastating for public health. Accurate data and open scientific discourse are fundamental for identifying health threats, developing effective interventions and responding to crises (e.g., pandemics). Politicizing science leads to a misinformed public, hindering effective health behaviors.

Resources may be diverted away from essential public services, including health care, toward security apparatuses or to benefit favored elites. Corruption can siphon funds meant for health infrastructure, drug procurement or service delivery.

Authoritarian systems often exacerbate existing social and economic inequalities, which are direct drivers of health disparities. Vulnerable groups may lose protections and access to services.

Science used to be a nonpartisan issue. It’s disheartening that public health has become so politically polarized.

Republican-led red states and regions of the country have much worse health outcomes than Democratic-led blue states and regions. This is a type of experiment where we can literally see how divergent approaches to public health and the social can impact a person’s life.

There’s a clear divergence in health policy choices. “Blue” states generally embrace policies that expand access, such as Medicaid expansion under the ACA, more robust social safety nets, higher minimum wages and stronger environmental regulations. “Red” states, conversely, often resist Medicaid expansion, pursue more restrictive reproductive health policies and may have less stringent environmental or worker protection laws.

These policy differences frequently correlate with significant disparities in health outcomes. States that expanded Medicaid tend to have lower uninsured rates, improved access to care, better management of chronic diseases and reduced mortality from conditions like heart disease and cancer… States with more restrictive policies often see higher rates of uninsured individuals, worse maternal and infant mortality rates and greater burdens of preventable diseases.

Beyond direct health policy, differences in approaches to education, social welfare and economic equity also contribute to health disparities. “Blue” states often invest more in these social determinants of health, which ultimately yield better health outcomes.

What of the much-discussed claims about the “deaths of despair” among “working class” white people (and now Black people and First Nations and other marginalized communities) in the long Age of Trump, and how the country arrived at this point?

Deaths of despair highlight the critical need for comprehensive policies that address economic insecurity, ensure equitable access to quality healthcare (including mental health and substance abuse treatment), rebuild community infrastructure and combat systemic racism and discrimination.

Trump’s “big, beautiful bill” is, like other public policy, something that can be evaluated in terms of its impact on public health and well-being, life chances, life outcomes and literally how long a person will live. What do we know?

The proposed budget prioritizes fiscal austerity and reduced government spending over a robust social safety net and access to health care. It suggests a view where health care is primarily a market commodity rather than a fundamental right, shifting responsibility from collective provision to individual burden.

Loss of health care access is a primary concern, as millions would lose essential health insurance, leading to delayed or forgone care, increased financial hardship and worse health outcomes.

While intended to save money, neglecting preventive and early care often leads to more expensive emergency room visits and hospitalizations for advanced, preventable conditions. Families face devastating medical debt from uninsured care, depleting savings, increasing poverty and perpetuating intergenerational cycles of disadvantage. Families bear an increased burden of care for sick relatives who cannot access formal health care, impacting their own health, finances and ability to participate in the workforce. Cuts to Medicaid and subsidies disproportionately affect those with limited financial resources.

51,000 is a very conservative estimate of the unnecessary deaths that will occur if Trump and the MAGA Republicans’ 2025 budget is enacted. What of shortened lives? Community impact from lost income, wealth, social capital and other resources and supports? Trauma from this type of shock to norms, and the anxiety and extreme stress that will result? These are not just abstractions. We have to connect systems and institutions to individuals.

The 51,000 deaths figure represents outright mortality. However, for many more, the lack of care or delayed treatment would lead to preventable illnesses, chronic conditions getting worse, increased disability and years of life lived in poorer health. This represents a significant loss of healthy life years and a reduction in overall well-being.

Premature deaths mean lost contributions to the workforce and economy. Illness and disability due to a lack of care also reduce productivity and earning potential for individuals and their families.

Iowa Republican Sen. Joni Ernst recently [spoke to] her constituents who were worried about what will happen to their lives if [the bill] is enacted and Medicaid, Medicare and health care more broadly is cut. “We are all going to die,” she told them. What would you tell Ernst if you had a chance to have a conversation with her?

The callous suggestion that cuts to life-saving programs simply accelerate an inevitable outcome ignores the vast body of evidence showing how these services add years of quality life, reduce suffering and allow individuals to contribute meaningfully to their families and communities.

When this vile bill is forced on the American people, what will it mean for the overall well-being and quality of life?

Short-term: Millions would immediately lose health coverage, leading to higher rates of delayed or foregone medical care. Individuals and families would face immediate, drastic increases in out-of-pocket medical costs and medical debt, pushing many into poverty. Widespread fear and uncertainty about health care access and financial security will immediately impact mental well-being. Patients with chronic diseases would see their conditions worsen due to a lack of access to medications and ongoing care. As primary care becomes less accessible, emergency rooms would likely see an increased burden of preventable conditions, which is a far more expensive and less effective way to deliver care.

Mid-term: The 51,000 projected deaths would become an annual reality, steadily increasing the nation’s mortality rate from preventable causes. National health metrics (e.g., infant mortality, life expectancy, rates of chronic disease management) would likely decline. A sicker, less productive workforce, coupled with increased medical debt, could depress economic activity and further strain state and local budgets.

Long-term: Decreased Life Expectancy. The U.S. life expectancy, already lagging behind many peer nations, could further stagnate or decline.

Children who grow up without adequate health care suffer long-term developmental and health consequences, perpetuating cycles of poor health and poverty.

Cuts to scientific research and public health infrastructure would cripple the nation’s ability to respond to future health crises (e.g., pandemics, emerging diseases) and diminish its capacity for medical breakthroughs.