Exclusive: The Trump administration dismantled the CDC’s peer review system. Staffers scrambled to salvage it.
Deep Dives
Explore related topics with these Wikipedia articles, rewritten for enjoyable reading:
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Federal Advisory Committee Act
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FACA charters are central to this article's narrative - understanding the 1972 law governing how federal agencies can seek outside expert advice provides essential context for why revoking these charters was so consequential for CDC peer review
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Department of Government Efficiency
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DOGE is mentioned as a source of scrutiny that CDC staffers were trying to avoid - understanding this advisory body's role and approach to federal agency reform provides important political context for the pressures facing career scientists
Dear Readers, I’ve been reporting this story for several weeks. It features on-the-record quotes from prominent CDC/NIH alumni, legal experts, and input from more than a dozen additional sources whose identities are protected here. It’s a 3,700-word deep dive into how the Trump administration tried to dismantle the CDC’s peer review process for external grants—and how career staff worked to save the system that ensures rigor and fairness in its decision making.
If you find this valuable, please share it and consider upgrading to support Inside Medicine. Thank you so much! —Jeremy Faust
You can’t just call a meeting of outside experts.
You need a FACA charter.
What am I talking about and why do you care?
The CDC is responsible for creating unified federal responses to countless public health problems. For the CDC to fulfill its duties, knowledge gaps like these—known unknowns—must be filled. How many American kids have epilepsy? Are men being asked the right questions when considering whether to receive prostate cancer screening? The answers guide national priorities and policies.
Answering these questions takes research, research that CDC scientists cannot perform, owing to lack of in-house expertise, sufficient resources, or both. So, a simple solution has long been in place: outsourcing.
The CDC sends around 80% of all the money it receives back out the door, including to state and local health departments. Around 10-20% of this goes toward competitive external research grants, amounting to hundreds of millions of dollars every year, funding that supports research into chronic diseases, birth defects, injury, global health, and infectious diseases.
Inside Medicine has learned that earlier this year, the Trump administration quietly dismantled the external peer review procedure that assured that CDC-funded extramural research reflected the “most meritorious ideas and projects,” and maintained public accountability.
Interviews with more than a dozen current and former HHS employees and legal experts reveal what appears to be another retreat from the venerable systems that safeguard transparency and fairness in federal science—only to be replaced by a looser framework prone to political influence and cronyism.
Even so, CDC scientific officers identified a workaround, and attempted to get these grants funded before the 2025 fiscal year ended on September 30. They wouldn’t know until the last minute if they had succeeded.
A system designed to ensure quality and fairness is scrapped.
Since 2003, CDC policy has required that outside (“extramural”) research funding decisions
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