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Trump cuts to advisory groups leaves hospitals without key expertise on disease

LEILA FADEL, HOST:

We've been taking stock recently of science that has not been done under President Trump. Federal advisory groups help guide the government on research and science issues. Since Trump took office, dozens of those groups have been canceled or frozen. Among them is one dedicated to preventing infection in healthcare settings. NPR's Katia Riddle reports.

KATIA RIDDLE, BYLINE: Drug-resistant organisms are a vexing problem for infectious disease experts. For years, doctors have been waging war on dangerous bacteria like MRSA. But in the last decade, a new villain appeared on the scene - a fungus called Candida auris.

SCOTT ROBERTS: It was first identified in the ear canal of a nursing-home patient in Japan in 2009. And it really wasn't around before that.

RIDDLE: Scott Roberts is an infectious disease doctor at Yale. He treated one of the first patients in the U.S. with this fungus.

ROBERTS: This was maybe 2018, 2019, and at the time, not much was known about it. And, you know, to this day, we're still trying to grapple with where this came from, why is it spreading so fast. And it's a bit of a mystery.

RIDDLE: Candida auris can survive on surfaces and cause life-threatening infections, especially in people who are immunocompromised. Once it takes up residence in a hospital, it's hard to evict. For all these reasons, says Roberts, he was grateful when the federal government stepped in to help figure out how to fight it by bringing it to the attention of the Healthcare Infection Control Practices Advisory Committee, or HICPAC. But in March of last year, that committee was terminated, along with its efforts to help fight Candida auris.

ROBERTS: And so to hear that we're losing a federal advisory committee on this and we're losing federal assistance is only going to make the problem worse.

RIDDLE: Fighting dangerous fungi was one of many problems that the committee was working on. It was staffed by a group of volunteers that brought perspectives from healthcare facilities - big and small, rural and urban - to work together on problems. The group would then make recommendations to the CDC to help guide policy. Hilary Babcock was one member. She says the reason this committee was important was not just because of their expertise. The CDC is already full of experts, she says.

HILARY BABCOCK: They don't need help, necessarily, knowing, like, what does the literature show. But what they don't do is work in hospitals and healthcare systems.

RIDDLE: Babcock is an infectious disease doctor in St. Louis. She says having this range of experts to give real-time feedback to the people working inside the federal government was invaluable.

BABCOCK: So that's really what the committees bring to that space, is that sort of lived experience of how this guidance works in those settings.

RIDDLE: In an email, representatives from the White House did not comment on this particular committee, but said that all committees that were terminated were, quote, "found to be redundant, unnecessary or ineffective," unquote. But industry groups like the American Association for the Advancement of Science have raised concerns that cutting these committees will hamstring urgently needed research. Carrie Wolinetz has for years worked with these federal advisory committees.

CARRIE WOLINETZ: As a federal official, I found advisory committees to be really helpful to me in my sort of thinking and policy development.

RIDDLE: Wolinetz was an official at the NIH. Now she works in healthcare policy and advocacy.

WOLINETZ: They would, like, challenge me on things (laughter) that I - you know, I thought to be true. They brought up, you know, real-world issues that me, from my sort of seat within government, would not necessarily have thought of.

RIDDLE: The case of Candida auris, the number of cases in the U.S. continues to grow. Scott Roberts, the infectious disease doctor, says one of the reasons is that protocols around disinfecting for this specific fungus are not well understood.

ROBERTS: If you don't adequately disinfect that medical equipment before you go to the next patient, you really risk transmitting it from one person to another.

RIDDLE: Roberts says that's part of the reason this committee's work was so critical.

ROBERTS: We really rely on federal assistance here to say, you know, this is a recommended screening protocol. Everybody should be doing this.

RIDDLE: Without these recommendations and guidelines, says Roberts, doctors like him are left with a patchwork of protocols. And that's no match for a sneaky, drug-resistant fungus.

Katia Riddle, NPR News.

(SOUNDBITE OF DESERTSHORE'S "MATCHLIGHT ARCANA") Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Katia Riddle
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