When the Trump administration quietly defunded the Women’s Health Initiative (WHI) — the nation’s largest and longest-running women’s health study — it sparked outrage across the medical and scientific communities. A quick reversal followed, but the episode revealed how vulnerable even legacy public health programs have become. This piece explores not only the WHI’s near-demise, but the broader policy pattern undermining women’s health, from slashed budgets at the NIH and CDC to the collapse of international aid programs and nutrition safety nets. At every level, programs that support women and children have been deprioritized or dismantled. The administration’s simultaneous push for pronatalist policies only highlights the hypocrisy. Reinstating funding is not enough: what’s needed is sustained advocacy and a renewed commitment to evidence-based, inclusive public health.
The WHI Funding Whiplash
When news broke in April that the Department of Health and Human Services (HHS) had abruptly cut funding for the Women’s Health Initiative (WHI), the reaction across the scientific and medical communities was swift and robust. After more than three decades of generating critical insights into cardiovascular disease, cancer, and osteoporosis in women — long excluded or underrepresented in clinical research — the WHI had become an institution in its own right.
The backlash was immediate and intense. Clinicians, advocates, and lawmakers denounced the decision as short-sighted and ideologically driven. Within days, the administration reversed course, with HHS Secretary Monica Bertagnolli announcing the funding would, in fact, be restored. But for many, the damage was already done — not only to trust in institutional stability but to the message it sent about the value of women’s health research in the broader national agenda.
This episode is not an isolated incident. It is emblematic of a broader trend: a pattern of volatility, neglect, and de-prioritization of women’s health that stretches across federal agencies and spans both domestic and global programs. From NIH and FDA budget threats to USAID cuts undermining reproductive health efforts abroad, the administration’s policy posture has consistently placed women’s health programs on shaky ground. Restoring WHI funding is a necessary first step — if it truly happens — but it must not be the last. Now is the moment for sustained vigilance, accountability, and action.
The Women’s Health Initiative: A Legacy at Risk
Launched in 1991 by the National Institutes of Health, the Women’s Health Initiative (WHI) was a landmark investment in research that centered women’s unique health needs after decades of exclusion from clinical trials. It quickly became the largest study of its kind in the United States, enrolling over 160,000 postmenopausal women to investigate the most pressing health issues facing them, including cardiovascular disease, cancer, and osteoporosis. The WHI’s groundbreaking findings reshaped medical practice — most notably, its early 2000s revelation that combined hormone therapy increased the risk of breast cancer and heart disease, prompting a radical reevaluation of menopausal care and saving countless lives. The WHI did more than produce headline-grabbing results; it shifted the research paradigm by proving the value of long-term, large-scale studies that center women as the default, not the afterthought.
That legacy was thrown into uncertainty when the White House quietly moved to terminate WHI funding earlier this year. The decision, buried within broader budget adjustments at the National Heart, Lung, and Blood Institute (which now houses WHI), came with no warning to the program’s regional centers. Institutions across the country scrambled to notify staff and participants of impending closures. Some had already begun dismantling their operations before the restoration was announced. Beyond the human toll (lost jobs, disrupted care) the most alarming consequence was the threat to the WHI’s longitudinal data set, a 30-year trove of clinical, demographic, and behavioral data that remains vital to understanding the aging process and health disparities among American women.
The backlash was swift. Within days, health advocacy organizations, researchers, and members of Congress began pressing HHS for answers. The public outcry was fierce enough to prompt an unusual reversal: HHS Secretary Monica Bertagnolli released a statement just three days after the news broke, announcing that WHI funding would, in fact, continue. She cited “the importance of preserving this historic resource” and committed to ensuring continuity of care and research. While the reversal has been welcomed, it did little to ease concerns that the program could be jeopardized again. With budgets increasingly shaped by political winds, the fate of foundational women’s health research may remain far too vulnerable.
A Pattern of Undermining Women's Health
The temporary defunding of the WHI was not an isolated misstep but rather part of a broader pattern of disregard for public health infrastructure, particularly where it intersects with the needs of women, LGBTQ+ people, and communities of color. Over the past few months, the new administration has pursued aggressive cuts to federal health agencies, with alarming consequences.
The Centers for Disease Control and Prevention (CDC) has been hit especially hard. Among the casualties of the administration’s fiscal agenda was a network of sexually transmitted infection (STI) research labs that played a critical role in tracking and responding to the nation’s syphilis outbreak — a disease now resurging at record levels, including among infants. Meanwhile, the NIH, long the gold standard of biomedical innovation, has seen funding reallocated away from basic research and prevention programs in favor of short-term, politically favored projects. Women’s health initiatives have been especially vulnerable, often dismissed as “non-essential” despite being essential to half the population.
Compounding the budgetary constraints is a wave of ideologically motivated censorship. Executive Order 14168, signed earlier this year, bars federal agencies from using a range of terms — including “gender,” “transgender,” and “sexual orientation” — in grant solicitations, internal communications, and official reports. As noted on public documentation platforms, the order has chilled federally funded research into LGBTQ+ health, effectively shutting down ongoing and prospective studies on gender-affirming care, minority stress, and related health disparities. Researchers have described scrambling to reword proposals or abandon lines of inquiry altogether to avoid noncompliance.
These decisions have direct consequences for maternal health — an area already marked by crisis in the United States. With one of the highest maternal mortality rates among high-income countries, the United States faces especially grim statistics for Black and Indigenous women, whose risk of death from pregnancy-related causes is two to three times higher than that of white women. Funding cuts have shuttered maternal health pilot programs and strained community-based initiatives designed to reduce these disparities. Food and nutrition support programs that contribute to maternal and infant health, such as the Supplemental Nutrition Assistance Program (SNAP) and the Women, Infants, and Children (WIC) program, are also under threat from proposed budget rollbacks.
The cumulative effect is a policy landscape in which the most vulnerable are consistently deprioritized. From disease surveillance to social supports, the foundations of women’s health are being quietly but deliberately dismantled — and the WHI is just the most visible example.
Global Repercussions: USAID and Women’s Health Abroad
The consequences of the executive branch’s health policy decisions are not confined within U.S. borders. In fact, some of the most severe impacts of its ideological realignment are being felt across the Global South, where decades of American leadership in global health are being swiftly reversed. The most dramatic example is the near-dismantling of USAID, the country’s primary foreign aid agency.
Earlier this year, the administration announced that 83% of USAID programs would be defunded or phased out, citing a need to “refocus resources on domestic priorities.” This move led to the rapid shutdown of health clinics and outreach programs in countries such as Myanmar, Sudan, and South Africa. These clinics provided not only contraception and maternal care but also vaccinations, HIV testing, and nutritional support. For many rural and conflict-affected regions, they were the only lifeline. The closures have already disrupted care for thousands of women and girls, and global health organizations are warning of surging maternal and neonatal mortality rates as a result.
The blow is compounded by parallel cuts to the President’s Emergency Plan for AIDS Relief (PEPFAR), long considered one of the most effective bipartisan global health initiatives in U.S. history. The suspension of PEPFAR grants has stalled HIV prevention and treatment efforts in high-burden regions, threatening to reverse hard-won progress against mother-to-child transmission. With millions dependent on antiretroviral therapies funded by PEPFAR, the risks of treatment interruptions are dire — not only increasing HIV-related deaths but also fueling potential drug resistance.
These material cuts are reinforced by ideological ones. The administration has fully reinstated the Mexico City Policy — known by critics as the “Global Gag Rule” — which prohibits U.S. funding to any foreign non-governmental organization that performs or even discusses abortion, even with non-U.S. funds. The reimplementation of the policy has forced clinics to shut down or drastically curtail reproductive health services, from contraceptive counseling to post-abortion care. Evidence from prior enactments shows that rather than reducing abortion rates, the policy increases unsafe abortions by limiting access to contraception and reproductive education.
Together, these changes constitute a full-scale retreat from global women’s health leadership. By slashing support to international partners and reinstating harmful restrictions, the administration is exporting a model of care that is underfunded, ideologically rigid, and fundamentally out of step with the needs of women worldwide.
Domestic Safety Nets Under Siege: SNAP, WIC, and Medicaid
As the Trump administration turns its focus inward, it has set its sights on dismantling the very safety nets that support the health and well-being of low-income women and children in the United States. Proposed budget cuts to core programs like SNAP, WIC, and Medicaid reveal a domestic agenda that mirrors the administration’s retreat from global health: one that is austere, exclusionary, and hostile to those most in need.
According to Kate Scully, Deputy Director of WIC at the Food and Research Action Council (FRAC), the administration’s fiscal blueprint includes deep reductions to SNAP — formerly known as food stamps — which provides nutritional assistance to more than 40 million Americans, the majority of them in households with children. WIC, a lifeline for pregnant and postpartum women and their young children, also faces proposed funding reductions despite strong evidence that the program improves birth outcomes and reduces infant mortality. Medicaid, the largest payer of maternity services in the country, is under similar pressure. Proposed cuts and caps on federal contributions would likely force states to reduce eligibility or benefits, undermining access to prenatal care, childbirth services, and postpartum support.
Beyond cuts, the administration is advancing structural changes designed to shrink the safety net further. Chief among them is the proposed elimination of Broad-Based Categorical Eligibility (BBCE), a policy that allows states to automatically qualify individuals for SNAP if they are enrolled in other low-income assistance programs. As the National WIC Association warns, removing BBCE could disqualify millions of households — including working families just above the poverty line — by narrowly redefining eligibility thresholds. Families could be forced to choose between food and healthcare, especially in states that have not expanded Medicaid under the Affordable Care Act.
The consequences of these changes are not abstract. They are measurable in increased food insecurity, missed medical appointments, untreated maternal mental health conditions, and babies born too early or too small. Programs like SNAP and WIC do more than prevent hunger; they are early interventions in a life course shaped by inequality. As documented by numerous public health agencies, access to these programs is strongly associated with improved long-term health outcomes, from reduced obesity and diabetes to higher educational attainment among children.
In targeting these supports, the administration is not merely tightening the budget — it is eroding the foundations of maternal and child health. For millions of women and children, particularly in rural, Black, Indigenous, and immigrant communities, these programs are not optional — they are essential.
The Imperative of Accountability and Sustained Advocacy
The rapid reversal of WHI funding cut is a rare example of public outcry making an immediate difference in federal health policy. Within days of the announcement, physicians, public health experts, advocacy organizations, and lawmakers mobilized across platforms — publishing op-eds, issuing joint letters, and flooding HHS with demands for reinstatement. That this collective action led to a full funding restoration is a testament to the power of professional and civic advocacy. It also highlights how fragile even legacy programs can be in the face of political expediency.
The lesson is clear: vigilance is not optional. As long as essential women’s health programs are subject to sudden defunding with no public process or rationale, there must be a persistent infrastructure of accountability. That means not only watchdog journalism and expert testimony, but also sustained organizing among clinicians, researchers, and patients. Advocacy must be proactive, not just reactive — building coalitions that can speak with urgency and authority when policy threatens to undermine health equity.
This moment calls for more than just defense. The restoration of WHI funding should be seen not as a victory lap, but as a starting point. It is a signal that the public still has the capacity to push back against harmful decisions but also a reminder of how easily decades of progress can be put at risk. Ensuring that WHI and programs like it continue to thrive will require more than one-time mobilization. It demands long-term engagement: pressure on appropriators, vigilance in the face of bureaucratic restructuring, and a broader political culture that understands women’s health as a pillar of public health, not a niche concern.
The future of women’s health — both in the U.S. and around the world — depends on what happens next. The policies have made clear where the risks lie. It is up to the public, the press, and the scientific community to ensure those risks are met with resistance.
Upholding Commitments to Women’s Health
The restoration of WHI funding — still only a promise — is a welcome relief, but it is no substitute for a sustained and principled commitment to women’s health. This single decision, made and then reversed within the span of days, highlights the broader instability that characterizes the current administration’s approach to public health. The WHI may have been saved this time, but the deeper infrastructure that supports women’s health research, access, and care remains vulnerable to political whims and ideological agendas.
True progress will require more than damage control. It will require reversing course on the broader pattern of defunding and deregulation that has undermined both domestic and global health initiatives, from the shuttering of STI surveillance labs at the CDC to the collapse of USAID-supported clinics abroad and the erosion of nutrition and Medicaid safety nets at home. These are not isolated acts of mismanagement; they reflect a worldview that treats women’s health as negotiable.
If the administration is serious about supporting families, advancing maternal health, and fostering a healthy population, it must commit to consistent, evidence-based policy grounded in equity, not expediency. Safeguarding women’s health means investing in the systems that allow women to thrive — not just restoring funding under pressure, but building a resilient, inclusive public health agenda that endures.