INCOMPETENCE & INJUSTICE

The Trump administration inherited a federal public-health system with its weaknesses already documented. On January 8, 2025, twelve days before Donald Trump returned to office, the Government Accountability Office reported that the Food and Drug Administration had failed to meet statutory targets for domestic food inspections since 2018. FDA officials identified limited workforce capacity as the agency’s primary obstacle. As of July 2024, FDA had 432 investigators assigned to domestic and foreign food inspections, 90 percent of its authorized level. FDA was planning expanded training, recruitment, and retention incentives because the shortage was interfering with the agency’s ability to meet inspection requirements.

Drug oversight carried its own warning. In November 2024, GAO reported that the vacancy rate among FDA investigators who inspect drug manufacturers had risen from 9 percent in November 2021 to 16 percent by June 2024. Attrition had outpaced hiring. FDA told GAO that the loss of experienced investigators and the resulting number of relatively inexperienced employees had limited the number of inspections it could complete. The problem had already reached the performance of the agency before the second Trump administration began.

HHS announced a major restructuring on March 27, 2025. The department said its workforce would fall from about 82,000 employees to 62,000 through the new reduction and earlier departures. FDA would lose approximately 3,500 employees. CDC would lose approximately 2,400. HHS would consolidate 28 divisions into 15, reduce regional offices from 10 to five, and centralize human resources, information technology, procurement, external affairs, and policy. The department projected $1.8 billion in annual savings. HHS stated that FDA inspectors and food, drug, and medical-device reviewers would remain protected. The contraction proceeded after federal auditors had identified insufficient workforce capacity as the primary obstacle to FDA meeting food-inspection targets.

The warning became more detailed two months later. On May 30, 2025, the HHS Office of Inspector General reported that FDA was conducting fewer domestic food-facility inspections than before the pandemic. Many facilities had gone without inspection within the three- or five-year intervals required by law, and FDA was conducting too few inspections to meet those intervals going forward. Significant violations appeared in 1 to 2 percent of inspected facilities each year. For the majority of those significant violations, FDA failed to conduct timely follow-up inspections. OIG stated that the agency could not adequately identify harmful conditions and prevent facilities from producing and distributing unsafe food without correcting those deficiencies.

Those deficiencies remained unresolved well into 2026. HHS OIG’s recommendation tracker listed all four recommendations from the May 2025 report as open and unimplemented as of April 15, 2026. They called for more facility inspections, better identification of facilities that had stopped operating, examination of the decline in significant violations identified during inspections, and timely follow-up when serious violations were found. FDA had concurred with every recommendation.

The broader FDA workforce problem remained as well. In February 2026, GAO reported that FDA’s responsibilities had expanded across food, drugs, medical devices, cosmetics, tobacco products, and other regulated goods while the agency continued struggling to recruit, retain, and train staff. GAO said those workforce problems had reduced FDA’s capacity to conduct inspections. Experienced food and drug investigators can take years to replace because training is lengthy and specialized. The agency responsible for overseeing products that account for roughly 21 cents of every dollar spent by American consumers entered 2026 with an inspection-capacity problem federal auditors were still documenting.

Food-safety modernization was unfinished at the same time. In January 2026, GAO reported that FDA had completed 41 of 46 requirements it identified under the Food Safety Modernization Act. The remaining work included guidance on hazard analysis and preventive controls for human food, protections against intentional adulteration, reporting on the national food emergency response laboratory network, updated agricultural practices for fruits and vegetables, and a product-tracing system intended to improve FDA’s ability to track contaminated food rapidly. FDA had begun developing that tracing system in 2024. By March 2025, officials expected completion in July 2028 after the compliance date for the Food Traceability Rule was extended.

The second Trump administration also arrived with institutional experience that gave public-health warnings unusually concrete meaning. On January 13, 2017, senior members of the incoming Trump team participated in a transition exercise with Obama administration officials covering major domestic incidents and the federal authorities, policies, capabilities, and coordination structures used to respond. The official White House readout listed incoming officials alongside the sitting HHS secretary, CDC director, Anthony Fauci, FEMA administrator, and other emergency officials. The purpose was to familiarize the incoming administration with systems used during major emergencies.

HHS conducted the much larger Crimson Contagion exercise in 2019. It involved twelve federal departments and agencies, twelve states, 96 local jurisdictions, 87 hospitals, and more than 100 private-sector partners. The scenario simulated a severe influenza pandemic and tested federal coordination with state and local governments. GAO later documented confusion over requesting and distributing critical supplies and reported that recommendations from the exercise remained unresolved when the COVID-19 response consumed the agencies responsible for addressing them. The first Trump administration therefore governed through the consequences of a public-health emergency after its own government had rehearsed such an event and identified weaknesses requiring correction.

That experience established a clear competence standard for 2025. Inspectors operate within a larger system of laboratories, records, travel, information technology, procurement, scientific analysis, state coordination, traceability, and enforcement. Outbreak investigators depend on epidemiologists, laboratory networks, data systems, and functioning relationships across federal, state, local, and foreign authorities. HHS chose a department-wide contraction while federal reports were already identifying shortages in the capacity needed to inspect, detect, trace, and respond. The department simultaneously centralized several of the support functions on which those operations depend.

The workload continued. By August 13, 2026, FDA and CDC were investigating a Cyclospora outbreak linked to iceberg lettuce from central Mexico involving 9,481 reported illnesses, 398 hospitalizations, and two deaths across 17 states. FDA had initiated an onsite inspection and sampling while increasing screening at the border. Six days later, FDA reported 431 Salmonella Javiana illnesses and 57 hospitalizations across 32 states linked to jalapeños from Sinaloa, Mexico. That investigation generated numerous downstream recalls involving salsa, guacamole, pico de gallo, prepared foods, and meat and poultry products containing the peppers. Each event required traceback, surveillance, laboratory analysis, inspection, communication, and coordinated removal of affected products from commerce.

The administrative record is therefore unusually direct. FDA entered 2025 with inspection shortfalls, investigator vacancies, unfinished food-safety requirements, and federal recommendations calling for greater capacity. HHS responded within months by reducing the department’s workforce by roughly 20,000 positions, including thousands at FDA and CDC. Federal watchdogs continued documenting inadequate inspection capacity and unresolved recommendations through 2026 while the agencies handled major outbreaks and safety events across food, drugs, medical devices, pet food, and other regulated products.

Incompetence appears in the handling of information already available to the people making the decisions. The federal government had identified the weakness, measured it, connected it to inspection performance, and prescribed corrective work. The first Trump administration had already experienced a pandemic after federal exercises exposed preparedness failures that remained unfinished. The second administration entered office carrying another package of warnings about public-health capacity and chose contraction before repair. By 2026, the inspection deficiencies remained, the corrective recommendations remained open, and the regulatory workload continued arriving in the form of contaminated food, unsafe products, outbreaks, and recalls.

The warning came with the agency. It identified the shortage, described the consequences, and specified what needed strengthening. The administration had the report, had the institutional history, had the prior experience, and had responsibility for the system that followed. It chose to make that system smaller before fixing what federal auditors had already documented as inadequate. That is the incompetence the record establishes.