00:00Hi everyone, I'm Maggie McGrath, editor of Forbes Women.
00:07On Tuesday, massive job cuts hit the U.S. Health and Human Services Department, slashing
00:12thousands of jobs from the CDC, FDA, and NIH.
00:17Within these cuts, the CDC has eliminated its entire team focused on assisted reproductive
00:26technology.
00:27Joining us to explain what this means for fertility treatment around the country is
00:31Barbara Kalora.
00:33She is the CEO of RESOLVE, the National Infertility Association.
00:37Barbara, thank you so much for joining us.
00:40Thank you for having me.
00:42So we're seeing reports of thousands of workers laid off from the Department of Health and
00:46Human Services.
00:47Many of those are within the CDC, and within that, there is this Office of Assisted Reproductive
00:52Technology.
00:54Broadly speaking, what does this mean?
00:56Well, this is a group of six people.
01:00That's it.
01:01Six people.
01:02But they were the team at the CDC, again, our nation's public health agency, that worked
01:07on infertility and in vitro fertilization, or IVF.
01:11In fact, their office was mandated by Congress in 1992.
01:16In other words, Congress passed a law that said CDC must collect this information on
01:22every IVF cycle, and they must report that to the public.
01:26So this office has been working under a congressional mandate for all of those years.
01:32And that entire team, again, only six people, have been let go.
01:36You mentioned thousands were let go.
01:38So you think about it, just this tiny, small group, yet they are the only ones at the CDC
01:46who worked on infertility and IVF.
01:48And one in six people globally are impacted by infertility.
01:54So that knowledge is now, like, gone.
01:56It's walked out the door.
01:58There isn't anybody at the CDC who now works on or knows anything about infertility or
02:03IVF.
02:05There's no one at the Center for Disease Control who knows about fertility and IVF.
02:12What about at the NIH?
02:13Or does that not matter?
02:15Well, I'm taking a deep breath because it's still hard for me.
02:20I've worked with these people for years.
02:22This is a division within the CDC that is very, very important to us and our community.
02:29And so at the NIH, the institute that worked on infertility and also human reproduction
02:37is called the National Institute for Child Health and Human Development, or NICHD.
02:44I've learned that their director of the entire institute was let go yesterday, Dr. Diana
02:50Bianchi.
02:52But there are folks within NICHD that do research and also fund research on infertility.
03:00I have yet to learn their fate, but already I can tell you their ranks were very small.
03:07You mentioned that a congressional mandate developed the Assisted Reproductive Health
03:12team within the CDC.
03:14Are these cuts, especially of the six people that you mentioned, are those technically
03:18against the law?
03:21I'm not a lawyer, but yes, I would say that that is the case.
03:26If Congress has said, you must do this, and you must do this every year, and you must
03:32collect this data, and you must report on this data, that's Congress mandating you to
03:38do something, which is, it's a law.
03:41So you've talked about data.
03:43We've talked about research.
03:44Let's get into the nitty-gritty ramifications of these six people losing their jobs.
03:49What will be, I guess, let's look at the first 30 days, 60 days.
03:54What will be the immediate near-term impact of these jobs not existing?
03:59It's a great question.
04:00And I would just say that, first of all, you've got a group of people that collect all this
04:06data from all of the clinics across the country.
04:09They contract out to a company to do all of the number crunching, and then they analyze
04:16that data.
04:17That's then put on the CDC website.
04:20So I've actually spoken to some of the team since they've been laid off.
04:26They're making the assumption that the contract has ended.
04:29Who's going to work with those folks?
04:32They don't know.
04:33There's nobody at CDC who knows that.
04:35So I think in the immediate, we probably won't feel something immediately.
04:42But all that data collection and all that work is going to stop.
04:46I think that probably means that, because they're always about a year behind, when you
04:51think about IVF, you're looking at what are the outcomes.
04:55We've got nine months of pregnancy, et cetera.
04:57So these things are always about a year out.
05:00So I would say that we're probably going to not have the data from the last year that
05:06they've collected.
05:07That usually comes out at some point near the end of the year.
05:11We won't have that at all.
05:12And then one of the things that this group did is they took that data, and they would
05:18produce research.
05:19And that research has really helped the field advance.
05:23So that's going to all stop.
05:25I don't know, quite honestly, who's going to be managing the content on the CDC website
05:31as it relates to infertility and IVF, because that was this particular group.
05:36So I will keep an eye on it and see if that data becomes stale and old.
05:42But certainly for patients who use this information, this was publicly available.
05:48It was meant for transparency.
05:49It was meant for patient access.
05:54And that is gone now.
05:55Wow.
05:56So eventually, we could have these websites that just are not up to date with the science.
06:03And I wonder, as we think about sources of research, data collection, information gathering,
06:09is there a private sector equivalent who could step in?
06:12I mean, these layoffs happened yesterday.
06:14So if it's a year, is there time for an institute on the private side to step in and pick up
06:22the baton?
06:23Actually, there is.
06:25It's the Society for Assisted Reproductive Technology.
06:28It's the physicians, the clinics.
06:31And they collect data, and they can fill this void.
06:35We've got to make sure patients know to go there.
06:38Going to the CDC is where everyone kind of goes when they get their public health information.
06:43So we've got to direct folks to that data now and that information.
06:48So I'm actually less concerned about some of that IVF success collection data.
06:56What I am concerned about is other ways that this particular group of people served as
07:01a resource within our federal government.
07:03A couple of examples that I know of, a couple of years ago, the Office of Personnel Management,
07:09which is kind of the HR department for federal employees, they wanted to add an IVF insurance
07:15benefit for federal employees.
07:17What did they do?
07:18They call this group at the CDC.
07:21They had them provide a briefing to them on infertility, on IVF, and all that information
07:27as they should.
07:28It's government to government.
07:29It's within their own resources.
07:34We know that members of Congress get asked about infertility from their constituents,
07:40and they call this group at the CDC.
07:43And they say, hey, I have a constituent who's asking me about what we're doing at the federal
07:47government about infertility.
07:49So they are a resource within the entire ecosystem of our federal government.
07:55And now that is gone.
07:58That's one of the ramifications or downstream effects of these six people being fired.
08:04I wonder, what are the other, perhaps lesser recognized, ramifications that could happen?
08:11I'm thinking about family planning information or programs.
08:19What are the other things that we're losing sight of because we're looking at IVF and
08:23looking at the big headlines here?
08:25Well, you know, when you have a group of people that are experts on infertility and IVF within
08:32the CDC, within our government, they were constantly building bridges.
08:38So for example, there is an STD group within CDC.
08:42Quite honestly, I don't know if they survived yesterday.
08:45There are some STDs that could cause infertility.
08:49They would work hand-in-hand on disseminating that information.
08:53What does the data show?
08:54Again, all of that evidence-based information.
08:57They worked very closely with the folks at NIH, the Office of Women's Health at HHS.
09:04So it's a small group of people overall, but they all worked really well together and
09:10provided an exchange of data and information to elevate the field.
09:16One of the things that I know they were working on was expanding access to IVF.
09:22They were looking at data from different states that had insurance mandates for IVF, looking
09:28at utilization, looking at outcomes, and then being able to put that research out there
09:33and say, actually having an IVF mandate is a very good thing.
09:37So they are doing a number of different things that now, I don't know where that's going
09:45to come from.
09:46We're going to, as a community, we're going to have to figure that out.
09:50Earlier this year, President Trump had referred to himself as the Fertilization President.
09:58I'd love your reaction to that in light of the cuts that we saw yesterday.
10:03Well, President Trump talked about IVF on the campaign trail.
10:09We were very surprised when he mentioned last year that he wanted to see IVF free.
10:16He said, I want everyone to be able to access IVF for free or your insurance pay for it.
10:24So he has really leaned in to expanding access to IVF.
10:29In fact, in February, he came out with an executive order that's asking his domestic
10:37policy counsel to come up with recommendations, policy recommendations.
10:41I was thinking about this yesterday when I was talking to the folks at CDC that got laid
10:47off, and they said it and I said it.
10:51They are a resource for the President in order to fulfill these policy recommendations.
11:00They are a resource to the Secretary of HHS, to the White House.
11:04If we're going to lean all in on IVF, as President Trump has said, why get rid of the people
11:10closest to you who know the most?
11:13So I honestly, you know, look, it was 10,000 or so people at HHS.
11:18This is six people.
11:19Maybe it was a mistake.
11:20Maybe no one knows that what they were doing at the White House.
11:23But I think we've just let some folks go that could be a valuable resource to the President
11:29as he wants to expand IVF.
11:31This is the group that can help them do that.
11:35I was just about to ask, what is the chance that these cuts get undone and that these
11:41workers are invited back to their positions in the near term or a month from now, two
11:46months from now?
11:47I am raising, I am raising the alarm that you've just let go the knowledge walked out
11:56the door that helped you the most in doing exactly what you want to do with this executive
12:02order.
12:03So let's rethink this because these are the folks that can really help you.
12:08We've talked a lot about research, data collection, the importance of the partnership that this
12:12office provided within the federal government.
12:15But I have to ask, if anyone at home is watching and they themselves are in treatment for infertility,
12:22do these cuts mean anything for their current treatment?
12:27Probably not.
12:28But if they're looking for credible, evidence-based information, there's a few sources, certainly.
12:33CDC is always a great source.
12:35The CDC also works with the World Health Organization and other health agencies around the globe.
12:41So it's an ecosystem that's constantly working to improve the patient experience and improve
12:47the outcomes.
12:49So in terms of people who are right now doing IVF, it's probably not going to be something
12:54that they're going to feel.
12:56But the care they're getting today is because of all this work and research.
13:02For example, used to be you did IVF and you got twins.
13:06Sometimes you got triplets.
13:08One of the things that the CDC is very, very proud of is because of this data and the work
13:12that they've done, we've been able to almost eliminate multiple births from IVF because
13:19doctors and patients are approaching it very differently.
13:22So we have better health outcomes for moms and for babies.
13:27And that's a good thing.
13:28So patients today are reaping the benefits of this group of people, whether they know it or not.
13:36I think that's a really important point.
13:38Sometimes with public health, the benefits are not always obvious or immediately obvious
13:43to those who are benefiting.
13:45So in this case, again, there could be this long tail effect on what patients feel because
13:51of what happened yesterday.
13:53Now I also want to ask, what does this mean for you and your organization?
13:57How does yesterday change what you're focusing on the day to day and what your 6 to 12 month
14:03plan looks like?
14:06Well, we're an advocacy organization.
14:09We talk to members of Congress.
14:11We talk to decision makers.
14:13We talk to state lawmakers because we are advocating for insurance coverage for IVF.
14:17We want to make sure IVF is protected.
14:20And we use data provided by the federal government.
14:22I'm kind of laughing because it's kind of ridiculous to think about.
14:25But in order to influence policy, I use data from the federal government to make my arguments.
14:30So certainly over time, that's going to go out the window.
14:35I'm not sure that I'm able to use that data anymore.
14:39And that's really incredibly credible information.
14:43We always, always, always cited CDC data in our policy work.
14:47So I think from our perspective, this is a group that I personally worked with very closely.
14:54I know they were working for the best for patients and their outcomes.
15:01And I think for advocacy groups and people who want to advocate, not having the most
15:06comprehensive data from our government is going to be a big gap.
15:14Is there anything else you would like to share with our Forbes audience about the cuts to
15:19the team on assisted reproduction technology or infertility access in the U.S. right now
15:24as a whole?
15:27You know, all of these cuts are hard.
15:29I'm sure every advocacy organization can stand here and talk about groups of people and departments.
15:36I'm seeing, you know, specific groups that have been let go.
15:41This is really unprecedented.
15:44And we've got to decide, you know, where we are as a nation.
15:48Certainly what do we want our public health agency to be?
15:53And I think this is going to take a complete rethinking for all of us.
15:59Barbara Kalora, CEO of Resolve, the National Infertility Association, thank you so very
16:05much for your time and your insight today.
16:06We really appreciate it.
16:09Thanks for covering the story.
Comments