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Changes in ecological systems over the past decade have increased the risk of zoonotic disease transmission to humans. A One Health framework is critical to public health emergency and pandemic preparedness, particularly with the increased risks of zoonotic disease spread. In January 2025, the US released its first-ever National One Health Framework to Address Zoonotic Diseases and Advance Public Health Preparedness. The 2023 Consolidated Appropriations Act placed responsibility of this framework under the joint jurisdiction of the CDC, USDA, and the Department of the Interior. But the US federal government, particularly HHS, has undergone dramatic changes to its bureaucratic structures. Little is known about the impacts these changes will have on national, state and local One Health priorities, programs, and policies.
Using a qualitative approach, this study explores how changes to federal One Health policy and bureaucratic institutions in the Trump Administration impact public health emergency response and preparedness capacity. First, primary and secondary data (2001-2025) from federal documents were collected and analyzed to identify trends and themes in US One Health policy development. Themes were compared between the first Trump Administration (2017-2020) and the current Trump Administration (January 2025-September 2025). Second, using elite interviews and state-level document analysis, a comparative case study of 3 incidences of highly pathogenic avian influenza (“bird flu”) outbreaks–2004 outbreak, 2014-2015 outbreak, and the 2024-2025 outbreak–is used to highlight the role of emergency management and public health bureaucratic structures in public health emergency response capacity, as well as how recent federal policy changes have impacted response capacity and resilience for zoonotic disease outbreaks.