The Trump administration is radically revising the scale and scope of the federal health workforce.

Approximately 1 in 4 employees at the Department of Health and Human Services have been laid off, forced out or pushed to take early retirement through a series of cuts designed to shrink an agency that provides health insurance to tens of millions of Americans, regulates medical products and funds disease research.

The reduction-in-force hasn’t been distributed equally. While an official accounting has not emerged, it’s become clear that communications, policy, IT and HR offices across agencies have been gutted or closed. About half of HHS’ 28 divisions are being eliminated or consolidated.

More downsizing may be forthcoming, too. A leaked budget document shows the White House aims to slash HHS spending by one-third.

Carrying out this overhaul is HHS Secretary Robert F. Kennedy Jr., an environmental lawyer turned anti-vaccine activist whose role in the “Make America Healthy Again” movement won him a close relationship with President Donald Trump. Kennedy has wasted little time trying to bend HHS to his agenda, which he says is focused on addressing what he describes as a chronic disease epidemic. Yet his actions so far have also raised concerns he aims to restrict vaccines, in keeping with the years he’s spent spreading misinformation about their safety and efficacy.

BioPharma Dive is closely covering the changes underway at HHS. Keep tabs on the latest major developments using this tracker: