— These advisors make healthcare safer for everyone
by Alexander Sundermann, DrPH April 17, 2025 • 5 min read
Sundermann is an assistant professor of epidemiology.
Whether you are placing a central line, managing a Clostridioides difficile case, or keeping a surgical field sterile, you're likely following standards influenced by the Healthcare Infection Control Practices Advisory Committee (HICPAC). While it may not be widely known outside of infection prevention circles, HICPAC plays a central role in shaping the evidence-based guidelines that frontline clinicians use every day to protect both patients and healthcare workers.
But now, this critical committee is at risk, as recent reports suggest HICPAC may be on the chopping block amid ongoing federal cuts. Like most federal advisory committees, HICPAC must be reauthorized every 2 years by HHS to continue operating. Without renewal, it automatically dissolves. In recent months, HICPAC -- along with other federal scientific advisory bodies -- has been targeted by executive action aiming to reduce federal spending and streamline programs.
The consequences of cutting HICPAC would be dire, setting back infection prevention decades and leaving our healthcare system unprepared for the next threat.
What Has HICPAC Done for Healthcare?
Created in 1991, HICPAC is a federal advisory committee to HHS and CDC comprised of leading non-federal experts in infectious diseases, epidemiology, nursing, microbiology, and public health. The group meets regularly to review emerging evidence and develop infection prevention recommendations that directly inform national healthcare policy. These meetings are open to the public and rooted in scientific transparency.
Hand hygiene, now second nature to clinicians across every healthcare setting, was standardized and modernized through HICPAC's national guidance. In the 1990s, the committee added recommendations to CDC's earlier guidance, and in 2002, HICPAC released updated recommendations underscoring the use of alcohol-based hand rubs and routine handwashing -- standards now embedded across hospitals, outpatient centers, and long-term care facilities.
In 1996, HICPAC introduced the definition of Standard Precautions -- the principle that all patient body fluids should be treated as potentially infectious. This guidance protects not only patients but also the healthcare workers who care for them. In 2003, the committee issued comprehensive guidance on environmental infection control, including best practices for hospital ventilation, surface disinfection, and water safety to limit the spread of pathogens like Legionella and C. difficile.
These are just a few examples. Over the last three decades, HICPAC has authored many guidelines for preventing central-line infections, catheter-associated urinary tract infections, surgical site infections, and more. It has issued guidance for dialysis centers, dental offices, ambulatory surgery centers, and nursing homes. It has even helped standardize infection data definitions used in public reporting and quality benchmarking. It has been a powerhouse in developing guidance to keep us and our patients safe in the hospital.
Because HICPAC is a federal advisory committee, its impact extends far beyond publishing technical documents. Its recommendations often form the foundation of national healthcare safety standards. The CDC routinely adopts HICPAC guidelines, which in turn inform regulations, accreditation requirements, and quality improvement initiatives nationwide. They become the protocols clinicians follow, the standards by which hospitals are evaluated, and the basis for infection prevention training across disciplines.
For instance, the Centers for Medicare & Medicaid Services (CMS) often aligns its Conditions of Participation for hospitals with CDC and HICPAC guidance. A recent example: in 2022–2023, CMS updated nursing home surveyor protocols to include Enhanced Barrier Precautions to prevent drug-resistant infections, citing HICPAC's 2021 recommendations as the "nationally accepted standards." Hospitals are required to have antibiotic stewardship programs and infection control policies consistent with CDC/HICPAC guidance in order to maintain federal funding.
Accrediting bodies like The Joint Commission also turn to HICPAC guidelines when developing infection control standards for hospitals. If CDC recommends specific isolation precautions, surveyors will expect to see them in practice. State health departments also often rely on HICPAC-informed guidance for infection reporting requirements and hospital licensing criteria.
In this way, HICPAC serves as a policy engine, translating new scientific evidence into practical, scalable recommendations adopted across U.S. healthcare. It ensures consistency so whether you're working at a rural critical access hospital or a major academic center, the standards of infection prevention should be the same. That uniformity saves lives.
And the impact is measurable. Since the adoption of HICPAC-supported prevention bundles, hospitals have seen significant drops in rates for certain types of infections. Between 2008 and 2013, central line-associated bloodstream infections in intensive care units decreased by 46%; surgical site infections dropped by 19%. These gains were not coincidental -- they were driven by clear, evidence-based guidance developed and disseminated through HICPAC and implemented nationwide.
HICPAC isn't without controversy, however. In late 2023, a draft revision of CDC's isolation precautions, developed through a HICPAC workgroup, drew criticism from some advocacy groups and clinicians. The draft proposed surgical masks for COVID-19 care instead of N95 respirators, prompting concerns about insufficient protection against airborne pathogens and a lack of expertise in airborne transmission within the committee. The CDC paused finalization of the guidance following widespread pushback and pledged to expand expert input, increase transparency, and re-engage stakeholders in revising the recommendations.
This is how scientific deliberation is supposed to work. Cutting HICPAC would not make that process better. It would eliminate it altogether.
What if HICPAC Is Disbanded?
Frontline clinicians, infection preventionists, nurses, and hospital quality teams rely on HICPAC guidance every day. Its recommendations shape the protocols used to prevent device-related infections, respond to emerging outbreaks, and meet regulatory and accreditation requirements. Without it, the CDC would lose a vital conduit of external clinical expertise. Hospitals would lose a trusted, standardized playbook -- one I've personally consulted countless times in my work. And clinicians could be left with fragmented, inconsistent guidance at a time when infection risks are rising.
Eliminating HICPAC wouldn't just slow progress -- it would erode the foundation of infection prevention in U.S. healthcare.
We cannot afford to let that happen. The professionals who serve on HICPAC are among the most respected in the field and have dedicated their careers to protecting patients. I know many of these brilliant individuals and can guarantee they are working tirelessly to keep us safe. Supporting their work means supporting safer healthcare for everyone.
As we face rising antimicrobial resistance, new and re-emerging pathogens, and an overburdened healthcare system, the need for unified, evidence-based infection prevention has never been greater. Now is not the time to dismantle an effective public health tool we have counted on for decades. It's time to double down on prevention and preparedness.
Alexander Sundermann, DrPH, is an assistant professor of epidemiology at the University of Pittsburgh. He studies how to detect and mitigate healthcare outbreaks using genomic surveillance and infection prevention innovations. The opinions expressed here are his own.
